U.S. Nuclear Regulatory Commission Operations Center Event Reports For 07/07/94 - 07/08/94 ** EVENT NUMBERS ** 27493 27494 27495 27496 27497 27498 27499 27500 27501 27502 27503 27504 +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27493 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: DRESDEN REGION: 3 |NOTIFICATION DATE: 07/06/94 | |UNIT: [ ] [2] [3] STATE: IL |NOTIFICATION TIME: 20:54 [ET]| |RX TYPE: [1] GE-1,[2] GE-3,[3] GE-3 |EVENT DATE: 07/06/94 | +------------------------------------------------+EVENT TIME: 19:25[CDT]| |NRC NOTIFIED BY: KUCZYNSKI |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: DICK JOLLIFFE +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JOHN JACOBSON RDO | |AESS 50.72(b)(1)(v) EMERGENCY SIREN INOP | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N Y 96 POWER OPERATION | 96 POWER OPERATION | | 3 | N N 0 COLD SHUTDOWN | 0 COLD SHUTDOWN | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | GRUNDY COUNTY OFFICIALS NOTIFIED LICENSEE THAT THEIR OFFSITE EMERGENCY | | SIRENS HAD BEEN INOPERABLE FOR LONGER THAN 1 HOUR POSSIBLY DUE TO LOCAL | | THUNDERSTORMS. | | | | SIRENS ARE BEING REPAIRED. | | | | LICENSEE WILL INFORM THE NRC RESIDENT INSPECTOR. | | | | DRESDEN IS LOCATED APPROXIMATELY 5 MILES FROM BRAIDWOOD AND 15 MILES FROM | | LASALLE. | | | | NOTE: SEE EVENTS #27490, #27494, & #27495 FOR SIMILAR EVENTS. | | | | *** UPDATE FROM LIZALEK TO HUFFMAN AT 0008 EDT ON 7/7/94 *** | | GRUNDY COUNTY SIRENS HAVE BEEN RETURNED TO SERVICE. R3DO(JACOBSON) | | INFORMED. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27494 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: BRAIDWOOD REGION: 3 |NOTIFICATION DATE: 07/06/94 | |UNIT: [1] [2] [ ] STATE: IL |NOTIFICATION TIME: 21:14 [ET]| |RX TYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 07/06/94 | +------------------------------------------------+EVENT TIME: 19:25[CDT]| |NRC NOTIFIED BY: YURKOVICH |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: DICK JOLLIFFE +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JOHN JACOBSON RDO | |AESS 50.72(b)(1)(v) EMERGENCY SIREN INOP | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |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 100 POWER OPERATION | 100 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | GRUNDY COUNTY OFFICIALS NOTIFIED LICENSEE THAT THEIR OFFSITE EMERGENCY | | SIRENS HAD BEEN INOPERABLE FOR LONGER THAN 1 HOUR POSSIBLY DUE TO LOCAL | | THUNDERSTORMS. | | | | SIRENS ARE BEING REPAIRED. | | | | LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | | | | BRAIDWOOD IS LOCATED APPROXIMATELY 5 MILES FROM DRESDEN AND 20 MILES FROM | | LASALLE. | | | | NOTE: SEE EVENTS #27490, #27493, & #27495 FOR SIMILAR EVENTS. | | | | *** UPDATE FROM LIZALEK TO HUFFMAN AT 0008 EDT ON 7/7/94 *** | | GRUNDY COUNTY SIRENS HAVE BEEN RETURNED TO SERVICE. R3DO(JACOBSON) | | INFORMED. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27495 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: LASALLE REGION: 3 |NOTIFICATION DATE: 07/06/94 | |UNIT: [1] [2] [ ] STATE: IL |NOTIFICATION TIME: 21:18 [ET]| |RX TYPE: [1] GE-5,[2] GE-5 |EVENT DATE: 07/06/94 | +------------------------------------------------+EVENT TIME: 19:25[CDT]| |NRC NOTIFIED BY: HENRY |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: DICK JOLLIFFE +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JOHN JACOBSON RDO | |AESS 50.72(b)(1)(v) EMERGENCY SIREN INOP | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N Y 2 STARTUP | 2 STARTUP | | 2 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | GRUNDY COUNTY OFFICIALS NOTIFIED LICENSEE THAT THEIR OFFSITE EMERGENCY | | SIRENS HAD BEEN INOPERABLE FOR LONGER THAN 1 HOUR POSSIBLY DUE TO LOCAL | | THUNDERSTORMS. | | | | SIRENS ARE BEING REPAIRED. | | | | LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | | | | LASALLE IS LOCATED APPROXIMATELY 15 MILES FROM DRESDEN AND 20 MILES FROM | | BRAIDWOOD. | | | | NOTE: SEE EVENTS #27490, #27493, & #27494 FOR SIMILAR EVENTS. | | | | ***UPDATE FROM LIZALEK TO HUFFMAN AT 0008 EDT ON 7/7/94 *** | | GRUNDY COUNTY SIRENS HAVE BEEN RETURNED TO SERVICE. R3DO(JACOBSON) | | INFORMED. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |FUEL CYCLE FACILITY | |EVENT NUMBER: 27496 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: COMBUSTION ENGINEERING INC. |NOTIFICATION DATE: 07/07/94 | | RXTYPE: URANIUM FUEL FABRICATION |NOTIFICATION TIME: 11:31 [ET]| |COMMENTS: LEU CONVERSION (UF6 to UO2) |EVENT DATE: 07/06/94 | | COMMERCIAL LWR FUEL |EVENT TIME: 10:35[CDT]| | |LAST UPDATE DATE: 07/07/94 | | CITY: HEMATITE REGION: 3 +-----------------------------+ | COUNTY: JEFFERSON STATE: MO |PERSON ORGANIZATION| |LICENSE#: SNM-33 AGREEMENT: N |JOHN JACOBSON RDO | | DOCKET: 07000036 |CARL PAPERIELLO EO | +------------------------------------------------+ | |NRC NOTIFIED BY: HAROLD ESKRIDGE | | |HQ OPS OFFICER: JOSEPH SEBROSKY | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |NBNL RESPONSE-BULLETIN | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | LICENSEE IS MAKING A REPORT IN ACCORDANCE WITH NRC BULLETIN 91-01 DUE TO | | DEGRADED CRITICALITY CONTROLS. | | | | THE FOLLOWING IS A TEXT OF A FACSIMILE FROM THE LICENSEE: | | | | "AT APPROXIMATELY 10:35 AM, JULY 6, 1994, WHILE EXAMINING PAPERWORK ON | | ROUTINE RECYCLE OPERATIONS, THE NUCLEAR CRITICALITY SPECIALIST NOTED THE | | POSSIBILITY THAT MASS CONTROL HAD BEEN LOST ON THREE OCCASIONS IN | | OXIDATION/REDUCTION FURNACES. FURTHER INVESTIGATION PROVED THIS TO BE THE | | CASE. MUFFLE BOXES ARE LOADED WITH MATERIAL, SEALED AND THEN FURNACED. THE | | MUFFLE BOXES CONTAIN TWELVE PANS IN TWO COLUMNS OF SIX. THE COLUMNS ARE | | SEPARATED BY A ONE FOOT SPACER. EACH COLUMN OF SIX PANS HOLDS MATERIAL UP | | TO THE SAFE MASS OF UO2. THE MUFFLE BOXES ARE COOLED BY SPRAYING WATER ON | | THE OUTSIDE SURFACE OF THE SEALED AS IT IS REMOVED FROM THE FURNACES. ON | | JUNE 28 AND 29, 1994 BACKUP FILTERS FINES OF 4.95 WEIGHT PERCENT MATERIAL | | WERE PROCESSED IN THE FURNACES. THE SAFE MASS LIMIT OF UO2 FOR THIS | | ENRICHMENT IS SIXTEEN KG OR 32 KG TOTAL IN THE MUFFLE BOX. NONE THE LESS, | | AMOUNTS OF 33.95 KG, 34.89 KG, AND 34.015 KG WERE SCHEDULED TO BE PROCESSED | | AS THREE SINGLE LOTS, EXCEEDING THE SAFE MASS LIMITS FOR A MUFFLE BOX BY | | 1.95KG, 2.89 KG, AND 2.015KG, RESPECTIVELY. WHEN THE ERROR WAS CONFIRMED, | | THE LOADING OF MATERIAL INTO MUFFLE BOXES WAS HALTED. THE MATERIAL IN THE | | FURNACES WAS CHECKED TO ENSURE THAT IT WAS WITHIN SAFE MASS LIMITS. | | | | THE SOURCE OF THE ERRORS WAS DETERMINED TO BE FAILURE OF OPERATORS TO | | FOLLOW EXISTING PROCEDURES AND INADEQUATE PAPERWORK ACCOMPANYING EACH | | RECYCLE LOT. CHANGES WERE INITIATED IN THE RECYCLE LOT PAPERWORK TO | | REQUIRE THE RECORDING OF THE WEIGHT OF MATERIAL LOADED INTO EACH SIDE OF | | THE MUFFLE BOXES. TRAINING OF ALL RECYCLE/RECOVERY OPERATORS IN THE NEW | | FORM AND RETRAINING IN THE EXISTING PROCEDURES WILL BE COMPLETED BEFORE | | OXIDATION/REDUCTION OPERATIONS RESUME. | | | | THE MASS OF THE URANIUM IN THE MUFFLE BOX WAS NEVER IN EXCESS OF A CRITICAL | | MASS, WHICH IS 36.8 KG FOR AN OPTIMALLY MODERATED, FULLY REFLECTED SPHERE | | OF UO2. WATER NEVER ENTERED THE MUFFLE BOX DURING COOLDOWN, AND NONE OF | | THE TRAYS LEAKED OR COLLAPSED. THIS REPORT IS SUBMITTED BECAUSE MORE THAN | | A SAFE MASS ON EACH SIDE OF A MUFFLE BOX RESULTS IN AN UNANALYZED | | CONDITION. IT IS FELT THAT, WITH FURTHER ANALYSIS, THE CONFIGURATION AS | | DESCRIBED ABOVE WILL BE SHOWN TO BE ADEQUATELY SUBCRITICAL UNDER ALL | | CREDIBLE CONDITIONS." END OF TEXT. | | | | THE LICENSEE HAS INFORMED REGION III (FRANCE) AND HEADQUARTERS (LIGHT) OF | | THIS REPORT. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27497 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: SUSQUEHANNA REGION: 1 |NOTIFICATION DATE: 07/07/94 | |UNIT: [1] [ ] [ ] STATE: PA |NOTIFICATION TIME: 12:55 [ET]| |RX TYPE: [1] GE-4,[2] GE-4 |EVENT DATE: 07/07/94 | +------------------------------------------------+EVENT TIME: 09:47[EDT]| |NRC NOTIFIED BY: GERRY RADISHOFSKI |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: JOSEPH SEBROSKY +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JACK DURR RDO | |AESF 50.72(b)(2)(ii) ESF ACTUATION | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | | | | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE REACTOR WATER CLEANUP SYSTEM AUTOMATICALLY ISOLATED ON HIGH | | DIFFERENTIAL FLOW. | | | | THE FOLLOW IS A TEXT OF A FACSIMILE FROM THE LICENSEE: | | | | "A BLOCKING BOUNDARY VALVE WAS ESTABLISHED TO ALLOW WORK ON THE RWCU HOLD | | PUMP DISCHARGE CHECK VALVE. A VALVE USED FOR BLOCKING TO ISOLATE THE CHECK | | VALVE PUMP FROM THE OPERATING SYSTEM LEAKED BY. THE LEAKAGE INTO THE | | ISOLATED SECTION OF THE SYSTEM AND OUT THROUGH THE DRAIN VALVES WAS | | SUFFICIENT TO ISOLATE THE ENTIRE SYSTEM ON HIGH DIFFERENTIAL FLOW. THE | | DRAIN VALVES WERE CLOSED AND THE LEAKAGE FORM THE SYSTEM STOPPED. SYSTEM | | RESTORATION IS IN PROGRESS." END OF TEXT. | | | | THE LICENSEE IS INVESTIGATING THE CAUSE OF THE VALVE LEAKING BY. THE P&ID | | SHOWED THE VALVE TO BE A FAILED CLOSE AIR OPERATED VALVE. IT APPEARS AT | | THIS TIME THAT IF THE AIR FROM THE OPERATOR IS REMOVED FROM THE VALVE | | SYSTEM DIFFERENTIAL PRESSURE CAN SLIGHTLY OPEN THE VALVE. THE LEAKAGE WAS | | COLLECTED BY A FLOOR DRAIN DIRECTLY UNDER THE DRAIN VALVE. | | | | THE HOLD PUMP IS USED TO MAINTAIN FILTER CAKE ON THE DEMINERALIZER IF THE | | RWCU SYSTEM IS ISOLATED FOR ANY REASON BECAUSE OF THIS THE WATER THAT | | LEAKED OUT THE DRAIN VALVE ALSO CONTAINED SOME RESIN. GENERAL READINGS IN | | THE AREA OF THE FLOOR DRAIN WAS 15 RAD PER HOUR BETA/GAMMA AND 1 RAD PER | | HOUR GAMMA. THE LICENSEE IS IN THE PROCESS OF DOING A GROSS | | DECONTAMINATION OF THE AREA. | | | | THE LICENSEE HAS INFORMED THE RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |FUEL CYCLE FACILITY | |EVENT NUMBER: 27498 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: BABCOCK & WILCOX CO. |NOTIFICATION DATE: 07/07/94 | | RXTYPE: URANIUM FUEL FABRICATION |NOTIFICATION TIME: 13:00 [ET]| |COMMENTS: HEU FABRICATION & SCRAP RECOVERY |EVENT DATE: 07/07/94 | | NAVAL REACTOR FUEL |EVENT TIME: 12:47[EDT]| | |LAST UPDATE DATE: 07/07/94 | | CITY: LYNCHBURG REGION: 2 +-----------------------------+ | COUNTY: CAMPBELL STATE: VA |PERSON ORGANIZATION| |LICENSE#: SNM-42 AGREEMENT: N |SKINNER RDO | | DOCKET: 07000027 |PAPERIELLO EO | +------------------------------------------------+ROY FEMA | |NRC NOTIFIED BY: COFFEY | | |HQ OPS OFFICER: DOUG WEAVER | | +------------------------------------------------+ | |EMERGENCY CLASS: UNUSUAL EVENT | | |10 CFR SECTION: | | |AAEC 50.72(a)(1)(i) EMERGENCY DECLARED | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | UNUSUAL EVENT DECLARED - FIRE IN A METALLURGICAL LAB WITH A MINOR INJURY | | | | A METAL FIRE OCCURRED WHEN REPAIRS WERE BEING MADE TO A SAW. AN UNUSUAL | | EVENT WAS DECLARED AT 1247 EDT. THE FIRE BURNED FOR ONLY A SHORT TIME | | BEFORE BEING EXTINGUISHED. NO OUTSIDE ASSISTANCE WAS REQUESTED. ONE | | WORKER RECEIVED A MINOR BURN AND WAS TREATED ON SITE. THERE WAS NO RELEASE | | OF RADIOACTIVITY. NO INFORMATION WAS IMMEDIATELY AVAILABLE ABOUT THE | | SPREAD OF CONTAMINATION IN THE FIRE AREA. THE UNUSUAL EVENT WAS TERMINATED | | AT 1308 EDT. | | | | THE LICENSEE NOTIFIED CAMEL COUNTY, THE VIRGINIA DEPARTMENT OF EMERGENCY | | SERVICES AND THE NRC RESIDENT. THE LICENSEE IS PREPARING A PRESS RELEASE. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |HOSPITAL | |EVENT NUMBER: 27499 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: ST. PATRICK HOSPITAL |NOTIFICATION DATE: 07/07/94 | | CITY: MISSOULA REGION: 4 |NOTIFICATION TIME: 13:15 [ET]| | COUNTY: MISSOULA STATE: MT |EVENT DATE: 07/06/94 | |LICENSE#: 2516773-02 AGREEMENT: N |EVENT TIME: 05:00[MDT]| | DOCKET: |LAST UPDATE DATE: 07/07/94 | | +-----------------------------+ | |PERSON ORGANIZATION| | |JOHN PELLET RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: JAMES BREWER (RSO) | | |HQ OPS OFFICER: TIM McGINTY | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |LADM 35.33(a) MED MISADMINISTRATION | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | A MEDICAL MISADMINISTRATION OCCURRED ON 7/6/94 AT ABOUT 0500 (MT) AT THE | | ST. PATRICK HOSPITAL LOCATED IN MISSOULA, MONTANA. | | | | A BRACHYTHERAPY PATIENT HAD A TEMPORARY IMPLANT IN THE TRACHEA DISLODGE AND | | BECOME EXTERNALIZED, POSSIBLY DUE TO EXCESSIVE COUGHING. THE PATIENT WAS | | SCHEDULED TO HAVE APPROXIMATELY 40 MILLI-CURIES OF Ir-192 (LOCATED IN 16 | | SEEDS SPACED IN 1/2 cm INTERVALS) DELIVERED FOR A TOTAL OF 40 HOURS. AFTER | | ABOUT 16 HOURS, IT WAS DISCOVERED THAT THE SOURCE HAD BECOME EXTERNALIZED, | | WITH ABOUT 4 SEEDS IN CONTACT WITH THE SKIN IN THE NECK AREA AND THE | | REMAINDER LYING TO THE SIDE OF THE PATIENTS NECK. | | | | THE PATIENT WAS CHECKED AT 0500 HOURS, WITH NO ABNORMALITIES NOTED. AT | | 0600 HOURS, AN X-RAY TECHNICIAN DISCOVERED THE PROBLEM. THE PHYSICIAN WAS | | NOTIFIED AND THE IMPLANT LEADS WERE UNTAPED AND PLACED IN A PORTABLE PIG IN | | THE ROOM. THE DOSE TO THE X-RAY TECH AND THE ATTENDING NURSE IS MINIMAL. | | THE WORST CASE DOSE TO THE SKIN OF THE PATIENT IS STILL BEING EVALUATED, | | HOWEVER, THE RSO CONSIDERS THAT THERE WILL BE NO ADVERSE EFFECTS ON THE | | PATIENT. | | | | THE IMPLANT WAS SUBSEQUENTLY RE-INSTALLED WITH ADDITIONAL MEASURES FOR | | SECURING IT. THE LICENSEE WILL FOLLOW UP WITH A WRITTEN REPORT TO THE | | REGION WITHIN 15 DAYS. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27500 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: MILLSTONE REGION: 1 |NOTIFICATION DATE: 07/07/94 | |UNIT: [ ] [2] [ ] STATE: CT |NOTIFICATION TIME: 14:07 [ET]| |RX TYPE: [1] GE-3,[2] CE,[3] W-4-LP |EVENT DATE: 07/07/94 | +------------------------------------------------+EVENT TIME: 14:00[EDT]| |NRC NOTIFIED BY: JOHN RESETAR |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: JOSEPH SEBROSKY +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: UNUSUAL EVENT +-----------------------------+ |10 CFR SECTION: |JACK DURR RDO | |AAEC 50.72(a)(1)(i) EMERGENCY DECLARED |AL CHAFFEE EO | |ASHU 50.72(b)(1)(i)(A) PLANT S/D REQD BY TS |DAN SULLIVAN FEMA | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | UNUSUAL EVENT DECLARED DUE TO A TECH SPEC REQUIRED SHUTDOWN. | | | | DURING THE QUARTERLY SURVEILLANCE OF THE 125 VOLT DC BATTERY SYSTEM ONE OF | | THE 60 CELLS WAS FOUND TO BE UNDER THE TECH SPEC LIMIT OF 2.08 VOLTS. THE | | CELL WAS ORIGINALLY FOUND TO BE AT 2.064. THE TECH SPEC ALLOWS 2 HOURS TO | | RETURN THE CELL VOLTAGE TO THE TECH SPEC LIMIT, IF THAT IS NOT ACCOMPLISHED | | THEN TECH SPEC 3.8.2.3 REQUIRES THE LICENSEE TO BE IN COLD SHUTDOWN WITHIN | | 36 HOURS. | | | | THE LICENSEE HAS RAISED THE FLOAT VOLTAGE IN AN ATTEMPT TO RAISE THE CELL | | VOLTAGE. CURRENTLY THE CELL VOLTAGE IS 2.077 VOLTS. THE VOLTAGE IS | | RECOVERING, HOWEVER, IT HAS NOT RECOVERED WITHIN THE 2 HOUR TIME FRAME. THE | | LICENSEE IS PURSUING SHUTDOWN AND RESTORING THE CELL VOLTAGE CONCURRENTLY. | | THE BASIS FOR TERMINATING THE UNUSUAL EVENT WILL BE THE RESTORATION OF THE | | CELL VOLTAGE OR THE PLANT BEING IN COLD SHUTDOWN. | | | | THE LICENSEE IS INVESTIGATING THE CAUSE OF THE ONE LOW CELL VOLTAGE ALL | | OTHER 59 CELL VOLTAGES WERE WITHIN SPECIFICATION. THE LICENSEE HAS INFORMED | | THE RESIDENT INSPECTOR AND ALSO STATE AND LOCAL OFFICIALS IN ACCORDANCE | | WITH THEIR PROCEDURES. | | | | * * UPDATE AT 21:39 7/7/94 FROM MULLIN TAKEN BY SEBROSKY * * * | | THE LICENSEE TERMINATED THE UNUSUAL EVENT AT 21:38EDT WHEN THE CELL VOLTAGE | | WAS RETURNED TO SPECIFICATION. THE LOWEST POWER GOT WAS 95.5%. THE | | LICENSEE PLANS TO INCREASE POWER SHORTLY. THE LICENSEE HAS INFORMED THE | | RESIDENT INSPECTOR AND STATE AND LOCAL OFFICIALS. | | | | HOO NOTIFIED R1DO(DURR), EO(ROSSI), AND FEMA(SHULL). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |GENERAL INFORMATION or OTHER | |EVENT NUMBER: 27501 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: SYNCOR INTERNATIONAL |NOTIFICATION DATE: 07/07/94 | | CITY: VIRGINIA BEACH REGION: 2 |NOTIFICATION TIME: 15:27 [ET]| | COUNTY: STATE: VA |EVENT DATE: 07/06/94 | |LICENSE#: 45-18378-01MD AGREEMENT: N |EVENT TIME: 15:30[EDT]| | DOCKET: |LAST UPDATE DATE: 07/07/94 | | +-----------------------------+ | |PERSON ORGANIZATION| | |PIERCE SKINNER RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: JEFF MUELLER | | |HQ OPS OFFICER: JOSEPH SEBROSKY | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |IBBF 30.50(b)(2)(ii) EQUIP DISABLED/FAILS | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | SYNCOR INTERNATIONAL IS MAKING A REPORT IN ACCORDANCE WITH 10 CFR 30.50 | | (FAILURE OF A PIECE OF EQUIPMENT REQUIRED BY A LICENSE CONDITION) DUE TO A | | PROBLEM AT THE LICENSEE'S VIRGINIA BEACH, VIRGINIA RADIOPHARMACY. | | | | AT THE RADIOPHARMACY THE LICENSEE STORES VOLATILE RADIOISOTOPES (I-131 IN | | NAI FORM AND XE-133) IN A FUME HOOD. THE FUME HOOD FAN FAILED AT | | APPROXIMATELY 15:30 HOURS 7/6/94 AND WAS RETURNED TO SERVICE AT 18:00 | | HOURS. DURING THE TIME THE FAN WAS INOPERABLE THERE WAS NO MATERIAL | | HANDLED IN THE FUME HOOD. THE LICENSEE ALSO DOES NOT SUSPECT THAT THERE | | WAS ANY LEAKAGE FROM THE FUME HOOD DURING THE TIME THE FAN WAS INOPERABLE. | | THE LICENSEE DOES NOT SUSPECT ANY LEAKAGE BECAUSE AN AIR SAMPLE WAS TAKEN | | PER THE LICENSEE'S PROCEDURES AND THE RESULTS WERE NOT SIGNIFICANTLY | | DIFFERENT THAN THERE NORMAL WEEKLY AIR SAMPLE. | | | | THE CAUSE OF THE FAILURE OF THE FAN WAS A BLOWN FUSE. THE FUSE WAS | | REPLACED AND THE FAN APPEARS TOP BE OPERATING NORMALLY. | | | | THE LICENSEE HAS DISCUSSED THIS EVENT WITH REGION II(BERMUDEZ). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27502 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: DIABLO CANYON REGION: 4 |NOTIFICATION DATE: 07/07/94 | |UNIT: [ ] [2] [ ] STATE: CA |NOTIFICATION TIME: 15:50 [ET]| |RX TYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 07/07/94 | +------------------------------------------------+EVENT TIME: 11:55[PDT]| |NRC NOTIFIED BY: JIM DYE |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: JOSEPH SEBROSKY +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JOHN PELLET 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 | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | 2 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE UNIT 2 AUXILIARY BUILDING VENTILATION SYSTEM ADSORBER BANK WAS OUTSIDE | | ITS DESIGN BASIS DUE TO A MUCH HIGHER ORGANIC IODIDE PENETRATION THAN | | EXPECTED. | | | | THE FOLLOWING IS A TEXT OF A FACSIMILE FROM THE LICENSEE: | | | | "ON JULY 7, 1994, PG&E RECEIVED THE RESULTS OF A CHARCOAL SAMPLE ANALYSIS | | THAT WAS PERFORMED IN ACCORDANCE WITH ASTM D-3803-1989. THE TEST | | METHODOLOGY IN ASTM D-3803-1989 IS MORE CONSERVATIVE THAN THE METHODOLOGY | | SPECIFIED IN REGULATORY GUIDE 1.52, WHICH IS REFERENCED IN TS 4.7.6.1.C. | | THE CHARCOAL SAMPLE WAS TAKEN FROM A UNIT 2 AUXILIARY BUILDING VENTILATION | | SYSTEM ABSORBER BANK THAT WAS REPLACED ON JUNE 24, 1994. THE SAMPLE WAS | | TAKEN IN ORDER TO CONFIRM THE RESULTS OF AN EARLIER SAMPLE SINCE THE | | EARLIER SAMPLE RESULTS INDICATED MUCH HIGHER ORGANIC IODIDE PENETRATION | | THAN EXPECTED. THE EARLIER SAMPLE INDICATED APPROXIMATELY 37% ORGANIC | | IODIDE PENETRATION. THE RESULTS OF THE MOST RECENT SAMPLE INDICATED THAT | | THE PREVIOUSLY INSTALLED AUXILIARY BUILDING VENTILATION SYSTEM ADSORBER | | BANK WOULD ALLOW APPROXIMATELY 33% PENETRATION OF ORGANIC IODIDE. THE | | OFFSITE DOSE DESIGN BASIS ASSUMES THAT THE AUXILIARY BUILDING VENTILATION | | SYSTEM ABSORBER BANK WILL ALLOW NO MORE THAN 30% PENETRATION OF ORGANIC | | IODIDE. SINCE THE ADSORBER BANK WOULD ALLOW MORE ORGANIC IODIDE PENETRATION | | THAN ASSUMED IN THE DESIGN BASIS, THE ADSORBER BANK WAS OUTSIDE OF ITS | | DESIGN BASIS. FOLLOWING REVIEW OF THE TEST RESULTS AT 11:55 PDT, PG&E | | DETERMINED THAT THIS EVENT CONSTITUTED A CONDITION OUTSIDE OF THE DESIGN | | BASIS. IT IS REPORTABLE IN ACCORDANCE WITH 10 CFR 50.72 (B)(II)(B). | | | | THIS EVENT IS NOT REPORTABLE FOR UNIT 1 BECAUSE THE UNIT 1 ADSORBER BANK | | WAS DETERMINED TO BE WITHIN ACCEPTABLE LIMITS DURING THE LAST REFUELING | | OUTAGE." END OF TEXT. | | | | THE LICENSEE WILL INFORM THE RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 27503 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: MAINE YANKEE REGION: 1 |NOTIFICATION DATE: 07/07/94 | |UNIT: [1] [ ] [ ] STATE: ME |NOTIFICATION TIME: 16:53 [ET]| |RX TYPE: [1] CE |EVENT DATE: 07/07/94 | +------------------------------------------------+EVENT TIME: 16:13[EDT]| |NRC NOTIFIED BY: ROBERT MALONEY |LAST UPDATE DATE: 07/07/94 | |HQ OPS OFFICER: JOSEPH SEBROSKY +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: UNUSUAL EVENT +-----------------------------+ |10 CFR SECTION: |JACK DURR RDO | |AAEC 50.72(a)(1)(i) EMERGENCY DECLARED |ERNIE ROSSI EO | | |CHARLES SHULL FEMA | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N Y 100 POWER OPERATION | 100 POWER OPERATION | | | | | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | UNUSUAL EVENT DECLARED DUE TO BOTH FIRE SUPPRESSION PUMPS BEING DECLARED | | INOPERABLE. | | | | THE PLANT HAS TWO FIRE SUPPRESSION PUMPS. P-4 IS AN ELECTRIC DRIVEN PUMP | | AND P-5 IS A DIESEL DRIVEN PUMP. THE P-4 PUMP WAS TAKEN OUT OF SERVICE ON | | 6/30/94 TO REPAIR THE PUMP MOTOR. THE P-5 PUMP HAD A SURVEILLANCE | | PERFORMED ON IT TODAY. THE SURVEILLANCE PROCEDURE REQUIRED A MANUAL START | | OF THE FIRE PUMP. THE FIRST TIME A MANUAL START OF THE FIRE PUMP WAS | | ATTEMPTED IT FAILED, ON THE SECOND ATTEMPT THE PUMP STARTED AND THE | | LICENSEE LEFT THE PUMP RUNNING. THE LICENSEE CONSIDERED THE P-5 PUMP | | OPERABLE BECAUSE IT WAS RUNNING. | | | | TO ALLOW TROUBLESHOOTING OF THE P-5 FIRE PUMP THE LICENSEE HAD THE LOCAL | | FIRE DEPARTMENT SUPPLY A PUMPER. THE PUMPER WAS CONNECTED TO THE MAINE | | YANKEE FIRE SUPPRESSION SYSTEM AND A DEDICATED MAINE YANKEE OPERATOR WAS | | SUPPLIED TO CONTROL THE FIRE DEPARTMENT CONNECTION AND MAINTAIN THE SYSTEM | | PRESSURE. AFTER THIS WAS DONE P-5 WAS SHUTDOWN TO PERFORM TROUBLESHOOTING. | | WHEN P-5 WAS ATTEMPTED TO BE RESTARTED IT DID NOT START. THE LICENSEE | | DECLARED THE PUMP INOPERABLE AND ENTERED AN UNUSUAL EVENT. | | | | TECH SPEC 3.23.B.2 REQUIRES THE LICENSEE TO ESTABLISH A BACKUP FIRE | | SUPPRESSION SYSTEM WITHIN 24 HOURS (WHICH WAS ALREADY ESTABLISHED PRIOR TO | | STOPPING PUMP P-5) AND ALSO TO ISSUE VARIOUS REPORTS TO THE NRC. THE TECH | | SPEC DOES NOT REQUIRE THE LICENSEE TO SHUTDOWN. THE BASIS FOR TERMINATION | | OF THE UNUSUAL EVENT IS THE RESTORATION OF ONE OF THE TWO FIRE SUPPRESSION | | PUMPS. THE LICENSEE IS CURRENTLY TROUBLESHOOTING PUMP P-5 AND SUSPECTS | | THAT THE CAUSE OF THE PROBLEM IS LOW VOLTAGE IN THE STARTING CIRCUITRY FOR | | THE PUMP. THE LICENSEE IS UNSURE AT THIS TIME HOW LONG IT WILL TAKE TO | | MAKE REPAIRS. THE FIRE PUMPER THAT WAS BROUGHT ONSITE IS CURRENTLY RUNNING | | IN A RECIRC MODE TO SUPPLY THE FIRE SUPPRESSION HEADER. | | | | THE LICENSEE HAS INFORMED THE RESIDENT INSPECTOR AND ALSO STATE AND LOCAL | | OFFICIALS. THE LICENSEE MAY ISSUE A PRESS RELEASE. | | | | * * * UPDATE 7/7/94 @ 20:08 FORM MALONEY TAKEN BY SEBROSKY * * * | | THE LICENSEE IS REQUIRED BY TECH SPEC 3.23.B REMEDIAL ACTION #2 TO NOTIFY | | THE NRC WITHIN 24 HOURS BY TELEPHONE OR TELEGRAPH OF ESTABLISHING A BACKUP | | FIRE SUPPRESSION SYSTEM. THEREFORE IN ADDITION TO INFORMING THE NRC OF THIS | | EVENT BECAUSE IT WAS AN UNUSUAL EVENT THE LICENSEE IS ALSO MAKING THIS | | REPORT IN ACCORDANCE WITH THEIR TECH SPECS. THE LICENSEE'S TECH SPECS ALSO | | REQUIRES THAT THE LICENSEE ISSUE A SPECIAL WRITTEN REPORT TO THE NRC WITHIN | | 14 DAYS OF THE EVENT. | | | | THE LICENSEE HAS STOPPED THE FIRE PUMPER THAT WAS BROUGHT ONSITE. THE | | LICENSEE DID THIS BECAUSE THERE ARE NO LOADS ON THE SYSTEM CURRENTLY. THE | | PUMPER IS STILL CONNECTED TO THE FIRE HEADER AND THE LICENSEE STILL HAS ONE | | DEDICATED MAINE YANKEE OPERATOR AND TWO INDIVIDUALS FROM THE FIRE | | DEPARTMENT ASSIGNED TO THE PUMPER. THE LICENSEE HAS ALSO ISSUED A 2 PAGE | | INTERIM DOCUMENT TO IMPLEMENT PROCEDURES TO MINIMIZE THE RISK OF A FIRE | | ONSITE UNTIL THE DIESEL DRIVEN PUMP (P-5) CAN BE PLACED BACK IN SERVICE. | | THE DOCUMENT INCLUDES STEPS SUCH AS NO SPARK PRODUCING OPERATIONS ALLOWED, | | NO USE OF FLAMMABLE LIQUIDS IN THE PLANT IS AUTHORIZED ETC... THE DOCUMENT | | ALSO INCLUDES PROCEDURES FOR USE OF THE TEMPORARY FIRE PUMPER. | | | | THE LICENSEE WILL INFORM THE RESIDENT INSPECTOR. HOO NOTIFIED R1DO(DURR) | | AND EO(ROSSI). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |GENERAL INFORMATION or OTHER | |EVENT NUMBER: 27504 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: AUTOMATIC SWITCH COMPANY |NOTIFICATION DATE: 07/07/94 | | CITY: FLORHAM PARK REGION: 1 |NOTIFICATION TIME: 18:49 [ET]| | COUNTY: STATE: NJ |EVENT DATE: 07/07/94 | |LICENSE#: AGREEMENT: N |EVENT TIME: 12:00[EDT]| | DOCKET: |LAST UPDATE DATE: 07/07/94 | | +-----------------------------+ | |PERSON ORGANIZATION| | | | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: JAMES WEAVER | | |HQ OPS OFFICER: JOSEPH SEBROSKY | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |CCCC 21.21 UNSPECIFIED PARAGRAPH | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE AUTOMATIC SWITCH COMPANY (ASCO) OF FLORHAM PARK, NJ ISSUED A 10 CFR 21 | | REPORT DUE TO A DEGRADATION OF THE LUBRICANT PRESENT ON THE SEAT AND DISC | | OF SINGLE SOLENOID 4-WAY VALVES. | | | | IT HAS COME TO ASCO'S ATTENTION THAT THERE IS THE POSSIBILITY THAT UP TO 92 | | SINGLE SOLENOID 4-WAY VALVES MANUFACTURED SINCE 1989 MAY NOT OPERATE IN | | ACCORDANCE WITH SPECIFICATIONS. THE CONDITION, WHICH HAS BEEN REPORTED TO | | ASCO, INVOLVES A SLOW OR INCOMPLETE SHIFTING TO THE DE-ENERGIZED POSITION. | | BASED ON THE INVESTIGATION THAT ASCO HAS CONDUCTED IT APPEARS THAT THERE | | COULD BE IMPEDED MOVEMENT OF THE SLIDING DISC AGAINST ITS SEAT, AS A RESULT | | OF THE DEGRADATION OF THE NYOGEL 775A LUBRICANT PRESENT ON THE SEAT AND | | DISC. TESTING INDICATES THAT THERE IS A DIFFERENCE IN THE CHEMICAL | | COMPOSITION OF 775A LUBRICANT SUPPLIED TO ASCO SINCE 1989, WHICH APPARENTLY | | ACCOUNTS FOR THE DEGRADATION. | | | | ASCO IS NOTIFYING THE APPLICABLE PURCHASERS OF THE PROBLEM. THE UTILITIES | | INCLUDE: CAROLINA POWER AND LIGHT, FLORIDA POWER AND LIGHT, IOWA ELECTRIC | | LIGHT & POWER, NEBRASKA PUBLIC POWER DISTRICT AND PUBLIC SERVICE ELECTRIC | | AND GAS, AND B&W NUCLEAR SERVICE. UPON REQUEST ASCO WILL PROVIDE ITS | | CUSTOMERS WITH A REPLACEMENT VALVE, HOWEVER, THE REPLACEMENT VALVE WILL NOT | | BE AVAILABLE FOR AT LEAST FOUR WEEKS DUE TO THE UNAVAILABILITY OF A | | COMPONENT. IN THE INTERIM, ASCO BELIEVES THAT IF THE CUSTOMERS REQUIRING | | REPLACEMENT VALVES EXERCISE THEIR VALVES ON A WEEKLY BASIS, PROPER SHIFTING | | WILL OCCUR. | +------------------------------------------------------------------------------+