ML20040E446

Public Version of Forms Accidently Omitted from Revision 5 to Emergency Plan Procedure 1903.10, Emergency Action Level Notification.

ML20040E446
Person / Time
Site:	Arkansas Nuclear
Issue date:	02/01/1982
From:	ARKANSAS POWER & LIGHT CO.
To:
Shared Package
ML20040E331	List: ML20040E332 ML20040E446
References
1903.10-ERR, NUDOCS 8202040341
Download: ML20040E446 (2)

Text

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i ARKANSAS POWER & LIGHT COMPANY i

t c Arkansas Nuclear One TITLE:

EMERGENCY ACTION LEVEL (EAL) NOTIFICATION FORM NO. 1903.10M REV. # 1 FC #

Page 1 of 2 CAUTION: NOTIFICATIONS TO TIE STATE OF ARKANSAS WILL REQUIRE USE OF AUTIENTICATION TABLES (ITEM NUMBER 11).

This is (identify yourself) at Arkansas Nuclear One with an Emergency Action Level Notification Report. Acknowledge when you are ready to proceed.

1. ( ) INITIAL ( ) FOLLOW-UP NO.

2. N/A

3. N/A

4. Date/ Time of beclaration DD MON YY HHMM

5. Unit: ( ) One ( ) Two

6. Class of EAL:

( ) A. UNUSUAL EVENT ( ) D. GENERAL EMERGENCY

( ) B. ALERT ( ) E. NONE m +- ( ) C. SITE EMERGENCY

~79 YD.f'C7 nditions ' Requiring EAL:

..c.,,,_.,.

l .

8. Areas Affected (Sectors / Distances):

9. Onsite Situation:

A. Prognosis of Situation: -

( ) Improving

( ) Stable

( ) Degrading B. General Population Protective Actions Recommended:

( ) None

' r-

- ,- ( ) Shelter

( ) Evacuation C.

Institutionalized Protective Actions Recommended:

( ) None

( ) Shelter

( ) Evacuation D. Radiation Monitoring Teams Activated:

( ) Yes

( ) No E. Emergency Response Centers Activated:

( ) None ,

~*

()EC 8202040341 820201 &

PDR ADOCK 05000313 F PDR

f .. . .

F O ARKANSAS POWER & LIGHT COMPANY s

, Arkansas Nuclear One TITLE: EtERGENCY ACTION LEVEL (EAL) NOTIFICATION FORM NO. 1903.10M REV. # 3 PC #

F. Local Assistance Requested: Page 2 of 2

( ) Fire

( ) Police

( ) Ambulance

( ) Other G. Evacuation of Onsite Personnel:

( ) Yes

( ) No

( ) Some H. Other Emergency Response Actions daderway:

10. Message Sent By: /

NAME POSITION

11. Message Authenticated By: A B C D E F G H I J K L M N O (None) /

_.m.~. .4 INDICATE ALPHABETICAL RESPONSE

,wa CHARACTERS CHALLENGED '"" *1 GIVEN J

w '

^ ~' 12 . Type of Release:

( ) None ( ) Airborne

( ) Potential ( ) Waterborne

( ) Actuil ( ) Surface Spill

13. Description of Released Material (Chemical & Physical Form, Estimate of Equivalent Curies of I-131 & XE-133 Released, Release Rate (Ci/sec),

Iodine / Noble Gas Ratio, etc):

i

14. A. Wind Direction: (From)

• B. Wind Speed: +

MPH 15, Temperature: F

• ' " ~

16 . Form of Precipitation:

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17. Atmospheric Stability:

18. Estimated Start / Duration Time of the Release:

(START) fDURATION)

19. Dcsc Rate at the Exclusion Area Boundary (0.65 miles):

mR/hr ( ) Projected ( ) Child Thyroid

( ) Actual ( ) Whole Body

20. Projected Doce:

mR/hr ( ) Whcle Body ( ) Child Thyroid at miles

21. REMARKS:

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