ML022060222
| ML022060222 | |
| Person / Time | |
|---|---|
| Site: | Arkansas Nuclear  |
| Issue date: | 07/17/2002 |
| From: | Entergy Operations |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| OP-1903.060 1903.060 | |
| Download: ML022060222 (47) | |
Text
Arkansas Nuclear One - Administrative Services Document Control Wednesday, July 17, 2002 Document Update Notification 103 TO:
ADDRESS:
DOCUMENT NO:
TITLE:
REVISION NO:
CHANGE NO:
SUBJECT.
ANO-NRC (EMERGENCY RESPONSE COORD.) - WASHINGTON OS-DOC CNTRL DESK MAIL STOP OPI 17 WASHINGTON DC 20555-DC OP-1903.060 EMERGENCY SUPPLIES & EQUIPMENT 034-03-0 PC-03 PERMANENT CHANGE (PC) is checked, please sign, date, and return within 5 days.
OD ANO-1 Docket 50-313 EJ ANO-2 Docket 50-368 Signature Date SIGNATURE CONFIRMS UPDATE HAS BEEN MADE RETURN TO:
ATTN: DOCUMENT CONTROL ARKANSAS NUCLEAR ONE 1448 SR 333 RUSSELLVILLE, AR 72801
/
tv)
/
COPYHOLDER NO.
ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE TITLE: Emergency Supplies & Equipment DOCUMENT NO.
CHANGE NO.
1903.060 034-03-0 WORK PLAN EXP. DATE TC EXP. DATE N/A N/A SET# t03 SAFETY-RELATED IPTE (o3 0YES ONO E[-YES ONO TEMP ALT
_IYES ONO When you see these TRAPS Get these TOOLS Time Pressure Effective Communication Distractionlinterruption Questioning Attitude Multiple Tasks Placekeeping Overconfidence Self Check Vague or Interpretive Guidance Peer Check First Shift/Last Shift Knowledge Peer Pressure Procedures ChangelOff Normal Job Briefing Physical Environment Coaching Mental Stress (Home or Work)
Turnover VERIFIED BY DATE TIME VERIFICATION COVER SHEET FORM NO.
I CHANGE NO.
1000.006A 1 050-00-0 I
ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE Page 1 TITLE:EMERGENCY SUPPLIES & EQUIPMENT DOCUMENT NO.
CHANGE NO.
11903.060 034-03-0
,FFECTED UNIT:
0 PROCEDURE El ELECTRONIC DOCUMENT SAFETY-RELATED "02 UNIT 1 E UNIT 2 El WORK PLAN, EXP. DATE N/AI0 YES E3 NO TYPE OF CHANGE:
E] NEW 0 PC El TC El DELETION
[] REVISION El EZ EXP. DATE: N/A DOES THIS DOCUMENT:
- 1. Supersede or replace another procedure?
13 YES
[NO (If YES, complete 1000.006B for deleted procedure.) (0CAN058107)
- 2.
Alter or delete an existing regulatory commitment?
EYES 13NO (If YES, coordinate with Licensing before implementing.) (0CNA128509)(0CAN049803)
- 3.
Require a 50.59 review per LI-101? (See also 1000.006, Attachment 15)
[
YES 13 NO (If 50.59 evaluation, OSRC review required.)
- 4.
Cause the MTCL to be untrue? (See Step 8.5 for details.)
13 YES
[NO (If YES, complete 1000.009A) (lCAN108904, OCAN099001, 0CNA128509, OCAN049803)
- 5.
Create an Intent Change?
E]YES Z NO (If YES, Standard Approval Process required.)
- 6.
Implement or change IPTE requirements?
13 YES ONO (If YES, complete 1000.143A OSRC review required.)
- 7.
Implement or change a Temporary Alteration?
13YES ONO (If YES, then OSRC review required.)
Was the Master Electronic File used as the source document?
0 YES E] NO INTERIM APPROVAL PROCESS STANDARD APPROVAL PROCESS ORIGINATOR SIGNATURE: (Includes review of Att. 13) DATE:
ORPI IIATOR SIGNATUR..(II3CIudes review of Att. 13) DATE:./
int and Sign name:
4i [9 PHONE#:
Pna 1inanme:
e PHONE #: 4997 SUPERVISOR APPROVAL:
DATE:
INDERENDENT REVIEWER:
DATE:
SRO UNIT ONE :**
DATE:
ENGINEERING:
DATE:
SRO UNIT TWO:**
DATE:
QUALITY:
DATE:
Interim approval allowed for non-intent changes requiring no UNIT SURVEILLANCE COORDINAGTOR (0CNA049803): DATE:
50.59 evaluation that are stopping work in progress.
M\\'
Standard Approval required for intent changes or changes SCTION LEAER: 1 DATE:
requiring a 50.59 evaluation.
4 t /o7-8`0 25 _
- If change not required to support work in progress, QUALITY ASSURANCE:
DATE:
Department Head must sign.
A Ih*
-if both units are affected by change, both SRO signatures OTHERS RS:
DATF:
are required. (SRO signature required for safety related procedures only.)
OT CTION L'15ERS:
DATE:
OTHER SECTION LEADERS:
DATE:
OTHER SECTION LEADERS:
DATE:
OSRC HIRMA/TE NIC REVIEWER: (0CNA049312) DATE:
OTHER SECTION LEADERS:
DATE:
(' 02 Z414 FI A PROVAb 71 ate:
OTHER SECTION LEADERS:
DATE:
-Io/t A" LXR. '
/Jt REQUIRED EFFECTIVE DATE: /-%' 71-".X. 7 OTHER SECTION LEADERS:
DATE:
rJRM TITLE:
FORM NO.
CHANGE NO.
PROCEDUREIWORK PLAN APPROVAL REQUEST 1000.006B 051-00-0
ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE TITLE:Emergency Supplies & Equipment DOCUMENT NO.
CHANGE NO.
1903.060 034-03-0 OPROCEDURE EJWORK PLAN, EXP. DATE N/A PAGE 1 OF 1 El ELECTRONIC DOCUMENT TYPE OF CHANGE:
Ml NEW ED PC El TC 0l DELETION El REVISION El EZ EXP. DATE:
N/A r-~rr t,, I -Li ;-
I,., I IUir:
(Include step # if applicable)
Step 3.4.1 Form 1903.060C page 1 of 3 uD'-Srir' I IUN Vt-CHANGEJ-: (F-or each change made, include sufficient detail to describe reason for the change.)
Deleted "twenty-five full faced respirators and" from the commitment P-41 10 which previously read "Provide twenty-five full faced respirators and sets of protective clothing for emergency TSC personnel."
Deleted RESPIRATORY PROTECTION EOUIP (Canister omask wlodine Canistcr) 25 Expiration Da from form.
flip M T i*
e I
DESCRIPTION OF CHANGE I
I 0
FORM NO.
1000.006C CHANGE NO.
050-00-0 I
I
PROCJWORK PLAN NO.
PROCEDURE/WORK PLAN TITLE:
PAGE:
1 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
03403-0 NOTE This procedure contains Improved Technical Specifications (ITS) content in the following format:
[ITS Example Content ITS]
This content is not valid until after the implementation of Improved Technical Specifications.
TABLE OF CONTENTS SECTION PAGE NO.
i.0 PURPOSE.............................................................
3 2.0 SCOPE...............................................................
3
3.0 REFERENCES
3 4.0 DEFINITIONS.........................................................
4 5.0 RESPONSIBILITIES....................................................
4
6.0 DESCRIPTION
4 7.0 LIMITS AND PRECAUTIONS..............................................
5 8.0 INSTRUCTIONS........................................................
6 8.1 INVENTORY..................................................
6 8.2 MONTHLY PERFORMANCE CHECKS.................................
7 8.3 ANO METEOROLOGICAL TOWER DATA MONTHLY REPORT...............
8 8.4 EMERGENCY MEDICAL LOCKER BATTERY CHECK.....................
8 8.5 EMERGENCY KIT SEAL ACCOUNTABILITY...........................
8 9.0 ATTACHMENTS AND FORMS 9.1 Form 1903.060A, "Control Room Kit Inventory Form"............
10 9.2 Form 1903.060B, "Onsite Radiological Monitoring Kit Inventory Form"..............................................
14 9.3 Form 1903.060C, "Technical Support Center Kit Inventory Form"........................................................
17 9.4 Form 1903.060D, "Main Guard House Kit Inventory Form"........
20 9.5 Form 1903.060E, "Emergency Operations Facility Kit Inventory Form"..............................................
21
PROC.IWORK PLAN NO.
PROCEDUREIWORK PLAN TITLE:
PAGE:
2 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
03403-0 Form 1903.060F, Form 1903.060j, Form 1903.060K, Form 1903.060P, Form 1903.060Q, Checklist"....
Form 1903.060R, Form 1903.060S, Form 1903.060U, Form 1903.060V, "Field Monitoring Kit Inventory Form"........
26 "St. Mary's Hospital Kit Inventory Form"...
28 "First Aid Supplies Inventory Form"..........
31 "Dose Assessment Kit Inventory Forms"......
32 "Monthly Emergency Kit Surveillance 34 "Met Tower Data Monthly Review Form".......
39 "Emergency News Center Kit Inventory Form"
.40 "UAMC Hospital Kit Inventory Form"...........
41 "Emergency Kit Seal Accountability Log" 43 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14
PROC.IWORK PLAN NO.
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PAGE:
3 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 1.0 PURPOSE The purpose of this procedure is to describe the contents of the emergency kits and the periodic inventory requirements for the indicated emergency supplies and equipment.
2.0 SCOPE This procedure applies to the emergency supplies and equipment contained in a
designated emergency kit or room unless otherwise indicated.
This procedure contains monitoring requirements for assessing conformance with limiting conditions for operation of Unit 1 Technical Specifications.
3.0 REFERENCES
3.1 References Used in Procedure Preparation:
3.1.1 Emergency Plan ITS 3.1.2 ANO-i Technical Specifications [ITS Unit 1 SAR Table 7-11A, Unit 2 SAR Table 7.5-3 ITS]
3.2 References Used in Conjunction with this Procedure:
3.2.1 1000.009, "Surveillance Test Program Control" 3.2.2 1601.601, "Maintenance & Calibration of Respiratory Protection Equipment" 3.2.3 1601.463, "Operation of the AM-33 Continuous Air Monitor (NMC)"
3.2.4 1904.002, "Offsite Dose Projections -
RDACS Method" 3.3 Related ANO Procedures:
3.3.1 1601.601, "Maintenance & Calibration of Respiratory Protection Equipment" 3.3.2 1003.005, Fire Prevention Inspection 3.3.3 1601.463, "Operation of the AM-33 Continuous Air Monitor (NMC)"
3.4 Regulatory Correspondence Containing NRC Commitments which are Implemented in this Procedure:
[BOLD] DENOTES COMMITMENTS 3.4.1 0CAN128305 (P-4110) Section 6.1.3 and 1903.060C.
Provide sets of protective clothing for emergency TSC personnel.
3.4.2 0CAN038313 (P-4141) Form 1903.060C.
Radiation monitor device is available in the TSC that will have both visual and audible alarms for monitoring radiation inside the TSC.
PROC/WORK PLAN NO.
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PAGE:
4 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 3.4.3 LIC-94-293 (P-14103) 1903.060A, Spare SCBA bottles have been verified to contain 2000 psi or greater.
3.4.4 0CAN118202 (P-4067) Form 1903.060Q - Monthly emergency kit equipment operability checks.
4.0 DEFINITIONS 4.1 Physical Inventory -
The counting of individual items within the kits to ensure minimum supply.
5:.0 RESPONSIBILITIES 5.1
- Manager, Emergency Planning The Manager, Emergency Planning is responsible for ensuring the periodic inventory of emergency kits described in this procedure and for coordinating the maintenance and replacement of equipment and supplies contained in these kits.
5.2 Manager, Radiation Protection/chemistry The Manager, Radiation Protection/Chemistry is responsible for the monthly checklist and periodic inventory of the emergency kits described in this procedure.
5.3 Surveillance Test Coordinator The Surveillance Test Coordinator is responsible for scheduling the Radiation Instruments Monthly Battery Checks in accordance with Tech.
Specifications.
5.4 Fire Prevention Coordinator The Fire Prevention Coordinator is responsible for ensuring the periodic inventory of fire lockers and carts described in Procedure 1003.005, "Fire Prevention Inspection" and for coordinating the maintenance and replacement of equipment and supplies contained in those lockers and carts.
6.0 DESCRIPTION
6.1 The following emergency kits are maintained at Arkansas Nuclear One for use in the event of an emergency:
6.1.1 Control Room Kit(Unit 1 Control Room Area; shared by both units) 6.1.2 Onsite Radiological Monitoring Kit (Operational Support Center) 6.1.3
[Technical Support Center Kit (Technical Support Center)]
6.1.4 Main Guard House Kit
PROCJWORK PLAN NO.
PROCEDUREIWORK PLAN TITLE:
PAGE:
5 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 6.2 6.3 7.0 LIMITS 7.i 7.2 7.3 7.4 7.5 7.6 7.7 7.8 6.1.5 Emergency Operations Facility Kit 6.1.6 Field Monitoring Kits A, B, C and D (Emergency Operations Facility) 6.1.7 Dose Assessment Kit (Emergency Operations Facility) 6.1.8 Emergency News Center Kit (Emergency Operations Facility) 6.1.9 Hospital Kit - St. Mary's Hospital, Russellville and University of Arkansas Medical Science Center (UAMSC),
Little Rock.
6.1.10 Fire Lockers (Unit 1 Turbine Bldg. 354' el., Unit 2 Turbine Bldg.
354' el., Turbine Bldg. 386' el., Unit 1 Auxiliary Bldg 386' el.)
6.1.11 First Aid Kits (Medical Lockers and Nurse's Station) 6.1.12 Initial Environmental Sampling Kit A Nurse's Station is maintained at Arkansas Nuclear One for use by a physician in the event of an emergency.
Contents of the emergency kits are listed on the forms attached to this procedure.
AND PRECAUTIONS If circumstances prevent surveillance in accordance with the current surveillance schedule refer to 1000.009. "Surveillance Test Program Control" for instructions.
Emergency kits shall be checked at the intervals specified by the Manager of Emergency Planning and the Surveillance Test Schedule.
Checklists shall be completed monthly.
Inventory lists shall be completed quarterly or after each use.
If the Emergency Kit has been kept intact per "Emergency Kit Seal Accountability",
a physical inventory is not required.
If kit is found unsealed, the contents of the kit shall be inventoried except for the following: First Aid Supplies Kit and ENC Kit.
When performing an inventory, the applicable forms shall be completed.
Discrepancies should be noted on applicable form.
Discrepancies shall be resolved or corrective actions shall be initiated.
This should be indicated on the inventory form.
When completed, the forms should be forwarded to Emergency Planning for review.
Emergency Planning will forward the forms to Records.
PROC./WORK PLAN NO.
PROCEDUREIWORK PLAN TITLE:
PAGE:
6 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 7.9 Monthly battery checks of portable survey-instruments are required per ITS Unit I Technical Specification 4.l.a; Table 4.1-1, Item 40 [ITS Portable survey instrument battery checks are required monthly.
(Unit 1 SAR Table 7-l1A, Unit 2 SAR Table 7.5-3) ITS]
8.0 INSTRUCTIONS 8.1 Inventory 8.1.1 Emergency kit inventory is required if any of the following conditions exist:
A.
The kit has been used.
B.
The kit is found unsealed.
C.
The kit is due for a scheduled quarterly inventory.
8.1.2 Kits that have been maintained by seal accountability do not require a physical inventory (Refer to section 8.5).
Performance checks must be performed.
8.1.3 IF kit meets the requirements for inventory, THEN perform a complete inventory.
8.1.4 IF first quarter of year, THEN replace all batteries contained within the kits that will expire prior to the first quarter of the following year and all batteries that do not have an expiration date.
Batteries contained in radiological instruments are exempt.
8.1.5 Perform a physical inventory by ensuring that the minimum quantity for each item listed on the appropriate inventory form is contained within the kit.
This step not required if the kit has been maintained by "Emergency Kit Seal Accountability", section 8.5.
8.1.6 Ensure expiration dates have not been exceeded nor will be exceeded within the next quarter on appropriate items except batteries.
(Batteries are checked 1st quarter of year) 8.1.7 Inspect O-Rings on sample heads.
Check for hardness or cracks that may cause the sample head to fail.
Replace as necessary.
8.1.8 Perform a operability check and battery check of all battery powered equipment.
Ensure instruments are left in the off position and batteries are removed when complete, if appropriate.
(Radiation instruments are covered by monthly checks.)
8.1.9 Ensure that the emergency kits are maintained clean and orderly.
8.1.10 Marking items on the inventory form as "SAT" implies that all of the above conditions have been met.
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7 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 8...11 Upon completion of inventory, ensure the kit is locked and contains a seal.
8.1.12 Complete appropriate forms and forward to Emergency Planning for review.
8.2 Monthly Performance Checks NOTE Respirators are maintained in accordance with current HP procedures.
8.2.1 Check and record the calibration due dates for the radiological instruments in the kit.
Replace or recalibrate any instrument whose calibration due date will expire prior to the next scheduled inspection.
8.2.2 Perform an operability check on each instrument listed on Form 1903.060Q as follows:
A.
Perform a physical condition check on each instrument.
B.
Perform a battery check on appropriate instruments.
C.
Perform a qualitative source check on appropriate instruments.
D.
Perform an operational test on appropriate equipment.
8.2.3 Ensure radiation instruments are powered by AC power at all times where appropriate to ensure batteries are charged.
8.2.4 Plug in and allow to charge for approximately one hour the following items (unless they are continuously plugged in):
A.
Frisker B.
Self Contained Air Sampler C.
EOF Kit Battery (used to check 12 VDC air samplers) 8.2.5 Ensure all radiation instruments are turned off where appropriate.
8.2.6 Marking items on the checklist form as "SAT" implies that all of the above conditions have been met.
8.2.7 Document the monthly instrument check on Form 1903.060Q "Monthly Emergency Kit Surveillance Checklist".
8.2.8 Upon completion of monthly checks, ensure the kit is locked and contains a seal.
8.2.9 Forward all completed forms to Emergency Planning for review.
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8 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 8.3 ANO Meteorological Tower Data Monthly Report 8.3.1 Perform a monthly review of the Summary Report of "Entergy Operations Inc.,
ANO Meteorological Tower Data Monthly Report."
Document this review on 1903.060R, "Met Tower Data Monthly Review Form".
8.4 Emergency Medical Locker Battery Check 8.4.1 Perform a bi-monthly exchange of Emergency Medical Team Radio Batteries.
Document this on Form 1903.060T, "Medical Team Radio Battery Surveillance".
8.5 Emergency Kit Seal Accountability 8.5.1 Each emergency kit must have a seal attached such that the kit cannot be used unless the seal is broken. The First Aid Supplies and ENC kits do not require a seal.
8.5.2 IF Emergency Kit is to be opened, THEN log the current seal number on Form 1903.06OV.
If this kit is being opened for an actual emergency event, this step is not required.
8.5.3 IF Emergency kit supplies are used,
- THEN, upon completion of use, perform kit inventory.
8.5.4 Upon closure of Emergency Kit, complete the remaining information on Form 1903.060V and install a new seal.
Log seal number on form 1903.060V.
8.5.5 Forward completed forms to Emergency Planning.
9.0 ATTACHMENTS AND FORMS 9.1 Form 1903.060A, 9.2 Form 1903.060B, 9.3 Form 1903.060C, 9.4 Form 1903.060D, 9.5 Form 1903.060E, 9.6 Form 1903.060F, 9.7 Form 1903.060J, 9.8 Form 1903.060K, 9.9 Form 1903.060P, 9.10 Form 1903.060Q, "Control Room Kit Inventory Form" "Onsite Radiological Monitoring Kit Inventory Form" "Technical Support Center Kit Inventory Form" "Main Guard House Kit Inventory Form" "Emergency Operations Facility Kit Inventory Form" "Field Monitoring Kit Inventory Form" "St. Mary's Hospital Kit Inventory Form" "First Aid Supplies Inventory Form" "Dose Assessment Kit Inventory Forms" "Monthly Emergency Kit Surveillance Checklist"
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9 of 43 1903.060 EMERGENCY SUPPLIES & EQUIPMENT CHANGE:
034-03-0 9.11 Form 1903.060R, "Met Tower Data Monthly Review Form" 9.12 Form 1903.060S, "Emergency News Center Kit Inventory Form" 9.13 Form 1903.060U, "UAMC Hospital Kit Inventory Form" 9.14 Form 1903.060V, "Emergency Kit Seal Accountability Log"
Page 10 of 43 Page I of 4 LOCATION:
Unit 1 Control Room
[]
Has been used F-Found unsealed E)
Due for inventory F1 Kit Seal Accountability No Physical Inventory Required.
INVENTORY LIST Required Corrective Equipment Quantity Sat Actions SURVEY INSTRUMENTS High Range Ion Chamber 2
Frisker w/Probe 1
Air Sampler
("10 VAC) i Air Sampler (Battery) 1 Sample Head 2
Sample Head O-Rings N/A Check Source SAMPLING SUPPLIES Watch (P) 2 Cloth Smear 50 Particulate Air Sample Filter 20 Silver Zeolite Cartridge 20 Expiration Date:
PERSONNEL MONITORING EQUIPMENT FORM TITLE:
KTFORM NO.
CHANGE CONTROL ROOM KIT INVENTORY FORM 1903.060A 034-03-0
.Dosimeter (0 -
200R)
Dosimeter (0 -
5R)
Dosimeter (0
200mR)
Dosimeter Charger (P)
TLD Badge (include 1 as BKG)
Page 11 of 43 Page 2 of 4 Required Corrective Equipment Quantity Sat Actions RESPIRATORY PROTECTION EQUIPMENT SCBA Units (6 -Unit 1 CR, 6 -Unit 2 CR, all medium masks) 12
'Spare SCBA Bottle 12 Extra SCBA Mask (4 Large, 4 Small) 8 Canister Mask w/Iodine Canister 12 Expiration Date:
Iodine Canister(Spare) 12 Expiration Date:
PROTECTIVE CLOTHING Anti-C Clothing 12 sets Surgeon Gloves 1 Box Maslin 1 bundle Masking Tape 2 rolls Duct Tape 2 rolls Safety Glasses (Beta Protection) 12 pairs II POSTING MATERIALS Radiological Posting Signs 12 "Radiation Area" Insert 6
"High Radiation Area" Insert 6
"RWP Required for Entry" Insert 6
"Airborne Radioactivity Area" Insert 6
"Respiratory Protection Required" Insert 6
"Notify HP Prior to Entry" Insert 6
"Contamination Area" Insert 6
"High Contamination Area" Insert 6
I FORM TITLE:
FORM NO.
CHANGE CONTROL ROOM KIT INVENTORY FORM I
1903.060A 034-03-0
Page 12 of 43 Page 3 of 4 Required Corrective Equipment Quantity Sat Actions "Radioactive Material" Insert 12 Blank Insert 6
Radiation Warning Rope/Ribbon 1 roll Yellow and Magenta Border Tape 4 rolls Control Room Survey Maps 5 copies Step-Off Pads 5
MISCELLANEOUS 20 KI Tablets, (Bottle of 14 Tablets)
Bottles Expiration Date:
Pencil 12 Magic Marker 2
Clipboard 2
Cutting Tool 1
Calculator (P) 2 Plug Adapter (household to Twistlock) 2 Flashlight (P) 4 Bulbs (Spare) 4 10 Mile EPZ Map 2
Meter Bags or equiv.
10 Ziplock Baggies or equiv.
10 2Printer Paper 1
Extension Cord (50-ft)
Emergency Telephone Directory 1
FORM TITLE:
FORM NO.
CHANGE J CONTROL ROOM KIT INVENTORY FORM 1 903.060A 034-03-0
Page 13 of 43 Page 4 of 4 Required S
Corrective Equipment Quantity Sat Actions Batteries "D" Cell 16 9-Volt 12 1 -
Indicates that spare SCBA bottles have been verified to contain Ž 2000 psi pressure.
2 -Approximately 500 sheet bundle (P)
- Requires performance check Performed By Reviewed By Emergency Planning Manager Date Date Date I FORM TITLE:
CIFORM NO.
CHANGE CONTROL ROOM KIT INVENTORY FORM 1903.060A 034 0 I
Page 14 of 43 Page 1 of 3 LOCATION:
Maintenance Facility LI Has been used
[]
Found unsealed jj Due for inventory Fj Kit Seal Accountability -
No Physical Inventory Required Required Corrective EquipmentQuantity Sat Actions SURVEY INSTRUMENTS High Range Ion Chamber 1
Beta-Gamma Survey Meter 1
Gamma Survey Meter w/Probe 1
Frisker w/Probe 1
Air Sampler (110 V) 1 Air Sampler (Battery) 1 Sample Head 4
Sample Head O-Rings N/A Check Source 1
SAMPLING SUPPLIES Watch (P) 2 Cloth Smear i00 Particulate Air Sample Filter 50 Maslin 1 Bundle Silver Zeolite Cartridge 20 Expiration Date:
PERSONNEL MONITORING EQUIPMENT Dosimeter (0-200mR) 80 Dosimeter (0-5R) 80 Dosimeter (0-200R) 20 Dosimeter Charger (P)
TLD Badge (include 1 as BKG) 10 FORM TITLE:
FORM NO.
ICHANGE ONSITE RADIOLOGICAL MONITORING KIT INVENTORY FORM 1903.060B 034-03-0
Page 15 of 43 Page 2 of 3
Required Corrective Equipment Quantity Sat Actions RESPIRATORY PROTECTION EQUIP SCBA Units 4
'Spare SCBA Bottles 4
Canister Mask w/Iodine Canister 4
Expiration Date:
Iodine Canister (Spare) 4 lExpiration Date:
PROTECTIVE CLOTHING Anti-c Clothing 50 sets Masking Tape 3 rolls Duct Tape 3 rolls POSTING MATERIALS Radiological Posting Signs 10 "Radiation Area" Insert 5
"High Radiation Area" Insert 5
"RWP Required for Entry" Insert 5
"Airborne Radioactivity Area" Insert 5
"Respiratory Protection Required" Insert 5
"Notify HP Prior To Entry" Insert 5
"Contamination Area" Insert 5
"High Contamination Area" Insert 5
"Radioactive Material" Insert 10 Blank Insert 5
Radiation Warning Rope/Ribbon 1 roll Yellow and Magenta Border Tape 6 rolls Step-Off Pads 10 I FORM TITLE:
ONSITE RADIOLOGICAL MONITORING KIT INVENTORY FORM FORM NO.
ICHANGE 1903.060B
'1034-03-0
Page 16 of 43 Page 3 of 3 Required Corrective Equipment Quantity sat Actions MISCELLANEOUS 20 KI Tablets, (Bottle of 14 Tablets)
Bottles Expiration Date:
Pencil 12 Magic Marker 2
Clipboard 3
Cutting Tool 1
Calculator (P) 1 Plug Adapter (household to Twistlock) 1 Flashlight (P) 3 Bulbs (Spare) 3 10 Mile EPZ Map 2
Meter Bags or equiv.
15 Zip-Lock Baggies 30 Security Badge Clips 15 Outside Gas Pump Key 1
Survey Maps (In OSC) 10 ea Batteries "D" Cell 12 "C" Cell 12 9-Volt 12
- Indicates that spare SCBA bottles pressure.
(2) - Requires performance check Performed By Reviewed By Emergency Planning Manager have been verified to contain Ž 2000 psi Date Date Date ________
I FORM TITLE:
I ONSITE RADIOLOGICAL MONITORING KIT INVENTORY FORM FORM NO.
I CHANGE 1903.060B 034-03-01
'i I
I
Page 17 of 43 LOCAl Q
[]
PION:
Page I of 3 Technical Support Center (3rd Floor Administration Building)
Has been used Found unsealed Due for inventory Kit Seal Accountability -
No Physical Inventory Required E Required Corrective Equipment Quantity Sat Actions SURVEY INSTRUMENTS Gamma Survey Meter w/Probe
[Frisker w/Detection Chamber]
1 Check Source 1
Air Sampler Sample Head 2
Sample Head O-Rings N/A PERSONNEL MONITORING EQUIPMENT Dosimeter (0-500 mR) 20 Dosimeter Charger (P) 1 TLD Badge (include I as background) 15 PROTECTIVE CLOTHING h Disposable Suits) 25 SAMPLING SUPPLIES Wa-ch (P) 1 Silver Zeolite Cartridge 10 Expiration Date:
FORM TITLE:
FORM NO.
CHANGE ITECHNICAL SUPPORT CENTER KIT INVENTORY FORM I1903.060C 034 Page 18 of 43 Page 2 of 3 Required Corrective Equipment Quantity Sat Actions POSTING MATERIALS Radiological Posting Signs 3
"Radiation Area" Insert 3
"High Radiation Area" Insert 3
"RWP Required for Entry" Insert 3
"Airborne Radioactivity Area" Insert 3
"Respiratory Protection Required" Insert 3
"Notify HP Prior to Entry" Insert 3
"Contamination Area" Insert 3
"High Contamination Area" Insert 3
"Radioactive Material" Insert 3
Blank Insert 3
Radiation Warning Rope/Ribbon 1 roll Yellow and Magenta Border Tape 1 rolls Admin Building Survey Maps 5 copies Step-Off Pads 3
MISCELLANEOUS 20 KI Tablets, (Bottle of 14 Tablets)
Bottles Expiration Date:
Pencil
-2 Note Pad 3
Clipboards 1
Flashlight (P) 3 Bulbs (Spare) 3 10 Mile EPZ Map 1
IFORM TITLE:
FORMNO.
CHANGE TECHNICAL SUPPORT CENTER KIT INVENTORY FORM 1903.060C 034-03-0
Page 19 of 43 Page 3 of 3 RequiredqI Corrective Equipment Quantity.
Sat Actions Batteries "C" Cell 12 "D" Cell 12 (P)
- Requires performance check Performed By Date Reviewed By Date Emergency Planning Manager Date IFORM TITLE:
FORM NO.
TFHNGEý TECHNICAL SUPPORT CENTER KIT INVENTORY FORM 1903.060C 034-03-0
Page 20 of 43 Page. of 1 LOCATION:
Main Guard House F1 Has been used Ej Found unsealed F-Due for inventory RI Kit Seal Accountability -
No Physical Inventory Required Equpmet IRequired atCorrective Equipment Quantity Sat Actions EVACUATION EQUIPMENT Vests 12 Bull Horn (P) 1 RESPIRATORY PROTECTION EQUIPMENT Canister Mask w/Iodine Canister 2
Expiration Date:
MISCELLANEOUS Flashlight (P) 3 Bulbs (Spare) 3 BATTERIES "AA" Cel-16 "D" Ce'!
12 (2)
- Requires performance check Performed By Reviewed By Emergency Planning Manager Date Date Date I FORM TITLE:
MIFORM NO.
CHANGE j
I.MAIN GUARD HOUSE KIT INVENTORY FORM I1903.060D 1034-03-0
Page 21 of 43 Page 1 of 5 LOCATION:
L]
F1 M]
M]
Emergency Operations Facility (First Floor Room 1I0)
Has been used Found unsealed Due for inventory Kit Seal Accountability -
No Physical Inventory Required Equpmet IRequired StCorrective Equipment Quantity Sat Actions SURVEY INSTRUMENTS Gamma Survey Meter 3
High Range Ion Chamber 1
Frisker w/Probe 2 ea.
Air Sampler (110 V) 2 Air Sampler (12 V) 1 Sample Head 4
Sample Head O-Rings N/A Check Source 1
Extension Cords 2
SAMPLING SUPPLIES Watch (P) 1 Cloth Smear 250 Particulate Air Sample Filter 100 Maslin I Bundle Silver Zeolite Cartridge 70 Expiration Date:
2Sample Bottles ( 1 gal.)
100 E-F Survey Map 5 ea.
I FORM TITLE:
EMERGENCY OPERATIONS FACILITY KIT INVENTORY FORM FORM NO.
CHANGE 1903.060E 034-03-0
Page 22 of 43 Page 2 of 5 Required Corrective Equipment Quantity Sat Actions PERSONNEL MONITORING EQUIPMENT Dosimeter (0-5) 10 Dosimeter (0-200mR) 50 Dosimeter Charger (P) 1 TLD Badge (include 1 as BKG) 20 RESPIRATORY PROTECTION EQUIPMENT Canister Mask w/Iodine Canister 13 Expiration Date:
Iodine Canister (Spare) 5 Expiration Date:
SCBA Units 5
'Spare SCBA Bottles 10 PROTECTIVE CLOTHING Anti-C Clothing 30 sets Masking Tape 3 rolls Duct Tape 3 rolls INITIAL ENVIRONMENTAL SAMPLING KIT Shovel Sample Bottles, i Gal.
3 Shears 1
Meter Bags or equiv.
10 Duct Tape 1 roll Paper Towels 1 bundle Surgeon Gloves 25 pair Carrying Bag 1
FORM TITLE:
OFORM NO.
CHANGE EMERGENCY OPERATIONS FACILITY KIT INVENTORY FORM 1903.060E 03403-0
Page 23 of 43 Page 3 of 5 Required i
Corrective Equipment Quantity Sat Actions I
Initials MISCELLANEOUS 20 IKI Tablets, (Bottle of 14 Tablets)
Bottles iExpiration Date:
Pencil 12 Magic Marker 3
Clipboard 3
Cutting Tool 2
Calculator (P) 1 Plug Adapter (household to Twistlock) 2 Flashlight (P) 3 Bulbs (Spare) 3 Meter Bag or equiv.
30 Zipiock Baggies or equiv.
30 PERSONNEL DECONTAMINATION SUPPLIES Scissors 2
Razor 4
Manicure Set 1
i Wash Cloths 100 Towels I
100 Bristle Brush 30 Cotton Balls pkg.
Cotton Swabs lpkg.
FORM TITLE:
EMERGENCY OPERATIONS FACILITY KIT INVENTORY FORM FORM NO.
CHANGE 1903.060E 034034
Page 24 of 43 Page 4 of 5 Required Corrective Equipment Quantity Sat Actions Hand Soap (Regular) 3 "Lava" Soap 3
"Rad-Con" 4 cans Shaving Cream 2 cans "Tide" 1 box Corn Meal 1 pkg.
Chlorox bt!.
Eyewash Solution w/Applicator 2
Paper Clothing 30 Bioassay Sample Containers 50 POSTING MATERIALS Radiological Posting Signs 40 "Radiation Area" Insert 20 "High Radiation Area" Insert 20 "RWP Required for Entry" Insert 20 "Airborne Radioactivity Area" Insert 20 "Respiratory Protection Required" Inser%
20 "Notify HP Prior to Entry" Insert 20 "Contamination Area" Insert 20 "High Contamination Area" Insert 20 "Radioactive Material" Insert 40 Blank Insert 20 Radiation Warning Rope/Ribbon 2 rolls Yellow and Magenta Border Tape 6 rolls Step-Off Pads 20 I FORM TITLE:
EMERGENCY OPERATIONS FACILITY KIT INVENTORY FORM FORM NO.
CHANGE 1903.060E 034-03-0
Page 25 of 43 Page 5 of 5 Required Corrective Equipment Quantity Sat
.Actions Batteries 9-volt 6
"C" Cell 36 "D" Cell 12 Indicates that spare SCBA bottles have been verified to contain Ž 2000 psi pressure.
2-Located outside sealed kit (P)
- Requires performance check Performed By Reviewed By Emergency Planning Manager Date Date Date FORM TITLE:
FORM NO.
CHANGEJ EMERGENCY OPERATIONS FACILITY KIT INVENTORY FORM I1903.060E 1034-03-0
Page 26 of 43 Page I of 2 LOCATION:
Emergency Operations Facility (First Floor Room 110)
Field Monitoring Kit jj A
j]
B j]
C jj D
[]
Has been used Ml Found unsealed
[]
Due for inventory (All kits are required to be inventoried)
El Kit Seal Accountability No Physical Inventory Required Required A
B C
D Corrective Equipment Quantity Sa Sa Sa Sa Actions t
t t
t SURVEY INSTRUMENTS 1,2High Range Ion Chamber 1
l2Gam.ma Survey Meter w/Probe 1
'Frisker w/Probe 1
'Air Sampler (12 VDC) 1 Sample Head 2
Sample Head O-Rings N/A Check Source 1
SAMPLING SUPPLIES Watch (P) 1 Cloth Smear 25 Particulate Air Sample Filter 25 Ziplock Baggies or equiv.
25 Forceps or equiv.
1 Surgeon Gloves 50 pr Silver Zeolite Cartridge 20 Expiration Date:
PERSONNEL MONITORING EQUIPMENT Dosimeter (0-500mR) 3 Dosimeter Charger (P) 1 FIELD MONITORING KIT INVENTORYFFORM 1903.060F 0343-0
Page 27 of 43 Page 2 of 2 Required A
B C
D Corrective Equipment Quantity Sa Sa Sa Sa Actions t
z:
t PROTECTIVE CLOTHING Masking Tape 1 roll Duct Tape 1 roll MISCELLANEOUS 4
KI Tablets, (Btl of 14 Tablets)
Bottles Expiration Date:
Pencil 3
Magic Marker 2
Grease Pencil 2
Clipboard 1
Cutting Tool 1
Flashlight (P) 3 Bulbs (Spare) 3 10 Mile EPZ Map 1
Russellville City Map Dardaneile City Map 1
Calculator (P) 1 Meter Bags or equiv.
15 Batteries "C
" Cell 4
" D" CelI 12 (P)
- Requires performance check May be stored outside of kit.
2 The Merlin Gerin WR-Telepole or equivalent can perform both low (0.05 mr/hr) range and high (1000 R/hr) range measurements and may be used in place of both of the listed instruments.
Performed By Date Reviewed By Date Emergency Planning Manager Date FORMFIELD MONITORING KITT
- FORM 3FORMNO. CHANGE
Page 28 of 43 Page 1 of 3 LOCATION:
St. Mary's Hospital
[]
Has been used El Found unsealed El Due for inventory
[]
Kit Seal Accountability -
No Physical Inventory Required I
~Required atCorrective Equipment Quantity StActions Instruments Beta-Gamma Survey Meter 1
Frisker w/Probe 1
Air Sampler (110 V) 1 Sample Head 1
Sample Head O-Rings N/A Check Source 1
SAMPLING SUPPLIES Watch (P)
Cloth Smear 200 Particulate Air Sample Filters 25 Ziplock Baggies or equiv.
25 Charcoal Cartridge 20 Expiration Date:
PERSONNEL MONITORING EQUIPMENT Dosimeter (0-200mR) 10 Dosimeter Charger (P) 1 TLD Badge (include 1 as BKG) 15 PROTECTIVE CLOTHING I
Anti-C Clothing 2 sets____
FORM TITLE:
FORM NO.
CHANGE j ST. MARY'S HOSPITAL KIT INVENTORY FORM 1903.060J 034-03-0
Page 29 of 43 Page 2 of 3 Required Corrective Equipment Quantity Sat Actions POSTING MATERIALS Radiological Posting Signs
ý20 "Radiation Area" Insert 10 "High Radiation Area" Insert 10 "RWP Required for Entry" Insert 10 "Health Physics Escort Required" Insert 10 "Airborne Radioactivity Area" Insert 10 "Respiratory Protection Required" Insert 10 "Notify HP Prior to Entry" Insert 10 "Contamination Area" Insert 10 "High Contamination Area" Insert 10 "Radioactive Material" Insert 20 Blank Insert 10 Radiation Warning Rope/Ribbon 1 roli Yellow and Magenta Border Tape 6 rolls Step-Off Pads MISCELLANEOUS Pencil 6
Magic Marker 2
Clipboard 1
Flashlight (P) 1 Bulbs (Spare)
I Meter Bags or equiv.
15 I
FORM TITLE:
FORM NO.
CHANGE IST.
MARY'S HOSPITAL KIT INVENTORY FORM 11903.060.1J 034-03-0
Page 30 of 43 Page 3 of 3 Performed By Reviewed By Emergency Planning Manager Date Date Date IFORM TITLE SFORM NO.
CHANGE IST.
MARY'S HOSPITAL KIT INVENTORY FORM
-r 1903.060J 1034-03-0 Required Corrective Equipment Quantity Sat Actions PERSONNEL DECONTAMINATION SUPPLIES "Rad-Con" 4 cans "Tide" I box Corn Meal 1 pkg.
Chlorox 1 btl.
Batteries 9-Volt 6
"D" Cell 4
(P)
- Requires performance check
Page 31 of 43 Page l of i LOCATION:
Nurse's Station, Medical Lockers E]
Has been used M
Due for inventory Required Corrective Equipment Quantity Sat Actions FIRST AID KITS/SUPPLIES Nurse's Station 1
Medical Locker U1 3541 1
Medical Locker U2 354' 1
Medical Locker UI/U2 386' 1
Medical Kit CA-!
Outage Medical Kit 1
Medical Kit Central Support 1
Building (CSB)
Performed By Reviewed By Emergency Planning Manager Date Date Date I
FORM TITLE:
FORM NO.
CHANGE FIRST AID SUPPLIES INVENTORY FORM 190.06K 1034-03-0
Page 32 of 43 Page I of 2 LOCATION:
Emergency Operations Facility (Second Floor Outside Room 260)
[]
Has been used El Found unsealed El Due for inventory El Kit Seal Accountability -
No Physical Inventory Required Required Corrective Equipment Quantity Sat Actions Supplies Pocket Calculators (P) 4 Printer Paper 1 pkg Cork Board 1
EPZ Map (I mile) 10 EPZ Map (10 mile) 10 Dry Erase Markers 10 Scotch Tape 2 rolls Felt-Tip Pens 10 Ball-Point Pens 10 Pencils 10 Binder Clips 25 Push-Pins and Labels 2 boxes Rulers 4
Clipboard Dardaneiie city map 1
Russellville city map 1
Stapler 1
Staples I box Paper Towels 1 pack 1
Liquid Board Cleaner bottle FORM TITLE:
FORM NO.
CHANGE DOSE ASSESSMENT KIT INVENTORY FORM 1903.060P 034-03-0
Page 33 of 43 Page 2 of 2 Required Corrective QEquipment uantity Actions Batteries IWatch/Calculator 10 (P)
- Requires performance check Performed By Reviewed By Emergency Planning Manager Date Date Date SFORM TITLE:
FORM NO.
[ CHANGE DOSE ASSESSMENT KIT INVENTORY FORM 1903.060P 034-03-0 FOR TIL:FRN.
CAG
Page 34 of 43 Page I of 5 TECHNICAL SUPPORT CENTER KIT Note 1:
The monthly operational check is satisfied by performing the "Daily Operational Checks" in procedure 1601.463.
CONTROL ROOM KIT Instrument Calibration Instrument Type Number Due Date Sat
- Ion Chamber
'Ion Chamber
-Frisker HP-210 Detection Chamber or equiv Air Sampler
!L0 V Air Sampler Battery Dosimeter 0-200 Rem N/A Dosimeter 0-5 Rem N/A Dosimeter 0-200 mRem N/A FORM TITLE:
EFORM NO.
CHANGE
[MONTHLY EMERGENCY KIT SURVEILLANCE CHECKLIST]
1903.060Q 034-03-0 Instrument Calibration Instrument Type Number Due Date Sat
'Frisker
'Gamma Survey Meter Air Sampler IIOV HP-210 Detection Chamber or equiv Dosimeter 0-500 mRem N/A
Page 35 of 43 Page 2 of 5 EMERGENCY OPERATIONS FACILITY KIT Instrument Calibration Instrument Type Number Due Date Sat E-530
'Gamma Survey Meter or equiv E-530
'Gamma Survey Meter or equiv E-530
'Gamma Survey Meter or equiv
'Ion Chamber
'Frisker
'Frisker HP-210 Detection Chamber or equiv HP-210 Detection Chamber or equiv Air Sampler 110 V Air Sampler 110 V Air Sampler 12 VDC Dosimeter 0-5 Rem N/A Dosimeter 0-200 mRem N/A ST MARY'S HOSPITAL KIT Instrument Calibration Instrument Type Number Due Date Sat iBeta Gamma iFrisker HP-210 Detection Chamber or equiv Air Sampler i10 V Dosimeter 0-200 mRem N/A FORM TITLE:
E CjFORM NO.
ICHANGE
[MONTHLY EMERGENCY KIT SURVEILLANCE CHECKLIST]
1903.060Q 034-03-0
Page 36 of 43 Page 3 of 5 FIELD MONITORING KIT A Instrument Calibration Instrument Type Number Due Date Sat 1,2Ion Chamber E-530 1' 2Gamma Survey Meter or equiv
- Frisker HP-2i0 Detector or equiv Air Sampler 12 VDC Dosimeter 0-500 mRem N/A FIELD MONITORING KIT B Instrument Calibration Instrument Type Number Due Date Sat
-,2Ion Chamber E-530
' 2Gamma Survey Meter or equiv
'Frisker HP-210 Detector or equiv Air Sampler 12 VDC Dosimeter 0-500 mRem N/A FIELD MONITORING KIT C Instrument Calibration Instrument Type Number Due Date Sat Ion Chamber E-30
- 2Gamma Survey Meter or equiv
'Frisker HP-210 Detector or equiv Air Sampler 12 VDC Dosimeter 0-500 mRem N/A FORMMTITLEMERGENCY KIT FORML NO CHANGE
Page 37 of 43 Page 4 of S FIELD MONITORING KIT D Instrument Calibration Instrument Type Number Due Date Sat "1,2Ion Chamber E-530 "1,
2Gamma Survey Meter or equiv
'Frisker HP-210 Detector or equiv Air Sampler 12 VDC Dosimeter 0-500 mRem N/A UAMC HOSPITAL KIT Instrument Calibration Instrument Type Number Due Date Sat
'Beta Gamma iFrisker HP-2l0 Detection Chamber or equiv Air Sampler 110 V FORM TITLE FORM NO.
CHANGE
[MONTHLY EMERGENCY KIT SURVEILLANCE CHECKLIST]
1903.060Q 034-03.0
Page 38 of 43 Page 5 of 5 ONSITE RADIOLOGICAL MONITORING KIT Instrument Calibration Instrument Type Number Due Date Sat lIon Chamber
'Beta-Gamma Survey Meter
'Gamma Survey Meter
'Frisker HP-210 Detection Chamber or equiv Air Sampler Battery Air Sampler ii0 V Dosimeter 0-200 Rem N/A Dosimeter 0-5 Rem N/A Dosimeter 0-200 mRem N/A i
- Required by Tech Specs.
2 The Merlin Gerin WR-Telepoles may be used in place of both of the listed instruments.
This telepole has a range of 0.05 mRem/hr to 1000 Rem/hr.
Corrective Actions Init./Date Performed By Reviewed By Emergency Planning Manager Date Date Date I FORM TITLE:
E CFORM NO.
CHANGE
[MONTHLY EMERGENCY KIT SURVEILLANCE CHECKLIST]
1903.060Q 034 0 I
Page 39 of 43 LOCATION:
Emergency Planning Department INSTRUCTIONS:
Page 1 of I
- 1.
Perform a monthly review of the Summary Report of "Entergy Operations Inc.,
ANO Meteorological Tower Data Monthly Report".
A.
The purpose of the review will be to assure that the 90% data recovery goal, specified in Reg. Guide 1.23, is satisfied and provide instructions for initiation of corrective action if necessary.
B.
This review will be performed on a monthly basis.
C.
Acceptance criteria Ž 90% Data Recovery.
- 2.
Monthly percentage readings:
A.
Horizontal Wind Direction @10 M or @57 M B.
Horizontal Wind Speed @10 M or @57 M C.
Delta Temp/Stab Class 10 -
57 M OR Sig Theta/Stab Class 57 M
- 3.
Results A.
This review is for the month and year of:
Satisfactory - All group readings Ž 90%
Unsatisfactory -
Any group reading < 90%
B.
IF unsatisfactory, THEN verify that meteorological data was unavailable (using RDACS or other means).
C.
IF data was unavailable, THEN initiate a Condition Report in accordance with Procedure 1000.104, "Condition Reporting and Corrective Action".
Condition Report Number:
Performed By:
Reviewed By:
Date:
Date:
I FORM TITLE:
FORM NO.
CHANGE IMET TOWER DATA MONTHLY REVIEW FORM I1903.060R 1034-03-0
Page 40 of 43 Page I of I LOCATION:
Emergency Operations Facility (Second Floor Room 240)
LI Has been used LI Due for inventory Required Corrective Equipment Quantity Sat Actions Media Packets 100 Emergency Instruction Booklets 20 Light Pointer 1
Stick Pointer 1
Clipboard 4
Overhead (books -
Unit 1 and 2
Unit 2)
Dry-Erase Markers 5
Paper Towels 1 pack Liquid Board Cleaner 1 bottle Media ID Badges 100 Note Pads 10 Performed By Reviewed By Emergency Planning Manager Date Date Date IFORM TITLE:
FORM NO.
CHANGE EMERGENCY NEWS CENTER KIT INVENTORY FORM 1903.060S 034-03-0
Page 41 of 43 Page I of 2 LOCATION:
University of Arkansas Medical Center (UAMC)
INSTRUCTIONS:
E] Has been used LI Found unsealed E] Due for inventory F-Kit Seal Accountability -
No Physical Inventory Required Required Corrective Equipment Quantity Sat Actions SURVEY INSTRUMENTS Beta-Gamma Survey Meter Frisker w/Probe Air Sampler (110 V) 1 Sample Head 1
Sample Head O-Rings N/A SAMPLING SUPPLIES Watch (P) 1 Cloth Smear 200 Particulate Air Sample Filters 25 Zipiock Baggies or equiv.
25 Charcoal Cartridge 20 Expiration Date:
Cutting Tool 1
PROTECTIVE CLOTHING Anti-C Clothing 4
Surgeon Gloves or equiv.
1 Box POSTING MATERIALS Radiological Posting Signs 4
"Radiation Area" Insert 2
"High Radiation Area" Insert 2
"RWP Required for Entry" Insert 2
FORM TITLE:
FORMNO.
CHANGE I
UAMC HOSPITAL KIT INVENTORY FORM 1903.060U 034-03-0
Page 42 of 43 Page 2 of 2 Required Corrective Equipment Quantity Sat Actions "Airborne Radioactivity Area" Insert 2
"Notify HP Prior to Entry" Insert 2
"Contamination Area" Insert 2
"High Contamination Area" Insert 2
"Radioactive Material" Insert 2
Blank Insert 2
Radiation Warning Rope/Ribbon 2 Rolls Yellow and Magenta Border Tape 1 Roll Step-Off Pads 2
MISCELLANEOUS Pens 2
Magic Marker 2
Clipboards 1
Meter Bags or equiv.
6 1
Maslin Bundle Extension Cord 1
SD-20 Tie Wraps 12 Ziplock Bags or equiv.
12 Batteries 9-vo:T 6
(P)
- Requires performance check Performed By Reviewed By Emergency Planning Manager Date Date Date FORMTTLE:
UMMFORM NO.
CHANGE FRTIL:
UAMC HOSPITAL KIT INVENTORY FORM
-r 1903.060U I034-03_0
C Page 43 of 43 Page 1 of 1 EMERGENCY KIT INVENTORY SEAL ACCOUNTABILITY Kit:
Kit Inventory Current Left Intact New Date Seal Number Reason for Entry (Yes/No)
Seal Number Init.
Return to Emergency Planning when complete.
FORM TITLE:
EFORMNO.
ICHANGE IEMERGENCY KIT SEAL ACCOUNTABILITY LOG 1903.060V 034-03-0