ML20236S870
| ML20236S870 | |
| Person / Time | |
|---|---|
| Site: | University of Virginia |
| Issue date: | 11/11/1987 |
| From: | Copcutt B, Mulder R VIRGINIA, UNIV. OF, CHARLOTTESVILLE, VA |
| To: | NRC OFFICE OF ADMINISTRATION & RESOURCES MANAGEMENT (ARM), NRC OFFICE OF ENFORCEMENT (OE) |
| Shared Package | |
| ML20236S858 | List: |
| References | |
| NUDOCS 8711300150 | |
| Download: ML20236S870 (26) | |
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UNIVERSITT OF VIRGINIA r
,A, DEPARTMENT OF NUCLEAR ENGINEERING AND ENGINEERING PilYSICS NUCLEAR REACTOR FACILITY SCIIOOL OF ENGINEERING AND APPLIED SCIENCE
(
j CIIARLOTTESVILLE, VA 22901
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November 11, 1987 Telephone: 801-9244136
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l Director Office of Enforcement U.S.
Nuclear Regulatory Commission ATTN: Document Control Desk Washington DC 20555
Subject:
Docket No. 50-62 and License No. R-66.
Licensee Response to Notice of Violation and Proposed Imposition of Civil Penalty (NRC Inspection Report No.
50-62/87-03), consisting of Reply and Answer to Notice.
Dear Sir,
Please find in attachment our response to the recent NRC Notice of Violation and Proposed Imposition of Civil Penalty, which is submitted under oath, and consists of a " Reply to Notice of Violation" and an " Answer to Notice of Violation".
The civil penalty payment is not being remitted at this time, pending NRC action on our request for mitigation of the proposed fine, which is made pursuant to 10 CFR 2.205.
Mitigation is being requested because the licensee immediately reported the event to the NRC, took prompt and broad corrective actions, quickly verified that no personnel overexposure above NRC limits were incurred, did not willfully violate regulations, etc..
These points are covered in detail in the " Answer to Notice of Violation".
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1 REPLY TO NOTICE OF VIOLATION BEL Reactor Facility Department of Nuclear Engineering and Engineering Physics University of Virginia (Docket No. 50-62, License No. R-66)
Date:
1 November 11, 1987
Reference:
NRC Inspection Report No. 50-62/87-03 of 10/26/87 First NRC Alleced Violation:
Violation of 10 CFR 20.201(b), 10 CFR 20.203 (c) (1) and (2):
"The licensee failed to make or cause to be made surveys necessary to identify a high radiation area in the neutron radiography facility; and did not take appropriate action to ensure the area was properly posted with a conspicuous sign or signs bearing the radiation caution symbol and the words:
Caution, High Radiation Area; and access to all of the entrances to the high radiation area in the neutron radiography facility was not controlled by any of the described means."
Licensee Resoonse:
The licensee admits that on the morning of July 2, 1987 it did not perform surveys necessary to identify the initiation of a high radiation area within the neutron radiography facility (NRF) blockhouse.
At the time this area was posted as a radiation area.
The high radiation field was found by a reactor staff member after it had already been inadvertently created.
Evidence suggests that the high radiation area existed for only a short time.
Circumstances:
The high radiation area was found to be confined to the interior of the NR facility blockhouse.
It was the consequence of an inadvertent partial
(~ 10%) draining of the water shield in one of two neutron beamports, in association with the operation
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2 of the UVAR reactor at full power.
Work on addition of shielding to the NR facility was in progress at about this time.
This work appears to have been related to the event only to the extent that it resulted in personnel being in the blockhouse at about the time of the partial drain.
Prior to-this moment, the beanport had been out'of service for about two weeks and was filled with water.
The area inside i
the blockhouse was surveyed on a regular basis and had been determined to be a radiation area with the UVAR at power and the beamport totally filled with water.
If work had not been in progress, the NRF blockhouse would normally have been secured with respect to physical access.
It is the fact that work was in progress which generated potential for NR personnel exposure.
Over-exposures were prevented because the reactor staff member first to enter the blockhouse following lunch was wearing his audible dosimeter.
This device indicated the existence of a higher than expected radiation field, which was then confirmed with a survey meter.
Reactor Facility personnel did not conceive of a mechanism by which the beamport water shield could suddenly and accidentally drain.
Beamport draining was deemed possible only with the activation of the water drain / fill pump, as the beamport lies below the height of the drain / fill system's excess water tank.
The pump was de-energized during most of the shield construction work, and had been re-energized as the work was being concluded.
It still has not been conclusively shown that the partial beamport draining was a result of activation of the water pump, although this appeared to be the most likely explanation.
The Reactor HP did not alter the normal weekly HP radiation survey frequency for the interior of the NR facility, since the experimenters and local workers were expected to perform additional surveys as necessary to meet regulatory requirements.
The experimenters did not use continuous monitoring because they relied on the beamtube's water shield remaining in place.
The presence of the water shield in the beamport was checked at intervals by visual inspection of the water level position in the see-through water lines of the beamport fill / drain system.
It has been suggested by the NRC that if a 10 CFR 50.59 safety analysis had been performed prior to the blockhouse modification, this violation would not have occurred.
The licensee agrees to the extent that the potential for accidental drainage might have been recognized ahead of time.
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l Corrective Steos:
3 Following the discovery of the high radiation area, the licensee immediately posted and-controlled access to the interior of the NR blockhouse and, after the UVAR power level had been reduced, caused a special radiation survey of the area to be made to identify the extent of the incident.
The NRC was promptly informed of the occurrence, and the doses to NR facility workers were verified within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />.
As expected from results of activation analysis performed on NR workers'. personal jewelry by the licensee immediately following discovery of the high radiation area, Landauer determined NR personnel dose exposures were significantly below NRC limits.
Still, the licensee recognized the significance of the incident and with due concern proceeded to-consider and take extensive corrective actions.
The reactor staff wrote and the Reactor Safety Committee (RSC) approved new UVAR Standard Operating Precedures (SOP's) 6.9, dealing with the operation of the beamports from the perspective of reactor operations.
In turn, the NR principal investigator developed experimental operating procedures for the NR facility for Reactor Safety Committee review and approval.
To address the subject of broader applicability of 10 CFR 50.59, the reactor staff wrote SOP's 2.12, and 2.13, which specify new procedures to be followed for modification of the NR Facility as well as other pertinent Reactor Facility facilities.
Modifications of the radiography facility will now be subjected to a prior 10 CFR 50.59 safety evaluation.
Also according to the new procedures, future modifications to the blockhouse will only be performed with the UVAR shutdown.
Specifically in connection with the NR facility, in order to preclude the development of another unanticipated situation of potential high dose exposure to personnel, in addition to the procedural changes, safety devices and interlocks were installed.
L These consist of a beamtube fill status indicator with readout at I
the reactor console, a second in-series beamtube water shield
- drain / fill pump switch operable from the reactor console (to involve the reactor operator in the draining of the beamtube),
l audible alarm to indicate inadvertent personnel entry into a high I
radiation area coupled to an automatic UVAR scram, and a BF3 i
redundant neutron monitor (of the beamtube fill status) to be l
used by the NR experimenters with the NRF and the UVAR in operation.
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The NR facility improvements were planned, analyzed and I
submitted to the RSC for approval before installation.
The l
additional shielding for the NR blockhouse was_ completed after a i
work method had been written.
After finishing the procedural i
l changes and installation of interlocks, a final detailed radiation survey of the NR facility under shutdown and operating conditions was performed.
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Written NR experimenter's' operating procedures were submitted to'the'RSC, approved'and put in use.
All reactor staff were issued Landauer "C-1"~(combination) badges to record both gamma and neutron exposures, although the potential for~ neutron exposures at the Reactor Facility is normally very low.
Up to tho time'of the incident, only NR personnel had been issued these combination badges.
To.date, the' incident has been thoroughly discussed at five meetings of the RSC, and at many management levels.
The fine imposed by the NRC resulted in~ scrutiny by the news media, and much time was spent by the University in satisfying their requests for interviews and information.
As part of broader corrective actions, a meeting was held with experimenters working at the Reactor Facility to discuss a policy for control of experiments.
This resulted in the formulation of guidelines for the conductance of experiments, which will be included as a discussion topic at annual general orientation meetings for new Reactor Facility personnel.
The guidelines were reviewed and approved by the RSC and have been distributed to all potential experimenters.
'Results Achieved:
Reactor management has extensively reviewed the incident and taken broad steps, both administrative and technical, to preclude a potential for over-exposure from occurring in the future at the Reactor Facility.
A general approach to control experiments has been formalized.
Date of Full Comoliance:
The licensee returned to full compliance, with the regulations listed above, shortly after the high radiation area was discovered in the early afternoon of July 2, 1987.
The area was thereafter properly posted and access was controlled.
1 Avoidance of Future Violations:
The licensee will strive to identify situations where a potential for accidental generation of reactor originated high intensity radiation beams may exist.
The licensee will operate the NR facility in accordance with new procedures and safety features.
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- Second NRC Alleaed Violation:
j Contrary to UVAR Technical Specification 6.3,
" 1.
In 1982, the neutron radiography facility, an experimental facility, was installed without written l
procedures.
2.
Procedures were not adequate, in that, between 1983 and June 1987, the neutron radiography facility was operated without written procedures.
3.
In June.1987, modifications were installed to the neutron radiography facility without written procedures.
4.
Prior to July 2, 1987, written procedures were not in effect for surveillance of the neutron detector in the neutron radiography blockhouse access control system."
Licensee Response:
The first NRC allegation is true and admitted, in that the neutron beamport concrete inserts were withdrawn in 1982 and the beamport's water shield fill / drain system was (safely) modified from an open-to a closed-loop system without written and approved procedures.
The NRC has indicated that the modifications made to the beamport were equatable with an
" installation" of an " experimental facility", a view we have now agreed to accept. The 1982 modifications made without approved written procedures are thus a violation of UVAR TS 6.3(2), which requires written procedures for the removal and installation of
" experimental facilities".
There has been always been agreement between the licensee and the NRC that the neutron beamports are " experimental facilities", as per definition given in UVAR TS 1.0.
Up until the time of the incident, the licensee did not recognize the blockhouse to fall under this same definition, because the-blockhouse did not affect the safety of the reactor and also because of its temporary and assumedly variable nature needed to meet experimental requirements.
Since the incident, the licensee has adopted the NRC viewpoint that the blockhouse is considered part of an " experimental facility".
With regard to the second NRC allegation, it is true that the NR experimenters operated the neutron radiography facility independently from the reactor staff, without written and approved experimental procedures, from 1983 until July 1987.
However, the adequacy of non-existent procedures cannot be judged.
Also, while desirable for radiation safety reasons, lack
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6 ofeexperimental operating procedures:for the NRLfacility isLnot'a
. violation ~of UVAR TS'6.3.
.TheLprocedures required by TS;6.3~for t
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-experimentalifacilities associated with the UVAR'are:for their 4
' installation and~ removal,~ not operation.
UVAR TS:6.3 addresses the-"safeJoperation.ofLthe reactor",.and does-not cover'other r
aspects of the: operation of ancillary experimental' facilities, such as radiological safety..It-istevident thatithe incident:
with:thelNR facility involved radiation safetyy not= reactor:
'l safety.
It has been noted to the NRC that operation of the NR
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facility has. minima 1' effects-on1UVAR reactivity, andLfor this
' reason-did not-involve the reactor operator,-until1the recent changeu.to UVARLreactor operating procedures;were adopted.
The third NRC. allegation, regarding the rearrangement of=and
.additional shielding added'in June of 1987'to the NR blockhouse
. walls'and roof without the use of approved written-procedures, is
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true..
The.additionLof shielding to the'NR facility was at the time not considered to: constitute a modification to the NR'
" facility",'because no:changeLto the beamport,-the: inserts, the
-beamcatcher or the drain / fill system were involved.. Addition of extra shielding' appeared to be'a. simple operation, not requiring a formal safety analysis or. written procedures..Since the l
incident, the. licensee has adopted;the NRC viewpoint that the entire-NR facility, including the blockhouse, is an " experimental
-facility".cLTherefore,?since-TS 6.3; requires written procedures-for-installation and' removal of-experimental facilities, the violation'is' admitted.
.The' fourth NRC allegation is denied..Even if the i
allegation.were to be true as stated,'it would'not by itself constitute a violation of this technical specification..This is discussed.in detail below, under the section entitled
" Circumstances".
Circumstances:
As regards the first:NRC allegation, the lack of approved written procedures for the 1982 " installation" of the NRF was the result of an oversight, based on an interpretation of the changes to the beamport, and theraddition of a beamcatcher and blockhouse, as constituting permissible modifications and additions to an already existing " experimental ~ facility" (the beamport), instead of constituting the installation of a new
" experimental facility".
This oversight has since been
' recognized by the' reactor management and the Reactor Safety Committee..
In connection with the second NRC allegation, until the aftermath of the incident, when the reactor staff developed new
7 UVAR Standard Operating Procedures requiring experimental j
operating procedures from the NR experimenters, no clear reason j
was seen for the reactor management to require experimental operating procedures for experiments located within the Reactor Facility, yet outside of the UVAR reactor pool and the UVAR 1
reactor room.
Experimenters at the Reactor Facility are I
concerned that the adoption of a very general requirement for approved written experimental procedures poses a significant potential for making even inconsequential variations to their experimental setups, of no safety significance, difficult and time constraining.
Difficulties related to procedural requirements conflicting with operations are not found at power reactors (where everything is subject to a procedure), because experiments are not and do not need to be routinely performed.
As pertains to the third NRC allegation, in June 1987 the l
NR experimenters decided to make improvements to the shielding of the walls and roof of the NR facility.
Reactor staff labor I
assistance was sought and obtained from the Reactor Director.
The general perception shared by the Reactor Director, the Radiation Safety Officer, the Reactor Health Physicist and the experimenters was that the intended addition of shielding was in a direction of greater safety.
Changes to the beamport, its
- insert, fill / drain closed loop system, or the beamcatcher were not to be made, therefore no formal safety analysis was done, and written procedures for adding the shielding were not developed for approval and use. It was generally believed at the time that the experimenters were within their rights to alter the experimental part of a setup without written procedures.
With respect to NRC's fourth allegation, it is again pointed out that the experimenter's so-called neutron " detector" is in reality a BF3 counter, not intended to be part of the " access control system".
As referenced earlier in the NRC inspection report 50-62/67-03 of August 6, 1987, on page 10, this neutron monitor for the NR facility was ordered reinstalled by NRC inspector Paul Burnett in July 1987.
We believed that it had been agreed, after consultations between this inspector and the NRC regional office in Atlanta, that its function would be that of a redundant monitor, not requiring calibration.
The problems posed by attempting a legal calibration of such a counter were extensively discussed with NRC inspectors.
The licensee is of the opinion that written surveillance procedures for this monitor are not needed, since its operability is automatically checked with each use of the NR facility.
When the beamport is draining, it is expected to indicate presence of neutrons, and if this were not to occur, this would be checked.
Also, lack of written surveillance procedures for this monitor does not constitute a violation of TS 6.3, which only requires
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such' written procedures for reactor' instrumentation and safety systems.
This monitor is not part of the reactor instrumentation or' safety systems, or the present access control
' system.
It is hoped'that the NRC will agree'to the use of the BF3 counter as intended by the licensee.
If this agreement'is j
not possible, the experimenters will strongly consider withdrawing it.from operation, to avoid legal entanglements in the future.
As already mentioned, this is a redundant device,
.and its intended use is consistent with experimental practices.
It may be a peculiarity to nuclear power reactors that all their radiation meters are considered to be " detectors" and as such subject to calibration requirements.
Corrective Steos:
Procedures were developed by the reactor staff and the experimenters and approved by the Reactor Safety Committee, covering the applicability of 10'CFR 50.59 safety analysis, and the operat3cn and modification of the NR facility.
Guidelines 2
for the conductance of experiments were drafted, discussed, refined, approved and distributed to Reactor Facility personnel.
Experimental operating procedures for the NR facility were developed to. remedy a perceived deficiency, not in the belief that TS 6.3 had been-violated.
Results Achieved:
The licensee believes that it now has a greater understanding of NRC views on a particular number of regulatory i
requirements. The licensee has made additions-to its already extensive number of operating procedures, and is hopeful that the lessons learned will result in maintaining the present good record of low dose exposure to Reactor Facility personnel.
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Date of Full Comoliance:
i The NR facility was put back into service on August 7, 1987.
By that time all safety measures had been installed in the NR
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l Avoidance of Future Violations:
The licensee expects that requirements for approved written i
j procedures for experiments have been clarified, so that future violations having to do with procedures can be avoided.
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9 Third NRC Alleced Violation:
It is alleged that in 1982, in violation of 10 CFR 50.59, the licensee made a change to a neutron beamport, which is a l
facility j
by removi. summarily described in the Safety Analysis Report (SAR),
ng the concrete plugs and constructing a blockhouse at the beamport to compensate for the removed plugs, without preparing a written safety evaluation to determine that the change did not involve an unreviewed safety question. This is an alleged violation of 10 CFR 50.59 (a) (1), which requires that a determination be made of whether a change to an item described in the SAR poses an unreviewed safety question or not, and 10 CFR 50.59 (b) (1),.which requires that written records of changes to items described in the SAR be kept, including the safety evaluation which provides the basis for the determination that a change did not pose an unreviewed safety question.
It is noted that the beamport inserts are described in SAR section 5.1, as concrete plugs to be installed in the 8-inch beamport when it is not in use.
Licensee Response:
It is admitted that the requirements given in 10 CFR 50.59 were not fully met when the above described changes to a neutron beamtube were made in 1982.
Circumstances:
The licensee made the (temporary) changes to the beamport, as described by the NRC in its allegation.
The changes were made on the basis of a safety evaluation which was sent to the Reactor Safety Committee on February 16, 1983.
This evaluation was based on tests performed with the beamport in January 1983, but the evaluation did not specifically state that it satisfied the provisions of 10 CFR 50.59, nor did it address the "unreviewed safety question" issue.
The safety evaluation was kept in the files of the Reactor Safety Committee.
The modifications were sanctioned by the Reactor Safety Committee, who made no further demands at the time.
The NRC maintains that such changes should be recorded in an licensee " updated" SAR.
The changes to the beamport and the building of a blockhouse were not considered permanent, insofar that the beamport can be returned to its former state quite easily.
With the removal of the shielding, neutron camera, water pump system and insertion of the concrete inserts, the beamport would no longer be "in use",
as referenced in the SAR.
1 10 In 1982, use by the research reactor community of 10 CFR 50.59 based " safety analyses" was not widespread-for.other than
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major modifications of the reactors.
The NRC indicated to the non-power reactor community in 1984, at a an annual meeting of directors of Test, Research, and Training Reactors (TRTR), that it would begin enforcing a stricter application of this regulation, to include also more minor reactor facility-
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alterations.
Clearly, the regulatory climate in 1982 was 1
different from today's.
NRC inspectors who have visited the
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Reactor Facility during the period from 1983 until June 1987 have on numerous occasions inspected U.Va.'s NR facility, and did not identify the 10 CFR 50.59 violation, nor the lack of approved written experimental operating procedures.
Were it not for the recent radiological incident, it is probable that the NR facility would have continued to operate as before.
Corrective Steps:
L New UVAR SOP 2.12 and 2.13 were developed and approved, to address the requirements of 10 CFR 50.59.
A written safety evaluation for the present as-is neutron radiography facility was re-donc and presented for review and approval by the Reactor Safety Committee.
In association with the various safety features which were installed, numerous 10 CFR 50.59 analysis were done.
These analyses are recorded in the Reactor Safety Committee files.
The changes made to the experimental facility will be referenced in the licensee updated UVAR SAR entitled "UVAR Design and Analysis Handbook".
Results Achieved:
A complete review of the NR facility operation has been achieved.
Date of Full Comoliance:
The NR facility was brought back in operation on August 7, 1987, the date by which full compliance was achieved.
Avoidance of Future Violations:
The reactor staff, the experimenters and the RSC are now well aware of the scope and emphasis placed by the NRC on the performance of 10 CFR 50.59 based safety analysis for reactor AD$
experimental facility modifications.
An updated QA/QC form is in use to address 10 CFR 50.59 requirements.
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1 ANSWER TO NOTICE OF VIOLATION l
Bv:
Reactor Facility Department of Nuclear Engineering and Engineering Physics University of Virginia (Docket No. 50-62, License No. R-66)
Date:-
November 11, 1987 L
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References:
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- 1) Notice of Violation and Proposed Imposition of Civil Penalty (NRC Inspection Report No. 50-62/87-03 of 10/26/87) l t
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- 2) University of Virginia's " Reply to Notice of Violation" 1
(10/11/87)
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- 3) Guidelines for the Conductance of Experiments at the
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Reactor Facility i
Purcose:
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Pursuant to 10 CFR 2.205, the University of Virginia requests mitigation of the NRC proposed $ 2,500 proposed civil I
penalty.
The proposed penalty is for violations which have been i
evaluated in the aggregate as a Severity Level III problem, for l
(admitted) violations of:
l and 10 CFR 20.203 (c) (2) ; and l
The licensee has provided in detail in the document entitled
" Reply to Notice of Violation" the responses, reasons for violations, and corrective actions taken with regards to the l
above violations.
The licensee agrees that the assignment of a I
severity level III to the violations in aggregate is in conformity with 10 CFR 2, App. C, Supplement IV, C.4.,
and that the assessment of the fine is in conformity with 10 CFR 2, App.
j C, Tables 1-A and 1-B.
However, the licensee believes that in view of the opportune discovery of the violations, the immediate reporting of the event to the NRC, the verification of no personnel exposures above NRC limits, and the extensive
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corrective actions taken by the Reactor Facility management, consideration of a mitigation of the proposed fine is justified.
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Basis for Mitication:
I In the NRC' cover letter to the Notice of Violation and l
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Proposed Imposition of Civil Penalty which was addressed to the Dean of the School of Engineering, the allegation is made that "Any mitigation that may have been warranted for your prompt and extensive corrective actions to preclude its recurrence at the x
neutron radiography blockhouse is offset by the lack of broader N
corrective action to assure that a similar problem does not occur i
in other aspects of the operation of the facility." The licensee
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finds no basis for this statement, and believes that, contrary to the NRC perception, from the date of discovery of the
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radiological violations, reactor management promptly initiated corrective actions, both specific to the neutron radiography facility, and broadly related to control over experiments 1
conducted at the Reactor Facility.
In the paragraphs below,, this
. y3 aspect and the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1987), to be used by a licensee in an appeal for mitigation, will be covered.
Broad Corrective Actions:
At the enforcement conference held at the Reactor Facility i
with members of the NRC's Region II and head offices, on August 13, 1987, the licensee presented its case in response to the NRC preliminary violation findings, at NRC request.
Much ground was covered in the licensee's presentation, due to the complexity of a
the issues, involving many details and possible interpretation of the regulations.
Still, a short period at the end of the conference was dedicated to a general discussion.
During this period, the NRC representatives were free to ask any questions, which they did.
From past experience with the regulatory process, the 4
licensee is well aware that the comprehensiveness of a licensee's
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actions following notification of violation is an issue of
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interest to the NRC.
The licensee believed it had made a good i
case for the broadness of the corrective actions planned and l
taken during the enforcement conference.
This belief was
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reinforced with the receipt of the Enforcement Conference Summary, sent by the NRC to the Reactor Director on September 4, l
1987.
In it was stated that in the opinion of the NRC, "this meeting was beneficial and has provided a better understanding of the inspection findings, the enforcement issues, and the status i
of your corrective actions." In this document no mention is made of management issues raised in the final inspection report.
The NRC did not seek to determine license actions taken after the enforcement conference, and the licensee believed that it had satisfied the NRC.
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To indicate the comprehensiveness of the licensee attention j
l' and actions, we point to the fiva Reactor Safety Committee
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meetings held to date since tbe inciQant, which were largely l
dedicated to the correctiva action developments.
The average
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frequency for RSC meetings normally is once every two months.
More than twenty items for RSC review and approval were presented to the Reachpr Safety Committee in connection with this incident, and the end dass not yet' appear in sight.
During one session of p
the RSC, NRC inspector Paul Burnett was asked to provide his i
personal assessment on the general applicability of 10 CFE 50.59 to, experiments other than the neutron radiography facility.
At tPa first meeting of the RSC following #he incident, the RSC Cnairman requeated tha.: the Reactor Director evaluate other facilities'associetod with the UVAR for which the potnntia.9 for accidental beam relerae might exist.
p The issue of 10 CFR 50.59 applicability and the hssocinted issue of rpector management control aver experiments at the Reziator Facility was'the subject of a private discussion between the Chairman of the Department of Nuclear Engineering and Engineering Physics >and the Reactor Director, held a few days
,'after the incident.
The RSC also addressed the issue, and requested,the Reactor Director to prepare a draft statement on this tfpic for RSC review and apprcval, e
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The draft. proposal on control over experiments was next discussed at e;49eting between reactor management and the
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' )! ekparimenters, held on September 1, 1987.
Thoro were many
' sc[gestions which came from this meeting and some written commeris from the experimenters took a while to return to the ReactNr 7.drector.
All comments were analyzed and a more polished N
n)stebent was written for RSC review and approval.
This statetent is now known as the " Guidelines for Experiments a
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"(q Conducted at the Reactor Tacility", and it has been videly dis tributed.
These guidelines reaffirm the authority of both the i
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Rosctor Dif.9ctor and the Reactor Health Physicist, permit a formal; ap;hach to-the evaluation of ? aactor and/or railiological safety risks associsted with future experiments at the Reactor t
Facility, and address the eventual need for experimenter's r /-
procedures.
The concern expressed by the Reactor Safety Comwittee by holding numerous meetings, and these adoption of
\\,espar! antal guidelines, are examples of the extent of reactor manages 2nt concern tir broad corrective actions, and should serve to revtrse thefiRC j t pression of a lack of management authority.
DiscusuAon of FactoIs Fa: Consideration of Miti'gation:
I Prompt Identification and Reporting z
The stieaming of radiation from a partially drained 4
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l af neutron beamtube was not noticeable externally to the NR blockhouse and the nearby reactor face radiation monitor did not alarm.
The problem was'discqvered by a reactor staff l'
member who entered the blockhouse to resume work after.
J-lunch.
His audible dosimetor/ indicated an unexpected high i
radiation field.
He exited'and called the Reactor Supervisor and Health Physicist.
Short:1y thereafter, the
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Reactor Director returned from lunch and was also informed.
5 From that point on, the Reactor Director determined licensee response to the event.
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Further notifications were made to the mb'2rincipal Investigator, the University's Radiation Safety Officer, and all potentially affected;NR workers. UVAR reactor power was reduced, following which the area was carefully surveyed by the Reactor Health Physicist.
The beamport was then re-filled, and the amount that had drained was estimated. The area was then posted and secured.
NAA was done on personal jewelry belonging to sevaral radiography workers.
Landauer was called to arrango for emergency development of radiation badges from the potentially affected personnel.
(This was very difficult to arrange, given that the fourth of July weekend began the next day).
By this time, the activation analysis results were ready, indicated that overexposure of personnel had not occurred,. Next, the Chairman of the Department was briefed, as.wss the Director of the U. Va.
Office of Environmental Healtil and Safety, to which the Reactor Health Physicist ah4 Radiation Safety Officer are attached.
At about this tigd, the NRC was notified by phone.
Finally, the NR workers were called to a debriefing meeting, provided with the preliminary dose data indicating that no overexposure had occurred, queried as to any information about the incident which they might have had, and finally asked 4to provide their phone and addresses during the holiday weekend.
Once the licensee possessed reliable information, the NRC was immediately informed of the problem.
As repeatedly stated, the high radiation area was found in the afternoon of July 2, after lunch.
It is impossible to determine exactly when the partial drain of the beam occurred, however it is likely that the problem occurred during lunchtime.
As is related above, the licensee took immediate action to correct the problem on discovery.
2.
Corrective Action to Prevent Recurrence Ini',ial corrective actions were specific to the NR facility and had to do with developing an understanding of the causes of the incident and identifying mechanical fixes.
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The following week, at a meeting attended by the Reactor Director, the NR Principal Investigator, and the Department Chairman, broader issues began to be raised as regards i
procedural controls over experiments.
Due to the hosting of I
the NRC inspectors, the licensee was forced to adapt and I
slow his corrective actions schedule to meet the NRC need for information.
Also, the licensee did not want to rush into actions which might lead to further violations.
Discussions with the inspectors were valuable in making i
certain that licensee actions would meet with their approval.
The attachments to this reply package to the NRC contain a chronology of the events which followed the incident, and indicates the considerable and early involvement of the RSC in the corrective actions.
Further details relative to the actions taken with regard to the introduction of safety devices and generation of new i
procedures and safety reviews are to be found in the licensee's " Reply to the Notice of Violation".
l Corrective actions of broader scope took more time to complete than actions directly related to the NR facility, and were based on frank discussions between staff, faculty, and experimenters.
A consensus had to be developed about mechanism by which reactor management control over experiments could be refined, without undue infringement on the freedom of the experimenters.
These discussions led to the formulation of " Guidelines for the Conductance of Experiments at the Reactor Facility".
In summary, the corrective actions were extensive, prompt and broad in scope.
The NRC assertion that lack of broader corrective actions exists at the Reactor Facility bears reexamination in light of this information.
3.
Past Performance NRC representatives have noted in the recent enforcement letter to the Dean of Engineering that, in its evaluation of prior recent licensee performance in the area of health physics, only minor health and safety problems have been found at the Reactor Facility.
The record of Reactor Facility personnel dose exposures shows, by the consistent low values, that in general good radiation protection practices are pursued at Virginia. Even with the recent event, it was possible to maintain the dose exposure to the most exposed individual to less than about 10 % of the NRC limit.
While it is possible to continue to point to the potential for overexposure presented by this
6 incident, a fact recognized by the licensee, it can also be stated that overexposure did not actually occur.
The Reactor Facility has had a safely operating NR facility since 1982 and this event should be viewed as a unique and single event.
Having occurred once, and having provoked a very positive licensee response, a repeat of this situation is not likely.
4.
Prior Notice of Similar Event As a result of an operational event, an NRC audit, or a specific NRC or industry notification, the licensee had no prior notice or knowledge of the existence of a problem with the beamport fill / drain system, which might have indicated that the event which occurred was likely.
Therefore, no preventive steps were taken prior to the event.
5.
Multiple Occurrences The event in question which lead to violations happened just once.
As soon as the licensee became aware of the condition, corrective actions were initiated.
Indications are that the problem existed for only a short time, over lunchtime, on July 2, 1987.
Other Considerations Supporting Mitigation:
It is stated in the regulations that the purpose of a civil fine is to emphasize to the licensee the need for lasting remedial action, and to deter future violations.
The licensee has, it believes, given indications that even when minor regulatory violations were discovered, it always took quick action to avoid repeat violatione.
Furthermore, it is stated that civil penalties are assessed if the regulator believes that the violations were willful.
It is clear that in this case the licensee did not commit a conscious violation.
The NRC has accomplished its purpose in proposing the fine.
This action has resulted in considerable pressures of many sorts to be brought on reactor management.
Reactor management has been duly concerned with taking prompt and broad corrective actions.
The mitigation of the fine should now be seriously considered.
6.
UNIVERSITY OF VIRGINIA DEPARTMENT OF NUCLEAR ENGINEERING AND ENGINEERING PIIYSICS r 'A' 3
NUCLEAR REACTOR FACILITY J
SCHOOL OF ENGINEERING AND APPLIED SFIENCE CHARLOTTESVILLE, VA 22901 F
e 2
November 13, 1987 Edgar S. Starke, Jr.
Dean and Earnest Oglesby Professor of Engineering and Applied Science University of Virginia
Dear Dean Starke:
Enclosed are four documents related to the recent NRC Notice of Violation and Proposed Imposition of Civil Penalty:
I Answer to Notice of Violation: This document responds to the allegations about management deficiencies and requests mitigation of the civil penalty.
II Reply to Notice of Violation: This document responds in detail to the alleged violations.
III Guidelines for Experiments Conducted at the Reactor Facility: A document prepared to tighten management control of experiments.
IV Memo to T.G. Williamson from J.L. Meem: A response to our request to the Reactor Safety committee for an evaluation of management control.
I believe that the civil penalty recommended by the NRC should be mitigated to no fine based on the following:
A) Severity: The exposures to personnel were low. The maximum exposure to an individual was a small fraction (less than 10%) of the allowable exposure under the regulations. This is consistent with the history of the reactor facility, and of the neutron radiography facility, in which personnel exposures have l
always been low; for most of our people the radiation exposures have always been below detectable levels.
B) Prompt Response: The high radiation area was discovered very soon after it had occurred by a staff member who wore an l
audible dosimeter. The staff actions of immediately reducing the reactor power and investigating the source and magnitude of the radiation were proper. In my view they evidenced a great deal of imagination and innovation when they had estimates of personnel exposures very quickly from the activation of gold in jewelry.
r Letter to Dean Starke Page 2 November 13, 1987 These estimates were later confirmed by the dosimetry service. We also promptly notified all proper authorities.
C) Management: At our request the reactor safety committee, an independent body, reviewed the question of management authority. The reply, in a memo to me from the chairman of the reactor safety committee, affirms the fact that the lines of authority are clearly established. Further, at my suggestion, a policy statement has been prepared and approved by the safety com.ittee which clearly states the authority of the reactor director and the health physicist for all experiments conducted at the reactor facility.
Throughout the course of this incident I have kept Dean Lowry apprised of the situation and he was present at the enforcement conference. We have also been in frequent communication with Dr. Ralph Allen, Director of the Radiation Safety office. Thus all levels of management which appear on the organization structure in our license, up to the President's level, have been involved from the beginning.
The response to the NRC is due 30 days from the notice of violation, November 23. The original is sent to the Office of Enforcement in Washington with copies to the regional office in l
Atlanta. Signatures must be notarized.
Yours truly, i
IhM t MN T.
G.
Willi'abson, Chairman Dept. of Nuclear Engineering and Engineering Physics i
TGW:ph cc: R.U. Mulder i
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1 M U November 4, i s rr.
e 1987 MEMORANDUM TO:
T.
G. Williamson, Chairman of the Department of Nuclear
,; E lll %
Engineering and Engineering Physics 4
FROM:
VJ. L. Meem, Chairman of the Reactor Safety Committee
SUBJECT:
NRC's Allegations Regarding Lack of Management Authority At the meeting of the Reactor Safety Committee on October 28, 1987, you were present upon invitation by the RSC Chairman to discuss the letter from the NRC to Dean Starke, dated October 26, 1987.
You requested a statement from the RSC with respect to the allegations in that letter about an apparent lack of management authority to ensure that operation of the Reactor Facility is conducted in a safe manner.
A subcommittee of the RSC was appointed, consisting of J.
L. Moem and A.
B.
Reynolds with the assistance of J.
P.
Farrar,.RSC Secretary, to respond.to these allegations. The full Reactor Safety, Committee met on November 4, 1987 and concurred with this statement, with R.U. Mulder choosing to abstain due to conflict of interest.
It should be noted that there are a number of other alleged violations in the NRC letter which are not addressed in this RSC response.
RESPONSE TC ALLEGATIONS OF LACK 0F(MANAGEMENT AUTHORITY l
The purpose of this memo is-to discuss several statements made in the NRC's letter of October 26, 1987, to Dean Edgar A.
Starke, Jr. with regard to lack of management authority at the Reactor Facility.
First, contrary to a statement in the NRC letter, there is not a lack of management authority to ensure the safe operation of the Reactor Facility.
Second, contrary to the NRC letter, the Chairman of the Department of Nuclear Engineering and Engineering Physics has given full authority to the Reactor Director to control experincntal facilities related to the reactors and the use of these facilities whenever they affect reactor safety and l
whenever any question is involved regarding operation in l
accordance with government regulations.
Third, contrary to the NRC letter, corrective action taken in response to the present event is broad enough to assure that a similar problem does not occur in other aspects of the operation of the facility.
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LFacility'Manacement and Delecation of Authority to the Reactor Director The jobidescription for the Reactor Director signed by.the?
Department: Chairman en July.10, 1984, states that'the duties'of-the Director-include " Assurance that the reactors are operated
- safely-and in accordance with federal and state regulations."
This has always;been interpreted by the Reactor Director and'the
. Reactor. Safety Committee to;mean that the. Director has full authority tolprohibit the actions,of any experimentergif.it compromises the safety of the reactor or violatesJa federal,
regulation, including. regulations that. govern radiological
. safety;.and there has-never been.any~ indication 1from the Department Chairman that'this interpretation i~ different'from
.that of the Reactor Director.
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The Chairman of the Department.is performing his managements duties in an appropriate-manner ~by directing the' Reactor Director to assure;that the reactors are operated safely and in accordance with-federal and state regulations.
It is.the duty of the Reactor Director,:with the assistance and-approval Of the Reactor SafetycCommittee and, in matters of-. radiological safety, with the~
assistance of;the Reactor Health Physicist, to determine how this is to be done.
.There is no questionLthat the Department Chairman has given the Reactor Director full authority to carry out this directive.
Role of the Reactor Health Physicist l
Regarding matters of radiological safety (which was the issue in~the modification of the neutron radiography' blockhouse),
h the1 Reactor Director adds to his own assessment the advice of the Reactor Health Physicist, who reports to the Radiation. Safety' officer, who in turn reports to the Director of-Environmental Health-and Safety.. The Reactor Health Physicist, therefore,
- reports to neither the Reactor Director-nor the Chairman of the Department of' Nuclear Engineering and Engineering Physics.
Both
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'the Reactor Director and the Reactor Health Physicist have full authority to enforce federal regulations with regard to the radiological safety of any facility associated with the reactors.
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3 NRC's Percention of Manacement'o'f' Blockhouse Modification The NRC concluded that there was a lack of management control at the Reactor Facility during the modification of the blockhouse.
However, the Reactor Director had and has authority over experimenters if the experiment affects reactor safety and/or radiological safety.
The Reactor Director, the Radiation Safety Officer, the Reactor Health Physicist and the experimenters believed that the June 87 modifications of the blockhouse would have no effect on reactor safety and radiological safety and that no federal regulations were being violated.
With regard to the requirement for procedures, the NRC interpreted the incident differently and in a manner, in the view of the Reactor Director and the Reactor Safety Committee, different from past interpretations by the NRC at the University of Virginia Reactor.
For example, NRC inspectors who have inspected the Neutron Radiographic-Facility since its establishment in 1982 have never indicated that operating procedures for that facility were required by federal
, regulations.
Had the Reactor Director known that a violation in the operation of the blockhouse was occurring, he would have had the unquestioned authority to prevent the experimenters from carrying out the modification.
He had the full authority to require procedures if he thought that federal regulations called for them, to have the procedures' approved by the Reactor Safety Committee, and to enforce the procedures.
. Corrective Action for other AspectE^of' Facility Operation The neutron radiography incident was reported by the Reactor Director to the Chairman of the Department of Nuclear Engineering and Engineering Physics late in the afternoon of July 2,
- 1987, soon after the necessary first measures had been taken by the reactor staff. In the days that followed,.the Department Chairman participated in numerous discussions with the Reactor Director at which both corrective actions specific to the neutron radiography facility, as well those with generic implications, were identified.
At the Department Chairman's suggestion, the Reactor Director prepared a draft of a policy for experiments.
At a meeting on September 1, 1987 this draft was presented and discussed with all experimenters.
After all comments had been received and considered, a final document was prepared, sent to 9
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4 the Reactor Safety Committee and approved by ition October 28,
'1987.
It is entitled " Guidelines for-Experiments Conducted at the Reactor Facility", and'it has been_made available to all-experimenters at the Reactor Facility.
These' guidelines, reaffirm
,;4 L
-the authority of-the Reactor Director and clarify the experiments which require review with respect"toS10'CFR 50.59-and reactor and
' radiological safety.
Developm'ent of these' guidelines was part of L
.the corrective action.taken in response to the present event and is broad enough to apply toLall aspects of the operation of the.
Reactor Facility.
1 The Reactor Safety Committee was called to a-special session on July 15,'1987 to' discuss the incident and the first of the NRC b
-inspection-results.
Since then'the Committee has met-4 more-times to consider. additional developments (July 24, August-11, September.16, and october 28, 1987).
So far,.23 separate communication 11tems bearing on this incident were brought to the Committee's attention.
The applicability of the federal 1
regulation 10 CFR'50'.59 to experiments'in general.was much discussed, and benefitted from the participation of NRC inspector 1
1 Paul Burnett.' The RSC has' called on the Reactor Director to give.
renewed attention to experiments involving radiation beams..
.1 conclusions Therefore, the Reactor Safety Committee does not agree 1that a lack of management authority exists at the Reactor Facility.
t.
Instead, the Chairman of the Department of Nuclear Engineering and Engineering' Physics has acted.in an appropriate manner by
'giving full' authority to the Reactor Director to assure that the reactors are operated safelyfand in accordance with federal and state regulations.
This has always been interpreted to.mean all facilities in the Reactor. Facility that are associated with the reactors.
Also, the Reactor Safety Committee does not agree i
that there is a lack of broader corrective action.
As detailed I
above, broad corrective actions to assure adequate management l
control over experiments were taken promptly.
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GUIDELINES FOR EXPERIMENTS CONDUCTED AT REACTOR FACILITY (approved by RSC on Oct. 28, 1987)
Experimenters using workspace within the Reactor Facility, and working with the UVAR, UVAR powered radiation-beam producing facilities, UVAR produced radioactive materials, or within the UVAR reactor room, shall be asked to submit to the Reactor Director a brief written description of their proposed experiments and/or experimental facilities.
Proposals will also be required to be submitted for intended significant changes to existing reactor related experiments or experimental facilities (as per above description).
Significant changes are those for which the degree of reactor and/or radiological safety is altered in a major way.
Experimenters using currently approved facilities for routine neutzon activation analysis (NAA) or isotope production, will not be bound by this requirement, because their work is covered by irradiation request procedures (listed in the UVAR SOP's 2.6, 6.1 through 6.7).
Similarly, laboratory experiments conducted in Reactor Facility laboratories for teaching purposes will generally not be affected.
The experimenter's submittal will describe the planned activity in sufficient detail to permit separate evaluations of radiological and reactor safety to be made by the Reactor Health Physicist and the Reactor Director.
To achieve these objectives, the proposals may, for the sake of comprehension, contain descriptions of ceneral experimental procedures or techniques, in addition to the expected experimental safety procedures.
This procedural requirement is placed on experiments to assure the safety of the reactor, experimenters and occupants of the Facility, and should in no way dictate the normal process of experimental investigations.
While the Reactor Health Physicist will examine the experimenter's proposal to identify possible radiological safety implications, the actual radiological safety analysis will be done by the experimenter (see UVAR Design & Analysis Handbook, Section 7.2, 7.4).
The experimenter will be made aware by the HP that he/she must assume responsibility for the radiological safety of work and workers.
The Health Physicist will also determine whether the experimenters and/or co-workers should receive training in radiation safety and be classified as restricted or' qualified users of radioactive materials.
Finally, the HP will determine what other procedural radiation safety requirements must be met, on a case-by-case basis (UVAR SOP's 2.6, 10.1, 10.3.B, 10.4.B.1, 10.5.B, 10.8, and 10.9 may be consulted).
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2 The Reactor Director will determine from the experimenter's written submittal whether the proposed experiment, or modification to an experiment, involves an unreviewed reactor safety question (UVAR TS 1.0, 3.1, 3.6, 3.7 can be consulted).
Reactor safety'is involved when experiments have the capacity to substantially change the reactivity, or affect the integrity, of the reactor.
If the proposal does not involve reactor safety matters, the Director may give his approval to the proposal, contingent on the prior determination by the Reactor Health Physicist that radiological safety concerns can be properly met.
If the Reactor Director determines that the proposal does pose unreviewed reactor safety questions, the experimenter will be requested to submit the proposal to the Reactor Safety Committee (as indicated in UVAR Design & Analysis Handbook, Section 8.1). The RSC will review written documentation and procedures, as required, for the construction, operation, modification, and removal of reactor associated experiments or experimental facilities located in the Reactor Facility (as stated in the UVAR Design and Analysis Handbook, Section 8.3, and UVAR TS 6. 2. 3. (1) ).
The Reactor Staff may be asked to assist in the preparation of experimental reactor safety procedures.
10 CFR 50.59 SAFETY ANALYSIS For the purpose of guidance, the following list of items are described in the UVAR SAR, and may be subject to a Title 10 CFR 50.59 safety analysis, should they be involved in an experiment, or modification to an experiment:
1)
Reactor Facility site, building, "new construction",
containment, shielding.
2)
Reactor Components and Controls: fuel elements, control rods, control drives, instrumentation, scrams, interlocks and alarms.
3)
Reactor Systems: pool, primary cooling system, secondary cooling system, heat exchanger, water purification, liquid waste disposal system, building ventilation and airborne discharge, core spray system.
4)
Experimental Facilities: Beam holes, experiments in line with a beam of radiation emanating from the UVAR reactor, large access facilities, in-core sections of rabbit facilities (excluding out-of-core transfer systems), fueled experiments.
The Reactor Safety Committee is the arbiter of last resort I
for deciding when a 10 CFR 50.59 safety analysis is required. It is anticipated that experiments, or experimental facilities located outside the UVAR pool boundary, will generally not i
I involve reactor safety concerns and will therefore not be subject to 10 CFR 50.59 provisions.
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3 The Reactor Facility Staff will, at the direction of the Reactor Director, assist individual experimenters in making an analysis of proposed experiments, experimental facilities, and changes thereto, in order to comply with provisions stated in the federal regulation Title 10 CFR 50.59, and UVAR SOP's 2.12 and 2.13.
The Reactor Staff will also assist in the preparation of QA/QC checklists, where necessary.
Supervision of UVAR Associated Experiments When the Reactor Staff is requested to assist experimenters with the construction or modification of an experimental facility associated with the UVAR, a senior reactor staff member will assist the principal investigator in the supervision of the activities.
Operation of UVAR Associated Experiments Experimenters may operate UVAR associated facilities without reactor staff participation, provided they follow written procedures as required by the RSC.
If disagreements concerning the operation of these facilities arise, the Reactor Health Physicist or senior staff members may overrule the experimenter, and if necessary, stop work in progress.
Such disagreements should be referred to the either the Reactor Director, the Department Chairman or the RSC committee for resolution, as soon as practicable.
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