U.S. Nuclear Regulatory Commission Operations Center Event Reports For 06/15/95 - 06/16/95 ** EVENT NUMBERS ** 28946 28947 28948 28949 28950 28951 28952 28953 28954 +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 28946 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: SALEM REGION: 1 |NOTIFICATION DATE: 06/15/95 | |UNIT: [1] [2] [ ] STATE: NJ |NOTIFICATION TIME: 08:44 [ET]| |RX TYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 06/14/95 | +------------------------------------------------+EVENT TIME: 15:15[EDT]| |NRC NOTIFIED BY: HEALY |LAST UPDATE DATE: 06/15/95 | |HQ OPS OFFICER: CHAUNCEY GOULD +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JENNY JOHANSEN 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 | +-----+----------+-------+--------+-----------------+--------+-----------------+ | 1 | N N 0 COLD SHUTDOWN | 0 COLD SHUTDOWN | | 2 | N N 0 COLD SHUTDOWN | 0 COLD SHUTDOWN | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE PLANT ENTERED TS LCO 3.4.1.4 @ 1515 ON 06/14/95 WHEN THEY DECLARED BOTH | | TRAINS OF BOTH UNITS OF RHR INOPERABLE DUE TO POSSIBLE IMPROPER | | INSTALLATION OF PUMP RECIRC VALVE CONTROL FLOW ORIFICE. | | | | THE CONDITION WAS IDENTIFIED DURING AN ENGINEERING REVIEW OF THE RHR | | DISCHARGE PIPING. IT WAS DETERMINED THAT THE DESIGN AND INSTALLATION IS NOT | | IN ACCORDANCE WITH ASME AND INDUSTRY STANDARDS. THIS COULD RESULT IN | | INADEQUATE FLOW MEASUREMENT ACROSS THE ORIFICE AND SUBSEQUENT INADEQUATE | | RECIRC VALVE OPERATION. THE RECIRC VALVES(RH29'S) ARE REQUIRED TO OPEN IN | | LOW FLOW CONDITION FOR PUMP PROTECTION AND CLOSE ON INCREASING FLOW FOR | | ADEQUATE INJECTION. BOTH UNITS ARE CURRENTLY IN MODE 5 WITH RHR IN SERVICE | | AND WILL REMAIN IN THIS CONDITION WHILE EVALUATION AND/OR TESTING IS | | COMPLETE TO VALIDATE THE ORIFICE FLOW INDICATION AND CONTROL FUNCTION. THE | | LCO THAT THEY ENTERED REQUIRES THAT THE RHR BE IMMEDIATELY RESTORED. RHR IS | | FUNCTIONAL, BUT TECHNICALLY INOPERABLE SINCE THE VALVE DESIGN IS | | QUESTIONABLE. THE LICENSEE DETERMINED THAT THIS EVENT IS REPORTABLE at 0745 | | ON 06/15/95. THE RI WILL BE INFORMED. LOCAL AGENCIES HAVE BEEN INFORMED. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |HOSPITAL | |EVENT NUMBER: 28947 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: ST JOSEPH HOSPITAL |NOTIFICATION DATE: 06/15/95 | | CITY: MARSHFIELD REGION: 3 |NOTIFICATION TIME: 11:42 [ET]| | COUNTY: STATE: WI |EVENT DATE: 06/08/95 | |LICENSE#: AGREEMENT: N |EVENT TIME: 09:15[CDT]| | DOCKET: |LAST UPDATE DATE: 06/15/95 | | +-----------------------------+ | |PERSON ORGANIZATION| | |LEWIS MILLER RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: LOSHEK | | |HQ OPS OFFICER: CHAUNCEY GOULD | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |LADM 35.33(a) MED MISADMINISTRATION | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | THE ST JOSEPH HOSPITAL/MARSHFIELD CLINIC IN MARSHFIELD WI REPORTED A | | MEDICAL MISADMINISTRATION. | | | | AN IMPLANT OF CS-137 FOR CERVIX CANCER WAS LEFT INSIDE THE PATIENT 15 HRS | | TOO LONG DUE TO THE WRONG EXTRACTION DATE(JUN 8 INSTEAD OF JUN 7) BEING PUT | | IN THE LOG. THE PATIENT HAS BEEN NOTIFIED AND THEY DO NOT ANTICIPATE ANY | | ADVERSE AFFECTS. THE LICENSEE HAS NOTIFIED THE REGION(B. GATONE). | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |OTHER NUCLEAR MATERIAL | |EVENT NUMBER: 28948 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: SYNCOR |NOTIFICATION DATE: 06/15/95 | | CITY: SHARON HILL REGION: 1 |NOTIFICATION TIME: 12:06 [ET]| | COUNTY: STATE: PA |EVENT DATE: 06/14/95 | |LICENSE#: 37-1846101-MD AGREEMENT: N |EVENT TIME: 14:00[EDT]| | DOCKET: |LAST UPDATE DATE: 06/15/95 | | +-----------------------------+ | |PERSON ORGANIZATION| | |JENNY JOHANSEN RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: TARA DOMITER | | |HQ OPS OFFICER: DOUG WEAVER | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |IBBE 30.50(b)(2)(i) ACCID MIT EQUIP FAILS | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | SYNCOR - FUME HOOD FAILURE - | | | | SYNCOR LOCATED AT 650 ELMWOOD AVE., SHARON HILL, PA REPORTED THE FOLLOWING | | EVENT. CONTACT PHONE NUMBER LOCATED IN THE HOO LOG. | | | | A FUME HOOD FAILED AT 1400 ON 6/14/95. THE HOOD CONTAINED 20 mCi OF I-131 | | AND 150 mCi OF Xe-133 AT THE TIME OF THE FAILURE. THERE WERE NO RELEASES | | ABOVE ALLOWABLE LIMITS. THE HOOD IS BEING REPAIRED. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 28949 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: BROWNS FERRY REGION: 2 |NOTIFICATION DATE: 06/15/95 | |UNIT: [ ] [ ] [3] STATE: AL |NOTIFICATION TIME: 15:12 [ET]| |RX TYPE: [1] GE-4,[2] GE-4,[3] GE-4 |EVENT DATE: 06/15/95 | +------------------------------------------------+EVENT TIME: 11:29[CDT]| |NRC NOTIFIED BY: DON SMITH |LAST UPDATE DATE: 06/15/95 | |HQ OPS OFFICER: DOUG WEAVER +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |DAVID VERRELLI RDO | |AESF 50.72(b)(2)(ii) ESF ACTUATION | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | | | | | | | 3 | N N 0 REFUELING | 0 REFUELING | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | ESF ACTUATION - DIESEL AND STANDBY GAS TREATMENT AUTO STARTS - | | | | AT 1129 (CDT) ON 6/15/95 AN AUTO START OF THE 3A AND 3B DIESEL GENERATORS | | OCCURRED AS A RESULT OF THE LOSS OF THE ATHENS 161 KV LINE WHICH WAS | | PROVIDING POWER TO THE 1A & 2A START BUSES. | | | | UNIT 3 4KV SHUTDOWN BOARDS 3EA & 3EB WERE BEING FED FROM THE ATHENS 161 KV | | LINE AT THE TIME OF THE EVENT. THE RESULTING UNDERVOLTAGE LED TO THE | | EXPECTED AUTO START OF THE 3A & 3B DGs AND SUPPORTING EECW PUMP STARTS. | | ADDITIONALLY, 3A RPS WAS LOST RESULTING IN THE EXPECTED AUTO START OF THE | | STANDBY GAS TREATMENT AND CONTROL ROOM EMERGENCY VENTILATION SYSTEMS. UNIT | | 2 WAS UNAFFECTED BY THE EVENT. | | | | THE CAUSE OF THE EVENT WAS LATER DETERMINED TO BE A RESULT OF A CROP DUSTER | | PLANE CUTTING THE C PHASE LINE AND BREAKING A CROSS ARM OF THE 161 ATHENS | | LINE OFF SITE SOUTH OF QUINN ROAD. (SEVERAL MILES AWAY FROM THE SITE) THE | | TRINITY 161 LINE IS NOW SUPPLYING POWER TO THE AFFECTED BUSES AND THE | | DIESELS HAVE BEEN RETURNED TO STANDBY. | | | | THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |GENERAL INFORMATION or OTHER | |EVENT NUMBER: 28950 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: COGEMA MINING, INC. |NOTIFICATION DATE: 06/15/95 | | CITY: LYNCH REGION: 4 |NOTIFICATION TIME: 16:05 [ET]| | COUNTY: STATE: WY |EVENT DATE: 06/13/95 | |LICENSE#: SUA1341 AGREEMENT: N |EVENT TIME: 12:00[MDT]| | DOCKET: |LAST UPDATE DATE: 06/15/95 | | +-----------------------------+ | |PERSON ORGANIZATION| | |CHRIS VANDENBURGH RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: JOHN VASELIN | | |HQ OPS OFFICER: DOUG WEAVER | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |NINF INFORMATION ONLY | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | COGEMA MINING, INC. - CHEMISTRY OUTSIDE OF ALLOWABLE BANDS AT SEVERAL WELLS | | | | THE LICENSEE MADE THIS REPORT IN ACCORDANCE WITH LICENSE CONDITION 28 OF | | THEIR LICENSE. THE MINE IN QUESTION IS THE IRIGARY URANIUM MINE LOCATED | | NEAR LYNCH, WYOMING. THE MINE IS NO LONGER BEING MINED AND IS IN THE FIRST | | STAGES OF RESTORATION. | | | | WELLS SSM3, SSM18 AND M2 WERE SAMPLED FOR CHLORIDES, CONDUCTIVITY AND | | ALKALINITY. EACH MINE EXCEEDED LIMITS IN TWO OF THE THREE CATEGORIES. NO | | URANIUM IS EXPECTED TO BE IN THESE SAMPLES, BUT THE RESULTS OF THE TEST FOR | | URANIUM WERE NOT YET AVAILABLE. THESE SAMPLES WERE ORIGINALLY TAKEN ON THE | | 11TH AND 12TH OF JUNE. CONFIRMATORY SAMPLES WERE TAKEN ON THE 13TH AND | | 14TH OF JUNE. THE LICENSEE INDICATED THERE WAS NO PUBLIC HAZARD ASSOCIATED | | WITH THESE SAMPLE RESULTS. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |GENERAL INFORMATION or OTHER | |EVENT NUMBER: 28951 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: COOPER CAMERON CORPORATION |NOTIFICATION DATE: 06/15/95 | | CITY: GROVE CITY REGION: 1 |NOTIFICATION TIME: 16:44 [ET]| | COUNTY: STATE: PA |EVENT DATE: 06/15/95 | |LICENSE#: AGREEMENT: N |EVENT TIME: 00:00[EDT]| | DOCKET: |LAST UPDATE DATE: 06/15/95 | | +-----------------------------+ | |PERSON ORGANIZATION| | | | | | | +------------------------------------------------+VERN HODGE NRR | |NRC NOTIFIED BY: SCHNEIDER | | |HQ OPS OFFICER: DOUG WEAVER | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |CDEF 21.21(b)(2) DEFECTS/NONCOMPLIANCE | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | PART 21 NOTIFICATION | | | | THERE EXISTS A POTENTIAL PROBLEM WITH A BELLOFRAM AIR CYLINDER, COOPER PART | | NUMBER AJ-009-000 WHICH IS USED TO CONTROL A BUTTERFLY VALVE IN THE DIESEL | | ENGINE INTAKE AIR SYSTEM. THESE AIR CYLINDERS ARE INSTALLED ON ALL NUCLEAR | | ENTERPRISE EDGs CURRENTLY IN SERVICE. | | | | THE FOLLOWING DOMESTIC PLANTS ARE AFFECTED - SHOREHAM, GRAND GULF, RIVER | | BEND, SHEARON HARRIS, CATAWBA, PERRY, BELLEFONTE, HARTSVILLE, COMANCHE | | PEAK, VOGTLE. THESE DIESELS ARE ALSO USED AT KORI AND YONGGWANG IN KOREA | | AS WELL AS KUOSHENG AND MAANSHAN IN TAIWAN. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |OTHER NUCLEAR MATERIAL | |EVENT NUMBER: 28952 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |LICENSEE: DIAMOND H. TESTING |NOTIFICATION DATE: 06/15/95 | | CITY: HONOLULU, HI REGION: 4 |NOTIFICATION TIME: 17:43 [ET]| | COUNTY: STATE: HI |EVENT DATE: 06/15/95 | |LICENSE#: AGREEMENT: N |EVENT TIME: 21:40[AH ]| | DOCKET: |LAST UPDATE DATE: 06/15/95 | | +-----------------------------+ | |PERSON ORGANIZATION| | |CHRIS VANDENBURGH RDO | | | | +------------------------------------------------+ | |NRC NOTIFIED BY: HANGES | | |HQ OPS OFFICER: DOUG WEAVER | | +------------------------------------------------+ | |EMERGENCY CLASS: NOT APPLICABLE | | |10 CFR SECTION: | | |BAD1 20.2202(a)(1) PERS OVEREXPOSURE | | | | | | | | | | | | | | +------------------------------------------------+-----------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | - PERSONNEL OVEREXPOSURE DURING RADIOGRAPHY - | | | | A RADIOGRAPHER RECEIVED 650 mR AS DETERMINED BY HIS SELF READING DOSIMETER. | | HIS FILM BADGE HAS BEEN SENT IN TO BE READ. THE SOURCE INVOLVED IS 40 Ci | | OF Ir-192. THE RADIOGRAPHER RECEIVED THE DOSE WHEN HE FORGOT THAT THE | | SOURCE HAD NOT BEEN STOWED. WHEN HE APPROACHED THE SOURCE THE SOURCE WAS | | PARTIALLY SHIELDED BY THE PIPE (1.5" WALL THICKNESS) AND READINGS APPEARED | | NORMAL. THIS CONTRIBUTED TO HIS EXPOSURE DURING THE EVENT. | | | | THE LICENSEE HAD INFORMED THE REGION PRIOR TO THIS CALL TO THE OPERATIONS | | CENTER. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 28953 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: BIG ROCK POINT REGION: 3 |NOTIFICATION DATE: 06/15/95 | |UNIT: [1] [ ] [ ] STATE: MI |NOTIFICATION TIME: 17:50 [ET]| |RX TYPE: [1] GE-1 |EVENT DATE: 06/15/95 | +------------------------------------------------+EVENT TIME: 17:07[EDT]| |NRC NOTIFIED BY: WITHROW |LAST UPDATE DATE: 06/15/95 | |HQ OPS OFFICER: DOUG WEAVER +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |LEWIS MILLER 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 95 POWER OPERATION | 95 POWER OPERATION | | | | | | | | | +-----+---------------------------------------------+--------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | - DC LOADS OUTSIDE OF DESIGN BASIS - | | | | DURING TESTING OF THE 125 VDC BATTERY CHARGER THE LICENSEE DISCOVERED THAT | | THE STACK LIGHTS ARE DRAWING 22 AMPS INSTEAD OF 10 AMPS. BASED ON THE MOST | | RECENT LOAD TESTING OF THE BATTERY AND DESIGN CALCULATIONS, THE LICENSEE | | CONCLUDED THAT THE BATTERY WOULD MEET ALL DESIGN REQUIREMENTS. | | | | THE LICENSEE ALSO DISCOVERED THAT THE STACK LIGHTS ARE NOT POWERED FROM THE | | BREAKER WHICH THEY BELIEVED WAS THE SUPPLY BREAKER. THE STACK LIGHTS ARE | | NORMALLY SUPPLIED BY AC POWER, BUT SWITCH TO DC WHEN AC POWER IS NOT | | AVAILABLE. THE LICENSEE IS INVESTIGATING BOTH THE ADDITIONAL LOAD AND THE | | ACTUAL POWER SUPPLY PATH TO THE LIGHTS. | | | | THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | +------------------------------------------------------------------------------+ +----------------------------------+ +-----------------------+ |POWER REACTOR | |EVENT NUMBER: 28954 | +----------------------------------+ +-----------------------+ +------------------------------------------------+-----------------------------+ |FACILITY: OYSTER CREEK REGION: 1 |NOTIFICATION DATE: 06/15/95 | |UNIT: [1] [ ] [ ] STATE: NJ |NOTIFICATION TIME: 18:29 [ET]| |RX TYPE: [1] GE-2 |EVENT DATE: 06/15/95 | +------------------------------------------------+EVENT TIME: 14:17[EDT]| |NRC NOTIFIED BY: VAN BLARCOM |LAST UPDATE DATE: 06/15/95 | |HQ OPS OFFICER: DOUG WEAVER +-----------------------------+ +------------------------------------------------+ NOTIFICATIONS | |EMERGENCY CLASS: NOT APPLICABLE +-----------------------------+ |10 CFR SECTION: |JENNY JOHANSEN RDO | |APRE 50.72(b)(2)(vi) OFFSITE NOTIFICATION | | | | | | | | | | | | | | +-----+----------+-------+--------+--------------+--+--------+-----------------+ |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 +------------------------------------------------------------------------------+ | STRUCTURAL FAILURE OF A FUEL BUNDLE | | | | A 7 X 7 FUEL ASSEMBLY SUFFERED STRUCTURAL FAILURE WHEN THE BOTTOM PLATE | | SEPARATED FROM THE TIE RODS WHILE LOWERING THE FUEL ASSEMBLY INTO THE SPENT | | FUEL POOL. THE BOTTOM TIE PLATE AND 41 FUEL RODS DROPPED ABOUT 7 FEET INTO | | THE FUEL RACK. THE UPPER TIE PLATE AND THE EIGHT TIE RODS ARE STILL | | SUSPENDED IN THE FUEL POOL. | | | | THE LICENSEE IS STILL ASSESSING THE SITUATION. AIR SAMPLES DID NOT | | INDICATE ANY ACTIVITY ABOVE NORMAL. APPROPRIATE STATE AND LOCAL OFFICIALS | | HAVE BEEN NOTIFIED. | | | | THE LICENSEE IS CONDUCTING A PRESS BRIEFING TONIGHT IN A LOCAL TOWN HALL. | | | | THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR. | | | | * * * COMMISSIONER'S ASSISTANT BRIEFING; AEOD (BROCKMAN), STATE PROGRAMS | | (SCHNEIDER), NMSS EO (WEBER), COMM JACKSON (BOYLE), COMM De PLANQUE | | (MCKENNA), NRR EO (MARSH), RI (PINDALE), PAO (DRICKS), R1 (LANNING), NRR | | (ZWOLINSKI), NRR PM (DROMERICK). | +------------------------------------------------------------------------------+