ML20207H534

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Public Version of Rev 17 to Emergency Procedure EP R-1, Personnel Injury or Illness (Radiologically Related) &/Or Overexposure
ML20207H534
Person / Time
Site: Diablo Canyon  Pacific Gas & Electric icon.png
Issue date: 04/08/1986
From:
PACIFIC GAS & ELECTRIC CO.
To:
Shared Package
ML20207H531 List:
References
EP-R-1-02, EP-R-1-2, NUDOCS 8607240357
Download: ML20207H534 (28)
v • d • e


Text

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.. 1 NUMBER EP R-1

, 3DG514@ Pacific Gas and Electric Company REVISION 17 m DATE 4/8/86

. DEPARTMENT OF NUCLEAR PLANT OPERATIONS I ) PAGE I 0F 16 1 AND ,

6 DIABLO CANYON POWER PLA?lT UNIT NO(S)

EMERGENCY PROCEDURE PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY

l. TITLE: RELATED) AND/0R OVEREXPOSURE W

)

APPROVED. -

C' PLANT MANAGEp' DATE i

, SCOPE 1 This procedure describes the actions which are to be taken in the

. event of:

1. Personnel injury or illness (minor or serious) where the victim is radiologically contaminated.
2. Overexposure (or suspected overexposure) from an external source.
3. Overexposure (or suspected overexposure) from an internal source.

4 A combination of the above.

Injuries or illnesses which do not involve radioactive contamination or overexposure are handled in accordance with Emergency Procedures M-1 or M-2. This procedure and changes thereto require PSRC review.

DISCUSSION Any radiologically related injury or illness or potential radiation

, overexposure is a serious matter requiring prompt attention'to the care of the patient and prompt appropriate corrective action to preclude re-occurrence. In addition, followup investigation to quantify the extent of exposure to radiation requires care in the gathering and retention of samples, radiation readings and other evidence which may contribute to the understanding of the incident and assist both in care of the injured and in preventing re-occurrence.

IMMEDIATE ACTIONS

1. The employee (s) who are at the scene shall:
a. Render all necessary first aid.

0607240357 860711 PDR ADOCK 05000275 F PDR DC0084 1XVIII

DIABLO CANYdN POWER PLANT UNIT NO(S) 1 AND 2 NUMBER EP P-1 REVISION 17 DATE 4/8/86 8!

PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY TRLE:

RELATED) AND/0R OVEREXPOSURE

b. Notify th'e control room (Shift Foreman) as soon as practical, and provide a phone number for the patients location.

NOTE:.' The S ft Foreman may be . notified b dialing Ext.

Dialin ctivates the ire a arm and medical emergency code call. The caller must remain on the phone to enable the Shift Foreman to dial into a conference call.

  • F, 2. Shift Foreman (Interim Site Emergency Ccordinator)
a. Evaluate plant status that may have produced the personnel injury, illness and/or overexposure. Sound the site emergency signal to clear the affected area, if the situation warrants it.
b. Dispatch additional first 1 such as the project construction EMT (ext.' -to the scene of the injury or illness if require . --
c. N is y and Radiation P tion personnel (ext.

J or R. P. Fo or shift CARP Desk, r 05 Tie Line, o ccess Control.)

d. Call an ambulance if the injury warrants it. Refer to Appendix 1 " Measures to be taken if Medical Care Is Required" for instructions.

SUBSE0 VENT ACTIONS The Shift Foreman shall direct all subsequent actions until relieved by the long-term Site Emergency Coordinator if the situation warrants it.

1. Actions Common to All Occurrences
a. Transport the patient to the first aid room, provided that this can be done without aggravating the injury,
b. Take actions as specified in the following sections as appropriate for the particular occurrence.

Section 2: Minor injury when contamination is present, o

DC0084 2XVIII

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DIABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2 ON DATE 4/8/86

' PAGE 3 0F 16 PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY TITLE.

RELATED) AND/OR OVEREXPOSURE Section 3: Serinus injury when contamination is present.

Section 4: Overexposure from external source Section 5: Overexposure from internal source.

c. Perform the notifications required by Appendix Z " Emergency Procedure Notification Instructions."

NOTE: Form 69-9221 " Emergency Notification Record" is provided to record notifications not documented elsewhere.

d. Collect personnel dosimetry assigned to the individual and have it evaluated,
e. Begin gathering information to assist the long-term Site Energency Radiological Advisor in his evaluation. Guidance on things which should be investigated is given in Appendix

(- 2 " Factors to Consider in Making a Preliminary Evaluation."

Close out the event with the following written reports:

f.

1) Report to NRC (required within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> for an Unusual Event, or within 30 days for a report under 10CFR20.403).
2) Form 62-4587 " Report of Industrial Injury to Employee."
3) Form 62-4586 " Employers' Report of Occupational Injury

. or Illness."

4) Action Request. (See Nuclear Plant Administrative Procedure C-12.)

(([][: Reports to NRC and the Action Request are not required for minor injuries or illness for which onsite first aid and decontamination is adequate.

DC0084 3XVIII

DIABLO CANYdN POWER PLANT UNIT NO(S) 1 AND 2 S ON DATE 4/8/86 PAGE 4 0F 16 PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY TITLE:

RELATED) AND/0R OVEREXPOSURE

2. Minor Injury or Illness When Contamination is Present The following steps apply to injuries where prompt medical attention is not required (i.e., first aid at the plant is adequate).
a. Make the following surveys and record the results on the

" Skin and Clothing Decontamination" Fonn (Fom 69-9392).

1) The wound prior to decontamination.
2) The object causing the injury (if possible) and any clothing penetrating or touching the injury. These items should be retained, if possible, until the long-tem Site Emergency Radiological Advisor has completed his evaluation so that detailed radionuclide analysis can be performed, if required.
3) The wound during each decontamination and after final decontamination, y

NOTE: These personnel surveys are in addition to other radiological surveys (e.g., work area, equipment) which may be required by radiation protection management.

b. Decontaminate the wound using the standard procedures discussed in Radiation Control Procedure G-4. In cases of severe contamination, where there is a realistic possibility that significant internal retention of radionuclides may have occurred, it is desirable to retain wash solutions (or samples thereof), swabs, and other such material which may be useful to the Site Emergency Radiological Advisor.

g: Refer to Emergency Procedure RB-5 " Personnel Decontamination" in the event normal decontamination facilities are overloaded or unavailable.

c. Complete any additional first aid measures.

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DC0084 4XVIII

DIABLO CANY N POWER PLANT UNIT NO(S) 1 AND 2 ON DATE 4/8/86 PAGE 5 0F 16 I

N PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY RELATED)AND/0ROVEREXPOSURE

d. Complete accident report Fom 62-4587, " Report of Industrial Injury to Employee" and forward to plant clerk for processing.

M: This documentation requirement assumes no medical attention (beyond first aid) is required and that no lost time occurs. If lost time beyond the day of injury is likely, or if medical treatment (including doctor referral) is required, complete Fom 62-4586,

" Employers' Report of Occupational Injury of Illness" and forward to plant clerk.

I -

3. Serious Injury or Illness When Contamination is Present The following steps apply to injuries or illnesses where prompt medical attention is required (i.e., the patient must be taken to a hospital) and the patient is contaminated. In this type of circumstance, the need for treatment of the injury and comfort of the patient will take precedence over the need for

( ,

decontamination.

a. Call HEDCOM for ambulance dispatch and French Hospital and l have the patient transported to French Hospital. The

, detailed steps to be taken if this is required are given in Appendix 1 of this procedure. The Control Room should keep personnel attending the patient informed of the status of

( the ambulance.

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b. During the interval until the ambulance arrives keep the patient as comfortable as possible. Survey and

, decontaminate the patient to the extent that time and conditions pemit. Do not decontaminate the patient if it will aggravate his injury. Record survey results on the

( " Skin and Clothing Decontamination" Fom (Form 69-9392.)

1) Survey a y wounds and/or the victim's skin (if possible).
2) Survey the object causing the injury (if possible) and any clothing penetrating or touching the injury. These items should be retained, if possible, until the long-term Site Emergency radiological Advisor has completed his evaluation so that detailed radionuclide analyses can be performed, if required.

DC0084 5XVIII

DIABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2

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  • RV ON DATE 4/8/86 PAGE 6 0F 16 N PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY RELATED)AND/OROVEREXPOSURE
3) Decontaminate the patient using the standard procedures discussed in Radiation Control Procedure G-4. In cases of severe contamination, where there is a realistic possibility that significant internal retention of radionuclides may have occurred, it is desirable to retain wash solutions (or samples thereof), swabs, and other such material which may be useful to the Site Emergency Radiological Advisor.

@_TE: Refer to Emergency Procedure RB-5 " Personnel Decontamination" in the event normal decontamination facilities are overloaded or unavailable.

c. An individual qualified in radiation monitoring shall accompany the victim to the hospital. This individual should take a liandheld radio with him.
4. Overexposure From External Source The following steps apply to cases where the patient has (or is "

I suspected to have) received a dose from an external source to the whole body, or any portion thereof, in excess of an applicable limit contained in Radiation Control Standard No.1, and where the individual does not require prompt medical attention for any other reason. Personnel suspected of overexposure shall not re-enter radiation controlled areas unless authorized by the Site Emergency Coordinator,

a. Provide any first aid or medical attention which the patient may required.

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b. Notify MEDCOM for ambulance dispatch and French Hospital and \

transport the patient to French Hospital in accordance with Appendix 1 for observation or treatment in any of the following circumstances: 1) The patient is known or suspected to have received at least any of the following:

a) 25 rem to the whole body, active blood forming organs, lens of eyes, gonads, head or trunk.

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DC0084 6XVIII

b

~ NUMBER EP R-1 0AsLO CANYO$ POWER PLANT UNIT NO(S) 1 AND 2 REVISION 17 DATE 4/8/86 PAGE 7 0F 16 PERSONNELINJURYORILLNESS(RADI0 LOGICALLY TITLE-RELATED) AND/0R OVEREXPOSURE

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b) 150 rem to the skin.

c) 375 rem to the extremities.

2) The patient shows signs of radiation sickness, such as nausea, vomiting, extreme sweating, weakness, diarrhea, extreme anxiety, incoherence, sensitivity of the nerves (tingling or itching sensation). ,
3) The patient shows evidence of radiation dermatitis (skindamage). Except for extremely high skin dose (greater than 5,000 rem), in which case pain occurs

. promptly and is intense, the symptnms at the time of exposure are a sensation of warmth and itching.

Redness, blistering and other effects may not appear for several days.

c. If the patient requires transportation to the hospital, during the interval until the ambulance arrives keep the

( patient comfortable. Survey the individual and perfom any decontamination which circumstances require and/or permit.

Do not aggravate any injury or unduly alarm the patient in performing these operations. Record survey results on the

" Skin and clothing Decontamination" Fom (Fonn 69-9392.) In cases of severe contamination, handle as in Step 3.b.3 to the extent practical,

d. To the extent practical, save all vomit, urine, feces or other samples which may assist the long-term Site Emergency Radiological Advisor in evaluating the accident. This is particularly important if internal deposition of radioactive materials is suspected.
e. Collect the patient's personnel dosimetry and any materials which suspected may)have such asbeen activatedwatches, belt buckles, (if a neutron exposure jewelry, prior to is sending him to the hospital or releasing him. This will be processed for evaluation.
f. Subsequent actions will be based upon the results of the evaluation of the external exposure. ]

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DC0084 7XVIII

4 O!A8LO CANYON POWER PLANT UNIT NO(S) 1 AND 2 hf0N DATE 4/8/86 PAGE 8 0F 16 I'I* PFRSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY R.:tJTED) AND/OR OVEREXPOSURE

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5. Overexposure From Internal Sources The following steps apply to cases where the patient has (or is suspected to have) ingested a significant quantity of radinactive material. If the ingestion was by breathing, this prncedure applies any time that the concentration to which the person has been exposed is greater than or equal to (MPC) x PF, where (MPC) refers to the normal (40 hr.) maximum permissible concentration, ,

and PF refers to the protection factor the patient obtained when a quantitatively fit tested to the respirator that was worn for the job.

. a.

Take injury any medicaldose or external action which Steps received may(be required 3 and as a The 4 above). result of treatment of these effects should take precedence over the evaluation of internal exposure,

b. Remove and retain for subsequent radiological analysis the patient's clothing and respirator.

)

c. Survey the patient thoroughly and record the results on the -

" Skin and Clothing Decontamination" Form (Form 69-9392).

d. Decontaminate individual to as low as practical without causing further injury. If practical, save samples of the decontamination solutinns, swabs, and other materials which may be of use in subsequent radiological evaluations.
e. Count the patient on the whole body counter. The results of this analysis will, in large measure, determine the necessity for further medical attention or surveillance,
f. Collect and save any urine, feces, or vomit which is passed from the patient. The long-tem Site Emergency Radiological Advisor may request that special urine samples be collected for bioassay.
g. Subsequent actions will be based upon the results of the evaluation of the internal exposure.
h. If the patient is sent to the hospital, make arrangements to have all urine, feces or vomit samples retained for radiological analysis.

$i OC0084 8XVIII

I AND 2 R ON WLO CANYON POWER PLANT UNIT NO(S) DATE 4/8/86 PAGE 9 0F 16 PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY M LE. RELATED) AND/0R OVEREXPOSURE REFERENCES 1.

Radiation Control Standard No. 1, " External Radiation Dose Control." l l

2. Radiation Control Standard No. 2 " Internal Dose Controls." .
3. Radiation Control Standard No. 5. " Medical."

4.

Radiation Control Standard No. 8. " Reporting and Recordkeeping."

5.

Radiation Control Procedure No. G-3, " Personnel Internal Exposure Control."

6.

Radiation Control Procedure No. G-4, " Personnel Contamination Control." ~

( 1 7. Emergency Procedure G-1, " Accident Classification and Emergency

\' Plan Activation."

Emergency Procedure G-2, " Establishment of the Onsite Emergency 8.

Organization."

9.

Emergency Procedure G-3, " Notification of Offsite Organizations."

10.

Emergency Procedure R-4, "High Radiation (In Plant).

11.

Emergency Procedure RB-5, " Personnel Decnntamination."

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12.

Emergency Procedure OR-1, "Offsite Support and Assistance" APPENDICES _

1. Appendix 1. Measures To Be Taken If Medical Care Is Required.
2. Appendix 2 ' Factors To Consider In Making A Preliminary Investigation.
3. Appendix Z, Emergency Procedure Notification Instructions.

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DIABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2 f0N DATE 4/8/86 PAGE 10 0F 16 PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY N

RELATED) AND/OR OVEREXPOSURE ATTACHMENTS l

1. Fom 69-9221, " Emergency Notification Record" (3/82).
2. Form 69-9392, " Skin and Clothing Decontamination Report" (7/85).
3. Fom 62-4587, " Report of Industrial Injury to Employee" (3/84).
4. Fom 62-4586, " Employers' Report of Occupational Injury or Illness"(7/79).

l 5. Fom 62-6015. " Medical Referral" (5/84).

. 6. Light Duty Program Letter.

7. Safety. Health and Claims Personnel to Be Contacted for Reporting of Injuries at Diablo Canyon (3/85).

.)

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l DC0084 10XVIII

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DIABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2 ON DATE 4/8/86  ;

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PAGE 11 0F 16 I'TLE PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY

) RELATED) AND/OR OVEREXPOSURE APPENDIX 1 MEASURES TO BE TAKEN IF MEDICAL CARE IS RE0VIRED l The following are the procedural steps to be taken in the event a contaminated patient must be transported to the hospital for medical treatment:.

1. Call MEDC0 d provide the following infomation: l
a. Name of caller.
b. Company affiliation.
c. Phone number of caller. (Where he can be reached.)
d. Name of in,iured or ill person.
e. Where the patient is located.
f. Where the patient is to be transported (French Hospital).
g. Nature of injury or illness.
h. Patient is contaminated.
1. Any other medical infomation which might be pertinent to transporting the patient.

Record this infomation on Form 69-9221, " Emergency Notification Record," or other suitable log.

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2. Contact the Security Shift Supervisor im call l

the security force at the Port San Luis entranc alert them that the ambulance is entering. It is o advisable to have an escort accompany the ambulance from the Security Building to the first aid room to minimize the delay in reaching the destination.

3. The victim shall be tra ed to French Hospital. Call ahead to the hospital (Pho nd provide the following infomation:
a. Name of caller.

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OLABLO CANYON POW R PLANT UNIT NO(S) 1 AND 2 h0N DATE 4/8/86 PAGE 12 0F 16 /

TE PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY RELATED) AND/OR OVEREXPOSURE APPENDIX 1 (Cont'd)

MEASURES TO BF TAKEN IF MEDICAL CARE IS REOUIRED

b. Company affiliation.
c. Phone number of caller. (Where he can be reached.)

y d. Name of injured or ill person.

e. Age of injured or ill person (approximate if not known).
f. Extent of injury, illness or symptoms.
g. Medical history (if known).
h. Radiological conditions.

Record this infomation on Fom 69-9221. " Emergency Notification -

Record", or other suitable log. J

4. Prior to arrival of the ambulance, the patient should be decontaminated to the extent practical without aggravation of injury.
5. If the patient cannot be enmpletely decontaminated prior to arrival of the ambulance, wrap him in a blanket prior to placing him in the ambulance in order to minimize the spread of contamination. Alternatively, he may be placed in the plant's Nuclear Accident Emergency Carrier.
6. An individual qualifted in radiation monitoring shall accompany the victim to the hospital. This individual should take a handheld radio with him.

E: Radios are stored in Access Control. Radiation protection equipment is stored at the hospital. Additional equipment

! and radios are also available at the PG&E San Luis Obispo l Service Center.

7. Two additional individuals qualified in radiation monitoring should be dispatched to French Hospital to assist hospital personnel.

NOTE: Refer to EP OR-1 "Offsite Support and Assistance" for air '

ambulance or medivat support, and for medical consultation.

DC0084 12XVIll

DIABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2 f5ON 7 DATE 4/8/86 PAGE 13 0F' 16 PERSON 1EL INJURY OR ILLNESS (RADI0 LOGICALLY I'I'E RELATED1 AND/OR OVEREXPOSURE APPENDIX 2 FACTORS TO CONSIDEP IN MAKING A PRELIMINARY INVESTIGATION It is important to conduct the preliminary investigation in a systematic manner to assure that pntentially valuable evidence is not overlooked, lost or destroyed. The following is a reference listing of items which should be checked (if they are applicable). Also, two other factors are important in conducting an investigation of this -

type, namely: a) information which is gathered shculd be written down in a comprehensive, neat manner, and b) all sanples, clothing, or other articles which are collected should be put in sample bottles or plastic bags, and labelled with the patient's name, date, collection time, sample identification, and other pertinent data.

1. Factors Connon to All Accidents
a. Date, time of occurrence.
b. Basic reconstruction of events.
c. Probable source (s) of radioactivity involved.
d. Names and addresses of all witnesses.
2. Considerations in Evaluating External Exposure
a. Exactly where was the patient located at the time of exposure?
b. How was patient physically oriented with respect to source

. (will help to evaluate nonuniform exposure)?

c. On what part(s) of body were dosimeters being worn?
d. Were self-reading dosineter readings recorded and all nonself-reading types collected?
e. Are there any " natural" dosimaters available? (Belt buckles, wrist watches, gold tooth fillings, and other such items are useful in determining neutron dose.)
f. Exactly what was the time interval over which exposure occurred?

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DC0084 13XVIII

NUMBER EP R-1 DIABLO CAbON" POWER PLANT UNIT NO(S) 1 AND 2 REVISION 17 DATE 4/8/86 PAGE 14 0F 16 -

PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY T871 RELATED) AND/OR OVEREXPOSURE

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g. Are there any applicable dose rate measurements, and if so, exactly where and when were they made?
1) Ion, chamber measurements
2) Area monitors
3) Other
h. What was the status of the plant at time of exposure?
3. Considerations in Evaluating Internal Exposure
a. Where was the patient located at time of exposure?
b. Exactly what was the time interval over which expnsure occurred?
c. Can sample (s) of liquids which were internally deposited be i

obtained? i

d. Can samples of airborne activity which were breathed be obtained before the area is purged?
e. Are there any applicable monitor readings?
1) Process monitors
2) Continuous Air Monitors
3) Area Monitors t
4) Other
f. Can samples of patient's clothing, decontamination solutions, secretions, respirator filters, be saved?

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g. Can the region in the vicinity of the occurrence be smear-tested, or can decontamination solutions be retained?

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l DC0084 14XVIII

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otABLO CANYdN POWER PLANT UNIT NO(S) I AND 2 ON 1 l DATE 4/8/86 j PAGE 15 0F 16 PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY TRLE:

RELATED) AND/0R OVEREXPOSURE APPENDIX Z EMERGENCY PROCEDURE NOTIFICATION INSTRUCTIONS

1. When this emergency procedure has been activated and upon direction from the Shift Foreman, procaed as follows:

In case of a minor injury with contamination present or an a.

. ,, overexposure case from any source which does not meet the criteria for 'an Unusual Event, notify the Plant Manager, Plant Superintendent and Supervisor of Chemistry and

. Radiation Protection or their designated alternates.

b. Designate this a Notification of Unusual Event in any case of an injury or overexposure requiring transportation of the patient to an offsite hospital or if extensive onsite decontamination is required (soap and water washings do not remove contamination or offsite decontamination assistance

( is required). Notify plant staff and response organizations X required for this classification by implementing Emergency Procedures G-2 " Establishment of the Onsite Emergency Organization" and G-3 " Notification of Offsite Organizations" in accordance with Emergency Procedure G-1

" Accident Classification and Emergency Plan Activation."

c. If the case involves an overexposure from an external source which exceeds:

Immediate Notification

  • Notification Within 24 Hours 25 Rem Whole Body 5 Rem Whole Body 150 Rem Skin 30 Rem Skin 375 Rem Extremities 75 Rem Extremities Notify the Director, NRC Region 5 by telephone and telegraph, mailgram and facsimile within the applicable time frame described above. Indicate the notification is pursuant to 10 CFR20.403 (Notification of Incidents).
  • Designate this a Notification of Unusual Event and complete l the additional notifications prescribed in section 1.b.

above.

DC0084 15XVIII

OLABLO CANYON POWER PLANT UNIT NO(S) 1 AND 2 ON DATE 4/8/86 PAGE 16 0F 16 #

PERSONNEL INJURY OR ILLNESS (RADI0 LOGICALLY TITLE:

RELATED) AND/0R OVEREXPOSURE

2. In addition to' notification perfonned above, also notify the following in any case where NRC notification is required,
a. Supervising Nuclear Generation Engineer (Personnel and Environmental Safety) or his alternate in the Department of Nuclear Plant Operations: _

Mr. W. H. Fujimoto PGandE:

Plant Ext: -

% Home:

i b. Compensation Claims Representative in the Department of Safety, Health and Claims, per the attached form RW-9.

NOTE: 1) The System Dispatcher will handle the notification of General Office Personnel if they cannot be promptly reached.

2) Nuclear Mutual Limited (NHL) holds the Company liability and property damage insurance for i Company personnel and property. They should be #

notified under the same circumstances as the NRC, Notification is made by the Company's Insurance Department. The Department of Nuclear Plant Operations should be requested to interface ,

between the plant and the Insurance Department I when required. American Nuclear Insurers / Mutual Atomic Energy Liability Underwriters (ANI/MAELU) holds third party insurance coverage and would be similarly notified in accidents involving a third party.

DC0084 16XVIII

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, 69-9392 _7/85 Page 1 of 3

  • . PACIFIC GAS AND ELE".TRIC COMPANY DEPARTMENT OF NUCLEAP. PLANT OPERATIONS DIABLO CANY0N POWER P;. ANT UNIT NOS.1 AND 2 .

TITLE: PERSONNEL DECONTAMINATION AND EV810A7!0N REPORT NAME S.S.N.

EXPOSURE I.D.f DATE/ TIME SKIN [ ] CLOTHING [ ] RWP/SWP # _ SURVEY LOG NO.

NOTE: Label initial and post decen contamination levels on drawings below. All levels are in net cpm. Clearly distinguish between direct survey and smearable contamination.

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C & RP IEChhlCIAN DATE/IIME REVIEnED BY DATE/IIME DC0464 37II

65-9392 7/85 .

Page 2 cf 3

TITLE
PERSONNEL DECONTAMINATION AND EVALUATION REPORT Plant location where contamination occurred

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Job evolution during contamination Cause of contamination I

l Radiological conditions during event 1

1 Results of personnel surveys -

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Disposition of individual Followup Actions I

Dose Calculated from Contamination: []N/A []

Dose Assigned To: []N/A [ ] Whole Body [] Skin [] Extremity 1

Dose Entered Into Exposure Record: Date/ Time By l

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l C & RP ENGINEER DATE/ TIME s DC0464 381I l

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r 61-9392 7/85 Page 3 of 3 ,'

TITLE: PERSONNEL DECONTAMINATION AND EVALUATION REPORT DOSE EVALUATION WORKSHEET Part 1. Dose Rate Conversion Factors [ ] Default value [ ] Spectrum No. -'

(a) (b) (c) (d) -

Maximum Branching Dose Rate Result of Sum of Beta ratio conversion (d) -

! Energy (MeV) (decimal) (rad /hr/pCf/cm2 ) (rad (b) x (c) 2 )

/hr/pC1/cm -

k (1)

Sum of

)l (d) + (h)

(rad /hr/pC1/cm2 )

j i

(e) (f) (g) (h)

Gasuna Branching Dose Rate Result.of Sum of

) Energies ratio conversion (h) i (MeV) (decimal) (rad /hr/pci/cm2 ) (rad (b) x (c) 2

/hr/pC1/cm).

J i

Part II. Dose Calculation

.: (j) (k) (1) (m) 1 Net corrected Answer from . time of contact Dose Sum of j cpm (j)x(k)x(1)x2.25x104 (1) (hrs) (m)

(mres/ probe area) (arem/ probe area)
  • write in space on pg.2 1

p .

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Location on accounTnuusen Jos muusam R.c.nuusam -

rrau muusan esee4B suss7 nw sea PACIFIC GAS AND ELECTRIC COMPANY Report of Industrial injury to Employee

1. Name: 6. Division:
2. Address: ZIP:
3. Telephone No.: 7. Department-
4. Social Security No.: 8. Date of Accident:
5. Occupation: 9. Time of Accident:

. 10. Location of Accident: 11. Nature of injury /Part of Body:

12. What were you doing and how did eccident occur?
13. Third party information:
14. Describe First Aid rendered:
15. Witnesses to Accident:

1.

2.

3.

16. Date injury reported: -

18.

Sgsature of Employee

17. Date 30 days elapses 19.

'See Over Segnature of SuperwoortCo. Telepnone No.

INSTRUCTIONS: This report (Items 1 thru 16) should be written and signed (Item 18) by the employee personally and countersigned by the supervisor. It is for ali industrial injuries and is in duplicate. The original is to be retained for Company records; the copy is to be detached after completion and given to the employee. Before signing (Item 19), the supervisor should fill in the date of the report (! tem 16) and compute and notate the date 30 days from the date the injury was reported (ltem 17).

If the employee later requires treatment by a doctor or becomes disabled, Form 62-4586 must be prepared and s forwarded to the Safety, Health and Claims Department IMMEDIATELY accompanied by the original of this report.

If the employee is unable to fill out or sign this report, it should be prepared, signed by the supervisor and the employee should be given a copy within 5 days as required by law.

11 the injured employee cannot write English, the report may be made according to a verbal statement. If necessary.

the employee may sign by a mark and a witness to the report should sign below the employee's mark.

~-._ .________.___,________ _ .__ . _ _ _ _ - _ _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . , _ _ _ _ _ _ _ _ __ ~ - _ _ _ _ _ _ . .

s

)

r INPORMATION FOR THE INJURED EMPLOYEE This nottee complies with the

.. California Labor Code t

l. General Information: The Company has an ersmane se8 sty program to help its employees avoid injury. In the event of a mort.

related iryury requiang meccal. care, special provision has been made for the best meccal services available. The Company is very much concerned with its iryured employees, and is proud to extend the mecca; program developed over years of experience for your benefit. Every reasonable effort unit be devoted in minirreng the extent and duration of your industnal iryury.

ine Company is entirely self insured for industrialinjuries to its employees which arise out of and occur in the course of employment.

Au compensation benefits, including medical treatment, rehabilitation programs, and esabahty payments are administered by the Company. If questions arise, please contact your supervisor. ,

18. Medical Benefita: Through continuing efforts, the Comparty has utilized the talents of highly quahfied physicians and speciahsts throughout PG&E system. A panel of doctors famihar enth the vanous Company programs and benefits, inclueng the hght duty work program, has been estabhshed to prende a greater service to the iryured employee.

h are entitled to receive medical, surgical, and hospital services and supplies reasonably required to cure or reheve you from the effects of your ir sury, inclueng nursing care and such things as crutches and artificial hmbs. Reasonable transportation esponse m-cadernal to treatment wiu also be provused.

Ill. Selection of heting Physician: Treatment of industnaliryured employees is provided by the employer at the employer's expense with trie employee having the opportunity to change physicians if desired. Cahlomia law permits employees who sustained an in-dustnat injury to be treated by a physician or at a facihty of their choice within a reasonable geographic area commencing 30 days after the dare tryury is reported, or immeestely by your personal physician, prtmded you notified the Comparty pnor to your iryury. g if you wish to continue your present treatment, you may do so, it is recommended that you conhnue with the physician that has been I provided. but if you wish to change doctors, notify your supervisor. The Company's esperience in this area is avadable to assist you in selecting the proper me6ca! care. If you elect to change to another treating physician or facihty after 30 days, you must notify your supervisor of the name and address of the physician or facihty you have selected to continue treatment. h should show this docu-ment to the physician or facahty so they win be not fied of the immediate duty to report to the Company as required by Secte 46tu2 of the Labor Code. If the facihty or physician requests, you are required to sign a me6 cal information release to permit reports of treatment to be rendered to the Company . ... . ..

IV. Amount of Indemnity Poyable: If your weekPy wage exceeds $33&D0 you are entitled to the maximum Temporary Disabdrfy indem-nity of $224 00 per week. .~,,.. Mng on the 4th full day after triury. If the work related iriury results in hospitahastion or more than 21 days of d sabehty, payments win commence the 1st full day ci disabihty. If your disabdtfy results in lost time for cwr two years or you lose time after two years, you will be paid temporary disabelsey at the ruso currently in effect. This apphes only to iriunes on or after 1171 Permanent Disabelsty is paid at the rate of 814040 pot week.

~

V. Rehabetttation: Effectt$ "Is'nuarit,1g75, the employer must p'rovide a rehabilitation program for ariy employoiwhere the treating physician advises the Company that the employee wiu be unable to retum to his usual and customary occupation at the time of argury, on a permanent basse.

This program prendes services suc'h as vocational evaluahon, counseling, retraining, including training and placement necessary to restore the inputed amployee to surtable employment, wfucts is notconnned to reempeoyment with PG&E. The Company works in corguncuan with the Califorma Rehabiktaban Bureau.

VI. Death Benefits: If your triury recules in death and you have a totsNy dependent spouse, the sum of 570.00040 le the maximum benefit, except in cases imotving a spouse and one or more dependern minor children, where the maximum is $9500040 There is also a maximum bunal allowance of $1,5004(L in cases of partial dependency, the death benent win be a sum equal to four times the amount annually devoted to the support pt the dependeres nas to suceos Sm0000E Vll. Furtherinformation: If you wish furUdsr indonImation on your liitticular cais, in ad$ tion to wMt your supervisor has pnmded, con-tact the Workers' Compensation Secten (415) 781-4211 Extensen 3171.

Indormahon and Assestance Officers located in the offices of the Dmaion of Industrial Accidents Workers' Compensation Appeals 3

Soard are a further source of informaten and services. The Workers' Compensation Appeals Board is the final arbiter of claims to g workers' compensahon

_ _ ~ _ _ _ - - . . - -

U

. . )

  • V*** 8 R** 7179 3 PAC'IFIC CAS and ELECTRIC COMPANY Employer's Report of Occupational injury or Illness CONFIDENT l AL-For Use by Company Attorneys civistoN oENERAL OFFICE oR I

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( Filing of this report is not en admision of liability, pimu: PACIFIC gay & ELECTRIC COMPANY ---

um. ..

... No report of injury required to be filed by en em-ployer or insurer by this chapter shell be admissable - - - -

as evidence in any adversary groceeding before the o,,sciat position: Mgr., Safety. Health & Claims Dept.

Workmen,s Compensation Appeals Board,,,

Tate,woas 781 4211 e xTassion: 3171 l Labor code. Section 6412 w I' '

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s2-6015 CEV.5/84 o ..

. EMPLOYEE NAME SSe OCCUPATION ACCIDENT REPORT NO.

DATE OF INJURY APPOINTMENT DATE/ TIME ME' DICAL REFERRAL FORM TO: NAME:

(PMYSICI AN. MOSP6TAL. MEDICAL GROUP. ETC.)

ADDRESS:

TE LE. NO:

This Pacific Gas and Electric Company employee sustained an industrial injury and now requires medical treatment. You are hereby authorized to provide treatment necessary to cure or relieve the effects of the injury. Please submit your reoort. billina and oriainal of this form to

~

Manaaer. Safety. Health and Claims Deoartment. Attention: Workers' Comoensation Section.

P.O. Box 7779. San Francisco. Ca 94106.

It is our policy to provide light work when available for industrially injured employees disabled from performing their regular jobs, depending on the physical restrictions of the employee.

There is a space provided below for you to state the specific work restrictions, if any, you consider necessary to return this employee to light work.

PLEASE COMPLETE THIS SECTION:

O Return to full work immediately.

O Return to light work immediately with the following restrictions:

How long will restrictions apply?

O Unable to work until:

O Return Appt: Date: Time :

O Discharged from treatment.

Signed if you have any questions, please contact the undersigned.

Pacific Gas and Electric Company By: Tele:( )

MOR..POREMAN SUPT.

Date:

. DISTRIOUTION:

ORIGINAL TO SE PORWARDEO SY PHYSICIAN TO SAPETY, ME ALTH AND CLAIMS DEPARTMENT.

COPY NO.1 TO DE RETURNEO SY PHYSICIAN TO EMPLOYEE FOR SUSMIS$10N TO SUPERVISOR.

COPY NO. 2 TO SE RETAINED sv PHYSICIAN.

_ . _ - _ . _ ~ . . _ . .

t PACIFIC OAS AND ELECTRIC C O MPANY

  1. q q, ,

1 DIABLO CANYON POWER PLANT PO Box 56 Avda Beach, Cahfomia 93424 (805) 595-7351 .

ne m onwetany P6a%T adA% ASIA 4

T 1

Dear Dr.

Thank you for being one of our panel physicians that treat our employees. Our primary goal is to provide employees who sustain industrial injuries requiring medical attention with prompt, first-class treatment. Your assistance in this endeavor is appreciated.

(' There is an area of concern to us. While the number of employees that require treatment by a physician has remained stable or, in some cases, declined, the number of disabling injuries requiring time away from work (i.e., lost time injuries) has dramatically increased.

We believe that some of this time away from work might possibly be avoided if the availability of light (modified) duty or desk-type work were more widely known. Some physicians have stated that in some cases the patient will respond more rapidly to treatment if kept busy in a light-duty capacity. Productive, light-duty assignments are almost.always available for employees released for work within the medical restriet h d ablished by the physician.

It is our policy to have an injured employee accompanied by a supervisor or other representative on the first, visst4o the doctor. Should there be any ,

questions about the availability or type of light duty that can be provided, he or she will be able to answer for us.

4 Our employees' welfare is our main concern. Should you have any questions about our program, I will be glad to call on you at your convenience.

Sincerely, NO[

R. C. Thornberry RCT:ws

e l .~. .

3/85 PACIFIC GAS AND ELECTRIC COMPANY Page 1 of 2 RW9 DEPARTMENT OF NUCLEAR PLANT OPERATIONS DIABLO CAhYCN F0WER PLANT UNIT NOS.1 AND 2 Safety. Health and Claims Personnel to be Contacted for Reporting of Injuries at Diablo Canyon 3 EMPLOYEE INJURIIS In all cases of serious employee injuries (for example, injuries involving hospitalization, electric contact, hernia, amputation, fractures, or injuries expected to result in lost tire from work beyond the day of injury) l or death, which occur while on the job, report should be made as follows: l Durina Working Hours: l T. B. Honey PGandE local ..

(If Mr. Honey is not available, the person answering tSe telephone will take the message and notify Mr. Honey or any other parties necessary in the Safety, Health and Claims Department).

Any Other Tire:

Report to one of the persons on the following list, trying each in order

(, \_ until.one is contacted: ~~

1. T. B. Honey Pinole
2. A. Thomas San Francisco
3. C. B. Powell San Francisco
4. P. S. Benitez San <Rafael
5. T. G. Scott Oakland
6. L. S. Lasagna Albany
7. S. R. Hutton Martinez
8. C. W. Allen San Francisco
9. B. L. Wade Larkspur

~

10. J. A. Glimme Danville
11. C. C. Cooper Oakland
12. D. E. Harelson Orinda
13. W. A. Hutchison San Carlos
14. J. C. Vocke Lafayette
15. R. W. Hall Richmond
16. I. M. Crawford Hercules
17. R. G. Schumaker El Granada
18. R. M. Petersen Walnut Creek
19. P. C. Boettcher Moraga
20. H. W. Reynolds Sunnyvale
21. B. P. Sadler Belmont u

l This listing extracted from Safety, Health, and Claims memo regarding Personnel to be Contacted for Reporting of Accidents, dated 10/3/84 DC0084 17XIII

>i,

S .

Safety' , Health and Claims Personnel to be Contacted for Reporting of Injuries at Diablo Canyon Page 2 of 2 e

Non-Employee Injuries '

W. O. James II, San Luis Obisp If he cannot be reached, contact one of the following in order of preference:

During working hours: I

1. > 1 John C. Echols  :

l

2. Doug G. Keeler
  • L 3. Scott P. Robinson (collection only) l l

After working hours on Monday through 8:00 a.m. on Monday through Friday, except holidays: / I

1. John C. Echols Pleasant Hill
2. Doug G. Keeler Concord
3. John C. Vocke Lafayette
4. C. O. Schreil San Carlos
5. Bill Williams San Jose
6. E. Anthony Giudici San Carlos
7. J. Alec McCorquodale La fayette '
8. Stanley W. Johnson Fairfield '
9. Scott P. Robison Alameda (collection only)
10. Bruce P. Sadler Belmont After 5:00 p.m~. on Fridays to 8:00 a.m. on Mondays and holidays:

Contact the Investigator delegated to stay on call for all emergencies. He may be reachedi through the System Dispatcher. If he is not available, the Dispatcher will follow the procedures for "After Working Hours."

O e

DC0084 18XII

T p Mioq'o UNITED STATES 8 e NUCLEAR REGULATORY COMMISSION g E WASHINGTON, D. C. 20555

+

..... July 23,1986 50-275/323 Diablo Canyon MEMORANDUM FOR: Chief, Document Management Branch, TIDC FROM: Director, Division of Rules and Records, ADM

SUBJECT:

REVIEW 0F UTILITY EMERGENCY PLAN DOCUMENTATION The Division of Rules and Records has reviewed the attached document and has detennined that it may now be made publicly available.

/hA-- /7 "*^A)

Donnie H. Grimsley, Director Division of Rules and Records Office of Administration jp

Attachment:

As stated w

,

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