Event Notification Report for November 26, 2024

EN Revision Imported Date: 11/26/2024

EN Revision Text: HIGH PRESSURE CORE SPRAY INJECTION INOPERABLE

The following information was provided by the licensee via phone and email:

"At 1822 CST on September 27, 2024, Grand Gulf Nuclear Station (GGNS) was conducting surveillance testing on the high pressure core spray (HPCS) division Ill diesel generator. Following initiation of the test signal, the HPCS pump room cooler start time exceeded the surveillance procedure allowance of less than or equal to 20 seconds. The HPCS pump room cooler started in 26.2 seconds. HPCS was already inoperable for performance of the surveillance testing.

"The event is being reported in accordance with 10 CFR 50.72(b)(3)(v)(D) as an event or condition which could have prevented the fulfillment of a safety function.

"Troubleshooting is in progress. HPCS, a single-train system, will remain inoperable until the condition is corrected.

"All sources of offsite power are available. No other safety systems are inoperable. Reactor core isolation cooling was verified to be operable per GGNS technical specification 3.5.1.B.1.

"The NRC Senior Resident Inspector has been notified."

* * * RETRACTION ON 11/25/2024 AT 1333 EST FROM JEFF HARDY TO IAN HOWARD * * *

"Investigation of the delayed start time of the HPCS pump room cooler indicated that the condition would not have challenged the ability of the room cooler to maintain temperatures less than the temperature limit of 150 degrees Fahrenheit. As a result, HPCS remained capable of fulfilling its safety function. Therefore, EN 57349 is being retracted.

"The NRC senior resident inspector has been notified of this retraction."

Notified R4DO (O'Keefe)

AGREEMENT STATE REPORT - DAMAGE TO TROXLER GAUGE

The following information was provided by the North Carolina Department of Health and Human Services via email:

"On November 14, 2024, the licensee reported a portable nuclear gauge was damaged by a member of the public's privately owned vehicle that drove into the cordoned off area where road workers were conducting their work. The gauge was hit by the vehicle and was damaged but the source and source rod were intact and in the shielded position. The gauge was placed in its transportation box and transported to the manufacturer for disposal/repair.

"North Carolina Emergency Management and local law enforcement were informed."

Damaged Device:
Portable Nuclear Gauge
Manufacturer: Troxler
Model: 4640B
Serial: 1599

NC Tracking Number: NC 240010

AGREEMENT STATE REPORT - LOST EXIT SIGN

The following report was received from the Texas Department of State Health Services (the Department) via phone and email:

"On November 18, 2024, the Department received notification from the licensee of a missing self-luminous exit sign. The licensee made the discovery on October 15, 2024, during a semiannual inventory of radioactive sources verification exercise. The device, which contains about 20 curies of tritium in gaseous form, is a Betalux, Model 171 with serial number C207471.

"The licensee believes the sign, which was located at the back of a building, was dislodged during Hurricane Beryl on July 8, 2024. The licensee stated that two possible scenarios on what might have occurred when the sign was removed. The licensee stated the sign may have been picked up together with the large amount of debris collected and cleared out for disposal by the cleaning crews following the storm. The other possibility is that the sign may have been blown away off campus by hurricane force winds.

"The licensee stated that there are currently no known exposures to persons at this time due to the loss of this device.

"Additional information will be provided in accordance with SA-300."

Texas Incident Number: 10145
Texas NMED Number: TX240044

THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf

AGREEMENT STATE REPORT - MEDICAL EVENT

The following information was provided by the Florida Bureau of Radiation Control (BRC) via email:

"Sacred Heart's failure to notify the Florida BRC at the time of the occurrence, 10/15/24, was identified by [the Florida BRC inspector] during a routine inspection.

"Sacred Heart intended to inject the patient with 6 mCi of Tc-99m mebrofenin which would travel to the gallbladder. Instead, the patient received 6 mCi of Tc-99m methyl diphosphonate which targeted the bladder wall. The dose received [by the patient] is estimated at 1.6 mGy. Sacred Heart states the syringe had the expected markings of mebrofenin, and the error was caused by the supplier in Alabama.

"The patient and primary physician were notified of the occurrence."

Florida Incident Number: FL24-110


A Medical Event may indicate potential problems in a medical facility's use of radioactive materials. It does not necessarily result in harm to the patient.

AGREEMENT STATE REPORT - LOST MOISTURE DENSITY GAUGE

The following information was provided by the Florida Bureau of Radiation Control (BRC) via email:

"The Florida BRC received initial notification at 1830 [EST] from licensee (4696-7) UES Professional Solutions of a lost in transit density gauge. More information about this incident was received at 2000 from the licensee's radiation safety officer (RSO).

"The licensee's technician noticed the soil moisture density gauge was missing from the back of his pick-up truck around 1530 [on 11/19/2024] when he returned to the job site after lunch. He realized the tailgate was open and, when he went to close it, he noticed the gauge wasn't there. The technician last used the gauge during a subgrade test right before he went to lunch around 1430. He thinks the gauge was lost while at lunch. The technician called his supervisor at 1730, who contacted the RSO. The employee admitted that the gauge case was not locked, but the gauge was secure in the case. The RSO and technician retraced the route several times, but were not able to locate the gauge.

"The density gauge is a Troxler [model] 3430 with serial number 31852 [nominally containing 8 mCi of Cs-137 and 40 mCi of Am-241:Be]."

Florida Incident Number: FL24-111

* * * UPDATE ON 11/20/2024 AT 1522 EST FROM MARK SEIDENSTICKER TO ERNEST WEST * * *

"A Jacksonville area inspector responded [on 11/20/2024] and reported their findings. UES Professional Solutions terminated the employee [on 11/19/2024] and used GPS tracking to retrace the route, but did not find the gauge. The Jacksonville Police Department was notified and is also waiting on video surveillance footage from the [restaurant] where the employee stopped."

Notified R1DO (Bickett), NMSS Events Notification (email), and ILTAB (email).

* * * UPDATE ON 11/21/2024 AT 0710 EST FROM MARK SEIDENSTICKER TO TENISHA MEADOWS * * *

"At 1630 EST on Wednesday 11/20/2024, the RSO called and stated an individual found the gauge. The licensee has the gauge back in their possession and are sending it to Troxler for testing before returning to service."

Notified R1DO (Bickett), NMSS Events Notification (email), and ILTAB (email).

THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf

EN Revision Imported Date: 11/25/2024

EN Revision Text: PART 21 - DEFECTIVE THERMAL OVERLOAD RELAY DISCOVERED DURING TESTING

The following information was provided by the licensee via phone and email:

"This notification is a 10 CFR 21.21(a)(2) interim report for General Electric thermal overload relay, model CF124G011, part number DD317A7861P003.

"A sample of overload relays were sent to PowerLabs for parts quality initiative testing. The results were reviewed by James A. FitzPatrick Nuclear Power Plant (JAF) and a deviation in one relay component was discovered. Testing identified a failure to latch on trip, which is a deviation from the performance characteristics of the relay. Under normal operation, the relay would latch in the tripped state requiring a manual reset of the relay. If the relay with the deviation were installed, the relay would trip when required; however, it would automatically reset. The unexpected reset could result in unintended cycling of associated equipment including repeated exposure to inrush current and potential damage.

"Bench testing would be expected to identify this condition prior to installation. Based on a review, this potential condition does not affect installed equipment. The affected relay was stored at JAF since July 1998.

"The cause of the deviation cannot be investigated because the part is not available; however, the evaluation of the potential effect of the condition on equipment where the relay could have been used at JAF is ongoing, and it is expected to be completed by February 28, 2025. This notification is being submitted as an interim report per 10CFR21.21(a)(2)."

"The NRC resident inspector has been notified."