Information Notice No. 81-03: Checklist for Licensees Making Notifications of Significant Events in Accordance with 10 CFR 50.72

                                                             SSINS No. 6870 
                                                             Accession No. 
                                                             IN 81-03      

                                UNITED STATES
                              February 12, 1981

Information Notice No. 81-03:   CHECKLIST FOR LICENSEES MAKING 
                                   NOTIFICATIONS OF SIGNIFICANT EVENTS IN 
                                   ACCORDANCE WITH 10 CFR 50.72 

Description of Circumstances: 

Significant events reported to the NRC Operations Center receive prompt 
evaluation by NRC technical staff. To assure that adequate information is 
obtained for evaluation, in an expedient manner, checklists have been 
developed for the various types of events and are currently in use by the 
duty officers manning the NRC Operations Center. In an effort to communicate
to licensees the most useful types of information needed depending on the 
event, a combined checklist has been developed and is attached to this 
information notice. We recognize that this list is not all inclusive, nor 
are all of its sections applicable to each event. Rather, it is an attempt 
to list certain key data elements that, based on past experience, appear to 
suffice for the vast majority of notifications. Having this type of 
information available at the time of notification, or shortly thereafter, 
will serve to expedite the notification and evaluation process and make it 
more efficient. It is not intended that licensees complete the checklist 
prior to, or as a condition of, making a notification. Instead, the list is 
intended to inform licensees of the types of information about events that 
have been useful to the NRC. 

We solicit your cooperation in obtaining any other information that may aid 
NRC in understanding the event and request that you volunteer such 
information where appropriate. 

Recommendation to Licensees: 

This information notice is provided for general information to licensees. 
Recipients should review the information for applicability to their 
facilities. No specific action or response is requested at this time. 

If you have any questions regarding this matter, please contact the Director
of the appropriate NRC Regional Office. 

1.   Checklist
2.   Recently issued IE Information

                                                               Attachment 1 
                                                               IN 81-03    

                    MADE IN ACCORDANCE WITH 10 CFR 50.72

A.   Identification:
     Date      Time      Name of Person Making Report
     Licensee                 Facility Affected
     Applicable Part of 10 CFR 50.72

B.   Description:
     Date of Event            Time
     Description of What Happened

C.   Consequences of Event: (Complete depending on type of event)
     Injuries                 Fatalities
     Contamination (personnel)     (property)
     Overexposures (known/possible)
     Safety Hazard (describe - actual/potential)
     Offsite Radiation Levels
     Integrated Dose               Location
     Meterology (wind speed)       From (direction)
     Weather Conditions (rain, clear, overcast, temperature)
     Equipment/Property Damage

D.   Cause of Event:

E.   Licensee Actions:

    Emergency Plan Activated (Yes/No)  Classification of Emergency  

Resident Inspector Notified (Yes/No)    State Notified (Yes/No)
Press Release Planned (Yes/No)               News Media Interest (Yes/No)

F.   Current Status: (Complete depending on type of event)

     1.   Reactor System Status
          Power Level Before Event           After Event
          Pressure            Temp. (thot)             (tcold)
          RCS Flow (Yes/No)        Pumps On (Yes/No)
          Heat Sink:  Condenser              Steam Atm. Dump
            Other             Sample Taken (Yes/No)         Activity Level
          ECCS Operating (Yes/No)            ECCS Operable (Yes/No)
          ESF Actuation (Yes/No)
          PZR or RX Level               Possible Fuel Damage (Yes/No)
          S/G Levels                      Feedwater Source/Flow
          Containment Pressure     Safety Relief Valve Actuation (Yes/No) 
          Containment Water Level Indication

          Equipment Failures
          Normal Offsite Power Available (Yes/No)
          Major Busses/Loads Lost
          Safeguards Busses Power Source
          D/G Running (Yes/No)                    Loaded (Yes/No)

 See Emergency Action Levels, Appendix 1, NUREG-0654, Revision 1,
     Criteria for Preparation and Evaluation of Radiological Emergency 
     Response Plans and Preparedness in Support of Nuclear Power Plants. 

2.  Radioactivity Release

     Liquid/Gas                              Location/Source
     Release Rate                            Duration
     Stopped (Yes/No)                        Release Monitored (Yes/No)
     Amount of Release                       Tech Spec. Limits
     Radiation Levels in Plant               Areas Evacuated

3.   Security/Safeguards 

     Bomb Threat:   Search Conducted (Yes/No)     Search Results
     Site Evacuated (Yes/No)
     Intrusion:     Insider                  Outsider
       Point of Intrusion                    Extent of Intrusion 
     Apparent Purpose
     Strike/Demonstrations:    Size of Group
     Sabotage: Radiological (Yes/No)              Arson (Yes/No)
     Extortion: Source (phone, letter, etc.)
       Location of Letter
     General: Firearms involved (Yes/No)          Violence (Yes/No)
     Control of Facility Compromised or Threatened (Yes/No)
     Stolen/Missing Material
     Agencies Notified (FBI, State Police, Local Police, etc.)

     Media Interest (present, anticipated)

 See 10 CFR 73.71(c), effective April 6, 1981.


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