U.S. Nuclear Regulatory Commission Operations Center Event Reports For 06/07/94 - 06/08/94 ** EVENT NUMBERS ** 27338 27361 27362 27363 27364 27365 27366 27367 +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27338 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: MILLSTONE REGION: 1 |NOTIFICATION DATE: 06/02/94 | |UNIT: [ ] [2] [ ] STATE: CT |NOTIFICATION TIME: 16:58 [ET]| |RX TYPE: [1] GE-3,[2] CE,[3] W-4-LP |EVENT DATE: 06/02/94 | +------------------------------------------------+EVENT TIME: 16:40[EDT]| |NRC NOTIFIED BY: JOHN RESETAR |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: THOMAS ANDREWS +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JOHN WHITE RDO | |ADAS 50.72(b)(2)(i) DEG/UNANALYZED COND | | |NLCO TECH SPEC LCO A/S | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N N 0 COLD SHUTDOWN | 0 COLD SHUTDOWN | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE LICENSEE HAS IDENTIFIED A POTENTIAL DESIGN ERROR INVOLVING THE CONTROL | | ROOM EMERGENCY VENTILATION SYSTEM. THE DESIGN OF THE DUCTING FOR THE | | CONTROL ROOM EMERGENCY VENTILATION SYSTEM MAY RESULT IN NO PURIFICATION OF | | RECIRCULATED AIR WHILE THE CONTROL ROOM VENTILATION IS IN RECIRCULATION | | MODE (I.E., THE FILTRATION UNIT MAY BE BYPASSED). THIS DOES NOT AFFECT THE | | ABILITY OF THE CONTROL ROOM EMERGENCY VENTILATION SYSTEM TO ACTUATE AND | | MINIMIZE THE INGRESS OF TOXIC GASES OR RADIOACTIVE GASES / PARTICULATES. | | | | THIS POTENTIAL PROBLEM WAS IDENTIFIED DURING A SYSTEM DESIGN REVIEW | | CONDUCTED AS PART OF A TRAINING SESSION. | | | | THE LICENSEE IS INVESTIGATING THE DESIGN OF THE SYSTEM TO SEE IF AN ACTUAL | | PROBLEM EXISTS. THIS NOTIFICATION IS BEING MADE AS A CONSERVATIVE MEASURE. | | THE PORTION OF THE SYSTEM BEING INVESTIGATED HAS NOT BEEN MODIFIED SINCE | | INITIAL CONSTRUCTION. | | | | AT THE TIME THIS POTENTIAL PROBLEM WAS IDENTIFIED, THE PLANT WAS IN THE | | PROCESS OF STARTING UP FROM A 41 DAY OUTAGE. THE HEATUP HAD PROGRESSED TO | | THE POINT WHERE THE LICENSEE HAD STARTED A REACTOR COOLANT PUMP AND STOPPED | | SHUTDOWN COOLING. THE LICENSEE HAS ENTERED AN LCO WHICH PREVENTS THEM FROM | | CHANGING MODES UNTIL THE POTENTIAL PROBLEM IS RESOLVED. THE LICENSEE HAS | | STOPPED THE HEATUP AND IS MAINTAINING THE REACTOR COOLANT SYSTEM AT 185 | | DEGREES WHILE THE INVESTIGATION IS PERFORMED. | | | | THE NRC RESIDENT INSPECTOR AND STATE OFFICIALS HAVE BEEN NOTIFIED. | | | | * * * UPDATE FROM SUDIGALA TO WEAVER AT 1151 EDT ON 6/7/94 * * * | | | | CONTINUING EVALUATION OF THE CONTROL ROOM AIR CONDITIONING SYSTEM INDICATES | | THAT DOSE CALCULATIONS WERE NOT CONSERVATIVE WITH RESPECT TO SYSTEM DESIGN. | | PROCEDURES IN PLACE WERE INADEQUATE TO REALIGN SYSTEM ON SINGLE FAILURE | | WITHIN DESIGN TIME LIMITATIONS. PLANT HEATUP IS ON HOLD PENDING | | RESOLUTION OF THIS ISSUE. THE NRC RESIDENT AND STATE OFFICIALS HAVE BEEN | | NOTIFIED. NOTIFIED R1 RDO (TRAPP). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27361 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: MILLSTONE REGION: 1 |NOTIFICATION DATE: 06/07/94 | |UNIT: [1] [ ] [ ] STATE: CT |NOTIFICATION TIME: 12:38 [ET]| |RX TYPE: [1] GE-3,[2] CE,[3] W-4-LP |EVENT DATE: 06/03/94 | +------------------------------------------------+EVENT TIME: 03:10[EDT]| |NRC NOTIFIED BY: CLEARY |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: STEVE SANDIN +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JIM TRAPP RDO | |AOUT 50.72(b)(1)(ii)(B) OUTSIDE DESIGN BASIS | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N Y 85 POWER OPERATION | 85 POWER OPERATION | | | | | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | LICENSEE DETERMINED THAT THE UHS TEMPERATURE HAD BEEN EXCEEDED DURING | | CONDENSER MUSSEL COOKING. | | | | "WHILE PERFORMING CONDENSER MUSSEL COOKING, THE ULTIMATE HEAT SINK | | TEMPERATURE LIMIT OF 75F WAS EXCEEDED. PRIOR TO AND AFTER MUSSEL COOKING, | | THE ULTIMATE HEAT SINK TEMPERATURE RETURNED TO 54F. ADDITIONALLY, CLOSED | | COOLING WATER TEMPERATURES EXCEEDED DESIGN BASIS LIMITS. THE PROBABLE CAUSE | | OF THIS EVENT WAS PARTIAL BLOCKAGE OF INTAKE STRUCTURE TRASH RACKS. THE | | BLOCKAGE OF THE TRASH RACKS REDUCED THE FLOW OF COOL WATER FROM LONG ISLAND | | SOUND INTO THE INTAKE BAYS." | | | | THE DESIGN LIMIT TEMPERATURE OF 85F FOR THE REACTOR BUILDING CLOSED COOLING | | WATER SYSTEM WAS EXCEEDED FOR APPROXIMATELY 1 HOUR OR LESS. THE ACTUAL | | TEMPERATURE WAS NOT AVAILABLE. THE ULTIMATE HEAT SINK TEMPERATURE WHICH BY | | INTERPRETATION IS NOW CONSIDERED THE INTAKE BAY REACHED 88F FOR THE SAME | | PERIOD OF TIME. THE LICENSEE FOLLOWING AN ENGINEERING REVIEW CONCLUDED THAT | | THIS EVENT WAS REPORTABLE AT 1200EDT ON 6/7/94. CORRECTIVE ACTIONS INCLUDE | | PROCEDURAL REVISIONS TO ENSURE TEMPERATURES ARE NOT EXCEEDED. LICENSEE | | NOTIFIED LAC TOWNSHIP AND THE NRC RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27362 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: COOPER REGION: 4 |NOTIFICATION DATE: 06/07/94 | |UNIT: [1] [ ] [ ] STATE: NE |NOTIFICATION TIME: 13:34 [ET]| |RX TYPE: [1] GE-4 |EVENT DATE: 06/07/94 | +------------------------------------------------+EVENT TIME: 12:15[CDT]| |NRC NOTIFIED BY: DAN KUSER |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: STEVE SANDIN +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |GARY SANBORN RDO | |ADAS 50.72(b)(2)(i) DEG/UNANALYZED COND | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N N 0 COLD SHUTDOWN | 0 COLD SHUTDOWN | | | | | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | LICENSEE DISCOVERED FIVE CONTAINMENT PENETRATIONS WHICH WERE NOT INCLUDED | | IN LOCAL LEAK RATE TESTING DURING WALKDOWN FOR DESIGN BASIS RECONSTITUTION. | | | | "AT 1215CDT THIS AFTERNOON, WITH THE PLANT SHUTDOWN, PRIMARY CONTAINMENT | | WAS DECLARED INOPERABLE UPON DETERMINING THAT FIVE TORUS PENETRATIONS | | THROUGH WHICH THERMOCOUPLE LEADS ARE ROUTED WERE NOT DESIGNED WITH DOUBLE | | SEALS NOR WERE THEY CAPABLE OF BEING TESTED. AT THE TIME, DUE TO PLANT | | CONDITIONS, PRIMARY CONTAINMENT INTEGRITY WAS NOT REQUIRED AND WAS NOT | | BEING MAINTAINED. FOUR OF THE FIVE PENETRATIONS WERE INSTALLED DURING | | CONSTRUCTION OF THE PLANT; THE FIFTH WAS ADDED DURING DESIGN CHANGE | | ACTIVITIES IN 1976. THESE DISCREPANCIES WERE IDENTIFIED DURING EVALUATION | | OF DATA COLLECTED DURING A PRIMARY CONTAINMENT PENETRATION WALKDOWN BY | | DESIGN BASIS RECONSTITUTION PERSONNEL. WHILE THESE PENETRATIONS ARE SUBJECT | | TO INTEGRATED PRIMARY CONTAINMENT LEAK RATE TESTING, LAST PERFORMED IN | | 1991, DUE TO THE LACK OF ANY TESTING PROVISIONS, NO LOCAL LEAK RATE TESTING | | HAS BEEN ACCOMPLISHED." | | | | "AN ENGINEERING REVIEW OF THE DESIGN OF THESE PENETRATIONS AS WELL AS AN | | ASSESSMENT OF THE REMAINDER OF INFORMATION OBTAINED DURING THE WALKDOWN IS | | ONGOING. ISSUES ASSOCIATED WITH THESE PENETRATIONS AND ANY OTHER PRIMARY | | CONTAINMENT CONCERNS RAISED DURING THE WALKDOWN WILL BE RESOLVED PRIOR TO | | ESTABLISHING PLANT CONDITIONS THAT REQUIRES PRIMARY CONTAINMENT INTEGRITY." | | | | THE FIVE PENETRATIONS IDENTIFIED ABOVE ARE "X218", "X209A", "X209B", | | "X209C" AND "X209D". THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |HOSPITAL | |EVENT NUMBER: 27363 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: DUBOIS REGIONAL MEDICAL CENTER |NOTIFICATION DATE: 06/07/94 | | CITY: DUBOIS REGION: 1 |NOTIFICATION TIME: 15:50 [ET]| | COUNTY: STATE: PA |EVENT DATE: 06/06/94 | |LICENSE#: 37-19568-01 AGREEMENT: N |EVENT TIME: 15:10[EDT]| | DOCKET: |LAST UPDATE DATE: 06/07/94 | | +-----------------------------+ | |PERSON ORGANIZATION| | |JIM TRAPP RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: NEAL SMARRA | | |HQ OPS OFFICER: STEVE SANDIN | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |LADM 35.33(a) MED MISADMINISTRATION | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | POSSIBLE MEDICAL MISADMINISTRATION DUE TO A MISPOSITIONED APPLICATOR AT THE | | DUBOIS REGIONAL MEDICAL CENTER (LICENSEE #37-19568-01) LOCATED IN DUBOIS, | | PA. [CONTACT MIKE BOZIC 814-375-3535]. | | | | AT 1510EDT ON 6/6/94 TWO CESIUM-137 SOURCES (EACH 15.3 MILLIGRAMS RADIUM | | EQUIVALENT) WERE PLACED IN OVOID APPLICATORS OF A MIDDLE AGED FEMALE | | PATIENT RECEIVING TREATMENT FOR CERVICAL CANCER. THE PHYSICIAN REQUESTED A | | RADIOGRAPH WHICH INDICATED THAT THE APPLICATOR WAS MISPOSITIONED BY | | APPROXIMATELY 9 CM. THE SOURCES WERE REMOVED AT 1625EDT FOR REPOSITIONING | | OF THE APPLICATOR. AT 1715EDT THE SOURCES WERE REINSERTED AND THE 16 HOUR | | EXPOSURE COMPLETED AT 0915EDT ON 6/7/94. THE PRESCRIBED EXPOSURE WAS 2000 | | CENTIGRAY ON THE 125 CENTIGRAY/HR LINE ON THE COMPUTER. THE LICENSEE HAS | | INFORMED THE REFERRING PHYSICIAN OF THE REQUIRED ADJUSTMENT AND DOES NOT | | BELIEVE THERE WILL BE ANY ADVERSE HEALTH EFFECTS TO THE PATIENT. THE | | REFERRING PHYSICIAN HAS DECIDED NOT TO INFORM THE PATIENT. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27364 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: SAN ONOFRE REGION: 4 |NOTIFICATION DATE: 06/07/94 | |UNIT: [ ] [2] [3] STATE: CA |NOTIFICATION TIME: 17:00 [ET]| |RX TYPE: [1] W-3-LP,[2] CE,[3] CE |EVENT DATE: 06/06/94 | +------------------------------------------------+EVENT TIME: 14:00[PDT]| |NRC NOTIFIED BY: CLAY WILLIAMS |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: STEVE SANDIN +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |GARY SANBORN RDO | |NLTR LICENSEE 24 HR REPORT | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N Y 98 POWER OPERATION | 98 POWER OPERATION | | 3 | N Y 97 POWER OPERATION | 97 POWER OPERATION | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | LICENSEE IS MAKING A 24 HOUR NOTIFICATION UNDER LICENSE CONDITION 2.G. | | | | "THIS IS A NON-EMERGENCY 24 HOUR NOTIFICATION." | | | | "ON JUNE 6, 1994, AT APPROXIMATELY 1400 HOURS DURING THE PERFORMANCE OF A | | JOINT COMPUTER GROUP SECURITY INVESTIGATION TO DETERMINE ACTIVE OR DEACTIVE | | SECURITY EQUIPMENT, EDISON DISCOVERED A CABINET WITHIN A VITAL AREA OF UNIT | | 3 THAT CONTAINED WIRING FOR THE SECURITY COMPUTER SYSTEM. THE CABINET WAS | | NOT FASTENED CLOSED IN ACCORDANCE WITH THE REQUIREMENTS OF THE PHYSICAL | | SECURITY PLAN. WHILE THIS CABINET WAS LOCKED CLOSED WITH A FILE PANEL KEY, | | THE PHYSICAL SECURITY PLAN FOR UNITS 1, 2 AND 3 REQUIRES CABINETS | | CONTAINING SECURITY RELATED WIRING TERMINATIONS TO BE EITHER: | | | | 1. ARMED WITH TAMPER SWITCHES, | | 2. WELDED CLOSED, OR | | 3. SECURED WITH "1A" FASTENERS. | | | | THEREFORE, EDISON CONCLUDED THAT THIS CONDITION WAS NOT IN CONFORMANCE WITH | | THE DESCRIPTION OF THE PHYSICAL SECURITY PLAN. WITHIN 10 MINUTES OF THIS | | DISCOVERY, EDISON INITIATED A COMPENSATORY 1 HOUR PATROL OF THE AFFECTED | | CABINET. EDISON HAS EVALUATED THIS CONDITION AND HAS DETERMINED THAT | | UNAUTHORIZED OR UNDETECTED ACCESS TO PLANT PROTECTED OR VITAL AREAS COULD | | NOT HAVE OCCURRED DUE TO THIS CONDITION. THE SECURITY EQUIPMENT VENDOR | | (ELECTRONICS SYSTEMS, USA) HAS INDEPENDENTLY AGREED WITH OUR FINDINGS. | | THEREFORE, THERE WAS NO SAFETY SIGNIFICANCE TO THIS CONDITION. WE ARE IN | | THE PROCESS OF INITIATING SYSTEM WALKDOWNS TO VERIFY SYSTEM INTEGRITY. UNIT | | 2 WAS OPERATING AT APPROXIMATELY 98% POWER AND UNIT 3 WAS OPERATING AT | | APPROXIMATELY 97% POWER WHEN THIS CONDITION WAS IDENTIFIED. IN ACCORDANCE | | WITH THE REQUIREMENTS OF LICENSE CONDITION 2.G OF LICENSE NO. NPF-10 AND | | NPF-15 FOR SAN ONOFRE UNITS 2 AND 3, RESPECTIVELY, A COPY OF THIS | | NOTIFICATION WILL BE FAXED TO THE NRC REGIONAL ADMINISTRATOR AT | | APPROXIMATELY 1600 HOURS JUNE 7, 1994. A WRITTEN FOLLOWUP REPORT WILL BE | | SUBMITTED WITHIN 14 DAYS." | | | | THE LICENSEE WAS UNABLE TO DETERMINE HOW LONG THIS CONDITION EXISTED OR | | WHAT THE LONG TERM CORRECTIVE ACTIONS WOULD BE. THE LICENSEE INFORMED THE | | NRC (WONG, ERNST AND YANDELL). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27365 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: SOUTH TEXAS REGION: 4 |NOTIFICATION DATE: 06/07/94 | |UNIT: [1] [2] [ ] STATE: TX |NOTIFICATION TIME: 17:27 [ET]| |RX TYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 06/07/94 | +------------------------------------------------+EVENT TIME: 15:54[CDT]| |NRC NOTIFIED BY: BILL MOOKHOEK |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: STEVE SANDIN +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |GARY SANBORN RDO | |AENS 50.72(b)(1)(v) ENS INOPERABLE | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | 2 | N Y 35 POWER OPERATION | 35 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE SITE EXPERIENCED A LOSS OF ALL TELEPHONE LAND LINES DUE TO A CABLE CUT. | | | | AT 1554CDT A TELEPHONE CABLE CUT WAS MADE BETWEEN PORT LAVACA AND CORPUS | | CHRISTI, TX, WHICH CAUSED THE LOSS OF ALL DEDICATED AND COMMERCIAL LAND | | LINES TO THE SITE. THE CURRENT ESTIMATE FROM GTE IS THAT COMMERCIAL SERVICE | | WILL BE RESTORED IN APPROXIMATELY 2 HOURS AND THAT THE DEDICATED LINES WILL | | BE AVAILABLE IN APPROXIMATELY 6 HOURS. THE SITE CAN BE REACHED VIA 800MHz | | MICROWAVE VIA THE LOAD DISPATCHER. THE LICENSEE INFORMED THE NRC RESIDENT | | INSPECTOR. | | | | * * * UPDATE 2234EDT 6/7/94 FROM PETER TO S.SANDIN * * * | | BOTH THE DEDICATED AND COMMERCIAL LAND LINES HAVE BEEN RESTORED TO SERVICE | | AS OF 2130CDT. THE LICENSEE WILL INFORM THE NRC RESIDENT INSPECTOR. | | NOTIFIED R4DO(). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27366 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: SOUTH TEXAS REGION: 4 |NOTIFICATION DATE: 06/07/94 | |UNIT: [ ] [2] [ ] STATE: TX |NOTIFICATION TIME: 18:41 [ET]| |RX TYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 06/07/94 | +------------------------------------------------+EVENT TIME: 15:38[CDT]| |NRC NOTIFIED BY: ROYCE BROWN |LAST UPDATE DATE: 06/07/94 | |HQ OPS OFFICER: STEVE SANDIN +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |GARY SANBORN RDO | |AESF 50.72(b)(2)(ii) ESF ACTUATION | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N Y 35 POWER OPERATION | 35 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | "22" EDG AUTOSTARTED DUE TO A SPURIOUS SIGNAL FOLLOWING THE COMPLETION OF | | MONTHLY SURVEILLANCE TESTING DURING THE COOLDWON CYCLE. | | | | "AT 1538CDT AT COMPLETION OF THE "22" ESF DIESEL GENERATOR MONTHLY | | SURVEILLANCE TEST, APPROXIMATELY 2-1/2 MINUTES AFTER THE DIESEL GENERATOR | | WAS PLACED IN COOLDOWN, THE DIESEL GENERATOR RECEIVED AN AUTOSTART SIGNAL. | | AN INVESTIGATION INDICATES THAT A SPURIOUS NON-EMERGENCY START OCCURRED. | | THE DIESEL GENERATOR WAS SHUTDOWN AND SUCCESSFULLY WENT THROUGH THE | | COOLDOWN CYCLE. THE STANDBY LINEUP WAS COMPLETED AND THE DIESEL GENERATOR | | REMAINS OPERABLE." | | | | THE EDG DID NOT PICK UP LOAD. THE NOISE WHICH GENERATED THE AUTOSTART | | SIGNAL IS BELIEVED TO HAVE BEEN CAUSED BY SOLENOIDS CYCLING DURING EDG | | COOLDOWN. THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |OTHER NUCLEAR MATERIAL | |EVENT NUMBER: 27367 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: SYNCOR INTERNATIONAL CORP. |NOTIFICATION DATE: 06/07/94 | | CITY: ST. LOUIS REGION: 3 |NOTIFICATION TIME: 19:29 [ET]| | COUNTY: STATE: MO |EVENT DATE: 06/07/94 | |LICENSE#: 24-19360-01MD AGREEMENT: N |EVENT TIME: 12:30[CDT]| | DOCKET: |LAST UPDATE DATE: 06/07/94 | | +-----------------------------+ | |PERSON ORGANIZATION| | |BRUCE JORGENSEN RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: DAVID PELLICCIARINI | | |HQ OPS OFFICER: STEVE SANDIN | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |IBBE 30.50(b)(2)(i) ACCID MIT EQUIP FAILS | | |IBBF 30.50(b)(2)(ii) EQUIP DISABLED/FAILS | | |IBBG 30.50(b)(2)(iii) REDUNDANT EQUIP INOP | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | SYNCOR INTERNATIONAL CORPORATION, WITH HEADQUARTERS AT 20001 PRAIRIE | | STREET, CHATSWORTH, CA 91311, IS MAKING A REPORT CONCERNING THE FAILURE OF | | A FUME HOOD AT THEIR NUCLEAR PHARMACY LOCATED IN ST. LOUIS, MO. | | | | A FUME HOOD USED AT THE NUCLEAR PHARMACY OF THE SYNCOR INTERNALTIONAL CORP. | | FACILITY LOCATED AT 1909 BELTWAY DRIVE, ST. LOUIS, MO 63114, FAILED AT | | 1230CDT. STORED INSIDE THE FUME HOOD WERE SEALED CONTAINERS OF XENON 133 | | (160 mCi) AND IODINE 131 (350 mCi). THE LICENSEE CONSERVATIVELY ESTIMATES A | | MAXIMUM LEAKAGE OF 13.3 uCi OF XENON 133 (SEALED VIALS) FOR A RESTRICTED | | AREA DILUTION OF 9.17 X 10(-7) uCi/ml ASSUMING NO SUPPLY AIR. AIR SAMPLING | | CONFIRMED IODINE 131 CONCENTRATIONS OF 1.25 X 10(-11) uCi/ml. THE CAUSE OF | | THE FUME HOOD FAILURE IS ATTRIBUTED TO HOT WEATHER AND FUME HOOD MOTOR | | OVERLOAD. THE MOTOR HAS BEEN REPLACED AND THE FUME HOOD RESTORED TO SERVICE | | AT 1630CDT. | | | | HOO NOTE: THE LICENSEE REPORTED A SIMILAR OCCURRENCE AT ANOTHER FACILITY ON | | 6/6/94 - SEE EVENT #27358. | +------------------------------------------------------------------------------+