ML20245D060
| ML20245D060 | |
| Person / Time | |
|---|---|
| Issue date: | 06/30/1989 |
| From: | NRC OFFICE OF ENFORCEMENT (OE) |
| To: | |
| References | |
| NUREG-0940, NUREG-0940-V08-N01, NUREG-940, NUREG-940-V8-N1, NUDOCS 8906260379 | |
| Download: ML20245D060 (428) | |
Text
{{#Wiki_filter:h Ah[2 $ [N h / [ N.bh. MP / h 9'4" [. ,,Mf }b[%
+
hhMQQIh?f&y$f WQQd% ' ;fb lm@yn % % + + ? n. ' = NW 5NUREG1 b%p q ty"xW3 e f h h W M ~h h h> f k @ M P W M @p )d( M z$h'MM.%m 4 %g. w cNe.a,_ m~3.4 o q r .w;w r MNMDd mu pk r . Ayew<w@h. 94 1 hyNQ& y eem-
. we m#o.. %m+
a,n:;c _
.. x- .+
'.v ,' ' "m. qt g.n , ,m(
r m a. P
- t lC
#, ,y.
*lNb(&N$y[j@
g #w; %+ ; e s~ '
.s +. m , W .
f C 3
, s
. e
'y
%n A e
pxd erp #4+ m e
- ,tiA [Y a. . ,xp"fd!M+
r
> , ' ' . 9A La. ~. ; n : aa pp a;r#.. , >%;- ,t f % .y ,
y g/4 p~y 5 q@wy4g ;LM wi % Ap*gf }k ;$,y r 4mr4 sdwN,y
> c.m . _M. c o V e.fy f 9, ?.hy Ohqp' MauM 7/@f lTOCh $U' N 'EM :
d:/qqP% f gdw Mf sfi;d.hp'c I Q:mhTsp@@ T1 ONh h.Nk t @s@
~M hdM"NU,&
up*Lyc Ma- a r'
- dpi ym$n&"h[VL2p /+,ww
!' s W fgh /QMp; M
' MS M
#y --
, 4 4 7 Mk < 6.% A r e !i, ! W 7
%.. KQ 1 A, m d 5f:h .;'r^ l h kh 1 ?_qSE. % p, l g"; I )
4 '@em'f yf,p'O. f f glfawh:ly.h fw %go. y - gq'!),& W '[Q.5 %j hWW.l.f +ap;hWW.n t m M,j%W 1
;fifW:lb , , _&c -) Y. , m" '?
y g+ *1 Q~ a%jm w %n S _' m% ;~Qmas vjuii r ..
&n nwp: ~ '
%w' , *r :. ' a g _ ;j7 %
s q
?
#%MW - ,
py%Ey%fo.%g31MWW%;4num.g&rcem'ent"i @mQw: 8 ag
%y a 9 n x.wp a , m po r 'p+;% - mm m x ~w w" &a t .m A%gpM 4;;;n Qe 'n w T'st w
- 4 m % g g,m,d:i % ::? i 'q:ncrM 4 .% w e m % .~:e p V r
e y % %,4 m)c::ea, n,g w%m;, 3j 9 :; e 5,n' 4 Mr A: - :. u ' m ms .. A c y ,;
% $'" i O / iflf'S S . . . % M."?@H5;d,$5!$
< r
$$$4dMM.MMMM f/ftN%@a deQ hg$$WM WinOW@$ MF% GW f#%9A ' MW N? '
/
As-MGM ' MV '
%"'V
- ! X' 1 " Md?
b;wy Q dd%gpCS n w 4,- ; , m1 ' d A ,. y aa W@wA
.-L y m;M V r:M 9 ; @g M% dW W r,'y4R.
1
- o. . < v< ww MfM dh. W wnA w
f y " g 'r m e;w 3 s; -c eg M,, Wmmg@f%.ks.p* (: 9 w y;4Qi p& m h%.dA k . .. .m W. ' ~ ni mm m 'dy m:bsu
,/;n D%yx
? > q; ,9
"..J.uqq s
' e 'J - vyn
', 4=v s Ms
. q Ny$sw@@c e
M, : '( n; m ~ ,6 ,r >
. 29 m.M & n
_s ,, v
'e a+;;~
$$(({ idl f@$p$g[k C (DMfy
, < f,0QQhWhh kt? 4 N <
j"y ' N h' f , M M *y k.fhf, .. j
- l ,
. f\
Wm wp mg uw wn -
&a1 y* r e im;, , '> w, ' ro W:h
- gMM .a
- %q,p'u;xgp@w %a b,g m m % U M D M tw +W " d p n 3- .m 4 m a~y' w
- : . < u pp g WW W n%nr Mwccu.n, s..'
", w my W%; n% "
, & &.;)%w : n, wg l - %y, yf;i[dMy%mf Maqn W;v.f bm a w&p-m ' m?, ,,v.uppm U #
y we ,. 4 gm% Lm wiry w 4't ~ ~ f u a ::n pV e ,o w L sd. S i wh YWiW t ,.::i%m;s 7n u } w%w tyki Ys V W W
- An -a
. n e
v@c m[ .on,1, W;;..s n ,? -
..,'e_ ^v97stw ~,- @m n, . e v s " u '(
tr' i rs; '; d; %g w 4 mWW@w;p eS A. .. 4gg.aM; wM Wgb--
,p, n ur
~~
5 w.z N~ y aMW
'%,'dA-q?: 1,.
e v s v.
~
W'"y% - t qM,g. ( 4Qo &:nn%#m a l= f, eporty W.~.s;e..uarter y %ca., wxama
- s. + <y, u <
ww w hbik$..hM. IkIC.#kh-7bb,N, rOgressin.n M ,% M.aW.w[a -4. . W ~ Wb.k wo,
' Mm.x
$gaN? hq s m A 4 a.
*' A,N, m
,,Y!c0 \fN '
S E Mb},L@Y@h ,f? k p%a%.::e E k,,h?'n NY Y U.* &m m"p ,W. ~ ',M iM
- .v, !
yhYf. e An wAl. w 79 ,
,. 1 6 e.
-N vn 4,s.
h e i7 m >: wLW.y/$pe
",a Y %a oc1:W W Y
- I; 9q;., . . i
.N: 1 +s:":e ,
%L fLw
.' . > b %-
.z ?
a p%)N% 5&ff,0QM%n,,. n > m.,m Us.. l:yh(= Q-i'y *!,-ff ' :' !iIA c Y'% f&%W b ,* ( '2Mg." Q Q;.Al % ' V 'i M L ,. u ?p %;p v
=:i:0 Y$&YQ'k
_ - Q r,
, <MM%
ff '"m : 2 gbyM%m&pMnarA w q p M Mm l;W', M 9 pph q m %;r-n aw n , Aaan r,
- MQ:g
'$;m A o&r kh QfhN .b.h % Q& 1 'N Y N' i" r o e ?v m 3~ * '
",a N ,, Y fh SMu61 % Riguldiory
$Nlwmm-Q..W,m;%~,,WRg%o . m hh 7 %@;rndg$*d.n , 4
. , Yd? -
A'. \ , :nYk e' Y,- ,
$ M.n M 4a CD1 MISSION * '
g&:pg:nmw4s n 6,Qav v. m, w. ~s , v m Qht f ir* n ,s n .
. M, , : h. , a HR s
- r x'
*.n V;a g n
W h,r%l'L;}MQ: yTV1-V,-v - e i Otk )} _ M V, { $k Wh. ' f'$ ' ." y 4 1 th,,, J; -
.l .' L
. N. , ,.%
~P #e ~' "
- _0'*~ Rice of'E,h,G'ovnf rcemenN,gsaM" e"" f' i' Q %. WHey G
u d Q ' M' ' 7MWM, O W[8 0@,Q(q-N'qV;#$' Q- i M; , ' , y"g4 t
, , i
' ' , ~/
%'W ; , < , > 4 pw% g Akn y..s
- 4
< e, p- .>
%.pf; y~.-
y-y
; m y?P s
',s d,4_gA 3 em eri' wt
><:7-
* , 1 1 . m h
p&owW? .e '; . MM ,Sp^ ? ,4 >( s w .. w ~,
&, @'Y, f' 1 wdw g,.QL.C sag, s . q , ,
m ( y< v A.. a m- ' s u,M. .,Ar- n
.j-
\- .
h :; Y 7.y %%% k$$Y, yf ,m . k?qq% h h < v < 0 WW4 %Am 1 Y&mM$ %.8 %' ~ s s J P:n..m A > a w ., %wMy7 q@ ym
^
;~A:* p n ,
8906260379 890630 h@k $M4 . PDP NUREG A.A a WE _4 ,. , C. 0940 R PDN "h y ;- 'p QWT*KWifSMr' k ' , fw w.!& dhTtOgN W 4 h O C a @k l h< < nj ,
,m am 2m - u. - _ _ - _ _ _ _ - - . _
L.I, P
'W' '
7 [%)a @g(M7 g, n .:e s M@ pMI" @g+, y u.; n. s ggit N' 3, 'q ' ,,F, -
,<>, @4th- gy.js ikW:M 3 , f: y a ,
pg g 4, ,J ' ec ' " . ' y q'p.3 y v. 3,g 's '. b .; s ,g
=n , e
- y 42
- @' t i p,, W, x,.,f i 2 i f > _M. ' 4_o' p.g - o '
J<(
~ [Q.f , y);Q Ui '
'r
^ J. ,' . ,9
.i - u; k ;.e ._ it
.,..,.,t..i ; j ,
g.a u b &,, r..,.., t
- +>
- m. +r,w" f g,3.
q '3 Mb,,hp ! J, .+. ny- gl 4 3
,3 g ' ,
g ws-e ' l ".n ;
' i ;t cp '?' 'w y a -
4" @fgi,;;l.; +-N,: , _?.<.;:- - _ x, r *
- 4 . , p-
')-'
, 'q t ,j Iff e ' '
a -
.m ) k
- v. . . , -
*^,
tt
,q Q'b,,4?:.n. q+]'
g r,
, '.<l O ,_ : i
'jydf,[ " / d',.;,N, ) 's
' ' ~
7 i
' * }p w>i 1:,, t h:$ s .w{,l ?
. u t
+j '.
1 ' u
.v
(:
.o . . #
1 I. (. s i 5
.l' '34--
I [fj4, Nf \ y b $hY ,,
. / , . . D t i', 'p. s , .
- 5 u-> ..-
, , .d. ; . , [f 1 p b l
W,,: A' _ , y it Wl1.} 7;w L (
.l p % :pf,qi
^
g , . o s, ,: 4 qa
': ;1 p, .~, t > 'T- 1 1, -;4,j ' ' 1 s ..q, : , + .
.1 s9..< M[t, i ' . s_ . .k .d 3 J.. 8 i r
.a i
_ lQ f t. ( ; Y.,'^ 1 ' .;, o$f(:h gy,:.
.ji 5
~.l:>
' ~
$0
, ~ a 'N./. i ?> >
.,,o c.
A,h -# ,
^
JAvailable from : p.6, -
, 1, dL- & t < c f AcJ r=,
g m- i ' ' k.
- .; ; , 4 , ,
;;ri g:Wl hs ,;, y', b' o, , '
1 j g .g.. , J'e i , , , , .
. . .. ! . o p& a
;v 3 ,
.i S.uperintenden..t .of, Documents. !
' r".
J. > s' ~4 f_. y ,z ~a ,, ~ EU.S/ Government 1 Printing Offi.ce. - ' W.a.'
. .u -
t;
' 4,
~ .c 1 Post Office Box 77082a hq g" ..WN W[f
...i.
~ MaMonfD.d200130082- O m;- ny it .
3 s y' .
+ : -
c f. k [g.. I. ' i:n e , '1. m x[ gyearYsubAdiption donsists of 4 issues for. h% m, 1 ,
' Lthis'p'ublicationb ,
t . _
, , x. ,
!gy~" W2~ ' s,. y 1
, 1, ,9. m. . L. <.
*g
'~
, o
. Sidle copies of this pubticatiy.,.. on-
.M m ',c .M ,"
s ,
- dro available from NationalTechnical. >
bed
- p; '
,...., , f7 >
{ information l Service / Springfield, VA 22161J
+
g 3 ,
,1, ,s . w. + "
t _i ~ 1 gp o. . - , r < n. pM,, iff > {; M; 4. e.o a
+1~- ? :- 3-t' i
3
, , ' (:
,.,' #T k i
y g ) F w . A '(_
+
in 4.' s
- , +" c ;
- _
.c y,. .k',
f , .a i pm -.m b- , b , ,-o ap ., . -
) ' , .
4,
- f) ,
t {'. r i f g [
\m, '.
0{ > u _ Ul M _1.o . _ . .
0 4ym C 4 ' F* . NUREG-0940 g ' ,;f ' ' Vol. 8, No.1 Enforcement Actions: Significant Actions.Reisolved Quarterly Progress Report. January- March 1989 Manusrxipt Completed: May 1989 Date Published: June 1989
- Office of Enforcement U.S. Nuclear Reculatory Commission (Washington, DC10555 pe =nes, 1
(M.....)
f-t i i l ABSTRACT This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January - fiarch 1989) and includes copies of letters, hotices, and Orders sent by the Nuclear Regulatory Consission to licensees with respect to these enforcement actions. Also incluaed are a number of enforcement actions that had been previously resolved but not published in this NUREG. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication. i NUREG-0940 111
CONTENTS Page ABSTRACT.................................................................. 111 INTRODUCTION................................................................ 1 l SUMMARIES................................................................... 3
- 1. REACTOR LICENSEES A. Civil Penalties and Orders l
ArizonaNuclearPowerProject, (Palo Verde Nuclear GeneratingPhoenix} Station Arizona EA 88-182......................................................I.A-1 Carolina Power and Light Company, R61eigh, North Carolina (Brunswick Steam Electric Plant) E A 8 8 - 14 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l . A - 13 Carolina Power and Light Company, Raleigh, North Carolina (Shearon Harris) EA 88-261.....................................................I.A-20 Coninonwealth Edison Company, Chicago, Illinois (Quad Cities Nuclear Power Plant, Units 1 and 2) EA 88-161.....................................................I.A-23 Commonwealth Edison Company, Chicago, Illinois (Braidwooo Nuclear Power Station, Units 1 and 2) EA 88-198.....................................................I.A-39 Consumers Power Station, Jackson, Michigan (Big Rock Point Nuclear Plant) l EA 87-80......................................................I.A-48 Consumers (Palisades NuclearPowerPlant Company,) Jackson, Michigan EA 88-140.....................................................I.A-63 Duke Power Company, Charlotte, North Carolina (0conee Nuclear Station) EA 88-228.....................................................I.A-70 Duke Pwer Company, Charlotte, North Carolina (McGuireNuclearStation) EA 88-247.....................................................I.A-75 Florida Power and Light Company, Juno Beach, Florida (Turkey Point) EA 88-267.....................................................I.A-83 NUREG-0940 v
CONTENTS (Continued) REACTORLICENSEES(Continued) ,P,aage GPU Nuclear Corporation, Parsippany, New Jersey (Oyster Creek Nuclear Generating Station) EA 87-185.....................................................I.A-86 Louisiana Power and Light Company, New Orleans, Louisiana (Waterford Steam Electric Station, Unit 3) EA 88-144.....................................................I.A-99 Maine Yankee Atomic Power Company,) Augusta, Maine (Maine Yankee Atomic Power Station EA 88-295....................................................I.A-121
\
Portland General Electric Company, Portland, Oregon (Trojan Nuclear Plant) EA 88-277................................................... 1.A-130 Sacramento Municipal Utility District, Herald, C611fornia (Rancho Seco) EA 86-110....................................................I.A-133 The Detroit Edison Company, Newport, Michigan (Enrico fermi Atomic Power Plant, Unit 2) EA 88-104....................................................I.A-141 The Detroit Edison Company, Newport, Michigan (Enrico Fermi Atomic Power Plant, Unit 2) EA 88-281....................................................I.A-159 Wolf Creek Nuclear Operating Corporation, Burlington, Kansas (Wolf Creek Generating Station) EA 88-282....................................................I.A-166 B. Severity Level III Violation, No Civil Penalty Carolina Power and Light Company, Raleigh, North Carolina (Shearon Harris) EA 88-205......................................................I.B-1 Commonwealth Edison Company, Chicago, Illinois (LaSalle County Station) EA 88-271......................................................I.B-3 Duke Power Company, Charlotte, North Carolina (0conee Nuclear Station) EA 88-317......................................................I.B-7 Alfred E. Geaudreau, Jr. EA 88-224.....................................................I.B-11 NUREG-0940 vi
CONTENTS (Continued) PEACTOR LICENSEES (Contirmed) l
- New York Power Authority, White Plains, New York '
I (Fitzpatrick Nuclear Power Plant) EA 88-239.....................................................I.B-15 Niagere Mohawk Power Corporation, Syracuse, New York (Nine Mile Point, Unit 2) L EA 89 04......................................................I.B-20 Northern States Power Company, Minneapolis, Minnesota (Prairie-Island Nuclear Generating Plant) EA 88-292.....................................................I.B-25 l ' I Texas Utilities Electric Company, Dallas, Texas (Comanche Peak Steam Electric Company) EA 88-278.....................................................I.B-27 Yankee Atomic Electric Company, Bolton, Massachusetts l l (Yankee Nuclear Power Station) EA 89-11......................................................I.8-31 C. Non-licenseo Vendor (Part 21), 30 Civil Penalty / Copes-Vulcan, Lake City, Pennsylvania EA 88-309......................................................I.C-1 II, MATERIALS LICENSEES A. Civil Penalties and Orcers Biomedical Diagnostic Services, Ltd., Troy, Michigan EA 87-231.....................................................II.A-1 Brigham and Women's Hospitol, Boston, Massachusetts EA 88-319.....................................................II.A-7 C & R Laboratories, Pearl City, Hawaii EA 88-256....................................................II.A-12 Entela. Inc., Grand Rapids, Michigan EA 88-318....................................................II.A-17 H & G Inspection Company, Inc., Houston, Texas EA 87-145....................................................II.A-23 Hemphill Corporation, Tulsa, Oklahoma EA 88-301....................................................II.A-36 Hole Truth, Inc., Oklahone City, Oklahoma EA 88-212....................................................II.A-41 NUREG-0940 vii
e . CCHTENTS (Continued) MATERIAL LICENSEES (Continued) Hcnolulu Medical Group, Honolulu, Hawaii EA 88-257....................................................II.A-55 Log-Tec, Cleveland, Oklahona EA 87-172....................................................II.A-61 Maryview Hospital, Portsmouth, Virginia EA 88-227....................................................II.A-71 Bill Miller, Inc., Henryetta, Oklahoma EA 88-155....................................................II.A-83 MQS Inspection, Inc., Elk Grove Village, Illinois EA 88-288....................................................II.A-96
'Huclear Pharmacy, Inc., Sylmer, California EA 85-100...................................................II.A-101 Precisicn Logging and Perf orating Company, Cleveland, Oklahoma EA 87-184...................................................II.A-115 Precision Materials Corporation, Edison, New Jersey EA 87-156...................................................II.A-132 St. Mary's Hospital, Richmond, Virginia EA 88-308...................................................II.A-147 Tracer Profiles, Inc., Oklahoma City, Oklahoma EA 87-204...................................................II.A-153 Urban Engineers, Inc., Philadelphia, Pennsylvania EA 88-274...................................................II.A-161 Veterans Administration, Edward Hines, Jr. Hospital, Hines, Illinois E A 8 8 - 4 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I . A- 16 8 Well Logging, Inc., Nowata, Oklahoma EA 87-99....................................................II.A-177 West Virginia University Hospitals, Inc., Morgantown, West Virginia EA 88-297...................................................II.A-186 l
l NUREG-0940 viii
i El&ORCEMENT ACTIONS: SIGNIFICANT ACTIONS RESOLVED l 1 January - March 1989 INTRODUCTION This issue of NUREG-0940 is being published te inform NRC licensees about significant enforcement actions and their reso'ution for the first quarter of 1989. Enforcement actions are issued by the Deputy Executive Director for Nuclear Materials Safety, Safeguards and Operations Support and the Regional Administrator. The Director, Office of Enforcement, may act for the DEDS in the absence of the DEDS or as directed. The actions involved in this j NUREG involve NRC's civil penalties as well as significant Notices of Violation. ; 4 An objective of the NRC Enforcement Program is to encourage licensees to improve their performance and, by example, the performance of the licensed i industry. Therefore, it is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by NRC, so all can' learn from the errors of others, thus improving performance in the nuclear industry and promoting the public ,
. health and safety as well as the common defense and security. {
A brief summary.of each significant enforcement action that has been resolved l in the first quarter of 1989 can be found in the section of this report ; enti tied "S'jmmaries." Each summary provides the enforcement action (EA) number to identify the case for reference purposes. The supplewnt number refers to the activity area in which the violations are classified according to guidance furnished in the U.S. Nuclear Regulatory Commission's " General
;catement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C, 53 Fed. Reg. 40019 (October 13,1988). Violations are categorized in terms of five levels of severity to show their relative importance within each af the following activity areas:
Supplement I - Reactor Operations Supplement II - Facility Construction Supplement III - Safeguards Supplement IV - Health Physics ! Supplement V - Transportation I Supplement VI - Fuel Cycle and Materials Operations ! Supplement VII. - Miscellaneous Matters Supp!erent VIII - Emergency Preparedness Part I.A of this report consists of copies of completed civil penalty or Order actions involving reactor licensees, arranged alphabetically. Part I.B includes copies of Notices of Violation that were issued to reactor licensees for a l Severity Level 111 violation, but for which no civil penalties were assesseo. Part .I.C includes a copy of a Notice of Violation that was issued to a non-licensed vendor for a Severity Level III violation, but for which no civil l penalty was assessed. Part II.A contains civil penalty or Order actions l involving materials licensees. Actions still pending on March 31, 1989 will be includeo in future issues of this publication when they have been resolved. NUPEG-0940 1
-- 511MMARIES
.l. REACTOR LICENSEES l
l A. Civil Per.alties and Orders Arizona Nuclear Power Project, Phoenix, Arizona (Palo Verde Nuclear Generating Station) Supplements I and IV, EA 88-182 A Notice of Violation and_ Proposed Imposition of Civil Penalties ' in the amount of $250,000 was issued on Decenber 1,1988 to emphasize the importance of establishing the proper working atmosphere at Polo Verde, the need to thoroughly review events to promote improveo performance, and the need to improve your activities related to plant operations and radiation safety. The first action was based on an event in which both trains of the essential chilled water system were rendered inoperable. In the area of radiation controls two separate civil penalties were proposed one for an event which resulted in an individual receiving a wmulative whole body raoiation dose in excess of the limits of 10 CFR Part 20 and significant deficiencies in the licensee's ALARA program and the other for a breakdown in the licensee's control of high radiation areas. The licensee responded and paid the civil penalties on December 29, 1988. Carolina Pcwer and Light Company, Raleigh, North Carolina (Brunswick Steam Electric Plant) Supplement I, EA 88-149 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $75,000 was issued December 30, 1988 to emphasize the importance of the prompt identification and resolution of equipment deficiencies. The action was based on the failure to take prompt and adequate corrective action with respect to equipment deficiencies that had the potential to affect the operability of safety-related components. The base civil penalty was increased by 50% because of the licensee's poor past performance. The licensee responded and paid the civil penalty January 27, 1989. Carolina Power ano Light Company, Raleigh, North Carolina (Shearon Harris) Supplement III, EA 88-261 A Notice of Violation and Proposed Imposition of Civil Penelty in the amount of $25,000 was issued December 28, 1988 to emphasize the necessity for thorough correction of identified prcblems. The action was based on several examples of failure to provide vital area barriers. The base civil penalty was mitigated by 50% because of the 11cer.see's prompt.and extensive corrective actions, identification of the violation, anc' prior performance offset by a prior similar Severity Level III violation and the duration of the violation. The licensee responded and paid the civil penalty on January 27, 1989. NUREG-0940 3
l Commonwealth Edison Company, Chicago, Illinois (Quad Cities, Units 1 and 2) Supplement I, EA 88-161 A Notice of Violation and Proposed Imposition of Civil Penalties in the amount of $125,000 was issued on September 15, 1988 tc emphasize
'th; need for mandgement to improve performance with respect to drawing control, post modification testir.g activities and operatnr response to indicated electrical The action was based on two problems involving (ground conditions.1) the shared diesel respond for approximately six months to a Unit 2 auto-start signal because of an undetected failure caused by a wiring error, and (2) the ungrounded 125 VDC battery system for Unit 2 was operated in a grounded conoition for approxim6tely six months. The first violation was escalated 50% because of the licensee's failure to take prompt and thorough corrective actions. The licensee responded in a letter dated October 17, 1988 paying the proposed civil penalty for the first violation and contesting the second violation. After consideration of the licensee's response, the staff has concluded that the violation occurred as stated ano imposed the $50,000 penalty January 23, 1989. lhe licensee paid the remaining penalty on February 22, 1989.
Connonwealth Edison Company, Chicago, Illinois (Braidwood Station, Units 1 and 2) Supplement I, EA 88-198 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $75,000 was issued on November 23, 1988 to emphasize the importance of implementing adequate management and prograrriatic controls to ensure the initial and continuing qualification of equipment important to safety. The action was based on a number of failures to adequately implement the environmental qualification requirements of 10 CFR 50.49. The base civil penalty was escalated by 50% because the licensee's corrective actions were not timely. The licensee responded and paid the civil penalty on January 25, 1989. Consumers Power Company, Jackson, Michigan (Big Rock Point Nuclear Plant) Supplement I, EA 87-80 A Notice of Violation and Proposed Imposition of Civil Penalty in " the amount of $187 22, 1988 to emphasize theimportanceof(500wasissuedSeptember management attention to, and EQ program,-and (2) aggressive management action to ensure that problems are promptly identified and corrected. The action was based on a violation of the equipment qual 11icetion requirements of 10 CFR 50.49. The base civil penalty of $150,000 was escalated 25% after weighing the licensee's poor corrective actions against the licensee's generally 9000 efforts tc be in compliance within the EQ deadline. The licensee responded in letters dated December 1, 1988. After considering the response, an Order Imposing the Civil Per,alty was issued January 31, 1989. The licensee paid the civil penalty on February 24, 1989.
'NUREG-0940 4
Consumers Power Plant (Palisades Nuclear Company,)Jachen, Michigan Supplement I, EA 88-140 A Notice of Violation and Proposed Imposition of Chil Penalty in the amount of $75,000 was issued on December 22, 1988 to emphasize the importance of taking timely and effective corrective actich in response to safety concerns and proper implementation of the licensee's fire protection' program to maintain safe shutdown equipment free of damage in the event of a fire. The action was based on the failure to satisfy fire protection requirements of 10 CFR Part 50, Appendix R and the failure of management to take aggressive and timely corrective action. 1he base civil penalty was increased by 50% because of the duration of the violation (1986 to 1988). The licensee responded and paid the civil penalty on January 20, 1989. Duke Power Company, Charlotte, North Carolina (Oconee Nuclear Station, Units 1, 2, and 3) Supplement I. EA 88-228 l A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $25,000 was issueo December 13, 1988 to emphasize the need for thorough problem recognition and resolution and the need for close and extensive interdisciplinary cczaunications with regard to ECCS and other safety system issues. The action was based on the licensee's failure to provide adequate proceourdi guidance to ensure that the high pressure safety injection system would remain operable ior all required accident conditions. The base civil penalty was mitigated by 50% because of the licensee's identification and corrective actions. The licensee responded and paid the civil penalty on January 12, 1989. Duke Power Company, Charlotte, North Carolina (McGuire huclear Station) Supplement I, EA 88-247 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $37,500 was issued January 19, 1989 to emphasize the need for prompt identification and resolution of safety significant problems. The action was based on the licensee's failure to ensure that the Unit I and 2 containment hydrogen skimmer systems could perform their intended function. The base civil penalty was reduced by 25% because of the licensee's corrective actions. The licensee responded and paid the civil penalty on February 15, 1989. Florida Power and Light Company, Juno Beach, Florida (Turkey Point) Supplement III, EA 88-267
' Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $100,000 was issued February 1,1989 to emphasize the need for ensuring that adequate compensatory measures are taken, and for improving both the licensee's awareness of vital equipment and management oversight of the su rity program. The action was based cu the improper repositioned , of a security guard posted as a compensatory measure and his resulting inability to maintain surveillance over the area to which he was originally assigneo.
The base civil penalty was increased by 100% due to the licensee's ccntinued poor performance in the area of security. The licensee responded and paio the: civil penalty on March 3,1989. NUREG-0940 5
.r
GPU Nuclear Corporation, Parsippany, New Jersey (0yster Creek Nuclear Generating Station) Supplement I, EA 87-185 A Confirmatory Order was issued November 5, 1987 based on a safety limit violation that occurred September 11, 1987. The Order confirms the licensee's commitment to remove the personnel of the operating shift on duty at the time of the safety limit violation from licensed duties and a second commitment to provide the staff with a copy of the licensee's investigation into the subsequent apparent willful destruction of a portion of the documentation of the event. A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $50,000 was issued January 18, 1989 based on a violation of a safety limit which involved the failure to maintain at least two recirculation loop discharge valves in the full open position. The licensee responded and paid the civil penalty on February 14, 1989. Louisiana (Waterforo Power and Light Steam Electric Company), New Orleans, LouisianaSupplement I, EA 88 Station A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $50,000 was issued August 18, 1988 to emphasize the concern with the licensee's inadequate corrective actions to preclude repetition of a significant condition adverse to quality and the lit.ensee's failure to establish and implement procedural requirements for significant commitments made to the NRC. The action was based on an event in which inaccurate reactor vessel water level indication twice resulted in cavitation of and subsequent loss of the operating shutdown cooling pump. The plant experienced a similar problem in July 1986 and the failure to fully implement the corrective actions for that event formea part of the basis for the proposed action. The licensee responded October 14, 1988 requesting that the penalty be rescinded. After considering the licensee's response, the staff concluded that the violations occurred as stated and an Order Imposing Civil Penalty was issued January 3,1989.. The licensee paid the civil penalty on February 1,1989. Maine Yankee Atomic Power Company, Augusta, Maine (Maine Yankee Atomic Power Station) Supplement III, EA 88-295 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $75,000 was issued February 13, 1989 to emphasize the importance of promptly increasing, improving and making more effective management oversight and attention to the security program to assure that security personnel, as well as all other individuals authorized access to the plant, understand and adhere to security program require-ments. The action was based on the failure to maintain positive control over a ring of vital area keys, inadequate lighting in the isolation zone, inadequate escott of vehtcles within the protected area, ia11ure to maintain an open observable area in a portion of the isolation zone, and multiple examples of a f ailure to adequately search personnel and packages entering the protected area. One of the violations was mitigated by 50% because of the licensee's corrective measures. The licensee responded and paid the civil penalty March 15, 1989. NUREG-0940 6
h Portland General Electric Company, Portland, Oregon (TrojanNuclearPlant)SupplementIII,EA88-277 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $75,000 was issued on December 30, 1988 to emphasize j the importance of maintaining adequate physical barriers. The action ; was based on violations involving access control to one of the vital areas of the plant, including an inadequate vital area barrier and failure ~ to take adequate compensatory measures for it, failure to properly badge and escort a visitor, and failure to record his visits. The base civil peralty was increased by 50% due to the licensee's prior notice of similar events. The licensee responded and paid the civil penalty on January 27, 1989. Sacramento Municipal Utility District, Herald, California (Rancho Seco) Supplements I and IV, EA 86-110 A Notice of-Violation and Proposed Imposition of Civil Penalty in the amount $100,000 was issued on January 13, 1989 to emphasize the importance of establishing and adhering to approved procedures, performing safety evaluations, avoiding unnecessary releases of radiation to the environment, and management assuring that commitments and requirements are met. The action was based on the significant breakdown in the management oversight of the program to properly implescent and control the plants radioactive effluent releases. The licensee responded ano paid the civil penalty February 13, 1989. The Detroit Edison Company, Newport, Michigan (EnricoFermiAtomicPowerPlant, Unit 2) Supplements,EA88-104 A Notice of Violation and Proposed Imposition of Civil Penalties in the amount of $200,000 was issueo June 16, 1988 to emphasize the importance of proper system design in accordance with regulatory requirements and the need to understand the affects of auxiliary equipment on system operability and the licensee's Technical Specifications. The violations involved (1) the disccvery that the licensee's containment isolation provisions for the primary con-tainment radiation monitoring system was not consistent with the requirements of 10 CFR Part 50, Appendix A, General Design Criterion 56, and (2) that the licensee h4d operated the non-interruptible Air System in a degraced mode which led to the violation of two Technical Specifications. Each violation was escalated 100% of the base civil penalty. The licensee responded July 15, 1988 and after consideration of the response, the staff concluded that escalation of the civil penalty for past perf6fmance was not warranted for the first violation. An Order Imposing Civil Penalties in the amount of $175,000 was issued December 28, 1988. The licensee paid the civil penalties on January 26, 1989. The Detroit Edison Company, Newport, Michigan (Enrico Fermi Atomic Power Plant) Supplement I, EA 88-281 A Notice of-Violation and Proposed Imposition of Civil Penalty in the amount of $50,000 was issued January 6,1989 to emphasize the importance of ensuring that problems identified on Deviation Event
'NUREG-0940 7 i
[ f Reports are' properly evaluated- and corrected, torque switch and limit switch settings are correctly specified and implemented, and 0 contractor personnel' specialized qualifications are adequately s described in procurement cocuments. .The' action was based on the licensee's failure to establish adequate design control measures to ' ensure that motor operated valve torque switches are properly installed and set.. The licensee responded and paid the civil
; penalty on February 1,.1989.
Wolf Creek Nuclear Operating Corporation, Burlington, Kansas (Wolf: Creek-Generating' Station) Supplement I, EA 88-282 A Notice of Violation and Proposed Imposition of Civil. Penalty in the amount of $50,000 was issued February 1, 1989 to emphasize the importance of-thoroughly analyzing the condition of degraded safety systems' prior to making operability determinations, effective use of independent verification organization findings, and senior managers properly ' discharging their safety oversight responsibilities. The' action was based on an event in which erosion reduced the pipe wall thickness of a section of the asential service water system piping to below that required by the ASME code minimum thickness and potentially rendering the piping unable to meet design basis seismic requirements. The licensee responded and paio the civil penalty on March 1, 1989. 4 B. Severit.y Level'III Violation, No Civil Penalty , Carolina Power and Light Company, Raleigh, North Carolina (Shearon Harris) Supplement III, EA 88-205 A Notice of Violation was issued September 13, 1988 baseo on a violation involving the failure of the licensee's site security !
. staff to identify and detect a loaded .38 caliber revolver which passed undetected through the security x-ray screening console.
A civil penalty was'not proposed because the licensee's staff i identified and immediately reported the violation, prompt corrective action was initiated, and the licensee had a good past performance in the area of physical security. ; Commonwealth Edison Company, Chicago, Illinois (LaSalle County Station) Supplement I, EA 88-271 A Notice of Violation was issued January 12, 1989 based on an event which involved a dual reactor water recirculation pump trip which resulted in unexpected neutron flux oscillations and terminated with a reactor scram on high neutron flux. A civil penalty was ; not proposed because the licensee identified the root cause of j the problem and took strong corrective actions. Duke Power Company, Charlotte, North Carolina I (0conee Nuclear Station) Supplement I, EA 88-317 L A Notice of Violat' ion was issued February 28, 1989 based on a violaticn involving a significant failure to ensure that the { emergency backup power supply via the Lee Station gas turbines i i NUREG-0940 8 l
could perform its intended function under all postulated accident scenarios cue to a design deficiency. A civil penalty was not proposed to encourage aggressive pursuit of future problems, corrective actions were prompt 'ina comprehensive, and routine surveillance v:ould nut have cett ted the situation. Alf red E. Geaudreau, Jr. Licensed Reactor Operator, Supplement VII, EA 88-224 A Notice of Violation was issued January 18, 1989 based on a violation involving the willful destruction of records which provided a chronology of a safety limit violation at the Oyster Creek Nuclear Generating Station. A civil penalty was not proposed because the . operator was immediately removed from operational duties and was terminated by the company. New York Power Authority, White Plains, New York (Fitzpatrick Nuclear Power Plant) Supplement I, EA 88-239 A Notice of Violation was issued February 8,1989 based on the use of torque and limit switches in four limitorque valve actuators with an insulation material type not environmentally qualified. A civil penalty was not proposed because the violation (1) was isolated and affected only one system, (2) was identified by the '~ licensee's staff and promptly reported, (3) and was promptly corrected. The licensee also race best efforts to complete EQ within the November 30, 1985 ceadline. Niagara Mohawk Power Corporation, Syracuse, New York - (Nine Mile Point, Unit 2) Supplement I, EA 89-04 A Notice of Violation was issued March 13, 1989 based on violations ' involving the inuperability of one of the two automatic depressuriza-tion system divisions since initial operation in 1986 because of a wiring error in the logic circuitry which occurred during a con- g struction modification in 1985, and the failure to promptly icentify and correct the condition adverse to quality until December 1988, - even though opportunities existeu to detect the error sconer. A civil penalty was not proposed because the violation was ioentified by a menber of the licensee's staff and the corrective actions were comprehensive. Northern States Power Company, Minneapolis, Minnesota l (Prattte Island Nuclear Generating Plant) Supplement III, EA 88-292 , A Notice of Violttion was issued February 1,1989 based on a violation ' anvolving' inadequate access controls which allowed an unauthorized individual to gain eccess to the facility. A civil penalty was not proposed because of the licensee's good performance in the area of concern and the licensee's excellent SALP performance and the low nunber of violations for the facility. 1 NUREG-0940 9 L
Texas' Utilities Electric Company, Dallas, Texas.
~ .(Comanche Peak Steam Electric Company) Supplement II, EA'88-278 l
l' A Notice of. Violation was issued February 28, 1989 involving the failure to submit a timely application for extension of the licensee's construction permit. A civil penalty was not proposed'because of the licensee's extensive corrective action programs which were getting under way at the time of the violation, but had not been fully ; implemented, and have since resulted in considerable improvements in management policies and procedures. Yankee Atomic Electric Company, Bolton, Massachusetts (Yankee Nuclear. Power Station) Supplement I .EA 89-11 b L A Notice of Violation was issued February 15, 1989 involving the operation of the reactor at lov power for indeterminate periods of time prior to November 1988 with certain reactor protective system power range and intermediate power range neutron flux trip values less conservative than the limiting safety system settings required by the Technical Specifications. A civil penalty was not proposed E because the. violation was identified by the licensee and promptly reporteo, corrective actions upon identification were prompt and extensive, and prior enforcement history was good as evidenced by ; the prior Category I SALP ratings in the operations area. C. Non-licensed Vendor (Part 21), No Civil Penalty l (' Copes-Vulcan, Lake City, Pennsylvania L Supplement VII, EA 88-309 A Notice of Violation was issued January 24, 1989 involving the failure to notify purchasers of incorrect valve assembly weight and center-of gravity information that was provided to them prior to Novenber 28, 1979 so that 'they could cause an evaluation to
-be performed pursuant to 10 CFR Part 21. A civil penalty was not proposed because pursuant to 10 CFR 21.61 the failure to notify l, did n t appear to be the result of a knowing and conscious failure.
II. MATERIALS LICENSEES A .' Civil Penalties and Orders Biomedical Diagnostic Services, Ltd., Troy, Michigan Supplement VI. EA 87-231 , A Notice of Violation arJ #Proposed Imposition of Civil Penalty in the amount of $750 was issued February 1,1989 to emphasize the j importance of maintaining adequate control over the licensee's ! raoiation safety program. The action involved the failure to follow licensee's procedures in that personnel did not wear whole body and extremity cosimetry on several occasions and at several locations, did not test int.oming packages of radioactive material for contamination, did not perform quarterly linearity tests the requircd length of time, and did not wear gloves when handling ; radioactive material. The base civil penalty was escalated by ' NUREG-0940 10 !
- _ - - _ _ _ _ _ l
7 r
~
i 50% because the violations were identified by the NRC and the
-licensee had..not, at the time of.the_inrpection, provided adequate assurance that sufficient aucit~ capability existed.to identify 2 sucn violations ~..=The licensee responsed and paid the civil penalty J ,J on March 21', 1989.
g,. , Brigham and Women's Hospital, Boston, Massachusetts
# Supplement <1V, EA 88-319 y
;A-Notice'hf Violation and Proposed Imposition of Civil Penalty in 1
. the amount of $5,000 was issued February 7,1989 to emphasize the. l need forL additional managenent ' attention to ' ensure proper !
implementation of the radiation safety program. The action was' based on the failure to maintain adequate surveillance and control , t of;a one curie gadolinium-153' source resulting in'it being lost; and failure.to provide' adequate training to certain personnel authorized access to areas where radioactive naterial was' located. The base civil: penalty was escalated 100% based on peor prior performance. . The' licensee responded and paid the civil. penalty on March 14, 1989. C & R Laboratories, Pearl. City, Hawaii Supplement IV, EA 88-256 A Notice of Violation and Preposed Imposition of Civi1 Penalty in
- the amount of $2,000 was issued December 7, 1988 to emphasize the need to ensure. implementation of effective control of the licensed program.. The action was based on violations involving exposure
.to radiation in excess of applicable limits, use of an inoperable radiation survey instrument, and failure to secure a radiation source in the shielded position. The base civil penalty was mitigated by 75% because of the licensee's good past performance.
The-licensee responded December 22, 1988 and is paying the civil ! penalty in installments. l
-Entela, Inc., Grand Rapids, Michigan I 1
Supplements IV and VI, EA 88-318 l l A Notice of Violation and Proposed Imposition of Civil Penalty in
' the' amount of $1,250.was issued February 16, 1989 to emphasize
.the need to ensure continual implementation of effective management
. control over the radiation safety program. , The action was based on the finding that the licensee's RS0' willfully failed to have eight individuals attend an approved training wurse in the use of moisture-density gauges in accordance with license requirements and allowed these individuals to use gauging devices without the-supervision ano physical presence of an individual who had received the approved training. Additional violations included failure to maintain adequate surveillance and control.of the mositure-density gauge in an unrestricted area resulting in the gauge being run over by a construction vehicle, failure to report to the NRC the event which caused damage to property in excess of $2,000 and failure to :
perform leak-testing at six month intervals were not assessed a civil penalty. The base civil penalty for the training violation was increased by 150% because the NRC-Identified the violation, prior i NUREG-0940 11 WL -__ ___._- _ _ _ _ _ - _ _ _ _ _ . -
notice, and the multiple examples involveo. The licensee responded end paid the civil penalty March 13, 1989. H & G Inspection company, Inc., Houston, Texas Supplement IV, El ' 145 A Notice of h olation and Proposeo Imposition cf Civil Penalty in the amount of $7,500 was issued October 26, 1987 to emphasize the need for improvement in the management control over personnel 4 exposures. The action was based on a radiological overexposure l to a ractographer. The licensee responded in a letter cated l December 16, 1987. After consideration of the licensee's response, an Order Imposing the Civil Penalty was issueo April 7,1988. The licensee requested a hearing April 25, 1988. A settlement was issued January 9,1989, and the licensee paid a civil penalty of
$3,000 January 19, 1989.
Hemphill Corporation, Tulsa, Oklahoma Supplement VI, EA 88-301 A Notice of Violation and Proposed Imposition of Civil Penalty in j the amount of $500 was issued on February 28, 1989 to emphasize the importance of conducting licensed activities in accordance with radiat%on safety requirements. The action was based on failure to have two individuals complete the app oved training course in
-accordancti with license requirements and allowing these individuals to use gauging devices without the supervision and physical presence l of an individual who had received the approved training, failure to !
perform leak tests on sealed sources at six month intervals, having a person as radiation safety officer other than named in license ' 1 requirements, and storage of material at an address and having mailing address other than that .)ecified in the license. The licensee responded and paid the civil penalty on March 28, 1989. j Hole Truth, Inc., Oklahoma City, Oklahoma 1 Supplements IV, V, VI, and VII, EA 88-212 An Order Modifying License and Notice of Violation was issued October 24, 1988. The action was based on' numerous violations and [ required the licensee to obtain independent consulting services to ! perform audits for two years to evaluate adherence to NRC requirements, i to observe and evaluate personnel performance, and to assess the l quality and accuracy of records concerning licensed activities. The licensee responded November 18, 1988. A letter accepting the licensee's plan for program audit was issued January 13, 1989. Honolulu Medical Group, Honolulu, Hawaii Supplements IV and VI, EA 88-257 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $2,500 was issued December 13, 1988 to emphasize the need : for more active involvement in licensed activities by the RSC, RSO and licensee management, including taking aggressive action to assure lasting corregion of the deficiencies in the licensee's program. The i NUREG-0940 12 l J
s uction was baseo on failure (1) to perform leak test. at required [ intervals, (2) 9 perform dose calibrator occuracy tests, (3) of L management and the radiation safety officer to perform annual audits L of the radiation safety program as required by the ALARA program, (4) to troin, (5) to keep required information on waste records and (6) to establish radiation oose rate trigger levels for surveys. The licensee paid the civil penalty on January 10, 1989. Log-Tec, Clev,'and, Oklahoma , EA 87-172 ' An Order Suspeading License and Order to Show Cause was issued September 8, 1987. The action was bcred on findings that the sole proprietor deceived an NRC inspector about the use of licensed material. The licensee by letter dated September 25, 1987 requested a hearing. The request was withdrawn in a letter dated December 1, 1967. An affidavit was signed February 3,1988 attesting that the licensee had met the conditions of the order. On February 23, 1988 : an Order Revoking License was issueo. Maryview Hospital, Portsmouth, Virginia Supplement IV,-EA 88-227 A Notice of Viulation and Proposed Imposition of Civil Fenalty in the omc.unt of $1,250 was issued December 19, 1988 to emphasize the importo.1ce of- complying with regulatory requirements and ensuring management oversight of licensed programs. The action was baseo on the.tailure to (1) perform a formal annual review of the radiation safety and ALARA program, (2) test ano calibrate equipment es required, (3) conduct a biaassay test, (4) conduct appropriate radiation , surveys, (5) perform appropriate radiation exposure rate measurements and wipe tests for removable contamination, (6) inventory sources and devices, and (7) maintain required records. The licensee responded , and paid the civil penalty on January 18, 1989. [ Bill Miller, Inc., Henryetta, Oklahoma Supplements IV and VI, EA 88-155 A Notice of Violation and Proposed Imposition of Civil Penalty in . the amount of $8,000 was issued September 13, 1988 to emphasize the j need to improve management controls over licensed activities. The ; action was based on failure to maintain surveillance, post, and rope off an area where industrial radiography was being performed, resulting in two members of the general public receiving radiation exposures. The licensee responded in letters dated Octob..e 11 ano November 18, 1968. After consideration of the licensee's >oponse and its ability to pay, the civil penalty was reduceo 50%. At Order Imposing a Civil i Penalty in the omount of $4,000 was issued January 3,1989. The licensee responded January 9,1989 and is paying the civil penalty i by inst 611 ment. i
)
NUREG-0940 13 1 1 l
p p HQS Inspection, Inc., Elk Grove Village, Illinois Supplements IV and VI, EA 88-288 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $5,000 was issued February 8,1989 to emphasize the need for comprehensive management oversight, evaluation, and control of activities involving radiation safety. ihe action was based on an individual receiving a dose to the whole body of 4.6 rems during the fourth quarter of 1988, in excess of the regulatory limit of 3 rem and failures to (1) remove the source tube and insert the safety plug on the exposure device prior to moving the device to a new locaticn within a restricted area, (2) innediately process the film badge or TLD of an individual whose pocket dosimeter is discharged beyond its range, and (3) bar exposed personnel from potential radiation exposure assignments until results of the film badges are available and employee is released by the RSO. The licensee responded and paid the civil penalty on February 28, 1989. Nuclear Pharmacy, Inc., Sylmar, California Supplements IV, V, VI, and VII, EA 85-100 A Notice of Violation e droposed Imposition of Civil Penalties in the amount of $68,000 was issued April 10, 1986 to emphasize the importance cf compliance with NRC requirements. The action was based on violations involving 1) failure to perform the required test f or molybdenum-99 breakthrough when preparing technetium-99m radiopharma-ceuticals, (2) material false statements n.ede to the NRC regarding the distribution and admirc.stering of contaminated radiopharmaceuticals, (3) violations of the October 1984 Order requiring the licensee to pe.rform dual verification of certain activities, (4) failure to > conduct required surveys and audits, (5) f ailure to keep proper records, and (6) failure to meet other requirements regarding preparation of doses. Th licensee paid the civil penalties on May 9, 1986. Precision Logging and Perforating Company, Cleveland, Oklahoma Supplements IV, V, and VI. EA 87-184 A Notice of Violation and Proposed Imposition of Civil Penalty in i the amount of $1,000 was issued December 10, 1987 to emphasize the need to improve management controls over licensed activities. The action was based on radiation safety violations involving (1) failure l lete required surveys, (2) unsecured material, (3) failure to l to comp (4) unavailable records, (5) missing shipping labels and papers, l post and (6)improperstorageoflicensedmaterial. The civil penalty was ' l increased 100% due to multiple occurrences and poor licensee enforcement history. The licensee responded in two letters dated January 7 and February 15, 1988. After consideration of the responses, the civil penalty was mitigated by 50%. An Order Imposing a Civil Penalty in the amount of $500 was issued July 7,1988. The licensee requested a hearing in a letter dated July 22, 1988. A settlement was signed l ano the' licensee paid the $500 civil penalty on March 3,1989. NUREG-0940 14
Precision Materials Corporation, Edison, New Jersey EA 87-156 An Order Modifying License, Effective Immediately, was issued Seotember 4, 1987. The action was based on uncertainty regarding operation cf the licensee's irradiator. The NRC was informed that (1) water was leaking f rom the irradiator pool at a signitit. ant l rate, (2) one of the RS0's had resigned, and (3) the other two l RS0's intended to resign effective September 4, 1987 after placing i the irradiator in shutdown status. The licensee was notified on ' December 22, 1987 that no plan had been submitted for resumption of operation and an Order Revoking License was issued February 10, { 1988. St. Mary's Hospital, Richnend, Virginia Supplement VI, EA 88-308 A Notice of Violation and Proposed lanposition of Civil Penalty in the amount of $1,250 was issued February 15, 1989 to emphasire the importacce of managing and maintaining an effective radiation safety program. The action was based on failure to have ar' equate written procedures to ensure that no one is present in the cobalt-60 teletherapy room during testing of door interlocks, a significant failure to maintain positive control over entry into a high radiation area anc f611ure to provide instruction and training to housekeeping personnel on procedures for working in an area where radioactive materials are usea. The basc civil penalty was mitigated by 50% , due to good prior performance and corrective action. The licensee ! paio the civil penalty on March 6,1989. Tracer Profiles, Inc., Oklahoma City, Oklahoma EA 87-204 A Order to' Show Cause and Order Suspending License (Effective Inrnediately) . . was issued October 30, 1987. The action involved failure to respond j to a Notice of Violation and three Confirmation of Action Letters dfter iepeated requests. These developments raised substantial questions about the licensee's willingness to c.omply with NRC requirements to ensure that licensed byprcduct material would be used in a nianner that would provide adequate protection of the public health and safety. Urban Engineers, Inc., Philadelphia, Pennsylvania Supplements IV, V, and VI, EA 80-274 A Notice of Violation and Proposed Imposition of Civil Penalty in the amount of $500 was issued December 29, 1988 to emphasize the , need for increased and improved cianagement attention to activities authorized by the license. The action was based on two examples of failure to secure or maintain constant surveillance over nuclear density gauges, use of gauge by an individual prior to receiving sufficient training and certification to use a gauge, failure to keep shipping papers accompanying a gauge in the proper location in transport vehicle, failure to perform leak tests at required frequency and failure to maintain records of required semi-annual
.NUREG-0940 15 u __
inventories of nuclear gauges. The licensee rerponded and paid the civil penalty on January 18, 1989. Veterans. Administration, Edward Hines, Jr., Hospital, Hines, Illinois EA 88-42 An Order to Show Couse Why 1.icense Should not be Modified, Effecthe Imeciately was issued February 25, 1968. The action imposeo verification requirements before a technologist administered any licensed mattr1al. The action was based on the technologist injecting a patient with a second agent in an effort to cover up a mistake and the subsequent false statement to VA and NRC personnel investigating the matter. On Decen.ber 30, 1988, the licensee requested that the crder be rescinded since the technologist hao performed satisfactorily ouring the oversight period and on March 21, 1989 the Order was rescinced. Well Logging, Inc., Howata, Oklahoma Supplements V and VI, EA 87-99 A Confirmatory Order Modifying License and Notice of Violation was issued August 24, 1987 confirming the licensee's comitments to retain a consultant to: eudit the licensee's cperations, review procedures, reexamine license requirements, develop management controls, and provide additional on-the-job training for individuals using licensed materials. The Notice of Violation included violations involving (1) failure to survey storage locations, job. sites, and trersportation vehicles, (2) unauthorized use of licensed material, and (3) failure to maintain various records. A civil penalty was not proposed because of the licensee's past performance and the agreement to retain a consultant. West Virginia University Hospitals, Inc., Morgantown, West Virginia Supplement VI. EA 88-297 A Notice of Violation and Proposeo imposition of Civil Penalty in the amount of $2,500 was issued February 1,1989 to emphasize the need for effective control of radioactive material. The action was based on the failure (1) to control licensed material, (2) to inventory radioactive sources after returning to the vault, (3) to make timel notification to the Comission regarding loss of sources, and (y)4 to wear proper dosimetry during handling of sources. The licensee responded and paid the civil penalty on i February 7, 1989. 1 NUREG-0940 16
t
'l:
.l
' l I.A. REACTOR LICENSEES, CIVIL PENALTIES AND ORDERS i l
1 1 NUREC-0940
---sw~--- --
I J
,iMg u. % UNITED STATsS l fo 8 NUCLEAR REGULATORY COMMISSION J
- ,I f
REGION V .
.. - 1450 MAhtA L ANE. sulTE 210 g,. WALNUT CREEK. CALIFORNIA 94596 o...+
DEC 011988 Docket Nos. 50-528, 50-529 and 50-530 License Nos. NPF-41,.NPF-51 and NPF-74 EA 88-182-Arizona Nuclear Power Project ATTN: Mr. ' D. B. Karner Executive Vice President Post Office Box 52034 Phoenix, Arizona 85072-2034-Gentlemen:
SUBJECT:
NOTICE OF VIOLATIONS AND PROPOSED IMPOSITIONS OF CIVIL PENALTIES s NRC~ INSPECTION REPORT NOS. 50-529/88-14, 50-529/88-22, 50-528/88-24 50-529/88-26, 50-528/88-30, 50-528/88-35, 50-529/88-37 and 50-530/88-33 AND LICENSEE EVENT REPORTS (LER's) UNIT 1-88-017-01, UNIT 2 88-011-01, AND UNIT 3 88-005-00 This-letter refers to inspections conducted from May 20, 1988 through October 12, 1988, concerning events reported by you in the referenced LER's, and concerning other activities at your Palo Verde Nuclear Generating Station. ! The.re'sults of these inspections were reported in the referenced NRC i inspection reports. Several significant-violations of NRC requirements were
. identified by these inspections. The apparent violations, their causes, and your corrective. actions were discussed with you during an enforcement conference held in this office on August 17, 1988. A summary of the 1 Enforcement Con.ference was sent to you by our letter dated Septemoer 15, 1988. '
Two Notices of Violation and Proposed Imposition of Civil Penalties are
' enclosed. The violation set forth in the first. Notice involves inoperability of the essential chilled water system at Unit I when operability was required by the Technical Specifications. The violations in the second Notice involve
- the overexposure of an individual to radiation; failure to perform radiation surveys adequate to evaluate the extent of radiation hazards in work areas-failure to properly control access to high radiation areas and locked high l
. radiation areas by locking, posting, and/or barricading, as appropriate; !
failure'to implement your program to maintain radiation exposures as low as is reasonably achievable; and failure to transmit a required radiation exposure report' to an individual.
. The violation in the first of the enclosed Nutices resulted from poor operator performance in that inadequate informal communications between operations personnel led to the inadvertent inoperability of both train of the Unit 1 l
essential chilled water system for a period of nine days. T: Sperator who disabled the system apparently sensed that what he was doing was incorrect, but nonetheless chose.to proceed rather than to elevate his concern to his supervisors. 'This error resulted in both trains of a safety system being
; rendered potentially inoperable, and under the NRC Enforcement Policy this
- violation could have been assessed at Severity Level II. However, the NRC NUREG-0940 1.A-1
2 staff has done a preliminary assessment of your analysis of the event and has concluded that the loss of the esser.tial chilled water system resulted in a degradation rather than a loss of safety function. Therefore, the violation has been categorized at Severity Level III. The violations in the second Notice are associated with the radiation over-exposure of an individual at Unit 2 and with other significant deficiencies in your ALARA ard Radiation Protection Programs. Some of the specific examples cited therein occurred after the enforcement conference %t are included because of their similarity to the previously discussed problems. We have
- oncluded that the overexposure event could have been prevented if your personnel had terminated work activities when faced with uncertainty regarding radiation levels in the refueling cavity. Additionally, we were particularly concerned that your oversight groups had identified the continuing failure of your ALARA comittee to carry out its responsibility, and yet senior management was denied an opportunity to act by not being provided this information. This Notice also contains a violation not assessed a civil penalty. The violation relates to the failure to properly notify the individual who received the cumulative overexposure of that problem, as described in Section I of the Notice.
In reviewing your performance since July 1987, we have become concerned with your failure to adequately control access to high radiation areas and locked high radiation areas. We view very seriously the September 8, 1988 event involving the defeat of the lock on a high radiation area by using a screwdriver to slide the lock bolt on the door clear of the strike plate. It was only fortuitous that the event did not result in another personnel overexposure. We are also concerned with your failure to implement prompt and effective corrective action to prevent recurrence of items brought to your attention as early as July 1988. We base this observation on the repetitive nature of violations that have been identified since the Enforcement Conference of August 17, 1988. Overall, these violations indicate significant weakness in your Radiation Protection Program. Upon consideration of the above events, we conclude that ANPP management has not established the proper working atmosphere at Palo Verde; has not effectively utilized oversight groups; and has not consistently demanded thorough, critical reviews of events so that lessons learned can be used as teaching tools to improve future performance. During the enforcement conference, I asked you to reevaluate th overexposure event to assure that you have fully identified those areas which represent the greatest potential for improud performance at the site. On September 14, 1988, your representatives presented the results of your reevaluation to my staff. Based on review of your evaluation and on our discussions with your personnel, we are convinced that you should implement the proposed corrective actions. l In particular, you should implement the recommendations related to the generic l areas beyond radiation protection, such as supervisory training, problem j identification and resolution, and the conduct of incident investigations. l l l l To emphasize the imDortance of establishing the proper working atmosphere at l Palo Verde, the need to thoroughly review events to promote improved NUREG-0940 1.A-2
3 l performance, and the need to improve your activities related to plant operations and radiation safety, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regionai Operations, to issue the enclosed Notices of Violation and Proposed Imposition of Civil Penalties in the amounts of Fifty Thousand Dollars ($50,000) and Two Hundred Thousand Dollars ($200,000), respectively, for the violations described in the enclosed Notices. In accordance with the !'
" General Statement of Policy and Procedure for NRC Enforcement Actions, 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violation in the first Notice has been categorized as a Severity Level III violation, and the violations in the second Notice have been categorized in the aggregate as two separate Severity Level III problems. The base value of a civil penalty for a Severity Level III problem or violation is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered for the violations in each Notice. No adjustment of the base penalty was deemed appropriate for the violation described in the first Notice. For the problems described in the second Notice the base civil penalty amount was increased by 100% in each Lase. for the violations in Section I of this Notice, the base civil penalty was increased by 100% based on your failure to take necessary corrective actions following the identification of significant weaknesses in your radiation protection program as a result of NRC inspections in the Fall of 1987 and early 1988 and two independent self audits addressing your ALARA program. This failure resulted in a delay, for an extended time, in the implementation of actions to assure compliance with radiation safety requirements as evidenced by the multiple violations. For the violations in Section II of the Notice, the base civil penalty amount was also increased by 100% based on the many instances from July 1987 through September 1988 in which you failed to post or control high radiation areas and the lack of adequate corrective actions permitting these examples to occur.
You are required to respond to this letter and should follow the instructions j specified in the enclosed Notices when preparing your response. In your ! response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. Additionally, you should address the , specific actions that have been taken to instruct your employees about the ! need to consult supervision when questions about tasks or procedures arise. After reviewing your response to the Notices, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notices are not subject to the clearance procedurer of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. ! Si erely, l John B. Martin Regional Administrator NUREG-0940 1.A-3 i
i 4 1
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalty (Reactor Operations)
- 2. Notice of Violation and Proposed Imposition of Civil Penalties (Radiological Controls) cc w/ enclosures:
J. G. Haynes, Vice President, Nuclear Production, ANPP Timothy Hogan, Chief Counsel, Arizona Corp. Commission A. C. Gehr, Esq Snell & Wilmer Arizona Nuclear Power Project
\
i l I I NUREG-0940 I.A-4 1 \. -- _ __
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (Reactor Operations) l Arizona Public Service Company Docket No. 50-528 Palo Verde Nuclear Generating License No. NPF-41 Station, Unit 1 EA 88-182 ' During an inspection conducted during the period of July 5 to July 8, 1988, a violation of NRC requirements was identified. In accordance with the " General , Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, ! Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil. penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violation and associated civil penalty are set forth below: VIOLATION ASSESSED CIVIL PENALTY I. Technical Specification (T.S.) 3.7.6 requires that at least two independent essential chilled water loops be operable during operational modes 1, 2, 3, and 4. With no essential chilled water loops cperable, T.S. 3.7.6 does not provide specific ACTION requirements, and therefore , the provisions of T.S. 3.0.3 are applicable. T.S. 3.0.3 requires that ' when a Limiting Condition for Operation is not met, except as provided in
-the ACTION requirement of the associated T.S., action shall be initiated wit.i.!n 1 hour to place the unit in a Mode in which the specification does not apply by placing the unit in at least Hot Standby within 6 hours and at least Cold Shutdown within the following 30 hours.
Contrary to the above, on May 20 to May 29, 1988, while Palo Verde Unit 1 ' was operating in Mode 1, both loops of the essential chilled water system were rendered inoperable, but the licensea neither restored loop operability nor placed the unit in the required Mode. This is a Severity Level III violation (Supplement I). Civil Penalty - $50,000 Pursuant to the provisions of 10 CFR 2.201, Arizona Public Service Company (Licensee), is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the result achieved, (4) the corrective steps that will be taken to avoid further violations, and (5) the cate when full compliance will be achieved. If an adequate reply is not received within the time specified in , this Notice, an order may be issued to show cause why the license should not ! be modified, suspended, or revoked or why such other action as may be proper " should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. NUREG-0940 I.A 5 l i L !
l Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesti7g the civil penalty, in whole or in part, such answer should be clearly marked as an Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.d of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be st;t forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalties, and answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region V, 1450 Maria Lane, Suite 210, Walnut Creek, California 94596, and a copy to Mr. T. Polich vior Resident Inspector, at the Palo Verde Nuclear Generating Stat 6. FOR 'HE NUCLEAR REGULATORY COMMISSION hn B. Martin l Regional Administrator Dated at Phoenix, Arizona on this l day of December 1988. NUREG-0940 1.A-6 l l
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTIES (Radiological Controls) i Arizona Public Service Company Docket Nos. 50-528, 50-529, 50-530 l Palo Verde Nuclear Generating License Nos. NPF-41, NPF-51, NPF-74 Station, Unit 1, Unit 2, and Unit 3 EA 88-182 During inspections conducted during the period of May 20 to October 12, 1988, violations of NRC requirements were identified. In accordance with the
" General Statement of Policy and Procedure for NRC Enforcement Actions," 10 ,
CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to ; impose civil penalties pursuant to Section 234 of the Atomic Energy Act of 1 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalties are set forth below: VIOLATIONS ASSESSED CIVIL PENALTIES ! I. A. 10 CFR 20.101(b)(1) provides, in part: "During any calendar quarter the total occupational dose to the whole body shall not exceed 3 rems." Contrary to the above, on May 22-23, 1988, at Palo Verde Unit 2, an individual received a whole body dose of 2.607 rems which resulted in his receiving an accumulated whole body dose of 3.209 rem for the i second quarter of 1988. B. 10 CFR 20.201(a) provides, in part: "As used in the regulations in this part ' survey' means an evaluation of the radiation hazards incident to the production, use, or presence of radioactive materials or other sources of radiation under a specific set of conditions." 10 CFR 20.201(b) provides in part: "Each licensee shall make or cause to be made such surveys as (1) may be necessary for the licensee to comply with the regulations in this part, and (2) are reasonable under the circumstances to evaluate the extent of the ' radiation hazards that may be present." Contrary to the above, during May 22-23, 1988, at Palo Verde Unit 2, individuals performed maintenance activities involving work in the refueling cavity without making the necessary radiation survey to ensure compliance with 10 CFR 20.101(b)(1). Consequently, a worker received a reported accumulated dose to the whole body of 3.209 rem for the second quarter of 1988. C. Technical Specification 6.8.la, provides, in part: "Wri tten procedures shall be implemented covering the applicable procedures recommended in Appendix A of Regulatory Guide 1.33, Revision 2, February 1978." Regulatory Guide 1.33, Appendix A, Section 7(e)(9), requires procedures addressing implementation of an ALARA Program. Licensee procedures established pursuant to TS 6.8.la. included the following requirements: NUREG-0940 I.A-7 1 l
i 2 , E , i
' 1. Procedure 75AC-9ZZ05, "ALARA Committee," Paragraph 5.2.1,
- states that "the ALARA Committee should meet at least monthly
'at the discretion of the ALARA Committee Chairman."
- 2. .75RP-9ZZ94, "ALARA Pre-Job - Review", states, in part:
"6.1.3.4' If the final man-rem estimate is less than 10, L the ALARA Supervisor reviews final man-rem estimates and pre-job briefing checklists, as soon as practical.
6.1.3.5 if.the final man-rem estimate is greater than 10, the ALARA Supervisor will complete the ALARA Evaluatica Form (Appendix 0) ann will forward both the Pre-job Review Form and the ALARA Evaluation Form
- to the Chairman of the ALARA Committee for final review and approval.
6.1.4.5 The. ALARA Representative shall also perform a final man-rem estimate. If the estimate is 10 man-rem or greater, the pre-job review shall be forwarded to the ALARA Committee, by the ALARA Supervisor, for their review and approval."
- 3. 75RP-9ZZ97. "ALARA Post-Job Review", states, in part:
"6.1 The ALARA Supervisor shall determine whether a post-job review is required for jobs with' exposures of 1.0 man-rem to l
10.0 man-rem. Jobs with exposures of 10.0 man-rem or more { shall be reviewed and a presentation of the review shall be . made to the ALARA Committee." ,
- 4. 75PR 9ZZO3, "ALARA Program," Section 5.9, states, in part:
"An annual evaluation of the ALARA Program's effectiveness l
shall be performed to ensure a continuing commitment to l- maintaining personnel. radiation exposure ALARA. The ALARA Supervisor shall be responsible for assimilating the information provided by the Radiological Services Manager, preparing the evaluation and making recommendations for program improvement based on this information. The PVNGS Plant Manager and the Vice President of Nuclear Production shall review and approve, as appropriate, the evaluation and any recommended improvements." j e Contrary to the above procedural requirements.
- 1. Monthly ALARA Committee Meetings had not been held during the period of March 1987 through July 1988.
- 2. During 1987, of 126 jobs requiring pre-job review and approval of the ALARA supervisor, approximately 61 were not reviewed and I approved by the ALARA supervisor. For 1988, of 73 jobs, 50 were not reviewed and approved by the ALARA supervisor.
'NUREG-0940 1.A-8
3,. n i ;c ll..
,i 3
- 3. In 1987, two pre-job estimates'of greater than 10 man rem had a _not received the final review and approval of the ALARA Committee Chairman. In addition, in the first seven months of 1 1988, two pre-job estimates of greater'than 10 man-rem had not '
been reviewed and approved by the ALARA Committne Chairman.
- 4. In 1987, eleven man-rem job estimates of greater than 10 man-rem were not reviewed and presented to the ALARA Committee.
In addition, in 1988 to the date of the inspection, eight' 3 man-rem estimates of greater than 10 man-rem, including the gr ' work' performed by the individual who received an overexposure , (see item II.A, above), were not reviewed and presented to the { ALARA Committee. I
~5. In 1987, there were nine jobs with exposures in excess of 10 man rem. As of August 11, 1988, the post-job raviews had not ,
been presented to the ALARA Committee. '
'6. An annual evaluation of the ALARA Program's effectiveness was not performed in 1987.
D. Technical Specification 6.11.1 requires procedures for personnel radiation protection to be prepared consistent with the requirements of 10 CFR Part 20 and to be approved, maintained and adhered to for all operations involving personnel radiation exposure. Procedure 75 RP-9ZZ44, " Radiation Exposure Permits," (REP) states, in part:
"6.4.1 The unit [ Radiation Protection) Manager or designee shall review the REP and determine whether an ALARA Review or Pre-Job briefing is required in accordance with 75 RP-9ZZ94.
6.4.2 If an ALARA Review is required and ALARA is unavailable, the RP Technician will complete an ALARA Pre-Job review to determine any dose reduction methods which could be used for that job." Contrary to the above procedural requirements, at least four_ Unit 2 REP's (Nos. 2-88-0133A, dated July 1, 1903, 2-88-0134A, dated July 1, 1988, 2-88-0135B, dated July 3, 1988, and 2-88-0112D, dated 4 August 31, 1988) requiring ALARA reviews were implemented for use and were in effect until October 3, 1988 without any completed ALARA I l reviews. Collectively, these violations have been evaluated as a Severity Level III problem (Supplement IV). l l Cumulative Civil Penalty -- $100,000 (assessed equally among the ' violations). II. A. Technical Specification, Section 6.12.2, provides, in part: 1 NUREG-0940 1.A-9 l b )
. < ,u q 'l .-; 4 "In addition to the requirements of Specification 6.12.1, areas accessible to personnel with radiation levels such that a major portion of the body could receive in 1 hour a dose greater than 1900 mrom shall be provided with locked doors to prevent unauthorized entry, and the keys shall be maintained under the administrative control of the Shift Supervisor on duty and/or radiation protection supervision. Doors shall remain locked except during periods of access by personnel under an approved REP which shall specify the dose rate levels ~in the inmediate work area and the maximum allowable stay time for individuals in that. area." Contrary to the above, on June 27, 1988, an unlocked door at Palo Verde Unit 2 provided access to an area on the 100' to 120' level of the Radwaste Building, High Level Drum Storage' and Transfer Cart area, where the intensity of radiation was such that a major portion of the body could have received up to 3500 arem in one hour. B. Technical Specification 6.12.1 states, in part:
"In lieu of the control device' or ' alarm signal' required by paragraph 20.203(c)(2) of 10 CFR Part 20, each high radiation area in which the dose rate is greater than 100 arem/hr but less than 1000 mrem /hr shall be barricaded and conspicuously posted."
' Contrary to the'above, on August 9, 1988, at Unit 2:
- 1. A high radiation area consisting of the outlet end of the "A"
. Shutdown Heat exchanger, which had whole body radiation exposure levels of 140 aren/hr at eighteen inches, was not barricaded.
- 2. A high radiation area consisting of the Unit "B" Shutdown cooling valve, $18-V910, with radiation levels of 120 arem/hr at eighteen inches, was not conspicuously posted and one side was not barricaded.
- 3. A high radiation area consisting of Shutdown Cooling valve, S1A-V172, and piping, EW-UV 65, with radiation levels of 150 mrem /hr at eighteen inches, was not conspicuously posted, and two sides of the area'were not barricaded.
C. Technical Specification 6.11.1 requires procedures for personnel radiation protection to be prepared consistent with the requirements of 10 CFR Part 20, and to be approved, maintained, and adhered to for all operations involving personnel radiation exposure.
- 1. Procedure 75AC-9ZZ01; " Radiation tixposure and Access Control" states, in part:
"5.1.1 All personnel who enter the Radiological Controlled Area must read and sign-in on the appropriate REP.
By signing in they indicate they have read and understand the requirements and will comply. Personnel shall read their appropriate REP prior to each entry to determine whether it has been revised." NUREG-0940 1.A-10
5
- 2. Radiation Exposure Permit No. 3-88-0008A, " Minor Work in Clean i L and Contaminated Areas," requires personnel covered by REP No. '
3-88-0008A to " contact RP prior to start of work," and prohibits entry into high radiation and locked high radiation ! areas. Contrary to the above procedural requirements:
- 1. On September 8, 9 and 12, 1988, two contract Maint nance Electricians working under REP-3-88-0008A, without: first <
contacting RP to inform RP that they were going to enter high ! radiation areas, entered the unlocked entrances to the High I
' Activity Spent Resin T,ank Room and the Waste Gas Decay Tank !
rooms, which were high radiation areas.
- 2. .On September 8, 1988, without first contacting RP to inform RP that he was going to enter high radiation areas, one contract.
Maintenance Electrician authorized to work under REP-3-88-000BA entered the Unit 3 High Activity. Spent Resin Tank room, No. R-125, a locked high radiation area. Collectively, these violations have been evaluated as a Severity Level III problem (Supplement IV). Cumulative Civil Penalty - $100,000 (assessed equally among the violations). III. VIOLATION NOT ASSESSED A CIVIL PENALTY 10 CFR 20.409(b) provides: "When a licensee is required pursuant to $$
-20.405 or 70.408 to report to the Commission any exposure of an individual to radiation or radioactive material, the licensee shall also notify the individual. Such notice shall be transmitted at a time not !
later than the transmittal to the Commission and shall comply with the .) provisions of $ 19.13(a) of this chapter." ' Contrary to the above, on June 22, 1988, the licensee submitted a letter to the Commission reporting the exposure received on May 22-23, 1988 by. 2
- an' individual from NRC licensed material while working at the Palo Verde Nuclear Generating Station, Unit 2, but had not, as of that date, notified the individual of his exposure.
This is a Severity Level IV Violation (Supplement IV). Purstant to the provisions of 10 CFR 2.201, Arizona Public Service Company (Licensee), is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commissicn, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each ! alleged violation: (1) admission or denial of the alleged violation, (2) the j reasons for the' violation if admitted, (3) the corrective steps that have been taken and the result achieved (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be
~
achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not NUREG-0940 I.A-11
,s 6 be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalties by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the cumulative amount of the civil penalties proposed above, or may protest imposition of the civil penalties in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalties will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalties, in whole or in part, such answer should be clearly marked as an
" Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalties should not be imposed. In addition to protesting the civil penalties, such answer may request remission or mitigation of the penalties.
In requesting mitigation of the proposed penalties, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, un!ess compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalties, and answer to a NoticeofViolation)shouldbeaddressedto: Director, Office of Enforcement. U.S. Nuclear Regulatory Comission, ATTN: Document Control Desk, Washington, . DC 20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region V, 1450 Maria Lane, Suite 210, Walnut Creek, California 94596, und a copy to Mr. T. Polich,' Senior Resident Inspector, at the Palo Verde Nuclear Generating Station. FOR T E NUCLEAR REGULATORY COMMISSION h . Regional Administrator l Dated at Phoenix, Arizona ' onthis/ day of December 1988. l NUREG-0940 I.A-12
1 f %, 1 [ O' l UNITED STATES - Y #
E NUCLEAR REGULATORY COMMISSION 1 o E REGION 11 I
(- ..,,. [" 101 MARIETTA ST.. N.W.
' ATLANTA. GEORGIA 30323 , . OEM 01988
- Docket Nos. 50-325 and.50-324
. License Nos. DPR-71 and DPR-62
, EA 88-149 Carolina Power and Light Company ATTN: Mr. E. E. UtleyL Senior Executive.Vice President Power Supply and Engineering and. Construction
~
Post. Office Box 1551 Raleigh,. North Carolina 27602 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT kOS. 50-325/87-39. 50-324/87-40; 50-325,324/88-15; 50-325,324/88-18; 50-325,324/88-21; 50-325,324/88-24;and50-325,324/88-27)
'This refers to the Nuclear Regulatory Commission (NRC) inspections conducted on' November 1-30, 1987, April 1-30, May 1 - June 4 June 5 - July 6, July 7 -
August 7, and July 16-22, 1988, at the Brunswick Steam Electric Plant. The
. inspections included a review of several events involving hardware and/or
. equipment deficiencies and failures which revealed inadequacies in your correc-tive' action process. These' events are-further discussed below. The reports documenting these inspections were sent to you by letters. dated December 29, 1987. May 23, July 25, August 8 August 17, and Sep hmber 2, 1988, respec-
'tively. As a result of these inspections, significant-failures to comply with NRC regulatory requirements were identified, and accordingly, NRC concerns relative to the inspection-findings were discussed in an Enforcement Conference held on September 8, 1988. A sumary of this conference was sent to you by letter dated October 5, 1988.
The violation described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involved two examples of failure to
. promptly identify and corrr.:, significant conditions adverse to quality.
Due to the nature and duration of the examples described below, it is apparent that your staff's awareness and followup of potential operability issues involving. equipment deficiencies lacked the aggressiveness necessary to ensure l, such . issues were promptly addressed and appropriately resolved. The first example cited .in the violation involved the failure to promptly I identify and correct the root cause of silicon bronze carriage head (SBCH) bolt failures inside safety-related motor control centers (MCC). Beginning in November 1986, the root cause of failure for thirteen S/16-inch SBCH bolts ; that were found in vertical-to-horizontal bus bar connections in safety-related '
'MCCs was not aggressively pursued. Even though additional failures continued NUREG-0940 1.A-13 i
a i Carolina Power and Light Company DEC 3 01988 to be found in 1987, a root cause failure analysis was still not performed at that time. During the January-February 1988 dual unit outage, a significant number of additional MCC 5/16-inch SBCH bolts were found with cracked or broken heads. This problem, in cor. junction with a seismic event, could have rendered safety equipment inoperable. It was not until late January 1988 that a detailed failure analysis of the silicon bronze bolts was initiated by your staff. Even after intergranular stress corrosion cracking (IGSCC) was identified as the failure mechanism and its accelerated attack on previously replaced SBCH bolts was confirmed, it took NRC intervention before your staff established a sampling program to determine the condition of other sizes and types of silicon bronze bolts in the MCCs. The second example cited in the violation involved a failure to promptly correct a deficiency in the high pressure coolant injection (HPCI) high steam line flow (HSLF) instrumentation. Beginning in late November 1987, your staff became aware of a non-conservatism and potential Technical Specification violation involving the setpoint of one of the Unit 2 HPCI system's HSLF instruments (2-E41-PDTS-N004-2). The non-conservatism, an omission of the instrument's negative standby -eading from its setpoint calculation, was discussed by the Resident Inspector in late November 1987 with senior members of your staff. Yet this problem was not addressed and its resolution confirmed until September 1988. During this same period of time, your staff believed that setpoint problems also existed with other HSLF instruments due to an unrelated instrument line sloping problem. Based on this belief, your staff made several setpoint adjustments to both the Unit I and Unit 2 reactor core isolation cooling (RCIC) and HPCI systems' HSLF instruments between Febrin y and June 1988. Although the omission of the negative standby reading from the Unit 2 N004 setpoint was compensated for during the first of these unrelated instrument line sloping setpoint reductions, it was not until additional analysis was performed on September 6, 1988, that your staff realized that the problem had been corrected. Additionally, the September 6, 1988 anslysis not only revealed to your staff that the majority of the instrument line sloping setpoint reductions were unnecessary, but that the Unit 1 N004 instrument setpoint had unknowingly been corrected for an omission of a negative standby reading as well. In essence, it took your staff from late November, 1987 to September 6, 1988, to fully resolve these HPCI and RCIC instrumentation setpoint issues. A third issue involving DC motor valve failures and design inadequacies was also discussed with you during the Enforcement Conference or. September 8,1988. After detailed evaluation of this issue, we have determined that the technical findings and conclusions made after each of the DC motor operated valve failures were adequate and would not be expected to have reasonably led you to the electrical-ralated design deficiencies that were brought to light after the fourth failure of HPCI steam admission valve 1-E41-F001 in June 1988. Although this issue was not included as an example in the violation, we note that there was a reluctance to challenge the system and equipment design during your 1984 voltage study,1987 HPCI Safety System Functional Inspectiun, and your NRC Bulletin 85-03 review activities. Had design adequacy been probed as part of those review efforts, it is quite possible that the existence of undersized motors on HPCI system valves (1- and 2-E41-F006), as well as the effects of starting resistors on motor operated valves, would have been determined much earlier. Along the same line, when the effects of starting resistors were NUREG-0940 I.A-14
Carolina Power and Light Company -3_ DEC30 20 questioned as a side issue to the third F001 valve failure in May 1988, it was ; not until late June 1988,'following the valve's fourth known failure and a ! heightened NRC_ interest, that you accelerated your review efforts and deter-mined that starting resistors presented an operability problem. Had your , management aggressively challenged the technical staff and had the technical ) staff applied a more appropriate safety significance to the problem in May 1988, the problem may have been resolved even sooner. In addition to the apparent lack of aggressiveness in your resolution strate-gies.for_the two equipment deficiencies discussed above, we have also observed an-apparent weakness in communication between the various levels of staff in your corrective action process. This weakness in htraplant communication 5 evident when the lead organization for resolving the silicon bronze bolt iss (i.e., your_ technical support group) was apparently unaware of the information that the maintenance group had regarding the existence of additional sizes, types, and locations of silicon bronze bolts inside the safety-related MCCs. i The NRC staff considers the deficiencies in your corrective action process to 1 have potentially significant safety implications and that any problem identified by your staff that involves the degradation of safety equipment should be given the utmost attention by your management.
,In. order to emphasize the importance of the prompt identification and resolution -of equipment deficiencies, I have been authorized, after consultation with the Director,.0ffice of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in ~the amount of Seventy-five Thousand Dollars ($75,000) for the violation described in the enclosed Notice. In accordance with the " General Statement of_ Policy and Procedure for NRC Enforcement Actions," in 10 CFR Part 2 Appendix C (1988) (Enforcement Policy), the violation described in the enclosed Notice has been categorized as a Severity Level III. The base value of a civil penalty for a Severity Level III violation is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered, and the base J civil penalty amount has been increased by 50% due to your poor past performance _I relative to taking prompt and adequate corrective action. For example, the j September-October 1987 Quality Verification Functional Inspection (NRC Report l Nos. 50-325/87-32 and 50-324/87-31) identified multiple examples of past failures to take prompt and adequate corrective action with respect to deficiencies addressed in Engineering work requests (EWR). Had your performance in this area been adequate, the examples set forth in the present violation would not likely have occurred, l
You are required to respond to this letter and should follow tne instructions l specified in the enclosed Notice when preparing your response. In your l response, you should document the specific actions taken and any additional j actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. 1 NUREG-0940 1.A-15 i l j
L j .1
)
i F ' C'arolina.. Power and Light Company DEC3& 1 i
+
s . The' responses directed by this. letter and the' enclosed Notice are not' subject ' ;
. to the~ clearance' procedures of. the Office of Management and. Budget: as. required
? . by the Paperwork Reduction Act of 1980,. Pub. L. No.'96-511.
~
L
, Should you: have any questions: concerning this. letter, please' contactLus. )
Sincerely,- ) Lc. ./ -
.(s a b
! M coTm L. Ern l- cting Regiona Administrator 4 !
Enclosure:
, . Notice of Violation and Proposed
' Imposition of Civi? Penalty.
L cc w/ encl: R. B. Starkey, Jr.. Manager-Brunswick Nuclear Project
- J..L. Harness, Plant General Manager State of North Carolina
. NUREG-0940 1.A-16
i
' NOTICE OF VIOLATION l AND b PROPOSED IMPOSITIDT0F ~ CIVIL PENALTY Carolina Power & Light Company- Docket Nos. 50-325, 50-324 ;
Brunswick Steam Electric Plant License Nos. DPR-71, DPR-62. ! Units 1 and 2 EA 88-149 As,a~ result of the Nuclear Regulatory Commission-(NRC) inspections conducted on November 1-30, 1987, April 1-30, May 1 - June 4, June 5 - July 6, and July 7 - August 7,1988, a violation of NRC requirements were identified. In accordance . , with the " General Statement of Policy and Procedure for NRC Enforcement Actions," l 10 CFR Part 2, Appendix .C.(1988), the Nuclear Regulatory Commission proposes to j impose a civil, penalty pursuant to Section 234 of the Atomic Energy Act of 1954, ! as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The violation and associated civil penalty are set forth below: 10 CFR Part 50 Appendix 8, Criterion XVI states that measures shall be- q established to assure that conditions adverse to quality, such as failures, j malfunctions, deficiencies, deviations, defective material and equipment, ] and nonconformances are promptly identified and corrected. In the case of significant conditions adverse to quality, the measures shall assure thSt the cause of the_ condition is determined and corrective action is taken to preclude repetition. Contrary to the above, the licensee failed to implement that portion of its Quality Assurance Program dealing with Criteria XVI of Appendix B as evidenced by the following examples:
- 1. The cause of a significant condition adverse to quality was not promptly determined in that a failure analysis was not pursued when numerous 5/16-inch silicon bronze carriage head bolts were
.found to have failed in electrical bus bar connections inside j safety-related motor control centers-(MCC) in 1987. 'Though other 5/16-inch silicon bronze carriage head bolts were previously found to have failed in November 1986, it was not until the discovery of still more failures in January-February 1988, that a failure analysis was undertaken. In April 1988, results of this failure analysis identified intergranular stress corrosion cracking to be the common mode failure mechanism for the silicon bronze carriage head bolts.
The resultant degradation of the MCCs could have potentially rendered associated safety equipment inoperable during a seismic event.
- 2. A condition adverse to quality was not promptly corrected in that, after a non-conservatism was identified in late November 1987 1
regarding the setpoint of the Unit 2 high pressure coolant injection system's high steam line flow instrument 2-E41-N004, the situation l was not properly evaluated and remained uncorrected until the dual unit outage in January 1988. The non-conservatism, an omission of the instrument's negative standby reading from its setpoint calcula-tion, resulted in the setpoint being greater than allowed by the Technical Specification value, and was subsequently determined to be applicable to the Unit 1 N004 instrument as well. NUREG-0940 1.A-17 (
l n l1 , g b INotice of ViolationL k This is a Severity Level III violation. (Supplement I). Civil Penalty - $75,000 j Pursuant. to the provisions of 10 CFR 2.201, Carolina Power and Light Company 1 (licensee) is hereby required to submit a written statement or explanation to. ! t the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a
" Reply to a Notice. of Violation" and should include: (1) admission or denial !
of the violation, (2) the reasons for the violation if admitted (3) the ! corrective steps that have been taken and the results achieved, (4) the '
' corrective steps which will be taken to avoid further violations, and (5) the date'when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority l of Section 182 of the Act. 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
Within the same' time as provided for the response required above under 10.CFR 2.201, the licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in- l the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director', 0ffice of Enforcement, U.S. Nuclear Regulatory Commission. Should the licensee fail to answer within the time specified, an order imposing the > civil penalty will be issued. Should the licensee elect to file an answer in " accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not'be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalt 1 Section V.B of 10 CFR Part 2, Appendix C (1988)y, thebefive
, should factors addressed addressed. Any in written answer in accordance with 10 CFR 2.205 should be set forth separately l from the statement or explanation in reply pursuant to 10 CFR 2.201 but may I
incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing k page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty.
. Upon failure to pay the penalty due, which has been subsequently determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282.
NUREG-0940 I.A-18
Notice of Violation The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II and a copy to the NRC Resident Inspector at the Brunswick Steam Electric Plant. FOR THE NUCLEAR REGULATORY COMMISSION r .
%M eting c Im Regional L. E nstAdministrator Dated at Atlanta, Georgia this.7dddayofDecember1988 6
NUREG-0940 I.A-19 ,
Sa Reap UNITED STATES NUCLEAR REGULATORY COMMisslON g- REGION 11
.*. 3 L -j* j 101 MARIETTA STREET,h1W.
' ATLANTA, GEORGIA 30323 c
' F.
*%, . /
...e DEC 281988 Docket No. 50-400 License No. NPF-63 EA 88-261 Carolina Power and Light Company ATTN: Mr. E. E. Utley Senior Executive Vice President Power Supply and Erigineering and Construction Post Office Box 1551 Raleigh, North Carolina 27602 Gentlemen:
SUBJECT:
NOTICE OF. VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 50-400/88-37) This refers to the Nuclear Regulatory Commission (NRC) inspection conducted by J. D. Ennis at the Shearon Harris facility on September 26-30, 1988. The inspection included a review of the circumstances surrounding the discovery and
. reporting of an unprotected pathway into a vital area. This vital area pathway was discovered by a member of the licensee's contract security force on September 19, 1988. The report documenting this inspection was sent to you by letter dated October 13, 1988. As a result of this inspection, a significant failure to comply with the NRC regulatory requirements was identified, and accordingly, NRC concerns relative to the inspection findings were discussed in an Enforcement Conference held on November 18, 1988.
The' violation described in Section I of the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involved several examples of failure to provide vital area barriers. These unprotected pathways had existed continuously since the facility was licensed and had not been detected during your corrective action for a previous similar violation. Furthermore, as a result of this event, your staff discovered several other unprotected pathways 1 into vi'al areas, as well as numerous examples of inadequate barriers to vital areas. None of these violations would have been of significant concern individ-ually, but collectively, their discovery does reflect a potentially significant i lack of attention to access controls especially in view of your previous action to correct similar problems in 1987. The NRC attaches great importance to comprehensive licensee initiatives for detectirig, correcting, and reporting safety and safeguards problems. However, i the barrier violations described herein could have been prevented had your I corrective action to the enforcement action (EA 87-29) issued on March 20, 1987, been sufficiently thorough. Therefore, in order to emphasize the NUREG-0940 1.A-20 l
)
Carolina Power & Light Company DEC 28.1988 necessity for thorough correction of identified problems, I have been authorized, after consultation with the Director, Office of Enforcement, and thw Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Twenty-five Thousand Dollars ($25,000) for the violation described in Section I of the enclosed Notice. In accordance with the " General Statement of PolicyEnforcement C(1988) (and Procedure for NRC Policy), Enforcement the violation Actions," described 10 CFR in Section Part,2 Appendix I of the enclosed Notice has been categorized as a Severity Level III violation because of the significant number of inadequate barriers as exemplified by the four items cited in the Notice. The base civil penalty for a Severity Level III violation is $50,000. The escalation and mitigation factors of the NRC Enforcement Policy were considered. In this case, the base civil penalty has been mitigated by 50 percent due to your prompt and extensive corrective , actions, identification of the violation, and prior performance as indicated by your recent SALP rating, offset by the prior similar Severity Level III violation (EA 87-029) and the added significance due to the duration of the examples in the violation. The violation described in Section II of the enclosed Notice, involving the j failure to make a timely report of the September 19, 1988 event as required by 10 CFR 73.71(b), has been categorized as a Severity Level IV violation. During the Enforcement Conference, it was noted that a complete reinspection of all vital areas was still in progress and that the reinspection was scheduled to be completed by the end of December 1988. Based on the results of that j reinspection to date, it is expected that additional violation examples will be i identified. Following our review of these findings, a decision will be made ! as to whether, in accordance with Section V.G.5 of the revised Enforcement j Policy, enforcement discretion is appropriate for the additional violations. ! l You are required to respond to this letter and the enclosed Notice and should l follow the fn'structions specified therein whcn preparing your response. In ] your response, you should document the specific actions taken and any additional i actions you plan to assure that the current efforts will identify any remaining i barrier degradations. After reviewing your response to this Notice, including l your proposed corrective actions and the results of future inspections, the NRC 1 will determir.e whether further NRC enforcement action is necessary to ensure complience with NRC regulatory requirements. In accordance with 10 CFR 2.790(d) and 10 CFR 73.21, safeguards activities and ! security measures are exempt from public disclosure. Therefore, the enclosure i to this letter will not be placed in the NRC Public Document Room. l The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. NUREG-0940 I.A-21 L_- - __
7
?,
Carolina Power & Light Company -3 .0EC 281988
. Should you have any questions concerning this letter, please contact us.
Sincerely, f Malcolm L. Ernst s Acting Regional. Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty (Safeguards Information) cc w/ enc 1: R. A. Watson, Vice President Harris Nuclear Project D. L. Tibbitts, Director of Regulatory Compliance C. S. Hinnant, Plant General Manager cc w/o enc 1:
. State of North Carolina 1
1 NUREG-0940 I.A-22 1 i
p o usetso states (janeg\ NUCt. EAR REGULATORY COMMIS$lON n asoion m [ . no moosevsty mono eLam si.tva, stumois sein
**"* September 15, 1988
. Docket Nos. 50-254; 50-265 Licenses No. DPR-29; DPR-30 EA 88-161-Commonwealth Edison Company ATTN: Mr. James J. O' Conner President
' Post Office Box 767 Chicago, IL 60690 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED imp 0SITION OF CIVIL PENALTIES (NRC INSPECTION REPORT NOS. 50-254/88011(DRS) AND 50-265/88012(DRS)) This refers to the inspection conducted on April 18-22, May 2-6, 11, 31 and June 1,1988, at the Quad Cities Nuclear Power Plant, Units 1 and 2, Cordova, Illinois. Violations of NRC requirements were identified as a result of this inspection. The referenced inspection report was sent to you by letter dated June 22, 1988. An enforcement conference was conducted in the Region III office on June 24, 1988, with Messrs. D. Galle, L. De1 George, N. Kalivianakis and others of your staff, and myself and others of the NRC Region III staff. Two significant violations were identified during this inspection and are included as part of the enclosed Notice of Violation and Proposed Imposition of Civil Penalties (Notice). Violation I.A involves the continued operation of Unit 2 for approximately six munths while the 1/2 Emergency Diesel Generator was incapable of ' automatically performing its intended safety function due to an undetected failure in the circuitry of the automatic start relay (ASR). Violation I.B involves the failure to perform a safety evaluation for various grounds which existed on the ESS DIV 1 125 volt battery system. Those grounds could have resulted in spurious operation or non-operation of 125 Vdc safety circuits. The violations occurred and continued as a result of poor performance in several areas: 1) the drawing error noted by the electrical maintenance department was not corrected in plant drawings for almost nine months;
- 2) once the design changes were incorporated, no apparent attempt was made to review the work that had been performed ten days earlier; 3) post 4 modification tests gave indications of circuit anomolies that were not properly resolved; and 4) operators did not investigate changes in the Ground Detector strip charts.
-CERTIFIED MAIL i RETURN RECEIPT REQUESTED NUREG-0940 I.A-23
3 l Commonwealth Edison Company. 2 September 15, 1988 In addition to the two violations described above, four other violations were identified and are described in the enclosed Notice under violations not assessed a civil penalty. To emphasize the need for management to improve performance with respect to drawing control, post modification testing activities and operator response to indicated electrical ground conditions, I have been authorized, after consultation.with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of
' Violation and Proposed Imponition of Civil Penalties in the amount of-One Hur, dred Twenty-Five Thousand' Dollars ($125,000) for the violations described in the enclosed Notice. -In accordance with the " General Statement .of Policy and procedure for NRC Enforcement Actions," 10 CFR, Part 2, Appendix C (1988)-(Enforcement Policy), the violations assessed civil penalties have each been categorized at Severity Level III.
The base value of a civil penalty for a Severity Level III~ violation -is $50,000. The escalation and mitigation-factors in the Enforcement Policy were considered.
.The base civil penalty amount for Violation I.A has been increased by 50 percent - because of your. failure to take prompt and extensive corrective actions to prevent recurrence. Although the violation was eventually identified by the plant staff, no mitigation of the civil penalty for'that factor is deemed appropriate-given that you had a number of prior opportunities to identify the problem. Specifically, this problem would have been identified if there had been proper followup .of the architect-engineers discovery of an electrical termination error, proper disoositioning of the post. modification test results, or proper evaluation of electrical system ground detection indications. In the case of violation I.B. - no escalation or mitigation of the base civil penalty was considered appropriate.
You are required to respond to this lette_r and should follow the instructions specified in the enclosed Notice when preparing your_ response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure -compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. NUREG-0940 I.A-24
l l Commonwealth Edison Company 3 September 15. 1988 i i The responses' directed by this letter and the enclosed Notice are not subject .i to the clearance procedures of the Office of Management and Budget, as required 1
=by the Paperwork Reduction Act of 1980, Pub. L., No. 96-511. j i'
Sincerely, J)F
~
~
A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalties
- 2. Inspection Reports No. 50-254/88011(DRS);
No. 50-265/88012(DRS) cc w/ enclosures: C. Reed, Senior Vice President H. Bliss, Nuclear
' Licensing Manager R. L. Bax, Plant Manager DCD/DCB(RIDS)
. Licensing-Fee Management Branch Resident Inspector, RIII Richard Hubbard J. W. McCaffrey, Chief, Public Utilities Division L
l i NUREG-0940 1.A-25 l L__-----__--- -
1 l 1 NOTICE OF VIOLATION L AND PROPOSED IMPOSITION OF CIVIL PENALTIES t 1 Commonwealth Edison Company. Docket Nos. 50-254; 50-265 Quad Cities, Unit I and 2 Licenses No. OPR-29; DPR-30 C.t 88-161
' During an NRC inspection conducted on Apri' 18-22, May b6,11, 31 and June 1, 1988 violations of NRC requirements were identified. In accordance with the
" General Statement of Policy and PrMedure for NRC Enforcement Actions "
10 CFR Part 2, Appendix C (1988) the Nuclear Regulatory Commission proposes to impose civil penalties pursu.nt to Section 234 of the Atomic Energy Act of 1954,sas amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil permities are set forth below: I Violations Assessed a Civil Penalty A. Quad Cities Technical Specification 3.9.E.1 requires in part that whenever the reactor is in Startup Hot Standby or Run Mode and the unit or shared diesel generators and/or their respective associated buses are made or found inoperable except as provided for in 3.9.E.2 (performance of maintenance), operability shall be restored within seven days or the reactor shall be placed in cold shutdown within 24 hours. Contrary to the above, from approximately July 11, 1986, to January 3, 1987, Quad Cities, Unit 2 continued in operation with the 1/2 Emergency Diesel Generator (EDG) being inoperable for a reason other than maintenance. The 1/2 EDG was incapable of automatically performing its intended safety function for Unit 2 due to an undetected failure (blown control power fuse) in the circuitry of the automatic start relay (ASR). This is a Severity Level III violation (Supplement I). Civil Penalty - $75,000 B. 10 CFR 50.59(b)(1) requires that the licensee maintain records of changes in the facility, to the extent that the changes constitute changes in the facility as described in the Safety Analysis Report. Those records must include a written safety evaluation which provides the bases for determining that the change does not involve an unreviewed safety question. A proposed change involves an unreviewed safety question if the probability of occurrence of a malfunction of equipment important to safety previously evaluated in the Safety Analysis Report may be increased. Final Safety Analysis Report Section 8.2.3.2.2 states, "The 125 volt battery system operates ungrounded with a ground detector alarrn set to annunciate the first ground. In addition, the ground fault resistance, and the time at which a ground fault occurs, is recorded by a recording voltmeter. Thus, multiple grounds, the only reasonable mode failure, are extremely unlikely." NUREG-0940 I.A-26
Notice of Violation 2 Contrary to the above, at the time of the inspection the licensee did not have a written safety evaluation for operating the ungrounded ESS DIV 1125 volt battery system from February 1986 until July 1986 with several grounds, constituting a change in the facility as described in the safety analysis report. This change involves an unreviewed safety question because it increase the probability of occurrence of a malfunction cause by the ESS DIV 1 125 volt battery i system. ' This is a Severity Lavel lII violation (Supplement I). Civil Penalty - 550,000 q l II. Violations Not Assessed a Civil penalty ' A. 10 CFR Part 50, Appendix B, Criterion III, Design Control, requires that measures be established to assure that applicable regulatory requirements and the uesign basis are correctly translated into specifications, drawings, procedures, and instructions. Contrary to the above, as of June 1,1988, the licensee's design control program did not assure that the design basis was correctly translated into drawings. For example:
- 1. The " Diesel Emergency Auto Start Relay" circuit shown on drawing No. 4E-13508, Revision AC, was also shown on drawing No. 4E-1656H, Revision J. However, the test switch was omitted from the circuit on drawing No. 4E-1656H, while the relay designations for ASR-1 relay and the switchgear cubicle number for 127814-1X3 (3-4) relay contact were not shown on drawing No. 4E-1350B.
- 2. Discrepancies were identified in the electrical design drawings associated with Units 1 and 2, 125Vdc ground detection system.
Drawing No. 4E-126858, Revision v cnd No. 4E-2685B, Revision S, did not represent the ground detection circuitry as it was installed in the field. In addition, S/D 4E-25755, Revision E, Annunciator Window No. 54, "125V Battery Ground" circuitry did l not show the negative ground contact (11-12) in the alarm circuit. This is a Severity Level IV violation (Supplement I). B. 10 CFR Part 50, Appendix B, Criterion V, Instructions, Procedures, ! and Drawings, requires that activities affecting quality be prescribed l by documented instructions, procedures, or drawings of a type ' appropriate to the circumstances, and be accomplished in accordance l with these instructions, procedures, or drawings. 1 NUREG-0940 1.A-27 l _______-__E
Notice of Violation 3 Contrary to the above, as of June 1,1988, certain activities affecting quality were either not prescribed or were not carried out in accordance with documented instructions or procedures of a type appropriate to the circumstances, in that:
- 1. The licensee did not have a procedure for or accomplish the lubrication of bearings and performance of certain other specified preventive maintenance activities on Limitorque motor operated valve actuators at 18 or 36 month intervals, although sudi activities were activities affecting quality, were appropriate to the circumstances, and were recommended in the vendor manual.
- 2. The licensee failed to perform preventive maintenance on 47 of 93 horizontal 4.16 kV electrical circuit breakers at the required interval, as required by procedure QEPM 200-1,
" Inspection and Maintenance of 4.16 kV Horizontal Circuit Breakers", Revision 1.
This a Severity Level IV violation (Supplement I). C. 10 CFR Part 50, Appendix B, Criterion XVI, requires measures to be established to assure that conditions adverse to quality and nonconformances are promptly identified and corrected. In the case of significant conditions adverse to quality, the measures shall assure that the cause of the condition is determined and corrective action taken to preclude repetition. Contrary to the above, the following conditiors adverse to quality were either not promptly identified or promptly corrected:
- 1. On November 8, 1986, the 1/2 Emergency Diesel / Generator was manually started and connected to Bus 13-1 to provide power to Unit I during modification work in the electrical switchyard.
The 1/2 Emergency Diesel / Generator feed breaker to Bus 13-1 subsequently tripped due to activation of the underexcitation relay. The licensee's corrective action included modification of the auto-start circuit; however, such corrective action did not correct the problem of activation of the underexcitation relay when manually starting the 1/2 Emergency Diesel / Generator.
- 2. During a monthly surveillance test on October 5,1987, 4.16 kV breaker 152-2329, which connects the 1/2 Emergency Diesel / Generator with Bus 23-1, failed to close. Corrective action included cleaning and lubricating the trip latch rollers ,
of breaker 152-2329 in accordance with an electrical preventive l l maintenance procedure; however, as of June 1, 1988, the licensee had not implemented corrective action to prevent l l NUREG-0940 I.A-28
W i l
' Notice of. Violation 4 recurrence in that neither inspections nor preventive maintenance had been performed on the identical Unit 2 Emergency Diesel / Generator 4.16 kV breaker latch mechanism.
- 3. In 1980, the licensee identified recurring problems with binding .i of auxiliary contacts in 480 volt motor control centers;
~
.I however, corrective action was not effected until July 1987.
- 4. In 1984, parallel isolation valves were replaced in Units 1 and
- 2. Due to opepting problems, it was determined later in 1984 that a Unit 1 isolation valve was incorrectly installed and
{ unable to isolate the condenser vacuum pump to prevent off gas radiation releases during reactor startup. Adequate corrective action was taken for Unit 1; however, a similar problem on Unit 2 was not identified and corrected until'May 1988. This is a Severity Level IV violation (Supplement I). D. 10 CFR Part 50, Appendix B, Criterion XVIII, requires that a comprehensive system of planned and periodic audits be carried out to verify compliance with all aspects of the quality assurance program and to determine the effectiveness of the program. Contrary to the above, during the period November 30 to December 4, ; 4 1987, the licensee conducted an audit (Audit QAA 04-87-55) of the l maintenance program, which as described in the audit plan, included preventive maintena' ce; however, with the exception of four or five Environmental Quali ' cation items, the audit did not verify compliance with and determine the effectiveness of the documented preventive maintenance program in that the examination of four or five items in
'one specific area does not constitute an audit of the full program.
This is a Severity Level IV violation (Supplement I). Fursuant to the provisions of 10 CFR 2.201, Commonwealth Edison Company is I hereby required to submit a written statement or explanation to the Director, , Office of Enforcement, U.S. Nuclear Regulatory Commission within 30 days of l the date of this Notice. This reply should be clearly marked as a " Reply to a ; Notice of Violation" and should include for each alleged violation: '
. (1)' admission or denial of the alleged violation; (2) the reasons for the violation if a Aitted; (3) the corrective steps that have been taken and the results achieved; (4) the corrective steps that will be taken to avoid further violations; and (5) the date when full compliance will be achieved. If an i adequate reply is not received within the time specified in this Notice, an l order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
NUREG-0940 1.A-29 L
1 s Notice of Violation 5 Within the same ti.v.e as provided for the response required above under 10 CFR 2.201, Commonwealth Edison Company may pay the civil penalties by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalties proposed above, or may protest imposition of the civil penalties in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the licensee fail to answer within the time specified, an order imposing the civil penalties will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalties, in whole or in part, such answer shoul'd be clearly marked as an " Answer to a Notice of. Violation" and may: (1) deny the violations listed in this Notice in whole or in part; (2) demonstrate extenuating circumstances; (3) show error 9 this Notice; or (4) show other reasons why the penalties should not be ir.ased. In addition to protesting the civil penalties, such answer may request remission or mitigation of the penalties. In requesting mitigation of the proposed penalties, the five factors addressed in Section V.B of 10 CFR, Part 2, Appendix C (1988) should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from tia statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g. , citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing the civil penalties. Upon failure to pay any civil penalties due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalties, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Peply to a Notice of Violation, letter with payment of civil penalties, and Director, Office answer to a Notice of Violation) should be addressed to: of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington D.C. 799 Roosevelt Road, Glen Ellyn, Illinois 60137. FOR THE NUCLEAR REGULATORY COMMISSION A. Bert Day s Regional Administrator Dated at Glen lyn, Illinois ThisJfdaySeptember1988 NUREG-0940 1.A-30
[peatoo o UNITED STATES f; " , m [' gg NUCLEAR REGULATORY COMMISSION l- WASHINGTON D. C. 20555 k . . . . . /' l l JA 2 3 np j Docket Hos. 50-254 and 50-265 Licenses Nos. DPR-29 and DPR-30 EA 88-161 s Commonwealth Edison Company l ATTN: Mr. James J. O' Conner President Post Office Box 767 Chicago, Illir.ois 60690 Gentlemen:
SUBJECT:
ORDER IMPOSING A CIVIL MONETARY PENALTY (QUAD CITIES) This refers to your letter dated October 17, 1988, in response to the Notice of Violation and Proposed Imposition of Civil Penalties sent to you by our letter cateo September 15, 1988. Our letter and Notice described two violations involving: (1) the continued operation of Unit 2 for approximately six months j while the I/2 Emergency Diesel Generator was incapable of automatically 4 performing its intended safety function due to an undetected failure in the circuitry of the automatic start relay; and (2) the failure to perform a safety evaluation for various grounds which existed er the ESS DIV 1125 volt battery system. j To emphasize the need for management to improve performance with respect to drawing control, post modification testing activities and operator response to indicated electrical ground conditions, civil penalties in the cumulative amount of Goe Hundred and Twenty-Five Thousand Dollars ($125,000) were proposea. In your response, you admitted and paid the civil penalty for Violation I.A; however, although you acknowledged Violation I.B in that no formal evaluation was performed in accordance with 10 CFR 50.59, you did not pay the civil penalty ds you believe the penalty partially duplicates the escalated penalty o for Violation I.A. You also requested reconsideration of the civil penalty proposed for Violation I.B in accordance with the factors in 10 CFR Part 2 Appendix C. After consideration of your response, we have concluded, for the reasons given in the Appendix attached tc the enclosed Order Imposing Civil Penalty, that you have not provided an adequate basis for mitigatier, and the civil penalty should be imposed. Accorair. gly, we hereby serve the i.nclosed Order on Common-wealth Edison Compeny imposing a civil menetary penalty in the amount of Fif ty Thousard Dollars ($50,000). As discussed in the Apperdix, your ?nterim policy for de611ng with electrical grounds was found not to be entirely responsive to our concerns. We vill review the effectiveness of your correctiu actions dutino a subsequer.t inspecider. [ NUREG-0940 I.A-31 1 t _ _ _ _ _ _ _ _ _ _ _
. }
r .F._ 3 r.. L- Commonwealth Edison Company h W. .. I' In accordance with Section 2.790 of- the NRC's " Rules of Practice," Part 2,
; -Title 10, Code of Federal Regulations, a copy of this letter and the er closure will be placed.in the NRC's Public Docurent Room.
Sincerely, k , . Wp-s M. Tayldf, Deputy-Executive Director-i J for Regional Operations
Enclosure:
Order Imposing Civil - Monetary Penalty w/ Appendix cc w/ enclosure: , C. Reed, Senior'Vice President H. Bliss, Nuclear Licensing Manager
- R. L. Bax, Plant Manager ,4 DCD/DCB (RIDS)
Licensing Fee Management Branch
. Resident inspector, RIII Richard liubbard J. W. McCaffrey, Chief, Public Utilities Division NUREG-0940 1.A-32
UNITED STATES fl0 CLEAR REGULATORY COMMISSION -l In the Matter of Docket Nos. 50-254; 50-265 , Quad Cities Units 1 and 2 Licenses No. DPR-29; DPR-30 j Corcova, 11 incis EA 88-161
)
ORDER IMPOSING CIVIL MONETARY PENALTY I Connonwealth Edison Company, Cordova, Illinois (licensee) is the holder of Operating Licenses No. OPR-29 and No. DPR-30 (licenses) issued by the Nuclear Regulatory consission. The licenses authorize the licensee to operate the Quad Cities facility in accordance with the cc:1ditions specified therein. II NRC inspections of the licensee's activities under the l u nses were conouctec on April 18-22, May 2-6, 11, 31 and June 1, 1988. The results of these inspections'indicateo that the licensee had not conducted its activities in full compliarte with NRC requirements. A written Notice of Violation and Proposed Imposition of Civil Penalties (Notice) was served upon the licensee by letter dated September 15, 1988. The Notice stated the nature of the violations, the provisions of the NRC's requirements that the licensee had violated, and the amounts of the civil penalties proposed for the violations. The licensee responded to the Notice by letter dated October 17, 1968. In its response, the licensee admitted Violation I.A and paid the associated civil per.alty. With respect to Violation I.B. the lice see acknowledged that no formal evaluation of continued operatiun with grourds in the DC system was performed pursuant to { IC CFR 50.59, tut requesteo recons- eration of the civil p ralty on the tesis
- bat (I) the civil perMty partid :) cuplic6ted th. esc 61ated civil re'elty NUREG-0940 1.A-33
7 s I p ! r assessed for Violation I.A. and (2) the mitigation factors in 10 CFR Part 2, j Appendix C, Section V.B., were not appropriately applied in assessing the pendity. 1 III j i After consider 6 tion of the licensee's response and the statements of fact, explanations, and argument for mitigation contained therein, the Deputy Executive Director for Regional Operations has determined, as set forth in the Appendix to this Order, that the original penalty proposed for Violation I.B. as designat-:f in the Notice of Violation and Proposed Imposition of Civil ; Penalty, should not be mitigated, i i IV i l In view of the foregoing and pursuant to Section 234 of the Atomic Energy Act of 1954, as ' amended (42 U.S.C. 2282, PL 96-295) and 10 CFR 2.205, IT IS HEREBY ! i ORDERED THt.T: 1 1 The licensee pay a civil penalty in the amount of Fifty Thousand Dollars j i ($50,000) within 30 days of the date of this Order, by check, draft, or money order, payable to the Treasurer of the United States and mailed to j the Director, Office of Enforcement, U.S. Nucleer Regulatory Connission, ATTN: Docurient Control Desk, Washington, D.C. 20555. I I I I NUREG-0940 1.A-34 l
V l' The licensee may request a hearing within 30 cays of the date.of this Order. A request for a hearing shall be clearly marked as a
- Request for an Enforcement Hearing" and shall be addressed to the Director Office of Enforcement, U.S.
Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Assistant General Counsel for Enforcement, the Regional Administrator, RIII, and to the NRC Resteent Inspector, Quad Cities, Units I and 2. If a hearing is requested, the Consnission will issue an Order designating the time and place of the hearing. If the licensee fails to request a hearing within 30 days of the date of this Order, the provisions of this Order shall be effective without further proceedings. If payment has not been made by that time, the matter may be referred to the Attorney General for collection. In the event the licensee requests a hearing as provided above, the issue to be considered at. such hearing shall be:
.whether on the basis of Violation I.B set forth in the Notice of Violation and Proposed imposition of Civil Penalty referenced in Section II above, which the licensee has admitted, the Order to pay a fifty Thousand Dollar civil penalty should be sustained.
FOR THE flUCLEAR REGULATORY COMMISSICN
. /
\ _[Ib CelesM.Taylc Deputy Executive Director for Regiera1 Operatiers Dated at Reckville tiaryland !
Rhis,)pdty of Jan,uary 1989. NUREG-0940- I.A-35 1
P. f APPENDIX EVALUATION AND CONCLUSION \
-l 1988, a hotice of Violation and Proposed Imposition of Civil OnSeptember15)wasissuedforviolationsidentifiedduringAnNRCinspection.-
Penalty (Notice Com:nonwealth Edison Company responded to the Notice on October 17, 1988. With h respect to Violation I.B., the' licensee acknowledges that no formal evaluation of continued operation'with grounds in the DC System was performed pursuant to
-10 CFR 50.59, but requests mitigation of the civil penalty. ,
h Restatement of Violation I.B. 10 CFR'50.59(b)(3) requires that the licensee maintain records of changes L in the facility, to the extent that the changes constitute, changes in the facility as described in the Safety Analysis Report. Those records must include 6 written safety evaluation which provides the bases for determining that the change does not involve an unreviewed safety question. I A proposed change involves an unreviewed safety question if the probability I l of occurrence of a malfunction of equipment important to safety prevtously evaluated in the Safety Analysis Report may be increased. L Final Safety Analysis Report Section 8.2.3.2.2 states, "The 125 volt battery system operates ungrounded with a ground detector alarm set to annunciate the first ground. In addition, the ground fault resistance, and the time at which a ground fault occurs, is recorded by a recording voltmeter. Thus, multiple grounds, the only reasonable mode failure, i are extremely unlikely." ; Contrary to the above, at the time of the inspection the licensee did not j have a written safety evaluation for operating the ungrounded ESS DIV 1 125 volt battery system from February 1986 until July 1986 with several grounds, constituting a change in the facility as described in the safety < analysis report. This change involves an unreviewed safety question i because it increases the probability of occurrence of a malfunction caused by the ESS DIV 1 125 volt battery system. This is a Severity Level III violation (Supplement I). Civil Penalty - $50,000 Sumary of Licensee's Response The licensee acknowledges that no formal evaluation of continued operation with grounds in the DC system was performed pursuant to 10 CFR 50.59. In view of the escalateo penalty for Violation I.A the licensee is requesting o.itigation of the penalty for Violation I.B since it believes the penalty partially cuplicates the escalated penalty proposed for , Violation I.A. For this reason, the licensee requests rect'nsideration ! cf the civil penalty for Viulation I.B. Additionally, the licensee cletms mitigation is appropriate because its corrective actions were unusudliy i pronpt and exten>1ve, and proper credit was not given for its past good performance irmiving salety evaluations. NUREG-0940 1.A-36
iAppendix- NRC Evaluation of Licensee's Response The licensee contends that a civil penalty should not be proposed for
. Violation 1.B because it partially duplicates the escalated penalty for.
~
Violation I.A.: The NRC staff concludes that the licensee has-not properly considered the factors that formed the basis-for escalating the civil penalty for Violation I.A and proposing the civil penalty for Violation I.B.
.The escalation-of tne civil. penalty for. Violation I.A for failure to take prompt and extensive-corrective actions to prevent recurrence was based on the licensee's failure to correct the problem cespite three clear oppor-
.tunities to'do so.
Violation.I.B represents a much broadcr concern than merely the licensee's failure to adequately disposition the particular ground indication that'resulted from the . improper wiring of the emergency diesel generator circuitry and constituted one of theLopportunities to discover'and correct the wiring problem. Rather,- Violation I.B concerns the licensee's failure to properly evaluate and disposition indications of. various system grounds during the stated. time period.' The licensee's failure to properly evaluate these grounds on an ungrounded system is a significant concern to the NRC ataff as the evaluation of such a condition is required by 10 CFR 50.59. .Therefore,
.the problem warrants the issuance of a separate Severity Level III violation and the proposal of a civil ~ penalty..
In assessing the escalation'and mitigation factors in the Enforcement Policy,'NRC considered all five factors and determined that no escalation or mitigation of the base penalty was warranted. The NRC staff determined and the licensee has agreed that no change was warranted for identification and reporting,-prior notice, or multiple occurrences. Concerning the licensee's request for reconsideration of the civil penalty,
- the licensee addresses two areas: (1)pastperformanceand(2) corrective action. The. licensee states the its past performance involving safety evaluations has been~ good, and its review of violations identified by the NRC for a three year period did not show any past violations for not performing adequate evaluations. For this reason, the licensee believes that the civil penalty shoulc be mitigated. The NRC staff review of the licensee's past performance shows that there were two previous violations of 10 CFR 50.59 identified by the NRC in early 1966 as cescribed in Inspection Reports No. 50-254/86002(DRP)andNo. 50-265/86002(DRF). After considering that information along with the licensee's SALP ratings in
;the general area of concern, the NRC staff concluced that no basis existed for mitigation of the civil penalty for past performance.
With-regard to the licensee's corrective actions, the NRC st6ff agrees
-that the~ steps.taken to raise the level of sensitivity for resolving b.
potential safety issues, such as the ground prcblem, are indicative of broad based ccrrective actions. However, the NFC concludes that the licensee's interim policy for dealing with DC power system grounds c'oes not provide. timely resolution or proper evaluatior of system grounding
- NUREG-0940 J.A-37
P L: ( + l r Appendix .3- _ E The licensee's interim policy allows a significant ground p(roblems. greater than or equal to 115 volts) to exist for up to 14 days prio location and removal or justification of continued operation. The NRC staff concludes that such a time period is unacceptably long given the magnitude of a significant ground. The licensee's evaluation of grounds under the interim policy is insufficient in that it is based solely on the magnitude.of the ground. To provide _a proper evaluation, other factors such as consideration of the specific' equipment affected, the nature of the ground, and.the presence of previously existing grounds should also be considered. On balance..the NRC staff finds no basis for. mitigating the civil penalty for corrective actions. In summary, NRC properly considered all five factors in Section V.B of the enforcement policy and correctly determined that no change to the base civil penalty.is appropriate. NRC Conclusion For reasons set forth herein, the NRC staff has concluded that the licerisee has not provided an acequate basis for remission or mitigation of the civil penalty proposed for Violation I.B. Consequently, the civil penalty in the amount of $50,000 should be imposed. i l l l NUREG-0940 1.A-38 I l l r - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ -
a f .f' Me UNITED STATES ) o g NUCLEAR REGULATonY COMMISSION 3 [ f,
-F nEciou ein m noosevcLv nono j
. GLcN eLLYN, ILLINOl$ 50337
'"** NOV 231988 Docke't Not. 50-456 and 50-457' L- -Licensas Nos.= NPF-72 and NPF-77
.EA-St-198-Commonwealth Edison Company.
ATTN: Mr. James J. O'Connor President. Post Office Box ~767 fChicago, Illinois- 60690 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND. PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORTS'NO. 50-456/88005(DRS) AND NO. 50-457/68006(DRS)) This refers to an NRC inspection conducted during the period February 29 through'May 4,~1988 of activities authorized by.NRC Operating Licenses Nos. NPF-72 and No..NPF-77 at the Braidwood Station, Units 1 and 2. The. inspection focused on the implementation of requirements for assuring environmental qualification (EQ) of electrical equipment and identified violations of NRC
-regulatory requirements. The details are presented in the subject inspection report'which was sent to you by letter dated May 27, 1988. An enforcement conference'was held.in'the NRC Region III office between Messrs. T. J. Maiman, A.-B. Davis, and others of our respective staffs on August 17, 1988, during which the violations, their root causes,.and your corrective actions were discussed. Additionally, the NRC staff has reviewed and considered the
'information contained in the various submittals, concerning EQ at the Braidwood Station, that have been made by Commonwealth Edison Company since ;
-the enforcement conference. '
The violations described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice). resulted from the failure of Braidwood ( Station engineering and maintenance personnel to ensure that electrical equip- -) ment important to safety was: (1) qualified for its intended service by i testing and/or analysis, (2) installed in the configuration qualified by test i and/or, analysis, and (3) maintained to preserve its qualification. It appears that the root cause of these violations was the failure to implement adequate ] management and programmatic controls that would: (1) assure that equipment was properly qualified, (2) verify that equipment was properly installed in the field, and (3) assure coordination between your maintenance and engineering ) ' staffs so that maintenance would be performed on equipment in a manner that
-would preserve its qualification. The programmatic nature of these violations and,the failure of management control systems are cause for significant concern. l
'As a result, two of the violations involving multiple examples have been !
categorized in the aggregate as a Severity Level III problem. i NUREG-0940 I.A-39 i
)
J
' Commonwealth Edison Company 2 IN7V 231985 L 'In addition,'two Severity' Level IV violations are contained in the enclosed Notice, The' first of. these'two violations' relates directly to the plant EQ l program but is not' included as a part of the above problem. Based on the i information that was available to you concerning the qualification of Bunker ;
Ramo electrical penetrations,-the NRC staff has corcluded that the failure ; to recognize the qualification deficiencies associated with the electrical
~
penetration is not significant enough to warrant inclu; ion in the escalated ! action. The second of these violations does'not relate directly to your : EQ program. Rather, it' involved the improper installation of components that may have~affected their ability to perform under various circumstances. i
.To emphasize the importance of implementing adequate management and .
programmatic controls to ensure the initial and continuing qualification of-equipment important to safety, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed
; Imposition of Civil Penalty in the amount of Seventy Five Thousand Dollars .($75,000) for the violations described in Section I of the' enclosed Notice.
In accordance with the'" General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations described in Section I in the' enclosed Notice have been categorized.in the. aggregate as a Severity Level III problem. The base value of a civil penalty for a Severity Level'III' problem'is $50,000. The escalation and mitigation factors.in the Enforcement Policy were considered and the base civil penalty has been increased by 50 percent because the corrective actions to prevent recurrence were not timely. Specifically, for the identified violations, the NRC prompted the licensee into taking the i recessary corrective actions. i The enforcement-action being taken in this case is based on the Enforcement Policy set forth in 10 CFR Part 2, Appendix C (1988). Because Braidwood, l Units 1 and 2 were granted-operating licenses after the November 30, 1985 EQ deadline, the Modified Enforcement Policy Relating to 10 CFR 50.49,
'" Environmental Qualification of Electrical Equipment Important to Safety 'for Nuclear Power Plants" (Generic Letter 88-07) was not applicable.
You are required to respond to this letter and should follow the instructions specifiedLin the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you. plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions, the NRC will l determine whether further NRC enforcement action is necessary to ensure 'l compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure l will be placed in the NRC Public Document Room. 4 NUREG-0940 1.A-40
i l Commonwealth Edison Company' 3 NOV 231988
.The responses directed by this letter and the accompanying No'tice are not subject to the clearance procedures of the Office of KAnagement and Budget 1 as. required by the Paperwork Reduction Act.-of 1980, PL 96-511.
Sincerely, C
$13Ac(\)w A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed-Imposition of. Civil Penalty
- 2. Inspection Reports No. 50-456/88005(DRS);-
No. 50-457/88006(DRS) cc w/ enclosures: C. Reed, Senior Vice. President T. J. Maiman, Vice President, PWR Operations H. Bliss,. Nuclear. Licensing Manager S. Hunsade , Nuclear Licensirg Administrator M. Lohmana, Project Construction and Startup Superintendent R. E. Queric, Station Manager P. L. Barnes, Regulatory
. Assurance Supervisor Licensing Fee Management Branch Resident Inspector, RIII-Braidwood Resident Inspector, RIII Byron D. W. Cassel, Jr., Esq.
Richard Hubbard J. W. McCaffrey, Chief, Public j Utilities Division H. S. Taylor, Quality Assurance Division , NUREG-0940 I.A-41
i 1 i NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY Commonwealth Edison Company Docket Nos. 50-456; 50-457 Braidwood Station Licenses No. NPF-72; NPF-77 Units 1 and 2 EA 88-198 During an NRC inspection conducted from February 29 through May 4,1988, violations of NRC requirements were identified. In accordance with the
" General Statement of Policy and Procedure for NRC Enforcement Actions,"
10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes , to impose a ~ civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: I. Violations Assessed A Civil penalty A. 10 CFR 50.49(a) requires each holder of a license for operation of a nuclear power plant to establish a program for qualifying electric equipment identified in 10 CFR 50.49(b). 10 CFR 50.49(b) defines equipment important to safety and includes: (1) Safety-related electric equipment, i.e., equipment relied upon to remain functional during and following design basis events, (2) Nonsafety-related electric equipment whose failure under postulated environmental conditions could prevent satisfactory accomplishment of the functions of safety-related equipment. 10 CFR 50.49(f) recuires that each item of electric equipment important to safety be qualified by testing and/or analysis under postulated environmental conditions. Contrary to the above, as of May 4, 1988, items of electric equipment important to safety were not properly qualified by testing and/or analysis as demonstrated by the following examples:
- 1. Eighty-four Limitorque actuators located inside and outside the Units 1 and 2 containments were determined to be unqualified because they contained lubricants with between 5 and 50 percent contaminants. No adequate sts and/or analyses were conducted to demonstrate that,these contaminated lubricants would support adequate functioning of the actuators under postulated accident conditions.
NUREG-0949 I.A-42
Notice of Violation 2 NOV 23 i9c i
- 2. Seventeen junction boxes located inside the Units I and 2 containments which were installed without weep holes and were used in control circuits associated with numerous systems important to safety. A qualified junction box had been tested with a weep hole to provide for drainage of condensation. The 17 junction boxes identified were considered unqualified because no test and/or analysis was performed to demonstrate that boxes ,
without weep holes would function under postulated accident conditions.
- 3. Twenty-two Whitman General J505 pressure switches located inside and outside the Units 1 and 2 containments and used in the operation of feedwater isolation valves, containment purge isolation valves, and steam generator power operated relief valves were determined to be unqualified since no test and/or l analysis was conducted to demon:;trate that the switches would !
function under postulated accident conditions.
- 4. Westinghouse components, including twenty-four OT-2A Switches, twenty-nine AR 440 and AR 660 relays, and eighty-four EZC indicating lights, located outside containment in Units 1 and 2 and used in various HVAC panels, were determined to be unqualified because these components had not been evaluated for similarity to components that had passed environmental qualification tests.
B. 10 CFR Part 50, Appendix B, Criterion V, as implemented by the licensee's Quality Assurance Program, requires that activities affecting quality be prescribed by documented instructions, procedures, or drawings, of a type appropriate to the circumstances and shall be accomplished ir accordance with these instructions, procedures, or drawings. Contrary to the above, specific maintenance activities affecting quality, necessary to preserve the qualification of environmentally qualified (EQ) components, were prescribed by documented instructions and procedures, but were not implemented as demonstrated by the following examples.
- 1. EQ Binder EQ-BB-HE10A for Target Rock Solenoid Valves specifies that the RTV Silicone rubber gasket be replaced each time the valve cover is removed. The cover of Solenoid Valve ICV-8114 was removed during completion of Work Request A99999, dated January 31, 1987. However, the licensee did not replace the specified silicone rubber gasket.
l NUREG-0940 1.A-43 ;
Notice of Violation 3 NOV 2319BS
- 2. EQ Binder EQ-BB-061, Tab E, for Rosemount Pressure Transmitters specifies inspection and cleaning of mating surfaces, lubrication of "0" rings, and torquing of the housing cover each time the cover is removed. The housing covers of pressure transmitters IPT-MS-042, IPT-MS-043, and IPT-MS-044 were removed in May 1986 during calibration; however, the licensee did not accomplish the above specified activities.
- 3. EQ Binder EQ-BB-027, Tab E, for Limitorque Valves specifies the main gear case lubricant to be inspected every 18 months until operating history indicates otherwise. The licensee, however, failed to inspect the lubricant following the initial 18-month interval and did not have documented justification based on operating history to do otherwise.
- 4. EQ Binder EQ-BB-064, Tab E, for Valcor Valves specifies the installation of new "0" rings whenever the housing cover of the solenoid valve is removed. In March 1988, the licensee discovered that the housing covers of Valcor Valves PS-22SA and B, PS-229A and B, PS-230A and B, IRC014C and D, and 2RC014A, B, C, and D had been removed; however, the specified "O" rings had not been replaced.
- 5. EQ Binder EQDF ESE-44A for Incore Thermocouple reference junction boxes specifies the replacement of the enclosure "0" ring each time the cover of the junction box is opened. The cover was removed from Junction Box 21T-01J during performance of Work Request A99999 dated February 5,1988; however, the licensee did not replace the specified "0" ring.
- 6. EQ Binder EQ-BB-015, Tab E, for 'U.M00 Limit Switches specifies torquing of the limit switch cover to 20 inch pounds to seal the switch. During the inspection, however, it was identified that the switch cover of NAMCO Limit Switch ISI-001B-A-Z5 had not been torqued, as required, following its removal for maintenance.
- 7. EQ Binder EQDP-AE-2 for Westinghouse Pump Motors specifies Mootl DTE Medium 011 to be used for lubrication of motor bearings.
In March 1988, however, it was discovered by the licensee that unqualified Mobil DTE Heavy Medium 011 had been used for motor bearing lubrication instead of the qualified DTE Medium 011. The unqualified oil had been used in eight Westinghouse pump motors in Units 1 and 2 and included the following motors: 1/2 CV01PA, 1/2 CV01PB, 1/2 S101PA, and 1/2 5101PB. NUREG-0940 1.A-44
Notice of Violation 4 NOV 231989
]
- 8. EQ Binder EQ-BB-008 for Reliance and Westinghouse Fan Motors specifies Chevron SRI-2 to be used as the motor bearing lubricant.
In March 1988, however, it was discovered by the licensee that unqualified Mobilux EP was being used as the lubricant for the motor bearings in Reliance and Westinghouse Fan Motors 2VA02CC and 2VA02CD. These violations have been categorized in the aggregate as a Severity Level III problem (Supplement I). Cumulative Civil Penalty - $75,000 (assessed equally among the violations). II. Violations Not Assessed A Civil Penalty A. 10 CFR 50.49(f) requires that each item of electric equipment important to . safety be qualified by testing and/or analysis under postulated environmental conditions. Contrary to the above, as of May 4,1988, four Bunker Ramo electrical penetration assemblies which are items of electrical equipment important to safety were unqualified. Specifically, the licensee had not performed an adequate test to qualify the penetrations in the installed configuration (with Raychem splices), nor did the licensee demonstrate qualification for the loss of coolant accident (LOCA) portion to the test procedure. Severity Level IV (Supplement I). I E. 10 CFR Part 50, Appendix B, Criterion V, as implemented by the licensee's Quality Assurance Prograin requires that activities affecting quality shall be prescribed by documented instructions, procedures or drawings, of the type appropriate to the circumstances and shall be accomplished in-accordance with these instructions, procedures or drawings. Contrary te the above, EQ Binder EQ-ME-4, Tab E, specifies torquing of mounting bolts on Limitorque valve actuator housings. As of May 4, 1988, however, the licensee failed to prescribe instructions or procedures to assure the specified torquing of approximately eighty-six Limitorque operators was properly accomplished. Severity Level IV (Supplement I). Pursuant to the provisions of 10 CFR 2.201, Commonwealth Edison Comp ny is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of NUREG-0940 I.A-45 l l
i
- Notice of Violation 5 Il0V 231988 the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation
(1) admission or denial of the alleged violation; (2) the reasons for the
. violation if admitted; (3) the corrective steps that have been taken and the results achieved; (4) the corrective steps that will be taken to avoid further violations; and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be'taken. Consideration may be given to extending the response time for good ,
cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, Commonwealth Edison Company may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part; (2) demonstrate extenuating circumstances; (3) show error in this Notice; or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. J Upon failure to pay any civil penalty due which subsequently has been determined l in accordance with the applicable provision of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. ] I l 1
/
NUREG-0940 I.A-46
i i I
~ Notice of Violation 6. NOV 231988 The responses to the Director, Office of Enforcement, noted above (Reply to a Notice'of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed.to: . Director, Office of Enforcement, U.S. Nuclear Regulatory Commission ATTN: Document Control Desk, Washington,.
D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Rcad, Glen Ellyn,' Illinois 60137 and a copy to'the NRC Resident Inspector at the Braidwood Station. FOR THE NUCLEAR REGULATORY COMMISSION G - 7 LI dW A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois this 23rd day of November 1988 I 1 1 NUREG-0940 1.A-47 i
I O
.m ass, unsTgO STATES NUCLEAR REGULATORY COMMISSION f5 a nacio= m
- f tee noosavatt noao oLaw sLLvw eLLswoss seiat
***** Septe, er 22, 1988 Docket No. 50-155 License No.'DPR-06 EA 87-80
' Consumers Power Company ATTN: David P. Hoffman-Vice President Nuclear Operations 212 West Michigan Avenue Jackson, Michigan 49201 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 50-155/86013(DRS)) This refers.to the NRC' inspection conducted on September 15-19, 1986, at the Big Rock Point Nuclear Plant of activities authorized by NRC License No.'DPR-06. The inspection was conducted by a special environmental qualifM.ation (EQ)
' inspection team to assess the program implemented at the Big Rock Point Nuclear Plant to meet the EQ requirements of 10 CFR 50.49. As a result of the ,
September 15-19, 1986 inspection, a violation of NRC regulatory requirements was identified. NRC concerns relative to this violation were discussed during Enforcement Conferences that were held on July 7, 1987 and July 21, 1988. The violation described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involved examples of failures to comply with the requirements of 10 CFR 50.49. The first example involved a Limitorque Motor Actuator that was removed from service after 13 years of operation and was then subjected to a loss of coolant accident (LOCA) test on April 23, 1975. The actuator was reinstalled and returned to service. It continued.to be used following the November 30, 1985 deadline for environmental qualification of equipment important to safety without being qualified by testing and/or analysis ' to evaluate aging as well as potential degradation due to the LOCA test. The second example involved the use of environmentally unquM ified butyl rubber and polyethylene insulated cables in Class 1E systems including the Main Steam Isolation Valve, the Core Spray System, the Containment Spray System, and the Reactor Depressurization System. The NRC staff believes that Consumers Power Company (CPCo) clearly should have known about the EQ deficiencies described above. For Limitorque Actuator l MO-7068, it should have been clear that the actuator was unqualified because 1 the maintenance documentation provided by Limitorque following the 1975 LOCA testing.of the valve actuator did not provide evidence that any refurbishment l of the degradable materials had been accomplished or any evidence that such
.NUREG-0940 I.A-48 l
l
' Consumers Power Comany 2 September 22, 1988
, refurbishment had been considered and found unnecessary. At the Enforcement
' Conferences, CPCo took the position that analysis showed qualification of the actuator for 40 years but ~the NRC staff has concluded that the data used to support that conclusion did not consider the case in which an actuator had already undergone a once-in-a-lifetime LOCA' test and CPCo should have recognized that fact.
.With regard to the unqualified cables inside the containment, CPCo was informed in an NRC Inspection Report dated August 8, 1984 that the NRC staff had concerns about the' qualification of the cables and that report stated that those concerns could be addressed by testing the installed :able or by showing qualification through testing already completed. CPCo decided to show qualification of the cables by demonstrating similarity of the installed cables to cables already
. tested. It is the NRC staff's position that CPCo clearly should have known that the similarity analysis that was performed by CPCo for the polyethylene insulated cable as well as the one it performed for the butyl rubber insulated cable were deficient. In.the case of the polyethylene insulated cable, the
- insulation formulation (which includes material, manufacturing process and fabrication) was not shown to be similar to that of the tested cable. In the case of the butyl rubber insulated cable, the insulation' formulation differed from that of the' cable cited in the test report relied on by CPCo and the test conditions used in the cited test report were unstated and therefore could not be show) to be equivalent to the conditions that the installed cable would be subjectad.to in a LOCA.
To empnasize the importance of (1) management attention to, and control of, the EQ program, and (2) aggressive management action to ensure that problems are promptly identified and corrected, I have been authorized, after consultation esith the Director, Office of Enforcement and the Deputy Executive Director for Regional Operations, to issue the Notice of Violation and Proposed Inposition of Civil Penalty (Enclosure 1) in the amount of One Hundred and Eight./-Seven Thousand Five Hundred Dollars ($187,500) for the violation describrd 'in the enclosed Notice. In accordance .with the " Modified Enforcement Pol icy Relating to 10 CFR 50.49," contained in Generic Letter 88-07 (Enclosure 2), be violation described in the enclosed Notice has been determined to be moderate and to have affected some systems and components, and therefore is considered to be j an EQ Category B violation. The base value of a Civil Penalty for an EQ 2 Category B violation is $150,000. In determining the civil penalty amount, the NRC considered the four factors , set forth in the " Modified Enforcement Policy Relating to 10 CFR 50.49," for l escalation and mitigation of the base civil penalty amount. These factors consist of (1) identification and prompt reporting of the EQ deficiencies (150%); (2) best efforts to complete EQ within the deadline (150%); , (3) corrective actions to result in full compliance (tSO%), and (4) duration l' of a violation which is significantly below 100 days (-50%). With respect to the first factor, no escalation or.mitiption is warranted since the general issues regarding qualification of ce = were clearly > l recognized by the NRC staff and CPCo well prior to thei avember 30, 1985 NUREG-0940 1.A-49 l
i Consumers Power Company 3 September 22, 1988 deadline and'a violation occurred in this case because CPCo failed to take adequate corrective action. With respect to the secend factor, 25 percent mitigation .is warranted because best efforts were applied by. the licensee to complete EQ within the deadline. However, full mitigation for those efforts is ! net appropriate because, notwithstanding the NRC staff's continued concerns with an issue as fundamental as cable qualification, CPCo did not satisfactorily resolve the issue prior to the deadline. With respect to the third factor, 50 percent escalation is warranted since the licensee's efforts to make an operability or qualification determination were not timely and the quality of the supporting analyses were unacceptable. With respect to the fourth factor, mitigation is inappropriate since the EQ violation existed in excess of 100 days. After reviewing these factors, the base civil penalty has been increased by. 25 percent. You are required to respond to this letter and should follow the instructions specified-in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, PL 96-511. Sincerely, A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalty
- 2. Generic Letter 88-07
- 3. Inspection Report No. 50-155/86013(DRS)
See Attached Distribution i l NUREG-0940 1.A-50
l NOTICE OF VIOLATION .
'l AND :
i PROPOSED IMPOSITION OF CIVIL PENALTY ] Consumers Power Company Docket No. 50-155 Big Rock Pcint Nuclear Plant License No. OPR-06 EA 87-80 l 1 During an NRC. inspection conducted on September.15-19, 1986, of the. licensee's
. program for environmental qualification (EQ) of equipment,fa violation of NRC l 1 requirements was identified. In accordance with the " Modified Enforcement Policy. Relating to 10 CFR 50.49, Environmental Qualification of Electrical ;
Equipment Important to Safety of Nuclear. Power Plants," contained in Generic Letter 88-07, the Nuclear Regulatory Commission proposes to impose a civil-penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act),;42'U.S.C. 2282, and 10 CFR 2.205. The particular violation and associated civil penalty are set forth below: 10 CF_R 50.49(f) requires each item of electrical equipment important to safety to~be environmentally qualified by testing and/or analysis. 10 CFR 50.49(k) specifies that requalification of electric equipment important to safety is not required if the Commission has previously required qualification in accordance with " Guidelines for Evaluating Environmental Qualification of Class IE Electrical Equipment in Operating Reactors," November 1979 (DOR
' Guidelines).
DDR Guidelines, Section 5.2.2, states that type tests should only be considered valid for equipment identical in design and material construction to the test i specimen and any deviations should be evaluated as part of the qualification , documentat % j Contrary to the above Consumers Power Company failed to quf ify equipment important to safety by appropriate testing and/or analysis as evidenced by the following examples:
- 1. Limitorque Motor Actuator M0-7068, an item of electrical equipment important to safety, was removed from service after 13 years of operation and was subjected to a loss of Coolant Accident (LOCA) test on April 23, l- 1975. This actuator was then reinstalled and returned to service in the l containment spray system without being qualified by testing and/or analysis to evaluate aging and degradation due to the LOCA test. This ;
condition existed from November 30, 1985 until February 13, 1987, at l which time Limitorque Motor Actuator MO-7068 was replaced. j 4 NUREG-0940 I.A-51
g - - -_ . _ _ _ _ _ _ _ _ __ _ _ _ _ _ - _ _ . _ i
-Notice of Violation 2
- 2. Butyl rubber and polyethylene insulated cables, items of electrical equipment important to safety, which had not been environmentally qualified by testing and/or analysis, were; installed in various Class IE circuits inside' containment. This condition existed from lovember 30, 1985 until June 30, 1987, at which time the-unqualified cables were replaced.
This is an EQ Category B violation. Civil Penalty - $187,500 (The facility operated in excess of 100 days in violation of EQ
. requirements.)
Pursuant to the provisions of.10 CFR 2.201,. Consumers Power Company is hereby-required to submit a written statement or explanation to the Director, Office of Enforcement, Nuclear Regulatory. Commission, within 30 days of the date of the letter transmitting this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each violation: (1) admission or denial of the violation; (2) the reason for the violation if admitted; (3) the corrective steps which have been taken and the results achieved; (4) the corrective steps which will be taken to avoid further violations, and (5) the date when fu11' compliance will be achieved. Where good cause is shown, consideration will be given to extending the response time. If an adequate reply is not received within the time specified in this Notice, an order may be issued te show cause why the license should not be
. modified, suspended, or revoked or why such other action, as may be proper, should not be taken. Consideration may be given to extending response time for good cause shown.
Within the same time as provided for response required above under 10 CFR 2.201,. the Licensee may pay the civil penalty by letter-to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draf t, or money order payable to Treasurer of the United States in the amount of the civil penalty proposed above or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an Order imposing the civil penalty will be issued. Should I the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting l the civil penalty, in whole or in part, such an answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violation of this Notice in whole or in part; (2) demonstrate extenuating circumstances; (3) show j error in this Notice, or (4) show other reasons why the penalty should not be j imposed. In addition to protesting the civil penalty, such an answer may I request remission or mitigation of the penalty. o i NUREG-0940 I.A-52 L
Notice of Violation 3 i In requesting mitigation of the proposed penalty, the factors addressed in ! the '%dified Enforcement Policy Nelating to 10 CFR 50.49, Environmental L Qualification of Electrical Equipment Important to Safety for Nuclear Power Plants," contained in Generic Letter 88-07 should be addressed. Any written '
. answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty.
Upon failure to pay any civil penalty due, which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555 with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen Ellyn, IL 60137, and a copy to the NRC Resident Inspector, Big Rock Point. FOR THE NUCLEAR REGULATORY COMMISSION b & A. 8ert Davis Regional Administrator Date at plen Ellyn, Illinois this 2 9 day of September 1988 NUREG-0940 I.A-53 i
i
/ 'o g . UNITED STATES
! o NUCLEAR REGULATORY COMMISSION WASHINGTON, D. C. 20555
...../
JAN 311989 Docket No. 50-155 License No. DPR-06 EA 87-80 Consumers Power Company ATTN: David P. Hoffman Vice President Nuclear Operations 212 West Nichigan Avenue Jackson, Michigan 49201 Gentlemen:
SUBJECT:
ORDER IMPOSING A CIVIL HONETARY PENALTY This refers to your two letters dated December 1,1988 in response to the Notice of Violation and. Proposed Imposition of a Civil Penalty (Notice) sent to you by our letter dated September 22, 1988. Our letter and Notice described one violation of the NRC's requirements regarding environmental qualification of electrical equipment important to safety that was identified during an inspection tht.t was conducted during the period September 15-19, 1986 at the Big Rock Point. Nuclear Plant. To enchasize the importance of (1) management attention to, and control of, the EQ program, and (2) aggressive management action to ensure that problems are prumptly identified and currected, a civil penalt Eighty-Seven Thousand Five Hundred Dollars ($187,500)y was proposed. of One Hundred In your response, you admitted the facts stated in the violaticn are sub-stantially correct. In addition, you requested that the Conunission reconsider the amount of tae proposed fine because of your belief that the guidance of l the P'odified Enforcement Policy is unduly punitive and not equitably applied l when one considers the specifics of the Big Rock Point situation, the complexity of the issues and the size of the plant. After consideration of your response, we have concluded, for the reasons given in the Appendix attached to the enclosed Order Imposing a Civil Monetary Penalty, that you did not provide sufficient basis for mitigation of the proposed civil penalty. Accordingly, we hereby serve the enclosed Crder on 1 Consumers Iower Company imposing a civil penalty in the amount of One Hundred i and Eighty-Seven Thousand Five Hundred Dollars ($187,500). We will review the effectiveness of your corrective actions during a subsequert inspection, i NUREG-0940 I.A-54 l
l Consumers Power Company t In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, ! Title 10, Code of Federal Regulations, a ecpy of this letter and the I enclosures will be placed in the NRC's Public Document Room. ' Sincerely, N _ - W .s J s M. Tay , Deputy Executive Director for Regional Operations
Enclosure:
Order Imposing a Civil Monetary Penalty j with Appendix cc w/ enclosure: ! Mr. Kenneth W. Berry, Director Nuclear Licensing Thomas W. Elward, Plant Manager ! Resident Inspector, RIII Ronald Callen, Michigan Public Service Commission Michigan Department of Public Health I 1 NUREG-0940 I.A-55
ki
. s
. UNITED 1 STATES !
. NUCLEAR REGULATORY COMMISSION l
In the. Matter of ) Docket No. 50-155 ,
' Consumers Power Company _
) ' License ho. DPR-06 !
Big Rock Point Nuclear Plant' ) EA 87 ; ORDER It1 POSING CIVIL MONETARY PENALTY Consumers Power Company (licensee) is the holder of Operating License No. DPR-06 issued by the Nuclear Regulatory Commission (NRC/Comission) on August 30,1962. The license authorizes the licensee to operate the Big Rock Point Nuclear Plant,
!.c in accordance with the conditions specified therein.
II A special' safety inspection of the licensee's activities was conducted during the period September 15-19, 1986. The results of the. inspection indicated that the licensee had not conducted its activities in full compliance with NRC requirements. A written Notice of Violation and Proposed Imposition of Civil Penalty (Notice) was served upon the licensee by letter dated September 22, 1988. The Notice :tated the nature of the violation, the provisions of the NRC's requirements that the licensee had violated, and the arsunt of the civil penalty , proposed for the violation. The licensee responded to the Notice by two letters dated Decem6er 1, 1988, In its response, the licensee admitted the facts stated in the violation, but argued that the guidance of the NRC's Modified Enforcement Policy. was unduly punitive and not equitably applied when the specifics-of the Big Rock Point situation, the complexity of the issues and the size of the plant are considered. The licensee requested that the Commission reconsider the amount of.the proposed fine. NUREG-0940 1.A-56
III l i After consideration of the licensee's rt.sponse and the statements of fact, explanation, and argument. for mitigation contained therein, the Deputy
]
Executive Director for Regional-Operations has determined, as set forth in the Appendix to this Order, that the penalty proposed for the violation designated in the Notice of Violation and Proposed Imposition of Civil Penalty should be imposed. IV In view of the foregoing and pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT IS HEREEY ORDERED THAT: J The licensee pay a civil monetary penalty in the amount of One Hundred and Eighty-Seven Thousand Five Hundred Dollars ($187,500) within 30 days o# the date of this Order, by check, draft, or money order, payable t( the Treasurer of the United States and mailed to the Director of Enforcement, U.S. Nuclear Regulatory Commission. ATTN: Document Control Desk, Washington, D.C. 20555. , V The licensee may request a hearing within 30 days of the date of this Order. A request for a hearing should be clearly marked as a " Request for an NUREG-0940 I.A-57
- i. p Enforcement Hearing" and should be addressed to the Director of Enforcement, i U.S. Nuclear Regulatory Connission ATTN: Document Control Desk, D.C. 20555, x .
with a copy to the Regional Administrator, Region III, 799 Roosevelt Road, w., Glen Ellyn, Illinois, 60137, and a copy to the NRC Resident Inspector, Big ' Rock Point Nuclear Plant. i If a hearing is requested, the Connission will issue an Order designating the timeandplaceofthihearing. If the licensee fails to request a hearing within 30 days of the date of this Order, the provisions of this Order shall be effective without further proceedings. If payment has not been made at d that time, the matter may be referred to the Attorney General for collection. In the event the licensee requests a hearing as provided above, the issue to be considered at such hearing shall be: whether the proposed civil penalty should be imposed in whole or in part. FOR THE NUCLEAR REGULATORY COMMISSION Y_-- mes M. Taylor, uty Executive Director
-f Regional Operations Dated ag Rockville, Maryland thisy day of January 1989.
NUREG-0940 1.A-58
APPENDIX l Evaluation and Conclusion On December 1,1988, Consumers Power Company (licensee) replied in two letters to the NRC's September 22 1988, Notice of Violation and Proposed Im of Civil Penalty (Notice),regarding environmental qualification (EQ)ofposition electrical equipment admitting that the facts stated in the violation are substantially correct, but raising objections to the NRC's conclusions that a civil pentity was warranted. The licensee states that the deficiencies in the Notice were identified and discussed with the NRC prior to the deadline of November 3f\ 1985 for compliance with 10 CFR 50.49 and.that required corrective action was imple-mented. In addition, the licensee contends that the amount of the proposed civil penalty is excessive for the significance of the deficiencies and the size or the facility and requests that the Commission reconsider the amount of the proposed fine. The violation is restated below followed by a summary of the licensee's response and the NRC's evaluation and the conclusion.
- 1. Restatement of Violation 10 CFR 50.49(f) requires each item of electrical equipment important to safety be environinentally cualified by testing and/or analysis.
10 CFR 50.49(k) specifies that requalification of electric equipment important to safety is not required if the Commissicn has previously required qualification in accordance with " Guidelines for Evaluating Environmental Qualification of Class IE Electrical Equipment in Operating Reactors," November 1979 (DOR Guidelines). D0R Guidelines, Section 5.2.2, states that type tests should only be considered valid for equipment identical in design and material construction to the test specimen and any deviations should be evaluated as part of the qualification documentation. Contrary to the above, Consumers Power Company failed to cualify equipment important to safety by appropriate testing and/or analysis ; as evidenced by the following examples:
]
- a. Limitorque Motor Actuator M0-7068, an item of electrical equipment important to safety, was removed from service after 13 years of operation and was subjected to a Loss of Coolant Accident (LOCA) test on April 23, 1975. This actuator was then reinstalled and ,
returned to service in the containment spray system without ! being qualified by testing and/or analysis to evaluate aging I and degradation due to the LOCA test. This condition existed from November 30, 1985 until February 13, 1987, at which time limitorque Motor Actuator M0-7068 was replaced.
- b. Batyl rubber and polyethylene insulated cables, items of electrical equipment ir:portant to safety, which hcd not been environmentally qualified by testing and/or analysis, were installed in various NUREG-0940 I.A-59
[ , p Appendix- ? Class IE circuits inside containment. This condition existed from ' Novesber 30, 1985 until June 30, 1987, at which time the unqualified cables were replaced.
- 2. Summary of Licensee's Response j The licensee admits that the facts stated in the violation are 4 substantially correct. However, Consumers Power Company claims ~ that, . ,
' prior to the EQ deadline, the qualification concerns had been identified and discussed with the NRC and that the~ licensee had implemented actions toisatisfy the concerns. Since the NRC had not notified the licensee to i the contrary the licensee had assumed the concerns had been satisfactorily addressed and its equipment was qualified. i Consumers Power Company also argues that a fine of the magnitude proposed is unreasonable for a generating plant the size and age of Big Rock. Point.
In fact, on.a per megawatt basis, the licensee argues this is the largest-fine the Commission has ever proposed for a licensee. The licensee also argues that the safety significance of the examples in the' Notice do not warrant a fine'in the amount proposed. In summary, the licensee states-that, due to the circumstances.that apply to the specifics of the Big Rock Point situation and the complexity of the issues involved, the guidance of the Modified Enforcement Policy is unduly punitive and has not been equitably: applied; The licensee contends that the amount of the proposed civil penalty is excessive and requests that the Commission reconsider the amount of.the proposed fine. 3.- NRC Evaluation of Licensee's Response l The NRC st4ff believes the licensee had no reasonable basis for assuming l that the NRC had approved its actions to satisfy the identified EQ concerns. ; As evidenced in various NRC documents, the NRC did ioentify and document ! the deficiencies stated in the Notite prior to the EQ deadline (as early as i 1983) and in each case identified tie need for replacement or new testing ! and analysis of the unqualified equ pment. The licensee's corrective actions were not presented to the MC until the September 1986 Region III EQ Inspection. During this inspection, the NRC again informed the licensee j that the actuator and cables in question were unqualified, The' licensee took an unreasonable length of time to correct the identified deficiencies and numerous meetings had to be held between the NRC.and the licensee to prompt the licensee and ensure that it took adequate corrective action. With regard to Limitorque Actuator M0-7068, the licensee claims that the NRC and its consultant, Franklin Research Institute, were aware that Actuator
'MO-7068 had been tested under LOCA conditions and returned to service after being inspected and refurbished "where needed." Since the NRC had raised no further concerns, the-licensee assumed the actuator was qualified for intended service.
The Franklin Research Center Technical Evaluation Report (TER), February 18, 1983, Page 3A, identified Actuator MO-7068 as Category Ib, " Equipment Qualification Pending Modification." The summary section of the TER identified the corrective action as " Replace or Rebuild and Qualify." NUREG-0940 1.A-60 )
p l l 1 Appendix In its conclusion, the TER stated, " radiation and thermal aging quali-fication testing has not been performed for this type actuator." The TER also stated this conclusion for other type Limitorque Model SMA-00 actuators. In the discussion, the TER acknowledged that the Actuator MO-7068 had at 1 one time been subjected by the licensee to a LOCA. However, that test was considered an adequate basis only for interim operation for Ty x SMA-00 actuators until they were replaced or rebuilt. Further, the TER did not state or imply that the LOCA-tested actuator, i.e., M0-7068, could be returned to service without refurbishment of degraded parts. The licensee, however, returned the actuator to service after the LOCA test without any evidence of refurbishing EQ-related components. Neither the NRC nor Franklin was aware that the actuator had been returned to service without the refurbishing of degraded parts. Based on these considerations, the licensee's claim that the actuator was qualified based on lack of NRC notification to the contrary is not supported. With regard to the Polyethylene and Butyl Rubber ir.sulated cables, the licensee claims that, in lieu of LOCA-testing the cables, it purchased a test report for $50,000 and qualified the cables by similarity. The licensee assumed the cables were qualified since the NRC had raised no
'further concern.
The February 18, 1983 Franklin TER identified Polyethylene and Se+y1 rubber cables as those for which equipment qualification had not been established. In June 1984 NRR identified these cables as unqualified during an EQ inspection. On July 25, 1984, the NRC granted the licensee an extension on the schedule for qualification of these cables until March 31, 1985. Finally, in September 1986, the Region III inspectors identified those cables as unqualified and required replacement or qualification by testing. Despite all these notifications, the licensee did not take timely corrective action. During an April 13, 1987 meeting between the Consumers Power Company and NRC staffs, the licensee committed to replace all Polyethylene and Butyl rubber cable in question. This commitment was documented in an April 15, 1987 Confirmatory Action Letter issued to the licensee by the NRC Region III office. The licensee claims it spent $50,000 to purchase test reports of similar cables because 10 CFR 50.49 parmits qualification by similarity. The licensee claims the NRC was aware of its approach to qualify by similarity and had raised no concerns, The NRC agrees that a licensee may qualify equipment by similarity as this is clearly allowed in the regulations. However, when the NRC inspection was conducted, the tests discussed in the purchased reports were found to be deficient in that they did not test similar or identical cable. The NRC had not reviewed the adequacy of these reports until the Region III inspection, at which time the reports were found clearly inadequate for applications at Big Rock, for the reasons given in the Notice. The licensee claims the NRC SER of November 15, 1985 further confirmed the qualification of these cables because there were no remarks to the contra ry. The NRC SER, however, only addressed the aproval of the NUREG-0940 1.A-61 i
L Appendix 4 i licensee's general approacic to resolving outstanding EQ deficiencies, not-the adequacy of the resolution of each specific issue. The corrective actions were scheduled to be reviewed during the NRC Region.III inspection. Based on the above considerations, the licensee's claim that the cables were qualified by similarity based on lack of NRC notification to the contrary, is. not supported. With regard to the licensee's argument concerning the safety significance of the violation, the NRC staff, under the Modified LQ Policy Enforcement Policy, considers violations'of EQ requirements to be safety significant because the electrical equipment required to be qualified are those which~ are important to safety. This is a case in which it appears that the components were properly categorized as important to safety. If the licensee cannot demonstrate that such components are qualified, for enforcement purposes, a significant violation has occurred. The only , exceptions to this practice include those cases in which a documentation deficiency of a minor nature exists which is readily correctable. In this case, the licensee failed to have adequate documentation and would have needed to develop extensive additional information to demonstrate qualification. Therefore, the NRC staff concluded a significant violation existed. While Consumers Power Company does operate a small reactor, Big Rock
.oint's
' size alone is nct a sufficient justification for mitigation of a civil penalty. The facility is categorized as a commercial power reactor and as such is subject unoer the Modified EQ Enforcement Policy, as unoer the " General Statement of Policy and Procedure for NRC Enforcement Action", 10 CFR Part 2 Appendix C, to the same base civil penalty as all other commercial power reactors. The NRC carefully considered whether it would be advisable to assess lesser civil penalties for smaller commercial power reactors and it was concluded that the inherent risks associated with any size commercial nuclear plant are such that a signi-ficant deterrent is needed to motivate a licensee to implement and maintain programs for detection and correction of problems that may constitute or lead to violations of regulatory requirements.
For these reasons, the NRC has concluded that mitigation of the civil penalty is not warranted.
- 3. Concluston The NRC has cGdcluded that this violation occurred as stated and there is no adequate basis for withdrawing the violation or reducing the amount of the civil penalty. Consequently, the proposed civil penalty in the amount of $187,500 should be imposed.
NUREG-0940 I.A-62
i l UNsTED STATES l[p egg]o., - NUCLEAR ' REGULATORY COMMIS$10N eEason m t ,...oo e m ,.... j coeu cu.vu. 6u~o,s ..m 4
....+
OEC 2 21988 Docket No. 50-255 License No. OPR-20 EA 88-140 Consumers Power Company. ATTN: David P. Hoffman, Vice President Nuclear Operations 212 West Michigan Avenue Jackson, Michigan 49201 Gentlemen: #
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 50-255/88012[DRS]) This refers to the NRC inspection conducted on May 9-13, 18, 51, June 14,
'9. and 30, 1988, at Palisades Nuclear Plant, Covert, Michigan and at NRC Headquarters Office, of activities authorized by NRC License No. OPR-20.
Violations of NRC requirements were identified by the NRC as a result of this inspection. The Inspection Report was sent to you by letter dated August 8, 1988. The inspection was conducted to review the status of fire protection activities including Unresolved Items identified during the previous fire protection inspection (Inspection Report No. 50-255/86022[0RS)) which was sent to you by letter dated November 14, 1986. On September 2, 1988, an enforcement conference was conducted with you and members of your staff and myself and members of the NRC staff to discuss the violations, root causes and corrective actions. The violations described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involve: (1) the failure to satisfy fire protection requirements set forth in 10 CFR Part 50, Appendix R, and (2) the failure of your management to take aggressive and timely corrective action. Of particular concern to the NRC is that the specific items referenced in Violation I were brought to your attention and addressed in the 1986 inspection report, yet the 1988 followup inspection found that adequate corrective action had not been implemented. This failure demonstrates the importance of adequate management involvement in the implementation of your corrective action program. Violation I described a failure to protect the Volume Control Tank (VCT) cutlet valve (MO-2087) to prevent spurious opening of the valve which could cause a loss of reactor coolant makeup capability required to ensure safe shutdown in the event of a fire. NRC Inspection Report No. 50-255/86022[0RS) specifically noted that a spurious signal analysis for this valve had not been CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 I.A-63 ' i
. ..____________.___J
r Consumers Power Company 2 DEC 2 21989 performed. In response to that intpection the procedural guidance to manually d close MO-2087 should it spuriously open was inadequate in that it faile to direct the operator to first open the power circuit. Spurious reopening of the valve after manual closure due to a hot short is not precluded with the power circuit closed. During the May 1988 inspection two power control cables were identified by NRC inspectors that could hot short and reopen MO-2087 when its power circuit is closed. Violation II.A involves the failures to have a completed breaker coordination study and adequately analyze the letdown flow path as required. In assessing the severity level for this violation, the NRC took into consideration your presentation at the September 2, 1988 enforcement conference. You presented information which indicated that although an analysis was not available'at the time of inspection, no instances were identified in which the loss of safe shutdown capability could have occurred witheregard to the breaker
-coordination issue. With respect to the second example of Violation II.A, you discussed an Emergency Operating Procedure, in place at the time, which you believe provided sufficient guidance for operators to isolate the DC power and effectively isolate the letdown high/ low pressure interface, if necessary. We have reviewed the information you provided and agree with youc conclusions. Therefore, Violation II.A is considered to be a Severity Level l IV violation. Violation 11.2 involves inadequate actions to correct emergency ,
lighting deficiencies in a timely manner and is also considered a Severity ! Level IV violation. To emphasize the importance of taking timely and effective corrective action in response to safety concerns and proper implementation of your fire protection i program to maintain safe shutdown equipment free of damage in the event of a fire, I have been authorized, af ter consultation with the Director, Office of , Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty l in the amount of Seventy-Five Thousand Dollars ($75,000) for Violation I l described in the enclosed Notice. In accordance with the " General Statement of policy and Procedure for NRC Enforcement Actions," 10 CFR, Part 2, Appendix C (1988) (Enforcement Policy), this_ violation has been categorized ; at a Severity Level III. The' base value of a civil penalty for a Severity l l- Level III violation is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered, and the base civil penalty amount has been ; l increased by 50 percent because of the duration of the violation. Specifically. l the issue of spurious interactions for valve MD-2087 was brought to your l l attention in 1986 and the 1988 inspection found that adequate corrective 1 action still had not been taken, You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you NUREG-0940 1.A-64 l
Consumers Power Company 3 DEC 2 2 1988 plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, 1 the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements.
'In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, I Title 10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public. Document Room.
l The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, Pub. L. , No. 96-511. Sincerely, fu f) -%E
/
LW f' A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalty
- 2. Inspection Reports No. 50-255/86022(DRS);
No. 50-255/88012(DRS); cc w/ enclosures: Mr. Kenneth W. Berry, Director Nuclear Licensing Gerald B. Slade, General Manager DCD/DCB (RIDS) Licensing Fee Management Branch Resident Inspector, RIII Ronald Callen, Michigan Public Service Commission Michigan Department of
.Public Health T. V. Wambach, Licensing l Project Manager, NRR Ronald Callen, Michigan Public Service Commission Michigan Department of Public Health i
NUREG-0940 I.A-65 s l
--- -- a
~
j } NOTICE OF VIOLATION AND PD0 POSED IMPOSITION OF CIVIL PENALTY Consumers Power Company Docket No. 50-255 Palisades Plant License No. DPR-20 EA'88-140 During ar. NRC inspection conducted on May 9-13, 18, 31, June 14, 29, and 30, 1988, vioiations of NRC requirements were identified. In accordance with the
" General Statement of Policy and Procedure for NRC Enforcement Actions,"
10 CFR, Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: I. Violation Assessed Civil Penalty 10 CFR Part 50, Appendix B, Criterion XVI, as implemented by Consumers Power Company Quality Assurance Program for Operational Nuclear Power Flants, Section 16, requires, in part, that conditions adverse to quality are promptly identified and corrected. 10 CFR 50.48(c) (3) and (4) require those fire protection features that require prior NRC approval shall be implemented by the end of the first refueling outage commencing 180 days af ter NRC approval. By letter dated May 26, 1983, the 180 day time period was commenced when the NRC approved the licensee's proposed features assuring compliance with Section III of Appendix R to 10 CFR Part 50. These features were to be completed by March 3, 1986. 10 CFR Part 50, Appendir R, Section III.L.7 requires that the safe shutdown equipment and systems for each fire area shall be known to be isolated from associated non-safety circuits in the fire area so that hot shorts, open circuits, or shorts to ground in the associated circuits will not prevent operation of the safe shutdown equipment. Contrary to the above, an adverse condition identified during the July 28 through September 30, 1986 NRC inspection had not been corrected as of the NRC inspection of May 9 through 13, 1988. The adverse condition related to the failure to isolate safety-related equipment from associated non-safety circuits as required by 10 CFR 50, Appendix R, Section III.L.7. Specifically, two control power cables to the VCT outlet valve (MO-2087) were id'ntified by the 1988 NRC inspection that could hot short with associated non-safety circuits and cause spurious opening and compromise or prevent safe shutdown by causing a loss of charging pump and subsequent loss of makeup capability. No other redundant, alternative or dedicated shutdown capability was provided. This adverse condition was identified by the 1986 inspection which NUREG-0940 1.A-66
i
'l I
Notice of Violation DEC 2 2 tgeo 1 2 i determined that the licensee had failed to do a spurious signal analysis on MO-2087 to ensure that spurious operation would not cause a loss of charging flow. This is a Severity Level III violation (Supplement I). Civil Penalty - $75,000 II. Violations not Assessed a Civil penalty A. 10 CFR Part 50, Appendix R, Section III.L.7, requires that the safe shutdown equipment and systems for each fire area shall be known to be isolated from associated non-safety circuits in the fire area so that hot shorts, open circuits, or shorts to ground in the associated circuits will not prevent operation of the safe shutdown equipment. Contrary to the above, during the July 28 through September 30,. 1986 inspection, the safe shutdown equipment and systems for each fire area were not known to be isolated from associated non-safety circuits in the fire area so that hot shorts, open circuits, or shorts to ground in the associated circuits would not prevent operation of the safe shutdown equipment. Specifically:
- 1. A fuse and circuit breaker coordic.ation analysis was inadequate in that the protection provided for fire induced associated circuit common bus failures could not be demonstrated due to the lack of time current curves. This inadequacy demonstrated a failure to adequately show that this type of associated circuit could not have prevented operation of required safe shutdown equipment.
- 2. The licensee had not analyzed.the letdown interface for spurious operations that could cause a fire induced LOCA via the letdown high/ low pressure interface. Since the licensee had not performed a letdown high/ low pressure interface spurious signal analysis, the licensee's protection for a fire induced LOCA via the letdown high/ low pressure interface could not be demonstrated. The NRC also identified that, as of May 13, 1988, two cables routed together were susceptible to the same fire that could have caused the simultaneous spurious opening of the i letdown orifice valves. l i
These two examples are considered as a Severity Level IV violation ! (Supplement I). I i NUREG-0940 1.A-67
d
. Notice of Violation' 3 EC 22 Q ' i B. 10 CFR Part 50, Appendix B, Criterion XVI, as implemented by Consumers Power Company Quality Assurance Program for Operational- Nuclear Power Plants, Section 16, requires, in part, that conditions adverse to quality, such as deficiencies of equipment, are corrected as soon as practical. It further requires that the controls assuring corrective action are implemented in a timely manner.
Contrary to the above following an NRC identification of eight hour Emergency Lighting System deficiericies in July 1986, during a corrective action review in September 1986 the licensee identified that additimal deficiencies existed with the lighting system. By letter dated December 12, 1986, they committed to correct these lighting system deficiencies by approximately November 13, 1987, However, while some corrective actions were taken, deficiencies still existed on June 30, 1988. This is a Severity Level IV violation (Supplement I). Pursuant to the provisions of 10 CFR 2.201, Consumers Power Company it hereby required to submit a written statement or exp'anation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission 4 or denial of the alleged violation, (2) the reasons for the vio1Mion if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be. issued to show cause why the license should not be modified, ; suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
- Within the same time as provided for the response required above under 10'CFR 2.201, the Licensee may pay the civil penalty by letter to the Director, '
Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil ! penalty by a written answer addressed to the Director, Office of Enforcement, ! U.S. Nuclear Regulatory Commission. Shculd the licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should '.
- the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or part, such answer should be clearly marked as .
an " Answer to a Notice of Violation" and may: (1) deny the violation listed ! in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error-in this Notice, or (4) show other reasons why the penalty > should not be imposed. In addition to protesting the civil penalty, such i answer may request remission or mitigation of the penalty. NUREG-0940 I.A-68
Notice of Violation 4 EC 2 21989 In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2 Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately 3 from the statement or explanation in reply pursuant to 10 CFR 2.201, but may 1 incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing f page and paragraph numbers) to avoid repetition. The attention of the licenses j is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be
-referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act U.S.C. 2282c.
The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 60137 and a copy to the NRC Resident Inspector, Palisades. FOR THE NUCLEAR REGULATORY COMMISSION A A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois This Et day of December 1988 NUREG-0940 I.A-69 ; ______________________________-____________L
UNITED STATES
/ja mso 'o NUCLEAR REGULATORY COMMisslON g , REGION il 101 MARIETTA STREET N.W.
I
) ATLANTA, GEORGI A 30323 f
v DEC 131988 Docket Nos. 50-269, 50-270, and 50-287 License Nos. DPR-38, DPR-47, and DPR-55 EA 88-228 Duke Power Company ATTN: Mr. H. 8. Tucker, Vice President Nuclear Production Department 422 South Church Street Charlotte, North Carolina 28242 Gentlemen: SU8 JECT: NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY { INSPECTION REPORT NOS. 50-269/88-25, 50-270/88-25 AND 50-287/88-25) This refers to the Nuclear Regulatory Commission (NRC) inspection conducted on August 1-15 1988, at the Oconee Nuclear Station. The inspecticn included a review of the circumstances surrounding tne licensee's identification en May 19, 1988 of the inadequate design analysis of the high pressure injection (HPI) system in the emergency core cooling system (ECCS) sump recirculation mode, comonly referred to as the " piggyback mode". The report documenting this inspection was sent to you by letter dated August 22, 1988. As a result of this inspection, a significant failure to cumply with NRC regulatory require-ments was identified, and accordingly, NRC concerns relative to .he inspection findings were discussed in an Enforcement Conference held on September 12, 1,988. The letter summarizing this conference was sent to you on October 3, 1988. The violation described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involved a significant failure to provide adequate procedural guidance to ensure the HPI system would remain operable for all required accident conditions. The root cause of this violation was inadequate documentation for the Original design assumptions and system performance requirements for tFe HP! piggyback mode of operation. As a result, HPI pump net positive suction head (NPSH) requirements during all operating scenarios were not adequately addressed during the o,iginalr system analysis, and Oconee operating procedures did not provide precautions or limitations regarding the concern that pressure drops through the pipi*ng and components utilized in the HPI piggyback mode could deprive the HPI pumps of edecuate NPSH during high flow conditions. Specifically, the operating procedures permitted the low pressure injection (LPI) and HP! system to both be injecting water simultaneously into the reactor coolant system without the necessary flow limitations. In addition, there was no guidance concerning the use of the 1 reactor building spray pumps which can also be aligned to the piggyback flowpath. Also, there were no precautions to prevent throttling of valves i LP-12 and LP-14 which are upstream of the HP! piggyback line (at discharge of ) theLPIcoolers). Furthermore, because of the lack of sufficient procedural l attention to the operation of the LPI/HPI crossover valves, LP-15 and LP-16, J adequate time may not have been available for the required manual-local opera- ; tion of these valves without interrupting HPI flow. ! NUREG-0940 I.A-70
Duke Power Company DEC 131988 An additional factor associated with the violation and an issue of concern to the NRC staff was the breakdown of communication between the various profes-sional staff disciplines involved. Although the licensee's Design Engineering Group (DEG) identified the inadequate design analysis on May 19, 1988 and was aware of the significance of the issue, due to a communication failure, the onsite operations personnel misunderstood the importance of the HPI pi mode to mitigate certain small break loss-of-coolant accidents (LOCAs)ggyback . Operations personnel incorrectly understood the piggyback mode to be one of several options available, rather than as a required mode under certain scenarios, for small break LOCA mitigation. Because station operations personnel were not aware of the importance of operation in this mode, the Oconee emergency opera-ting procedures were only partially modified in June to include some additional guidance on HPI piggyback operation. .While these modifications provided guidance reoarding the NPSH aspects of operation in the piggyback mode, they still did not provide sufficient guidance to fully assure operation of the HPI system. Notwithstanding your issuance of an LER, it was not until early August, when questions were raised by the NRC, that DEG and operations staff finally communicated and the safety-related nature of the piggyback mode of operation was accepted by the operations staff. Procedures were then revised to provide specific provisions, such as operation of the LPI/HPI crossover valves, to assure operability of the safety-related requirement of the piggyback mode of operation. The NRC considers the violation to be of significant safety concern because, as a result of the inadequate procedural guidance, there was a lack of reasonable assurance that the ECCS would have remained operable for the entire spectrum of all loss-of-coolant accidents. Therefore, the staff considers this to be a Severity Level III violation. To emphasize the need for thorough problem recognition and resolution and the need for close and extensive interdisciplinary communications with regard to ECCS and other safety system issues, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Twenty-Five Thousand Dollars ($25,000) for the violation described in the enclosed Notice. In accordance . with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2 Appendix C (1988) (Enforcement Policy), the violation described in the enclosed Notice has been categorized as a Severity Level III violation. The base value of a civil penalty for a Severity Level IIIvviolation or problem is $50,000. The NRC Enforcement Policy allows for adjustment of a civil penalty under certain circumstances. The escalation and mitigation factors in the Enforcement Policy were evaluated as follows. Although your commitment to verify all safety-related calculations led to your initial discovery concerning the inadequate NPSH for HPI pumps on May 19, 1988, it was not until early August 1988 (after discussions with the NRC Resident Inspector) that your DEG i and your onsite operations personnel understood that the piggyback mode of operation of the HPI system was a requirement of the ECCS. Once your staff fully recognized the extent of the problem in early August, extensive corrective action was taken. However, because of the initial failure to fully comprehend the extent and safety significance of the problem, there was a delay in taking the appropriate corrective action. Therefore, only 25% mitigation was warrar+ed NUREG-0940 1.A-71
Duke Power Company DEC 131988 for each of the factors of identification and corrective action. The staff considered your prior performance and decided that the generally favorable SALP ratings in Plant Operations (1) and Engineering Support (2) were offset by the enforcement history in the area of Operations and Engineering at the facility since January 1987. Therefore, neither escalation nor mitigation was considered warranted for the factor of past performance. Finally, the staff considered the prior notice of similar events and multiple occurrences factors and concluded that they were not applicable. Therefore, based on all the considerations, mitigation by 50% of the base civil penalty was considered appropriate. The NRC is encouraged, however, by your commitment to revie,1 all safety-related calculations at Oconee. The staff is also encouraged by yo r initiative to staff an on-site design engineering group to provide more timely response to an understanding of engineering issues. You are ruquired to respond to this letter and the enclosed Notice and should follow the instructions specified therein when preparing your response. In your response, you should document the specific acticas taken and any addi-tional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determins whether further NRC enforcement action is necessary to ensure compliance with NPC regulattry requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely,
,Y
' Malcolm L. Ernst Acting Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty l cc w/ enc 1: M. S. Tuckman, Station Manager State of South Carolina NUREG-0940 1.A-72
A NOTICE OF VIOLATION AND PROPOSED IMPOSITIDT0F CIVIL PENALTY l Duke Power Company Docket Nos. 50-69, 50-270, and 50-287 Oconee Nuclear Station License Nos. DPR-38, DPR-47, and DPR-55 Units 1, 2, and 3 EA 88-228 During an NRC inspection conducted on August 1-15, 1988, a violation of NRC requirements was identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended ("Act"), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violation and associated civil penalty are set forth below: Technical Specification 6.4.1.k. requires that the station be operated and maintained in accordance with approved procedures and that written procedures with appropriate check-off lists and instructions be provided for the long-term emergency core cooling systems. Procedures shall include provision for remote or local operation of system components necessary to establish high and low pressure injection within 15 minutes after a line break. Contrary to the above, prior to May 19, 1988, adequate instructions were not provided for long-term emergency core cooling systems, specifically the High Pressure Injection (HPI) system. Plant personnel did not recognize the HPI piggyback mode as a required safety-related operational mode of the ECCS under certain conditions and, therefore, procedures did not provide adequate guidance regarding the utilization of the HPI piggyback mode to mitigate certain.small break LOCAs. Because the operating procedures did not provide precautions or specific limitations regarding system equipment, certain pemitted combinations of reactor building spray, low pressure injection and high pressure injection flow could have resulted in a loss of net positive suction head to the HPI system pumps resulting in the HPI sump recirculation mode not fulfilling design requirements. Adequate procedures, including guidance for operation of the LPI/HPI crossover valves, were not fully implemented until August 19, 1988. This is a Severity Level III violation (Supplement I). Civil Penalty - ($25,000). Pursuant to the provisions of 10 CFR 2.201, Duke Power Company (licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include: (1) admission or denial of the violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps which will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be oroper should not be taken. Consideration may be given to extending
)
NUREG-0940 I.A-73 I
~#
Notice of Violation the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under th or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Viola-tion" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitiga-tion of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201 but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty. Upon failure to pay the penalty due, which has been subsequently determined in accordance with. the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act. 42 U.S.C. 2282. The responses to the Director Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil pengity, and Answer to a Notice of Violation) should be addressed to: Directdr, Office of Enforcement, U.S. Nuclear Regulatory Consnission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region 11 and a copy to the NRC Resident Inspector, at the Oconee Nuclear Station. FOR THE NUCLEAR REGULATORY COMMISSION h u/ n Malcolm L. Ernst [ Acting Regional Administrator Dated at. Atlanta, Georgia this /fM day of December 1988 NUREG-0940 1.A-74
,~,.k
,y
- UNITED STATES L
3 j NUCLEAR REGULATORY COMMISSION t REOlON11 k, 10104ARIETTA ST., N.W.
, , ATLANTA GEOROBA 30323 JAN 19 1999 Docket Nos. 50-369 and 50-370 License Nos. NPF-9 and NPF-17 EA 88-247 Duke Power Company ATTN: Mr. H. B. Tucker, Vice President' Nuclear Production Department '
422 South Church Street Charlotte, North Carolina 28242 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NOS. 50-369/88-24, 50-370/88-24, 50-369/88-29, AND 50-370/88-29) This refers to the Nuclear Regulatory Comission (NRC) inspections conducted on August I through September 16, 1988, and August 29 through September 9, 1988, at the McGuire Nuclear Station. The inspection included a review of the past and current operability of the hydrogen skimer system and a review of the circumstances surrounding'the inoperability of various safety systems due to'an inadequate functional verification phase of post-modification testing. The reports documenting these inspections were sent-to you by letters dated September 27, 1988, and October 11, 1988. As a result of these inspections, significant failures to comply with NRC regulatory requirements were identified and, accordingly, NRC concerns relating to the findings of the inspections were discussed in an Enforcement Conference held on October 27, 1988. The letter summarizing this conference was sent to you on November 25, 1988. The violations described ir. Section I of the enclosed Notice of Violation and Proposed Imposition of Civil Ptaalty (Notice) involved a significant failure to ensure that the Unit l'and 2 hydrogen skimmer (VX) systems could perform their intended function. The first violation, I. A., involved the inoperability of Se VX' system in that flow rates from several enclosed compartments inside the containmerits of both units were less than that necessary to limit potential hydrogen buildup during a design basis accident to less than four percent volume, as specified in Section 6.6.1 of the Final Safety Analysis Report (FSAR). Though the Technical Specifications do not directly address the VX system p rformance and testing standards, the Technical Specification bases include hydrogen control as part of the definition of overall system operability. The compartment flow rates necessary to achieve required system performance were not assured because a VX system flow balance was not performed for each train in each unit during preoperational testing. Additionally, no administrative controls were established to ensure correct compartment damper position since initial startup. l NUREG-0940 1.A-75 !
Duke Power Company m 1919 The violation was identified as a result of the NRC resident inspector I discovering a partially closed damper in Unit I during a containment closeout inspection. No other dampers were found mispositioned and Unit I startup proceeded. Further review of the significance of VX damper position raised a concern about the adequacy of the system flow balance. based on available test data. Plant managemer.t committed to perfom a similar damper alignment on Unit 2 during the next refueling outage, and verify the adequacy of the VX system flows. Thereafter, two other closed dampers were identified during that outage. The length of time these dampers were mispositioned could not be determined, but with certainty, considerably exceeded the limits of the t Technical Specifications. Subsequent flow testing determined that the VX l system did not meet the FSAR design requirements. The second violation, I.B, again identified by the resident inspector, arose out of a failure to perform an adequate safety evaluation when Unit 2 was restarted on July 21, 1988 with the VX system unable to meet design requirements. The evaluation stated that test flow rates in several enclosed compartments were insufficient to limit the hydrogen accumulation to less than four percent ; volume, as specified in the FSAR. Ti ' e evaluation, used by plant manrgement { to justify startup, essentially stated that the degraded VX system in combina- 1' tion with the hydrogen mitigation system (HMS) ignitors would preveni, the accumulation of hydrogen and provide adequate protection. This reasoning was flawed in that the design basis for the VX system is different from that of ; the HMS, and Technical Specifications do not allow the VX system to be i inoperable based on the operability of the HMS. ! To emphasize the need for prompt identification and resolution of safety ! i significant problems, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional j Operations, to issue the enclosed Notice of Violation and Proposed Imposition i of Civil Penalty in the amount of Thirty-Seven Thousand Five Hundred Dollars I ($37,500) for the violations concerning the hydrogen skimmer system. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," in 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations described in Section I of the enclosed Notice have been cate-gorized in the aggregate as a Severity Level III problem. The base civil I penalty for a Severity Level III problem is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered, and the civil penalty amount has been mitigated by 25 percent in recognition of your compre-hensive corrective actions, Those actions include plans to modify the VX systems on Unit I and 2 so as to enhance your ability to balance system flow; to conduct tests to optimize the flow balance of the VX systems: and to establish appropriate controls to ensure a balance is maintained. Also you have stated that ynu will more clearly delineate the operability determi-nation process and establish requirements to ensure that the requirements of 10 CFR 50.59 are met. However, full mitigation for corrective actions is not warranted because questions about the adequacy of the preoperational l l NUREG-0940 I.A-76
I Duke Power Company MN 10 E system flow balances existed prior to the Unit 2 outage and corrective, actions were not sufficient to-preclude' plant startup with the VX system in a condition other than as described in the FSAR. No further mitigation nor escalation of the civil penalty was deemed appropriate.
.The violation described in Section II of the enclosed Notice involved a failure l to perform appropriate post-maintenance testing following modifications to '
ensure proper installation of the modifications, and to ensure the subject ; equipment would perferm all intended safety functions prior to declaring the 1 equipment operable. The deficiencies'at the McGuire Nuclear Station, which'
. were identified by. Duke Power Company as a result of findings at the Catawba Nuclear Station, resulted in the automatic safety functions for several compo-nents being inoperable. These deficiencies included inoperability of the automatic closure capability of INV-142B, a volume control tank outlet valve; i inoperability of.an open permissive necessary to open INS-1 and INS-18, A and B ' train containment sump to containment spray (NS) pump supply valves; and Anoperability of-the interlock on 2ND-4, a residual heat removal (ND) system valve designed to close on the switchover sequence from the injection mode to .the cold leg recirculation mode. Each of the three examples are Technical
. Specification violations which existed for extended periods of time and resulted from a breakdown in the post-maintenance and post-modification testing program at the McGuire Nuclear Station. A civil penalty is not being proposed for the violation described in Section II in recognition of your identification, complete reporting of the problem, and your comprehensive corrective action. The NRC is encouraged by your intersite review of ope"ating experience that identified the functional verification problems ant your thorough corrective actions. Those actions include issuing a maintenance management procedure which defines the minimum functional verifi-cation. requirements for a p6rticular class of component, revising other station procedures to give more detailed guidance for work on valve operators, and establishment of a special" review group to review functional verification after maintenance and modification to ensure all appropriate areas are covered. You are required to respond to this letter and should follow the instructions 'l specified in the enclosed Notice when preparing your response. In your I response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of thh letter and its enclosure will be placed in the NRC Public Document Roon. , 1 NUREG-0940 I.A-77
)
Duke Power Company ,$$l 19 W l The resporises directed by this letter and enclosed Notice'are not subject to -l the clearance procedures of the Office of Manager, ant and Budget as required by the Paperwork Reduction Act of 1980, Public Law No. %-511. l Sincerely.- Malcol d . Ernst Acting Regional Administrator Enclosuta-Notice or Violation and Proposed l Imposition of Civil Penalty cc w/ encl: T. L. McConnell, Station Manager Senior Resident Inspectors - McGuire & Catawba State of North Carolina i i NUREG-0940 1.A-78
NOTICE OF VIOLATION AND PROPOSED IMPOSITIDN~0F CIVIL PENALTY Duke Power Company Docket Nos. 50-369 and 50-370 1 McGuire Nuclear Station License Nos. MPF-9 and NPF-17 l Units 1 and 2 EA 88-247 I
)
During the Nuclear Regulatory Comission (NRC) inspection conducted on August 1, 1988 - September 16, 1988 and August 29, 1988 - September 9, 1988 ! violations of NRC requirements were identified. In accordance with the
" General Statement of Policy and Procedure , fur NRC Enforcement Actions,"
10 CFR Part 2 Appendix C (1988), the Nuclear Regulatory Comission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: I. Violations Assessed A Civil Penalty A. Technical Specification Limiting Condition for Operation (LCO) 3.6.5.6, Containment Air Return and Hydrogen Skimer (VX) system, applicable in Modes 1, 2, 3, and 4 requires, with one train inoperable, to restore the inoperable train to operable status within 72 hours or be in at least hot standby within the next six hours and in cold shutdown within the following 30 hours. Contrary to the above Units 1 and 2 VX systems were found to have been inoperable in that they could not perform their intended function of preventing the accumulation of hydrogen below four percent volume in localized areas or compartments of the containment, as follows:
- 1. On October 18, 1988, as found flow measurements of Unit 1 VX system indicated that the "A" train pressurizer cavity and both "A" and "B" trains in the reactor vessel head areas had low flows . Prior to the Unit I shutdown of October 11, 1988, the reactor was operated in modes 1 through 4 in excess of the LCO time limit since initial plant startup.
- 2. On July 19, 1988, as found flow measurements of the Unit 2 VX system indicated that the VX dampers in the reactor vessel head area were closed and low flows existed in several other contain-ment compartments. Prior to the Unit 2 shutdown on May 27, 1988, the reactor was operated in modes 1 through 4 in excess of the LCO time limit since initial plant startup.
B. 10 CFR 50.59, Changes, Tests, and Experiments, states that the holder of a license authorizing operation of a production or utilization l facility may make changes in the facility as described in the safety analysis report without prior Commission approval, unless the pro-posed change involves a change in the Technical Specifications incorporated in the license or an unreviewed safety question. Further, Section 50.59(b) states that the licensee shall maintain records of changes in the facility made pursuant to Section 50.59, to the extent that such changes constitute changes to the facility NUREG-0940 I.A-79
-2
] !
Notice of Violation ! as described in the safety analysis report. These rea rds must include a written safety evaluation which provides the basis for ( the determination that the change does not involve an unreviewed l safety question as defined in 10 CFT< 50.59. ' Section 6.6 of the McGuire Final Safety Analysis Report (FSAR) l describes, in part, that each hydrogen skimmer fan has been sized to assure that the flow rates for each compartment can. limit hydrogen accumulation to four percent volume. ! Contrary to the above, on July 21, 1988, the licensee decided to { operate Unit 2 with several containment enclosed compartment flow ? rates less than that necessary to limit hydrogen accumulation to four percent volume, a condition other than that described in the FSAR, and performed a safety evaluation that was inadequate in that it 3 did not determine whether the change involved an unreviewed safety j question. Collectively, the violations have been categorized as a Severity Level III problem (Supplement I). Cumulative civil penalty - $37,500 (assessed equally between the violations). II. Violation' Not Assessed A Civil penalty 10 CFR Part 50, Appendix B, Criterion XI, Test Controls, states in part that a test program shall be established to assure that all testing required to demonstrate that structures, systems and components will perfonn satisfactorily in service is identified and performed in accordance with written test procedures which incorporate the requirer:ents and acceptance limits contained in applicable design documents. Technical Specification LCO 3.5.2, ECCS subsystems .T AVG greater than 350'F, requires that two independent.ECCS subsystems, each of which is comprised, in part, of an operable centrifugal charging pump, one.RHR pump, and a flow path capable of taking suction from the refueling water storage tank on a safety injection signal and automatically transferring suction to the containment sump during the recirculation phase of operation, shall be o erable in Modes 1, 2, and 3. If one train is inoperable, the Technical Specification requires that operability be restored within 72 hours or that the plant be in at least HOT STANDBY within the next six hours. Technical Specification LC0 3.6.2, Containment Spray System, requires that the two independent containment spray systems shall be operable in Modes 1, 2, 3, and 4 with each spray system capable of taking suction from the refueling water storage tank and transferring suction to the contain-ment sump. If one train is inoperable, the Technical Specification requires that operability be restored within 72 hours or be in at least HOT STANDBY within the next six hours. I NUREG-0940 I.A-80 _ _ _ _ _ _ - i
i Notice of Violation Contrary to the above, the licensee's post maintenance verification and post-modification testing program was inadequate in that the program , failed to ensure proper installation of modifications and failed to i ensure modified equipment would perform all intended functions prior to declaring the equipment operable. These failures resulted in three -) examples of Technical Specification violations as follows: 1
- 1. Volume control tank outlet valve,1NV-1428, was inoperable because it could not close automatically on a safety 1,0jection signal, .
rendering Unit I centrifugal charging pumps inoperable without 1 manual operator action from November 10, 1987 until August 29, 1988, while operating in Modes 1, 2, and 3.
- 2. An open permissive signal necessary to open "A" and "8" train ;
containment sump to containment spray pump supply valves, INS-1 and ; INS-18, was inoperable from November 8, 1987, when Unit 1 entered l Mode 4, until September 3,1988, rendering both trains of containment spray incapable of transferring suction to the containment sump, and therefore, inoperable.
- 3. An interlock on residual heat removal valve 2ND-4, designed to close .
on the switchover sequence from the injection mode to the coid leg recirculation mode, was inoperable from July 1,1987 when Unit 2 entered Mode 3. until Unit 2 shutdown on May 27, 1988, rendering an 1 RHR pump, an ECCS subsystem, inoperable on the switchover. l This is a Severity 1.evel III violation (Supplement 1). Pursuant to the provisions of 10 CFR 2.201, Duke Power. Company is hereby required to submit a written statement or explanation to the Director Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each violation: (1) admission or denial of the violation, (2) the reasons for the violation if admitted, (3) the correc- i tive steps that have been taken and the results achieved, (4) the corrective ! steps which will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the ) license should not be modified, suspended, or revoked or why such other action i as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Coninission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of NUREG-0940 1.A-81 f
1 Notice of Violation . the civil penalty in whole or in part by a written answer addressed to the i Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should l ' the licensee fail to answer within the time specified, an order ' imposing the l civil penalty will be issued. Should the licensee elect to file an enswer in ! accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, i such answer should be clearly marked as an " Answer to a Notice of Violation" , and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation n' the proposed penalty, the five fectors addressed in !
'Section V.B of 10 CFR Pan 1, Appendix C (1988), 'should be addressed. Any '
written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or'explanal. ion in reply pursuant to 10 CFR 2.201 but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty. Upon failure to pay the penalty due, which has been subsequently determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be n. ' erred to the Attorney General, and the penalty, unless compromised, , remitted, or mitigated, may be collected by civil' action pursuant to j Section 234c of the Act, 42 U.S.C. 2282. ' The responses to the Director, Office of Enforcement, poted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II and a copy to the NRC Resident Inspector, McGuire Nuclear Station. FOR THE NUCLEAR REGULATORY COMMISSION m Malcolm L. Ernst Acting Regional Administrator Dated at Atlanta, Georgia this pf/f day of January 1989 NUREG-0940 1.A-82
[ I i l. I o mag UNITED ST ATES [n g% NUCLEAR REGULATORY COMMisstON O' n REGION ll 3 y 101 MARIETT A STRE ET. N.W. f ATLANTA GEORGIA 30323
$ i
%*..../ gg g Docket Nos. 50-250 and 50-251 License Nos. DPR-31 and OPR-41 EA 88-267 Florida Power and Light Company ATTN: Mr. W. F. Conway Senior Vice PresiJent - Nuclear Post Office Box 14000 Juno Beach, Florida 33408-0420 Gentlemen:
SU8 JECT: NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NOS. 50-250/88-31 AND 50-251/88-31) This refers to the Nuclear Regulatory Cow 11ssion (NRC) inspection conducted by Ms..Orysia M. Masnyk at the Turkey Point facility on October 6-7, 1988.. The inspection included a review of the circumstances surrounding the repositioning i of a guard providing compensatory measures for a degraded vital area barrier and subsequent failure to report the event within the required one hour. The report documenting this inspection was sent to you by letter dated October 27, 1988. As a result of this inspection, a significant failure to comply with NRC regulatory requirements was identified and, accordingly, NRC concerns relative to the inspection findings were discussed in an Enforcement Conference held on November 14, lab 8. The letter sumarizing this Conference was sent to you on November 22. Gb8.
'The violation described in Section I of the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) involved a failure to provide adequate compensatory measures for a degraded vital area barrier. The events that resulted in this violation included the repositioning of a guard providing compensatory meesures for a degraded vital area barrier which resulted in a failure to control access to vital equipment until discovered by the Senior NRC Resident Inspector two days later. Unit 3 was at full power and Unit 4 was in Modes 3 through 5 during this time frame. This violation is significant in that it demonstrates a lack of awareness of vital areas and vital area boundaries by the security force and a lack of management oversight for security force operations. Additionally, althcugh you reported this event, it was not done within the required one hour time frame.
To emphasize the need for ensuring that adequate compensatory measures are taken, and for improving both your awareness of vital equipment and management oversight of the security program. I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director i for Regional Operationc, to issue the enclosed Notice of Violation and Proposed j Imposition of Civil Penalty in the arount of One Hundred Thousand Dollars ! ($100,000) for the violation described in Section 1 of the enclosed Notice. l In accordance with the " General Statement of Policy and Procedure for NRC I Enforcement Actions," 10 CFR Part 2 Appendix C (1988) (Enforcement Policy),
.NUREG-0940 I.A-83 l
m_ l
TE8 1 tagg Florida Power and Light Compwy the violation described in the enclosed Notice has been categorized as a Severity Level III violation. The base value of a civil penalty for a Severity Level III violation is $50,000. The escalation and mitigation factors were considered, and the base civil penalty amount has been increased by 100 percent due to your continued poor performance in the area of security. On April 21, 1987, a civil penalty was proposed for numerous examples of access control violations (EA 87-040). The civil penalty was escalated because of prior poor perfomance and prior notice based on internal reports of similar problems. Your response included a statement that FPL had taken steps to facilitate the identification of trends to plant and corporate management and to heighten the awareness of security requirements and problems. On July 28, 1987, a civil penalty was imposed for access control violations (EA 87-098). The civil penalty was escalated because of continued poor perfomance, and we emphasized the continuing need for increased management involvement in oversight and control of the security program. Your response took issue with the signi-ficance of the violations, but stated that the corrective actions would reduce the likelihood of similar problems in the future. On February 11, 1988, a civil penalty was proposed for access control violations (EA 87-179). The civil penalty was escalated due to continued poor perfomance and the number of violations. In that letter, we noted that FPL's Security Enhancement Program had failed to adequately address the security problems at Turkey Point. Your response described additional programmatic corrective actions. It is imperative that Florida Power and Light Company management take the necessary action to assure that this pattern of security violations is terminated and to assure that the security of the Turkey Point facility can be adequately maintained. You must clearly understand that a continuation of this level of performance cannot be tolerated. We acknowledge that additional FPL supervisors have been assigned to shiftwork to increase the FPL presence on site during that period. We expect this added attention by FPL and the meetings that have taken place between NRC and the utility to emphasize the significance of maintaining an adequate level of security at Turkey Point including compensatory measures. Should additional significant security violations occur, we intend to consider action in addition to civil penalties. The violation described in Section II of the enclosed Notice cites the failure to report the security event within the required one hour. This violation has been categorized at Severity Level IV. You are required to respond to this letter and the enclosed Notice and should follow the instructions specified therein when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with 10 CFR 2.790(d) and 10 CFR 73.21, safeguards activities and ; security measures are exempt from public disclosure. Therefore, the enclosure i l to this letter, with the exception of the report cover page, which presents a l l nonexempt summary, will not,be placed in the NRC Public Document Room. i NUREG-0940 I.A-84
j i j Florida Power &' Light Company The response directed by this letter and its enclosure are not sub, ject to the m clearance procedures of. the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
,Should you have any questions concerning this letter, please contact us.
Sincerely, Mal L. Ernst Acting Regional Administrator
Enclosure:
Notice of Violation and Proposed ' Imposition of Civil Penalty (Safeguards Infonnation) cc w/ enc 1: J. S. Odom Vice President Turkey Point Nuclear Plant J. E. Cross, Plant Manager
' Turkey Point Nuclear Plant L'. W. Bladow, Plant QA Superintendent J. Arias, Jr., Regulatory and Compliance Supervisor cc w/o encl:
State of Florida 1 l NUREG-0940 1.A-85
B y [ %j g UNITED STATES NUCLEAR REGULATORY COMMISSION r,, ;y WASHINGTON, D. C. 20555 -
%,...../
N O V 0 T 1907 Docket No. 50-219
. License No. DPR-16 EA 87-185 GPU Nuclear Corporation ATTN: Mrf P. R. Clark President 100 Interpace Parkway-Parsippany, New Jersey 07054 Gentlemen:
Subject:
CONFIRMATORY ORDER Enclosed is a Confirmatory Order, effective immediately, confirming commitments made to the NRC in various letters concerning the events associated with (1) the violation of a safety limit at Oyster Creek on September 11, 1987, and (2) the subsequent destruction of a sequence of alarms tape associated with this ) event. Issuance of this order does not preclude the NRC from taking additional enforcement action upon completion of the ongoing independent investigations of this matter. In accordance with 10 CFR 2.790 of the NRC's " Rules of Practice," Part 2 Title'10, code of Federal Regulations, a copy of this letter and the enclosed Order will_be'placed in the NRC's Public Document Room. In addition to the commitments set forth in the enclosed Order, you are requested to provide a copy of the Order to each member of Operating Shift "B" that was on duty at the time fo the safety limit violation. The responses directed by the accompanying Order are not subject to the clearance proceJures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, PL 96-511. Sincerely,
,, /
de W p j/ J s M. Taylor, Deputy Executive Director for Regional Operations
Enclosure:
Confirmatory Order cc w/ enc 1: M. Laggart, BWR Licensing Manager Licensing Manager, Oyster Creek State of New Jersey L CERTIFIED MAIL RETURN RECEIPT REQUESTED i NUREG-0940 I.A-86 s
UNITED STATES NUCLEAR REGULATORY COMMISSION In the Matter of ) Docket No. 50-719
) License No. DPR-16 GPU NUCLEAR CORPORATION ) EA 87-185
)
(Oyster Creek Nuc' ear Generating Station) ) CONFIRMATORY.0RDER (EFFECTIVE IMMEDIATELY) I GPU Nuclear Corporation, Parsippany, New Jersey 07054 (the " licensee") is the holder of License No. DPR-16 (the " license") issued by the Nuclear Regulatory Commission (NRC/ Commission) which authorizes the licensee to operate the Oyster Creek Nuclear Generati,ng Station in Ocean County, New Jersey, in accordance with conditions specified therein. The license was issued on August 1, 1969. II On September 11, 1987, at approximately 2:15 a.m., while the reactor was in cold shutdown and Operating Shift B was on duty in the control room, a viola-tion of the license technical specifications occurred at Oyster Creek involving the failure to maintain the facility in accordance with Safety Limit 2.1.E. This Safety Limit requires at least two of five recirculation pump suction and discharge velves be in the full open position, unless the reactor vessel head l Nl,lREG-0940 1.A-87
2 6 i is. removed and the reactor is flooded to a level above the main steam nozzles. The violation occurred when the reactor operator at lne controls placed the control switch for the B Recirculation '-^n nscharge valve in the closed position, in preparation for shutting down the B pump as a result of the need to isolate the Reactor Building Closed Cooling Water (RBCCW) System due_to a RBCCW 1eak. At the time, the discharge valves for the A, D, and E recircula-tion loops were closed, and closure of the B loop discharge valve resulted in the violation of the Safety Limit.
.The operator was immediate~1y alerted that the safety limit had been violated when he received an alarm'in the control room. In response to that alarm, the operator apparently immediately opened the discharge valves for the A and D recirculation loops so as to return the plant to a condition within the bounds .
of the Safety Limit. III Subsequently, during.the morning of September 11, 1987, licensee management concluded that'a paper tape record for the Sequence of Alarms Recorder had been recoved, and there might have been an attempt, by a member or members of l the Shift in the control room (Operating Shift B), to conceal or destroy the j record. The record provided evidence of a safety limit violation. The licensee immediately initiated, on September 11, 1987, an internal investiga-tion and relieved the "B" shift crew of licensed duties, pending the results of an internal investigation which is being conducted by a consultant. NUREG-0940 1.A-88
-_-_____-__-_______-_-_L
l. i 3 In' letters'from the President of GPU Nuclear Corporation to the NRC, dated
' September 22, 1987,~and October 26, 1987, respectively .the licensee indicated I
that the NRC would be notified, and NRC approval obtained, before any' members of the "B" shift crew were returned to licensed duties. Further, the October 26 letter indicated that a copy of the licensee's investigation report would be provided to the NRC upon its completion. The NRC investigation of this matter is continuing independent of the above mentioned licensee actions and activities. IV In view of the importance of a thorough investigation of these events to identify the circumstances associated with the Safety Limit violation and sub-sequent' destruction of the Sequence of Alarns record, I have determined that the commitments made in the September 22 and October 26, 1987 letters are required in the interest of public health and safety, and therefore, should be confirmed by an immediately effective Order. VI In view of the foregoing, pursuant to Sections 103, 161(i), 161(o) and 182 of the Atomic Energy Act of 1954, as amended, and the Commission's regulations in 10 CFR 2.204 and 10 CFR Part 50, IT IS HEREBY ORDERED, EFFECTIVE IMMEDIATELY, THAT THE LICENSE IS MODIFIED AS FOLLOWS:
.NUREG-0940 1.A-89
1 4 j A. The' licensee shall prohibit any member of the operating Shift B who was on duty on September 11, 1987 from performing licensed duties unless the l licensee notifies and obtains the approva.1 of the NRC Regional Administrator, Region I, prior to returning such a person to licensed duties; and B. The licensee shall provide the NRC Regional Administrator, Region I, a- ! copy of the. Investigation Report prepared by or on behalf of the licensee concerning.this event upon completion of its investigation. The Regional Administrator, Region I may relax or terminate any of the above ; conditions for good cause shown. , l VII l The licensee, or any person who is adversely affected by this Order, may request a hearing within 30 days of the date of this Order. A request for ; hearing should be clearly marked as a " Request for Hearing" and shall be l submitted to the Director, Office of Enforcement, U.S. Nuclear Regulat'ory 1 Commission, ATTN: Docket Control Desk, Washington, D.C. 20555 with copies ! l to the Assistant General Counsel for Enforcement, the Regional Administrator, Region I, 631 Park Avenue, King of Prussia, PA 19406 and the NRC Resident Inspector, Oyster Creek Nuclear Generating Station. A REQUEST FOR HEARING SHALL NOT STAY THE IMMEDIATE EFFECTIVENESS OF THIS ORDER. I J
.NUREG-0940 I.A-90
t 5 If a hearing is requested, the Comission will issue an Order designating the time and.' place of the hearing. If a hearing is held, the issue to be considered at such hearing shall be whether this Order shall be sustained. If a person other than the licensee requests a hearing, that' person shall_ set forth with particularity the manner in which the petitioner's interest is adversely affected by this Order and should address the criteria set forth in 10 CFR 2.714(d). Upon failure of the licensee and any other person adversely affected by.this Order to answer a request for a hearing within the specified time, the
. Order shall be final without further proceedings. AN ANSWER TO THIS ORDER OR A REQUEST FOR HEARING SHALL NOT STAY THE IMMEDIATE EFFECTIVENESS OF THIS ORDER.
FOR THE NUCLEAR REGULATORY COMMISSION
/
a
. - - 'sA&
sM. Taylor.deputyExecutive
, irector for Regional Operations Dated at Bethesda, Maryland
- this 5th day of November 1987 l
1 NUREG-0940 1.A-91
p'.I t.
.u i
V '3 ls L ,+ [se sof h, .
' UNITED STATES
, .( i4( i;l NUCLEAR REGULATORY COMMISSION REGION I
[L L <g / 47s ALLENDALE ROAD '
'se** - KING OF PRUS$1A. PENNSYLVANIA ta408
[ . January 18, 1989 l Docket.No. 50-219 l
' License'No. DPR-16 EA 87-185:
GPU Nuclear Corporation l ATTN: Mr. P.' R. Clark President j 100'Interpace parkway Parsippany,.New Jersey 07054 L
' Gentlemen:
SUBJECT:
NOTICE'0F VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC Inspection No. 50-219/87-29 and NRC.0ffice of Investigation Report No. 1-87-015) This refers to the Augmented Inspection Team (AIT) review conducted by this office on September 11-17, 1987 at the Oyster Creek Nuclear Generating
-Station, as well as a subsequent investigation conducted by the NRC Office of Investigations. The inspection and investigation were conducted in response to a safety limit violation which occurred at Oyster Creek on September.11, 1987, as well as the subsequent destruction of a record of the violation by.a member
- of the crew of licensed operators on duty at the time. The inspection report was sent to you September 28, 1987 The synopsis of. the 01 Report 15 enclosed.
On' September 6, 1988, an enforcement conference was conducted with you and members of your staff to discuss the findings of the inspection and investiga-tion,.as well'as the related violations, their causes and your corrective actions.
'The' specific safety limit that was violated at your facility occurred while the reactor was shut dcwn and involved the failure to maintain, for approximately two minutes, at least two recirculation loop discharge valves in the full open position, as required by the technical specification safety limit. The viola-tion occurred when the control room reactor operator, in response to direction from a Group Shift Supervisor (GSS) to secure the recirculation pumps, shut one of the two recirculation loop discharge valves that were open at the time. The recirculation pumps needed to be secured because a leak' ha 1 developed in the Reactor Building Closed Cooling Water (RBCCW) system during maintenance of one -I of its isolation valves, and therefore, the RBCCW, which provides cooling to the recirculation pumps seals, needed to be isolated. Although the normal operating procedure was to close the discharge valve prior to securing the pumps, the pumps could and should have been secured without the discharge valves beir,g closed, given the status of the plant at the time.
In addition to the violation of the safety limit, numerous maintenance deficiencies occurred prior to the RBCCW isolation valve leak. If these
' maintenance-activities had been properly controlled, and if there had been CERTIFIED MAIL ITtURN RECElpi REQUESTED NUREG-0940 1.A-92
1 1 GPU Nuclear Corporation 2 appropriate coordination between plant engineering and the maintenance personnel, the leak could have been prevented. For example, an attempt was made to perform repairs to the RBCCW isolation valve while it was on its backseat, rather than with the system isolated and vented as required by procedura. In addition, this change was made without approval by appropriate management, as required. Further-more, the method used to backseat the valve was not in accordance with procedures, and the approval of plant engineering was not obtained prior to utilizing an alternate approach. These violations demonstrate the importance of proper control of maintenance l and operational activities at your facility to ensure that the facility is operated safely and in accordance with the technical specifications. There-fore, I have been authorized, af ter consultation with the Deputy Executive Director'for Operations and the Commission to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Fifty Thousand Dollars (550,000) for the violations set forth in the enclosed Notice. Although a safety limit violation could be lassified at Severity Level I in accordance with Section A.1 of Supplement I of the " General State-ment of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appenaix C (Enforcement Policy) (1988), the NRC has decided that a Severity Level I classification is inappropriate in this case because of the condition of the plant, which was shut down at the time, the fact that the violation existed for a very short time (less than two minutes) because the control room operator immediately opened two other discharge valves after having made the error and the fact that at similar plants this requirement is not a safety limit. Rather, the NRC has decided that it is more appropriate to classify the safety limit violation and the maintenance violations in the aggregate as a Severity Level III problem to focus on the underlying NRC concern, namely, inadequate control of u.aintenance and operational activities. The base civil penalty amount for a Severity Level III violation or problem is 550,000. The NRC considered fully mitigating the civil penalty since the investigation and analysis of the event by your management, and the subsequent corrective actions, were considered unusually prompt and extensive. However, given your past poor performance (as evidenced by Category 3 rating in the operations area during the latest Systematic Appraisal of Licensee Performance and a $205,000 civil penalty issued in August 1987) and the fact tSet a siritar event occurred at Oyster Creek in 1979 ne adjustment of the base civil penuity is deemed approprio te. The NRC recognizes that consideration of a 1979 event is outside 'of the normal two year period for consideration of past performance; however, the occurrence of such a sigr.ificant event clearly shculd have served n p-ior notice given the similarities of the two problems. In addition to these violations, the NRC has also evaluated the willful I destruction of a sequence of alartns tape (concerning this safety limit viola- l tion) by the on-shift control room operator. This individual's employment was i subsequently terminated by GPU Nuclear upon completien of its investigation. ] During the NRC Enforcement Conference, the OI investigation, and your internal i investigation, the individual stated that this willful destruction occurred as I a result of anger, frustration, fear and embarrassment at having caused the ' safety limit violation, and was not an attempt to conceal the safety lim't i NUREG-0940 1.A-93 !
.1-%
GPU. Nuclear Corporation 3- , P violation.. Nonetheless, this willful destruction of records constitutes a violation'of the reactor operator license that this individua~l possessed at the time, and accordingly, a Notice of Violation.is being sent today to this former operator. E You are required to' respond to this letter and the er.::losed Notice and should follow..the instructions specified in the enclosures when. preparing your response. The NRC recognizes that a substantial amount of material' has been provided to the NRC concerning this matter, and therefore,. where applicable, you may make reference.to this material in your response. After
-reviewing your response, the NRC will determine if further action is needed to ensure compliance with requirements.
In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code'of Federal Regulations, a copy of this letter and its enclosures will'be placed in the NRC Public Document Room. The responses. directed by this letter and the enclosed Notice are not subject
- to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
' Sincerely, D
William T. Russell ! Regiona1' Administrator l
Enclosure:
i Notice of Violation and Proposed Imposition of Civil Penalty j cc w/ encl: , M. Laggart, BWR Licensing Manager l l _' Licensing Manager, Oyster Creek i i Put:lic Document Lccal'Public Rcom Document Room (POR) (LPDR) Nuclear Safety Information Center (NSIC) i NRC Resident Inspector ! State of New Jersey l Michael Hi m 1, Esquire P.O. Bor. 5600 I J Wo6 bridge, New Jersey 07095 1 NUREG-0940- 1.A-94 1
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY GPU Nuclear Corporation Docket No. 50-219 Oyster Creek Nuclear Generating Station License Nos. OPR-16 EA 87-185
.During an Augmented Team Inspection conducted on September 11 - 17, 1987 (in response.to a safety limit violation identified by your staff and reported to the NRC) and a_ subsequent investigation conducted.by the NRC Office of Investi-gations, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Proc'edure for NRC Enforcement Actions,"
10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (ACT), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. Technical. Specification 2.1.E, Safety Limits, requires that, during all modes of operation, except when the reactor head is off and the reactor is flooded to a level above the main steam nozzles, the suction valves and associated discharge valves in at least two of the five recirculation loops shall be in the full open position. Contrary to the above, between approximately 2:17 a.m. and 2:19 a.m. on September 11, 1987, while the plant was in the shutdown condition with reactor water level at normal and the reactor vessel head on, less than two of the five recirculation loop discharge valves were in a. full open position. B. Technical Specification 6.8.1 requires that written procedures shall be established, implemented and maintained.
- 1. Sta; ion Procedure 107, Procedure Control, Revision 32, Step 5.3.5.1, i requires that no prerequisites, precautions, or acceptance criteria can be changed in a procedure without the approval of either the '
Plant Operations Director, Manager Plant Operations, Operations ; Control Manager, Manager Plant Material, Plant Engineering Director, ~ Ofrector/ Deputy Manager Rariiclogical Conteois (Rad Crn requirements only), PRG Chairman or Vice Chairman, er Directer / Deputy Of rectw. ) i Contrary to the above, shortly af ter 2:00 a.m. en September 11, 1987, while maintenance was being parforcec on a Reactor Building Clored ] a Cooling Water (RPCN) System isciation valve (No. V-5-167), using ' Station Procedure 700.1.030, an t.ttempt was made to repack the valve while on its backseat, rather then isolated and vented as required by the procedure prerequisites, representing a charga in Station Procedure ; L 700.1.030 without obtaining the approvc1 of any of the designated j management individuals set forth in Station Procedure 107. J l
)
NUREG-0940 I.A-95
i 2
- 2. Station Procedure A100-SMM-3917.06, Manually Backseating Station Valves, Revision 0, in part, specifies the instructions for manually backseating station valves with limitorque operators, and states that if the valve is unable to be backseated manually due to location, radiation levels, etc., the valve may be electrically j backseated in accordance with Procedure 700.2.012 with engineering i approval. j Station Procedure 700.2.012, Electrically Backseated Station Valves, .
Revision 3, Prerequisite 3.4, requires, in part, that the Group Shift j Supervisor sign the data sheet indicating that permission has been ' granted to perform this backseating operation. Further, Precaution and Limitation 4.1, states, in part, that only valves listed in
. Attachment I of Station Procedure 700.2.012 may be backseated utilizing this procedure, and if another valve requires backseating, I Plant Engineering approval is required with regard to applicability f of the valve to this procedure.
Contrary.to the above, drring the 8:00 a.m. to 4:00 p.m. shift on September 10, 1987, Valve No. V-5-167, which was not a valve listed in Attachment I of Procedure 700.2.012, was electrically backseated without permission being obtained from Plant Engineering and without the Group Shif t Supervisor signing a data sheet granting permission to electrically backseat the valve.
- 3. Station Procedure 108, Equipment Control, Revision 38, Step 5.1.9.,
specifies, in part, that if equipment or piping is to be opened, valves and switches shall be aligned and tagged so as to insure that the work does not present a hazard to personnel or equipment from pressure, vacuum, fluids, gases, or radioactive contamination. Further, Step 5.1.15 recuires in part, that if a tag is placed on a component's power supply, a tag shall also be placed on each remote control. A tag need not necessarily be placed on the component's : manual operator if the manual operator or its ast,ociated components are not part of the safety boundary. l Contrary to the aSove, although the manual operator for RBCCW i Isclation Valve No. U-5-167 was repacked en Septerrbcr 11, r187, and I operation of this valve affects the safety bour.dary, the valve was not tagged, as required. I These violations are categorized in the aggregate as a Severity Level III pr21em. (Supplement 1; Civil Penalty - $50,000 (assessed equdly mong the violations). Pursuant to the provisions of 10 CFR 2.201, GPU Nuclear Corporation (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a NUREG-0940 1.A-96 I m~_._--m._-
f \ 3 Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps that have been taken to avoid further violations, and (5) the date when full compliance will be achieved. The NRC recognizcs that a substantial amount of material has been provided to the NRC concerning this matter, and therefore, where applicable, you may make reference to such material in your response. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of section 182 of the Act, 42 U.S.C 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to ! answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenu-ating , circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.8 of 10 CFR Part 2, Appendix C (1988) should be addressed. Ary written answer in accordance with 10 CFR 2.20E should be set forth separately L from the statement or expl.anation in reply pursuant to 10 CFR 2.201, but may 3 incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licen,ee I is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. l Upon failure to pay any civil penalty due which subsequently hat, been deter-reined in accc. dance with the applicable provisions of 10 CFR P.205, this matter may be referred to the Attorrei Jeneral, and the penalty, unless comprom' sed, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. , NUREG-0940 1.A-97
c. 4 II, The responses to;the Director, Office of Enforcement, noted above should be. , addressed to: Director, Office of Enfucement, U.S. Nuclear Regulatory
. Commission,-ATTN: Document Control Desk, Washington, DC 20555, with.a copy to- !
the Regional' Administrator, Region I, U.S. Nuclear Regulatory Commission, ! 475 Allendale~ Road, King of Prussia, Pennsylvania 19406, and a copy to the NRC . l Resident Inspector at Oyster Creek Generating Station. ; FOR THE NUCLEAR REGULATORY COMMISSION M William T. Russell Regional Administrator y
. Dated at King of Prussia, Pennsylvania this ign day of January 1989 4
l l l l NUREG-094. I.A-98 = _ _ - - _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _
i
-1 i
i I I rf UNITED STATES l h .y. y NUCLEAR REGULATORY COMMISSION [- 'bi ' f.- REGION IV
$11 RYAN PLAZA ORIVE. suite 1000
, ARUNGTON, TEXAS 70011 _
A E I 8 1988 1 l Docket No.:- f3-382 License No.: NPF-38 EA 88-144 Louisiana Power & Light Company ATTN: J. G. Dewease, Senior Vice President Nuclear Operations
/317 Baronne Street
.New Orleans, Louisiana 70160 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT 50-382/88-15) This refers to the inspection conducted by personnel of the NRC Region IV office during the period of May 12-20, 1988, of activities authorized by NRC Operating License NPF-38 for Waterford Steam Electric Station, Unit 3. The inspection included review of the events which occurred on May 12,.1988, when problems with refueling water level instruments and ensuing low reactor coolant system (RCS) water level twice resulted in the loss of the operational train of shutdown cooling. During this inspection and subsequent followup, it was determined that certain of your activities were in violation of NRC requirements. On May 27, 1988, NRC Inspection Report 50-382/88-16~was issued which provided the detai h of the inspection performed May 12-20, 1988. An enforcement conference was held with members of.your. staff in the NRC Region IV office on June 14, 1988, to discuss the issues related to these events. Violation A in the enclosed Notice of Violation and Proposed Imposition of
. Civil Penalty (NOV) involves a loss of control of reactor vessel water level on May 12, 1988, that resulted in the cavitation and subsequent loss of the operating shutdown cooling puan. The ina rucate level indication resulted from the improper installation and care of the tygon tube level instrument. It is significant that.this event occurred twice on May 12, 1983, on two separate
-operational shifts, and is repetitious of a previvor significant condition adverse te quality wisich occurred in July 1986 (reference Licensee Event
-Report 50-382/86-15). In the July 1986 event, inaccurate reactor vessel water level indication, brought about-in part by tygon tube deficiencies, resulted in
- the-vortexing, cavithtion, ar.d loss of both shutdown cooling pumps. As a result of this earlier eveat, Waterford-3 operations management should have i
CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 I.A-99
r Louisiana Power & Light Company exercised a heightened degree of awareness prior to conducting part-loop operations on May 12, 1988, to ensure that the reactor coolant drain-down procedure adequately detailed the necessary steps for correctly performing such an operation, and that plant operators were trained and briefed to properly implement this procedure. Your implementation of corrective actions taken in response to the July 1986 event was not adequate in that it did not preclude the May 12, 1988, event. This is a violation of Criterion XVI, Appendix B to 10 CFR 50. Further, your inadequate implementation of commitments in response to NRC Generic Letter 87-12, " Loss Of Residual Heat Removal (RHR) While The Reactor Coolant System (RCS) Is Partially Filled," contributed to your inability to preclude repetition of this significant condition adverse to quality. Generic Letter 87-12 was issued, in part, in response to the April 10, 1987, Diablo Canyon loss-of-RHR event to emphasize the safety significance that the NRC places on potential loss of shutdown cooling events and loss of control of reactor vessel level during part-loop operations. Violation B in the enclosed NOV involves four examples of the failure to follow Waterford-3 procedures. This failure to follow procedures resulted in your conducting part-loop operat ons on May 12, 1988, without: (a) using the refueling water level indicator system (RWLIS) and the heated junction , thermocouple (HJTC) level indicator system; (b) performing the reactor coolant drain-down procedure prerequisite of blowing down the RWLIS level detector reference legs; (c) backfilling and venting the RWLIS; and (d) detecting, upon that approximately 30 feet of excess refueling level initialinspection(RLIS)hosecontainedentrappedair. indication system Although the reactor coolant drain orocedure was deficient, enough information was available to the operators to have prevented the loss of control of reactor vessel water level and the subsequent loss of the operational SDC pump if your operations staff had properly implemented these procedures. This is a violation of Criterion V, Appendix B to 10 CFR 50, in that you failed to follow procedures developed pursuant to this requirement. i l During the enforcement conference, your staff emptasized the fact that shutdown l cooling was never actually lost on May 12, 1988, kithough the NRC staff agrees l with this conclusion, it weds to be emphasizeo that er a result of the failure ! to follow procedures on the part of the Waterford-3 staff and insufficient l corrective actions for a prev'ous event, a loss of shutdtwn cooling could have occurred just as it did 2 y.ars ago. The fact that your operators centinued to drt.in the reactor coolant system with the availcble water level instrunnts indicating significantly different reactor vessel water levels is a significant L cencorn. The NRC staff is also concerned that the ccrrective actions you proposed at the enforcement conference were shortsighted insofar as they did not appear to address the broader implications associated with the potential for a sustair.ed loss of shutdown cooling. l l To emphasize the concern with your inadequate corrective actions to preclude i repetition of a significant condition adverse to quality and your failure to establish and implement procedural requirements for significant commitments NUREG-0940 I.A-100
)
I Louisiana Power & Light Company - made to the NRC,.I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to. issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount. of Fifty Thousand Dollars ($50,000) for the violations of Statement described Polic in the enclosed Notice.- In accordance with the " General ' Appendix C (1988) y(Enforcement Policy), the violations described in thean
-enclosed Notice have been categorized in the aggregate as a Severity Level III problem. The base value of a civil penalty for a Severity Level III violation or problem is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered and no adjustment has been deemed appropriate.
You are required to respond.to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. In formalizing your corrective actions, you should address all previous commitments made to the NRC in this area and your ability to fully implement these commitments. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether more stringent enforcement action is necessary to ensure lasting corrective action in this area. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The response directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as recuired by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely, f f { g 40. d / .4 , Robert D. Martin j rtegional Administrator
Enclosure:
Apper, dix - Notice of Violation and . Proposed. Imposition of Civil Penalty ) ec w/ enclosure: (Seenextpage) l i NUREG-0940 1.A-101
L NOTICE OF VIOLATION AND PROPOSED IMPOSITIDT0F CIVIL PENALTY Louisiana Power & Light Company Docket: 50-382 Waterford Steam Electric Station Operating License: NPF-38 Unit 3 EA 88-144 During an NRC inspection conducted on May 12-20, 1988, viol >. ions of NkC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) the Nuclear Regulatory Commission proposes to. impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954,.as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. Inadequate Corrective Actions Criterion XVI of Appendix _B to 10 CFR Part 50, requires, in part, that for significant conditions adverse to quality, measures shall be established to assure that the cause of the condition is determined and corrective action is taken to preclude repetition. In July 1986, a loss of both shutdown cooling pumps occurred at Waterford-3, an event constituting a "significant condition adverse to qual i ty. The licensee's measures established to preclude repetition of this event included specific commitments made in a September 21, 1987 , I response to Generic Letter 87-12, " Loss of Residdal Heat Removal (RHR) While The Reactor Coolant System Is Partially Filled." These measures as set forth in the September 21, 1987 response, included:
- 1. During part-loop operations, operators will utilize two independent and diverse RCS level measurement systems - the heated junction thermocouple (HJTC) system and the refueling level indication ,
system (RLIS), and that the H1TC system level indication shall t,e ! ir.onitored continuously while draining, and frequently while the RCS is partielly drained. I
- 2. " . . . when the reactor vessei head is not in place (cr when 1 preparing for head removal or replacement) the RCS water level is maintained several feet abcVe the hot leg centerline. This precludes the possibility of losing SDC [ shutdown ecoling] flow due to vottexing." !
l i
- 3. "During installation, the tubing length of the RLIS was maintained to a minimum." f I
2 Contrary to the above, the licensee failed to take adequate corrective actions to preclude repetition of a significant condition adverse to quality in that, on May 12, 1988 at approximately 6:15 a.m. and again at 9:35 a.m., inaccurate reactor vessel water level indication resulted , in vortexing, cavitation, and subsequent loss of the operational shutdown (1 NUREG-0940 1.A-102
1 m )1 i I Notice of Violation : cooling; pump. These events are repetitious of the occurrence in July _1986 (reported in LER 86-15) where a series of events, including inaccurate l 1 water level indication resulting from improper installation and care of { the tygon tube instrument, resulted in vortexing, cavitation, and loss of < both shutdown cooling pumps. The licensee's measures to prevent a j recurrence of that condition, including the licensee's commitments in { 12, j response 1988 in that to.the Generic Letter 87-12, two independent were of means notlevel fullyindication implemented onan (HJTC May 'd' 1 RLIS}werenotbothusedwhendrainingduringpart-loopoperation,theRCS .{ water level was not maintained several feet above the hot leg centerline t when the reactor-vessel head was not in place, and the RLIS tubing length ) was not maintained to a minimum when installed. Therefore, the measures ! were not adequate to prevent a similar condition frcm occurring. B. Failure to Follow Procedures 1 10 CFR.50,. Appendix.8, Criterion V, requires, in part, that activities affecting quality be prescribed by documented instructions, procedures, or- < drawings. The activities shall be accomplished in accordance with these i instructions,_ procedures, or drawings. Pursuant to this requirement, Waterford 3 operating procedure OP-1-003, Revision 6, " Reactor Coolant System Drain Down," establishes, in part, the requirements for draining down the reactor coolant system (RCS) to the refueling water storage pool (RWSP):
- 1. Step 6.4.8 of Procedure OP-1-003, Revision 6, states that the plant staff will, " Perform frequent cross checks of the RWLIS, RLIS (Tygon Tubing), if in service, and the HJTC level indication on QSPDS, during RCS drain down."
- 2. Step 8.4.6 cf Attachment 8.4 of Procedure OF-1-003, Revision 6, requires the bicwdown'of wuter from the pressurizer reference leg.
- 3. Attachment 8.4 of Procedure OP-1-003, Revision 6, requires, in part, a backfill and venting of the tubing in the refueling water level indicator system (RWLIS) to ensure that air is removed from the systes.
4 Step 8.6.6.5 of Attachment 8.6 of Procedure OP-1-003, Revision 6, requires that the refueling level indicator of the refueling levt.1 indicatinn systen (RLIS) be inspected for any condition which could cause the refueling lovel indicator to give false indication. Contrary to the above, on May 12, 1988, Procedure OP-1-003, Revision 6, was not followed in that: t 1.a. During a drain-down of the RCS to the RWSP, no cross checks of reactor vessel water level were performed between the RWLIS indicators and the heated junction thermocouple (HJTC) water level NUREG-0940 1.A-103 L ___ _
' Notice of Violation indicator system indicators as required by Step 6.4.8 of
- f. ,' _
Procedure OP-1-003, Revision 6. Further, at the time of the RCS drain-down, the HJTC water level indicator system was not operable. 1.b. During a second RCS drain-down of May 12, 1988,-plant operators relied solely on r' actor vessel water level indication provided by the RLIS,-even though Step 6.4.8 of Procedure OP-1-003, Revision 6, requires that cross checks of the RLIS indications be made with the RWLIS indications.
- 2. The RWLIS level detector reference leg was apparently not blown down as required by Step 8.4.6 of Attachment _8.4 of Procedure OP-1-003, Revision 6, in that licensee personnel detected water in the reference
; 3 leg subsequent to the commencement of the RCS drain down.- The discovery of water in the RWLIS detector reference leg contributed to the licensee's decision to rely solely on the RLIS for reactor vessel water level indication.
- 3. RCS drain-down to part-loop was performed even though the RWLIS backfill and venting had r;ot been performed as required by Attachment 8.4 of Procedure OP-1-003, Revision 6. Performance of the RWLIS backfill would have removed entrapped air which can cause false water level indication. 1 4 Even though the RLIS tubing was inspected prior to and during the RCS drain down of May 12', 1988, it was not performed in accordance with Step 8.6.6.5 of Attachment 8.6 of Procedure OP-1-003, Revision 6, in that several licensee personnel, initially, failed to detect upon inspection, that approximately 30 feet of excess RLIS hose contained entrapped air and consequently caused erroneously high RLIS reactor vessel water level indication.
Collectively, these violations have been cate orized in the aggregate as a Severity Leve'l Ill problem (Supplement 1 . I Cumulative Civil Penalty - $50,000 (assessed equally between the violatior,s). ! Pursuant to the provision 3 of 10 CFR 2.201, Louisiana Power & Light Company is hereby required to submit a written statement or explanation to the Director. Office of Enforcement, U.S. Nuclear Regulatory Comminicn. within 30 days of the date of this Notice. This reply should be clear'y n.arked as a " Reply to a Notice of Violation" and should include for eacn alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved (4) the corrective steps that will be taken to avoid further violations,'and(5)thedatewhenfullcompliancewillbeachieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause wny the license should not be modified, suspended, or revoked or why such other action as may be proper should not be NUREG-0940 I.A-104 i
Notice of Violation ta ken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Jomission, with a check, draf t, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty in whole or in part, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to *he other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, end the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office af Enforcement, noted above (Reply to a l Notice of Violation, letter with payment of civil penalty, 6nd answer to a l Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, l D.C. 20555 with a copy to the Regional Administrator, ').5, Nuclear Regulatory Comission, Region IV, and a copy to the NRC Resident Inspector, at the Water-ferd 3 Steam Electric Station. FOR Th NUCLEAR REGULATORY COMMISSION f f/3ku l Robert D. Martin Regional Administrator Dated at Arlington, Texas, this ay of August 1988. NUREG-0940 1.A-105
.; 'g ; UNITED STATES -
1- n- . NUCLEAR REGULATORY COMMISSION 2 e wAsHWGTON, D. C. 20666 JAN43 m Docket No. 50-382 License No. NPF-38 EA No. 88-144 l -Louisiana Power & Light Company ATTN: J.'G. Dewease, Senior Vice President Nuclear.0perations
'317~Baronne Street New Orleans,. Louisiana 70160 Gentlemen:-
SUBJECT:
ORDER IMPOSING. CIVIL MONETARY PENALTY l This. is in reference.to your letter dated October 14, 1988 that was in response to the Notice of Violation and Proposed Imposition of Civil Penalty sent to you on August- 18,.1988.. Our letter and Notice described two violations of- NRC - requirements. identified during an NRC inspection' conducted in May 1988. Violation A in the Notice involved LP&L's failure to take adequate corrective action following a July 1986 event in.which shutdown cooling capabi11ty at Waterford 3 was. temporarily lost, in that your corrective ' actions were not
. adequate to prevent a May 12, 1988 event in which a similar set of circumstances ?ed to a near loss of: shutdown cooling capability at the plant.
L Violation B in the Notice involved several procedural violations that were ! related to the.May 12, 1988 event. To emphasize' the significance.of taking
-adequate corrective actions'and adhering to procedures, NRC proposed a $50,000 moneterf. civil renalty for these violations.
1 In your October 14 response, you denied Violation A, claiming that the May 12 i evetit was not a repetition of the July 1986 event and therefore was not a ! vMiation of Criterion .XVI, Appendix B tc 10 CFR 50. You admitted Violation B ;
- l. but disputed statements made in that part of the Notice. Finally,, you l requested that the proposed civil pnnalty be rescinded. NRC's detailea ,
evaluttion of your response and our conclusions are contained in the Appendix- i to tu enclosed Order. For the reasons that are explained in the Appendly NRL I has concluded nt' at the violatior,s did occur as stated and that the civil L.. per,alty h appropriate ar.d steuld be imposed. l NRC does recognize that LP&L assumed a leadership role in developing meaningful l responses to Generic Letter 87-12 and in response to the July 1986 event. It should be noted however, that the NRC was not fully satisfied with the quality
'of the responses received from licensees and therefore follcwed up that letter with Generic Letter 88-17. Nevertheless, in evaluating the May 1988 event and
! -your response to the Notice of Violation, be gave close scrutiny to the imple-mentat1on of the corrective ecticos that you had develuped in respnnse to Generic
-Letter 87-12 and have concluded that not ali of the programmatic 1 improvements discussed it,your response t< Ceneric Le.ter 67 *.2 .ere orcperly impler ented.
Had sutn improvements teen iro b ented, 9 e 'lNiit M vf losing ccntrcl of NUREG-0940 I.A-106
- _ _ _ _ _ _ _ _ _a
i I Louisiana Power & Light Company ' reactor vessel water level and the subsequent cavitation of the operating siiut-down cooling pump on May 12, 1988 would have been greatly reduced. In general, we believe that your deniel of Violation A is based on a relatively narrow view of the causes and corrective actions associated with the July 1986 l event. A broader view includes consideration of the facts that, in both the July 1986 and May 1988 events, (1) a loss of reactor vessel water level control occurred, (2) shutdown cooling capability was temporarily lost or interrupted (although for a significantly greater period of time in 1986), and (3) a com- 1 bination of operator error, procedural inadequacies and insufficient training were contributing factors. Accordingly, we serve the enclosed Order on Louisiana Power & Light Company imposing a civil monetary penalty in the amount of Fifty Thousand Dollars ($50,000). f We wish to address another point made in your response to the NRC. Your October 14 letter indicated that LP&L valued its " continued good relationship with the NRC" and considered that "a broad admission to the particulars of the NOV may go some ways to furthering that relationship." To the contrary, NRC does not expect a licensee to admit to the particulars of a violation to further its relationship with NRC. The NRC intends, and moreover has an obligation, to be accurate in its enforcement actions and we expect a licensee to challenpr us when it is perceived that we have acted in error. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosures will be placed in the NRC's Public Document Room. Sincerely,
/ l_-
[ J mes H. Tay ; eputy Executive Director j for Regional Operations 1 1 Enclosures; i As Stated cc: Louisiana Radiation Control Program Director l 4 NUREG-0940 I.A-107
g7m7 ,# A f f z
. . UNITED STATES NUCLEAR REGULATORY C0f1 MISSION t
In the Matter of ) F ' LOUISIANA POWER &: LIGHT COMPANY. ) Docket No. 50-382 Waterford Steam Electric Station;. Unit 3 License No. NPF-38:' ' {
.- EA 88-144
+
+3 ORDER IMPOSING CIVIL MONETARY PENALTY 1
I.
~~ q l'
et Louisiana Power & Light Co. (licensee) is the holder of Operating License Noi s c .. , NPF-38 issued by the Nuclear Regulatory Commission (NRC/ Commission) on-
.tv ..: . . .,
?
; March 16, 1985. .The license authorizes'the licensee to operate the Waterford
. Steam Electric Station, Unit 3 in accordance with'the conditions specified' j 1
tharein.
.c gg i,
LA'special inspection of the licensee's activities was conducted during May.12-20, 1988.- The results cf this inspection indicated that the licensee had not conducted its activities in full compliance with NRC requirements. A written Notice of Violation and Proposed Impositicr of Civil Peralty was. served upon the licensee by letter dated August 18, 1988. The Notice stated the nature of the violations, the provisions of the NRC's requirements that the licensee had violated, and the amount of the civil penalty proposed for the
. violations. The licensee responded to the Notice of Violation and Proposed Imposition of Civil Penalty by letter dated October 14, 1988. In that response the licensee denied Violat. ion A, admitted Violation 8 but disputed two statements ni the 'violatien, and requested a withcrawal of the proposed civil penalty.
NUREG-0940 1.A-108
< l h,
a , III j I l After consideration of the licensee's response and the statements of fact, explanation, and arguments for mitigation. contained therein, the Deputy Executive' Director for Regional Operations has determined as set forth in the Appendix to this Order that the violations occurred as stated and that the penalty proposed for the violations designated in the Notice of Violation and , P.roposed ' Imposition of Civil Penalty should be imposed. 3 I l IV In view'of the foregoing and pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT'IS HEREBY ORDERED THAT: 1 The licensee pay a civil penalty in the amount Jf Fifty Thousand Dollars ($50,000) within 30 days of' the- date of this Order, by check, draft, or money order, payable to the Treasurer of the United States and mailed to , the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission, ATTN:' Document Control Desk Washington, D.C. 205S5. The licensee raay request a hearing within 30 days of the date of this Order. A E request for a hearing should be clearly marked as a " Request for an Enforcement i llearing" and shall be addressed to the Director, Office of Enforcerrent, U.S. NUREG-0940 I.A-109 l L l L :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
f j. -] Ji;: ( l
. Nuclear Regulatory Comission, ATTN: Document Control Desk, Washington, D.C. i l
'20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Comission, Region IV, and a copy to the NRC Resident Inspector at Waterford 3. l a q l
- )
If a hearing is requested, the Comission will issue an Order designating the J time ~and place of the hearing. If the licensee fails to request a hearing i J within 30 days of the date of this Order, the provisions of this Order shall be l l effective without further proceedings. If payment has not been made by that " time, the matter may be referred to the Attorney General for collection. l
'In the' event the licensee requests a hearing as provided above, the issues to I
be considered at such hearing shall be:
-(a) whether the licensee was in violation of the Comission's requirements as set forth in the Notice of Violation and Proposed Imposition of Civil Penalty referenced in Section II above and (b) whether, on the basis of such violations, this Order should be sustained.
FOR THE NUCLEAR REGULATORY COMMISSION
/
e f
/JamsM. Taylor [
/ D uty Executive Director p or Regional Operations Dated at Rcckville, Maryland, this 3rd coy of Ja nua r.'/ 1 C 39 NUREG-0940 I.A-110
APPENDIX ; i EVALUATIONS AND CONCLUSIONS On August 18, 1988, a Notice of Violation and Proposed Imposition of Civil Penalty (Notice) was issued for violations identified during an NRC inspection ir May 1988. . Louisiana Power and Light Company. responded to the Notice on October 14, 1988. The licensee denied Violation A, admitted Violation B but disputed two statements in the violation, and requested a withdrawal of the proposed civil penalty. The NRC's evaluation and conclusions regarding the licensee's arguments are as follows: Restatement of Violation A Violation A A. Inadequate Corrective Actions Criterion XVI of Appendix B to 10 CFR Part 50, requires, in part, that for significant conditions adverse to quality, measures shall be established to assure that the cause of the condition is determined and corrective action is taken to preclude repetition. In July 1986, a loss of both shutdown cooling pumps occurred at Waterford 3, an event constituting a "significant condition adverse to quality." The licensee's measures established to preclude repetition of this_ event response to included specific Generic Letter commitments 87-12, made inHeat
" Loss of Residuai a September 21,1987)
Removal (RHR While the Reactor Coolant System is Partially Filled." These measures as set forth in the September 21, 1987, response, included:
- 1. During part-loop operations, operators will utilize two independent and diverse RCS level measurnent systems - the heated junction thermocouple (HJTC) system and the refueling level indication system (RLIS), and that the HJTC system level indication shall be monitored continuously while draining, and frequently while the RCS l 1s partially drained.
- 2. "
. . . when the reactor vessel head is not in place (or when preparing for head removal or replacement) the RCS water level is maintained several feet above the hot leg centerline. This precludes the possibility of losing SDC [ shutdown cooling] ficw due to vortexing."
- 3. "During installation, the tubing length of the RLIS was maintained to a minimum."
Contrary to the above, the licensee failed to take adequate corrective actions to preclude repetition of a significant condition adverse to l quality in that, on May 12, 1988, at approximately 6:15 a.m. and again at 9:35 a.m., inaccurate reactor vessel water level indication resulted in vortexing, cavitation, and subsequent loss of the operational shutdown , cooling pump. These events are repetitious of tLe cccurrence in July 1980 l NUREG-0940 1.A-111 i _ __ - -_ _ A
Appendix (reported in LER 86-15) where a series of events, ir.cluding inaccurate water level indication resulting from improper installation and rare of the tygon tube instrument, resulted in vortexing, cavitation, and los.s of both shutdown cooling pumps. The licensee's measures to prevent a recurrence of that condition, including the licensee's commitments in response to Generic Letter 87-12, were not fully implemented on May 12, 1988, in that the two independent means of level indication (HJTC and RLIS) were not ooth used when draining during part-loop operation, the RCS water level was not maintained several feet above the hot leg centerline when the reactor vessel head was not in place, ano the RLIS tubing length was not maintained to a minimum when installed. Therefore, the measures were not adequate to prevent a similar condition from occurring. Sumary of Licensee's Response to Violation A The licensee contests Violation A, as written, on the basis of the following arguments:
- 1. The May 1988 event is not a repetition of the July 1986 event.
- 2. Commitments made by Waterford 3 in response to Generic letter 87-12 are not a continuation of the corrective action for the July 1986 event.
- 3. The Generic Letter 87-12 commitments cited in Violation A were not commitments made by LP&L to the NRC.
The summary details of these three arguments are presented in the following
/ paragraphs.
A. The May 1988 event is not a repetition of the July 1986 event. The licensee agrees with the NRC that the July 1986 extended loss of shutdown cooling event constituted a significant condition adverse to quality. In that event, two separate drain paths were being used to lower RCS level. Because the drain down rate was too high, the resulting vacuum in the RCS collapsed the RLIS tygon tube causing an inaccurate level indication (actual level was lower than indicated). Recognizing a problem with the level measurement, operators isolated one of the drain paths, overlooking the other. Operators began venting the RCS, and upon completion of the venting process, the RLIS indicated level fell to 9 feet (well below the not leg). Since past local level indicators were suspect, f and since the B LPSI pump was operating satisfactorily, operations personnel felt the RLIS indication of 9 feet was inaccurate. Shutcown { cooling was lost when the operating shutdown couling pump began to l cavitate dee to loss of pump suction because of the continued draindown ] l from the other drain path. Shutdown cooling was lost for approximately 220 minutes (RCS hot leg temperature increased from 138 F to 232 F). By contrast, LP&L characterizes the liay 1988 event as brief cavitation of a low pressure safety injection (LPSI) pump which did not result in a lost of shutdcun coolirg cue to correct orcrotor atticos and procedures. Thc NUREG-0940 I.A-112
i 1 Appendix 1 licensee does acknowledge that certain design control and procedural l l implementation errors associated with the installation and operation of : the newly installed RWLIS did occur. The licensee summarizes these errors l as: (1) the failure to recognize the significance of RLIS design changes 1 which allowed excess RLIS tubing and subsequent air entrainment; and (2) the failure to coordinate procedure changes (RCS drain down) with construction completion to ensure RWLIS/RLIS were properly placed in service. Because the July 1986 event resulted in an extended loss of shutdown cooling and the May 1988 event resulted in only LPSI pump cavitations, the licensee argues that the May 1988 event was not a repetition of the July 1986 event. LP&L argues that similarity of events does not constitute repetition. B. Commitments made in response to Generic Letter 87-12 are not a continuation of corrective action for the July 1986 event. The licensee argues that the corrective actions for the July 1986 event stand on their own, and that " commitments to Genu ic Letter 87-12 are immaterial beccuse such commitments are not a continuation of corrective action from the July, 1986 event." C. LP&L did not make, and fail to implement, the commitments as cited in the NOV. LP&L argues that the three Generic Letter 87-12 response statements cited in Violation A were not commitments. LP&L states that the Generic Letter 87-12 response was not intended to provide exhaustive detail for procedural steps, nor discuss all potential situations to which procedures could apply. As a result, LP&L states that there was never the intent or belief that a summary description could logically constitute a commitment. , i With respect to the first response statement cited in Violation A, the licensee maintains that the company's Generic Letter 87-12 response generally , summarizes some elements of app?icable Waterford 3 procedures that existed at the time its response was written. However, it could not be construed ) as a commitment because to do so would preclude the licensee from ever using the improved RWLIS system. Additionally, LP&L states that because the Generic Letter 87-12 response statement, that the HJTC system shall be continuously monitored while draining and frequently while the RCS is l partially drained, ft only a summary description of then extant procedures, it does not cover all possible instances of applicability (i.e., there could be instances in which the HJTC xx ld not be available for use during i part-loop operations). l LP&L asserts that a similar argument can be made for the second Generic Letter 87-12 response statement cited in Violation A that the water level will be maintained above the hot leg centerline. NUREG-0940 I.A-113 l T
Appendix For the third response statement cited in Violation A, LP&L agrees that a deficiency existed in not identifying the excess RLIS tube as a potential cause of inaccurate level measurement. However, the licensee believes that this deficiency is adequately covered as a procedure violation in Violation B. NRC Evaluation of Licensee's Response to Violation A A. The NRC staff disagrees with the licensee's fundamental assertion that the dissimilarities between the 1986 and 1988 events preclude characterizing the 1988 events as a repetition of the 1986 event. The licensee appears to be focusing narrowly on the specific circumstances of each and, by doing so is overlooking the important elements that are common to each. The staff's evaluation of both the May 1988 event and the licensee's response to , Violation A reveals that the May 1988 event was sufficiently repetitious of the most important elements of the July 1986 event. In both events, a loss of reactor vessel level control resulted in LPSI pump cavitation due l to vortexing. The only difference was in the manner in which level 4 control was lost. Although level control was lost by different means, operator error, inadequate procedures, and lack of sufficient training 4 contributed to the loss of level control in both instances. 1 1 In response to Violation A LP&L notes that following the cavitation of l the A LPSI pump during the Hay 1988 event, the B LPSI pump was vented and l started with no problems occurring. LP&L fails to indicate, however, that prior to starting the B LPSI pump, RCS level was restored to above the s common suction point for both the A and B LPSI pumps by using the A high ) pressure safety injection (HPSI) pump. During the 20 minutes that i transpired between stopping the A LPSI pump, restoring level with the A HPSI pump, and starting the B LPSI pump, RCS level was low enough that cavitation of the B LPSI pump could have been expected to have occurred if the operators had attempted to start the B LPSI pump prior to restoring i RCS level with the A HPSI pump. The NRC staff acknowledges that prompt operator action to start the A HPSI l pump to restore level prevented a sustained loss of shutdown cooling. l This procedural geidence to restore level witn en HPSI pump was developed l as a result of both the July 1986 event and Generic Letter 87-12. However, I the NRC staff's concern is that a sustained loss of shutdown cooling w6s avoided, not because adequate preventive measures had been developed and i were taken, but rather because sufficient mitigative measures were taken. i The NRC staff concludes that had LP&L developed and properly implemented ! adequate preventive measures such as establishment and verification of adequate level indication, the licensee would not have had to rely on operators properly implementing actions for an off-normal event. Had the May 1988 event actually resulted in a sustained loss of shutdown cooling , for a similar duration as the July 1986 event, NRC staff would have considered l this a more serious violation and an increase in the Severity Level of the violaticn would have been appropriate. NUREG-0940 I.A-114
Appendix B. The NRC staff notes that the only elem2nt of proof necessary to establish a violation under Criteria XVI of Appendix B to 10 CFR part 50 is to demonstrate that adequate corrective action has not been taken to preclude repetition of earlier known conditions adverse to quality. A violation for the May 1988 event was thus established by the fact that this event occurred following the July 1986 event which has previously been shown to be similar. In the instant matter, the NRC staff went even further than was necessary and also demonstrated that the licensee had not complied with the corrective actions listed in its response to Generic Letter 87-12 which the NRC staff concluded were in part taken to remedy causes of the July 1986 event. The NRC staff disagrees with the licensee's conclusions that the corrective actions for the July 1986 event stand on their own and that the response to Generic Letter 87-12 is independent of the July 1986 event corrective dCtions. The intent of the July 1986 corrective action was to preclude a ; loss of shutdown cooling capability during part-loop operations. Actions i resulting from Generic Letter 87-12 had the same purpose. Since the licensee's Generic Letter 87-12 task force concluded among other things, that improve-ments to procedures were needed to further reduce the chances of experiencing another sustained loss of shutdown cooling event, it must be concluded that the licensee understood that the July 1986 event corrective actions were not sufficient in scope to accomplish this. A review of the licensee's response to Generic Letter 87-12 reinforces this conclusion. As noted in LP&L's response, ". . . the scope of the [ Generic Letter 87-12] task force review encompassed not only Generic Letter 87-12, but also previous NRC and industry critiques of applicable loss of shutdown cooling events including the July 1986 loss of shutdown cooling event at Waterford 3. Althou reviews of such events had been conducted (improvements implemented)gh at Waterford 3 on a case-by-case basis in the past, the task force felt there was a benefit in performing a comprehensive review to integrate the previous elforts." The NRC staff therefore finds that enhancements to the licensee's Procedure OP-1-003, " Reactor Coolant System Drain Down," were required as part of the corrective actions resulting from the July 1986 event. Further revisions to this same procedure were required following the licensee's task force review of Generic Letter 87-12 in order to further reduce the likelihood of experiencing future sustained losses of shutdown cooling capability with the RCS partially drafned. The licensee's July 1986 event corrective actions were only :;ufficient enough to preclude loss of RCS level control under virtually the same conditions that occurred ir. July 1986. The Genetic Letter 87-12 corrective actions were intended to more broadly address the effects and importance of RCS level control during part-loop operations.. On this basis, the NRC staff concludes that the programmatic improvements described in Generic Letter 87-12 were a continuation of the corrective actions that occurred following the July 1986 sustained loss of shutdcwn ecoling event at Waterford 3. C. LPal argues that the first Cereric Letter 87-12 response statement cited in Violation A should not be ccnstrued as a cerrnitment because if it were interpreted literally, the licensee could never renduct part-loop cperations with an irrrrrwed reactor vessel water level inalcatina system (i.e., the PWLIS) tecause cross cheds of level v euld alwap beve to be tenducteu Ly comparirg 'he RLIS dr.d the HJTC syt wn. The ,%C :,tof f agreet NUREG-0940 I.A-115
)
-5 i
( f ,
""a _ Appendix- 6-y ,
withitheilicensee that a Generic-Letter response is not meant to provide a detailed explanation of the licensee actions in response to a particular issue but rather is meant to provide a sumary description of the actions.
. Such a< sumary would:in turn provide the.NRC staff with an appreciation of-L the licensee's approach tc a perticular problem. In'this case a. reasonable reading of the' licensee's response to Generic Letter 87-12:is that the licensee. intended to. require:that two independent methods-of level indication be utilized when conducting part-loop operations. The individual. methods of indication!to be used can be changed at the licensee's discretion. If
- however, the licensee subsequently modifies its procedures to no longer require two . independent: level indications, it;is expected that the NRC '
staff would be made aware of such a fundamental change. The licensee's-reasoning fails to consider the key element of the programmatic enhancement-that the NRC staff. believed the licensee intended to implement, i.e., that two. independent and diverse level measurement systems would always be used by the operators., The licensee's new RWLIS is not. independent of the previously. existing RLIS because the RLIS level sensing piping taps into )
-the RWLIS level sensing piping - Since the RWLIS and RLIS are not independent-of each other,'either system would have to be used independently of the HJTC system (the only. remaining level indicating system) in order to
- . conduct part-loop operations with two independent level indicating systems.
~Notwithstanding-the< licensee's contention that a prerequisite to the governing-
?Draindown)procedurei(Procedure OP-1-003, permits part-loop operations withoutRev. 6 Reactor the HJTC Coolant system.in Systes service, Step 6.4.8.of the same procedure clearly incorporates this progransnatic I
improvement. LP&LLfurther contends that the first response statement to Generic Letter
~87-12 cited in Violation A is composed of sumary statements of then extant procedures that did not cover all possible instances of applicability.
Specifically, the licensee cites a-passage in Section 6.2.1 of their response that states ". . . the HJTC system is available as a reliable cross check for other RCS level indications when the reactor head is in place." The NRC' staff agrees that there is no specific language in LP&L's response that comits to not performing part-loop operations when the HJTC system is not Loperable. However,_it is the NRC staff's understanding that the second response statement cited in Violation A was' intended to preclude the conduct of part-loop operations with the vessel head not in place. Since LP8L cpparently intended to have the HJTC system in service when the reactor vessel head is in place, the first two response statements, when taken 4 togethec, appear to preclude part-locp operations when tne HJTC system'is ! inoperable. However, notwithstanding the Interpretation of these Generic d Letter.87-12 response statements, it is the NRC staff's conclusion that . LP&L had intend 9d not to conduct part-lcop operations under any circumstances ; without two independent and diverse means of reactor vessel water level '
. indication available.
The. implication.in the licensec's discussion of the second response statement was that there could be conditions in which the reactor vessel head may not be in place while at the same time the reactor vessel water level may be drained down to a level at or near that of the hot leg centerline. LP&L provided rc examples, bewever, of such possible conditions. In reading Section 6.2.2, " Temperature," of the licensee's ' response to Generic Letter 87-12, there dces not appear to be a basis to NUREG-0940 I.A-116
Appendix infe. that there could be any plausible exception for not maintaining l reactor vessel water level several feet above the hot leg centerline when J the reactor vessel head is not in place. In Section 6.2.2, the licensee discussed the importance of temperature indication in determining the a)proech to boiling and the need for determining when the containment saould be isolated. The licensee stated in Sections 6.2.2 and 5.2.2 that when the vessel head is in place (except when preparing for head removal or installation) at least two core exit thermocouple (CETs) would be available for temperature indication. It is in this context that LP&L noted that reactor vessel water level would be maintained several feet above the hot leg centerline when CET information is not available (i.e., when the vessel head is not in place). The NRC staff strongly agrees with the sound reasoning of this position and could find no prudent reason for i deviating from it. The NRC staff concludes that had the licensee revised l OP-1-003, " Reactor Coolant System Drain Down," to include this programmatic l enhancement as a precaution or limitation to the procedure, and correctly j implemented such procedural guidance on May 12, 1988, the event would not ! have occurred because plant initial conditions would not have been set. With respect to the third response statement specified in Violation A, the NRC staff agrees that the RLIS length "was maintained to a minimum" at the time of the response to Generic Letter 87-12. However, as a result of the subsequent RLIS modification necessitated by the installation of the new RWLIS, RLIS tubing was not maintained to a minimum. The NRC staff's concern in this instance is that while the licensee recognized the importance of minimizing tubing length when responding to the Generic Letter, that concern was not applied to a later situation where it was equally applicable. Had that been done, proper indication may have been available evt though the backfill and walkdown procedures described in Violation B were not performed. R statement of Violation B Violation B B. Failure to follow Procedures 10 CFR 50, Appendix B, Criterion Y, requires, in part, that activities affecting quality be prescribed by documented instructions, procedures, or drauirgs. The activities shall be accomplished in accore nce vith these instructions, procedures, or drawings. Pursuant to this requirement, Waterford 3 Operating Procedure OP-1-003, Revision 6, " Reactor Coolant System Drain Down," establishes, in part, the requirements for draining down the reactor coolant system (RCS) to the refuelingwaterstoragepool(RWSP): I 1. Step 6.4.8 of Procedure OP-1-003, Revision 6, states that the plant ! staff will, " Perform frequent cross checks of the RMLIS, RLIS (Tygon j Tubing), if in service, ano the HJTC level indication on QSPDS, ; j during RCS druin down."
- 2. Step 8.4.6 of Attudrent 8.4 of frecedure OP-1-003, Pcvision 6, requires the blowdcwn of water from the pressurizer reference leg.
NUREG-0940 1.A-117
Appendix 3. Attachment 8.4 of Procedure OP-1-003, Revision 6, requires in part, a backfill and venting of the tubing in the refueling water level indicator system (RWLIS) to ensure that air is removed from the system.
- 4. Step 8.6.6.5 of Attachment 8.6 of Procedure OP-1-003, Revision 6, requires that the refueling level indicator of the refueling level indication system (RLIS) be inspected for any condition which could cause the refueling level indicator to give false indication.
Contrary to the above, on May 12, 1988, Procedure OP-1-003, Revision 6, was not followed in that: 1.a. During a drain-down of the RCS to the RWSP, no cross checks of reactor vessel water level were performed between the RWLIS indicators and the heated junction thermocouple (HJTC) water level indicator system indicators as required by Step 6.4.8 of Procedure OP-1-003, Revision 6. Further, at the time of the RCS drain-down, the HJTC water level indicator system was not operable. 1.b. During a second RCS drain-down of May 12, 1988, plant operators relied solely on reactor vessel water level indication provided by the RLIS, even though Step 6.4.8 of Procedure OP-1-003, Revision 6, requires that cross checks of the RLIS indications be made with the RWLIS indications.
- 2. The RWLIS level detector reference leg was apparently not blown down as required by Step 8.4.6 of Attachment 8.4 of Procedure OP-1-003, Revision 6, in that licensee personnel detected water in the reference leg subsequent to the commencement of the RCS drain down.
The discovery of water in the RWLIS detector reference leg contributed to the licensee's decision to rely so bly on the RLIS for reactor vessel water level indication.
- 3. RCS drain-down to part-loop was performed even though the RWLIS backfill and venting had not been performed as required by Attachment 8.4 of Procedure OP-1-003, Revision 6. Performance of the R'LIS w backfill would hcVe removed entrapped air which can cause false water level indication.
- 4. Even though the RLIS tubing was inspected prior to and during the RCS i drain-down of Maf 12, lo88, it was not performed in accordance with :
Step 8.6.6.5 cf Attachntent 8,6 of Procedure OP-1-003, Revision 6, in I that several licensee personnel, initially, failed to detect upon inspection, that approximately 30 feet of exces:: RLI5 hose contained entrapped air and consequently causec erroneously high RLIS reactor ; vessei water level indication. I Summary of Lic?nsee's Response to Violation B The licensee admits to Violation 8, but takes issue with two of the violation statements. The licensee rotes that r.o cross cherb of the RLIS er PWLIS with the HJTC system dre required because Prerequisite 3.2 cf OP-1-003, Fevision 6, states that "QSPCS hJ1C level ir.dications . . . are in st.rvice when the reactor NUREG-0940 1.A-118 l
Appendix ! vessel head is in place, except when preparing for head removal or replacement." The licensee was in the process of installing the reactor vessel head while conducting part-loop operations thereby obviating the need for i having the HJTC system in service.
'The licensee denies that the operators relied solely on RLIS indications during the second drain down. LP&L states that the second drain down was halted due to discrepancies between the RWLIS and the RLIS noted by operator cross checks.
1 I NRC Evaluation of Licensee's Response to Violation B The NRC staff agrees that Prerequisite 3.3 as currently stated in OP-1-003, Revision 6. " Reactor Coolant System Drain Down," allows entry into the procedure without an operable HJTC system when the reactor vessel head is not in place. The existence of this prerequisite is not by itself inappropriate provided that before drain down commences a second level indicator is operable. However, its existence without a later procedural step to place the system in operation is inappropriate for two reasons. First, the licensee's Generic Letter 87-12 programmatic improvement was intended to preclude draining down to the RCS hot leg centerline when the reactor vessel head is not in place. Second, step 6.4.8 of OP-1-003 Revision 6 could not have been implemented, as stated, on May 12, 1988 with the HJTC inoperable. The procedure at issue is subject to two inter-pretations. First, accepting that the prerequisite does not require HJTC to be operable when the head is being removed or installed because of the need to disconnect-the HJTC, the procedure must presume it is operable prior to drain down in order to accomplish step 6.4.8. Under this reading the procedure was not followed in that the HJTC was not used in accordance with step 6.4.8. Alternatively, notwithstanding the prerequisite allowing HJTC to be out of service, the procedure can be considered inadequate because it is internally inconsistent with the requirement to use the HJTC. In either case, the procedure is not sufficiently clear for acceptable use. However, the staff, in finding the violation, utilized the first reading because it gives full credit to each step and is consistent with the response to the Generic Letter. The NRC staff agrees that during the drain down that comenced at 9:13 a.m. on May 12, 1988, disparities between the RLIS ar.d RWLIS level indicators led Waterford 3 operators to again stop the drain down of the P.CS. However, in the NRC staff's review of this event, that drain down was considered the third of three reriods of draining that occurred, with the first drain down connencing at approxinutely 3:09 a.m. on May 12 and, as discussed below, the second commencing at approximately 5:14 a.m. The Waterford 3 Independent Safety Evaluation Group (ISEG) noted in the Draft Assessment Report lil-BB that uoon recommencing drain down at 5:14 a.m. on May 12, operators decidad to use only the RLIS to continue the drdn down that had sti.rted eariter that morning. As stated in the report, the crerators were reluctant to rely on level indications from tne RWLIS system since it had Int been recalibrsted after having found l water in the reference leg. Finding water in the reference leg resulted in confusion over whether the instruments had been calibreted with the reference lec wet or dry. The RWLIS reference leg was not blokn dcwn as requ1 rod by procedure, ar.d it appeart that discovery of water in the reference leg ard the resulting confusion (crtributed to the cwrse of events that led to the cavitaticn or the operable SDC pump. For these reasers the staff cercludes tbt for the second drain down only the RLIS level indicator was L&d. NUREG-0940 I.A-119
Appendix Summary of Licensee's Request for Reclassification of NOV Severity Level and Withdrawal of Civil Penalty The licensee argues that the May 12 event conditions do not meet the threshold for a Severity Level III violation because a loss cf a required safety system never occurred. They agree that the procedural violations noted in Violation B clearly occurred and led to LPSI pump cavitations. However, LP&L argues that the results of these procedural violations are consistent with a Severity Level IV classification, i.e., failure to meet regulatory requirements that have more than minor safety or environmental significance. Consequently..LP&L requests that the NOV be reassigned as a Severity Level IV violation and the Civil Penalty be rescinded as not generally applicable to a Severity Level IV violation. NRC Response to Licensee's Request for Reclassification of NOV Severity Level Since the NRC staff does not agree with the licensee's denial of Violation A for reasons that have been previously stated in this Appendix, and since the licensee has made a qualified admission of Violation B, which the NRC staff has also previously addressed, it is concluded the violations occurred as stated. As indicated in Generic Letter 87-12 and recently reiterated in Generic Letter 88-17 the NRC staff concerns regarding the issue of decay heat removal in a pressurized water reactor with reduced reactor coolant system inventory have increased over the past several years. The articulation of those concerns in the above mentioned documents as well as in other issuances by the NRC staff make it clear that not only are such problems of more than minor concern but when it is considered that the violations in this case involved many of the factors involved in a past event, they are of significant concern and therefore properly classified at Severity Level III. NRC Conclusion The NRC staff corscludes that the violations described in the August 18 Notice of Violation and Proposed Imposition of Civil Penalty occurred as stated. Accordingly, the proposed civil penalty in the amount of Fifty Thousand Dollars ($50,000) should be impossd. 4 I l NUREG-0940 1.A-120 _ _ _- - - - - - - - _ _- -- - - - - _ - - --- - --------- _ - - - - - - - - - - ---------_-------_-----J
- 1 O 4; l
i l u
.[W b
**o?g\ UNITED STATES I E NUCLEAR REQULATORY COMPAISSION REGION I .I 475 ALLENDALE ROAD !
g k**** / ; . KING OF PRUSSIA. PENNSYLVANIA 1940a February 13, 1989 Docket'No. 50-309
~'
License No. DPR-36. EA-88-295-
- Maine Yankee Atomic Power Company ATTN: Mr. C. D. Frizzle President.
^
83 Edison Drive-
~ Augusta, Maine ;04336 Gentlemen:
Subject:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL' PENALTIES
'(NRC Inspection No. 50-309/88-20)
This refers to the NRC physical security inspection conducted on November 14-18, 1988,. at.the Maine Yankee Atomic Power Station, Wiscassett, Maine. The intrection was conducted to review the. circumstances associated with (1)' a violation. identifietl by your staff .and reported to the NRC involving
. inadequate control.of a ring of-security and vital area Leys; and (2) another security violation identified by the NRC during a maintenance team inspection between October 3 and. November 10, 1988. During the inspection, the report of which was sent to you on' December 8,,1988, additional violations of NRC physical security requirements were identified. On December 20,-1988, an enforcement conference was conducted with Mr. J. Randazza, former President, and other
. members of the Maine Yankee staff to discuss the violations, their causes'and you- corrSctive actions.
The violations, which are described in the enclosed Notice of Violation and
-Froposed Imposition of Civil Penalties, include the failures to: (1)' implement Mrtain requirements for positive control.of the ring of security and vital
.rea keys which was assigned to the Operations Department (resulting in temporary loss of the keys), as well as the failure to implement immediate compensatory zmeasures and notify the NRC Operations Center promptly when the ring of keys was I recognized as missing; (2) maintain adequate lighting in certain portions of the protected area; (3) maintain proper control, on two occasions, of vehicles unattended within the protected area with keys in the ignition; (4) maintain an open observable area in a portion of the isolation zone; and (5) adequately conduct searches of personnel and packages entering the protected area on several ,
occasions. 1 The violation involving the missing ring of keys is of particular concern to the NRC because it involved numerous errors by operations supervision, as well as contractor and licensee security supervision. Further, the violation ; demonstrates serious procedural deficiencies. The violation occurred when the Assistant Operations Manager, a n er using one of the keys to enter a high radiation area, did not return the key to its original.Storege location, as required. Rather, he left the key in his protective clothing which was
- l. subsequently'sent to an offsite laundry facility. Although your procedures NUREG-0940 I.A-121 l
u________:_ _
g n Maine Yankee Atomic Power Company 2 I3 39 required that such keys assigned to security personnel be accounted for each shift, your procedures only required keys assigned to the Operations Department be accounted for on a weekly basis (rather' than each shift as . required by your NRC approved Physical Security Plan). Accordingly, the ring of keys was not recognized as missing for approximately 39 hours. When the ring of keys was eventually recognized as missing by the Plant Shift Supervisor, he did not inform security personnel (Centractor Security Shift Supervisor) until approximately 6 nours later. Furthermore, when the Licensee Security Supervisor was informed, he did not initiate appropriate compensatory measures until . approximately 18 hours later, and then, only after consulting with the Security l Director. In addition, although the event should have been reported to the NRC ! Operations Center within an hour of initial discovery, it was not reported until j approximately 3 hours after the Security Director became aware of the event. ' The other violations, which are set forth in Section II of the enclosed Notice, are also.of concern to the NRC because they either involve multiple examples or are repetitive in nature. For example, several packages and several personnel were observed by the NRC entering the protective area without adequate searches. In addition, the failure to provide adequate lighting as well as the failure to maintain an isolation zone in certain portions of the protected trea, had been identified by the NRC during previous inspections conducted in January 1987 and' October 1988. However, actions taken at those times were not effective in either identifying the exterit of the problem or preventing recurrence of additional violations. The NRC recognizes that you developed initiatives, as described at the enforcement co3ference, for improving the security program, including a review and upgrade of the security plan and implementing procedures, retention of an independent security consultant, and a planned increase in management oversight of the program. Nevertheless, these violations represent serious weaknesses in your security program that emphasize the importance of promptly increasing, improving and making more effective management oversight and attention to the program to assure that security personnel, as well'as all other individuals authorized access to the plant, understand and adhere to security program requirements. Therefore, to emphasize these concerns, I have been authorized, after consulta-L tion with the Director, Office of Enforcement, and the Deputy Executive Director for Nuclear Materials Safety, Safeguards and Operations Support, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalties in the amount of Seventy-Five Thousand Dollars (575,000) for the violations described in Sections I and II of the enclosed Notice. In accordance with the General Statement of. Policy and Procedure for NRC Enforcement Actions" 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violation set forth in Section I of the Notice is classified individually as a Severity Level III violation, while the violations set forth in Section II of the Notice are classifieJ in the aggregate as a Severity Level III problem because they involve either multiple or recurrent violations. The base civil penalty amount for a Severity Level III violation or problem is 550,000. In each case, the NRC considered the escalation and mitigation factors for civil penalties set forth in the Enforcement Policy. A civil penalty of 525,000 is appropriate for the violation in Section I. A civil penalty of $50,000 is appropriate for the violations in Section II. NUREG-0940 I.A-122
Maine Yankee Atomic Power Company 3 IL7 : ; 1939 In assessing these penalties, the NRC considered the extensive initiatives by management to correct these deficiencies (and improve the security program) once informed of the extent of the violations during the exit interview of the inspection. With respect to the violation in Section I of the Notice, we also considered that you identified this violation. However, this was offset by the duration of the violation, since compensatory measures were not taken until approximately 24 hours after the Plant Shift Supervisor first became aware of the missing key and that you were required to periodically check all keys. With respect to the violations in Section II of the Notice, we considered that these violations were identified by the NRC, and the plant security staff should have reasonably discovered these violations sooner. You are required to respond te this letter and should follow the instructions specified in the enclosed Notice when preparing your rcsponse. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. Portions of the enclosed Notice contain details of your security program that ! have been determined to be exempt from public disclosure in accordance with 10 CFR 73.21 (Safeguards Information). Therefore, those portions will not be placed in the NRC Public Document Room and will received limited distribution. Further, in your response to this letter and Notice, you should place all Safeguards Information in enclosures, so as to allow your letter (without enclosures) to be placed in the Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, P. L. No. 96-511. Sincerely, h William T. Russell Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty (Contains Safeguards Information (SGI)) NUREG-0940 1.A-123 _ - - _ - - - - - - - - - - - - - .- 1
?
Maine Yankee Atomic Power Company 4 ' ' '?!3 cc w/ encl; (w/o' SGI.): Dr. E. T. Boulette, Vice President-, Operations and Plant Manager John Garrity, Vice President, Quality Programs and Engineering-P. L. Anderson, Project Manager G. D. Whittier, Licensing Section Head J. A. Ritsher, Attorney (Ropes and Gray) Philip Ahrens, Esquire Public Document Room (PDR) Local Public Document Room (LPDR) Nuclear Safety Information Center (NSIC) NRC Resident Inspector (w/SGI) State of Maine i I 1 i l 1 I I i i 1 l 4
-NUREG-0940 I.A-124
_._________M
hd b k SsQ\W \ NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTIES ' Maine Yankee Atomic Power Company Docket No. 50-309 Maine Yankee Atomic Power Station License No. DPR-36 EA. 88-295 During a Nuclear Regulatory Commision (NRC) physical security inspection conducted on November 14-18, 1988, as well as a maintenance team inspection conducted between October 31 and November 10, 1988, violations of NRC physical security requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (Enforcement Policy) (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954 as amended (Act), 41 U.S.C. 2282, and 10 CFR 2.205. The , particular violations and associated civil penalty are set forth below: ' I. VIOLATION OF SECURITY AND VITAL AREA KEY CONTROL REQUIREMENTS License Amendment No. AM.64, Paragraph (d)(1) to the Facility Operating License No. DPR-36 requires the licensee to implement and fully maintain all provisions of the NRC approved " Security Plan for Maine Yankee Atomic Power Station" (the Pian). Further,.Section 5.8.1 (d) of Appendix A (Procedures) of the licensee's technical specifications requires that written procedures covering the implementation of the Plan shall be established, maintained and implemented. l I l NUREG-0940 I.A-125
?
'2 t.
e This is a Severity Level III violation. (Supplement III) Civil Penalty - $25,000 II. VIOLATIONS OF OTHER PHYSICAL SECURITY REQUIREMENTS i NUREG-0940 I.A-126
________________j ' I,$: . ' l
.l.c
.3 j 1
l l l l l l~ NUREG-0940 1.A-127
F' e.c; [ s ce H 4-E l n 1 i j These violations are classified in the aggregate as a Severity . Level III. (SupplementIII) Civil Penalty.- $50,000 (assessed equally among the violations) Pursuant to the provisions of 10 CFR 2.201, Maine Yankee Atomic Power Company (Licensee) is hereby required. to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of the this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation"'and should include for each alleged violationi (1) admission or denial of the alleged violation, (2) the reasons for the' violation, if admitted, (3) the corrective steps that have been taken and the results' achieved, (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be ", NUREG-0940 1.A-128
1 5 ) l taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalties by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalties proposed above, or may protest imposition of the civil penalties in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalties will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalties, in whole or in part, such answer should be clearly marked as an " Answer to Notice of Violation" and may: (1) deny the violation (s) listed in this Notice in whole or in part, (2) demon-strate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalties, such answer may request remission or mitigation of the penalties. In requesting mitigation of the proposed penalties, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provis1ons of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined la accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The response to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalties, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region I, 475 Allendale Road, King of Prussia, Pennsylvania 19406. FOR THE NUCLEAR REGULATORY COMMISSION h& [ h William T. Russell Regional Administrator Dated at King of Prussia, Pennsylvania this /J M day of February 1989 NUREG-0940 1.A-129
[ a UNITED STATES NUCLEAR REGULATORY COMMISSION
. .I REGION V o, -
g ,(( 1450 MARIA LANE, SulTE 210 WALNUT CREEK, CALIFoRNI A 94596 DEC 3 0 :988 Docket No. 50-344 - EA 88-277 Portland General Electric Company ATTN: Mr. David W. Cockfield Vice President, Nuclear 121 S. W. Salmon Street Portland, Oregon 97204 Gentlemen: SU. JECT: NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTIES
REFERENCES:
NRC Inspection Reports No. 50-344/86-42, 50-344/88-45 and 50-344/88-49 This letter refers to the inspection conducted from October 17 through 20, 1988, at the Trojan Nuclear Plant concerning events of October 7 - 11, 1988 related to your failure to properly control access to vital equipment at the intake structure. The results of the inspection were reported in NRC Inspection Report No. 50-344/88-45 provided to you by letter dated November 3, 1988. Several significant violations of NRC requirements were id:ntified. The apparent violations, their causes, and your corrective act!ons were discussed with you during an enforcement conference held in your offices on November 17, 1988. A summary of the Enforcement Conference (NRC Inspection Report No. 50-344/88-49) was sent to you by letter dated December 6, 1988. The violations set forth in the enclosed Notice of Violation and Proposed Imposition of Civil Penalties involve degradation of a vital area barrier and failure to take adequate compensatory measures; failure to record a visitor's entrances and exits from the vital area; failure to properly search and escort the individual badged as a visitor; and absence of one of the barriers required to protect vital equipment. Furthermore, the Notice also describes two violations for which no civil penalty is being proposed due to their relatively minor significance: (1) a violation involving a failure to timely report a security event, and (2) a violation involving a failure to properly secure Safeguards Information. Violations I.A and I.B of the enclosed Notice resulted from poor planning of the desilting operation and from your failure to consider recent security plan changes declaring the intake basin a vital area. These violations are of particular concern to the NRC because of a series of relevant NRC Information Notices and our identification during past inspections of problems in your security organization. In reviewing your performance, we note that in a past NRC Inspection Report (No. 50-344/86-42, dated January 29, 1987), we registered our concern with CERTIFIED ;&IL PmTN PICEIPT FMLTS~ED NUREG-0940 1.A-130
2 i your failure to implement appropriate compensatory measures for physical i barrier degradations. We are particularly concerned that as recently as ' July 13, 1988, we identified a violation consisting of an inadequate vital crea barrier at the intake structure, the same area which is the focus of this enforcement action. The subject violation coula have been prevented had more thorough corrective action been taken to identify other barrier vulnerabilities in that area. To emphasize the importance of maintaining adequate physical barriers, I have been authorized, after consultation with the Director, Office of Enforcement, cnd the Deputy Executive Director for Regional Operations to issue the cnclosed Notice of Violation and Proposed Imposition of Civil Penalty in the ' amount of Seventy-Five Thousand Dollars ($75,000) for the violations described in Section I of the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions, 10 CFR Part 2, , Appendix C (1988), (Enforcement Policy), the violations contained in Section I ! cf the enclosed Notice have been categorized in the aggregate as a Severity , Level III violation. The base value of a civil penalty for a Severity Level III violation is
$50,000. The escalation and mitigation factors in the Enforcement Policy were considered. The base civil penalty amount has been increased by 50% due to your prior notice based on the July violation.
In addition, Section II of the Notice includes one violation involving a failure to report a security event in a timely manner and a second violation involving a failure to properly protect Safeguards Information. These violations have been categorized as Severity Level IV violations and no civil penalty is being proposed. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional ! cctions you plan to prevent recurrence. Your cesponse should also address both your plans to initiate a design study concerning proper security for the intake structure and the results of surveying how other licensees with similar plant designs are protecting their intake structures. Both of these issues were discussed during the enforcement conference. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC i enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter will be placed in the NRC Public Document Room. In accordance with Section 2.790(d) of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, documentation of the findings of your safeguards and security measures are exempt from public disclosure; therefore, the enclosed Notice of Violation and Proposed Imposition of Civil Penalty will not be placed in the Public Document Room and will receive limited distribution. NUREG-0940 1.A-131
-__ _ D
f I s r 3 fWe have, determined that the enclosure so des'ignated contains Safeguards. Information and.therefore is subject to the controls of 10 CFR 73.21. The responses' directed by this letter and the accompanying Notice are not subject to:the clearance provisions of the Office of Management and Budget as ; I required by the Paperwork Reduction Act of 1980, P.L. 96-511. Sincerely,
) . oJC (1 .
. nartin -
4 Regional Adminis or
Enclosure:
Notice of. Violation and Proposed Imposition of Civil Penalty ec w/ enclosures: C. A. Olmstead, PGE
'J. W.'Durham, Esq., PGE I
NUREG-0940. I.A-132
, , y W l
. l:* , ..
~
g# "*' UMTED STATES 4 Y ' i NUCLEAR REGULATORY COMMISSION
.I RE0lON V.
]Q' = 1460 MARIA LANE,SulTE 210
'4.. ,t g WALNUT CREEK, CALIFORNIA 94696 osee*
JM L nd Docket No, 50-312 EA 86-110-
- Sacramento Municipal . Utility District Rancho.'Seco Nuclear Generating Station ATTN: J. F. Firlit, Chief Executive
. : Officer Nuclear 114440 Twin Cities Road Herald, California.-95638-9799:
' Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (INSPECTION REPORT NO. 50-312/86-15) This refers to a special.NRC inspection conducted at Rancho Seco by members , :efLthe'NRC staff,during the period of April 1, 1986.through May 23, 1986, of
-cctivities authorized by.NRC License No. DPR-54. The. subject inspection report was transmitted to you by separate correspondence dated June 6., 1986.
.An enforcement conference related to the inspection findings was held at the Region.V. office'on June 20,.1986, with members of the District staff. Based
~~
on the results of this inspection and discussions lduring the enforcement
'cenference, it was established that certain of your licensed a:tivities were
~
not~ conducted in' full compliance with NRC requirements.
.The violations' set forth'in the enclosed Notice'of Violation and Proposed Imposition of Civil Penalty'(Notice) demonstrate a failure of the District to:
.(1) implement its technical specification requirements to preclude release of liquid effluents containing radioactivity in amountO axceeding the dose' criteria set forth.in 10 CFR Part 50 Appendix I; (2) evaluate changes to the facility as 1 required by 10 CFR 50.59;.and (3) maintain and implement procedures and report the release'of radioactive material in effluents as prescribed in the facility
'Tcchnical Specifications. These violations and inspection findings present'a picture'of how the District during 1985, despite commitments made in the letter dated September 24,'1984, improperly' accounted for the amounts of radioactivity released in liquid effluents end ended up with an inaccurate record of radioactive r21 eases for the year 1985.' ;
i By letters of July 3,1986 and October 8, .1987, you described your corrective I cctions in response to the. inspection findings. We acknowledge your continuing d efforts.to improve your performance in the area of radioactive effluents as
'well as many other areas during'the plant shutdown. As the two letters referenced above limited themselves largely to corrective actions of a technical and programmatic nature, by a letter dated December 23, 1987, the NRC requested !
pursuant to 10 CFR 50.54(f) your assessment of the management and personnel CERTIFIED MAIL ~ 7 RETURN RECflPT REQUESTED
'NUREG-0940: 1.A-133 1
- --- --_A
- Sacramento Municipal Utility District considerations' surrounding the inspection findings. Your evaluation of those p areas'was provided in a letter dated January 25, 1988, which has been. reviewed
- l. by the NRC staff.
Notwithstanding all the information you have provided concerning these-issues, as well as their relative age, we view the violations as demonstrating a significant breakdown in the oversight of your program to control radioactive effluent releases. ~ This is especially significant given your prior commitn,ent to resolve the. effluent release problem which occurred in 1984. We recognize that the effect of the radioactive releases was not significant. Nevertheless, a civil penalty is appropriate _ because of the failure of many levels of your management to assure that programs and commitments were properly implemented in an area which had previously been of heightened concern and visibility both within your organization and the NRC staff. To emphasize the importance of_ establishing and adhering to approved procedures, performing safety evaluations, avoiding unnecessary releases of radiation to the environment, and management' assuring that commitments and requirements are met, I have been. authorized, after consultation with the Commission and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and' Proposed Imposition of Civil Penalty (Notice) in the amount of
$100,000 for the violations described in the Notice. In accordance with the
" General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part~'2,-Appendix C (1988), the violations described in the enclosed Notice have been' collectively classified as a Severity Level III problem. The base value of a civil penalty for a Severity. Level III problem is $50,000. 'The escalation and mitigation factors in the Enforcement Policy were considered. Despite the comprehensive wrrective actions that were'taken prior to restart, escalation of the penalty is appropriate based on the duration of the violations and the significant breakdown in management controls of the radioactive effluent discharge program. In sum, the penalty is being proposed to make it clear that NRC will not tolerate conduct such as that demonstrated by supervisors and managers who either were not technically qualified to be involved in controlling and monitoring
-radioactive effluents or were at least negligent in controlling the program.
You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response,
~
.you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, j including your proposed corrective actions, the NRC will determine whether l further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements.
In accordance with 10 CFR 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, code of Federal Regulations, a copy of this letter and the enclosure will be placed in the NRC's Public Document Room.
.NUREG-0940 I.A-134 i
_ - _ _ _ - _ _ - - _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ A
e , t .; h', 7 Sacramento Municipal Utility-District E . 4 The responses directed by this? letter and the enclosed Notice,are not subject
.to the clearance procedures of.the Office of Management andLBudget as required
'by the' Paperwork Reduction _Act.of 1980, PL 96-511.
' Sincer,dly,-
- 's $ , n I'. '
John B. Martin - 3 RegionalJAdministrator
Enclosure:
Notice of Violation'and Proposed Imposition of Civil Penalty. cc w/ enc 1:
-J. Vinquist, SMUD K. A. Meyer, SMUD .
State'of California. 8 l' l NUREG-0940 1.A-135
g - - - }W L 1a l L NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY Sacramento Municipal- Utility District Docket No. 50-312 Rancho Seco Nuclear Generating Station License No. DPR-54 EA 86-110 During an-NRC inspection conducted during the period April 1, 1986 through May 23, 1986, violations of NRC requirements involving control of radioactive effluentt were identified. In accordance with the " General Statement of Policy and Procedures for Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended ("Act"), 42 U.S.C. 2282, P.L. 96-295, and 10 CFR 2.205. The violations and associated civil penalty are set forth-below:
)
l A. 10 CFR Part 50, Appendix I, Section IV.B, provides that:
"The licensee shall establish an appropriate surveillance and monitoring l !
program to:
- 1. Provide data on quantities of radioactive material released ir.
liquid and gaseous effluents to assure that the provisions of paragraph A of this section are met...." 1
)
Contrary to the above requirement, as of April 1, 1986, an adequate i surveillance program was not established to provide data on quantities of radioactive material released in liquid effluents to assure compliance with the provisions of. paragraph A of 10 CFR Part 50, Appendix 1. B. 10 CFR 50.59 provides, in relevant part, that: (a)(1) "The holder of a license authorizing operation of a production or utilization facility may (i) make changes in the facility as , described in the safety analysis report, (ii) make changes in l the procedures as described in the safety analysis report, and (iii) conduct tests or experiments not described in the safety analysis report, without prior Commission approval, unless the proposed change, test or experiment involves a change in the technical specifications incorporated in the license or an unreviewed safety question." (b)(1) "The licensee shall maintain records of changes in the facility
... made pursuant to this section, to the extent that these changes constitute changes in the facility as described in the safety analysis' report ... These records must include a written safety evaluation...."
The updated FSAR submitted July 22, 1982 and subsequent FSAR amendments submitted through July 1985, provide in Section 11, Radioactive Waste and Radiation Protection, that: j l NUREG-0940 1.A-136 1 1
A
' Notice of Violation "During normal plant operations, the Rancho Seco Nuclear Generating Station is designed.not to release any liquid effluents containing radioactivity of plant origin to the environment. All potentially radioactive wastes are processed by degasification, filtration, demineralization, and/or evaporation to remove radioactive and nonradioactive components. Radioactivity removed by these processes is retained within the filter cartridges and exchange resins and concentrated evaporated bottoms for offsite disposal in drums by an NRC-licensed disposal contractor."
Contrary to' the above requirements, without having performed an evaluation to determine whether a change in the Technical Specifications was required or if an unreviewed safety question was involved, and without having created or maintained a record of a safety evaluation, from January 1983 through March.13, 1986, procedures and temporary system modifications were imple-mented to facilitate the pumping of radioactive water from the Demineralized Reactor Coolant Storage Tank (T-621) through a temporary conduit to either Regeneration Hold-up Tank (T-950 A or B), and ultimately released to the environment. C. Technical Specification 4.21, Liquid Effluents, provided in part that:
"The radioactivity content of each batch of radioactive liquid waste to be discharged shall be' determined prior to release by sampling and analysis in accordance with Table 4.21-1..." Table 4.21-1 requires in part that each batch waste release tank be sampled prior to release and analyzed for Cs-134 and Cs-137. Footnote (c) of Table 4.21-1 provides in part that: "Other peaks which are measurable and identifiable, together with the listed nulcides, shall be identified and reported."
Technical Specification 6.9.2.3 provided in part that:
"The radioactive effluent release reports shall include a summary of the quantities of radioactive liquid and gaseous effluents and solid waste released from the unit as outlined in Regulatory Guide 1.21,
' Measuring, Evaluating, and Reporting Radioactivity in Solid Westes and Releases of Radioactive Materials in Liquid and Gaseous Effluents from Light-Water-Cooled Nuclear Power Plants,' with data summarized on a quarterly basis, following the format of Appendix B thereof."
Regulatory Guide 1.21 provides in Paragraph B.2 that:
"In many cases the criteria for sensitivity of effluent measurements have been modified to reflect as low as practicable dose considera-tions in the offsite environs; i.e., the sensitivity of effluent measurements should be sufficient to detect concentrations which, when dispersed in the offsite environs, would result in a dose to individuals of a small fraction of natural background radiation."
Paragraph C.10 of Regulatory Guide 1.21 provides in part that:
"The sensitivity limits given for radioactivity analyses in Appendix A of this guide are based on the potential significance in the NUREG-0940 1.A-137
u ih L Notice'of Violation. - 3~- environment of the quantities of radioactive materials released. For some radionuclides, lower detection limits.than those given herein may be readily achievable and when measurements below the stated sensitivity limits are attained, the results should be recorded and reported." Contrary to the above requirements, on June 4, 1985, isotopic analysis of a batch of radi' oactive liquid waste (B RHUT 85-98) identified measurable concentrations of Cs-137 (2.33 E-7 1 4.9 E-8 uCi/ml),.but were not identified or~ reported on the " Rancho Seco Radioactive Liquid Waste-Release Permit" 85-98. or in the " Semiannual. Ef fluent Release Report" .(RJR 8S-491) for the period January 1 through June 30, 1985. Analyses of releases on June 6, 1985 (85-99) and June 17, 1985 (85-110) also found measurable concentrations of Cs-137 which were identified but not reported.
~
'D. Technical Specification 3.17.2. provided that: "The dose or dose commitment to a member of the public f.om radioactive materials in liquid
. effluents released beyond the site boundary shall be limited . . . during any calendar; year to 3 mrem to the total body and to 10 mrem to any organ."
Contrary to the above requirement, during calendar year 1985, radioactive materials in liquid effluents were released such that a member of the public could have received a total body dose in_ excess of 3 mrem when calculated in accordance with the methods described in the Technical Specifications. The. dose calculated for 1985 using the licensee's Offsite Dose Calculation Manual was approximately 3.9 mrem. E. Technical Specification-6.8.1 provides in part that: " Written procedures shall be established . implemented and maintained ccvtring ... the applicable procedures recommended in Appendix .' A' . of oculatory Guide
- 1. 33, November 1972. '.' Regulatory Guide 1.33, November 1972, Section G.,
recommends that procedures be developed for liquid radioactive waste systems, including discharging of effluents. 4 i Contrary to the above requirement, from March 30, 1983 to January 6,1986,
~
and from March 6, 1986 through March 30, 1986, no procedure was implemented , or maintained to control the transfer of radioactively contaminated water I from the Demineralized Reactor Coolant Storage Tank (T-621) to the Regene- _! rated Hold-Up Tanks (T-950 A and B) for ultimate release to the environment. ( During 1985, about 787,500 gallons were transferred from T-621 to T-950 A j and B and then released to the environment. l F. Technical Specification 6.8.3 provided that: " Temporary changes to procedures ) of 6.8.1 above may be made provided:
- a. The intent of the original procedure is not altered... [and]
l b. The change is documented, reviewed by the PRC and approved by the , l Plant Superintendent within seven (7) days of implementation." ' l l N'JREG-0940 I.A-138 L _--. _____ -_____._____-._ _ --- _ _ __-
Notice of Violation ; Contrary to the above requirement, on January 6,1986, without approval by , the Plant Review Committee (PRC), the licensee implemented a temporary ! change to Procedure A.10, " Demineralized Reactor Coolant Storage System," to allow the pumping of water from T-621 to T-950 A and B for offsite release. From January 6,1986 to March 6,1986, the licensee estimates that about 350,000 gallons of water were transferred. The above violations, A, B, C, D, E, and F have been categorized in the aggregate as a Severity Level III problem (Supplements I and IV). Civil Penalty - $100,000 - assessed equally among the violations. Pursuant to the provisions of 10 CFR 2.201, Sacramento Municipal Utility District (licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory ! Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have bien taken and the results achieved, (4) the corrective step that will be taken to avoid further violations, and (5) the date when full compliance will b3 achieved. If an adequate reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good'cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the rmount of the civil penalty proposed above, or the cumulative amount of the civil penalties if more than one civil penalty is proposed, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory 3 Commission. Should the licensee fail to answer within the time specified, an
]
Order imposing the civil penalty will be issued. Should the licensee elect to j file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, ! in whole or in part, such answer should be clearly marked as an "Answe- to a Notice of Violatior.," and may: (1) deny the violation listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., NUREG-0940 1.A-139
Notice of Violation' . citing page;and paragraph numbers) to avoid repetition. The attention of the
-licensee is directed to the other provisions of 10 CFR'2;205, regarding the
' rocedures for imposing a civil penalty.
p jupon failure to pay any civil penalty due which subsequently has been l determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and.the penalty, unless compromised, remitted, or mitigated..may be collected'by civil action pursuant
'to Section 234(c) offthe Act, 42 U.S.C. 2282(c).
The responses to the. Director,.0ffice of Enforcenant,-noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555 with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region V, 1450 Maria Lane, Suite 210, Walnut Creek, California 94596,~and a copy to the NRC Senior Resident Inspector, Anthony J. D'Angelo, Rancho Seco. RT NUCLEAR REGULATORY COMMISSION r-s'ss., ff2/ O John B. Martin Regional Administrator
-Dated at Walnut Creek, California this /3 day of January 1989.
NUREG-0940 1.A-140 1 1 ___-__ --_______ -__- __ -
I
.anseug UtelTED STATES
. kg NUCLEAR REG'ULATORY COMMIS$10N g- REGION lit s ne noosEvnt mono
.$ GLEN ELLYN. GLUNOlb 60lH
**** JUN 161988 Docket No.'50-341
. License No. NPF-43
.EA 88-104 The Detroit Edison Company ATTN: B. Ralph Sylvia Group Vice President Nuclear Operations 6400 North Dixie Highway Newport, Michigan 48166 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVII. PENALTIES (NRC INSPECTION REPORTS NO. 50-341/87048(ORP) AND NO 50-341/88014(DRP))
.This refers to the special inspections conducted on October 18, 1987 to March 31', 1988, and January 17 to April 28, 1988, at the Enrico Fermi Atomic .
Power Plant, Unit 2, authorized to operate ~ under NRC Operating License !
, No. NPF-43. These inspections examined the circumstances surrounding a Primary Containment Radiation Monitoring (PCRM) system containment isolation valve design control problem and an inoperable Noninterruptible Air System Control Air Compressor (NIAS CAC). The potential loss of primary containment inte:grity, due to PCRM system isolation valves failing to meet 10 CFR Part 50, Appendix A, General Design Criterion (GDC) 56, was identified by you and i reported on October 17, 1987. The failure to enter Technical Specification i action statements due to inoperability of a Standby Gas Treatment subsystem, a Control Room Emergency Filtration System flowpath damper and a Main Steam Isolation Valve Leakage Control subsystem whic.h was caused by the out of service Division II NIAS CAC was identified by the NRC. The details are contained in the subject inspection reports which were sent to you by letters dated May 9, 1988 and May 13, 1988, respectively. On April 28, 1988, an enforcement conference was held between Dr. C. J. Paperiello and other members of my' staff and you and other members of your staff during which the violations, the root causes, and your corrective actions were discussed. )
I i CERTIFIED MAIL METURN RECEIPT REQUESTED NUREG-0940 I.A-141
'The Detroit Edison Company 2 JUN 161988 '
The design' control violation, which is described as Part A of the enclosed Notice of Violation.and Proposed Imposition of Civil Penalties (Notice), resulted from a failure to determine that the 1984 modification to the containment isolation valve design was not an acceptable alternative to GDC 56. In addition, when the modification was made, you failed to request a.. change to Technical Specifications to include the automatic isolation valves and procedures were not put in place to periodically test these valves in accordance with the applicable portions of 10 CFR Part 50, Appendix J and other testing requirements (logic testing, functional testing, and positive indicator checks). A temporary exemption from GDC 56 was granted by the NRC on November _13, 1987, to be effective through the end of the local leak rate outage in March 1988. To support operation with this exemption, you committed to upgrade the effectiveness of-the isolation scheme to include treating the .. subject valves as primary containment isolation valves in a manner consistent j with Technical Specifications, revising the Emergency Operating Procedures and { enhancing operator training. On March 29, 1988, the NRC staff approved an ! amendment to the Fermi 2 operating license which accepted your permenant ; reciesign of the containment isolation configuration as an acceptable I alternative to those specified by GDC 56. The Technical Specification action statement violations, which are described in Part B of'the enclosed Notice, resulted from the failure to recognize that the operation of the Division II NIAS CAC was required to support the operability of a Standby Gas Treatment subsystem, Control Room Emergency Filtration System damper and Main Steam Isolation Valve Leakage control , subsystem. This failure led to exceeding, by approximately thirteen days, i
'two Technical Specification action statements that required the unit to be shut down. Specifically, the action statements for the Standby Gas Treatment and Control Room Emergency Filtration Technical Specification required the i unit to be placed in COLD SHUTDOWN within 36 hours following the end of the '
allosed seven days of inoperability specified in the action statements. In , this case, however, that seven day period ended at 10:15 p.m. on January 21, i 1988, and notwithstanding the fact that the affected Systems remained l inoperable, the unit continued to operate ir, violation of the Technical Specifications until February 3, 1988. Your engineering staff did not provide adequate guidance on the system interfaces to other departments and your operations staff was not sufficiently inquisitive to identify these violations when the Division II NIAS CAC was taken out of service. These violations are another example of the Fermi organization failing to fully appreciate its Technical Specification requirements. The violations described in the Notice resulted in significant degradations in the plant's ability to respond to certain types of accidents. NUREG-0940 1.A-142
'The Detroit Edison Company 3 JUN 161989 To emphasize the importance of proper system design in accordance with regulatory requirements and the need to understand the affects of auxiliary equipment on system operability and your Technical Specifications, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice in the amount of Two Hundred Thousand Dollars (5200,000) for the violations described in the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations described in Parts A and B of the enclosed Notice have separately been categorized at Severity Level III. The base value of a civil penalty for a Severity Level III violation is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered. The base civil penalty amount for the violation in Part A has been increased 50% because of the minimal corrective actions that were taken initially which necessitated NRC intervention and by an additional 50% because of your poor past performance in the area of engineering and technical support which included a previous civil penalty (EA 87-232) for failures in this area. Mitigation of the civil penalty for identification and reporting was considered but deemed inappropriate because of your failure to fully recognize the scope of the problem at the time the initial modification was made. The base civil penalty amount has been increased by 100 percent for the violation in Part B because of your poor past performance in handling out of service equipment, which was discuseed in the Plant Operations section of the most recent Systematic Assessement of Licensee Performance, as well as for the inadequate engineering and technical support mentioned above, which in this case allowed plant operations personnel to operate the plant in a degraded conditon. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules af Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public Document Room. NUREG-0940 1.A-143
k p p -i: The. Detroit Edison Company 4 JUN 161988 F The responses directed by this letter and the enclosed Notice are not subject.. to the clearance procedures of the Office of Management and Budget, as required -
'by the Paperwork Reduction Act of 1980, Pub. L., No. 96-511.
Sincerely,. [: % A. Bert Davis Regional Administrator L-
Enclosures:
- 1. Notice of Violation and 4 F Proposed Imposition of 1 i- Civil Penalties !
- 2. Inspection Reports
,- No. 50-341/87048(DRP),. .l No. 50-341/88014(DRP) .! l
'cc w/ enclosures: 1 Patricia Anthony,- Licensing P. A. Marquardt, Corporate Legal Department- 3 DCD/DCB .(RIDS) . J
' Licensing Fee Management Branch i Resident Inspector, RIII 'l Project Manager, NRR j Ronald Callen, Michigan )
Public Service Commission 1 Harry H. Voight, Esq. I Michigan Department of Public Health; i Monroe County Office of
' Civil' Preparedness )
j
.NUREG-0940 I.A-144
' NOTICE OF VIOLATION AND
, 'MPOSITION OF CIVIL PENALTIES
.The Detroit Edison' Company Docket No. 50-341
'Enrico Fermi Atomic Power Plant License No. NPF-43
. Unit 2 EA 88-104 During NRC inspec'tions conducted on October 18, 1987 to March 31, 1988, and January 17. to' April 28,1988, violations of NRC requirements were identified.
In accordance with the " General Statement of Policy and Procedure' for NRC
- Enforcement. Actions,",10 CFR, Part 2, Appendix C (1988), the Nuclear Regulatory Ccmmission proposes to impose civil penalties pursuant to Section 234 of the-Atomic Energy' Act of,1954, as amended ( Act), 42 U.S.C. 2282, and 10 CFR 2.205. ;The particular violations and associated civil penalties'are set forth below:
A. 10 CFR' Part 50, Appendix A, General Design Criterion 56 requires, in part, that~each line that connects directly to the containment atmosphere and penetrates primary reactor contai.nment shall be provided with containment
' isolation' valves both inside and outside primary contain,_ent unless it.
can be demonstrated that the containment isolation provisions for a specific class of lines, such as instrument lines, are acceptable on some other-defined basis. Contrary to the above, as of October 17, 1987, the containment isolation configuration for the primary containment radiation monitoring (PCRM) system violated the requirements of General Design Criteria 56.in that containment isolation valves were not provided on the system lines both inside.and outside primary containment and this configuration was not accepted on some other defined basis. This is a Severity Level III violation (Supplement I). j Civil Penalty - 5100,000. B.1. With the unit in Modes 1, 2, or 3, Technical Specification Limiting Condition for Operation Action Statement 3.7.2.b.:' requires that if a Control Room Emergency Filtration System flowpath camper is inoperable
'fer seven days, the unit be placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours.
Technical Specification 1.25 defines a system, subsystem, train, l component, or device to be OPERABLE or having OPERABILITY when it is i capable of performing its specified functions and when all necessary attendant instrumentation, controls, electrical power, cooling or seal water, lubrication, or other auxiliary equipment that are required for the system, subsystem, train, component, or device to i perform its function (s) are also capable of performing their related support functions. ; i j l NUREG-0940 I.A-145 l
4 f-Notice of Violation 2 JUN f 61983 Contrary to the above, at 10:15 p.m. on January 21, 1988, with the unit in Mode 1, a Control Room Emergency. Filtration System flowpath damper, which had been inoperable for seven days because the ne:essary attendant noninterruptible air compressor was 'out-of-service, was not returned to service nor was the unit placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in.the following 24 hours. B.2. With the unit in Modes 1, 2, and 3, Technical Specification Limiting Condition Action Statement 3.6.5.3.a.1 requires that if one Standby Gas Treatment subsystem is inoperable for 7 days the unit be placed in HOT-SHUTDOWN within 12 hours and COLD SHUTDOWN in tha following 24 hours. Technical Specification 1.25 defines a system, subsystem, train, component, or device to be OPERABLE or having OPERABILITY when it is capable of performing its specified functions and when all necessary attendant instrumentation,- controls _, electrical power, cooling or seal water, lubrication, or other auxiliary equipment that are required for the system, subsystem, train, component, or device to perform its function (s) are also capable of performing their related support functions. Contrary to the above, at 10:15 p.m. on January 21, 1988, with the unit in Mode 1, the Division II subsystem of Standby Gas Treatment, which had been inoperable for seven days because the necessary attendant noninterruptible air compressor was out-of-service, was not returned to service nor was the unit placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours. , ( This is a Severity Level III problem (Supplement I). ! Civil Penalty - 5100,000 (assessed equally between the violations). Pursuant to the provisions of 10 CFR 2.201, Detroit Edison Company (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation; (2) the reasons for the violation, if admitted; (3) the corrective steps that have been taken and the results achieved; (4) the corrective steps that will be taken to avoid further violations; and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action, as may be proper, should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted ! under oath or affirmation. I NUREG-0940 I.A-146 l l . _ _ _ _ _ _ _ _ - _ _ _ _ _
JUN 1 6 twe:i
. Notice of. Violation 3 Within the-same time as provided for the response required under 10 CFR 2.201, the Licensee may pay the civil penalties by letter to the Director, Of fice of Enforcement, U.S. Nuclear Regulatory Cammission, with a check, draft, or money order payable to the Treasurer of the United States in the cumulative amount of the civil penalties proposed above, or may protest imposition of the civil penalties in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee f ail to answer within the time specified, an Order imposing the-civil penalties will be issued. Should the Licensee elect to file an' answer in accordance with 10 CFR 2 205 protesting the civil penalties, in whole or in part, such answer shoulo be clearly' marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part; (2) demonstrate extenuating circumstances; (3) show error in this Notice; or~ (4) show other. reasons why the penalties should not be imposed.
In addition to protesting the civil penalties, in whole or in part, such answer may request remission or mitigation of the penalties. In requesting mitigation of the proposed penalties, the five factors addressed in Section V.B of 10 CFR, Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing civil penalties. Upon failure to pay any civil penalties due which subsequently have been determined in accordance with the applicable provision of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalties, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. l The responses to the Director, Office of Enforcement, noted above (Reply l to a Notice of Violation, letter with payment of civil penalties, and l Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control l Desk, Washington, D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 60137 and a copy to the NRC Resident Inspector at Fermi. FOR THE NUCLEAR REGULATORY COMMISSION O 47 7 h b % A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois this 16th day of June 1988 NUREG-0940 1.A-147
f o UNITED STATES .
'g ! g_ NUCLEAR REGULATORY COMMISSION ,n .
wAsHawaTow, o. c.20ssa J
,e OEC 2 81988 Docket No. 50-341 License No. NPF [ EA 88-104 The Detroit Edison Company ATTN: 8. Ralph Sylvia Senior Vice President Nuclear Operations 6400 North Dixie Highway Newport, MI 48166 L Gentlemen:
SU8 JECT: ORDER IMPOSING CIVIL MONETARY FENALTY This refers to your letter dated July 15, 1988, in response to the Notice of Violation and Proposed Imposition of Civil Penalties sent to you by our letter dated June 16, 1988, and in response to NRC Inspection Report No. 50-341/88017 and No. 50-341/8814 sent to you by our letters dated May 9,1988 and May 13, 1988 respectively. Our letter and Notice of Violation described two Severity Level !!! problems, one dealing with inappropriate design controls, and the other dealing with violation of a Technical Specification action statement. To emphasize the importance of proper system design in accordance with regulatory requirements and the need to understand the effects of auxiliary equipment on system operability and your Technical Specifications, a civil penalty of Two Hundred Thousand Dollars ($200,000) was proposed. In your response, you admitted Violation A occurred as stated in the Notice of Violation, but denied Violation 8. In addition, you requested remission of the proposed civil penalty. You also sought to meet with us concerning this case. Following the staff's discussions, apparently you chose not to pursue a meeting. 1 After consideration of your response, we have concluded, for the reasons given in the Appendix attached to the enclosed Order Imposing Civil Monetary Penalty, that both violations did occur as set forth in the Notice of Violation and Proposed Imposition of Civil Penalty. However, we have concluded that escalation of the civil penalty for past poor performance was not warranted for Violation A. Consequently, the proposed escalation of $25,000 on this basis have been withdrawn. In all other aspects, you did not provide sufficient basis for withdrawal of the violation or further reduction of the civil penalty amount. Accordingly, we bereby serve the enclosed Order on Detroit Edisen Corrpany ir: posing a civil penalty ir the amount of One Hundred Seventy-Five Thousand Dol 16rs (5175.000). He will review the effectiveness nf your corrective actinns curing a sLbsequent -it:spectior , rERTIFIED l' AIL kt au ntttari PECUESTED NUREG-0940 1.A-148
1 The Detroit Edison Company l I In a'ccordance with Section 2.790 of'the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosures .
.will be placed in the NRC's Public Document Room.
Sincercly,
\_
a s M. Taylor Deputy Executive Director or Regional Operations
,1
Enclosure:
Order Imposir.g Civil i Monetary Penalty witt Appendix cc w/ enclosure: Patricia ' An'hony Licensir.g P. A. Marquardt, Corporate Legal Department DCD/DCB(RIDS) Licensing Fee Management Branch Resident Inspector, RIII Ronald Callen, Michigan-Public Service Commission Harry H. Voight, Esq. Michigan. Department of Public Health Monroe County Office of Civil Preparedness u O NUREG-0940 1.A-149 'l i l
L UNITED STATES NUCLEAR REGULATORY COMMISSION In the Matter of ) Docket No. 50-341 Detroit Edison Company ) License No. NPF-43 (Fermi 2) ) EA 88-104 ORDER IMPOSING CIVIL MONETARY PENALTY I Detroit Edison Company (licensee) is the holder of Operating License No. NPF-43 issued by the Nuclear Regulatory Commission (NRC/ Commission) on July 15, 1985. The license authorizes the licensee to operate Fermi 2 in accordance with the conditions specified therein. II Special safety inspections of the licensee's activities were conducted during the periods October 18, 1987 through March 31, 1988 and January 17 through April 28, 1988. The results of these inspections indicate that the licensee had not conducted its activities in full compliance with NRC requirements. A written Notice of Violation and Proposed Imposition of Civil Penalty (Notice) was served upon the licensee by letter dated June 16, 1988. The Notice stated the nature of the violations, the provisions of the NRC's requirements that the. licensee had violated, and the amount of the civil penalty proposed for the violations. The licensee responded to the Notice of Violation and Proposed Imposition of Civil Penalty by letter dated July 15, 1988. In its response, l the licensee admitted Violation A and denied Violation B. In addition, the l licensee requested remission of the civil peralty. NUREG-0940 1.A-150 ! l
l l I
-2.-
III After consideration of the licensee's response and the statements of fact, explanation, and argument for mitigation contained therein, the Deputy Executive Director for Regional Operations has determined, as set forth in the Appendix to this Order, that the violations occurred as stated in the Notice. However, escalation of the civil penalty for past poor performance was not warranted for Violation A. . Consequently, the proposed escalation of the penalty on this basis has been withdrawn. In all other aspects, the penalties proposed for the violations designated.in the Notice of Violation and Proposed Imposition of Civil Penalty should be imposed. IV In view of the foregoing and pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT IS HEREBY ORDERED THAT : The licensee pay a civil monetary penalty in the amount of One Hundred Seventy-Five Thousand Dollars ($175,000) within 30 days of the date of this Order, by check, draft, or money order, payable to the Treasurer of the Unitec States and mailed to the Director of Enforcement, U.S. Nuclear Regulatory Commissbo, ATTN: Document Control Desk, Washington, D.C. 20555. The licensee r:ay request e tearino within 30 cays of the date of this Orcer. A request for a hearing shoulo be clectly marked os a 1equest for an Enforcet.ent Eearing" and should be addressed to the Director of Enforcerrer.t, U.S. Nuc%nr NUREG-0940 1.A-151
Regulatory Comission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Assistant General Counsel for Enforcement, the Regional Administrator, Region III, 799 Roosevelt Road, Glen Ellyn, Illinois, 60137, and a copy to the NRC Resident Inspector, Fermi 2. If a hearing is requested, the Comission will issue an Order designating the time and place of the hearing. If the licensee fails to request a hearing I within 30 days of the date of this Order, the provisions of this Order shall l l be effective without further proceedings. If payment has not been made at 1 that time, the matter may be referred to the Attorney General for collection. ( In the event the licensee requests a hearing as provided above, the issues to be considered at such hearing shall oe: s (a) whether the licensee was in violation of tl.e Commission's requirements as set forth ir Violation B of the Notice of Violation and Proposed Imposition of Civil Penalties referenced in Section II above, and i (b) whether, on the basis of Violations A and B, this Order should be sustained. 1 FOR THE U.S. NUCLEAR REGULATORY COMMISSION x l Ja M. Taylo , Deputy Executive Director r Regiona Operations Rockville, itaryland V Dated this qfdt,d d ay of December 1988. ; NUREG-0940 1.A-152
APPENDIX EVALUATION AND CONCLUSION 1988, a Notice of Violation and Proposed Imposition of Civil OnJune16(NOV)wasissuedforviolationsidentifiedduringNRCinspections. Penalties f Detroit Edison Company (licensee) responded to the NOV on July 15, 1988. In its response, the licensee admitted that Violation A occurred, but denied that Violation B occurred as stated in the NOV. The licensee requested partial mitigation of the civil penalty for Violation A and the withdrawal of Violation
- 8. The violations are restated below, followed by a summary of the licensee's response, the NRC evaluation, and the NRC conclusion.
I. Restatement of Violation A A. 10 CFR Part 50, Appendix A, General Design Criterion 56 requires, in part, that each line that connects directly to the containment atmosphere and penetrates primary reactor containment shall be provided with containment isolation valves both inside and outside primary containment unless it can be demonstrated that the containment isolation provisions for a specific class of lines, such ac instrument lines, are acceptable on some other defined basis. Contrary to the above, as of October 17, 1987, the containment isolatior, configuration for the primary containment radiation monitoring (PCRM) system violated the requirements of General Design Criteria 56 in tr.at containment isolation valves were not l provided on the system lines both inside and outside primary containment and this configuration was not accepted on some other defined basis. This is a Severity Level III violation (Supplement I). Civil Penalty - $100,000 Summary of Licensee's Response The licensee admits Violation A as stated in the NOV but believes extenuating circumstances exist which make the proposed escalation of the civil penalty unwarranted.
- 1. Corrective Action to Prevent Recurrence The licensee states that action was taken promptly following identification of the problem to isolate the affected system and perform leakage testing. Submittals were made to the NRC in a timely manner. Frequent communications occurred between the licensee and the NRC until the interim resolution was reached. The licensee cites the NRC letter granting the temporary exemption to CDC 56 which states that the licensee had made a good faith effort to come into compliance with GDC 56.
NUREG-0940 I.A-153 ,
i il W , 1 4 q: ' Appendix: * -
'2. 'Past Performance LThe licensee believes 1that increasing the civil penalty based on past' performance specifically including an original design deficiency. .
p (EA 87-232),; involving:the 72CF Bus design deficiency is inappropriate.. Increasing the civil: penalty,. it is argued, is not appropriate when
, two existing unrelated design problems are discovered.in'the same general' time period. The licensee stated that it believes that thei
' purpose'of the provision in 10 CFR Part 2,' Appendix C'for increasing
.a penalty based on poor past performance is to penalize utilities for-ineffective corrective action and that use of.this provision.is only appropriate when a licensee violates a requirement,. supposedly takes .?
corrective action, but then repeats the violation. Therefore, the licensee argues _ that corrective action for an original design problem discovered in September 1987.could not have affected a modification performed in :1984.' and. so should not form the . bases for escalation of'theLcivil penalty for poor past performance.
- 3. Prompt Identification and Reporting Reduction of up.to 50%.of the base' civil penalty may be given when a-licensee identifies-the violation and promptly reports the. violation.
to the NRC. In this case, the licensee argues that it identified and
. reported the problem.
NRC' Evaluation of Licensee's Response
,I With respect to unusually prompt and extensive corrective action, the..
issue:is.not the licensee's good faith. The issue. is the adequacy of
'the corrective actions. .The NRC staff does not agree that the actions i' taken demonstrate adequate effort to either compensate for the technical deficiency.or.come into compliance with GDG 56. The NRC had to meet with the. licensee to convince it to commit to taking compensatory actions during the time the licensee would be operating under the exemption it had requested from GDC 56. In addition, the licensee had proposed the exemption without compensatory measures. Further, the licensee's proposal to achieve compliance
.with GDC 56 was deficient in that the NRC had to convince the licensee that additional automatic isolation valves with proper signal diversity would be required to satisfy GDC 56. The base civil penalty was increased 50% based on these considerations which demonstrated minimal corrective actions.
With respect to past performance, 10 CFR Part 2, Appendix C, Section V.B. i addresses past performance in subsection 3. It states that the base civil j penalty may be increased as much as 100% for prior poor performance in the general area of concern. It further states that, in weighing this factor, ' consideration will be given to a number of factors including the effective-ness of previous corrective action for similar problems, overall perforrnance such as SALP evaluations, and prior enforcement history ir.cluding Severity Level IV and Y violations in the area of concern. It is not necessary for ! application of this f actor that prior corrective actiers be shewn to be I ineffective. The factor may be gplied uper or ossessn.ent of overall past perferrmance in the general t rea of com;r n. Therefore, the NRC stafi coes not derte with the itcensee's tr cerstancirW of 7 ef flication 0; this factor. NUREG-0940 1.A-154
l l l I Appendix I Specifically, a correlation to corrective action is not necessary. However, after reconsidering the circumstances of this case, the staff has concluded 1 that escalation of the civil penalty for this factor is not warranted. 1 With regard to the factor of identification and reporting, while the licensee reported the violation, it was the NRC who actually raised the i issue of compliance with GDC 56. The Resident Inspector had to convince 1 the licensee that it did not meet GDC 56 or an alternative an described in the UFSAR. Also, it would be inappropriate to mitigate the civil penalty based on this factor due to the length of time that a significant deficiency existed without discovery. Therefore, no reduction was made. II. Restatement of Violation B B.I. With the unit in Modes 1, 2, or 3, Technical Specification Limiting Condition for Operation Action Statement 3.7.2.b.2 requires that if a Control Room Eurgency Filtration System flowpath damper is inoperable for seven days, the unit be placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours. Technical Specification 1.25 defines a system, subsystem, train, component, or device to be OPERABLE or having OPERABILITY when it is capable of performing its specified functions anri when all necessary attendant instrumentation, controls, electrical power, cooling or seal water, lubrication, or other auxiliary equipment that are required for the system, subsystem, train, component, or device to perform its function (s) are also capable of performing their related support functions. Contrary to the above, at 10:15 p.m. on January 21, 1988, with the unit in Mode 1, a Control Room Emergency Filtration system flowpath damper, which had been inoperable for seven days because the necessary attendant noninterruptible air compressor was out-of-service, was not returned to service nor was the unit placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours. B.2 With the unit in Modes 1, 2, and 3, Technical Specification Limiting Condition Action Statement 3.6.5.3.a.1 requires that if one Standby Gas Treatment subsystem is inoperable for seven days the unit be placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours. Technical Specification 1.25 defines a system, subsystem, train, component, or device to be OPERABLE or having OPERABILITY when it is capable of performing its specified functions and when all necessary attendant instrumentation, controls, electrical power, cooling or seal water, lubrication, or other auxiliary equipment that are required for the system, subsystem, train, component, or device to perform its function (s) are also capable of performing their related support functions. NUREG-0940 1.A-155
Appendix Contrary to the above, at 10:15 p.m. on January 21, 1988, with the unit in Mode 1, the Division II subsystem of Standby Gas Treatment, which had been inoperable for seven days because
' the necessary attendant noninterruptible air compressor was out-of-service, was not returned to service nor was the unit placed in HOT SHUTDOWN within 12 hours and COLD SHUTDOWN in the following 24 hours.
This is a Severity Level _III problem (Supplement I). Civil Penalty - $100,000 (assessed equally between the violations). Sumary of Licensee's Response The licensee denies that Violation B occurred. The licensee references Section 9.3.1.2 of.the Fermi Updated Final Safety Analysis Report (UFSAR) which states in part, "There is a normally closed intertie between the Divisions I and II noninterruptible control air systems. During a l maintenance outage of the supply to one of these divisions, the intertie ! is opened so that the division having the outage can be supplied by the l other division." The licensee believes that its proposed method of ' operation of the Noninterruptible Air System (NIAS) as described in the UFSAR was acceptable to the NRC, based on its belief that active discussion , took place between licensee representatives and NRR on this subject during l the licensing of the facility. Thus, a decision not to put NIAS into 1 Technical Specifications was made consciously with the NRC during the j Technical Specification development process. The licensee contends that there'is no regulation, order, or license condition which makes the method of operation as described in the UFSAP. illegal. The licensee denies that there is_a Technical Specification requirement for complete independence of the two noninter uptible air i systems (NIAS), based upon the context of the licensing history of the i facility discussed above. ) i The licensee stated that, if the NRC should find that violations did ) occur in this instance, a situation existed where remission or mitigation I of the proposed penalty would be appropriate. The licensee argues that it i relied upon the licensing history of Fermi 2 in determining its legal ' obligations and in taking actions which it took. In addition, additional steps were taken and self-imposed restraints imposed by the licensee when the facility was operated in the configuration which formed the bases for the violation. These actions were taken as a result of management involve- ! ment in and recognition of an caerating condition which should not be allowed to continue beyond a reasonable period of time. Petroit Edison believes that its actions are consistent with the NRC's view of greater management involvement in nuclear activities and establish-ment of prudent operating practices. So, if the NRC finds that a violation ! L occurred, then Detroit Edison's actions should be considered in light of l its understanding of its UFSAR and the proposed penalties stould be remitted or mitigeted, not doubled.
'NUREG-0940 1.A-156
l I 1 l Appendix i s NRC Evaluation of Licensee's Response i In determining the appropriate action to take in the event one of the 1 redundant divisions of the NIAS is inoperable, the respective action I statements for the redundant equipment required to be operable by Technical ] Specifications should be examined. That equipment which requires the affected 1 division of NIAS to be operable should be declared inoperable. In this case, the NIAS serves as a support system for the control room amergency filtration system, the standby gas treatment subsystem, and the main steam isolation valve leakage control system and is required for these systems to be considered operable. With a division of NIAS rendered inoperable, the affected division would be governed by a 7 day action statement, rather than the 30 day administrative action statement the licensee imposed. It should be noted that both the staff and the licensee in the SER and USAR, respectively, stated that the noninterruptible control air is
" supplied through two separate systems (Division I and Division II) to" emergency equipment. The licensee admits that its NIAS was designed to be redundant and not subject to a single failure. Furthermore, the state-ment in Section 9.3.1.2 of the UFSAR regarding the intertie between Divisions I and II is not inconsistent with requirements specified in the Technical Specifications. Reading this provision with the Technical Specifications would permit the intertie but for no longer than 7 days.
The licensee's argument that it relied on the licensing history of Fermi 2 in determining the appropriate action that it took is not controlling and may reflect an unacceptable understanding of the Technical Specifications. The decision not to include a specific Technical Specification for a support system such as NIAS is consistent with the NRC's general approach to Technical Specifications that support systems are encompassed by the concept of operability. At the time of licensing, the licensee should have understood that operability extended to the NIAS. The NIAS System serves as a support system for equipment required operable by Technical Specifications, and is therefore, addressed explicitly in Technical Specification 1.25. In other words, since the redundant NIAS System supports redundant equipment required to be operable by Technical Speci-fications, a loss of one division will make the affected portions of i systems which NIAS supports inoperable as defined in Technical Specifi-cation 1.25. The licensee's failure to appreciate the meaning of operability is cause for concern. With respect to the licensee's arguments concerning mitigation and extenuating circumstances, the NRC does not believe that mitigation is appropriate. The root cause for this violation was the failure of the licensee's engineering staff to provide adequate guidance on the system interfaces to other departments and the failure of the operations staff ; to identify these violations when the Division II NI AS was taken out ; of service. The plant operations section of the SALP 8 report covering the period April 1986 through March 1987 lists examples where the licensee failed to recognize the appropriate 6ction to bc taken under the license v+cn equipment was found cct of service. The licerree's respor;se to SALP P l acknowhcged the Ca'ecory 3 rat ir 9 in plant crerations circ indicated that l NUREG-0940 I.A-157 I ____ _ _ _ _________ _ --- J
Appendix [ development of an operability matrix to facilitate better understanding-of Technical Specification /FSAR nuances which could affect operation of
.the plant, would be investigated. SALP 9 discussed the plant operations area and noted that violations "...when viewed collectively indicate a negative trend showing a lack of attention to detail and poor understanding of Technical Specification actions by operational personnel." Because of prior poor performance in this area, the civil penalty was escalated 100-percent. The staff.does not believe mitigation is warranted.
III. HRC Conclusions l 4 The NRC staff has concluded that Violations A and B occurred as set forth in the hotice of Violation and Proposed Imposition of Civil. Penalty. However. the staff concluded that escalation of the civil penalty for past performance was not warranted for Violation A. Accordingly, the proposed civil penalties in the amount of $175,000 should be imposed. NUREG-0940 1.A-158
p ass UNITEo STATES
/ o NUCLEAR REGULATORY COMMISSION '8 g REGION lil 'N'
- s 799 ROOSEVELT RO AD e CLEN ELLYN. 8LLINots 601M
*"** ' January 6, 1989 Docket No. 50-341 License No. NPF-43 EA 88-281 The Detroit ~ Edison Company ATTN: Mr. B. Ralph Sylvia Senior Vice President Nuclear Operations 6400 North Dixie' Highway Newport,' Michigan 48166 Gentlemen:
SUBJECTi NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 50-341/88025(DRS)) This refers to the NRC inspection conducted during the period September 6-21, and October 4-6, 1988, at Fermi Nuclear Power Station, Unit 2, of activities authorized by NRC Operating License No. NPF-43. The inspection was conducted in response to your identification and reporting of the failure of Recirculation Pump B Discharge Valve (B3105F0318) to close on August 20 and 28,1988 and to the issuance of Confirmatory Action Letter CAL-RIII-88-024. The inspection identified four apparent violations of 10 CFR Part 50, Appendix B, which contributed to the reduced reliability and failure of safety related motor operated valves (MOV). The details of the events that led to these violations are presented in the subject inspection report which was sent to you by letter dated November 9, 1988. On November 18, 1988, we held an enforcement conference with you and members of your staff during which the violations, the root causes, and your corrective actions were discussed. The violations described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty (Notice) are indicative of a programmatic breakdown in your MOV torque switch program and resulted because: (1) design control measures failed to maintain a current controlled list of torque switch setting ranges and failed to establish suitable programmatic guidance to ensure that acceptable torque switch setting ranges were maintained after maintenance and testing activities; (2) procurement documents were inadequate in that they did not require contractor personnel to be task qualified with the specific skills necessary to perform assigned maintenance on safety-related MOVs; (3) the procedure for' MOV testing was inadequate to establish correct switch settings 1 to avoid backseating during the open cycle or tripping before travel completion; and (4) prompt and comprehensive corrective action was not taken for licensee
~ identified deficiencies, thereby permitting recurrence of those deficiencies.
NUREG-0940- I.A-159
The Detroit Edison Company- 2 January 6, 1989 During a review of your Deviation Event Reports (DERs), NRC identified a number of weaknesses in your MOV torque switch program which served as precursors to the August 20 and 28, 1988 discharge valve failures. For example: (1) DER 87-0397 (October 7, 1987) discussed an issue that required torque switch settings to be increased to correspond to motor operator changeouts due to environmental qualification (EQ). The engineering review of 16 affected valves identified 4 valves that required torque switch ad,justments. One of these 4 valves was the Recirculation Pump B Discharge Valve (83105F0318) that failed to close on August 20 and 28, 1988 due to a torque switch setting that did not correspond to the EQ installed motor operator; (2) DER 87-0565 (January 7,1988) and DER 88-0174-(February 2,1988) identified that a controlled document had not been established depicting minimum and maximum allowable torque switch settings; l and (3) DER 88-0592 (March 26,1988) identified damage to an operator as a l result of a preloaded torque switch failure to trip the valve at the intended i thrust. It was' determined that the torque switch was incorrectly installed by craft contractor personnel; however, corrective action focused on the failed 1 valve and did not focus on other MOVs that had been worked on by craft ! contractor personnel. The NRC believes that the information contained in the ) above DERs was sufficient to alert your staff to this safety issue. Had your corrective. action program provided for a more timely review and resolution of , problems and an earlier identification of adverse trends, the MOV failure might ] not have occurred. j l To emphasize the importance of ensuring that problems identified on Deviation . Event Reports are properly evaluated and corrected, torque switch and limit switch settings are correctly specified and implemented, and contractor i personnel specialized qualifications are adequately described in procurement I documents, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Vic1ation and Proposed Imposition of Civil Penalty in the cumulative amount of Fif ty Thousand Dollars (550,000) for .] the violations described in the enclosed Notice. In accordance with the " General 1 Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, ) Appendix C (1988),(Enforcement Policy), the violations described in the enclosed Notice have been categorized as a Severity Level III problem. The base value of a civil penalty for a Severity Level III problem is $50,000. The escalation and mitigation factors in the Enforcement Policy were considered and found to be offsetting. We concluded that mitigation was appropriate for your identification . and reporting and for your prompt and extensive corrective action once your I investigation revealed the generic implications of the torque and limit switch problem. Escalation was deemed appropriate for your poor prior past performance in the area of Engineering / Technical Support, as evidenced by a SALP 3 rating for the period April 1, 1987 through March 31, 1988. Some of the problems noted in the SALP report were the lack of a program to address testing or long-term operability of MOVs identified in Bulletin 85-03, management involvement and engineering for maintenance and the failure to extrapolate lessons learned on one component to other similar components. There was also a prior notice of similar events, as evidenced by at least four Deviation Event Reports that l addressed specific problems with torque switches. NUREG-0940 1.A-160
The Detroit Edison Company 3 January 6, 1989 You are required to respond to this letter and should. follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future 1.nspections, the NRC.will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public Document Room. The responses directed by this letter and the accompanying Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, PL 96-511. L Sincerely, i W A. Bert Davis Regional Administrator
Enclosures:
1, Notice of Violation and Proposed Imposition of Civil Penalty
- 2. Inspection Report
} No. 50-341/88025(DRS)
- 3. Enforcement Conference Report No. 50-341/88034(DRS) cc w/ enclosures: s Patricia Anthony, Licensing i P. A. Marquardt, Corporate J Legal Department DCD/DCB (RIDS) l Licensing Fee Management Branch Resident Inspector, RIII Ronald Callen, Michigan Public Service Commission Harry H. Voight, Esq.
Michigan Department of Public Health Monroe County Office of Civil Preparedness l NUREG-0940 I.A-161 1
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY L Detroit Edison Company Docket No. 50-341 Ferm.1 2 License No. NPF-43 EA 88-281 As' a result.of an inspecti_on conducted during the period September 6-21 and October 4-6, 1988, violations of NRC requirements were identified. In-accordance with the " General Statement of Policy and Procedure for NRC Enforcemer:t Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory i Commission: proposes to impose a civil penalty pursuant to Section 234 of the I Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. 1 The particular violations and associated civil penalty are set forth below: -l A. 10 CFR P' art 50, Appendix B, Criterion XVI,. Corrective Action, as implemented by Detroit Edison's UFSAR, Section 17.1.17 requires that measures be established to assure that conditions adverse to quality such as failures, malfunctions, deficiencies, deviations, defective material and equipment, and nonconformances are promptly identified and corrected. In the case of significant conditions adverse to quality, the measures shall assure that the cause.of the condition is determined and corrective action taken to preclude repetition.
-Contrary to the above, the licensee's corrective action program failed -
.to achieve-prompt correction of identified deficiencies which constituted significant conditions adverse to quality when measures were not taken to assure that the cause of the condition was determined and corrective action initiated to preclude repetition of these deficiencies, as evidenced by the folicwing examples:
- 1. October 7,1987, DER No. 87-397: Described an error in torque switch settings on MOVs which had had motor operators replaced.
- 2. January 7,1988, DER No. 87-0174 and February 2, 1988, DER No. 87-0565: Established a need for a document to control torque switch setting ranges.
- 3. January 26, 1988, DER No. 88-0119: Described valve inoperability due to an unbalanced (preloaded) torque switch.
- 4. March 26, 1988, DER No. 88-0592: Identified damage to a motor operator as a result of a failure of a preloaded torque switch to trip at the intended thrust.
As a result of the failure to correct the above deficiencies in a timely I manner, the torque switch for the B Recirculation Pump Discharge Valve was incorrectly installed and set during May 1983. The safety-related valve subsequently faile te crerate under cesign ccnditions on August 20 anc 28, 1958. NUREG-0940 I.A-162
Notice of Violation 2 B. 10 CFR Part 50, Appendix B, Criterion III, Design Control, as implemented by Detroit Edison's Updated Final Safety Analysis Report (UFSAR), Section 17-.1.3 requires, in part, that measures shall be established to , assure that applicable regulatory requirements and the design basis are ! correctly translated into specifications, procedures and instructions. In addition, it requires that design control measures be applied to maintenance and delineation of acceptance criteria for inspections and tests. Contrary to the above, as of August 28, 1988, the licensee failed to assure that: (1) the design basis for safety-related MOV torque switch setting ranges were correctly translated into specifications, procedures, and i instructions; and (2) that controlled torque switch setting ranges were incorporated into the acceptance criteria of applicable maintenance, inspections and test procedures. As a result, such activities contributed j to the reduced reliability and failure of safety-related MOVs. l C. 10 CFR Part 50, Appendix B, Criterion V, Instructions, Prccedures, and Drawings, as implemented by Detroit Edison's UFSAR, Section 17.1.6 requires that activities affecting quality be prescribed by documented instructions, procedures, or drawings of a type appropriate to the l circumstances and shall be accomplished in accordance with these ' instructions, procedures, or drawings. Instructions, procedures, or drawings shall include appropriate quantitative or qualitative acceptance criteria for determining that important activities have been satisfactorily accomplished. Contrary to the above, as of August 28, 1988, MIE-0043, MOV Electrical Testing, Revision 4, did not include appropriate ' quantitative or qualitative acceptance criteria to assure that the safety-related MOV torque switch was properly installed and set. Specifically, prescribed limit switch settings were incorrect in value, in tolerance and in r-ference starting position; and no guidance was provided on how to properly install a torque switch, avoid a preloaded condition, and where to locate torque switch setting ranges. D. 10 CFR Part 50, Appendix B, Criterion IV, Procurement Document Control, as implemented by Detroit Edison's UFSAR, Section 17.1.5 requires that measures be established to assure that applicable requirements which are necessary to assure adequate quality are suitably included or referenced in the documents for procurement of material, equipment, and services. Contrary to the above, as of August 28, 1988, applicable requirements i necessary to assure adequate quality were not included or referenced in documents for procurement of contractor services. Specifically, no requirements were specified to have contractor mechanics task qualified with the specific skills necessary to perform maintenance on safety-relatec MOVs. As a result, during the Sring 1988 outa;e, five torque switches were impr perly installed (crelcaced) and cre c ' five VJVs was rerderet i r.o p e rabl e . NUREG-0940 I I.A-163 '
.. _ - ____ ___- _ - _ A
f r Notice of-Violation 3
/r (Co11ect'ively, these violations nave been categorized as a Severity Level III problem (Supplement I).
Civil Penalty - 550,000 (assessed equally among the violations) Pursuant to the provisions of 10 CFR 2.201, Detroit Edison Company, is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission within 30 days of.the date of this Notice. ~This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged. violation; (2) the reasons for the violation if admitted; (3) the corrective actions that have been taken and the results achieved; (4) the corrective actions that will be taken to avoid further violations; and (5) the date when full compliance will be achieved. If an adequate-reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232,
.this' response shall be submitted under oath or affirmation.
Within the same time as provided for the response required above under 10 CFR 2.201, the licensee may pay the civil penalty by lettersaddressed to the: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a' check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Of fice of' Enforcement, U.S. Nuclear Regulatory Commission. Should the licensee fail to answer within the time specified, an Order imposing the civil penalty will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part; (2) demonstrate" extenuating circumstances; (3) show error in this Notice; or (4) show other reasons why the penalty should not be imposed. In addition to protesting;the civil penalty, such answer may request remission or mitigation of the penalty. In, requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR, Part 2, Appendix C (1988) should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately fromtthe statement or explanation in reply pursuant to 10 CFR 2.201, but may incor'porate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205, regarding the pro:edure w for imposing a civil penalty. i NUREGy0940 I.A-164
Notice of Violation 4 Upon failure to pay any civil penalty due which subsequently has been determined in'accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuunt to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and answu to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 60137, and a copy to the NRC Resident Inspector at Fermi. FOR THE NUCLEAR REGULATORY COMMISSION A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois This 6th day of January 1989
)
NUREG-0940 I.A-165 j
.l
k ,. m , J ummo svAves . L fr>*P< NUCLEAR REGULATORY COMMISSION n f 'f L i 9 naoeom w :
*5 stinyas m.aza onsva,su m 1ess Anumeros, Texas insti
]J j
. j iSU FB -I W -
l l4lV ,3 p l N ^ Docket No. STN 50-482' R License No.. NPF-42 4
;~ EA 88-282 ,
[ r Wo'If Creek Nuclear Operating Corporation-
. ATTN: Bart D. Withers ,i
.: . President and Chief Executive Officer R i Post Office Box 411 'l j Burlington,-Kansas- 66839 -l J
;p Gentlemen:: ,
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION RFPORT NO. 50 482/88-200). This is in reference to the results of the NRC's Quality Verification Function ~. . 1' Inspection'(QVFI) conducted June 6-17, 1988, and to the two potential enforcement issues that were discussed with you during an enforcement conference conducted in our offices in Arlington, Texas on November 16, 1988. .The results of this: 4 inspection were provided to you 'in an inspection . report dated September 16, and ! a Notice of Violation (Notice) for violations that were not the subject of the enforcement conference was provided to you on October 19. The issues disclosed by the QVFI team inspection which are the subject of this correspondence involved your failure in 1987 when faced with erosion of. piping in.a section of the plant's Essential Service Water (ESW) system to ensure that a you remained in compliance with the Technical Specifications regarding the operability of the ESW system and your failure in 1984 to ensure that deficient 0-rings found in valves in the containment hydrogen control sampling system were replaced with.the correct 0-rings. The'NRC considers WCNOC's failure to properly address the operability of the
' ESW tystem in February 1987 a significant violation of the plant's Technical Specification (T.S.) requirements in that you operated the plant throughout the F
CERTIFIED MAIL RETURN RECEIPT REQUESTED
.NUREG-0940 I.A-166 L
~ L L .L.._.__l_ -__._.~. - . _ - _ - _ _ _ _
FB -l 198g Wolf Creek Nuclear Operating Corporation L period from February 13, 1987 until July 1, 1987, when repairs to the system were completed, without an adequate basis for your position that Loop A of the ESW system remained operable. In NRC's view, the information your staff had available in February 1987 regarding erosion of a section of pipe in the ESW system, which established that the pipe had eroded to less than 40 percent of the American Society of Mechanical Engineer (ASME) code minimum allowable wall
' thickness in some locations, should have led your staff to declare that loop of the ESW inoperable and to follow T.S. 3.7.4 which requires you to have two ESW loops operable within 72 hours or shut down the plant. In accordance with !
the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 , CFR Part 2, Appendix C (1988), the failure to assure operability of the ' Essential Service Water System, which is described in the enclosed Notice, has been classified at Severity Level III. NRC is particularly concerned that plant management had'information which ; should have resulted in either a full evaluation supporting the operability of the piping in its degraded state or in a declaration that the system was ; inoperable. Neither was done, which allowed the plant to continue to operate in an unanalyzed condition for a considerable time. Compounding our concern about the disposition of this issue is plant management's handling of the information contained in Safety Engineering Surveillance Report SSR-87-045. That report, which was made available to plant management in draft form in May 1987 and completed in early June, raised questions regarding whether a proper operability determination had been made as well as whether the operations personnel were provided enough information to make an adequate evaluation of the pipe wall thinning issue. Notwithstanding this report plant management did not address the immediate question of the operability of the i Essential Service Water system. The root cause of this violation appears to have been a weakness in your program in place at that time for involving plant engineering groups in operational matters and a weakness in communications between the two parts of your organization. We recognize that your corrective actions, which were initiated between the time you discovered the ESW system erosion problem and the time this matter was addressed by the QVFI team, included not only the development of a program to monitor for erosion and corrosion but changes aimed at providing your engineering staff a role in the determination of operability of degraded safety systems and at improving communication between your engineering and operational staffs. Because of the corrective actions you have taken and the amount of time that has pass.ed since the violation, the NRC staff considered at length whether a civil penalty should be proposed in this case. However, the need to provide l operating shift personnel with the necessary engineering support to make appropriate operability determinations is a very significant issue. In addition, the need for senior managers to discharge their oversight NUREG-0940 I.A-167
! l FEB -1 1989 l l Wolf Creek Nuclear Operating ' Corporation responsibility is of paramount importance and must be accompliu ed with an j emphasis on safety. Therefore, to emphasize the importance of: 1) thoroughly 1 analyzing the condition of degraded safety systems prior to making operability determinations, 2) effective use of independent verification organization findings, and 3) senior managers properly discharging their safety oversight responsibilities, I have been authorized, after consultation with the Director, ! Of fice of Enforcement, and the Deputy Executive Director for Regional I Operations, to issue the enclosed Notice of Violation and Proposed Imposition i of Civil Penalty in the amount of Fifty Thousand Dollars (550,000) for the i violation described in the enclosed Notice. ; The base value for a Severity Level III violation is $50,000. Although we gave , careful consideration to each of the factors in our Enforcement Policy that ' permit adjustments to this amount, no adjustment has been made because your corrective actions, which warranted a reduction in the amount, were balanced i against the duration of this violation, which warranted an increase. ! Regarding the 0-ring issue, Wolf Creek maintenance employees discovered q inadvertently during-the 1987 refueling outage that the wrong 0-rings had been d installed in several Valcor solenoid valves in the Containment Hydrogen Control system. This problem was traced to valve maintenance in 1984 which was performed specifically to install 0-rings with an acceptable qualified life in these valves but, because of apparent personnel errors, was not properly completed. While NRC considers this a violation of requirements to take adequate corrective actions once problems affecting quality are identified, we are not including a citation for this violation with this letter because we consider it another example of Violation A, " Failure to Take Adequate Corrective Actions," in the Notice sent to you on October 19, 1988, which was also based on the QVFI and to which you have adequately responded. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. Please include in this response e discussion of how the changes that you have already implemented or any additional changes you plan to implement have resulted in or will result in an effective process for evaluating degradation of any plant safety system and arriving at an operability determination. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. 1 NUREG-0940 I.A-168
.. , '; n
. J' ,
yg ] jggg [.:- Wolf Creek Nuclear' Operating - 4'
. Corporation-The responses' directed by this letter and the enclosed Notice are not subject
'to the clearance. procedures of the Office of Management and Budget as. required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
L ' Sincere)y,-
~ .,
(( g * $$ Robert D. Martin ~ r ' Regional Administrator-
Enclosure:
Notice of Violation-and _ Proposed Imposition of Civil' Penalty Cc: Kansas Radiation Control' Program Director T NUREG-0940 I.A-169
FEB - 1 1989 NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY Wolf Creek Nuclear Operating Corporation Docket No. 50-482 Wolf Creek Generating Station License No. NPF-42 EA 88-282 During an NRC inspection conducted on June 6-17, 1988, a violation of NRC requirements was identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), - 42 U.S.C. 2282, and 10 CFR 2.205. The particular violation and associated civil penalty are set forth below: Wolf Creek Technical Specification (T.S.) 3.7.4 requires that at least two independent Essential Service Water (ESW) loops be operable in Modes 1, 2, 3, and 4 With only one ESW loop operable, the Action requirement of T.S. 3.7.4 requires that at least two ESW loops be restored to operable status within 72 hours or be in at least Hot Standby (Mode 3) within the next 6 hours ar.d Cold Shutdown (Mode 5) within the following 30 hours. Contrary to the'above, one of the two required ESW loops became inoperable on February 13, 1987 due to system erosion. The licensee failed to restore the ESW loop to operable status within 72 hours of the loop becoming inoperable in that repairs were not made until July 1, 1987 and failed to be in Hot Standby (Mode 3) within the next 6 hours and Cold Shutdown (Mode 5) within the following 30 hours. This is a Severity Level III violation (Supplement I). Civil Penalty - $50,000. Pursuant to the provisions of 10 CFR 2.201, the Wolf Creek Nuclear Operating Corporation is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a
" Reply to a Notice of Violation" and should include for each alleged violation:
(1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved (4) the corrective steps that will be taken to avoid further violations,and(5)thedatewhenfullcompliancewillbeachieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. 4 NUREG-0940 1.A-170
FEB - 1 1989 ) l
' Notice of Violation Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear R;gulatory Ccmmission.- Should the Licensce fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in.accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notir.e in whole or in part, (2) dcnonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty r H id not be imposed. In addition to protesting the civil penalty in whole or ,
part, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalt Section V.B of 10 CFR Part 2, Appendix C (1988)y, , shouldthe five factorsAny be addressed. addressed in written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to in CFR 2.201, but may l incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to. avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure of imposing a civil penalty. I Upon failure to pay any civil penalty due which subsequently has been ( determined in accordance with the applicable provisions of 10 CFR 2.205, this l matter may be referred to the Attorney General, and the penalty, unless l compromised, remitted, or mitigated, may be collected by civil action pursuant l to Section 234c of the Act, 42 U.S.C 2282c. The responses to the Director, Office of Enforcement, noted a ove (Reply to a ' Notice of Violation, letter with payment of civil penalty), and answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555 with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region IV, and a copy to the NRC Resident Inspector, Wolf Creek Gcnerating Station. ) i
\
FOR THE NUCLEAR REGULATORY COMMISSION auk; Robert D. Martin i Regional Administrator I Dated at Arlington, Texas, l this 1st day of February 1989, i NUREG-0940 I.A-171
e-4 1 I.B. REACTOR LICENSEES, SEVERI1Y LEVEL III VIOLATION, + NO CIVIL PENALTY NUREG-0940
Docket No. 50-#0 License No. NPF-63 SEP15 W EA 88-205 n l' ' Carolina Power and Light Company. ATTN: Mr. E. E. Utley_ Senior Executive.Vice President Power Supply and Engineering. and Construction P. 0. Box.1551-Raleigh, NC 27602 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION (NRC INSPECTION REPORT NO. 50-400/88-21) This refers' to the Nuclear Regulatory Commission (NRC) . inspection conducted at the Shearon Harris Nuclear Plant on July 18-22, 1988. The inspection included a review of the circumstances surrounding the introduction of contraband into the- site protected area. The report documenting this inspection was sent to you by letter dated August 10,1988. As a result of this inspection, a signif-icant failure to comply with NRC regulatory requirements was identified, and accordingly, NRC concerns relative to the inspection findings were discussed in
;an Enforcement Conference held on August 16, 1988. The. letter summarizing this Conference was sent to you on August 26, 1988.
The violation described in the enclosed Notice of Violation (Notice) involved a failure by your site security staff on July 13, 1988, to identify and detect a loaded ,,38 caliber revolver which was passed through a security X-ray screening console undetected by the console operators and subsequently carried into the
. protected area. The unusual facts and circumstances disclosed during your investigation of the event serve to emphastre strengths and weaknesses in your site security program. _This event occurred at the end of a twelve-hour shift being worked by the security staff which coincided with the beginning of the site work day, the period of heaviest personnel traffic into the site. It is evident that this combination of circumstances contributed to the event's occur-rence. It was fortunate, however, that the employee who unknowingly carried the revolver into the protected area had the integrity, honesty, and presence of mind to immediately.and properly report the incident when she discovered the revolver in her purse. Her awareness of security requirements and her subsequent actions reflect favorably on your general security training. Nevertheless, the fact that this significant event occurred points out that diligence and atten-tion to detail by the security staff can never be permitted to lapse, even momentarily.
In accordance with the " General Statement of Policy),and EnforcementActions,"10CFRPart2.AppendixC(1988 Procedure the violation for NRC described in the' enclosed Notice has been classified as a Severity Level III violation. NUREG-0940 I,B-1
Carolina Power and Light Company SEP13 M Normally. a civil penalty is considered for a Severity Level III violation. However, after consultation with the Director Office of Enforcement, and the Deputy Executive Director for Regional Operations, I have decided that a civil penalty will not be proposed in this case because this event was identified and 1smediately reported by your staff, prompt corrective action was initiated, and because of your good past performance in the area of physical security. I also noted that you have initiated long tem corrective action to improve the working conditions for the security staff, particularly their return to eight hour sliffts.. 1 You are required to respond to this letter and the enclosed Notice and should follow the instructions specified therein when preparing your response. In your response, you should document the specific actions taken and any additional . actions-you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is I necessary to ensure. compliance with NRC regulatory requirements. In accordance with 10 CFR 2.790(d) and 10 CFR 73.21 safeguards activities and security measures are exempt from public disclosure. Therefore, the enclosure to this letter will not be placed in the NRC Public Document Room. The responses directed by this letter and its enclosure are not subject to the. clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Should you have any questions concerning this letter, please contact us. Sincerely, J. Nelson Grace Regional Administrator
Enclosure:
Notice of Violation ec w/ enc 1: R. A. Watson, h ee President Harris Nuclear Project D. L. Tibbitts, Director of Regulatory
. Compliance C. S. Hinnant, Plant General Manager bec w/ enc 1: (See page 3)
NUREG-0940 1.B-2 '
n ase UNITED STATES
\ NUCLEAR REGULATORY COMMisslON 8 'g REGION 841
{ t veomoostvstemoao j u u iuva. .u.~o . ..n, UAN 12 E Docket Nos. 50-373 and 50-374 Licenses Nos. NPF-11 and NPF-18 EA 88-271 Consnonwealth Edison Company ATTN: Mr. Cordell Reed Senior Vice President Post Office Box 767 Chicagc, Illinois 60690 l Gentlemen
- l
SUBJECT:
NOTICE OF VIOLATION (NRC INSPECTION REPORTS NO. 50-373/88022(DRP); ! 1 AND NO. 50-374/88021(DRP)) This refers to the inspection conducted from August 9 through October 21, 1988, ! of activities at the LaSalle County Station and to the enforcement conference l which was held on November.18,1988, between Mr. D. Galle and members of your staff and myself and members of the NRC staff. The inspection documented the results of a review of the March 9,1988 neutron flux oscillation event. In response to that event, NRC dispatched an Augmented Inspection Team (AIT) to investigate the event and detennine its causes. On March 9,1988. Unit 2 experienced a dual reactor water recirculation pump trip which resulted in unexpected neutron flux oscillations and terminated with a reactor scram on high neutron flux. NRC has determined that design control measures were deficient in verifying core decay ratio calculations. As a result, a simplified core model used for the cycle specific calculations degraded the quality of the calculations to an unacceptable level. The sensitivity of the calculation results to the radial power distribution modeling should have been identified during the licensing of Unit 1 Cycle 2 reload if a more thorough analysis had been performed in response to questions concerning the decay ratio. Additionally, it has been determined that the licensee failed to provide operating procedures which were responsive to safety concerns raised in a G.E. Service Information Letter (SIL). The absence of explicit operating procedures resulted in an incorrect operator response to the dual recirculation pump trip event in that an attempt was made to restart the pumps without first inserting control rods to the 80 percent rod line using the plant's prescribed control rod shutdown sequence. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2. Appendix C (1988), the violations described in the enclosed Notice have been classified as a Severity Level III problem. This problem is being categorized at a Severity Level III because the violations resulted in the reactor responding in an unexpected manner, which is a significant regulatory concern even though the actual event was subsequently determined to be of low safety significance. Though CECO QA questioned the contractor's low decay ratio calculations that were considered NUREG-0940 1.B-3
Commonwealth Edison Company 2 MI to be " state of the art" at that time, the issue was dismissed after receiving the contractor's assurance that the numbers were co rect. -The NRC believes that the event should have been prevented, and is in large measure due to the lack of understanding on the part of the contractor and the lack of proper design control. measures by the licensee to adequately assess the information provided by the contractor. A civil penalty is considered for a Severity Level III problem. However, after consultation with the Director, Office of Enforcement and the Deputy Executive Director.for Regional Operations, I have decided to exercise enforcement discretion and not impose a civil penalty in this case. This action is being taken in accordance with the guidance contained in Sestion V.G.3 of the Enforcement Policy, particularly for your identification of the root cause of the problem and your strong corrective actions. It is. recognized that
. CECO is now assuming a leadership role in pursuing core oscillation problems in the. industry. By exercising our enforcement discretion in this case, we want
- to emphasize your positive' performance taken in response to a serious problem.
We expect that you will take similar action in the future. You are required to respond to this letter and should follow the instructions specified in the_ enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing ycur response to this Notice,-including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. '~ The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, PL 96-511. Sincerely,
) W A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation
- 2. Inspection Reports No. 50-373/88022(DRP);
No. 50-374/88021(DRP) See Attached Distribution NUREG-0940 1.B-4
i i
)
NOTICE OF VIOLATION l ); Commonwealth Edison Company Docket Nos. 50-373; 50-374 ( i LaSelle, Units 1 and 2 Licenses No. NPF-11; NPF-18 " l EA 88-271 During an NRC inspection cenducted from August 9 through October 21, 1988, at the LaSalle County Station, violations of WRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the violations are listed below:
- 1. 10 CFR Part 50, Appendix B, Criterion III, requires that design control measures be established to assure that applicable regulatory requirements and the design basis, as' defined in 10 CFR 50.2 and as specified in the license application, for those structures, systems, and components to which this appendix applies are correctly translated into specifications, drawings, procedures, and instructions. These measures shall provide for verifying or checking the adequacy of design such as by the use of alteinate or simplified calculational methods, or by the performance of a suitable testing program.
Contrary to the above, as of December 1986, the licensee failed to have adetste design control measures in place to verify the results of the cor.. rector performed Unit 2, Cycle 2, stability decay ratio calculations. Those calculations were in substantial error in predicting the onset of core instability, and resulted in unexpected neutron flux oscillations (unstable core) and a reactor scram on March 9,1988 after a dual reactor water recirculation pump trip.
- 2. 10 CFR Part 50, Appendix P. Criterion V, requires, in part, activities affecting quality shall be prescribed by documented procedures, of a type appropriate to the circumstances ano shall be accomplished in accordance with these procedures. The procedures shall include appropriate quanti-tative or qualitative acceptance criteria for determining that important activities have been satisfactorily accomplished.
Contrary to the above, on March 9,1988, LaSalle Abnormal Operating Procedure, LOA-RR-07, Loss of Recirculation Flow-Both Loops, Revision 5, did not correctly prescribe the operator action necessary to recover from l a loss of recirculation flow as evidenced by: A. LOA-RR-07 did not include guidance t. ) manually insert control rods to or below the 80 percent rod line using the plant's prescribed i control rod shutdown insertion sequence before attempting to restart a recirculation pump. This guidance was generically provided to the license in G.E. Service Information Letter No. 380, Revision 1, BWR Core Thermal Hydraulic Stability. As a result, the reactor operators were not provided with appropriate procedures to respond to-the j unexpected core flux oscillations that occurred after the loss of both recirculation loops on March 9,1988. These flux esci11ations were terminated by a high neutron flux reactor scram. NUREG-0940 1.E-5
$ 6 l i. Notice of Violation 3g 121939 ! 2 !
- 8. LOA-RR-07 did not include appropriate qualitative and quantitative L acceptance criteria for assuring that important activities have. ,
- been satisfactorily accomplished.. Specifically, verbatim compliance- !
with the procedure would not direct the operator to perform the ! various required technical specification surveillance contained in LaSalle Operating Surveillance LOS-RR-SR1, Thermal Hydraulic Stability Surveillance, within the allowed time frame, j These violations. represent a Severity Level III problem (Supplement 1). Pursu' ant to the ' provisions of 10 CFR 2.201, Commonwealth Edison Company is hereby required to submit a written statement or_ extl anation to the U.S. Nuclear Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, ; 799 Roosevelt Road, Glen Ellyn, Illinois 60137, and a copy to the NRC Resident- ! Inspector, at the facility which is the subject of this Notice within 30 days i of the date of the. letter transmitting this Notice. This reply should be j clearly marked as a " Reply to a Notice of Violation" and should include for. l each violation: (1) the reason for the violation if admitted; (2) the l' corrective actions that have been taken and the results achieved; (3) the corrective actions that will be taken to avoid further violations; and (4) the ; date when full compliance will De achieved. Where good cause is shown, j consideration. will be given to extending response time. If an adequate reply l 1s not received within the time specified in this Notice, an Order may be issued to show cause why the licenses should not.be modified, suspended, or ! revoked or why such other action as may be proper should not be taken. l l FOR THE NUCLEAR REGULATORY COMMISSION i A Bert Davis l Regional Administrator l Dated at Glen Ellyn, Illinois ThisfpayofJanuary1989 i i NUREG-09,0 1.B-6 i
__,,7 i UNITED ST ATES [ p ascg%, NUCLE AR REGULATORY COMMisslON J' '#' -
$. RECtON H 101 M ARIETT A STRE E T, N W.
(t ; , , .. j . M' e' ATL ANT A. CEORGI A 30323 d.. R$ 2 8 9 7 Docket'Nos. 50-269, 50-270, and 50-287 License Nos. DPR-38, DPR-47, and DPR-55 EA 88-317
' Duke Power Company' ATTN: Mr. H. B.-Tucker, Vice Presiden,t Nuclear Production Department 422 South Church Street-Charlotte, North Carolina 28242 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION-
'(INSPECTIONREPORTNOS, 50-269/88-34, 50-270/88-34 AND 50-287/88-34)
This refers to the the Nuclear Regulatory Comission (NRC) . inspection conducted at.the Oconee Nuclear Station on November 15 - December 16, 1988. The inspec-tion included a review of the inadequate performance capability of the Lee - Station Transmission System, the circumstances involved in the discovery of the issue and the corrective actions. This issue was identified by you as a result of your review of electrical and mechanical system calculations for completeness in response-to the NRC safety system functional inspection (SSFI) in 1986. .The report documenting this inspection was sent to you by letter dated December 30. 1988. NRC concerns relative to the inspection findings were discussed in an' enforcement conference held on January 6,1989. The letter summarizing this conference was sent to you on January 27, 1989.. The. violation described in the enclosed Notice of Vi.olation involved a significant failure to ensure that the emergency backup power supply via the Lee Station gas turbines could perform its intended funtion under all postulated accident scenarios due to'a design deficiency. This violation resulted from a failure to adequately consider the effects of a 1979 modification that added motor driven emergency feedwater pump loads to emergency backup power supply. Speci-
.fications and calculations were not adequate to demonstrate that the original plant design regarding the capability of the Lee Station Transmission System was maintained. )
i L 'In accordance with the " General Statement of Policy and Procedure for NRC i Enforcement Actions," "10 CFR Part 2 Appendix C (1988), the violation described j l '. > ! in the enclosed Notice has been classified as a Severity Level 111 violation. ] L Normally, a civil penalty is considered for a Severity Level ill violation. i However, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Nuclear Materials Safety, Safeguards, and Operations i Support, I have decided that a civil penalty will not be proposed in this case. ! No civil penalty is being proposed to encourage your aggressive pursuit of future problems and in this case because the design deficiency identified with the Lee transmission line was the result of your internal followup from the NRC SSF1 inspection; once the design deficiency was identified, your corrective actions were prompt and comprehensive; and routine surveillance or quality assurance activities would not have detected this situation. NUREG-0940 1.B-7 j
Duke Power Company FEB 2 8 M89 You are required to respond to this . letter and the enclosed Notice and should follow the instructions specified therein when preparing your response. In
-your. response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to.this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcem it action is necessary to ensure compliance with NRC regulatory requirements.
LIn accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, ]1 Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Should you have any questions concerning this letter, please contact us. Sincerely, P 1 olm L. Ernst cting Regional Administrator
Enclosure:
Notice of Violation cc w/ encl:
' M. S. Tuckman, Station Manager State of South Carolina n
NUREG-0940 1.B-8
E ) NOTICE OF VIOLATION I
- l. . Duke Power Company Docket Nos. 50-269, 50-270, and 50-287. J Oconee Unit 1, 2 and 3 License Nos. DPR-38, DPR-47, and DPR-55 I' EA 88-317 During the Nuclear Regulatory Commission (NRC) inspection conducted November 15 - j December 16, 1988, a violation of NRC requirements was identified. The violation involved inadequate design analysis of the emergency backup power supply. In accordance with the " General Statement of Policy and Procedure for NRC Enforce-ment Actions," 10 CFR Part 2, Appendix C (1988), the violation is listed below:
10 CFR 50, Appendix B Criterion III, Design Control, requires that measures be established to ensure that applicable regulatory requirements and the design basis are correctly translated into specifications, drawings, procedures, and instructions. i Contrary to the above, following the addition of the Motor Driven Emergency Feedwater Pumps to the emergency power system in 1979, the licensee failed f to ensure that design specifications and calculations were adequate to 4 demonstrate sufficient capacity and capability of the Lee Station gas l turbines to provide power to the emergency bus for all postulated accidents. On October 17, 1988, Duke Power Company (DPC) Desigi Engineering (DE) identified by calculations that the voltage levels on the standby bus when powered from the Lee Station were inadequate under certain postulated accident conditions. Inadequate voltage levels could result in the trip-ping of some safety-related equipment due to overcurrent conditions while starting or potentially cause cafety-related motor damage. This is a Severity Level III violation (Supplement I). Pursuant to the provisions of 10 CFR 2.201, Duke Power Company is hereby required to submit a written statement or explanation to the Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II, and a copy to the NRC Resident Inspector, Oconee, within 30 days of the date of the letter transmitting this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include: (1) admission or denial of the violation, (2) the reason for l i the violation if admitted, (3) the corrective steps which have been taken and the results achieved, (4) the corrective steps which will be taken to avoid further violations, and (5) the date when full compliance will be achieved. I 1 NUREG-0940 1.B-9
Notice of Violation - ' C 'Where good cause is shown. consideration will be given to extending the response. time. If an adequate reply is not received within the time =specified in this Notice, an_ order may.be issued'to'show cause why the license should not be , modified, _ suspended,- or revoked or why such other action ~ as may be proper should not be taken. u FOR THE NUCLEAR REGULATORY COMMISSION n l . \ O 1 M co m L. Er st p t Acting Regional Administrator-i Dated at Atlanta, Georgia I. this21 4 day of February 1989 l i i l I f
.l 1
6: NUREG-0940 1.B-10
y ) i I I
, fr. y UNte Lu 6 8 Alth !. J' ?. 4 'g NUCLEAR REGULATORY COMMISSION !
i "' REGION I v 8 476 ALLENDALE ROAD 1
..... ' KING OF PRUaSIA. PENNSYLVANIA 1s4o6 January 18, 1989 Docket No. 55-7693
-License No. OP-5451 l EA 88-224 l Alfred E. Geaudreau, Jr. -
l 10ME ADDRESS DELETED l ! LWCER 10 CFR 2.790
Dear Mr. Gesudreau:
1
SUBJECT:
NOTICE OF VIOLATION (NRC Office of Investigation Report No. 1-87-015 and Enforcement Conference Conducted On September 7, 1988.) On September 11, 1987, while you were working as a control room operator at GpU Nuclear's Oyster Creek Nuclear Generating Station, a, safety limit set i forth in the facility's technical specifications was exceeded for approximately
- two minutes while the reactor was shut down. The safety limit required that the discharge valves in at least two of the five recirculation loops be fully open, unless 'the reactor head was off and the reactor was flooded to a level above the main steam nozzles. The violation occurred when you, as the control room operator on' shift at the time, shut the two discharge valves that were open at the time in ~ response to direction from your Group Shift Supervisor (GSS) to secure the recirculation pumps. The pumps had to be secured because the Reactor Building Closed Cooling Water (RBCCW) System, which provides cooling to the recirculation pump seals, had to be isolated to stop a leak in this system which developed during maintenance activities.
After the safety limit violation occurred at approximately 2:17 a.m., you promptly opened two other discharge valves to restore the plant to a condition consistent with the technical specifications. Huwever, a short time later, you willfully tore some of a sequence of alarms tape which provided a chronology of the event. Furthermore, you discarded a portion of the torn tape in a waste l basket, flushed the remainder of the torn tape down a toilet, and failed to promptly inform management of your actions. This willful destruction of records constitutes a violation of the reactor operator license that you
' possessed at the time.
This violation is described in the enclosed Notice and was admitted by you during an enforcement conference conducted with you by the NRC in the Region I office on September 7, 1988. The violation is classified at Severity Level IIT in I accordance with the " General !,catement of Policy and Procedure for I!RC .. force-l_ ment Actions," 10 CFR 2, Appendix C (Enforcement Policy) (1988). Although the l NRC understands your position that you acted out of self-directed anger rather j L than in an attempt to conceal your mistake, the willful destruction of plant { records is a serious matter constituting dereliction of duty which clearly rises t l CERTIFIED MAIL RETURN RECEIPT REQUESTED l NUREG-0940 1.B-11 l
m f -- g s i
.1 l
2 [ j L i to the threshold, set' forth in the Enforcement Policy, for taking action against .f an-individual. Consequently,- the violation' is cited against your individual
. l i ce n s e..
W Although a t:tvil penalty is considered for a Severity Level III violation,-I ;
.have'been authorized, after consultation with the Deputy Executive Director l for. Operations and the Commission not to' issue a civil penalty in this case because GPU Nuclear immediately removed you from operational duties.pending ]
completion:of an internal investigation of this event, and, upon completion of .l its investigation, terminated.your employment with the company on April 13, 1988 l thereby resulting in the expiration of your license pursuant to 10 CFR Part 55. But for the action of GPU Nuclear, NRC would have considered proceeding to suspend your license in. view of your willful destruction of the tape which demonstrates a serious violation of your limse and constitutes an act for which you are personally responsible and whic.n cannot be tolerated by the NRC. At the enforcement conference, you indicated the desire to apply-for an NRC operator license in the future, and you requested that any restriction imposed by the NRC concerning your ability to obtain a license be temporary in nature. The HRC is concerned that af ter you had made and corrected the safety limit violation..you willfully destroyed a required record and you failed to promptly report that record destruction to your management. Therefore, should you seek an NRC operator's license in the future, you should be prepared to describe why the NRC should believe, in light of your actions at Oyster , sek on September 11, 1987, that if confronted with a similar problem or a crisis in future licensed duties, you will maintain a proper safety perspective as your primary concern, and respond in a professional and responsible manner consistent with the obliga-tions of an NRC operator's license. You are required to respond to this letter and the enclosed Notice and should follow the instructions specified in-the Notice when preparing your response. Ir accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title'10, Code of Federal Regulations, a copy of this letter and its enclosure, appropriately sanitized for Privacy Act purposes, will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely, h)h William T. Russell Regional Administrator
Enclosure:
Notice of Violation NUREG-0940 1.B-12
O NOTICE OF VIOLATION Alfred E. Geaudreau, Jr. Docket No. 55-7693 HOME A00RESS DELETED License No. OP-5451 UNDER 10 CFR 2.790 EA 88-224 During an enforcement conference conducted with you on September 7, 1988 to discuss certain findings of the September 1987 Augmented Inspection Team inspection and a subsequent investigation conducted by the NRC Office of Investigations, a violation of your reactor operator license, issued pursuant to 10 CFR Part 55, was admitted. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the particular violation is set forth below: Reactor Operator License No. OP-5451, issued pursuant to 10 CFR part 55, requires, in part, that when manipulating the controls of the Oyster Creek reactor, you shall observe the operating procedures and other conditions specified in the facility license which authorizes operation of the facility. Oyster Creek Technical Specification 6.10.1 requires that records and logs of facility operation be maintained for at least five years. Contrary to the above, on September 11, 1987, at some time after approximately 2:17 a.m. (when an event occurred at Oyster Creek involving a violation of a safety limit because of less than two of the five recir-culation loops discharge valves being full open as required by the Oyster Creek Technical Specifications), you willfully destroyed a Sequence of Alarms tape of the event by tearing the tape and throwing a portion of the torn tape in a waste basket, and flushing another portion of the torn tape down a toilet. This is a Severity Level III Violation. (Supplement VII) Pursuant to the provisions of 10 CFR 2.201, you are hereby required to submit a written statement or explanation to the Director, Office of Enforcement, !' U.S. Nuclear Regulatory' Commission, with a copy to the Regional Administrator, Region I, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include: l (1) admission or denial of the alleged violation; (2) the reasons for the violation if admitted; (3) the corrective steps that have been taken and the results achieved; (4) the corrective steps that have been taken to avoid further violations; and (5) the date wher, full compliance will be achieved. ! Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C 2232, this response shall be submitted under oath or affirmation.
)
NUREG-0940 I.B-13 . I
1 .> l l-sq g. The respo'nse to the Director,' Office of Enforcement, noted above should be. addressed toi Director,.0ffice of Enforcement, U.S. Nuclear Pegulatory
-. Commission.. ATTN: Document. Control' Desk, Washington, DC'.20555, with a copy:
. to the . Regional Administrator, U.S. Nuclear Regulatory Comraission, Region I,.
475.Allendale; Road, King of Prussia Pennsylvania. 19406. FOR THE NUCLEAR REGULATORY COMMISSION hTD William T. Russell Regional Administrator Dat'ed at King of Prussia, Pennsylvania- 1 this 18h day of January .1039 j
.)
I 1 l e
)
i 4 I 1 l
. s. ,
I NUREG-0940 1.B-14
.__. - _____ _ _-__-__ _ a
UNITED STATES
- NUCLEAR HEGULATORY COMMISSION
-p
' g-e j REGION I
<a ALLENOALE ROAD
- f KING d . . rRUS$4 A, PENNEYLVANI A 19406
**** February'8, 1989
. Docket No. 50-333 License No. DPR-59 EA-88-239 New York Power Authority
' James' A. FitzPatrick Nuclear Power Plant ATTN: Mr. John C. Brons
+ Executive Vice President Nuclear Generation 123 Main Street White Plains, New York 10601 Gentlemen:
Subject:
HOTICE OF VIOLATION (NRC Inspection Report Nos. 50-333/86-04;
'60-333/86-13; 50-333/87-14 and 50-333/87-21)
This refers to the NRC inspections conducted during the periods March 11 - May 9, 1986,. August 9 - September 29, 1986, April 27 - May 1, 1987 and September 1 - October 20, 1987 to review the program for the environmental qualification (EQ) of equipment at the FitzPatrick Ruclear. Power Plant. The inspection reports were sent to you on June 23, 1986, November 10, 1986,
' September- 23, 1987,- and November 13, 1987, respectively. During these-inspec-tions, the NRC reviewed violations of NRC requirements identified.by your staff involving the lack of. qualification of certain items of electrical equipment. On November 29, 1988, an enforcement conference was conducted with members of your staff to discuss the significance and. extent of the
. violations, causes of the violations, and the corrective actions taker or planned.
One of the violations, which is described in Section I of the encloseo Notice of Violation, involved the use of torque and limit switches in four Limitorque valve actuators with an insulation material type not qualified to perform the l
. intended function during the postulated harsh environmental conditions within the primary cordainment. This problem, which was identified by your staff, !
I involved the four Reactor Recirculation System discharge valves and discharge
. bypass valves which are required to isolate to prevent diversion of emergency core cooling system flow in the event of a break in the Reactor Recirculation System.
i As you acknowledged during the enforcement conference held on November 29, 1988, as a result of inspections performed by your staff you clearly should have kr.cwn of this deficiency prior to November 30, 1985, which was the deadline for being in compliance with the EQ requirements. However, records from that inspection erroneously identify the torque and limit switch insula-tion in these actuators to be Fibrite (brown) verus Durez (red). Although the i former was known to be qualified for use in the primary containment, there was no documentation to demonstrate qualification of the latter. 1 I 4 NUREG-0940 I.B-15 l L p ; o .
New York Power Authority 2 In accordance with the " Modified Enforcement Policy Relating to 10 CFR 50.49," the enclosure to Generic Letter 88-07 (Enclosure 2), the violation described in Section I of the enclosed Notice has been determined to be an EQ Category C , violation because the violation was isolated and affected only one system. ' The base value of a civil penalty for an EQ Category C violation is 575,000. However, after cont,ultation with the Deputy Executive Oirector for Materials Safety, Safeguards, and Operations Support, and the Director, Office of Enforcement, I have decided that the civil penalty should be mitigated in its entirety in this case, for reasons set forth herein. In determining civil penalty amounts for such violations, the NRC considers the four factors set forth in the " Modified Enforcement Policy Relating to 10 CFR 50.49", for escalation and mitigation of the base civil penalty amount. These factors consist of (1) identification and prompt reporting of the EQ deficiencies ( 50%); (2) best efforts to complete EQ within the deadline ( 50%); (3) corrective actions to result in full compliance (150%); and (4) ; duration of a violation which is significantly below 100 days (-50%). j With respect to first factor, 50% mitigation is appropriate since the' violation was identified by your staff and promptly reported to the NRC. With respect to ' the second factor, 50% mitigation is appropriate in light of the your best efforts to complete equipment qualification prior to the November 30, 1985 deadline as evidenced by internal and third party audits as well as properly i supported qualification determinations for the vast majority of the installed J equipment. With respect to the third factor, 50% mitigation is appropriate since corrective actions were promptly taken when the deficiency was initially identified. With respect to the fourth factor, additional mitigation is inappropriate since this EQ violation existed in excess of 100 days. Although j Section IV.B of the Enclosure to the Generic Letter 88-07, states that a minimum {
$50,000 should normally be issued, on balance, full mitigation of the civil j penalty is appropriate, in accordance with the specific guidance described l therein, since (1) the violation was isolated and affected only one system; i (2) the violation was identified by your staff and promptly reported to the NRC; i (3) the violation was promptly corrected; and (4) the New York Power Authority l made best efforts to complete EQ at Fitzpatrick within the November 30, 1985 ;
deadline. I In addition to the violation set forth in Section I of this Notice, another j violation identified by your staff is set forth in Section II of the enclosed j l Notice. That violation is classified at Severity Level IV in accordance with l i the normal enforcement policy set forth in 10 CFR Part 2, Appendix C as documen- l tation was available and appropriately provided by the licensee to demonstrate l qualifiability of the equipment involved. l l You are required to respond to this letter and the enclosed Notice and should follow the instructions specified in the Notice when preparing your response. l- In your response, you should document the specific actions taken and any j additional actions you plan to prevent recurrence. After reviewing your ; response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. It should be noted that while the NRC staff has recognized that NUREG-0940 I.B-16
New York Power Authority 3 best efforts were made to come into compliance with EQ requirements by the November 30, 1985 deadline, there is some concern that the heavy reliance
;on contract engineering expertise used to achieve compliance could be a long ~ term problem for your EQ program. As previously discussed with plant staff, the NRC staff concludes that it is essential that the plant EQ personnel assume a more active role in the activities of this program in ot-der to maintain the high level of' quality that existed at the time of the NRC inspection.
In'accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations', a copy of this letter and its enclosure will be.placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject
'to the clearance procedures of the Office of Management and Budget, otherwise required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
Sincerely,
/
William T. Russel Regional Administrator
Enclosures:
- 1. Notice of Violation
- 2. Generic Letter 88-07 cc w/encls:
J. Phillip Bayne, President W. Fernandez, Resident Manager A. Klausmann, Senior Vice President - Appraisal and Compliance Services R. L._ Patch, Quality Assuance Superintendent George M. Wilverding, Manager Nuclear Safety Evaluation Gerald C. Goldstein,~ Assistant General Counsel R. E. Beedle,'Vice President Nuclear Support S. S. Zulla, Vice President Nuclear Engineering R. Burns, Vice President Nuclear Operation Dept. of Public Tervice, State of New York State of New York, Department of Law Licensing Project Manager, NRR Public Document Room (PDR) Local Publ.ic Document Room (LPOR) Nuclear Safety Information Center (NSIC) NRC Resident Inspector State of New York NUREG-0940 1.B-17
NOTICE OF VIOLATION New York Power Authority Docket No. 50-333 FitzPatrick Nuclear Power Station License No. OPR-59 EA 88-239 During four NRC inspections conducted between March 1),1986 and October 30, 1987 of the licensee's program for environmental qualification (EQ) of electrical equipment important to safety, violations of NRC requirements identified by the licensee were evaluated. In accordance with the (1) " Modified Enforcement Policy Relating to 10 CFR 50.49, Environmental Qualifi- i cation of Electrical Equipment Important t.o Safety of Nuclear Power Plants," the enclosure to Generic Letter 88-07, as well as (2) " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C, the particular violations are set forth below: I. VIOLATION CLASSIFIED IN ACCORDANCE WITH GENERIC LETTER 88-07 10 CFR 50.49 (f) requires that each item of electric equipment important to safety shall be qualified by testing of identical or similar equipment under conditions identical or similar to these postulated for an accident, and that qualification based on similarity shall include a supporting analysis to show that the equipment to be qualified is acceptable. Contrary to the above, from November 30, 1985 through March 31, 1986, the qualification of four Limitorque valve actuators in the Reactor Recircula-tion System was not established in that the torque switch and limit switch insulation material was Durez (red), not Fibrite (brown), which was not qualified by Limitorque for prime.ry containment use. This violation constitutes an EQ category C violation. -II . VIOLATION CLASSIFIED IN ACCORDANCE WITH 10 CFR PART 2, APPENDIX C 10 CFR 50.49(j), requires, that a record of the qualification shall be maintained in an auditable form to permit verification that each item of electrical equipment important to safety is qualified and that the equipment meets the specified performance requirements under postulated environmental conditions. Contrary to the above, from November 30, 1985 through January 28, 1987, documentation in a qualification file was inadequate to establish qualifi-cation of sixty-four Rosemount pressure transmitters installed in the analog transmitter trip system. The transmitters were installed without the use of required thread sealant at the instrument conduit connection, and there was no record in the qualification file to verify that the transmitters, as installed, would function properly in a post accident condition. NUREG-0940 1.B-18 J
g % 1 2 I This is a Severity' Level IV violation (Supplement I) Pursuant to the provisions.of 10 CFR 2.201, the New York Power Authority l(Licensee) is hereby required to submit a written statement of explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, withini 3 30 days of the date'of this Notice. This reply should be clearly marked as a 1
'" Reply to a Notice of Violation" and should include for.each alleged violation:
(1) admission--or. denial of the alleged violation;-(2) the reasons for the violation.if admitted,'(3) the corrective steps that have been taken and the results achieved, (4) the corrective' st'eps that will be taken to avoid further 1 violations, and (5) the date when full compliance was or will be achieved. ; -l Consideration may be given to extending the response time for good cause shown. Under the aut/rority. of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. FOR THE NUCLEAR REGULATORY COMMISSION i
/
William T. Russell Regional Administrator zDated a$ King of Prussia, Pennsylvania thisff4dayofFebruary1989 1 i NUREG-0940 1.8-19
r as eg y UNITED STATES f [ , ' f, ( ' ,,y NUCLEAR REGULATORY COMMISSION {
- REGION 1 I b' ,o 47s ALLENDALE ROAD
***** KING OF PRU9stA, PENNSYLVANIA 19406 3 March 13, 1989 {
Docket No. 50-410 License No. NPF-69 EA 89-04 3 Niagara Mohawk Power Corporation ATTN: Mr. Lawrence Burkhardt, III l Executive Vice President - Nuclear 1 301 Plainfield Road Syracuse, New York 13212 Gentlemen:
Subject:
NOTICE OF VIOLATION (NRC Inspection Report No. 50-410/88-21) This refers to the special NRC safety inspection conducted on December 3-2), 1988, at Nine Mile Point, Unit 2, Scriba, New York to review the circumstances associated with violations of NRC requirements which were identified by your staff and promptly reported to the NRC. The report of the inspection was sent to you on January 9,1989. On February 2, 1989, an enforcement conference was conducted with you and members of your staff to discuss the violations, their causes, and your corrective actions. Of particular concern to the staff, as discussed in the enforcement conference, was that a construction error was made , and it was not identified despite preoperational testing and several subsequent operational surveillance tests. The violations, which are described in the enclosed Notice of Violation, involve: (1) the inoperability of one of the two Automatic Depressurization System (ADS) divisions since initial operation in 1986 (contrary to the technical specifications) because of a wiring error in the logic circuitry wh'ich occurred during a construction modification in 1985; and (2) the failure to promptly identify and correct this condition adverse to quality until December 1988, even though opportunities existed to detect this error sooner. With respect to the second violation, the procedure for oerforming the preoperational test of the system in May 1986, which should have identified this error, was inadequate and the error went undetected. In addition, in July 1986 during the performance of the ADS logic surveillance test, the specific step of the test procedure which would have identified this wiring error was deferred without proper justification. In May 1988, during perform-ance of this same ADS logic test, a testing anomaly associated with the wiring error '.,e5 identified; however, inadequate technical review resulted in failure ta ebtain proper resolution of the problem. Furthermore, this error was not l icentified by the Quality Assurance Program during reviews of the "as built" condittor, of the facility prior to startup, nor during any subsequent reviews of testing. NUREG-0940 1.8-20
i i Niagara Mohawk Power Corporation The NRC recognizes that the safety significance of the inoperable ADS division was' minimized because of the operability of other redundant Emergency Core Cooling System (ECCS) equipment, namely, the other automatic ADS trip system, the manual initiation capability of the ADS valves, the High Pressure Core Spray System and the Reactor Core Isolation Cooling System. Nonetheless, i the two violations are classified in the aggregate as a Severity Level III problem in accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy) because the regulatory concern in this case was the failure to identify and correct this technical deficiency despite several previous opportunities. Although a civil penalty is normally considered for a Severity Level III violation or problem, I have considered the escalation and mitigation factors set forth in the enforcement policy and have decided, after consultation with the Director of %forcement and the Deputy Executive Director for Nuclear Materials Safety, Safeguards, and Operations Support, not to issue a civil penalty in this case because: (1) the violation was identified by a member of your staff who was persistent and inquisitive in pursuing a problem during a monthly surveillance test that was not specifically designed to detect such errors; and (2) your corrective actions for these violations, when identified, were comprehensive. Although the Division I ADS trip system was inoperable for an extended duration because of failures to identify and correct the error during previous tests, the NRC has c'ecided not to utilize this escalation factor nor prior notice since these are the fundamental bases for the NRC decision to classify the two violations in the aggregate as a Severity Leval III. Further-more, the enforcement history at Unit 2 is average, as evidenced oy Category 2 ratings in the operations and surveillance. areas during the last two SALP assessments, and therefore, neither escalation or mitigation of the civil penalty amount for this factor is warranted. The NRC also recognizes that Niagara Mohawk Power Corporation (NMPC) has made extensive management and organizational changes within the Nuclear Division since Unit I went into an extended shutdown in December 1987. These changes were instituted to correct generally poor performance which has occurred over an extended period. The problems that led to this extended shutdown of Unit 1 included the failures, at multiple levels within the NMPC organization, to promptly identify and correct existing problems. The NRC is encouraged that the program developed in response to the Unit I shutdown for aggressively improving your organization's ability to resolve existing problems at both units may have contributed to the persistent and inquisitive attitude exhibited by the technician who identified this error in December 1988. You are required to respond to this letter and the enclosed Notice and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing you response to this Notice, including your proposed corrective actions and NUREG-0940 I.B-21
l Niagara Mohawk Power Corporation f ! the results of: future inspections, the NRC will determine whether further NRC enforcernent action is necessary to ensure compliance with NRC regulatory ) requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and its enclosure , will be place in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely,
]
1 { x William T. Russell ) Regional Administrator ?
Enclosure:
Notice of Violation cc w/ encl: C. Mangan, Senior Vice President, Nuclear J. Willis, General Station Superintendent C. Terry, Vice President, Nuclear Engineering and Licensing W. Drews, Maintenance Superintendent J. A. Perry, Director, Unit 1 Restart Task Force D. Palmer, Acting Manager, QA W. Hansen, Manager, Corporate Quality Assurance R. G. Smith, Unit 2 Superintendent, Operations R. Randall, Unit 1 Superintendent, Operations C. Beckham, Manager, Nuclear Quality Assurance Operations R.,B. Abbott,-Station Superintendent, Unit 2 K. Dahlberg, Station Superintendent, Unit 1 J. F. Warden, New York Consumer Protection Branch Connor & Wetterhahn John W. Keib, Esquire Department of Public Service, State of New York State of New York, Department of Law Director of Power Division Licensing Project Manager, NRR NUREG-0940 1.B-22
l NOTICE OF VIOLATION Niagara Mohawk Power Corporation Docket No. 50-410 Nine MHe Point Unit 2 License No. NPF-69 I EA 89-04 1 l During an inspection conducted on December 3-21, 1988, NRC inspectors reviewed the circumstances associated with a violation of a technical specification limiting condition for operation which was-identified by the licensee and reported to the NRC. During the inspection, another violation of NRC require-ments was identified. In accordance with the " General-Statement of Policy and (
. Procedure for NRC Enforcement Action," 10 CFR Part 2, Appendix C (Enforcement l Policy) (1988), the violations are set forth below: i A. Technical Specification Limiting Condition for Operation (LCO) 3.3.3 ;
requires, in part, that the Emergency Core Cooling System (ECCS) actuation instrumentation shall be oper:ble as shown in Table 3.3.3-1. Table 3.3.3-1 requires, in part, two operable Automatic Depressurization j System (ADS) trip channels per trip sy* tem whenever the reactor is in , Operational Conditions 1, 2, and 3. Technical Specification LCO Action Statement 3.3.3.c-1 requires that with either ADS trip system inoperable, the inoperable ADS trip system must be restored to operable status within 7 days providing High Pressure Core Spray System and Reactor Core Isolation Cooling System are operable, or the plant shall be placed in HOT SHUT 00WN within 12 hours. Contrary to the above, between November 1986 (initial fuel load) and December 8, 1988, while the reactor was, at times, in Operational Conditions 1, 2, or 3, the ADS Division I trip system was inoperable due to a wiring error in the logic circuitry, and the reactor was not placed in the hot shutdown condition. B. 10 CFR 50, Appendix B, Criterion XVI, requires that measures be established to assure that conditions adverse to quality are promptly identified, and the cause determined and corrected. Niagara Mohawk Power Corporation > Quality Assurance Topical Report, Section 16, Corrective Action, also requires that for conditions adverse to quality, appropriate corrective action shall be implemented in a timely manner. ) Contrary to the above, during a modification to the logic circuitry of one of the ADS trip systems in 1985, a wiring error was'made that resulted 3 in one of the systems being inoperable (as described in Violation A above), i and prior to December 8,1988, this condition adverse to quality was not ' identified and corrected, notwithstanding the performance of (1) the preoperational test of the trip system logic circuitry in May 1986, as well as'(2) two surveillance tests of the logic circuitry in July 1986 and May 1988. These violations are categorized in the aggregate as a Severity Level III problem. Pursuant to the provisions of 10 CFR 2.201, Niagara Mohawk Power Corporation j is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of { l NUREG-0940 I.B-23 !
[h!. -
~,.,c-4 Y Notice of Violation ~ the'date'of this Notice. This reply should be clearly marked as a " Reply (7 to 'a Notice of Violation" and should include for each alleged violation:
(1) admission or denial of;the alleged violation, (2) the reasons for the m' violation if; admitted,'(3) the corrective steps that have been taken and-the. results? achieved,-(4) the corrective steps that will be.taken to avoid further
, violations, and.(5) the date when full. compliance will.be achieved. If ani
.. adequate reply is not-received within the time.specified in this. Notice, an ,
order may be issued to.show cause why the. license should'not.be modified, suspended, or revoked or why such other action as may be proper should not c be taken. -Consideration may.be given to extending the response time for good-cause shown. FOR THE NUCLEAR REGULATORY COMMISSION j William T. Russell Regional Administrator
'DatedatKing9fPrussia, Pennsylvania
~
this day of /JmMarch .1989 1 I l i l N'UREG-0940 I.B-24 l
.__--______-_______-____-__-__A
s E
** MOO UN1TED STATES y, , g NUCLEAR REGULATORY COMMISSION h' S REGloN lli N IE 799 ROOSEVELT RO AD
- GLEN ELLYN, ILUNOIS 601 M oi +* FEB 011989 Docket Nos. 50-282 and 50-306 License Nos. DPR-42 and DPR-60 EA 88-292 h Northern States Power Company ATTN: Mr. C. E. Larson Vice President l Nuclear Generation 414 Nicollet Mall Minneapolis,. Minnesota 55401 Gentlemen:
l
SUBJECT:
. NOTICE OF VIOLATION (NRC INSPECTION REPORTS NO. 50-282/88023[DRSS];
NO.'50-306/88023[DRSS]) This refers'to the inspection conducted during the period November 8-18, 1988 at the Prairie Island Nuclear Generating Plant authorized by NRC Operating Licenses No. DPR-42 and No. DPR-60. The NRC inspection consisted of a review of a licensee identified violation which involved inadequate access controls and allowed an unauthorized individual to gain access to your facility. The details of the event are described in an NRC Inspection Report which was sent to you by letter dated December 9, 1988. An enforcement conference was held on December 13, 1988 between you and other members of your staff and
' Mr. C.' Nore11us and others of the NRC staff. The purpose of the conference was to discuss the violations, causes, and corrective actions.
During preparation for a scheduled inspection, an NRC inspector conducted a l: routine review of licensee security event reports for the third quarter of
- 1988 sent to the Region III office by your staff. One of the documented l- events appeared to represent a violation in that an individual who had not been authorized access was given a badge allowing both protected and vital area access to the facility. The violation occurred as a result of deficiencies in your access control program. During the NRC inspection, it was determined that initial corrective action had been taken to prevent recurrence of the violatfor.. The event demonstrated a serious deficiency in the screening program for granting unescorted access to your facilities. In addition, while you identified the event and documented it in a log which was 1
reviewed by NRC, you failed to report the event within one hour as required by L' 10 CFR 73.71. A Severity Level IV violat'lon for a late report is enclosed in l 1 the Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the violation CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 I.B-25
)
)
1 TEB S 1 1989 1 Northern ~ States Power Company ' L described in.the enclosed Notice has been classified at a Severity Level III. A civil penalty is considered for.a Severity Level III violation. However, after consultation with the Director, Office of Enforcement and the Deputy 1 Executive Director for Regional Operations, I have decided that a civil penalty will not be imposed in this case because of your good performance in-the area of concern. In assessing your performance, NRC considered your excellent SALP performance and the low number of. violations for.the facility. Yo'u are required to respond to this letter and should follow the instructions specified~in the enclosed Notice when preparing your response. In your , response, you should document the specific actions taken and any additional ~ actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. , 1 Areas discussed in.this Notice concern subject matter which is exempt from j disclosure according to 10 CFR 73.21(c)(2). Consequently, the enclosures to this letter will not be placed in the NRC Public Document Room. Your response to the violation identified in the enclosed Notice should be submitted in accordance with 10 CFR 73.21. 1 The' responses directed by this letter and the enclosed Notice.are not subject to the clearance procedures of the Office of Management and Budget'as required by the Paperwork Reduction Act of 1980, Pub. L., No. 96-511. Sincerely, d ha & I D O - A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation
- 2. Inspection Reports No. 50-282/88023(DRSS);
No. 50-306/88023(DRSS) (UNCLASSIFIED SAFEGUARDS INFORMATION) See Attached Distribution l NUREG-0940 I.B-26
.l q
e ,, gf "*%k UNITED STATES [ NUCLEAR REGULATORY COMMISSION WAsHawoTow o.c 20ses
. 7,. -
' f" -
%,...../ . o-FEB 2 81989 Docket No. 50-445 License No. CPPR-126
'EA 88-2784 Mr. William-J. Cahill, Jr.
Executive Vice President, Nuclear Texas Utilities Electric Company 4
. 400 North Olive Street, L. 8. 81-4
-Dallas,' Texas 75201'
Dear Mr. Cahill:
SUBJECT:
NOTICE OF VIOLATION'
.This relates:to the matter of the expiration of the facility construction ; ' permit CPPR-126 for the Comanche Peak Steam Electric Station, Unit 1. This situation was brought to your attention during discussions with the NRC on January 28, 1986.
The violation described in the enclosed Notice of Violation involves your failure to submit a timely application for extension of your construction permit. The construction permit originally was issued on December 19, 1974 extended once in-1982, and expired on August.1, 1985. No timely request to extend the. cor:struction permit was filed pursuant to 10 CFR 2.109. ' However, construction' activities were continued until January 29, 1986 despite the expired construction pemit, at which time you filed a request for an extension. This omission, which appears to have been due to an administrative oversight on-your part, demonstrated a significant failure to adequately
- monitor a regulatory constraint. 'It was incumbent on you, as an'NRC licensee.
- to assure that administrative actions necessary prior to the expiration'date were taken on a' timely basis and your failure has' led to needless expenditure l - of time and resources by the Consission.
The NRC recognizes that its regulatory activities did not change substantially L - with the. expiration of the construction _ permit on August-1,1985 and that the staff issued an extension of the permit on February 10, 1986. While the failure did not have a direct safety impact, the lack of adequate administrative controls and sensitivity to regulatory requirements to assure schedules are met could potentially lead to violations with serious consequences. - Therefore, the failure of TU Electric to submit a timely request-for_ extension to the NRC to assure'that requirements are met in a timely manner is a significant regulatory concern. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2. Appendix C (1988), the violation described in the enclosed Notice has been classified as a Severity Level III violation. A civil penalty is considered for a Severity Level III violation.
. However, after consultation with the Comission and the Deputy Executive ,
'NUREG-0940
- I.B-27
Mr. William J. Cahill, Jr. FEB 2 81989 l. Director for Regional Operations, I have decided to exercise enforcement discretion and not propose a civil penalty in this case. The extensive corrective action programs which were just getting under way at the time of the violation, but which had not yet been fully implemented, have since resulted in considerable improvements in management policies and procedures. This corrective action, as well as the age of the violation and overall safety significance of the violation, were considered in this decision. Furthermore, it does not appear likely that this particular violation will be repeated. You are required to respond to this letter and should follow the instructions. specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this
' Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements.
In accordance with Section 2.790 of the NRC's " Rules of Practice." Part 2, Title 10, Code of Federal Regulations, a copy of this letter and and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, P.L. No. 96-511. Sincerely, hh Dennis M. Crutchf , AY ing Ahsociate Director' for Special Projects l Office of Nuclear Reactor Regulation
Enclosure:
Notice of Violation j cc w/ enclosure: , See next page I a 1 NUREG-0940 1.B-28
l NOTICE OF VIOLATION Texas Utilities Electric Company Docket No. 50-445 Comanche Peak Steam Electric Station License No. CPPR-126 Unit 1 EA 88-278 , During discussions with the NRC on January 28, 1986, a violation of NRC requirements was identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions " 10 CFR Part 2, Appendix C (1988), the violation is listed below: 10 CFR 50.10(b) states that no person shall begin the construction of a production or utilization facility on a site on which the facility is to be operated until a construction permit has been issued. 10 CFR 50.55(b) states that if construction of a facility is not completed by the latest completion date, the permit shall expire and all rights thereunder shall be forfeited. 10 CFR 2.109 provides that if a timely application is made at least thirty days prior to the expiration date, the existing license will be deemed not to have expired. Contrary to the above, Construction Permit CPPR-126 expired on August 1, 1985 and although the applicant failed to file a timely request for extension as provided by 10 CFR 2.109, activities at Unit 1 for which a construction permit is required continued until at least January 29, 1986, at which time the applicant filed for an extension. The extension was approved by the staff on February 10, 1986. This is a Severity Level III violation (Supplement II). Pursuant to the provisions of 10 CFR 2.201, Texas Utilities Electric Company (applicant) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of the letter transmitting this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include: (1) admission or denial of the violation, (2) the reason for the violation if admitted, (3) the corrective steps which have been taken and the j results achieved, (4) the corrective steps which will be taken to avoid l further violations, and (5) the date when full compliance will be achieved. l If an adequate reply is not received within the time specified in this Notice, l I NUREG-0940 1.B-29 1
5 l
-an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown.
FOR THE NUCLEAR REGULATORY COMMISSION
~
ennis M. Cru c'hfield Ac g Associate Director for Special Projects Office of Nuclear Reactor Regulation Dated at Rockville, Maryland this 28thday of February 1989. NUREG-0940 1.B-30 i l
l pamgCgq ch . UNITED STATES
! ~i ,0 - NUCLEAR AEGULATORY COMMISSION l REGION I
[ 478 ALLENDALE ROAD
'g ***** ,/ KING OF PRUS$3A. PENNSYLVAN1A 19404 February 15, 1989 Docket No. 50-29 License No'. DPR-3 EA 89-11 Yankee Atomic Electric Company ATTN: Dr. Andrew C. Kadak, president and Chief Operating Officer 580 Main Street Bolton, Massachusetts 01740-1398 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION (NRC Inspection Report No. 50-29/88-25) This refers to the'special NRC safety inspection conducted on December 27-30, 1988, at the Yankee Nucleer Power Station, Rowe, Massachusetts to review the circumstances associated with a violation of a technical specification limiting condition for operation (LCO) which was identified as a result of your operating and engineering staff's review of a planned modification at the facility. The violation was promptly reported to the NRC. The report of the inspection was sent to you on January 19, 1989. On January 27, 1989, an enforcement conference
.was conducted with you and members of your staff to discuss the violation, its causes, and your corrective action.
.The violation, which is described in the enclosed Notice of Violation, involved operat10n of the reactor at low power for indeterminate periods of time prior to November 1988 with certain reactor protective system power range and intermediate power range neutron flux trip values less conservative than the limiting safety system settings required by the technical specifications.
The violation existed during certain startups ar.d shutdowns of the reactor, and resulted from impruper adjustments by a reactor operator to the fine gains on these power range and intermediate power range neutron flux instruments. These adjustments were made so as to avoid an unnecessary reactor trip; however, the adjustments were made without recognizing that they resulted in certain trip values being less conservative than the settings described in the technical specifications. The safety significance of this violation was minimized by the fact that other instruments provided backup trips which would have shutdown the reactor prior to any of the required safety settings being exceeded, although not all of those trips are credited in the safety analysis. Nonetheless, the NRC is concerned that these adjustments to safety related instrumentation were made even though procedures lacked guidance concerning gain adjustments during plant startup and shutdown evolutions, and these adjustments had not been covered in training programs. Furthermore, although there was no caution in the appropri- ' ate procedure, the operator (s) who made these adjustments did not exhibit a sufficiently inquisitive attitude toward the making of equipment adjustments without appropriate procedural controls and in this case without adequate NUREG-0940 1.8-31
Yankee Atomic Electric Company 2 l l knowledge of the full effects of the adjustments. In addition, the oversight provided by shift supervision and shift technical advisors during the startup and shutdown evolutions was not sufficient to identify these deficiencies. The NRC recognizes that this violation appears to constitute an isolated departure from an otherwise conservative operating philosophy at this facility, as evidenced by Category I ratings in the operations area during the six prior SALP assessment periods, iionetheless, these adjustments to nuclear instrumentation without appropriate procedural controls represents a signifi- 3 cant regulatory concern, and therefore, is classified at Severity Level III in accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy). l Although a civil penalty is considered for a Severity Level III violation, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Nuclear Materials Safety, Safeguards, and Operations Support, not to issue a civil penalty in this case because (1) the violation was identified by your staff and promptly reported to the NRC; (2) your corrective actions upon identification were prompt and extensive; and (3) your prior enforcement history has been good, as evidenced by the prior Category I SALP ratings in the operations area. You are required to respond to this letter and the enclosed Notice and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC ; enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely,
/
William T. Russell Regional Administrator
Enclosure:
Notice of Violation NUREG-0940 1.B-32
L.. NOTICE OF VIOLATION w 50-29 Yankee Atomic Electric Company Docket.No. Yankee Nuclear Power Station License No. OPR-3 EA 89-11 During an inspection conducted on December 27-30, 1988, the NRC reviewed the circumstances associated with a violation of:NRC requirements which was
-identified by the licensee and reported to the NRC. In accordance with the
" General' Statement of policy and Procedure for NRC Enforcement Action," 10 CFR Part 2, Appendix C (1988), the violation is set forth below:
.. Technical Specification 3.3.1 and Table.3.3-1, Reactor Protective System Instrumentation, requires a minimum of four operable chanrels of power range neutron flux instrumentation and intermediate power range neutron
. flux instrumentation whenever the reactor is in either Modes 1 or 2, or whenever the reactor trip system breakers are in the closed position anri the control rod drive system is capable of rod withdrawal. If less than four channels are operable, Technical Specification 3.0.3 requires the facility be placed in at least hot standby within one hour and cold shutdown within the following 30 hours.
~ For channel operability, Technical Specification 2.2.1, Limiting Safety System Settings, requires that the reactor protective system (RPS) instru-mentation setpoints shall be consistent with the trip setpoint values conta.ined in Technical Specification Table 2.2-1. Table 2.2-1 states that the~ power range and intermediate power range neutron flux high setpoints must be set less than or equal to 108% of rated power, and the power range neutron flux low setpoint must be set at less than or equal .to 35%
of rated thermal power. Technical Specification Table 3.3-1 requires that the power range neutron flux low setpoint shall be operable whenever reactor power is less than 15 Mwe. Contrary to the above, for an-indeterminate number of times prior to November 9,1988, while the reactor was operated in either Mode 1 at power less than 15 Mwe, Mode 2, or with the reactor trip system breakers closed and the rod control system capable of rod withdrawal, all six of v the power range and intermediate power range nuclear instrument channels were inoperable, and-the reactor was not placed in hot standby. Those instrument channels were rendered inoperable during those times because of operator (s) adjusting the fine gains on those RPS instruments, resulting in the intermediate power range neutron flux high trip value being greater than 108%, and the power range neutron flux low trip value being greater than 35%, which is less conservative than the sepoint values set forth in Table 2.2-1 of the Technical Specifications. This is a Severity Level III violation (Supplement 1) NUREG-0940 I.B-33 C -- --_ _ _
q.
.,a
' 't >
g f; s {. L Nf;!' Pursuant toithe provisions of 10-CFR 2.201, Yankee Atomic Electric Company _ iis hereby' required to submit a written statement or explanation'to the Director, K Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as-a " Reply ' to a Notice'of Violation" and should include: (1) admission or denial of the-violation,:(2) the reasons for the violation if admitted, (3) the corrective
- f. steps that have been.taken and..the results achieved, (4) the corrective steps that will be. taken to avoid further violations,. and -(5) the date when full z
compliance will be achieved. If.an adequate reply is not received within the time specified.in this Notice, an-order may be issued to show cause why the license should not be modified.. suspended, or revoked or why such other-action. 1 as.may be proper should'not be taken. Consideration'may be given to extending ]
.the response time for' good cause shown. .
L FOR THE NJCLEAR REGULATORY COMMIS$10N i 4 4 William T. Russell Regional Administrator Dated at King of Prussia,-Pennsylvania this:/5 4Yday of February 1989 i NUREG-0940: I.8-34
._______-_____________m
l 1.C. N0N-LICENSED VENDOR (PART 21), NO CIVIL PENALTY NUREG-0940 I _- .. _ _ 1
) i 4 , I i UNITED STATES
/ \ NUCLEAR REGULATORY COMMISSION 3
y [ wAswswoTow. o. c. aoses January 24, 1989
*eee*
Docket No.: 99900080/88-01 Mr. J. T. DiCarlo, President and Chief Executive Officer Copes-Vulcan Division of White Consolidated Industries. Inc. Martin and Rice Avenues Lake City, Pennsylvania 16423
Dear Mr. DiCarlo:
This refers to the in'.?ection conducted by Mr. J. J. Petrosino of this office on November 7-11,1988'of your facility at Lake City, Pennsylvania and the discussions of the findings with Mr. D Mays of your staff at the conclusion of the inspection. The inspection was conducted as a result of Northern States Power Company's (NSP) reanalysis of some piping systems that were identified as being stressed beyond their original design operating limits due, in part, to incorrect weight and center-of-gravity data that was provided by Copes-Vulcan (C-Y) to the Westinghouse Corporation. Areas examined during the NRC inspection and our findings are discussed in the enclosed report. This inspection consisted of an examination of procedures and representative records, interviews with personnel, and observations by the inspector. I During this inspection it was found that the implementation of your QA program failed to meet.certain NRC requirements. The most significant problem was your i failure to notify all purchasers of incorrect valve assembly weight and center- ] of-gravity information that was provided to them prior to November 28, 1979 so i that they could cause an evaluation to be performed pursuant to 10 CFR Part 21. This is especially significant because you were aware of the incorrect center- ] of-gravity and weight data, but failed to notify the NRC or, any of your l customers, other than Westinghouse. The specific findings and references to { the pertinent requirements are identified in the enclosures to this letter. 1 In accordance with the " General Statement of Policy and Procedures for NRC Enforcement Actions," 10 CFR Part 2 Appendix C (1988), the violation described in the enclosed Notice has been classified at a Severity Level III problem because Part 21 reports would have been required if C-V had notified its purchasers and they had performed the required evaluations. This taeue is a significant regulatory concern. However, a civil penalty is not being proposed because pursuant to 10CFR 21.61 the failure to notify did not appear to be the result of a knowing and conscious failure. Also enclosed is a Notice of Nonconformance which describes an apparent weakness in your program for compliance with 10 CFR Part 50, Appendix B. We acknowledge that C-V ns NUREG-0940 I.C-1 i
-4 i
Mr. J. T. DiCarlo -
)
and continues to be cooperative with the staff in' its review to determine j the magnitude and scope of the problem as evidenced by your letter dated l November 22, 1988, notifying customers not previously notified of the problem. { l You are required to respond to this letter and should follow the instructions ' specified in the enclosed Notices when preparing your response. -Your response should. document the specific action taken and any additional actions you plan 1 to prevent recurrence. After reviewing your rr,sponse,. including your proposed i corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. 1 The responses requested by the accompanying Notices are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reductior. Act 1980, PL 95-511. In accordance with 10 CFR 2.790 of the Commission's regulations, a copy of this letter and the enclosed inspection report will be placed in'the NRC's Public' Document Room. Should you have any questions concerning this inspection, we will be pleased j to discuss then with you. < Sincerely, i , Brian K. Grimes, Director Division of Reactor Inspection and Safeguards Office of Nuclear Reactor Regulation
Enclosures:
- 1. Appendix A-Notice of Violation
- 2. Appendix B-Notice of Nonconformance
- 3. Appendix C-Inspection Report 99900080/88-01 cc: w/ enclosures All Licensees NUREG-0940 I.C-2
7 APPENDIX A 1 Copes-Vulcan EA 88-309' I Docket No.: 99900080/88-01 1: !
- l. ;
NOTICE OF VIOLATION 1 During an inspection conducted on November 7-11, 1988 a violation of NRC requirements was identified. In accordance with the " General Statement of' Policy and Procedures for NRC Enforcement Actions," 10 CFR Part 2, Appendix C
-(1988) the violation is listed below:
Section 21.21 " Notification of. failure to comply or existence of a defect," of 10 CFR Part 21 requires, in part, that each individual or other entity subject to.the regulations adopt _ appropriate procedures to provide for evaluating deviations or informing the licensee or purchaser of the deviation
.in order that the-licensee.or purchaser may cause the deviation to be evaluated. A director or responsible officer subject to the regulations of this part.or a designated person shall notify the Comission when he obtains information reasonably indicating a failure-to comply or a defect affecting a basic component.
Contrary to,the above, Copes-Vulcan. failed to notify all of its commercial nuclear customers of ' incorrect center-of-gravity and weight information that was provided:to them on valve assembly drawings so that the customer could notify the appropriate licensees or perform an evaluation. This incorrect information was found to have been used in the piping analyses for the D.C. Cook Unit 1 and 2 and Prairie Island Unit 1 and 2 facilities. Reanalysit of the affected piping systems resulted in stress conditions that exceeded the licensee's FSAR design limits. If this information had been adequately reviewed at the time it would have resulted in a 10 CFR Part 21 submittal (88-01-01). This is Severity Level III Violation (Supplement VII). Pursuant to the provisions of 10 CFR 2.201, Copes-Vulcan is hereby required to submit a written statement or explanation to the U.S. Nuclear Regulatory Comission, ATTN: Document Control Desk, Washington, D.C. 20555 within 30 days of the date of this letter transmitting this Notice'. The reply should be clearly marked as a " Reply to Notice of Violation and should include: (1) the reason for the violation, if admitted, (2) the corrective steps that have been taken and results achieved, (3) the corrective steps that will be taken to avoid further violations, and (4) the date when full compliance will be achieved. Where good cause is shown, consideration will be given to extending the response time. 1 1 I i NUREG-0940 1.C-3 ) 1
APPENDIX B Copes-Vulcan Docket No.: 99900080/88-01 i NOTICE OF NONCONFORMANCE During an itspection conducted November 7-11, 1988, the implementation of the quality assurance (QA) program at.the Copes-Vulcan facility in Lake City. Pennsylvania was reviewed. The results of the. inspection revealed that certain activities were not conducted in accordance with NRC requirements. These items
~are set forth below and have been classified as a nonconformance with the requirements to Appendix B to 10 CFR Part 50.
Criterion III, " Design Control," of Appendix B to 10 CFR Part 50 requires, in part, that measures shall be established to assure that applicable regulatory { requirements and the design basis for systems, and components are correctly I translated into specifications and drawings. The verifying or checking process shall be performed by individuals other than those who performed the original design. Contrary to the above, it was found that Copes-Vulcan failed to have its valve assemb".y center-of-gravity and weight data verified for technical adequacy by someone other than the individual who performed the original calculations, (88-01-02). Examples include: VALVE ID DRAWING NO. 3/4-IA58-R L-140209 1-IA56-RE L-137918 1-IA58-RE L-137968 ; 2-IA58-RE L-138049 ! I-ID56-R B-132315~ I-1058-R B-132318 2-ID58-R B-132338 Please provide us within 30 days from the date of this letter a written i statement containing: (1) a description of steps that have been or will be ' taken to correct this item; (2) a descri be taken to prevent recurrence; and (3) the ption of steps dates your that have been corrective actionsor and will preventive measures were or will be completed. We will consider extending the response time if you can show good cause for us to do so. NUREG-0940 I.C-4
i 11.A. MATERIALS LICENSEES, CIVIL PENALTIES AND ORDERS
?
NUREG-0940
ii etasco UNITED STATES fg NUCLEAR REGULATORY COMMISSION [.
.4 [- $ REGloN lil 799 moostvEtt noAo L ,j otem ettvn. stunois sois7
- },
4...* FEBo3 ggg , Docket No. 030-18190 License No. 21-20279-01 EA~87-231-f ' Biomedical Diagnostic Services', Ltd.
~ ATTN: Ram Gunabalan, M.D.
President 1555 W. Big Beaver Road Suite G14 < Troy, MI 48084 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY
.(NRC INSPECTION REPORT NC. 030-18190/88001(DRSS))
This refers to the1 inspection conducted on November 15-16, 1988, at your faci.11 ties in Troy and_ Detroit, Michigan. As a result of the inspection, NRC identified multiple violations of NRC requirements. A copy of the inspection report was forwarded to you by letter dated December 7,1988. An enforcement conference was held in the Region III office on December 8, 1988 to discuss the . violations, causes, and corrective actions between you and Mr. C. Norelius and other members of the NRC Region III staff. The results;of the inspection indicated a lack of management control over licensed activities as it relates to your radiation safety program. It appears that the departure of an individual in July 1988, who was acting as Radiation Safety Officer (RS0) is directly tied to the recent decline in performance at your facilities. While the individual violations are not significant safety concerns, the violations in the aggregate raise significant concern regarding radiation safety at your facilities. As part of the corrective actions requested by this; letter, you are specifically requested-to address how you will achieve improved management oversight to ensure your program meets NRC requirements in.the' future. During the enforcement conference on Decemoer 8, 1988, NRC representatives expressed concern that you personally might not be able to effectively administer the radiation safety program as it currently exists
- because of other demands on your time. Please address in your response your plans for oversight of day to day activities and plans for comprehensive audits as necessary for successful administration of your program.
To emphasize the importance of maintaining adequate control over your radiation safety program, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Seven Hundred fifty Dollars NUREG-0940 II.A-1
w. _ _ _ _ - - -
~
[/ i y FEB e 3 ggg L : Biomedical' Diagnostic Services- 4 ($750).for the violations described in the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations
- described in the enclosed Notice have been categorized as. a Severity Level III probitm.
The base value of a civil. penalty for a Severity Level III violation or problem is $500. The escalation and mitigation factors in the Enforcement Policy were
- considered. .The base civil. penalty amount has been increased by 50 percent because'the violations were identified by NRC and because, at the time of inspec-tion, your program did not provide adequate assurance that sufficient audit capability existed to identify'such violations.
You are required to respond..to this letter and should' follow the instructions specified in the enclosed. Notice when preparing your response. In your response, you should document the . specific actions taken and any additional ctions you plan'to prevent, recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC wi11' determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory. requirements. In accordance with Section 2.790 of the NRC's'" Rules of Practice'," Part 2, Title 10,.Coce.of Federal Regulations, a copy of this letter and its' enclosure will be placed in'the NRC Public Document Room.
. The' responses. directed by this letter and the enclue ed Notice are not subject to the clearance procedures of the Office of Management and Budget, as required
- by the Paperwork Reduction Act of 1980, Pub. L., No. 96-511.
Sincerely, O h kW A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition
.of Civil Penalty
- 2. . Inspection Report No. 030-18190/88001(DR55)
- See Attached Distribution Y
NUREG-0940- II.A-2 1
7 , a.. NOTICE OF VIOLATION
-AND.
PROPOSED IMPOSITION OF CIVIL PENALTY l Biomedical Diagnostic- Docket No. 030-18190.
. Services, Ltd. License No. 21-20279-01 Troy, Michigan EA 87-231
'During an NRC inspection conducted on November 15-16, 1988, violations of NRC
- requirements were identified. In accordance with the " General Statement of
', Policy and Procedure for NRC. Enforcement Actions," 10 CFR Part 2, Appendix C
'(1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act'of.1954, as amended (Act),
~42'U.S.C. 2282,:and-10 CFR 2.205. The particular violations and associated civilfpenalty are set forth below:
- A. License Condition No.f17 requires that licensed material be possessed and.
used.in'accordance with the statements, representations, and procedures contained in-the. licensee's application dated March 12, 1982.
- 1. Item No. 15 of this application states that the procedures in Appendix G1of Regulatory Guide- 10.8 (1980) will.be followed.
Appendix G requires that whole body. personnel monitoring devices (film badges or TLDs) be worn by personnel at all times while in areas where radioactive materials are used. Appendix G also requires that TLD finger badges be worn by personnel during preparation, assay, and injection of radiopharmaceuticals.
- Contrary to the above, f rom November 7 through 15, 1988, a nuclear medicine technologist at the Troy, Michigan facility, while not wearing whole body or finger personnel monitoring devices, prepared, assayed, and injected' patient radiopharmaceutical doses. In addition, a nuclear medicine technologist at the Detroit, Michigan facility, while not wearing whole body or finger personnel monitoring devices, prepared, assayed, and injected patient radiopharmaceutical doses on November 15, 1988.
- 2. Item No.14 of this application states that procedures in Appendix F of Regulatory Guide 10.8 (1980) will be followed. Appendix F requires that' incoming packages containing radioactive material be wipe tested for contamination upon receipt.
Contrary to the above, from November 7,1988 to the date of the inspection, incoming packages containing radiopharmaceutical doses had not been wipe tested for contamination upon receipt at the Troy, 1 Michigan facility.
- 3. Item No. 10 of this application states that 48-hour duration dose calibrator linearity tests will be performed on a quarterly frequency.
NUREG-0940 II.A-3 _ _ _ _ _ _ _ - _ _ _ _ = _ _ _ _. _ _ - _ _ _
m" , i r' y, x i< r .. . . L . ? Notice'of Violation .2
.( s Contrary to the above,.as.of the date.of the inspection, a 48-hour N
- duration :linearity. test on the Capintec CRC-4 dose calibrator used at
-the Detroit, Michigan facility had not been performed 'for the, third
~
quarter of 1988, in.that the test performed was only of a 27.5-hour m duration. Additionally, the test for the fourth quarter of 1988 performed.in-November 1988 was only of a'9 hour' duration.
-4. Item No.' 15 of this application states that procedures in Appendix ~G ;
.of: Regulatory Guide _10.8 (1980) will be followed. Appendix G requires. l that personnel. wear: disposable gloves'at all times while handling =l radioactive materials.
Contrary :to the above, on November 15, 1988, a nuclear medicine technologist.at the Troy, Michigan facility was observed handling radioactive material (a sealed source containing cesium-137) while i not we'aring gloves.
-B. License Condition No.11 requires that the use or supervision of use of licensed material. be limited to: a named physician. !
10:CFR 35.25(a)-requires that a licensee that permits the receipt,- possession, use.or transfer of Dyproduct material by-an' individual under the supervision of.an' authorized user shall: .(1) instruct the supervised
? individual. in the' principles of radiati.on safety; (2) require the
= supervised individual to follow the instructions of the authorized user, .
- follow the. procedures of the Radiation Safety Officer; and' comply with j appropriate regulations and license conditions; and (3) review periodically. the supervised individual's use of byproduct material.
Contrary-to the above, in-November 1988, the licensee permitted an x-ray
- technologist who was not under the supervision of an authorized user to .
use byproduct material at the Livonia, Michigan, facility. Specifically, l the technologist performed a dose calibrator linearity test utilizing a technetium-99m linearity source, and was not instructed in radiation safety-
'by an authorized user or the procedures of the Radiation Safety 0fficer
~and was-not periodically reviewed.
~
C. 10 CFR 35.70(a) requires that licensees survey with a radiation detection survey instrument t the end of each day of use all-areas where radiopharmaceuticals are routinely prepared for use or administered. 10 CFR 35.70(e) requires that licensees survey for removable contamination
.once each week all areas where radiopharmaceuticals are routinely prepared x for use, administered, or stored.
Contrary to the above, on October 17 and 18 and November 7-11 and 14, 1988, in areas where radiopharmaceuticals are routinely prepared for use and administered, surveys with a survey instrument were not performed at the j l 1 NUREG-0940 II.A-4 m - _ - - . - - - _ - - - _ - - _ - - - - _ - _ - _ -
Notice of Violation 3 f . end.of each day at the Troy, Michigan facility. Additionally, the licensee did not survey for removable contamination at the Troy, Michigan facility between September 16 and October 3, 1988 and between October.14 and November 1,1988, or-at the Detroit, Michigan facility between September 30 and November 9, 1988, in areas where radiopharmaceuticals were routinely prepared for use and administered. D. 10 CFR 35.53(c) requires that a licensee shall retain for a period of two years -a: record of radiopharmaceutical dosages containing photonemitting
-radionuclides.
Contrary to the abov'e, records of radiopharmaceutical dosages containing photon-emitting radionuclides for July 7 and 18; August I and 8; September 1,.20, and 26; and October 4 and 14, 1988 were not retained or available.for review at the Troy,-Michigan facility. E. .10 CFR 35.59(b)(2) requires that each sealed source be tested for leakage at intervals not to exceed six months or at other intervals aoproved by the Commission or an. Agreement State. Contrary to.the above, between December 1987 and October 1988, a period greater than six months, a sealed source located at the Troy, Michigan facility containing approximately 200 microcuries of cesium-137 was not tested for leakage. No other interval had been approved by the-Commission or'an Agreement State. This is a repeat violation. These violations have been evaluated in the aggregate as a Severity Level III problem (Supplement VI). Cumulative Civil Penalty - 5750 (assessed equally among the violaticns). Pursuant to the provisions of 10 CFR 2.201, Biomedical Diagnostic Services, Ltd. (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation; (2) the reasons for the violation if admitted; (3) the corrective actions that have
'been taken and the results achieved; (4) the corrective actions that will be taken to avoid further violations; and (5) the date when full compliance will ~be achieved. If an adequate reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the .
- response time for good cause shown. Under the authority of Section 182 of the Act 42 U.S.C. 2232, this response shall be submitted under oath or af firmation.
I NUREG-0940 II.A-5
Notice of Violation 4 Within the same time as provided for the response required under 10 CFR :.201, the Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an Order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of 1 Violation" a.1d may: (1) deny the violations listed in this Notice in whole ] or in part; (2) demonstrate extenuating circumstances; (3) show error in this ] Notice; or (4) show other reasons why the penalty should not be imposed. In i addition to protesting the civil penalty, in whole or in part, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any j written answer in accordance with 10 CFR 2.205 should be set forth separately ! from the stat -'nent or explanation in reply pursuant to 10 CFR 2.201, but may J incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g. , citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. , Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provision of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, , unless compromised, remitted, or mitigated, may be collected by civil l action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Regional Administrator, Region III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 50137. FOR THE NUCLEAR REGULATORY COMMISSION A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois this 1st day of February 1989 NUREG-0940 II.A-6
a p
'.b
* [j NUCLEAR REOULATORY COMMISSION I }
f , ReOION I .- 4 > 478 ALLeNOALe ROAD W...* - c - sono or enuestA. PENNSYLVANIA 194o8 February 7,.1989 Docket No. 030-12239 License No. '20-17131-01 EA 88-319' LBrigham'and Women's'. Hospital ATTN:- H. Richard Nesson, M.D. President-L75 Francis Street Boston, Massachusetts 02115 -
.Gentlemeni-
Subject:
? NOTICE. OF VIOLATION AND PROPOSE' D IMPOSITION OF CIVIL PENALTY (NRC Inspection Report No. 30-12239/88-002) This-letter refers to the NRC inspection conducted on December 19-20,.1988 at-
' Brigham and Women's Hospital,L Boston, Massachusetts,. of. activities authorized .
'by NRC License No. 20-17131-01. The report of the. inspection was sent to you on January. 3,'1989; ' The) inspection was conducted to review the circumstances
- associated with'an event,,which was identified by your staff and reported to the NRC, involvingLthe. loss of a one curie gadolinium-153 source at'the..
facility in _ late November 1988. During the inspection, ' violations of NRC requirements'were-identified. On January 13, 1989, an enforcement conference was conducted with Mr.- K. Veinbergs of your staff, as well as Mr.~ George ~.Winert, your consultant, to discuss the violations, their causes and your. corrective actions.
'The violations,'which are described in the enclosed Notice of Violation and
' Proposed -Imposition of Civil Penalty, include: (1) failure to maintain adequate surveillance and control of the source, resulting in it being lost.
l. and (2) failure to provide adequate training to certain personnel authorized access to areas where radioactive material was located. The violations j I represent 'a significant lack of control of licensed materials and licensed activities, and they are further indications of a' continuing decline in regulatory performance at your facility. As you know,'the recent enforcement history at Brigham'and Women's Hospital has not been good, as evidenced by the i h notification of 25 violations during the previous.three NRC inspections conducted since 1983, as well as the issuance of
$1,875 and $5,000 civil penalties on November 8, 1983 and July 6,'1988,-
- respectively, for the violations identified during two of those inspections.
(; -This recent loss of a radioactive source and the related violations demonstrate
~ that control of operations at your facility has not sufficiently improved to
' preclude the occurrence of significant violations at your facility. Further, although specific commitments were made in your August 6,1988 response to the l previous' civil penalty so as to improve control of activities (including 4 commitments-to hire a full time health physicist as the Radiation Safety I Officer (R50), and to assure that the RSO and the Chairman of the Radiation Safety Committee are independent), implementation of several of those NUREG-0940 II.A-7
1 p Brigham and Women's Hospital 2 l commitments had not been completed at the time cf the enforcement conference. Although your letter of January 23, 1989, in response to the Confirmatory Action Letter issend to you on January 18, 1989, addressed your schedule for meeting those commitments, additional management attention is needed to assure proper implementation of the radiation safety program at your facility and prompt correction of the underlying causes of deficiencies when they are identified. Therefore, to emphasize this need, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Five Thousand Dollars ($5,000) for the violations set forth in the Notice. The violations have been classified in the aggregate as a Severity Level III problem. The base civil penalty amount for a Severity Level III violation or problem is $2,500. The escalation and mitigation factors were considered, and the base civil penalty amount has been increased by 100% based on your prior poer enforcement history. Although we considered a 50% reduction of the base civil penalty amount based on your identification of the lost source, a reduction was considered inappro-priate because (1) the training violation was identified by the NRC; (2) the_ loss of the source was easily identifiable; and (3) the violations may have been prevented and/or identified sooner had the new RSO, who the licensee agreed to hire in response to the NRC civil penalty dated July 6, 1988, in fact, been hired in time to have increased and improved oversight and control of *.he radiation safety program. You are required to respond to this letter and the enclosed Notice, and should follow the instructions specified in the enclosed Notice when pmparing your response. In your response, you should document the specific actie s taken and any additional actions you plan to prevent recurrence. After revie m g your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further action is needed to ensure compliance with regulatory requirements. Furthermore, we emphasize that any recurren e of these violations may result in more significant enforcement act on. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regu?ations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, PL No. 96-511. Sincerely, William T. Russell Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty NUREG-0940 II.A-8
NOTICE OF VIOLATION AND PROP 0"D 1*rC51r10N OF CIVIL Fi'NALTY Brigham and Womet, s Hospital Docket No. 030-12239 Boston, Massachusetts 02115 License No. 20-17131-01 EA 88-319 On December 19-20, 1988, an NRC inspection was conducted to review the circum-stances associated with the loss of a one curie gadolinium-153 source at the licensee's facility. During the inspection, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure l for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2281, L and 10 CFR 2.205. The particular violations and associated civil penalty are , set forth below. ' .A. 10 CFR 20.207(a) requires that licensed materials stored in an unrestricted area be secured against unauthorized removal from the place of storage. 10 CFR 20.207(b) requires licensed materials in an j unrestricted area be under the constant surveillance and immediate control of the licensee. As defined in 10 CFR 20.3(a)(17), an unrestricted area is any area access to which is not controlled by the licensee for purposes of protection of individuals from exposure to radiation and radioactive i materials. Contrary to the above, on November 22, 1988, a one curie gadolinium-153 source (the source), located in its shipping container, was stored in the nuclear medicine department hot lab (an unrestricted area since it was accessible to numerous personnel, including unescorted and untrained security and housekeeping personnel), and at the time, the source was not secured from unauthorized removal, and was not under constant surveillance and immediate control of the licensee. Subsequently, an unauthorized removal of the source and its shipping container occurred from the hot lab and neither have been located. B. 10 CFR 19.12 requires, in part, that all individuals working in a restricted area be instructed in the precautions and procedures to mini-mize exposure to radioactive materials, in the purposes and functions of protective devices employed, and in the applicable provisions of the Commission's regulations and licenses. Contrary to the above, as of November 28, 1988, unescorted housekeeping personnel were permitted to enter restricted areas where radioactive material was stored, such as research laboratories, and these individuals had not been instructed in the precautions and procedures to minimize exposure to radioactive materials, in the purposes and functions of protective devices employed, and in the applicable provisions of the Commission's regulations and licenses. NUREG-0940 ll.A-9 ____d
*
- Notice of Violation 5 These violations are categorized in the aggregate at Severity L:: val III (Supplement'IV).
Cumulative civil penalty - $5,000 (assessed equally between the violations). Pursuant to the provisions of 10 CFR 2.201, Brigham and Women's Hospital (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of.the date of this Notice. This reply should be clearly marked as a
" Reply to a Notice of Violation" and should include for each alleged violation:
(1) admission or denial of the alleged violation, (2) the reasons for. the violation if admitted, (3) the corrective steps that have been taken'and the results achieved, (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an' order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of.the Act, 42 U.S.C. 2232, this response shall be' submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to 1 answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of t10 CFR Part 2, Appendix C (1988), shr>uld be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may l_ incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing l- page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. NUREG-0940 II.A-10 4
Matice of Violation 6 The response to the Director, Officer of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555 with a copy to the Regiorial Administrator, U.S. Nuclear Regulatory Commission, Region I, 475 Allendale Road, King of Prussia, Pennsylvania 19406. FOR THE NUCLEAR REGULATORY COMMISSION 1 h William T Russell Regional Administrator Dated at King of Prussia, Pennsylvania this /#" day of February 1989 l NUREG-0940 II.A-11
f % UNTTED STATES
!' p, NUCLEAR REGULATORY COMMISSION
{ O
;p REGK)N V 1460 MARIA LANE. SUITE 210
\.*s.** [ WALNUT CREEK, CALIFORNIA 94606-6388 DEC 0
- 1988 Docket No. 030-17088 License No. 53-19179-01 EA 88-256 C & R Laboratories ;
ATTN: Mr. Roland Watson President & RSO 2248 Aumakua Street Pearl City Hawaii 96782 l Gentlemen: I
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 030-17088/88-02) - This refers to the NRC special safety inspection conducted on September 17, 1988 at the licensee's_ facilities in Pearl City, Hawai' of activities authorized by NRC License No. 53-19179-01. The inspec..on was conducted to examine the circumstances associated with the licensee's reported radiation , overexposure of a radiographer during a radiographic operation at the Kahe I Power Plant, Honolulu, Hawaff. The results of the inspection were discussed with you at the conclusion of the inspection, and on October 19, 1988, during the enforcement conference betwe: i you and representatives of the NRC staff. The violations identiffei include (a) exposure to radiation in excess of i applicable limits, (b) use of an inoperable rediation survey instrument, and (c) failure to secure a radiation source in the sitelded position. The latter two violations contributed to the occurrence of '.ho first. Collectively, these violations demonstrate a need to imprr w tM administration and control of your radiation safety program to ensure adher.nce to NRC requirements and safe performance of licensed activities. These violations are of particular concern because of your involvement in them and because the direct cause of the violations appears to be your fatigue due to your long work hours. To emphasize the importance of these matterr 'nd the need to ensure implemen- ' tation of effective control of your license.o program, I have been authorized, after consultation with the Director, Office of Enforcement and the Deputy Executive Director for Regional Operations, to issue the attached Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Two Thousand Dollars ($2,000) for the violations described in the enclosed Notice. The violations have been categorized in the aggregate as a Severity Level II violation in accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy). The base civil penalty for a Severity Level II violation is $8,000. The NRC Enforcement Policy allows for reduction of a civil penalty .under certain circumstances. In this case, the base civil penalty is reduced by 75% because of your good past performance. Further reduction was not considered appropriate because of the seriousness of the overexposure incident. NUREG-0940 II.A-12
l
\
l C & R Laboratories DECC 19S8 You are required to respond to this letter and should follow th instructions specified in the enclosed Notice when preparing your response. In your i response, you should document the specific actions taken and any additional ; corrective actions you plan to prevent recurrence. In addition, you should l describe what actions have been taken to ensure that you and your employees j understand the importance of strict adherence to these corrective actions. After reviewing your response to this notice, including your proposed corrective actions and the results of future inspections, the NRC will detennine whether further NRC enforcement action is necessary to ensure compliance with'NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure l will be placed in the NRC Public Document Room. The response directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, P.L. No. 96-511. Sincerely, n>Eb _. Ac,d')\ . artin ~ Regional Administ
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penelty NUREG-0940 II,A-13 li _ _ __. - - _
NOTICE OF VIOLATION AND
. PROPOSED IMPOSITION OF CIVIL PENALTY C & R Laboratories Docket No. 030-17088 ,
Pearl City Hawaii License No. 53-19179-01 EA 88-256 During the NRC special inspection conducted on September 17 3 1988 at Pearl City, Hawaf f, violations of NRC requirements were identiffnd. In accordance with the " General Statement of Policy and Procedure for NRC Er.forcement Actions," 10 CFR Part 2, Appa ndix C (1988), 53 Fed. Reg. 40019 (Oct. 13, 1988), the Nuclear Regulatory Commission proposes to impose a civil penalt pursuant to Section 234 of the Ataic Energy Act of 1954, as amended (Act)y, 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. 10 CFR 20.101(a) provides, in part, that no licensee shall possess, use, or transfer licensed material in such a manner as to cause any individual in a restricted area to receive, in any calendar quarter, from radioactive material and other sources of radiation, a total occupational dose in excess 1.25 rems to the whole body or lens of the eyes, or 18.75 rems to the hands and forearms, or feet and ankles. Contrary to the above, a radiographer working at the Kahe Power Plant near Honolulu, Hawaii on August 10, 1988,' received calculated occupational doses of 6.1 rem to the whole body,118.0 rem to the right hand, and 2.2 rem to the lens of the eyes. The total measured occupational quarterly dose, based on the radiographer's film badge, was 6.0 rem to the whole body.
- 8. 10 CFR 34.22(a) provides, in part, that during radiographic operations, the sealed source assembly shall be secured in tfe i shielded position each time the source is returned to that position.
Contrary to this requirement, at the time of the overexposure on August 10, 1988, the radiographer had not secured the sealed source assembly in the shielded position after the source was returned to that position. C. 10 CFR 34.43(b) provides, in part, that a survey witii a calibrated and operable radiation survey instrument shall be made after each exposure to confirm that the sealed source has been returned to its shielded position. Contrary to this requirement, at the time of the overexposure on August 10, 1988, the licensee radiographer made a survey of the radiographic exposure device with an inoperable survey instrument. Collectively, the above violations have been categorized in the aggregate as a Severity Level II violation (Supplement IV). Cumulative Civil Penalty - $2000 (assessed equally among the violations). NUREG-0940 II.A-14
Notice of Violation Pursuant to the provisions of 10 CFR 2.202, C & R Laboratories is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1)admissionor denial of the alleged violation, (2) the reasons for the violation if admitted,(3 ! achieved,(4)thecorrectivestepsthathavebeentakenandtheresults
) the corrective steps that will be taken to avoid further l violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
Within the same time as provided for response required above under 10 CFR 2.202, the licensee may pay the civil penalty by letter addressed to the i Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a l check, draft, or money order payable to the Treasurer of the United States in I the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in wble or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission. Should the licensee fail to answer within the time specified, an order imposing the civil penalty wf11 be issued. Should the ifcensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in rhole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" e,d may: (1) deny the violations listed in this Notice in whole or inpart,(2 demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty in whole or in part, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalty, the factors addressed in Section V.8 of 10 CFR Part 2, Appendix C (1988), 53 Fed. Reg. 40019 (Oct. 13, 1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts o' the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to ovoid repetition. The attention of the licensee is directed to other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be cullected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. NUREG-0940 II.A-15
Jo Notice of-Violation The responses: to the Dir' ector,.0ffice of Enforcement, noted above (Reply to a Notice:of Violation, letter with . payment of civil penalty, and answer to-a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington-D.C. 20555, with a copy to the Regional-Administrator' U.S. Nuclear Regulatory , Commission, Region V,1450 Mar.ia Lane, Walnut Creek . California, 94596.
'FOR THE NUCLEAR REGULATORY COMMISSION-bf 0_.
Ertin Re~1 na Administrator
/Zu o .
-Dated at Walnut Creek, California this 74 day of December 1988 1
l 1 NUREG-0940 II.A-16
j; I g nec - i UNITED STATES [*g NilCLEAR . REGULATORY' COMMISSION - d+ > g nEcion m
'5 'f 799 ROO5EVELT RO AD etc~ cu.vn, itu~Ois som
...,+ February 16, 1989 Docket No. 030-29214 License No. . 21-24704-01f '
- EA 88-318 Entela, Inc.
. . ATTN: Mr. Kenneth M. Sweers President 3033 Madison Avenue, S.E.
Grand Rapids,. Michigan 49508 Gentlemen:
+~ ' .
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY
'(NRC.INSPECTIONREPORTN0;,030-29214/88001[DRSS))
This refers to the inspection; conducted during th'e period December. 15-21, 1988, at your_ facility'in Grand-Rapids, Michigan. The inspection. included a review' of the circumstances which resulted in damage to one of your moisture-density gauges at a construction site near Whitehall, Michigan. The damage to the gauge was identified by your staff on November 25, 1988 and reported to the NRC by telephone on November 28, 1988. The report of the inspection was forwarded to you by letter dated January 20, 1989. During the inspection, violations of NRC requirements were identified. The violations, the causes, and your corrective actions were discussed during an enforcement conference in the NRC Region III office on January 10, 1989, between you and other metabers of your staff and Mr. C.' E. Norelius and other members of the Region III staff. The violations identified during the NRC inspection resulted from a breakdown in'the implementation of an effective management control program. The violation in Section I of the enclosed Notice of Violation and Proposed Imposition of Civi'l Penalties (Notice) is of particular concern because your Radiation Safety Officer (R50) disregarded your. license requirements and willfully chose to permit eight individuals to use moisture-density gauges at various field sites even though he knew these individuals had not completed an approved training course as required by your NRC license. The RSO made this decision because an NRC-approved course was not available in your geographical area and it was inconvenient and expensive to send these individuals to a more distant training site. We acknowledge, however, that your RSO did personally give some instruc-tions to these individuals as well as provide for on-the-job training before they were permitted to work without supervision. The NRC inspector interviewed two of the'eight individuals during the inspection and concluded that they had a basic understanding of radiation setety principles. Nevertheless, if a licensee cannot meet an NRC requirement, NRC should be contacted to determine 1
. whether relief can be granted. It is not acceptable to proceed and violate a requirement.
NUREG-0940 II.A-17
k Entela, Inc. 2 February 16, 1989 In Section II of the Notice, Violation A resulted when an Entela, Inc. employee failed to maintain constant surveillance and immediate control over a moisture-density gauge after he had placed it on the ground in an unrestricted area at a construction site. The gauge was subsequently run over by a construction vehicle and severely damaged. Violation B resulted from your failure to notify the NRC Operations Center of the damaged gauge incident in a timely manner and Violation C resulted when you failed, in several instances, to test sealed sources contained in moisture-density gauges at six month intervals. Willful violations of NRC requirements for financial benefit will not be tolerated by the Commission. Your license may be suspended should there be future instances of willful noncompliance. To emphasize the significance with which we view intentional violations of our safety requirements and the need to ensure continual implementation of effective management control over your radiation safety program, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Nuclear Materials Safety, Safeguards, and Operations Support, to issue the enclosed Notice of Viola-tion and Proposed Imposition of Civil Penalty in the amount of One Thousand 1 Two Hundred Fif ty Dollars (51,250) for the violation described in Section I of the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violation described in Section I of the enclosed Notice has been categorized at Severity Level III. The base civil penalty for a Severity Level III violation or problem is 5500. The NRC Enforcement Policy allows for the adjustment of a civil penalty under certain circumstances. In this case, after considering the mitigation / escalation factors in the Enforcement Policy, we concluded that a 150' percent increase in the base civil penalty is appropriate for the violation in Section 1 of the Notice because: (I) the violation was identified by the NRC, (2) prior notice was given in NRC Information Notice No. 88-10: " Material s Licensees: Lack of Management Controls Over Licensed Programs," and should have alerted you to the need for ensuring that radiatior safety activities were performed in acccrdance with license conditions and specifically, to review the training given to the workforce to ensure that it was proper regarding the requirements of the license, and (3) the violation involved at least eight separate examples. The mitigation due for your good prior performance was off-set by the escalation warranted by these three factors. For the violations set forth in Section II of the Notice, no civil penalty has been assessed. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your i response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. You should also address what actions , you have taken or plan to take to ensure that intentional violation of any safety requirement does not occur in the future. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. l ! NUREG-0940 II.A-18
Entela, Inc. 3 February 16, 1989 In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely,
) 4 A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalty
- 2. Inspection Report No. 030-29214/88001(DRSS) i t
NUREG-0940 II.A-19 l
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY Entela, Inc. Docket No. 030-29214 3033 Madison Avenue License No. 21-24704-01 Grand Rapids, Michigan EA 88-318 During an inspection conducted during the period December 15-27, 1988, four violations of NRC. requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act'of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below:
- 1. Violation Assessed a Civil Penalty I
License Condition No. Il reouires that licensed material be used by, or under the supervision and in the physical presence of, individuals who i have completed a manufacturer's training course and have been designated by the licensee's Radiation Protection Officer. Contrary to the above, eight licensee employees, who had not received the required training, used licensed material on numerous occasions during 1988 ; and this use was not by, or under the supervision and in the physical -l presence of, individuals who had completed a manuf acturer's training course. This is a Severity Level III violation (Supplement VI) Civil Penalty - 51,250
- 11. Violations Not Assessed a Civil penalty A. 10 CFR 20.207(b) requires that licensed materials in an unrestricted area and not in storage be tended under the constant surveillance and immediatescontrol of the licensee.
I License Condition No.17 requires that licensed material be i possessed and used in accordance with statements, representations, and procedures contained in certain referenced documents. 1 The referenced application dated April 28, 1986 requires that when : moisture-density gauges are in the field, the user will maintain ; control over them a+ all times and gauges must never be left l unattended. Contrary to the above, on November 25, 1988 a licensee employee left a moisture-density gauge containing licensed material in an unrestricted ; area without maintaining constant surveillance and immediate control resulting in the gauge being run over by a construction vehicle and severely damaged. NUREG-0940 11.A-20
l Notice of Violation 21 B. 10 CFR 20.403(b)(4) requires each licensee to report to the NRC' Operations Center within 24 hours any event involving licensed material possessed by the licensee that may have caused or threatens to cause damage to property in excess of $2,000. Centrary to the above, on November 25, 1988, a moisture-density gauge in the possession of the licensee sustained damage of $3,000 when it was run over by a vehicle at a construction site and the event was not reported to the NRC until November 28, 1988. C. License Condition No.12 requires that sealed sources contained in moisture-density gauges be tested for leakage and/or contamination at intervals not to exceed six months. Contrary to the above, two Humboldt Scientific 5001 moisture-density gauges, each containing a 9 millicurie cesium-137 sealed source and a 44 millicurie americium-241. sealed source, were not tested for leakage and/or contamination between April 1988 and December 1988, an interval greater than six months. These are Severity Level IV violations (Supplements IV and VI). Pursuant to the provisions.of 10 CFR 2.201, Entela, Inc. (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement,.U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a
- Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the elleged violation; (2) the reasons for the violation if admitted;
-(3) the corrective actions that have been taken and the results achieved; (4) the corrective actions that will be taken to avoid further violations; and (5) the date when full compliance will be achieved If an adequate reply is not received within the time specified in this Notice, an Order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Considerr. tion may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
Oithin the same time as pro;ided for the response required under 10 CFR 2.201, the Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draf t, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of
. Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to ,
answer within the time _specified, an Order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may:
'NUREG-0940 II.A-21
,W #
l w
~
Notice of' Violation > 3 I (1) deny the ' violations listed in this Notice in whole or in part; i (2)-demonstrate extenuating circumstances; (3) show error in this Notice; or (4) show other reasons why the penalty should not be imposed. In addition to protesting- the civil penalty, in whole or .in part, such answer may. request
? . remission or mitigation'of the penalty. ,
In' requesting' mitigation of.the proposed penalty, the.five factors addressed i in'Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any-F written answer in accordance with 10 CFR 2.205 should be set forth separately
- from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201. reply by specific reference (e.g. . citing
, page and paragraph numbers) to avoid repetition. The attention of the. . .!
% licensee is directed to the other provisions of 10 CFR 2.205, regarding the j procedure for imposing a civil penalty.
Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provision of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may'be collected by civil action pursuant to .; Section 234c.of the Act,'42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed.to: Director, Office of Enforcement, U.S. Nuclear Regulatory. Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Regional Administrator,, Region .III, U.S. Nuclear Regulatory Commission, 799 Roosevelt Road, Glee Ellyn, Illinois 60137. FOR THE NUCLEAR REGULATORY COMMISSION hr A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois this 16th day of February 1989 5-NUREG-0940 II.A-22
UNffED STATES g*#*% NUCLEAR REGULATORY COMMISSION f n MEGION IV
'S E 811 RYAN PLAZA DRIVE. SUITE 1000
- AMUNGTON, TEXAS 78011
' o W 26198T
-x Docket No: 30-29319 License No: 42-26838-01 EA: 87-145 H & G Inspection Company, Inc.
ATTN: Harry Gibson, President Post Office Box 721856 Houston. Texas 77272 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 30-29319/87-03) This refers to the routine radiation safety inspection conducted by Mr. Lorenzo Wilborn on June 29, 1987, at the H & G Inspection Company Inc.'s facility in Evanston, Wyoming. The inspection also followed up on an event that you had identified and reported. The event involved the overexposure of a radiographer. During an enforcement conference conducted on July 27, 1987, in Region IV offices, the findings of the NRC inspection were discussed with you. At that time, you inforined us of the corrective actions taken and of your plans to preclude future recurrence.
.This event is of significant concern to the NRC in that it is another overexposure following one for which you were cited in July 1986. This new violation involved the overexposure of a radiographer in that' the radiographer l received a cumulative dose of 3.135 rems during a calendar quarter. Review of i
records showed the overexposure occurred during the period of January 21, 1987, ( to April 9,'1987. During this period, the radiographer was required to work additional hours which contributed to the rate of radiation dosage accumulation. Also, during this period when the monthly film badges came back on two occasions with higher than expected doses, significant hetions were not taken to reduce dosage accumulations to prevent the ultimate overexposure. To emphasize the need for improvement in your management control over personnel exposures, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Seven Thousand Five Hundred Dollars ($7.500) for the violation described in the enclosed Notice. In accordance with the " General Statement
.of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1987) (Enforcement Policy), ti.e violation described in the enclosed Notice has been categorized at a Severity Level III.
1 CERTIFIED MAIL RETURN RECEIPT RE0 VESTED NUREG-0940 II.A-23
OCT 261987
.4 H &'G Inspection Company, Inc. L The base value of a civil penalty for a Severity Level III violation is $5,000.
The escalation and mitigation factors in the Enforcement Policy were considered and the. base civil-penalty amount has been increased by 50 percent. In determining .this amount, we considered your identification and reporting of the current violation. However, the penalty was increased based on your pria' enforcement history as reflected by the 1986 overexposure and your corrective action _ described during the enforcement conference. Corrective action of only retraining the radiographer is insufficient. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. In preparing your response you should consider: the establishment of monthly administrative exposure control levels to ensure that quarterly limits are not reached; actions to be taken if exposures exceed control levels; efforts to keep personnel exposures as low as is reasonably achievable; evaluation of the pocket dosimeter and film badge readings; training of affected personnel; and an audit of the effectiveness of your Radiation Safety Program by an outside, independent organization. After reviewing your response
.to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further NRC enforcement action is~ necessary to ensure compliance with NRC regulatory requirements.
In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title _10, Code of Federal Regulations, a copy of this letter and its enclosures will be placed in the NRC Public Document Room. The re.unses directed by this letter and the enclosed Notice are not subject-
.to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
Sincerely,
'k(LA , ~a Robert D. Martin Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty cc: Texas Radiation Centrol Program Director i NUREG-0940 II.A-24
._-_______-_-________-__a
4 l
)
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY tl & G Inspection Company, Inc. Docket No. 30-29319 ATTN: Harry Gibson, President License No. 42-26838-01 1 Post Office Box 721856 EA 87-145 i J Houston, Texas 77272 During an NRC insoection conducted on June 29, 1987, a violation of NRC requirements was confirmed. In accordance with the " General Statement of i Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C 3 l (1987), the Nuclear Regulatory Commission proposes to impose a civil penalty I pursuant to Sr.ction 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violation and associated civil penalty are set forth below: 10 CFR 20.101(a) limits the whole body exposure of an individual in a restricted area to one and one er calendar quarter, except as provided by 10 CFR 20.101(b)Paragraph quarter rems p(b) provides, in part, that a licensee may permit an individual in a restricted area to receive a total occupational dose to the whole body greater than one and one quarter rems per calendar quarter, provided that such dose during any calendar quarter shall not exceed three rems and other conditions not relevant here are satisfied. Contrary to the above, a radiographer working for H & G Inspection Company, Inc. in the state of Wyoming received a whole body dose of 3.135 rems-in the calendar quarter from January 10 through April 9, 1987. This is a Severity Level III violation (Supplement.IV). Civil Penalty - $7,500. Pursuant to the provisions of 10 CFR 2.201, H & G Inspection Company, Inc. is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as ~a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the . violation if admitted, (3) the corrective steps that have been taken and the results achieved,.(4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in NUREG-0940 II.A-25 1 L
Notice of Violation the . amount of the civil penalty proposed above, or the cumulative amount'of the civil penalties'if more than one civil penalty is proposed, in whole or in part. , by a written answer addressed to the Director, Office of Enforcement, U.S. i Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued.- Should the y Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the ' civil penalty, in whole or in part, such answer should be clearly marked as an -
" Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances,
-(3) show error in this Notice, or (4) show other reasons why the penalty should.
not be imposed. In addition to protesting the civil penalty in whole or in i part, such answer may request remission or mitigation of the penalty. ! In requesting mitigation of the proposed penalt Section V.B of-10 CFR Part 2, Appendix C (1987)y, , shouldthe five factorsAny be addressed. addressed in written answer in accordance with 10 CFR 2.205 should be set forth separately
.from the statement or explanation in reply pursuant to 10'CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is. directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty.
Upon. failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D. C. 20555 with a copy to ~the Regional Administrator, U.S. Nuclear Regulatory Comission, Region IV. FOR THE NUCLEAR REGULATORY COMMISSION
'kdy N. % a Robert D. Martin Regional Administrator Dated at, Arlington, Texas l Thisf(/ Fay of October 1987.
NUREG-0940 I1.A-26 l
..j[" % UNITED STATES s 't NUCLEAR REGULATORY COMMISSION-
, j j- WASHINGTON, D. C. 20665 k.. ...*
/ APR 07 388 Docket No. ^ 29319 License No. 42-26838-01 EA 87 145 H & G Inspection Company, Inc.
ATTN: Harry Gibson-President Post Office Box.721856 Houston,. Texas 77272 Gentlemen:
SUBJECT:
ORDER IMPOSING OIVIL MONETARY PENALTY This' refers to your letter dated December 16, 1987, in response to the Notice of Violation and Proposed Imposition of Civil Penalty sent to you hy our letter dated October' 26, 1987, and your supplemental letter dated February 11, 1988, , i rresponse to our telephone conversation of February 4, 1988. Our letter and Notice described a violation identified during an NRC inspection conducted June 29, 1967, at the H & G Inspection Company, Inc.'s facility in Evanston, Wyoming. To emphasize the importance of complying with NRC requirements, a civil penalty of Seven Thousand Five Hundred Dollars ($7.500) was proposed for the violation. In your response, you denied the violation and requested mitigation of the Civil Penalty for the reasons discussed. After consideration of.your response, we have concluded for the reasons given in the Appendix attached to the enclosed Order Imposing Civil Penalty, that the violation did occur as set forth in the Notice of Violation and Proposed Imposition of Civil Penalty. We have given careful consideration to your
. request for mitigation of the proposed penalty and have concluded that the penalty should not be mitigated. accordingly, we hereby serve the enclosed Order on H & G Inspection Company Inc. imposing a civil monetary penalty in
.the amount of Seven Thousand Five Hundred Dollars ($7,500). We will review the effectiveness of your corrective actions during a subsequent inspection.
In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosures ! will be placed in the NRC's Public Document Room. ! Sincerely,
- / j
~
a s M. Tay1 , Deputy Executive Director or Regional Operations 1
Enclosures:
As Stated I cc: Texas Radiation Control Program Director , NUREG-0940 II.A-27 a
i UNITED STATES NUCLEAR REGULATORY COMMISSION' In th'e Matter of. ) Docket No. 30-29319
) License No. 42-26838-01 H & G INSPECTION COMPANY,'INC. ) EA 87-145 F
Houston. Texas ) ORDER IMPOSING CIVIL MONETARY PENALTY.
< I H & G Inspection Company, Inc. (licensee) is the holder of NRC Materials
! License No. 42-26838-01, issued by the Nuclear Regulatory Commission (NRC/ Commission) on August;11, 1986. The license was amended on September 15, 1986. The license authorizes the licensee to possess and use sealed sources for industrial radiography and replacement of sources in accordance with the conditions specified therein. II A routine unannounced radiation 50fety inspection of the licensee's activities
.was conducted at.the licensee's facilities at Evanston, Wyoming, on June 29, 1987.. The inspection was a followup to an event that had been previously reported to the NRC in the licensee's letter of April 21, 1987. The event involved the overexposure of a radiographer to a cumulative whole body dose of 2.135 rems during the period from January 21 to April 9, 1987. The circumstances surrounding this overexposure reflect a lack of management control over the safe use of licensed material. This violation is of further concern to the NRC inasmuch as the licensee was cited in July 1986 for an overexposure to a radiographer which occurred in the fourth quarter of 1985.
A Notice of Violation was issued July 21, 1986, and a Civil Monetary Penalty i of Two Thousand Five Hundred Dollars ($2,500) was assessed and paid. I i NUREG-0940 II.A-28
p , y-4'
.q. C 4 , L! ,
As a result of the.1987 overexposure, a written Notice of-Violation and L, LProposed Imposition of Civil Penalty was served'upon the licensee by letteri dated October!26, 1987; The Notice stated the nature of the. violation,'thef Lprovision'of.the' NRC'st requirement that: the licensee had violated.' and the amount of.the7civ11 penalty proposed for the violation. The licensee' Lresponded to the Notice of' Violation and Proposed Imposition.of Civil Penalty by11etterdatedDeceder.16,1987. . The licensee's response was supplemented by' letter dated February 11, 1988.- In its' response, the licensee denied the violation and sought mitigation of.the proposed civil. penalty. III; ,
!After.. consideration'of the licensee's response' denying the violation and the
. statements of fact, explanation, and request for. mitigation of the civil
'p:nalty contained therein, the Deputy Executive Director for Regional aOperations has determined as set forth in the Appendix.to this Order that the-
- violation occurred as stated and the penalty proposer' for the violation designated
.in the' Notice of Violation and Proposed Imposition of Civil Penalty should be.
- imposed. -
IV In view of the foregoing and pursuant to Section 234 of the Atomic Energy Act of 1954,. es amended -(Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT IS HEREBY ORDERED THAT:
" NUREG-0940 II.A-29 i
g _ -_
& The licensee pay a civil' penalty in the amount of Seven Thousand Five Hundred Dollars ($7,500) within 30 days of the date of this Order,.by check,
'L draft, or-money order, payable to the Treasurer of the United States and mailed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Connission, ATTN: Document Control Desk Washington, D.C. 20555. The licensee may request a hearing within 30 days of the date of this Order. A request for a hearing should be clearly marked as a " Request for an
. Enforcement Hearing" and shall be. addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555, with a copy to the Regional Administrator, U.S.
Nuclear Regulatory Commission, Region IV. I If a hearing is requested. the Commission will issue an Order designating the time and place of the hearing. If the licensee fails to request a hearing I within 30 days of the date of this Order, the provisions of this Order shall I
-be effective without.further proceedings. If payment has not been made by ]
that time, the matter may be referred to the Attorney General for collection. In the event the licenset requests a hearing as provided above, the issues to be considered at such hearing shall be: (a) whether the licensee was in violation of the Commission's requirements as
. set forth in the Notice of Violation and Proposed Imposition of Civil Penalty referenced in Section II above, and ,
NUREG-0940 II.A-30
i
'(b) whether, on the basis of such violation, this Order should be sustained.
FOR THE NUCLEAR REGULATORY'COMISSION
//
\7 ~-
s . Taylor, De y Executive Director for egional Oper tions Dated at Rockville, Maryland, this 7 W ay of April 1988. l NUREG-0940 II.A-31
.--_-___m___
E APPENDIX EVALUATIONS AND CONCLUSIONS On October 26, 1987, a Notice of Violation and Proposed Imposition of Civil Penalty (NOV) was issued for the violation identified during an NRC inspection. H & G Inspection Company responded to the Notice on December 16, 1987 and February 11, 1988. The licensee denied the violation and requested mitigation of the civil penalty. The NRC's evaluation and conclusion regarding the licensee's arguments are as follows: I. Restatement of Violation 4 10 CFR 20.101(a) limits the whole body exposure of an individual in a restricted area to one and one l as provided by 10 CFR 20.101(b) quarter rems per calendar quarter, exceptPa licensee may permit an individual in a restricted area to receive a total 1 occupational dose to the whole body greater than one and one quarter rems { per calendar quarter, provided that such dose during any calendar quarter shall not exceed three rems and other conditions not relevant here are satisfied. Contrary to the above, a radiographer working for H & G Inspection Company. Inc. in the state of Wyoming received a whole body dose of 3.135 rems in the calendar quarter from January 10 through April 9, 1987. This is a Severity Level III violation (Supplement IV). Civil Penalty - $7,500. Summary of Licensee's Response The licensee denied the violation, stating that the system used to measure whole body dose and the documentation in support of that system indicatad that there was an overexposure of the radiographer when, in fact, no such overexposure actually occurred. The licensee stated that there were four specific reasons that contributed to the recorded overexposure: (a) the radiographer failed to follow verbal instructions given to him and continued to work in areas where he picked u) additional radiation exposure, (b) there was a lapse of almost 20 days )etween the time that film badges were sent in from the Wyoming site and the time H & G Inspection became aware of the excessively high readings and notified the employee, (c) the film badge results were high as shown by a third party evaluation of the radiographer's exposure, j and (d) there was inadequate management control over parts of the program i that could have prevented the event, including the length of time to learn of the overexposure, control over remote site personnel, and a lack of understanding by employees of the mandatory nature of the procedures regarding the length of time they can work in the field. l NRC Eva,1uation of Licensee's Response { The NRC staff has carefully reviewed the licensee's response and concluded i that the violation occurred as stated. Three of the licensee's reasons ! for the recorded overexposure: (a) the radiographer failed to follow ! verbal instructions, (b) the lapse of time for H & G to notify employees NUREG-0940 II.A-32 l
)
s , -;.
. IAppendix D lofhighreadings,iand(c)inadequatemanagementcontrolthatcouldhave-
; prevented the event, are examples of'H & G's management weakness in-E t. : implementing its responsibilities. This was the reason for the' proposed
* . civil l penalty.-)It is the licensee's responsibility to establish a system for. evaluating and' maintaining compliance with'the dose limitations-ispecified.in the NRC Rules and Regulations.
- The licensee's argument that no such overexposure actually occurred'and that;the film badge results were high as shown by a third party' evaluation are not, accepted by the NRC. Central to the third party's evaluation is
- an-asrumption that the individual was a distance of 28 feet from the co111 mated source during'the. entire time. The third party's assumption; in this_ regard cannot be. accepted since it fails.to demonstrate that the individual did not perform his duties near an unretracted source which would_' account for the overexposure.
II.: Sunsnar_y of Licensee's' Request for Mitigation 1
'The licensee denied'the violation and requested mitigation of the Civil Penalty. based on errors:in the NRC's letter transmitting the Notice of Violation and extenuating circumstances that dictate remission or-mitigation of the. Civil Penalty. The licensee stated that the letter was-
. substantially in' error by. suggesting that H & G Inspection did not take the overexposure.very seriously when.they had a long history of
- compliance with regulatory programs throughout the country. and there had >
.been only a small number _of overexposure compared to the number of employees and amount of work over the 11 years that H &-G' Inspection has
.F been in this business. Further, the licensee stated that the last overexposure occurred in 1985 and not 1986'as referenced in the NRC letter. In_ regard to extenuating circumstances, the licensee stated that H & G. Inspection is a small company and the commitments for' corrective actions will 1ncrease the cost of doing business by a' substantial amount. LThe licensee also-asserts that the amount ~of.the Civil Penalty proposed is significantly higher than'the amount proposed or issued by the NRC for other violations of this type'. In addition, the licensee states it has undertaken a series of programmatic changes including:- (1) revising its program manual. (2) revising _and writing new forms and procedures, and ^ (3) hiring a. third-party consultant to review the implementation of its program on a monthly basis. NRC' Evaluation of Licensee's Request for Mitigation The licensee's contention that the NRC October 26, 1987, letter transmitting the Notice of Violation erroneously refers to an overexposure in 1986 that actually occurred'in.1985 is correct.. However, this typographical error m is immaterial to the civil _ penalty since NRC typically reviews events twithin the last two years and this 1985 exposure was in this period and resulted in a Notice of Violation and Proposed Imposition of Civil Penalty issued on July 21, 1986. (See Part 2, Appendix C, V.B.) With regard to the licensee's argument that the NRC's letter transmitting the civil penalty was in error by suggesting that H & G did not take the overexposure seriously, the NRC maintains that its letter did not state that the licensee did not'take the overexposure seriously but stated that 1 "significant actions were not taken to reduce dosage accumulations to j 1
' NUREG-0940 II.A-33 4 ,
----2 ---,-. '------,-n----{a- . _, - -- - - - _ . - - - - - , - - - - - - , , - - , - - - - _ - - - - . - , , - - - - - --
Appendix- I prevent the. ultimate overexposure" and that " improvement in your management control over personnel exposures" was needed. The licensee's claim that there have.been only a small number of overexposure compared to the number of employees.and the amount of work over.the 11 years that H & G has been in business is also unpersuasive. On July 21, 1986 the NRC issued the civil penalty in the amount of $2,500 ; for a whole body exposure of 3.4 rems resulting from failures to perform i surveys a ner each radiographic exposure and failure to follow operating : procedures. Having another overexposure less than a year after being ; cited for an overexposure is rare and indicates that the licensee's corrective actions were ineffective. The licensee noted in its response that "there was inadequate management control over the parts of the program that could have prevented this event...." i With respect to the licensee's claim that H & G is a small company and the commitments for corrective actions will increase the cost.of doing business E by a substantial amount, the NRC maintains that the cost of implementing , additional administrative controls to ensure future compliance with NRC d regulatory requirements 1s an expected financial obligation. There has not been any indication or claim that such cost combined with the Civil : Penalty will be of such magnitude that it will put the licensee out of business or adversely activities (See affect its C, Part 2, Appendix ability)to V.B. . safely conduct licensed NRC enforcement action is taken as necessary to-ensure that each licensee will achieve and maintain compliance with NRC regulatory requirements in the interest of public health and safety. As to H & G's corrective actions, the actions described in the responses appear appropriate and comprehensive. However, mitigation for sv:h corrective action was not warranted because they were not timely and were' taken following NRC suggestions rather than on the licensee's initiatives. The licensee further claims that the amount of the Civil Penalty proposed is significantly higher than the amount' proposed or issued by the NRC for other violations of this type. The licensee stated that another company engaged in similar work at the Shute Creek site was only issued a $500 civil penalty for much more serious violations. The NRC presumes the licensee is referring to the civil penalty issued on February 28, 1985 to A-1 Inspection, Inc. (EA 85-08). NRC normally does not compare the civil penalty of one case to another case since each escalated enforcement < action is considered on its own merits. However, in the A-1 Inspection, Inc. case, the penalty was reduced because of A-l's corrective actions taken before the enforcement conference and the licensee's financial status. 'In the H & G case, corrective action was not taken prior to the enforcement conference and H & G, while a small company, is considerably larger than A-1. In addition, H & G previously had an overexposure during the fourth ouarter of 1985. NUREG-0940 II.A-34
.=._ - - .-. !j; I i s.
- Appendix; _-4.
IIII. NRC Conclusion u ' The NRC staff concludes.that the violation occurred as stated in'the 4 Notice of Violation, and further, a sufficient basis-for mitigation of
o- -the Civil Penalty was'not provided by the licensee. Consequently, the proposed Civil Penalty in the amount of Seven Thousand Five Hundred.
. Dollars ($7,500)shouldbeimposed.
1 .g. .NUREG-0940 II.A-35
- ---------_--__a
g -- (' gg i f. ' L=
# % , UNITED STATES
.C.- -
NUCLEAR REGULATORY COMMISSION
. REGIO'N IV
.g $11 RYAN PLAZA DRIVE. SUITE 1000
?
' ARLINGTON, TEXAS 76011 I
FEB 28195 l d
/
Docket No. 30-09777'
' License No.
35-15785-01 L EA 88-301' I 1Hemphill Corporation ATTN: John Hemphill, Vice President. ' 540 North 87th East Avenue Tulsa, Oklahoma 74115 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 30-09777/S8 01)
~.This refers to the inspection conducted on December.1,'1988, at your facility t in Tulsa, Oklahoma. The results of the December 1 inspection, in which several violations of NRC requirements'were identified by our inspectors, were provided
-to you in an inspection report dated December 15, 1988, and were discussed with.
you at an enforcement conference in our offices on December 22, 1988.
~
As a result of our discussions with you at the enforcement conference and our review of your letter dated December 16,-1988, we have not cited one of the
-apparent violations included in the December 15 inspection report. We accept-the conclusion that the dosimetry results were affected by a heat-damaged film badge and that no overexposure occurred.
The violations which remain, and which are. described in more detail in the
' enclosed Notice of Violation (Notice), involve: permitting persons who had not completed the Troxler course to use gauges containing licensed material without supervision; using individuals other than the responsible individual specified by the license to serve as Radiation Protection Officer; storing'and using' licensed material at a location other than that specified in the license; and failing to conduct leak tests of sealed sources at the proper 6-month frequency.
These violations collectively are of concern to the NRC as they indicate a breakdown in the management of your NRC-licensed activities and a need to focus greater management attention on the requirements associated with your license. CERTIFIED MAIL RETURil RECtlP1 RE00ESTED NUREG-0940 II.A-36 L 1
FEB 281989 Hemphill Corporation i
.This view'is supported by the. fact that in 1985, an NRC inspection revealed a number of violations which were brought to the company's attention. These ]
findings should have prompted management to take actions to ensure compliance. 'l NRC urges you to develop effective audit programs designed to ensure that you
-are in fact complying with all NRC requirements. It is incumbent on you to know what is in your license and obtain prior approval before changes of t matters described.in your license are made. 2 To emphasize the importance of conducting your licensed activities in accord with NRC's radiation safety requirements, I have been authorized, af ter consul- !
tation with the Director, Office of Enforcement, and the Deputy Executive Director for Nuclear Materials Safety, Safeguards, and Operations Support, to-issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Five Hundred Dollars ($500)'for the violations described in the enclosed Notice. In accordance with the " General Statement of Polic Procedure for.NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988)y and (Enforcement Policy), the violations described in the enclosed Notice have been categorized collectively at Severity Level III. The base value' of a civil penalty for a Severity Level III violation is $500. The mitigation and escalation factors ~in the Enforcement Policy were considered and no adjustment has been deemed appropriate. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing.your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this ! Notice, including your proposed corrective actions and the results of future ' inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance.with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget as rsequired by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely. Of[j k dUII Robert D. Martin Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty cc: Oklahoma Radiation Control Program Director NUREG-0940 II.A-37
i FEB 281989 3 NOTICE OF VIOLATION AND f I PROPOSED IMPOSITION OF CIVIL PENALTY Hemphill Corporation Docket No. 30-09777/88-01 Tulsa, Oklahoma License No. 35-15785-01 EA 88-301 ; 1 During an NRC inspection conducted on December 1, 1988, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended ( Act), 42 ll.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. License Condition 12 states, in part, that licensed material shall be used by, or under the supervision and in the physical presence of, individuals who have completed the Troxler training course in the use of the devices. Contrary to the above, the NRC inspection disclosed that two individuals who had not completed the Troxler training course and who were not supervised by trained individuals had engaged in the use of licensed i materials. The licensee had no records to confirm the period during which ) this violation occurred but estimated that this began in 1985 and ( ' continued until the date of the inspection. B. License Condition 13 requires, in part, that sealed sources containing licensed material be tested for leakage at intervals not to exceed 6 months, except for sealed sources that are stored and not being used, i and that a record be maintained of this test. Contrary to the abo e, leak tests were not performed on the sealed .sotrces in four Troxler gauges from October 1986 until January 1988, even though j the gauges had been used during that period. ] i C. License Condition 18 requires the licensee to possess and use licensed i material in accordance with statements, representations and procedures L contained in the application dated September 27, 1983, and letter dated : March 28, 1984 ! Contrary t.o the abnve, Mr. C. Howell Mullis, Jr., specified as the j Radiation Protection Officer in Item 7 of the application dated September i 27, 1983, was not serving as the Radiation Protection Officer on the date { of the inspection. Mr. Mullis died in January 1987 and was succeeded as l Radiation Protection Officer by Mr. Roger Cornwell and later by Mr. John l Hemphill, neither of whom was specified on the license as Radiation l Protection Officer. l l 1 NUREG-0940 II.A-38
FEB 281989 i i N;tice of Violation 4 l D. License Condition 10 states, in part, that licensed material may be used at 4834 S. 83rd East Avenue, Tulsa, Oklahoma, and at temporary job sites of the licensee anywhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction. License Condition 2 states the licensee's mailing address as 4834 S. 83rd East Avenue, Tulsa Oklahoma. Contrary to the above, the licensee had moved in September 1987 and the current use and storage location for the licensed material is 540 N. 87th East Avenue, Tulsa, Oklahoma, which was not a temporary job site. Additionally, the licensee's mailing address was also 540 N. 87th East Avenue, a location other than that stated in License Condition 2. l The above violations are considered collectively as a Severity Level III i violation (Supplement VI). Cumulative Civil Penalty - $500 (assessed equally among the violations) Pursuant to the provisions of 10 CFR 2.201, Hemphill Corporation (Licensee) is h reby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of tha date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an ordtr may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a ch:ck, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or the cumulative amount of the civil penalties if more than one civil penalty is proposed, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty in whole or in part such answer should be clearly marked as an " Answer to a Notice of Violation and may: (1) deny the violations listed in this Notice in whole or in part (2) demonstrate extenuating circumstances, (3) show error NUREG-0940 II.A-39
g> C / FEB 28 i989 n Notice of Violation !: in. this Notice, or'(4) show other reasons why tile penalty shculd not b'e imposed. In-addition to protesting the civil penalty in whole or in part, such answer may request remission or mitigation of the penalty. E M In requesting mitigation of the proposed penalt Section V.B of 10 CFR-Part 2,. Appendix C ,(1988)y, should bethe six factors addressed. Anyaddressed i
' written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may-incorporate. parts of the 10.CFR 2.201 reply by specific reference (e.g., citing 1 page and paragraph numbers) to avoid repetition. The attention of the Licensee i is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. ,
Upon failure to pay any civil penalty due which subsequently has ~been determined'in accordance with the applicable provisions of 10 CFR 2.205,,this q matter may be referred to the Attorney General, and the penalty, unless 1 compromised, remitted, or mitigated, may be. collected by civil action pursuant j to Section 234c of the Act, 42 U.S.C. 2282c. 1 8 TheresponsestotheDirector,OfficeofEnforcement,notedabove(Replytoa Notice of Violation letter with payment of civil penalty and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555'with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region IV, 611 Ryan Plaza Drive, Suite 1000, Arlington, Texas
-76011.
FOR THE. NUCLEAR REGULATORY COMMISSION
.y
/ f,i )
$Nj:(/b h2ifQ Robert D. Martin ,
Regional Administrator { L Dated at Arlington, Texas, I This 28th day of. February 1989. 1 1
.NUREG-0940 II.A-40
**gpa maoug'o UNITED STATES g
E" t .g NUCLEAR REGULATORY COMMISSION
.; . ;- WASHINGTON, D. C. 20555
' %,ha**/ OCT 241989 Docket No. 30-20880 License No. 35-23304-01 EA 88-212 c Hole Truth, Inc. s ATTN: L. D. Robertson Post Office Box 94670 Oklahoma City, Oklahoma 73143 fL Gentlemen:
SUBJECT:
ORDER NODIFYING LICENSE, EFFECTIVE IMMEDIATELY, AND NOTICE OF VIOLATION (NRC INSPECTION REPORT NO. 30-20880/88-01) This refers to the inspection conducted on July 14-15, 1988, at your facility in Oklahoma City, Oklahoma. During this inspection, the NRC inspector identi-fied 15 apparent violations of NRC requirements. The results of the inspection were sent to you in a letter dated August 22, 1988. The findings of the inspec-
' tion demonstrated a significant breakdown in your radiation safety program and were discussed with you at an enforcement conference on August 30, 1988. During the enforcement conference, your consultant indicated that the change in your performance of licensed activities may have been caused by pressures placed on you as a result of the bankruptcy of two well logging companies with which you had been associated.
Enclosed is an Order Notice of Violation Modify)ing (Notice Licenseof(Order),
. The purpose Effective this Order Immediately, is to provide and assurance that over the long term your performance will not again deteriorate. The Crder requires you to obtain independent consulting services to perform audits for two years of your program to evaluate adherence to NRC requirements, observe and evaluate personnel performance, and assess quality and accuracy of records concerning licensed activities. Depending on the results of the audit findings, NRC may consider a request for relaxation of the audit requirements.
The Notice requires you to respond and include for each violation: (1) the reason for the violation, if admitted, (2) the corrective actions that have been taken and results achieved, (3) the corrective actions that will be taken to avoid further violations, and (4) the date when full compliance will be achieved. You are required to respond to this letter and enclosed documents and should follow the instructions specified in the enclosed Order and Notice when prepar-ing your response. In the response the NRC expects you to explain, the issues which your consultant indicated at the enforcement conference to be the root cause of the management breakdown of your radiation safety program. This information, which may be private in neture, may be submitted under separate cover as traterial to be withheld in whole or in part from public disclosure for reasons stated in Section 2.790(a)(6) of 10 CFR Part 2. After reviewing your. response to the Notice, including your proposed corrective actions and NUREG-0940 II.A-41
.: I
- k.,
4 l Hole Truth, Inc.. .the results'of future inspections, the NRC.will determine whether~further L:E .NRC enforcement action, including a civil penalty, or license suspension or' revocation, may be necessary to ensure compliance with NRC regulatory requirements. i# 2n accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, I Title 10, Code of Federal Regulations, a copy of this letter and the enclosure l will'.be placed in the NRC's Public Document Room. l 1
'The responses directed by this letter and accompanying Order are not subject {
L- to the clearance' procedures of the Office of Management and Budget, as .a required by.the Paperwork Reduction Act of 1980, Public Law 96-511. m Sincerely i- .
/
N' J ms M. Taylor eputy Executive Director for Regional Operations cc: Oklahoma Radiation Control Director
Enclosures:
- 1. - Order' Modifying License
- 2. Notice'of Violation 3.:10 CFR 2.790 l'
NUREG-0940 I1.A-42
UNITED STATES NUCLEAR REGULATORY COMMISSION In the Matter of ) Docket No. 30-20880 N0LE TRUTH INC. ) License No. 35-23304-01 Oklahoma City, Oklahoma ) EA 88-212 ORDER MODIFYING LICENSE, EFFECTIVE IMMEDIATELY I Hole Truth,-Inc. (licensee), is the holder of Material License No. 35-23304-01 issued by the Nuclear Regulatory Commission (NRC or Commission) on May 30, 1984. The license is due to expire on May 31, 1989. The license authorizes the licensee to possess sealed sources of americium-241 and cesium-137; to possess and use any form of iodine-131, iridium-192, gold-198 and silver-110; to possess and use any form except liquids of scandium-46; and to possess and use beads or wires of ccbalt-60, in tracer studies in oil and gas wells. II On July 14-15, 1988, NRC Region IV conducted an unannounced inspection of the licensee's activities at the licensee's facility in Oklahoma City, Oklahoma. The inspection disclosed numerous apparent violations of NRC and license requirements. The results of the inspection were discussed with the licensee at an Enforcement Conference on August 30, 1988. As a result of information provided by the licensee at the Enforcement Conference, two violations were modified, one violation was withdrawn and one additional violation was identi-fied. The resulting violations are discribed in more detail in the Notice of Violation being issued this date. These violations involve the:
- 1. Failure to possess material such that the radiation levels in an unrestricted area were not in excess of 100 millirem in any 7 consecutive days as required by 10 CFR 20.105 (b)(2).
NUREG-0940 II.A-43
l F
- 2. Failure to keep records of receipt of byproduct material fr June 16 to October 4, 1987 in accordance with 10 CFR 30.51(a).
l I
- 3. Failure to maintain records for each use of licensed material in accordance with 10 CFR 39.39.
i
- 4. Failure of an individual to wear personnel dosimetry while working with licensed material in accordance with 10 CFR 39.65. 1
- 5. Failure to block and brace radioactive material packages during transport in accordance with 49 CFR 177.842(d) and 10 CFR 71.5(a).
- 6. Failure to use Specification 7A, Type A packaging for transport of radioactive material not in excess of A-2 limits in accordance with 49 CFR 173.415(a) and 10 CFR 71.5(a).
- 7. Failure to exchange personnel dosimetry monthly for processing by the supplier from January to June 1988 as required by License Condition 19 and the license application.
- 8. Failure to maintain records of monthly surveys of the storage bunker in accordance with License Condition 19 and operating procedures.
- 9. Failure to perform adequate surveys of vehicles used for storing and transporting licensed materiel and keep records of such surveys in accor-dance with License Condition 19 and operating procedures. Specifically, NUREG-0940 II.A-44
.., .v I'.
I 'l(_.' [ q [ ,
- l the licensee's surveys failed tol identify the presence of. a vialicontaining approximately 10 mil 11 curies of. iridium-192 which had been present in the c
.i s
locked rearLcompartment of a pickup truck since. July 9, 1988 and emitted measured radiation levels at the rear surface of the truck of 1.5 millirem
.per hour.
- 10. l Failure to perform adequate surveys of job site operations and. keep records of such surveys in accordance with License Condition 19 and operating procedures. Specifically, the licensee's surveys failed to identify unlabeled pipe couplings contaminated with radioactive material which
.had measured radiation levels of 0.6 mr/hr at 6 inches from the surface of the. pipe coupling.
-11. Failure to maintain records of: surveys of licensed materials upon receipt in.accordance with License Condition 19 and operating procedures.
.12. Failure to maintain up-to-date' records of radiation exposures as measured by TLD personnel dosimeters for 1987 in accordance with License Condition 19 and operating procedures.
- 23. Failure to return unused radioactive material to the storage bunker in accordance with License Condition 19 and operating procedures.
- 14. Failure.to maintain disposal records of radioactive materials from June 16, 1987 to July 15, 1988 in accordance with License Condition 19 I and operating procedures.
NUREG-0940 II.A-45
nw; i
.l b
L L
- 15. Failure:to label as a radioactive source items which contained fixed contamination frora radioactive material in excess of 0.2 mR/hr, as p
L required by License Condition 19 and operating procedures. III The president and owner of Hole Truth Inc. (licensee) and his consultant attended j the Enforcement Conference held on August 30, 1988. During the Enforcement l Conference', the licensee stated that, (1) surveys had been performed, but no records were available; (2)_ corrective actions had been taken on all items i 1 discussed; and (3) that he only lacked duplicate copies of personnel monitoring 'j i records to be in full compliance with NRC requirements. Furthermore, the j licensee committed to having its consultant inspect its operations on a quarterly 4 basis for'at least one year and for the owner's wife who had just finished a ! k radiation. safety course given by the consultant to aid in the management of the j i radiation safety records for the company. The licensee's censultant indicated j l that'the apparent violations were due largely to the pressures brought-about by ] the impact of the economic downturn in the oil industry which led to the bank- j l i ruptcy of two well logging companies with which the licensee had been associated. The licensee did not dispute the statements of its consultant. 4 IV On September 23, 1988, the NRC reinspected the licensee's program and found that all but one of the apparent violations resultir.g from the July 14-15, 1988, 1 _NUREG-0940 11.A-46 4
inspection had been corrected. Nonetheless, the fact that these violations occurred remains a significant concern to the NRC because collectively they are indicative of a breakdown of management oversight and control. In addition, the apparent abrupt decline in the quality of the program, when compared to the licensee's previous performance, is also of significant concern. Further, although the licensee maintains that it performed the surveys referenced above, it is clear from the NRC's review that some of the surveys were inadequate, in that the licensee failed to identify during a vehicle survey the presence of a vial containing approximately 10 m1111 curies of iridium-192 which had been present in the locked rear compartment of a pick-up truck since July 9, 1988 and emitted measured radiation levels at the rear surface of the truck of 1.5 millirem per hour. In another case, surveys did not identify unlabeled pipe couplings having radiation levels in excess of 0.2 mP/hr. The nature and number.of the violations identified during the July 14-15, 1988 inspection, including failure to identify radiation levels in an unrestricted area and on unlabeled pipe couplings, raises a question concerning the licensee's commitment ana ability to, comply with the Commission's requirements in the future. Conse-quently, without the further action ordered here, I lack the reasonable assurance that licensed activities will be properly conducted such that the health and safety of the public will be adequately protected. Therefore, I have determined, pursuant to 10 CFR 2.204, that the public health, safety, and interest require that the license should be modified, as described below, effective immediately, l and that no prior notice is required. i NUREG-0940 II.A-47
)
V Accordingly, pursuant to Sections 81, 161b, 1, and o, and 182 cf the Atomic Energy Act of 1954, as amended, and the Commissions regulations in 10 CFR 2.204 and Parts 30 and 39, IT 15 HEREBY ORDERED THAT, EFFECTIVE IMMEDIATELY: License No. 35-23304-01 is modified to require that: A. An independent party, qualified in the area of radiation safety, perform quarterly audits of the Radiation Safety Program. The audits shall continue for a period of 2 years. The credentials of the independent party and the proposed audit program shall be submitted to NRC Region IV for review and approval within 30 days of the date of this Order. Audits shall be conducted for the purpose of evaluating the effectiveness of the radiation safety program in assuring adherence to NRC requirements and safe performance of licensed activities. These audits shall include, at a minimum:
- 1. Assessment of the effectiveness of managenient control and oversight of the program in assuring that radioactive material is used safely and that operations are conducted in compliance with NRC requirements.
- 2. Observation and evaluation of the performance of the licensee while engaged in licensed activities at a well logging field site at least NllREG-0940 II.A-48
-:7 -
4
,,;.twice 'during the two-year audit period provided that the field site audits.are separated by at'least'12 months.
- 13. Assessment of the quality and accuracy of records required to be' s
maintained concerning licensed activities. The firstisuch independent audit shall be conducted within 1 monthsof the NRC's notification to the lice'nsee of NRC's approval of the audit program.
-The results of'each audit shall be simultaneously provided to the licensee and the-Regional. Administrator,:NRC Region IV, within 2 weeks of completion of the audit. ,The. licensee shall provide to the Regional Administrator, NRCRedionIV,within30daysof'receiptof'theresultsof+eachaudit,a description of the: corrective actions taken for each recommendation by the _ independent party and justification for any recommendation not accepted.
The Regional Administrator, NRC Region IV, may'in writing, relax or
' rescind any of these conditions for good cause shown.
VI l
. The licensee or any person adversely affected by this Order may request a hearing within 30 days of the date of this Order. Any answer to this Order or request for hearing shall be submitted to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, Washington, D.C. 20555. Copies also shall < be sent to the Assistant General Counsel for' Enforcement, Office of the General NUREG-0940 II.A-49
_-_ _ ___ - _ a
i 1 Coursel, at' the same address and to the Regional Administrator, NRC Region IV, 611.Ryan Plaza Drive, Suite 1000,- Arlington, Texas 76011. If a person other than'the licensee requests a hearing, that person shall set forth with o particularity the manner in which. the petitioner's interest is adversely i affected by this Order and should address the criteria set forth in 10 CFR 2.714(d). Upon failureLof the licensee to answer or request a hearing within the specified time,!this Order shall be final.without further proceedings. An answer to.this' Order or a request for hearing shall not stay.the immediate
-effectiveness df this Order.-
.If a hearing is requested, the Commission will issue an Order designating the l 1
time and place of'any hearing. If a hearing is held, the issue to be considered f at such a hearing shall be whether, this Order should be sustained. FOR THE NUCLEAR REGULATORY COMMISSIOP i l . - l l a
\ s il___ $ M Tay1 , Deputy Executive Director or Regiona Operations
- Dated at Rockville, Maryland, thisghdayofOctober1988.
NUREG-0940 II.A-50 , I: i
l-L NOTICE OF VIOLATION L Hole Truth, Inc. ' Docket No. 30-20880 Oklahoma City, Oklahoma License No. 35-23304-01 EA 88-212 During an NRC inspection conducted on July 14-15, 1988, violations of NRC
' requirements were identified. In accordance with the " General Statement of Policy),and (1988 Procedureare the violations forlisted NRC below:
Enforcement Actions," 10 CFR Part 2, Appendix C A. 10 CFR'20.105(b)(2) requires, in part, that, except as may be otherwise authorized by.the Commission, no licensee possess, use, or transfer licensed material in such a manner'as to create, in any unrestricted area, radiation level!, which, if an individual were continuously present in the area, could result in his receiving a dose in excess of 100 millfrems in any seven consecutive days. Contrary to. the above, on July 14, 1988, radiation levels at the rear surface of the licensee's pickup truck, an unrestricted area, measured li-millirems per hour (250 millirems per 7 days). B. 10 CFR 30.51(a) requires that each byproduct material licensee shall keep records showing the receipt, transfer, and disposal of byproduct material. Contrary to- the above, records of receipt of byproduct material were not maintained for the period of June 16 through October 4, 1987. C.- 10 CFR 39.39 requires each licensee to maintain records for each use of licensed material. Contrary to the above, records of use of licensed material were not maintained for the period from June 6, 1988 until the date of the inspection. D. 10 CFR 39.65.provides that the licensee may not permit an individual to act as a logging supervisor or a logging assistant unless that person wears at all times during the handling of licensed radioactive materials, either a film badge or a thermoluminescent dosimeter (TLD). Contrary to the above, on August 30, 1988, the licensee's owner and , president stated that while acting as a logging supervisor, he had not i always worn his TLD. l E. 10 CFR 71.5(a) requires that each licensee who transports licensed material outside the confines of its plant or other place of use, or who delivers licensed material to a carrier for transport, shall comply with applicable requirements of the regulations appropriate to the mode of transport of the Department of Transportation in 49 CFR Parts 170-189.
- 1. 49 CFR 177.842(d) requires that packages of radioactive material be blocked and braced so that the material cannot change position during conditions normally incident to transportation.
NUREG-0940 II.A-51
O
! L
, i'- B Notice of? Violation - h ,7 Contrary to the'above, a vial .(package) containing iridium-192 bea'ds , t was on July 9,1988, in an open,. unsecured plastic crate in the back i of the licensee's pickup truck.
- 2. 49 CFR 173.415(a) authorizes for shipment Specification 7A, Type A packaging for radioactive material not in excess of A-2 limits. .
1 Contrary to the above, a vial containing iridium-192 beads', which was' s not in excess.of 'A -2 limits and did not meet Specification 7A, Type A packagirg, was transported on July 9,1988. F. License Condition 19 requires that the licensee conduct its program in. accordance with the statements, representations', and procedures contained in the iicense application dated September'22, 1985, and the-letter: dated February 14, = 1984. - 1.- Item 12 of the application requires that the thermoluminescent dosimeter (TLD) be exchanged monthly for processing by the supplier. Contrary to the above, the licensee.did not return for processing the; monthly TLD badges from January to June 1988. 2.- . Section 2,'Part I.B.(3)(c) of the operating-procedures' submitted as Item 15 of the application requires that records of monthly. bunk'e r surveys be maintained. Contrary to the above,. since approximately July 15, 1987,_ records of surveys which' were performed had'not been made or maintained.
- 3. Section 2, Part IV.C. of the operating prccedures submitted as Item.15 of the application requires that surveys be made of the transportation vehicle and Section 2, Part I.B(3)(d) requires records be kept.
l Contrary to the above, as of July 9,1988, surveys were not made of the transportation vehicle or, if made, were inadequate to identify radiation levels which exceeded the limits for a unrestricted area in accordance with 10 CFR 20.105(b)(2). Additionally, records of vehicle surveys had not been made since approximately July 14, 1987.
- 4. Section 2, Part II.B.3 of the operating procedures submitted as Item 15 of the application requires that job site surveys be made before and after each procedure using radioactive material.
Section 2 Part I.B(3)(c) requires records of job site surveys be kept. Contrary to the above, as of July 9,1988, the jobsite surveys had not been made or, if made, were inadequate to identify radiation levels of 0.6 mr/hr on pipe couplings contaminated with radioactive material. Additionally, records of jobsite surveys had not been ' made since approximately July 14, 1987. NUREG-0940 II.A-52
hotice of Violation 3-p!
- 5. Section 2,.Part II.A.5 of the operating procedures submitted with the
[- . application. requires that the1TLD badge reports will be kept up-to-date by the Radiation Safety Officer. Contrary to.the above, as of the date of the inspection, records of results of radiation exposures'as measured by TLD badges were not available for 1987.
- 6. Section 2 Part III.D. requires.'the licensee to maintain a record of the results of surveys conducted after receipt of packages of radio-active tracer material.
Contrary to.the above, since approximately July 14, 1987, records had not been made or maintained for surveys conducted after the receipt of packages of radioactive material.
- 7. Section 2, Parts VI.C.9 and.VI.F.10 of the operating procedures submi,tted with the license application requires that any unused radioactive material be returned to the storage bunker until it can be used or returned to the supplier for disposal.
' Contrary to the above, from July 9,1988 until the date of the
' inspection, a vial containing approximately 10 millicuries of
. iridium-192 was not returned to the storage banker.
- 8. Section 2, Part VII.A.3 of the operating procedures submitted with the license application requires that a waste disposal log be maintained. Figure 3 provides a copy of the form to be maintained.
Contrary to the above, a waste disposal loo was not maintained for the period June 16, 1987, until the date of the inspection.
- 9. Section 2, Part.IX.B.4.c.(3) of the operating procedures submitted with the license application requires that an item containing " fixed" contamination more than 0.2 mR/hr and is such that it is continually used in tracer operations be labeled as a radioactive source.
Contrary to the above, on the date of the inspection, pipe couplings which contained " fixed" contamination of more than 0.2 mR/hr from I radioactive material and were continually used in tracer operations were not labeled as radioactive sources with typical radiation readings of 0.6 mR/h at 6 inches. The above violations have been categorized in the a gregate as a Severity Level III problem. (SupplementsIV,V,VI,andVII Pursuant to the provisions of 10 CFR 2.201, Hole Truth, Inc. (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of j the date of this Notice. This reply should be clearly marked as a " Reply to a i Notice of Violation" and should include for each violation: (2) the reasons for the violation if admitted, (2) the corrective steps that have been taken and the results achieved, (3) the corrective steps that will be taken to avoid NUREG-0940 II.A-53 = _ _ - _ )
y
' Notice of ViolationL .further violations, and (4) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, 'an s
' order may be issued to show cause why the license'should not be modified, suspended, or revoked or.why such other action as may be proper'should not be
' taken. Consideration may be given to extending the response time for good
.cause.shown.
FOR THE' NUCLEAR REGULATORY COMMISSION n _ /
'Ja M L-s M. Taylorheputy Executive Director.
for Regional Operations
' Dated at Rockville,' Maryland '
This38fe day of October 1988. i s - 1 1 l 1 i NUREG-0940 II.A-54
- - -- ----- _J
pm 8fo UNITED STATES 48 uf]o 9" g NUCLEAR REGULATORY COMMISSION
'f nj REGION V 1450 MARIA LANE,SulTE 210 e,, ,4 g, WALNUT CREEK, CALIFORNIA 94596 DEC '181988 Docket No. 030-11006 License No. 53-16421-01 EA 88-257 Honolulu Medical Group ATTN: Richard Littenberg, M.D.
Medical Director 550 South Beretania Street
, Honolulu, Hawaii 96813 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION NO. 88-01) This letter refers to the NRC inspection conducted on September 16, 1988, at the Honolulu Medical Group, Honolulu, Hawaii, of activities authorized by NRC License No. 53-16421-01. The report of this inspection was sent to you on-October 14, 1988. During the inspection, violations of NRC requirements were identified. On October 19, 1988, an enforcement conference was conducted with you and other members-of your staff to discuss the violations, their causes and your. corrective actions. The violations, which are described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty, includei (1) leak tests of sealad sources were not conducted on a semiannual basis, (2) the dose calibrator was
.not tested for accuracy on an annual basis, (3) the Radiation Safety Committee, with the assistance of the Radiation Safety Officer, did not review the Radiation Safety Program on an annual basis, (4) the records of waste disposal were not adequately maintained, (5) training was not provided to janitorial or nursing personnel who work with or near licensed materials, and (6) the radiation dose rate trigger levels were not established for use with required radiation surveys.
Although the safety significance of the individua*. violations is low, the NRC is particularly concerned about a continuing lack of management oversight at your facility, as evidenced by the number of violations identified during this inspection, as well as the fact that a number of violations were identified by the NRC during the previous inspections, in August 1986, in September 1983, and in October 1980. Two of the violations identified in the 1986 inspection were repeated in this inspection and are described as Violations A and C in j the enclosed Notice of Violation. In addition, in regard to Violation A, leak { testing, ue note that in response to the August 1986 Notice of Violation you l committed to quarterly leak testing. That commitment was not met. CERTIFIED MAIL - RETURN RECEIPT REQUESTED t NUREG-0940 II.A-55 i < 1 g C ___ __
2 Based on our evaluation of these violations, we conclude that: (1) the individual users of licensed material have not always followed required procedures, (2) the Radiation Safety Officer (RS0) has not been aggressive in training, monitoring and evaluating the activities of those involved in licensed activities, and (3) the Radiation Safety Committee (RSC) has not exercised sufficient control in the overall safety program. Accordingly, increased and improved involvement by licensee's management and by the Radiation Safety Officer is needed to assure that the program is properly and consistently implemented by the users. Thus, management must see to it that the Radiation Safety Officer is more eggressive in auditing the program to assure that deficiencies are promptly identified and effectively corrected. To emphasize the need for more active involvement in licensed activities by the RSC, RSO, and licensee management, including taking aggressive action to assure lasting correction of the deficiencies in your program, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Two Thousand Five Hundred Dollars ($2,500) for the violations described in that Notice. In accordance with the " General Statement of Policy and Procedures for'NRC. Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the violations described in the Notice have been classified in the aggregate as a Severity Level III violation. The base civil penalty amount for a Severity Level III violation is $2,500. After careful consideration of the escalation and mitigation factors addressed in the enforcement policy, we have concluded that the escalation warranted due to the repetitive nature of previous violations ir, offset by your recent comprehensive corrective action that included obtaining the service of a radiation consultant to review your program on a quarterly basis. You are required to respond to this letter and the enclosed Notice, and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. As part of your i response you should address why the corrective action described in your l September 4, 1986 letter was ineffective and why you believe the current j actions will be effective. After reviewing your response to this Notice, l including your proposed corrective actions and the results of future ( l inspections, the NRC will determine whether further action is needed to ensure l compliance with regulatory requirements. Recurrence of these violations may result in more significant enforcement action. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. l l NUREG-0940 II.A-56
. 1 3
11 TheLresponses' directed by this letter and the enclosed Notice are not subject ! to the clearance procedures of the Office of Management and' Budget.as required J by the Paperwork Reduction Act of 1980, P.L.-.No. 96-511. s Sincerely, 4 n il 0 ~- gg
~
. martin Regional Administrator
Enclosure:
' Notice of Violation and Proposed Imposition of. Civil Penalty
{ I i l 1 o NUREG-0940 II.A-57 _ _ _ _ _ _ - - _ _ - . - - - - 1
I n. N-NOTICE OF-VIOLATION AND L PROPOSED IMPOSITION OF CIVIL PENALTY
. Honolulu Medical Group Docket No. 030-11006 550 South Beretania Street License No. 53-16421-01 u . Honolulu, Hawaii EA 88-257 During an NRC inspection conducted on September 16, 1988, violations of NRC requirements were' identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions, 10 CFR Part 2, Appendix C F
(1988), the Nuclear Regulatory Commission proposes to impose a' civil penalty pursuant to Section 234 of the Atomic Energy Act of_1954, as amended (Act). 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil
! penalty are set forth below:
A. 10 CFR 35.59(b)(2) (effective April 1, 1987) provides, in part, that a licensee in possession of any sealed source shall test the source for leakage at intervals not to exceed six months. 10 CFR 35.14(1)(1) (superseded text) required, in part, that a licensee in possession of sealed sources test the source for leakage at intervals not to exceed six months. Contrary to the above, a 200 uci Cs-137 sealed source was not leak tested from November 19, 1986 to June 25, 1987, a period exceeding six months. Also, a 100 uci I-125 sealed source was not leak tested from May 1,.1987 to December 1,1987, a period exceeding six months. This is'a repeat violation. B. 10 CFR 35.50(b)(2) provides, in part, that a licensee shall test each dose calibrator for accuracy upon installation and at least annually thereafter. Condition No. 15 of License No. 53-16421-01 requires, in part, compliance with licensee's statements and representations in an undated letter
~
received March 23, 1981. Item 2 of this letter requires that the licensee perform accuracy tests on the dose calibrator upon installation and at least annually thereafter, in accordance with procedures in Regulatory Guide 10.8, Appendix D, Section 2, (October 1980). Contrary to the above requirement, the licenser did not perform the , annual accuracy checks on the dose calibrator for the years 1986 and I 1987. C. 10 CFR 35.20(a) requires each licensee to develop and implement a written radiation protection program that includes provisions for keeping doses ALARA. Condition No. 15 of License No. 53-16421-01 requires, in part compliance with licensee's statements and representations in an application dated February 26, 1986. Licensee's written ALARA program, dated February 10, l 1980, referenced in the application dated February 26, 1986, requires that an annual formal audit to include reviews of operating procedures NUREG-0940 II.A-58
- p. ,
3
~~r 2
B , a and past exposure records, inspections, etc., and consultations with the
~
1 radiation protection staff or outside consultants, be made by management and that,the Radiation Safety Officer (RS0) review and audit at least annually the effectiveness of.his own radiation protection program. Contrary to,the~above, the licensee did not perform the required annual audits by management and tne RSO for the year 1986. This is a repeat
' violation.
D._ 10 CFR 35.92(b)'provides that the licensee shall retain a record of each byproduct material disposal for three years. The record must include the-date of disposal, the date on which the byproduct material was placed in storage, the radionuclides disposed, the survey instrument used, t6
. background dose rate, the dose rate measured at the surface of each waste container, and the name of the individual who performed the disposal.
lL, t: Contrary to the above, for disposals made'during December 1987 the ifconsee had not (1) recorded the date when the byproduct material was placed in storage, (2) recorded the background dose rata, and (3) l recorded the survey, instrument used for the> survey measurements of the obyproduct material which had been placed in storage.
.E. ' Condition No.15 of !.icense No. 53-16421-01 requires in part, compliance with licensee's. statements and representations in~an_ application dated J'= February 26,'1986. Section 12 of an application dated February 15, 1980, referenced:in the application dated February 26, 1986, requires.that the licensee conduct a training program.for all personnel.directly involved in' duties with_or in the vicinity of radioactive materials and that the i
housekeeping and security personnel staff participate at least once in a Department-of Nuclear Medicine orientation covering basic radiation protection, departmental layout and restricted areas containing licensed material., Contrary to the above, for personnel hired in 1986 ano 1987, training was not conducted by the licensee for individuals directly involved in duties with or in the vicinity of radioactive materials, and an orientation was not provided by the licensee for members of the housekeeping and security staff. F. 10 CFR 35.70(d) provides that the licensee shall establish radiation dose rate trigger levels for the surveys required by 10 CFR 35.70 (a) and (b). Contrary to the above, at the time of the inspection, the licensee had not established the required radiation dose rate trigger levels for surveys requirid by 10 CFR 35.70(a) and (b).
.These d stionc have been categorized in the aggregate as a Severity Level III violation (Supplements IV and VI).
Cumulative Civil Penalty - $2,500 - assessed equally among the violations. Pursuant to the provisions of 10 CFR 2.201, Honolulu Medical Group, Honolulu, Hawaii (Licensee) is hereby required to submit a written statement or explanation to the director, Office of Enforcement, U.S. Nuclear Regulatory NUREG-0940 II.A-59 e i
3 i Commission, within 30 days of the date of this Notice. This reply should be i clearly marked as a " Reply to a Notice of Violation" and should include, for I each alleged violation: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the co.rective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the { civil penalty in whole or in part or by a written answer addressed to the ) Director, Office of Enforcement U.S. Nuclear Regulatory Commission. Should { the licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in i accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in j part, such answer should be clearly marked as an " Answer to a Notice of i Violation," and may: (1) deny the violations (s) listed in this Notice in , whole or in part, (2) demonstrate extenuating circumstances, (3) show error in I this Notice, or (4) show other reasons why the penalty should not be imposed. 1 In addition to protesting the civil penalty, such answer may request remission j or mitigation of the penalty.
]
In requesting mitigation of the proposed penalty, the factors addressed in l Section V.B of 10 CFR Part 2. Appendix C (1988) should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. The responses to the Director Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Conunission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Cou.ission. Reaion V.1450 Maria Lane, Walnut Creek, California, 94596. FOR THE NUCLEAR REGULATORY COMMISSION p JO Nre((In T #- Regional Administrate Dated at Walnut Creek, California this d f] day of December 1988 NUREG-0940 II.A-60
s
# %, UNITED STATES 8 g NUCLEAR REGULATORY COMMISSION WASHINGTON, D. C. 20665
-h r
%,..... SEP 081907 Docket No. 30-20294 License No. 35-23134-01 EA 87-172 Log-Tec ATTN: Roger Couffer, Owner Post Office Box 61 Cleveland,-Oklahoma 74020 Gentlemen:
SUBJECT:
. ORDER SUSPENDING LICENSE (EFFECTIVE IM4EDIATELY) AND ORDER TO SHOW CAUSE Enclosed is an Order, effective immediately, suspending your byproduct material license. In addition, the Order requires that you show cause why your license should not be revoked. In'accordance with Section 2.790 of the NRC'c " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and the enclosures will be placed in the NRC's Public Document Room. The responses directed by this letter and accompanying Order are not subject to the clearance procedures of the Office of Management and Be.dget, as required by the Paperwork Reduction Act of 1980, PL 96-S11. i Sincerely, 1 Ja es M. Tay1 , Deputy Exer utive irector for Regional Operations
Enclosure:
As stated l CC' Oklahoma Radiation Control Program Director CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 II.A-61
UNITED STATES NUCLEAR REGULATORY COMMISSION
'In the Matter of- )
LOG-TEC. ) Docket No. 30-20294
.Fost Office Box 61~ ) License No. 35-23134-01 Cleveland, Oklahoma 74020 ) EA 87-172 ORDER SUSPENDING LICENSE (EFFECTIVE I!91EDIATELY)
AND ORDER TO SHOW CAUSE I Log-Tec, (Licensee) P. O. Box 61, Cleveland, Oklahoma 74020 is the holder of a 3 Byproduct Material License issued by the Nuclear Regulatory Commission (NRC/Comission) on June 14, 1984 pursuant to 10 CFR Part 30. The license is , due to expire on June 30, 1989. The license authorizes the Licensee to possess and use licensed materials (americium-241 and cesirm-137 sources of up_to 4.6 and 10 curies per so:trce, respectively) in oil and gas well logging. The license specifies that sources shall be used by, or under the supervision and in the-physical presence of,
- lector Apodaca or Roger Couffer. Mr. Apodaca is no longer employed by Log-Tec and is no longer a part owner of Log-Tec. Presently, !
Mr. Couffer is the sole proprietor of Log-Tec. Mr. Couffer is en experienced well logger who has been employed at four other well logging companies and who has been involved in licensed activities since April 1974 as' a user, supervisor, or owner. II On August 19, 1987, a routine NRC inspection was cor; ducted at Log-Tec facilities in Cleveland, Oklahoma. During the course of the inspection, the L NOREG-0940 II.A-62
m ,
, y .
. ),
tr
\
ik i
'NRC inspector determined that the Licensee was in' apparent violation of seven
- regulatory requirements. These apparent violations included the failure to
.-(a)' store radioactive material at an authorized location, (b)' survey storage.
Lfacilities, (c) provide for personnel monitoring, (d) maintain utilization records,. (e)'proherlylabelradioactiveshippingpackages,(f)-performleaktestson-sealed sources,.and.(g) calibrate survey instruments.' When these apparent violations were discussed with Mr. Couffer,-the company's sole _ proprietor, the NRC inspector was told that the Licensee's sources had not been used since
;about June 1986.
n Contrary to.the above, on August:21, 1987, the President of-Inland Oil-
' Corporation provided a-sworn statement that the Licensee had conducted well logging operations for Inland Oil Corporation on July 9, 1987. According to the President, he and another person witnessed Mr. Couffer conducting the logging process. Inland Oil Corporation also provided NRC with written documentation (i.e., neutron log)' received from the Licensee that verified the results of the logging process.
'On AugustL21, 1987, an NRC investigator and an NRC inspector interviewed Mr. Couffer about his use of radioactive sources. Again, Mr. Couffer reiterated that he had done no logging using radioactive sources since June 1986. However, when confronted with the copy of the neutron log received from fnland 011 Corporation, Mr. Couffer admitted that he had performed this work and had used a radioactive source to do so. Also, Mr. Couffer stated that he
.had no records of his work at Inland 011. Mr. Couffer said that he told the l
l NUREG 0940 IJ.A-63 l 1
V NRC inspector that he had not used radioactive sources because he knew his f records were not up-to-da'te and he was afraid to admit this. Mr.'Couffer stated that-he had none of the records required by NRC and never thought about' 1 keeping such records. He stated that his survey equipment was out of calibration because he did not have the money for such maintenance. Mr. Couffer also admitted that he had not used film badges in a long time 2 because he could not afford such associated expenses. Also, Mr. Couffer g admitted'that 'he, doing business as (dba) Log-Tec, had conducted licensed well logging activities for other companies (i.e., Continental Oil, JGW, and
- Covenant 011) .since June 1986 besides that done for Inland Oil Corporation.
NRC contacted and subsequently obtained Inland Oil Corporation company neutron ray-logs that document Mr. Couffer's use of radioactive sources for logging operations on September 9, 1986, December 10, 1986, and June 30, 1987. III Mr. Couffer's action in deceiving the NRC inspector demonstrates that he is untrustworthy and uncommitted in his compliance with Commission requirements. Therefore, I lack the requisite reasonable assurance that Mr. Couffer, dba Log-Tec, will comply with Commission requirements in the future. Accordingly, I have determined that the public health, safety, and interest require that License No. 35-231 K-01 be suspended, effective immediately, as described below. NUREG-0940 II.A-64 i
L{ l fw j.- t j l l'
- 4.- i I have.further determined that pursuant to 10 CFR 2.201(c) and 2.202(f) no prior (notice is requirhd and that the suspension should be ,imediately j effective pending furt'her Order.
l i IV
'l Accordingly,inviewoftheforegoingandpursuanitosections81,161b.,161c.,
1611. .. 161o., 182,'and 186 of the Atomic Energy Act of 1954, as amended, and 1 the Comission's regulations in 10 CFR Section 2.202 and.10 CFR Parts 30 and 39,
- !T IS' HEREBY ORDERED, . IP91EDI ATELY. EFFECTIVE, THAT:
i' F A. . Activities authorized under License No. ~35-23134-01 are suspended. B. Mr. Couffer, dba Log-Tec, shall place all byproduct material in his possession in locked storage and within 30 days shall transfer such material to a person authorized to receive the material and shall notify the NRC Region IV office upon compliance. C. Mr. Couffer, dba Log-Tec, shall show cause, in accordance with Section V of this Order, why License No. 35-23134-01 should not be revoked. j l NUREG-0940 II.A-65
1
.i The Regional Administrator, Region IV, may relax or rescind any of the above provisions upon demonstration of good cause by Mr. Couffer, dba Log-Tec.
)>
V l Pursuant to 10 CFR 2.202(b), Mr. Couffer, dba Log-Tec, may show cause why License No. 35-23134-01 should not be revoked by filing a written answer under oath or affirmation within twenty days of the date of issuance of this Order, setting forth the matters of fact and law on which the Licensee relies. Mr. Couffer, dba Log-Tec, may answer this Order, as provided in 10 CFR 2.202(d), by consenting to the provisions specified in Section IV above. Upon consent of Mr. Couffer, dba Log-Tec, to the provisicas set forth in Section IV of this Order, or upon his failure to file an answer within the specified time, the provisions specified in Section'IV above shall be final without further Order. VI Pursuant to 10 CFR 2.202(b), Mr. Couffer, dba Log-Tec, or any other person adversely affected by this Order may request a hearing within twenty days of this Order. A request for a hearing should be clearly marked as a " Request for an Enforceneent Hearing" and shall be addressed to the Director, Office of Enforcement, U. S. Nuclear Regulatory Commission, ATTN: Document Control Desk, NUREG-0940 II.A 66
j .- L ,w 6-l- \t .. Washington, DC.20555 .with a copy to the Regional Administrator, U. S. Nuclear Regulatory Comission, Region IV, 611 Ryan Plaza Drive, Suite 1000 Arlington, Texas 76011. .If a person other than Mr. Couffer, dba Log-Tec, requests a hearing, that person shall set-forth with particularity the manner in'which the petitioner's
. interest is adversely affected by this Order and should address the criteria
- set forth~in 10 CFR 2.714(d). 'An answer.to this Order or a request for hearing shalinotstaytheimmediateeffectivenessofthisOrder.-
2If a hearing is requested by Mr.'Couffer, dba Log-Tec, or a person whose - interest is. adversely affected, the Comission shall' issue an Order designating the time and place.of any. hearing.- If a hearing is held, the issue to be considered at such a-hearing shall be whether this'0rder should be sustained. FOR THE NUCLEAR REGULATORY COMMISSION' J mes M. Tay1 , Deputy Executive Director for Regiona Operations i Dated at Bethesda, Maryland, thisgNay.ofSeptember1987. i NUREG-0940- II.A-67
t:. , , c ,
.Iki ..
u:y N ' # q . . -;c,% W4
'J -f*. .
**; UNITED STATES -
E-t E .j- NUCLEAR REGULATORY COMMISSION ! WASHINGTON D. C. 20555
~i 'I RB22MB
- p. s,.
i
*****^ f Docket No.- 30-20294 m
License No.. 35-23134-01' EA 87-172 ' i- Log-Tec
'n ATTN: Mr. Roger A. Couffer Post' Office Box 61 Cleveland, Oklahoma 74020. '
Dear Mr. Couffer:
'l
SUBJECT:
ORDER REV0 KING LICENSE. {
~
Enclosed is an Order Revoking License which revokes License No 35-23134-01. l In accordance with 10 CFR 2.790 of the NRC's " Rules of Practice," Part 2,. Title 10,' Code of Federal Regulations..a copy of this letter and the enclosed Order'will be placed in the NRC's Public Document Room.- ! Sincerely, s
. J esM.Taylon,DeputyExecutiveDirector j ',for Regional Operations
Enclosure:
As Stated CERTIFIED MAIL RETURN RECEIPT REQUESTED
~ NUREG-0940 II.A-68
UNITED STATES NUCLEAR REGULATORY COMMISSION In Matter of )
) Docket No. 30-20294 LOG-TEC ) License No. 35-23134-01 Cleveland,0K ) EA 87-172 ORDER REV0 KING LICENSE I
On Septenber 8, 1987, the NRC issued an Order to Log-Tec suspending its license (effective immediately) and requiring it to show cause why its license should not'be revoked. t II By letter dated September 25, 1987, the Licensee, without providing good cause, requested a hearing on the Order. In a letter dated December 1, 1987, the licensee withdrew its request for a hearing and recuested that its License No. 35-23134-01 be terninated. Cn February 3, 1988, Roger A. Couffer, on behalf of the licensee, signed an affidavit attesting that he had met the conditiens of 10 CFR Section 30.36 (d)(1) and that he neither owns nor possesses radioactive material licensable by the NRC. The Commission has found the information submitted to be adequate. l III . 1 ! Accordingly, pursuant to Sections 81, 161, 182, and 186 of the Atomic Energy Act of 1984, as amended, and the Commission's regulations in 10 CFR 30.61, NUREG-0940 II.A-69 E_ --- - __
[., y , } .. ') n p. L, % j . , t. -. License No.- 35-23134-01 is revoked. { FOR THE NUCLEAR REGULATORY COMMISSION
/ }
[ h _ _ _.fTT P
'... v
)
I s s -Jpas M. TayloV, Deputy Executive Director i V
/.
,- for Regional Operations i
\
4
. Dated et Bethesda, Maryland ;
- , this 23 day of February 1988.
l ny i I I 1
- \_
-NUREG-0940 II.A-70 -
I
1
\
#8 ' ~. ' 0808T80 STATSS NUCLEAR REoOLATORY CoMMisslON r
7
, messo8s 88 -
tel MAR 8ETTA STAGET,ti.et. ATLA 8d7A. GEORGIA 30333 - DEC 191988
. Docket Mos.3 030-03347.and 030-00521-Lt.icense'Nos. 45-10831-02 and 45-10831103 EA 88-227 ,
! Maryview Ho pital-ATTN: 'Mr.:J. Burkhart Executive Vice President /CEO 3636 High Street . .
Portsmouth, Virginia 23707' Gentlemen:
SUBJECT:
NOTICE'0F VIOLATION"AND PROPOSED IMPOSITION OF CIVIL PENALTY
'(NRC- INSPECTION REPORT N05. 45-10831-02/88-01 AND 45-10831-03/88-01)
- Mr. E. Kline at; Maryview Hospital on August 11 and 12,:1988,This and Special NRC- refers to the Nuc inspection conducted by Mr. E. Kline and Mr.1 Cline at Maryview Hospital. on September 21 1988. The inspection included both your nuclear medicine and teletherapy - Ifcenses. 'as well as an examination of activities related to radiation safety and compliance with NRC regulations and the conditions of your-licenses. - The report documenting this inspection was sent to you by.-letter
. dated September 16, 1988. As a result of these inspections, numerous failures .
to comply with NRC regulatory requirements were identified. Accordingly,'NRC concerns relative to the inspection findings were discussed in an Enforcement Conference held on September 21, 1988. The letter summarizing this Conference wasLsent to you on.0ctober 18.-1988. . A' subsequent review of records submitted
- by Maryview Hospital dated August 22 September 7, 21, 23, 26, and October 4
1988, revealed additional examples of violations of regulations and conditions of your licenses. These violations are included with violations I.A.2.,
!.A.11., and !!.A., with the addition of violation I.A.4. in the. enclosed
. Notice.,
The violations which- are described in the enclosed Notice of Violation and Proposed -Imposition of Civil Penalty (Notice) include, for example, failure to perfom a fomal annual review of radiation safety and ALARA programs.
--test 1and calibrate equipment as required, (3) conduct a bioassay test, conduct appropriate radiation surveys (5) perfom appropriate radiation 1 exposure rate measurements and wipe tests for removable- contamination,
- (6). inventory sources and devices, and (7) maintain required records. Collec-tively, these violations are of significant concern to the NRC because they j represent an overall weakness in your Radiation Safety Program.. NRC views j this. lack of management controls and oversight as indicative of potential '
safety problems. '
.To emphasize the importance of complying with regulatory requirements and ensuring. management oversight of licensed programs, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of II.A-71 NUREG-0940
-i e
Maryview Hospital 2 j i i Violation and Proposed Imposition of Civil Penalty in the amount of Twelve Hundred and Fifty Dollars ($1,250) for the violations described in the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement - Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations described in the enclosed Notice have been categorized i collectively as a Severity Level III problem. The base value of a civil penalty for a Severity Level III problem is $2,500. The NRC Enforcement Policy allows for reduction of a civil penalty under certain circumstances. In this ' case, the base civil penalty amount has been reduced by fifty percent because of your prompt and extensive corrective actions to prevent recurrence. l You are required to respond to this letter and the enclosed Notice and should ! follow the instructions specified therein when preparing your response. In l your response, you should document the specific actions taken and any I additional actions you plan to prevent recurrence. After reviewing your l response to this Notice, including your proposed corrective actions and the results of any future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory , requirements. ' In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and its enclosure 1 will be placed in the NRC Public Document Room. l The responses directed by this letter and i.ts enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Should you have any questions concerning this letter, please contact us. Sincerely, it.olm L t cting Re onal Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty cc w/ encl: Commonwealth of VA d NUREG-0940 II.A-72 ! j
h NOTICE OF VIOLATION l AND I PROPOSED IMPOSITION OF CIVIL PENALTY I
- Maryview Hospital _ Docket Nos. 030-03347. and 030-00521 Portsmouth, Virginia License Nos. 45-10831-02 and 45-10831-03 EA 88-227 During the Nuclear Regulatory Commission (NRC) inspection conducted on August 11-12, and Special NRC inspection conducted on September 21, 1988, ,
and based on a review of records submitted by Maryview Hospital dated September 7, 21, 23, 26, and October 4,1988, violations of NRC requirements
- were identified. In accordance with the " General Statement of Policy . and
- Procedure' for NRC Enforcement Actions," 10 CFR Part 2 Appendix C (1988), the Nuclear Regulatory Comission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are
, set forth below:
I. .uclear N Medicine License No. 45-10831-02 A. License Condition 19. requires the licensee to conduct its program in accordance with the statements, representations, and procedurcs contained in the documents, including enclosures, referenced in the application. with cover letter dated March 4, 1985; ALARA program dated January 1, 1985; and letters dated December 9, 1986,
' January 30, 1987, November 5, 1987, January 21, 1988, February 18, 1988, and May 16, 1988.
- 1. Item 6. of the licensee's application with cover letter dated March 4,1985, requires the Radiation Safety Committee to review the entire radiation safety program at least annually to determine that all activities are being conducted safely and in accordance with state regulations, NRC regulations and the conditions of the license. The review shall include an examina-tion of all records, reports from the radiation safety officer, results of NRC inspections, state inspections, written safety procedures and management control system.
Item I.b. of the licensee's ALARA program dated January 1,1985, requires the management of Ma ryview Hospital to perform a formal review of the radiation safety program including ALARA considerations. This shall include reviews of operating procedures, past exposure records, inspections, etc., and consultations with the radiation protection staff or outside l consul tants. Item II.c.3. of the licensee's ALARA program dated January 1. j 1985, requires the Radiation Safety Committee to evaluate the institution's overall efforts for maintaining exposures ALARA on 1 I NUREG-0940 II.A-73 J
N; L Notice of Violation 2 an annual basis. This review will include the efforts of the I Radiation Safety Officer, authorized users, and workers as well ! as those of management. J Item III.a.1. of the licensee's ALARA program dated January 1, 1985, requires the Radiation Safety Officer to perform an annual
' review . of. the Radiation Safety Program for adherence to ALARA .
concepts. Reviews of specific procedures may be conducted-on a 1 more' frequent basis. Contrary to the above, between December 18, 1985 and August 11, '! 1988, the licensee's Radiation Safety Comittee, management, ) and Radiation Safety Officer failed to perform a formal annual i review or evaluation of the entire radiation ' safety program, including the ALARA program.
- 2. 10CFR35.50(b)(3) requires the licensee to test the dose calibrator for linearity upon installation and at least
- quarterly thereafter over the range of its use between . the highest dosage' that will be administered to a patient and 10 microcuries.
Item 10.' of the licensee's application with cover letter dated March 4, 1985, requires the licensee to perform' a linearity
. test of the dose calibrator upon installation, and quarterly thereafter. l Item 10., Section 4 " Test of Dose Calibrator Linearity," of the licensee's application with cover letter dated March 4,1985, requires the licensee, when performing a dose calibrator linearity test, to plot the measured net activity for each time interval versus the predicted activity on semi-log graph paper in order to determine crrors greater than !5 percent. ,
I' Contrary to the above, (a) Between December 18, 1985 and April 2, 1986; between June 17, 1986 and October 2,1986; and between May 6,1987 and { October 19, 1987, the licensee failed to test the dose calibra- ' tor (Capintec CRC 17 - Serial No. 17225) for linearity at quarterly intervals. (b) Between March 18, 1985 and August 11, 1988, the licensee failed to plot the required linearity test data for the dose
-calibrator.
(c) Between May 6 and October 19, 1981, the licensee failed to test the dose calibrator down to 10 microcuries.
- 3. Item 10. of the licensee's application with cover letter dated 1 March 4.1985, requires the licensee to calibrate all survey instruments every six months and following repair. l NUREG-0940 II.A-74
@ j
'l l
Notice of Violation 3 Contrary to the above,
-(a) Between' December 18, 1986 and January 7,1988, and between January 8, 1988 'and August 11, 1988, the licensee failed to. 1 calibrate a Victoreen Thyac lII (Serial No. 491-40)' survey l meter on a six month frequency.
(b) Between January 8,1988 and August = 11, 1988 the L licensee ^ failed- to, calibrate a Keithley Model 36100 Ion Chamber (Serial No.16850).
- 4. Item 9. of the licensee's application with cover letter dated March 4,1935, re:;uires the liccrsee to have onsite a low-level-survey meter (Victoreen. Thyac III) capable . of detecting 0.1
-milliroentgen per hour to perform contamination surveys.
Contrary to the' a bove', at the- time of the enforcement conference (September 21, 1988), the licensee . failed' to have onsite a low-level survey meter capable of detecting 0.1. milliroentgen per hour to perform contamination surveys. The survey meter was being' calibrated 'at a calibration facility.
- 5. Item 10. of the licensee's application with cover letter dated March 4, 1985, requires the- licensee to test the accuracy of the dose calibrator upon installation and every six months thereafter using several radionuclides including cesium-137, cobalt-60, cobalt-57, and barium-133. - A record will be kept of these checks.
Contrary to the above. between December 17. 1986 and July 17, 1987, the licensee failed to perform required accuracy tests on a Capintec CRC 17 (Serial No.17225) dose calibrator at a frequency of once every six months. On July 17, 1987,i January 18, 1988, and vuly 15, 1988, the licensee failed to test the accuracy of the dose calibrator using all of the required radionuclides in that cobalt-60 and barium-133 were not used.
- 6. Item 10. of the licensee's application with cover letter dated March 4, 1985, requires the licensee to perform a test for geometrical variation of the dose calibrator upon installation.
Contrary to the above, upon installation of a Capintec CRC 17 (Serial No. 17225) dose calibrator, the licensee failed to perform the required test for geometrical variation.
- 7. Item 19. of the licensee's application with cover letter dated March 4,1985, requires the licensee to perform a bioassay test (thyroid count) of any individual involved in an iodine-131 ;
therapy procedure in which more than 1 millicurie of oral NUREG-0940 II.A-75
Notice of Violation 4 solution or 10 millicuries in capsule form is administered. The thyroid count shall be administered within 24 hours of the iodine-131 administration. Contrary to the above, the licensee failed to perform a thyroid ! count of a Nuclear Medicine Technologist who administered I greater than 10 millicuries of iodine-131 in capsule form for l therapeutic purposes on June 11, 1987 (11.97 millicuries) and January 13, 1988 (11.48 millicuries). ]
- 8. Item 17., Section D. of the licersee's application with cover l letter dated March 4, 1985, requires the licensee to perform 1 weekly surveys, consisting in part of a series of wipe tests, j to measure contamination levels in the Nuclear Medicine Department's elution, pre aration, and injection areas. The method for performing wipe tests will be sufficiently sensitive l to detect 100 dpm. ]
10 CFR 20.401(b) requires each licensee to maintain records in the same units used in this required by 10 CFR 20.201(b)part, showing the results of surveys Contrary to the above, between December 18, 1985 and August 11, l 1988, the weekly wipe tests performed by the licensee were l inadequate in that the survey meter used by the licensee was not capable of detecting 100 dpm. Also, the licensee failed to express removable contamination measurements in disintegra-tions per minute per 100 square centimeters (dpm/100 cm r ), the units used in Part 20, for weekly wipe tests performed between December 18, 1985 and August 11, 1988.
- 9. Item 14., Section 2. and 3. of the licensee's application with cover letter dated March 4, 1985, requires the licensee to measure and record the radiation exposure rate at three feet and at the surface of the package upon receipt of packages containing radioactive material.
Item 14., Section 6. of the licensee's application with cover letter dated March 4, 1985, requires the licensee to wipe the external surface of the final source container, which houses radioactive material, upon receipt of the container. The licensee shall assay and record the wipe test for removable contamination. 10CFR20.401(b) requires each licensee to maintain records in dpm, the units used in Part 20, showing the .esults of surveys required by 10 CFR 20.201(b). NUREG-0940 II.A-76 1
Notice of Violation 5 10 CFR 20.205(b)(1) and (2) requires the licensee, upon receipt, to monitor ~ the external surfaces of the package containing radioactive material for radioactive contamination caused by leakage. of the radioactive contents unless excepted by 10 CFR 20.205(b)(1). If removable radioactive contamination in excess of 0.01 microcuries (22,000 dpm) per 100 square centimeters of. package surface is found on the external surface of the package, the licensee shall immediately notify. the final delivering carrier and the appropriate Nuclear Regulatory. Commission Office. Contrary to the above, (a) No exposure rate and wipe tests surveys were performed on packages containing. radioactive material received on December 18,1986 (two separate shipments); December 19, 1986 (two septrate shipments); December 20, 1986; and December 22, 1986. (b) The licensee failed to record the radiation exposure rate measurements and wipe test results for packages containing radioactive material received on February 2 and November 26, 1987. (c) No exposure rate and wipe test surveys were performed on a package of. radioactive material (strontium-90 sealed source containing approximately 10 millicuries) upon receipt on or about February 1988.. (d) The licensee failed to properly determine removable
. contamination- levels upon receipt of packages containing radioactive material in that. the wjpes were recorded in counts per minute (cpm) and not dpm/100 cm .
- 10. Item 20. of the licensee's application with cover letter dated March 4, 1985, requires the licensee to perform radiation surveys, upon arrival of shipments of therapy sources at the institution.
Contrary to the above, between May 7,1987 and August 11, 1968 the licensee failed to perform radiation surveys of five shipments containing cesium-137 brachytherapy sources upcn ' arrival in the institution't Radiation Oncology Department from another institution. l
- 11. Item 19., Section 11., " Instructions For Radiation Safety Officer For Therapy Cases Using Iodine-131," of the licensee's application and cover letter dated March 4,1985, requires the Itcensee to survey the iodine-131 therapy patient's room for l contamination before the therapy patient's room is reassigned to another patient. ;
NUREG-0940 II.A-77 l ___ _- __ _ A
i i Notice of Violation 6 l 10CFR35.315(a)(7) requires the licensee to survey the patient's room and private sanitary facility where radiopharma-ceutical therapy was received, for removable contamination with a radiation detection survey meter before assigning another patient to the room. The room must not be reassigned until removable contamination is less than 200 dpm/100 cme , Contrary to the above, on April 15, 1988, the licensee retssign-ed a patient's room (Room 409, R0f M-27-86) where radiopharma-
.ceutica? therapy was performed with removable contamination levels at 228 dpm/100 cm on the " toilet floor." Also, the licensee's records for removable contamination surveys of iodine-131 therapy procedures performed in Room 409 on January 29, 1987; January 6 and April}5, 1988, failed to express contamination levels in dpm/100 cm .
- 8. License Condition 18.A.(1) requires the licensee to test for leakage and/or contamination each sealed source containing licensed material, other than hydrogen-3, with a half-life greater than thirty days and in any form other than gas, at intervals not to exceed six months.
Contrary to the above, between December 17, 1986 and July 26, 1987; and between January 14, 1988 and July 29, 1988, the licensee failed to test for leakage and/or contamination a sealed source containing cesium-137, licensed material, with a half-life greater than thirty days and in a form other than gas. C. 10 CFR 35.59(g) requires the licensee to conduct a quarterly physical inventory for all sealed sources in its possession. The licensee shall retain each inventory record for five years. The licensee's quarterly inventory records of sealed sources shall contain the model number of each source, and serial number if one has been assigned, the identity of each source radionuclides and its nominal activity, the location of each source, and the signature of the Radiation Safety Officer. L Contrary to the above, between April 1,1987 and July 20, 1987, the l licensee failed to conduct a ' :ond quarter physical inventory of a cesium-137 sealed source. Also, the licensee failed to record the mooel number of the cesium-137 sealed source and signature of the Radiation Safety Officer on the quarterly inventory records of sealed I sources between July 20, 1987 and August 11, 1988. l 10 CFR 35.70(d) requires a licensee to establish radiation dose rate D. l trigger levels for the surveys required by 10 CFR 35.70(a) and (b). 10 CFR 35.70(g) requires a licensee to establish removable contam-ination trigger levels for the surveys required by 10 CFR 35.70(e). 1 NUREG-0940 II.A-78
Al' t r Notice of Violation 7 Con'trary' to the above, between Ahril 1, 1987 and. August 11, 1988,
~
-the licensee failed to ' establish radiation dose rate and removable contamination trigger. levels in accordance with 10 CFR 35.70(a), (b),
P and (e)- for ear.h area surveyed in the Nuclear Medicine Department. E. 10CFR35.50(e)(1) requires the licensee -to record, on the dose calibrator daily constancy check records, the model and serial number
- and initials of the. individual who= performed the check, i '10 CFR 35.50(e)(2) requires the licensee _to record, on the dose l- calibrator annual accuracy test records, the model and serial number of. the dose calibrator, the model and serial number of each source, and the signature of the Radiation Safety Officer.
10CFR35.50(e)(3) requires the licensee to record, on the dose calibrator quarterly linearity test records,- the signature of the Radiation Safety Officer, c Contrary to the . above, between April 1, 1987 and August 11, 1988 the licensee failed to record the signature of the Radiation Safety Officer on the dose calibrator quarterly linearity test records; 'the model and serial number of the dose calibrator, the model 'and serial number of each source, and the signature of the Radiation Safety Officer on the dose. calibrator annual accuracy test records; and the model and serial number and initials of the individual who performed the check on the dose calibrator daily constancy check records. F. 10CFR.35.21(b)(2)(xi) requires the . licensee's Radiation Safety Officer ~ to establish, collect in one binder or file, and implement written policy and procedures for ' keeping a copy of all records and reports required by NRC regulations. 10 CFR 30.52(b) requires- the licensee ~ to make available to the NRC 'for . inspection, upon reasonable notice, records kept by him pursuant to the regulations in this chapter. Contrary to the above, at the time of the inspection on August 11, 1988, the licensee's Radiation Safety Officer failed to establish, collect in one binder or file, and properly implement written policy and procedures for. keeping a copy of all required records and reports required by NRC regulations (i.e., dose calibrator accuracy tests, teletherapy leak tests, radiation safety training, and Nuclear I Medicine consultant reports). Also, the licensee failed to make available to the NRC at the time of the inspection, upon reasonable
. notice, records (i.e. receipt surveys of sealed sources, teletherapy leak tests, and dose calibrator linearity tests ) kept by him pursuant to NRC regulations.
NUREG-0940 II.A-79
LKotice of Violation 8-G. 10 CFR 19.11 requires a licensee to post current copies of certain documents _ in a t sufficient number of places to permit individuals F engaged in licensed activities .to observe tiie documents on their way to or from ' the . particular licensed activity locationa to which the documents apply. These documents include 10 CFR Part 19, 10 CFR Part 20, the license complete with. amendments and documents incorpo-rated into'the license by reference, and operating procedures appli-E cable to licensed activities. If posting of-these documents is not
~
practicable, the licensee may _ post a notice that describes. the documents and states where they may be examined. (;' Contrary to the above, on August 11, 1988, the licensee had not - posted the required documents nor a notice stating where the documents might_be examined. II.. Teletherapy License No. 45-10831-03 A. License Condition 14.A. requires the licensee to test the teletherapy source for leakage at intervals not to exceed six months. Records of
-test results shall be kept in units of microcuries and maintained for inspection by the NRC.
License Condition 24. requires the licensee to conduct its program in accordance with the statements, representations, and procedures contained in the application dated August 25, 1983 Unless otherwise provided in the license. Item 17., " Description of Operating Procedures," requires the licensee to maintain records of teletherapy leak testing within the Department of Radiology. Contrary to the above. (1) The licensee failed to perform leak tests on a Picker C-8 teletherapy unit (Source Serial No. S-3923) between July 23, 1985 and February 19, 1986. (2) The licensee's records of test results were not maintained ! in units of microcuries for leak tests performed on September 18, 1986 (Source Serial No. S-3923) and October 1,1986 (Source Serial No. AMS-2425). i (3) The licensee's records of teletherapy leak testing performed on July 9,1986, March 31,1987, and September 2,1987, were not maintained within the Department of Radiology and therefore were ; unavailable for inspection by the NRC. l l NUREG-0940 II.A-80 ____ ___________________J
e l Notice of Violation 9 B. 10 CFR 35.51(a)(3) requires the licensee to conspicuously note on the survey instrument the apparent exposure rate from a dedicated check source as determined at the time of calibration. Contrary to the above, the licensee failed to note on a Keithley Model 36150 (Sedal No. 25185) and Eberline E120 (Serial No.12195) survey meter the exposure rate from a dedicated check source, as determined at the time of calibration on October 15, 1987 and January 27, 1988, respectively. C. License Condition 24. requires the licensee to conduct its program in accordance with the statements, representations, and proc'edures contained in the letter dated July 15, 1986. Item 4. of the licensee's letter dated July 15, 1986 requires the licensee to per-form survey meter calibrations in accordance with Attachment #2B (Appendix D, Regulatory Guide 10.8, Revision 1.) Item B. and D. of Appendix 0 (Regulatory Guide M.8, Revision 1, October 1980) requires the licensee to measure the exposure rate with a survey meter, from a reference check source of long half life, at the time of the survey meter calibration. The licensee shall take a reading of this reference check source at least quarterly and maintain records of the checks. Contrary to the above, the licensee failed to perform and maintain records of quarterly reference source checks for a Keithley Model 36150 (Serial No. 25185) survey meter between Februar August 11, 1988; and a Eberline E120 (Serial No.12195)ysurvey 9,1987 and meter between January 27, 1988 and August 11, 1988. These violations have been evaluated in the aggregate as a Severity Level III problem (Supplement IV). Cumulative civil penalty - $1,250 (assessed equally among the violations). > Pursuant to the provisions of 10 CFR 2.201, Maryview Hospital (licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each violation: (1) admission or denial of the violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps which will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be '; ued to show .;ause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. NUREG-0940 II.A-81
l Notice of Violation 10 Within the same time as provided for the response required above under 10 CFR 2.201, the L11censee may pay the civil penalty by letter addressed to the
- Director Office of . Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, .or money' order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil' penalty .in whole or in ~ part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: . (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty.
In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C -(1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from -the statement or explanation in reply pursuant to 10 CFR 2.201 but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty. Upon failure to pay the penalty due, which has been subsequently determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act 42 U.S.C. 2282.. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Cvfice of Enforcement, U.S. Nuclear Regulatory Comission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II. FOR THE NUCLEAR REGULATORY COMMISSION colm Ly rns A ting Regional Administrator Dated a,t Atlanta, Georgia this /f % day of December 1988 NUREG-0940 II.A-82
f: l L i D4 UNITED STATES
.y ', NUCLEAR REGULATORY COMMISSION i h : ; REGION IV 811 RYAN PLAZA oRIVE. SUITE 1000 ARLINGTON, TEXAS 79011.
i EP 13 m l a Docket No. 30-15283 . I License No. 35-19048-01 ! EA 88-155
' Bill Miller, Inc. .
ATTN: William A. Miller, Prrsident Post Office Box 1107 ' I Henryetta, Oklahoma 74437 Gen +.lemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC INSPECTION REPORT NO. 30-15283/88-01) This. refers to the inspections conducted on February 27 and May 11, 1988, respectively, at the Wynnewood Refinery in Wynnewood, Oklahoma, and at the Bill Miller, Inc. facility in Henryetta, Oklahoma. During these inspections, the NRC inspector identified apparent violations that were subsequently discussed with you at an enforcement conference on June 10, 1988, in the Region IV cffice. The violations identified include (a) failure to maintain surveillance of an area in which the area industrial radiography where radiography was performed,was and being(performed, (b) failure to postc) failure to r where radiography was performed resulting in impermissible radiation levels in an unrestricted area. These violations allowed a situation which produced substantial potential for excessive radiation exposure to members of'the general public. This is of particular concern because the radiographer were trained and knowledgeable as to the applicable requirements and their failure to implement basic radiation protection measures, in view of their knowledge, demonstrated a careless disregard for regulatory requirements and the protection of the public' health and safety. This failure, for which the licensee is responsible, allowed a situation which not only had the potential for excessive radiation exposure but, in fact, resulted in two members of the general public receiving radiation exposures ss a result of the situation. Collectively, the violations demonstrate a significant breakdown in management eversight and control over your licused program at field locations. To emphasize the need to improve maaagement controls over licensed activities, I have been authorized, af ter consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to CERTIFIED MAIL RITURR RECETPT REQUESTED NUREG-0940 II.A-83
i i Bill Miller, Inc. issue the enclosed Notice of Violation and Proposed Imposition of Civil Per lty in the amount of Eight Thousand Dollars ($8,000) for the violations descrioed t in Section I of the enclosed Notice which relate directly to the radiation I exposure incident at the Wynnewood Refinery. In accordance with the " General l Statement of Polic and Procedure for NRC Enforcement Actions," 10 CFR Part 2, l Appendix C (1988) y(Enforcement Policy), these violations have been categorize1 as a. Severity Level II problem. Although these violations would normally be i classified at Severity Level III, the violations have been classified at I Severity Level II in accordance with Section III of the Enforcement Policy i since these violations involved careless disregard of NRC requirements. The base civil penalty for a Severity Level 11 problem is $8,000. The escalation and mitigation factors in the Enforcement Policy were considered and no adjustment has been deemed appropriate. The violations described in Section II of the enclosed Notice were identified l by the NRC inspector and have been categorized as Severity Level IV violations. ; You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your I response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. In addition, you should describe what actions have been taken to ensure that your employees understand the importance ; of strict adherence to these requirements. After reviewing your response to I this notice, including your proposed corrective actions and the results of l future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. ' In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, l Title 10, Code of Federal Regulations, a copy of this letter and its enclosure ! will be placed in the NRC Public Document Room. I The response directed by this letter and the enclosed Notice are not subject to : the clearance procedures of the Office of Management and Sudget as required by i the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely, ! Robert D. Martin j Regional Administrator { l
Enclosures:
l Notice of Violation and j Proposed Imposition ! of Civil Penalty cc: Oklahoma Radiation Control Program Director ) NUREG-0940 II.A-84
i l l NOTICE OF VIOLATION i i AND PROPOSED IMPOSITION OF CIVIL PLNALTY Bill Miller, Inc. Docket No. 30-15283 Henryetta, Oklahoma License No. 35-19048-01 EA 88-155 i During NRC inspections conducted on February 27 and May 11, 1988, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: I. Violations Assessed a Civil Penalty A. By License Condition 16, the licensee is required to follow procedures submitted with the license application. The licensee's Operating and Energency Procedures Manual submitted with the license application dated September 13, 1985 requires, in Section III, Part 8.1.5, that direct surveillance of the area where a source is to be exposed must be conducted by the radiographer or his assistant in order to keep all personnel out of the area while the source is exposed. Contrary to the above, surveillance by the licensee's radiographer and his assistant at the area in which industrial radiography was to be performed at the Wynnewood Refinery on February 25, 1988 was insufficient in that two individuals were in the area when the source was exposed. B. 10 CFR 34.42 requires that areas in which radiography is being performed shall be consp(icuously posted as required by 10CFR20.203(b)and(c)1). 10 CFR 20.203(b) requires that eacia radiation area shall be conspicuously posted with a sign or signs bearing the radiation caution symbol and the words " CAUTION RADIATION AREA." 10 CFR 20.203(c)(1) requires that each high radiation area shall be , conspicuously posted with a sign or signs bearing the radiation caution symbol and the words " CAUTION HIGH RADIATION AREA." Contrary to the above, at the Wynnewood Refirery on February 25, 1988, the licensee's radiographer and assistant radiographer did not post the radiation area and the high radiation area in which industrial radiography was being performed. NUREG-0940 II.A-85
m Notice of Violation C. 10 CFR 20.105(b) requires that no licensee shall possess, use, or transfer licensed material in such a manner as to create in any unrestricted area radiation levels which, if an individual were continuously present in the area, could result in the individual receiving a dose in excess of 2 millirems in any I hour.10 CFR 20.3 defines an unrestricted area as any area access to which is not controlled by the licensee for purposes of protection of individuals from exposure to radiation. License Condition 16 requires that the licensee shall conduct its program in accordance with the statements, representations, and procedures submitted with the license application dated September 13, 1985, and the letter dated December 4, 1985. Section III, Part 8.1.2 of the licensee's Operating and Emergency Procedures Manual, submitted with the license application, requires the radiographer to rope off the boundaries of the area in which it has been calculated that the radiation levels would be 2 mR/hr or greater. Contrary to the above at the Wynnewood Refinery, on February 25, 1988, the licensee's r 41ographer used licensed material in such a manner that two individuals who were present in an unrestricted area could have received between 200 and 450 millirems for the 14 seconds that the source was exposed, based on measurements and calculations made by the NRC inspector via the reenactment of the incident. The area . was deemed to be unrestricted in that the radiographer and assistant radiographer did not rope off the area in which industrial radiography was being performed to establish a boundary within which the radiation level would be 2mR/hr or greater. Collectively the above violations have been categorized in the aggregate as a Severity Level II problem (Supplements IV and V!). Cumulative Civil Penalty - $8,000 (ascessed equally among the violations). II. Violations Not Assessed a Civil Penalty A. License Condition 16 requires that the licensee shall conduct its program in accordance with the statements, representations, and ' procedures submitted with the license application dated September 13, 1985, and the letter dated December 4, 1985. Sectinn III, Part 13.4 of the Operating and Emergency Procedures Manual, submitted with the
' application requires that an unannounced field inspection shall be performed on each radiographer at least once each 90 days by the Radiation Safety Manager.
Contrary to the above, records of internal audits maintained at the licensee's headquarters indicate that the radiographer in charge at Wynnewood, Oklahoma, on February 25, 1988 was not audited during the NUREG-0940 II.A-86 l
l l (C
' Notice of Violation !
period September 16, 1987 to February 2, 1988. A review of utilization records confirmed that the individual had worked with i licensed material'during this time. This is a Severity Level IV violation (Supplement VI). i
- 8. 10 CFR 20.408 requires each person licensed to possess or use byproduct material for the purpose of radiography to submit a report of radiation exposure to the Commission for individuals who have been ;
exposed to radiation or radioactive material and who have terminated i employment. Such a report shall be furnished within 30 days after the exposure of the individual has been determined by the licensee or 90 days after the date of termination of employment or work I assignment, whichever is earlier. Contrary to the above, as of May 11, 1988, a licensee representative confirmed that a report was not submitted to the NRC for an individual who had terminated employment and was last listed on the per:sonnel monitoring report of October 1987. This is a Severity Level IV violation (Supplement IV). l i C. 10 CFR 20.409 requires that when a-licensee is required pursuant to 10 CFR 20.408 to report to the Comission any exposure of an individual to radiation or radioactive material, the licensee shall also notify the individual. Such notice shall be transmitted at a time not later than the transmittal to the Contnission. Contrary to the above, as'of May 11, 1988, a licensee representative confirmed that a report was not submitted-to an individual who had terminated employment and was last listed on the personnel monitoring report of October 1987. This is a Severity Level IV violation'(Supplement IV). Pursuant to the provisions of 10 CFR 2.201, Bill Miller, Inc. is hereby required to submit a written statement or explanation to the Director, Office of ' Enforcement, U.S. Nuclear Regulatory Comission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission or denial of the alleged violetion, (2) the reasons for the violation if admitted, j (3) the corrective steps that have been taken and the results achieved (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. NUREG-0940 II.A-87
lj q .N f s Notice of' Violation ,
'Within the same time as provided for the response required above under 20-CFR 2.201,.the licensee may. pay the civil penalty by letter addressed to the
-Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money ' order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty.in 'whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear' Regulatory Commission. Should the licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in ,
accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, ! such answer should.be clearly marked as an " Answer to a Notice of Violation" i and may: (1) deny the violations listed in this Notice in whole or in part, .i (2) demonstrate extenuating circumstances, (3) show error in this Notice, or ' (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty in whole or in part, such answer may request i remission or :nitigation of the penalty. ] In requesting mitigation of the proposed penalt Section V.B of 10 CFR Part 2, Appendix C (1988)y, the five
, should factors addressed be addressed. Any in written answer in accordance with 10 CFR 2.205 should be set forth separately
. from the' statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee .
is directed to the other provisions of 10 CFR 2.205, regarding the procedure ! for imposing a civil penalty. 1 l Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless > compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of.the Act, 42 U.S.C. 2282c. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement,
. U.S. Nuclear Regulatory Commission, ATTN: Document Control nesk, Washington, L D.C. 20555 with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region IV.
FOR THE NUCLEAR REGULATORY COMMISSION
/ ,
Robert D. Martin Regional Administrator Dated at Arlington, Texas, this 13th day of September 1988 NUREG-0940 II.A-88
'/ UNITED STATES j %,,[
NUCLEAR REGULATORY COMMISSION WASHINGTON, D. C. 20555
- 7. j
%,,, 44l 0 $ gg Docket No. 30-15283 License No. 35-19048-01 EA 88-155 Bill Miller, Inc.
ATTN: William A. Miller President Post Office Box 1107 Henryetta, Oklahoma 74437 Gentlemen:
SUBJECT:
ORDER IMPOSING A CIVIL MONETARY PENALTY This refers to your two letters dated October 11, 1988 and November 18, 1988 in response to the Notice of Violation and Proposed Imposition of Civil Penalty (Hotice) sent to you by our letter dated September 13, 1988. Our letter end Notice described several violations, identified during NRC inspections conducted ' February 27 and May 11, 1988. To emphasize the need to improve management controls over licensed activities, a civil penalty of Eight Thousand Dollars ($8,000) was proposed for certain of the violations. In your response, you do not deny any of the violations for which a civil penalty was proposed but request mitigation of the civil penalty based on the current financial condition of your company. At our request, you provided financial information to permit the NRC to assess your company's ability to pay the full civil penalty amount proposed. After careful consideration of your' response, we have concluded, for the reasons given in the Appendix attached to the enclosed Order Imporing Civil Monetary Penalty, that a sufficient basis has not been provided for full mitigation of the civil penalty, but that the proposed penalty in this instance should be reduced because of your financial condition. Accordingly, we hereby serve the enclosed Order on Bill Miller, Inc., imposing a civil penalty in the amount of $4,000. Given the current financial condition of your company, we would agree to allow you to pay the imposed civil pMalty in twenty-four monthly installments, 3n lieu of one lump sum payment. Please inform us within 30 days if you wish to pay in installments. At that time a
" Promissory Note in Payment of Preexisting Debt" will be sent to you for signature. We will review the effectiveness of your corrective actions during a subsequent inspection.
In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosures will be placed in the NRC's Public Document Room. Sincerely, y
\- f, /
. res :. Tay crc N puty Executive Citector 1
fer D qi:ra l C .:i;tions Encicsures: As StMed cc: Oklahoma Radiatien Control Director NUREG-0940 II.A-89
i. UNITED STATED. " NUCLEAR REGULATORY COWilSSION-
.f In the Matter of 1 BILL MILLER, INC.
Henryetta, Oklahoma 1 Docket No. 30-15283 i l p License No. 35-19048-01 ! EA 88-155 .i ORDER IMPOSING CIVIL MONETARY PENALTY i I a Bill Miller, Inc., Henryetta, Oklahoma (the licensee) is the holder of. . Materials License No. 35-19048-01 issued by the Nuclear Regulatory Commission (NRC/Comission) on' June 25,.1979, and amended last in its entirety on March 13,
)
1986. The license authorizes the licensee to perform industrial radionrephy. i l II J
~
Inspections of-the licensee's activities were conducted on February 27 and May 11, j 1988. The results of these inspections indicated that the licensee had not con-ducted its activities in' full compliance with NRC requirements. A written Notice 4 of Violation and Proposed Imposition of Civil Penalty (Notice) was served upon the licensee by letter dated September 13, 1988. The Notice stated the nature of the violations, the provisions of the NRC's requirements that the licensee had violated,'and the arrount of the civil penalty proposed for certain of the i violations. The licensee responded to the Notice by two lett'ers dated October 11 l and November 18, 1988. In its response, the licensee did not contest the violations for which a civil penalty was proposed. However, the licensee did request that the proposed civil penalty be mitigated due to finaricial hardship. By letter dated f.ovember 9, 10E8,
+he NRC provided the licensee with tne opportunity to submit specific fin 3ncial information on the ete r rany's rxer t praf in ire losse ::.o i t s i.e t ..c r t h. e licensee submittec this informe ion by letter dated
- ver. Lee :8, I MS.
NUREG-0940 II.A-90 _ - _ _ _ _ _ _ - _ - _ - _ _ _ - _ - - - ~
)
i f ,( !D! 1 1 III 4 l After consideration of the licensee's response and~the statements of fact, I l explanation, and argument for mitigation contained therein, the Deputy Executive Director for Regional Operations has determined-as set forth in the Appendix to this Order that the violations for which a civil penalty was pro-posed occurred as stated, but that the civil penalty proposed in the Notice of Violation would constitute an excessive financial hardship for the licensee, and therefore should be mitigated by 50 percent. IV In view of the foregoing and pursuant to Section 81, 161b, 182, and 234 of the Atomic Energy Act of 1954,'as anended (Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT IS HEREBY ORDERED THAT: The licensee pay a civil penalty in the amount of four Thousand Dollars ($4,000) within 30 days of the date of this Order, by check, draft, or l money order, payable to the Treasurer of the United States and mailed to the Director, Office cf Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555. In the alternative, the civil penalty ma3 be paid in 24 monthly installments which would include accrued inturest. The licensee is to ir. form the Director, Office of Enforcement, within the 30 day period if it elects this alternative. NUREG-0940 II.A-91
7, . .a . . .
<r f
;:[
l m
-(3 7 3- :
1 4 V t, ; l The' licensee may request a hearing' within 30' days of the date of' this Order.
'LA rhquest for s hearing should be clearly marked as a." Request for an i Enforcement. Hearing" and~shall be addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission, ATTN: Document. Control Desk, a
Washington, DC.20555. A~ copy of the~ hearing request shall also be sent to the. Assistant General Cour.sel for' Enforcement, Office of the General Counsel, U.S. I Nuclear Regulatory Comission, Washington DC 20555, and to the Regional Admini-strator, U.S.; Nuclear Regulatory Comission, Region IV.
-]
If_ a he' aring is requested, the.comission will issue' an Order designating the-
, time and place of the hearing. If the licensee fails to request a hearing 1 i
within 30 days of the date of this Order, the provisions of Section IV of
,this Order shall be effective.withoutjfurther proceedings. . If payment'has not
-been made by that time, the matter may be referred to the Attorney General for e collection. i i
In the. event the licensee requests a hearing as provided above, the issues to ! be considered at such hearing shall be: i j i l
.NllREG-0940 II.A-92
1
~
r j 1 L m i
- whether, on.the basis of the admitted violations, this Order should
.j!I .'be sustained
'i FOR THE~ NUCLEAR REGULATORY COMMISSION'
.jf s
&;. . . / -
n M.-Taylor Deputy Executive Director r Regional Operations Dated at Rockville, Maryla,1d this 3 day Lof _ January .1989 I Ir l $
'h NUREG-0940 II.A-93
L E
.\ 'l I
APPENDIX EVALUATIONS AND CONCLUSIONS-
, On September 13, 1988, a Notice of Violation and Proposed Imposition of Civil Penalty (Notice) was issued to. Bill Hiller Inc. (licensee) for violations identified during an NRC inspection. A civil penalty was proposed for-certain- :
of-the violations identified. The licensee responded to the Notice by a letter dated October 11, 1988, and claimed that the proposed penalty would impose a financial hardship on the company. The licensee also provided statements of l l corporate financial, status by letter dated November 18, 1938 to support its
- argument that the proposed civil penalty be mitigated because of financial hardship. The NRC's evaluation and conclusion regarding the licensee's arguments are as follows:
r I. yiolationsAssessedaCivilPenalty A. By License Condition 16, the licensee is required to follow procedures submitted with the license application. The licensee's Operating and Emergency Procedures Manual submitted with the license application dated September 13; 1985 requires, in Section III, Part 8.1.5, that direct surveillance of the area where a sourca is to be exposed must be ccnducted by the radiographer or his assistant in order to keep all personnel out of the area while the source is exposed. Contrary to the above, surveillance by the licensee's radiographer and his assistant at the area in which industrial radiography was-to be performed at the Wynnewood Refinery on February 25, 1988 was insufficient in that two individuals were in the area when the source was exposed. B. 10 CFR 34.42 requires that areas in which radiography is being performed shall be conspicuously posted as required by 10 CFR 20.203(b) and (c)(1). 10 CFR 20.203(b) requires that each radiation area shall be conspicuously posed with a sign or signs bearing the radiation cautiott symbol and the words " CAUTION RADIATION AREA." 10 CFR 20.203(c)(1) requires that each high radiation area shall be conspicuously posted with a sign or signs bearing the radiation caution symbol and the words " CAUTION HIGH RADIATION AREA." Contrary to the above, at the Wynnewood Refinery on February 25, 1988, the licensee radiographer and assistant radiographer did not post the radiation area and the high ra m tion area in which industrial radiography was being performed. C. 10 CFR 20.105(b) requires that no licensee shall possess, use, or ! transfer licensed material m such a manner as to create in any } or*estricted area radiatier levels which, if an irdividual were l a tirutusly present in the area, coula result in the ir.dividual receiving o cote in excess of i millirens 'e any 1 hour. 10 C~R 20.: cef ir:es an unrcstr:cted area as any area ; .ess tc which is net cont.rol'ed by the l a er.see ice prposes of ;rt tectici r.t individuals f rom exposure to radiat ion. NUREG-0940 1I.A-94 l
)
\ Notice of Violation License Condition 16 requires that the licensee shall conduct its program in accordance with the statements, representations, and procedures submitted with the license application dated
'eptember 13, 1985, and the letter dated December 4,1985.
Section III, Part 8.1.2 of the licensee's Operating and Emergency Procedures Manual, submitted with the license application, requires the radiographer to rope off the boundaries of the area in which it has been calculated that the radiation levels would be 2 mR/hr or greater. Contrary to the above at the Wynnewood Refinery, on February 25, 1988, the licensee's radiographer used licensed material in such manner that two individuals who were present in an unrestricted area could have received between 200 and 450 millirems for the 14 r.econds that the source was exposed, based on measurements and calculations made by the NRC inspector via the reenactment of the incident. The area was deemed to be unrestricted in that the radiographer and assistant radiographer did not rope off the area in which industrial radiography was being performed to establish a boundary within which the radiation level would be 2 mR/hr or greater. Collectively the above violations have been categorized in the aggregate as a Severity Level II problem (Supplements IV and VI). Cumulative Civil Penalty - $8,000 (assessed equally among the violations).
SUMMARY
OF LICENSEE RESPONSE The licensee, in its response, does not deny any of the violations for which a civil penalty was proposed. However, the licensee does request mitigation of the civil penalty based on the severe economic burden the civil penalty would place on Bill Miller, Inc. NRC Evaluation of Licensee's Request for flitioation The NRC Enforcement Policy recognizes that a licensee's ability to pay is a proper consideration in determining the amount of a civil penalty. The licensee's financial information submitted in its November 18, 1988 letter demonstrates that imposition of a civil penalty in the amount proposed would { create a severe financial burden. Recognizing the current financial situation, the penalty is being reduced by 50 percent. The NRC also finds, consistent with its Enforcement Policy, that the imposition of tha reduced civil penalty will not result in economic termination of the licensee's business or financial hindrance of the licensee's ability to safely conduct licensed activities. { l NRC Conclusion The NRC staff has carefully reviewed the licensee's response and the financial information submitted by the licensee, and has concluded that, in light of the licensee's financial situation, the proposed civil penalty should be mitigated by 50 percent to $4,000. NUREG-0940 II.A-95 l
-__-_-_-_a
.et i
1
.a nse UNITED STATES '
(+f NUCLEAR REGULATORY COMMISSION
.s y, ; nEcios m
% E
- 799 ROOSEVELT moAD cLas tL6vN. stuNois sois
~
=....
FE9 0 81989 I Docket No. 030-04041 ! License No.-12-00622-07 i EA 88-288 : ' MQS Inspection, Inc. ATTN: Hugh V. Doran i President L2301. Arthur Avenue Elk' Grove Village, IL 60007 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED ' IMPOSITION OF CIVIL PENALTY j
-This' refers to an on-site inspection conducted on November 10, 1988 at your j
. Elk Grove Village, Illinois facility and our continuing irispection' ar.d )
evaluation of' subsequent reports and information received at the NRC Region III Office, November 11-21, 1988. The inspection was in response to a radiography incident that occurred on November 3, 1988, and was reported by your staff to the NRC-on November 8, 1988. The inspection report was mailed to you on j December 7, 1988. An enforcement conference was held on December 9, 1988, between you and members of your staff and Mr. C. Norelius and others of the I NRC Region III staff, to discuss the incident, its causes, and corrective I actions.
.The NRC inspection effort was initiated after your Corporate Radiation Safety I
. 0fficer (RS0) notified Region III on November 8,1988, of a dose to a i radiographer of 4.47 rems and a dose to a radiographer's assistant of 2.57 rems. J The Corporate RSO was not promptly notified of the event because there was a delay in sendic.g the film badges to the vendor. This delayed NRC notification.
The NRC inspection showed that violations had occurred before and after the exposure of the two individuals. It appears that the root cause of the problem a is failure to adhere to procedures. The NitC is concerned that the manager of { the Madison Heights Branch Office failed to assure that the individual's film ) badges were immediately sent'for processing and failed to bar these individuals { from potential. radiation exposure assignments until results of the film badges 1 h were available and the individuals were released by the RSO. These failures j L reflect an unacceptable attitude by your branch manager for radiation safety l and are also indicative of inadequate management oversight and training I deficiencies. The NRC views such violations as well as the overexposure as ' j .significant. To emphasize the need for comprehensive management oversight, evaluation, and control of activities involving radiation safety, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and j Proposed Imposition of Civil Penalty in the amount of Five Thousand Dollars CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 II.A-96 i V
MQS Inspection, Inc. 2 ($5,000) for the violations described in the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the violations described in the enclosed Notice have been categorized as a Severity Level III problem. The base value of a civil penalty for a Severity Level III violation is $5,000. The escalation and mitigation factors in the Enforcement Policy were considered and no adjustment has been deemed appropriate. Mitigation of the civil penalty due to your good prior performance is offset by escalation warranted by the duration of Violations B and C. You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. Your response should include what actions have been or will be taken to assure that your supervisors and managers at each of your branch offices understand your procedural and license requirements and will be accountable to assure those requirements are met. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will cetermine whether further NPC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by tFis letter and the enclosed Notice are not subject to the clearance procedures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Sincerely, d 11d - A. Bert Davis Regional Administrator
Enclosures:
- 1. Notice of Violation and Proposed Imposition of Civil Penalty .
- 2. Inspection Report i No. 030-04041/88-002 l 1
I See Attached Distribution l NUREG-0940 II.A-97 i
NOTICE OF VIOLATION. AND PROPOSED' IMPOSITION OF CIVIL PENALTY ' MQS Inspection, Inc. Docket No. 030-04041 Elk Grove Village, IL' License No. 12-00622-07 l g, EA 88-288 m During'an'NRC inspection conducted November 10-21, 1988, violations of NRC ! requirements were identified. :In accordance with the " General Statement of
-Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commission proposes'to impose a civil penalty a .-
pursuant to Section 234 of the Atomic. Energy Act of 1954, as amended (Act),
'42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set'forth below:
LA 10 CFR 20.101(b)(1) requires that a licensee limit the total occupational dose'to1 the whole body of an individual in a restricted area to 3 rems during'any calendar quarter. o Contrary to the above, during the fourth quarter of 1988, an individual who1 performed radiography in a restricted area received a total whole body occupational dose of 4.6. rems. B. .10_CFR 34.33(d)' requires that if an individual's pocket dos 1 meter is discharged'beyond its range, his film badge or TLD be immediately sent for processing-. Contrary to the above, on November 3,1988, during radiography at the Midland, Michigan site, a radiographer's and a radiographer's assistant's
-dosimeters were discharged beyond their range and the film badges worn-1 by these individuals were not sent for processing until November 7, 1988.
C. License Condition No.19 requires .that licensed material be possessed and used in accordance with the statements, representations, and procedures contained in a letter dated August 21, 1981. 3-Item No. 3.4 of this letter in procedures titled Post Emeroency Action
; requires that exposed personnel be barred from potential radiation exposure assignments until the results of the film badges are available and the employee is released by the RSO.
Contrary to the above, af ter an incident on November 3,1988 involving licensed material, two individuals were allowed to perform radiography on November 4, 5, 7, and 8, 1988, and the results of the film badges were not yet available and these individuals were not released by the RSO. D. License Condition No.19 requires that license material be possessed and used in accordance with the statements, representations, and procedures contained in application dated July 28, 1980. NURfG-0940- II.A-98
.( l l:
\
; Notice of Violation- 2 m
I i
-Item No._8.1.5'of this application, under procedures titled Operating and )
Emergency Procedures requires that upon completion of the scheduled )
- radiographic operations. in the established restricted _ area, the sou'rce 4 tube be removed and the safety plug be' inserted.
Contrary to, the above, on November 3,1988, after completion of'a scheduled radiographic ' operation, in an -established restricted area, the - source tube was not removed and'the safety plug was not. inserted prior to moving the exposure device to new location. Collectively, these violations have been categorized.as a Severity Level III problem (Supplements _IV.and VI). Cumulative Civil Penalty - $5,000 (assessed equally among the violations). pursuant to the provisions' of 10 CFR 2.201, MQS Inspection, Inc. .is hereby required to submit a: written statement or explanation to the Director, -i
;0ffice of Enforcement, U.S.- Nuclear Regulatory Commission, within 30 days of
_the date of this Notice. This reply should be clearly marked as a " Reply "to a-Notice of Violation" and should include for each alleged violation:_ (1) admission or denial of the alleged violation; (2) the reasons _for the violation if. admitted; (3) the corrective actions that have been taken and the_results achieved; (4) the corrective actions that will be taken to avoid ifurther violations;-and (5) the date when full compliance will be achieved. ! If an adequatelreply is not received within the time specified in this Notice, aii Order may-be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken; _ Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall=be submitted under oath or affirmation. Within the same time as provided for the response required under 10 CFR 2.201, the. Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S.-Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil
~
penalty proposed above, or may protest imposition of the civil penalty in whole Lor 'in part by a written answer addressed to the Director, Of fice of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within i the time specified, an Order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed _in this Notice in whole or in part; (2) demonstrate extenuating circumstances; , (3) show error in this Notice; or (4) show other reasons why the penalty, should
- not be imposed. In addition to protesting the civil penalty, in whole or in part, such answer may request remission or mitigation of the penalty. !
NUREG-0940 II.A-99 m
e@ Not N e of Violation 3! b
.In requestir.; mitigation 'of the proposed penalty the 'five factors addressed iin.SectionLV.B of.10.CFR Part P, Appendix C'(1988).,--should be addressed. Any P iwritten answer in accordance vish 10 CFR 2.205.should be-set-forth separately-ifrom the rstatement or explanation in reply; pursuant'to.10 CFR 2.201, but may'
% ' incorporate parts:of'the 10 CFR 2.201 reply by specific reference ~(e.g., citing
'page'and paragraph ~ numbers)'to avoid repetition. The' attention of the licensee 3 Lis directed to.the-other provisions'of 10 CFPJ2~.205, regarding.the' procedure ]
for imposing'a' civil _ penalty. [' 'Upon failure to pay any civil penalty due which subsequently has been determined.
~
in accordance with.the applicable provision of 10-CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, ; or mitigated, may be collected by civil action pursuant to Section 234c of"the
- Act, 42 U.S.C 2282c.,
The responses'to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to.a
' Notice of. Violation) should be addressed to: Director, Office of Enforcement',
U.S. Nuclear; Regulatory Commission, ATTN: . Document Control Desk,. Washington, D.C. 20555,:with a' copy to the Regional Administrator, Region III, U.S. L. Nuclear Regulatory Commission, 799 Roosevelt Road, Glen'Ellyn, Illinois'60137. FOR THE NUCLEAR REGULATORY COMMISSION M A. Bert Davis Regional Administrator Dated at Glen Ellyn, Illinois this 8th day of February,1989 1 l i l j i 1
'NUREG-0940 II.A-100 1
li
[
/ o,, UNITED STATES 8 o NUCLEAR REGULATORY COMMISSION
[o { I wAsWNGTON, D C. 20006
%*****/ ~
APR 101986 Licen.se No. 37-21322-01 License No.'12-18044-01MD License No. 14-19990-01MD
' License No. 20-21227-01MD License No. 37-18461-01MD q License No. 37-19586-01MD License No. 48-17466-01MD EA 85-100 Nuclear' Pharmacy. Inc.
ATTN: Monty Fu, Chairman
' of the Board and Chief Executive Officer
.12847 Arroyo Street
'Sylmar, California 91342 Gentlemen:
SU8 JECT: NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTIES (INSPECTION REPORTS NO. 030-14386/84-01; 030-14386/84-02; 030-19637/84-01; AND 030-12831/84-01) This refers to inspections of your NRC-licensed facilities during the periods July 26-October 3.and November 16-19, 1984. The facilities inspected included: Chicago, Illinois; Des Moines, Iowa; Wauwatosa, Wisconsin; Philadelphia'and Harrisburg, Pennsylvania, and Woburn, Massachusetts. The findings of the initial series of inspections were discussed during an Enforcement Conference in Chicago, Illinois on October 2, 1984 between Robert L. Sanchez, former President of Nuclear Pharmacy..Inc. (NPI), and other members of the NPI staff and James G. Keppler, Region III Administrator, and others of the NRC staff. In addition, an investigation was conducted by the NRC Office of Investigations.
.The NRC staff has carefully reviewed the infonnation obtained during the inspections, investigation, enforcement conference, and management meetings with NPI staff and has concluded that numerous violations of NRC requirements occurred representing a serious breakdown in management control over NRC-licensed activities.
As a result, the safety and well-being of patients receiving radiopharmaceuticals prepared by NPI was jeopardized. Members of NPI's staff, including individuals in management positions, repeatedly falsified records, made material false
-statements, and willfully deceived the NRC staff. The specific circumstances of the violations are described below.
The NRC was informed by the U. S. Food and Drug Administration that a generator manufacturer, Medi-Physics, had sent a defective molybdenum-99/ technetium-99m generator to the NPI facility in Chicago. However, when the NRC Region III staff contacted the manager of the NPI facility by telephone on July 6, 1984, NRC was informed that NPI had identified the defective generator and that no doses contaminated with molybdenum-99 had been administered to patients. CERTIFIED MAIL RETURN RECEIPT RE0 VESTED NOREG-0940 II.A-101
l i . ', b 1 I-Nuclear. Pharmacy, Incorporated During an inspection and investigation that was initiated on July 26, 1984, the E NRC staff learned that NPI had identified the mo?ybdenum-99 breakthrough problem
~ involving generator No. 1167 on May 21, 1984. This was three days after doses -
contaminated with molybdenum-99 had been distributed to area medical facilities and administered to patients. NRC also learned that NPI corporate management
. made no internal investigation of the circumstances that led to the distribution
.'of the contaminated doses prepared from the generator until af ter the start of the NRC inspection on July. 26, 1984. This was more than nine weeks after the Manager of the Chicago facility and the Corporate Radiation Safety Officer became aware of the breakthrough problem and more than three weeks after the Manager of the Chicago facility willfully made a material false statement when he informed
.NRC that no contaminated doses had been administered to patients. An NRC review of NPI customer records'showed that 24 medical facilities in the Chicago area had. received potentially contaminated radiopharmaceuticals.
In response to'this new information obtained on July 26, 1984, Region III issued a Confirmatory Action Letter to NPI on July 27, 1984. This letter confirmed NPI's verbal commitment to contact the 24 medical facilities and submit to Region III an analysis 'of any potential misadministration. NPI's August 3, 1984 response to the Confirmatory Action Letter conclu'ded that two medical facilities had received and administered to patients material contaiC og an unacceptable level
.of molybdenum-99 during the period May 18-20, 1984.
Region III contacted each of the 24 medical facilities and, contrary to NPI's conclusion, learned that 5 medical facilities had admid stered to 12 patients radiopharmaceuticals contaminated with excessive molybdenum-99. As a result, these patients received doses significantly greater than the anticipated radiation dose. On October 26,-1984- the NRC issued an Order Modifying NPI's license. This l Order imposed additional specific requirements that were to be implemented by I November 2, 1984. During the period November 16-19, 1984, the Region III staff conducted an unannounced. inspection at the Chicago facility to determine the status of compliance with the October 26, 1984 Order. This inspection disclosed-numerous violations of the Order, including many examples of falsification of records.
]
To emphasize the importance of compliance with NRC requirements, I am issuing I the enclosed Notice of Violation and Proposed Imposition of Civil Penalties in the cumulative amount of Sixty-eight Thousand Dollars ($68,000) for the Severity Level I, II', and III violations described in the enclosed Notice. The base civil penalty amounts for Severity Level I, II, and III violations are $10,000, $8,000 and $5,000, respectively. The violations were categorized in accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1985). Item I in the enclosed Notice of Violation involves the original incident, the licensee's failure to perform the required test for molybdenum-99 breakthrough when preparing technetium-99m radiopharmaceuticals. This violation has been l categorized as a Severity Level II violation because contaminated i radiopharmaceuticals were distributed to 5 medical facilities and administered I to 12 patients. _ NUREG-0940 II.A-102
Nuclear Pharmacy, Incorporated Item II in the enclosed Notice involves material false statements made to the
' Commission in a telephone conversation and in the written responses to a Confirmatory Action Letter. The licensee falsely stated that.(1) doses . contaminated with molybdenum-99 had not been distributed to medical facilities, (2) contaminated radiopharmaceuticals had not been administered to patients, and (3) NPI had contacted each potential recipient of contaminated radiopharmaceuticals to verify that contaminated material had not been administered. These statements were material because the NRC relied or, these false statements and delayed-initiating an inspection. Because the false statements were deliberately made, they have been categorized as Severity Level I violations.
Item III in the enclosed Notice contains one violation involving' falsification of records by NPI to indicate that the required molybdenum-99 breakthrough tests were completed when they had.not been performed. It also contains a violation involving three separate incidents of falsification of records required to demonstrate compliance with the October 1984 Order. Because these record falsifications were deliberate, they have been categorized as Severity Level I violations. Item IV in the enclosed Notice contains several violations of the October 1984 Order that required the licensee to perform dual verification of certain activities. The violations have been categorized in the aggregate as a Severity Level III problem based upon their significance and the fact that they are all related and caused by the licensee's failure to adequately control its radiation safety program. Item V in the enclosed Notico contains several violations identified at three NPI facilities involving failure to conduct required surveys and audits, failure to keep proper records and failure to meet other requirements regarding preparation .of doses. These violations have been categorized in the aggregate as a Severity Level .III problem based on their significance and the fact that together they represent inadequate corporate implementation and control of the radiation
. safety program.
In late' July 1985 NPI merged with Syncor. I recognize that during a similar molybdenum breakthrough incident in May 1984 the Syncor organization responded expeditiously and appropriately. In addition, comprehensive improvements in NPI's management controls were made following the issuance of the October 26, 1984 Order. Since the merger with Syncor, the principal individuals involved in NPI's May 1984 incident have resigned, been terminated, or are in positions not affecting NRC-licensed activities and a management structure is now in place which emphasiz,es good radiation safety practices. However, because of the overall significance of these matters from the standpoint of demonstrating the need for (1) vigilant adherence to requirements directly affecting the potential for harm to the public, (2) immediate and comprehensive action to evaluate the causes of incidents (3) implementation of lasting effective corrective action to prevent such occurrences, and (4) candor with the NRC, a j civil penalty is proposed without mitigation. NUREG-0940 II.A-103
Nuclear Pharmacy Incorporated ~ .4-
.You are required to respond to this letter and should follow the instructions' specified in the enclosed Notice when preparing your response. In your response you should document the specific actions taken and any additional actions you plan-to prevent recurrence. After reviewing your response to this Notice, including your proposed' corrective actions, the NRC will determine whether further NRC enforcement action. is necessary to ensure compliance with NRC
. regulatory requirements. j In accordance with Section 2.790 of the NRC's " Rules of. Practice," 10 CFR Part 2, a copy of this. letter and its enclosures will be placed in the NRC' ;
Public Document Room. < i The'. responses directed by this letter and the enclosed Notice are not subject te I the clearance. procedures.of the Office of Management ~and Budget, as required by { the Paperwork Reduction Act of 1980, PL 96-511. j Sincerely, i
/ l
\ _FM Ja TM. Taylor Director fice of Ins crion and Enforcement
Enclosure:
Notice of Violation and Proposed Imposition of
. Civil _ Penalties.
NUREG-0940 II.A-104
f4 + i L i y NOTICE OF VIOLATION AND {
' PROPOSED IMPOSITION OF CIVIL PENALTIES 1
. Nuclear Pharmacy. Inc. . License No. 12-18044-01MD fP.O. Box 25141 .
License No. 14-19990-01MD j
. Albuquerque New Mexico L...' License No. 37-18461-01MD J License No. 37-19586-01MD i License No. 48-17466-01MD EA 85-100 I
i
'A special series' of safety inspections were conducted during July 26-October 3 and November 16-19, 1984 to review the circumstances surrounding the distribution !
of contaminated radiopharmaceuticals that were prepared by the licensee, Nuclear g Pharmary, Inc. (NPI).: The NRC Office of. Investigations also conducted an
' investigation of the molybdenum-99 contamination incident. On.the bases of its investigation it appears that NPI, including individuals in management, misled
,the NRC. on numerous' occasions concerning the seriousness of the molybdenum-99 contamination incident and. willfully.made statements to deceive the NRC. In accordance with the " General Statement of Policy and Procedure for Enforcement
- Actions," 10 CFR Part 2, Appendix C (1985). the Nuclear Regulatory Commission proposes to impose: civil penalties pursuant to Section 234 of.the Atomic Energy
'Act of;1954, as amended..("Act"),-42 U.S.C. 2282, PL 96-295, and 10 CFR 2.205.
The violations and the associated. civil penalties are set.forth below: _ I .. . Failure to Tes+ the Generator Eluates 10 CFR 30.34(g) requires that each licensee preparing technetium-99m radiopharmaceuticals from molybdenum-99/ technetium-99m generators test t'.
.' generator eluates for molybdenum-99 breakthrough in accordance with procedures specified in 10 CFR 35.14(b)(4)(1) through.(iv).
Contrary to the above, on May 18,19, and 20,1984, at its Chicago facility. the licensee failed to test eachseluate for molybdenum-99 breakthrough after eluting a defective molybdenum-99/ technetium-99m generator.(NPI No. 1167). As a result, contaminated radiopharmaceuticals were distributed to medical facilities and administered to patients. This. is a Severity Level II violation (Supplement VI). (Civil Penalty - $8,000) II. flaterial False Statements A .' During a telephone conversation on July 6,1984, the Manager of the NPI Chicago facility told the Chief, NMSS Section 1 and Chief, NMSS Section 2 of NRC's Region III Office that NPI had received a faulty technetium-99m generator whose eluates were contaminated with molybdenum-99 in excess of regulatory limits. He stated that no doses from the defective generator had been sent out to medical facilities. Contrary to Section 186 of the Atomic Energy Act of 1954, as amended, the conversation contained a material false statement. The statement i NUREG-0940 I1.A-105
1 Notice of Violation was false in that it was determined as a result of a Region III inspection and investigation conducted during the period July 26, 1984 through March 7,1985 that doses prepared from the defective generator had in fact been distributed to five Chicago area medical facilities and had been administered to approximately 12 patients. This statement is material because in reliance on this statement the NRC delayed initiating an inspection. This is a Severity Level I violation (Supplement VII). (Civil Penalty - $10,000) B. In a July 12, 1984 followup letter to the July 6,1984 telephone conversation, the Manager stated: " Monday, May 21, 1984,'2 customers, St. Joseph's Hospital in Joliet, IL, and Imaging Center in Oak Lawn, IL, made a report regarding potential Mo-99 activities above acceptable limits with the prepared technetium product dispensed on Sunday, May 20, 1984." No other recipients of dispensed doses were mentioned. Following a special inspection at the Chicago NPI facility, NRC Region III issued a Confirmatory Action Letter to NPI on July 27, 1984. This letter confirmed NPI's commitment to contact all medical facilities that might have received doses contaminated with mohbdenum-99 to confirm in writing that all medical facilities had been notified, to make an analysis of potential misadministration, and to send NRC a report of NPI's findings. NPI responded to the Confirmatory Action Letter by letter dated August 3, 1984 prepared by NPI's Vicc-President of Professional and Regulatory Affairs and the Corporate Radiation Safety Officer with the concurrence of the Manager of the NPI Chicago facility. The August 3, 1984 response stated: "On Sunday May 20, 1984, generator
'1167' was again eluted by . . . . Part of this elution was used to prepare Tc-99m Sulfur Colloid. Three doses of this materi:al were dispenseu that morning, but none were used by any customers. The hospitals . . . are listed below: . . . Sherman Hospital . . . St.
Joseph . . . North West Community . . . ." The response also stated: "Even though all doses [ prepared from material eluted on Friday, May 18,1984,] were returned to us, each customer was contacted by our Manager to verify that no material was administered." The response further stated: "Although some of this material was injected, it is our contention none contained significant quantities of Mo-99." Contrary to Section 186 of the Atomic Energy Act of 1954, as amended, the letter contained material false statements.
- 1. The August 3, 1984 response contained a false statement in that radiopharmaceuticals were administered to patients at St. Joseph and Northwest Community Hospitals. One dose administered at St. Joseph hospital was determined to contain significant quantities of Mo-99.
NUREG-0940 II.A-106 i _ _ _ _ _ _ _ _ _ - _ _ _ _ _ -
Notice of Violation 2. The August.3, 1984 response contained another false statement in tha} NPI had not contacted each potential recipient of contaminated radiopharmaceuticals to verify that material had not been administered. The statements are material because if the NRC had known the facts as they actually occurred, an inspection would have begun immediately. Each material false statement is a separate Severity Level I violation (Supplement VII). (Civil penalty - $20,000) III. Falsification of Records A. 10 CFR 30.34(g) requires that each licensee preparing technetium-99m radiopharmaceuticals from molybdenum-99/ technetium-99m generators test the generator eluates for molybdenum-99 breakthrough in accordance with procedures specified in 10 CFR 35.14(b)(4)(i) through (iv). 10 CFR 35.14(b)(4)(iv) requires that any licensee using generators or reagent kits maintain records for three years of the molybdenum-99 test conducted on each elution from the generator for Commission inspection. Contrary to the above, at the NPI Chicago facility records of elutions for.May 18, 19, 20, and 21, were falsified in that they indicated that molybdenum-99 breakthrough tests had been performed on Generator No. 1167'and that the test results were within regulatory limits when, in fact, molybdenum breakthrough had occurred on the generator and any test results could not have been within limits. This is a Severity Leve! I violation (Supplement VII). (Civil Penalty - $10,000) l 1
- 8. Section V.C.2 of the October 26, 1984 Order required that two authorized users independently verify (1) the performance of all tests, assays, and surveys of NPI radiopharmaceutical products and product packages as required by the NRC license and (2) that accurate records of the results be prepared. The authorized users were required, by signature, to note each verification and complete the verification prior to any !
material leaving the facility. ' Contrary to the above, at the Chicago facility:
- 1. During an inspection on November 17, 1984 and M the presence of !
two NRC inspectors, an authorized user performed a moiyodenum-99 test, recorded the test results, and then initialed for another authorized user who was on the other side of the laboratory. When the inspectors noted that the first user had initialed the verification form for the second user, the second user initialed the form after stating to the NRC inspectors that he J;d not observe the test results. NUREG-0940 II.A-107
Y Notice of Violation a
- 2. Receipt / survey records for November 5 and 6,1984 were falsified. ]
NPI receipt / survey records show that an individual performed q surveys between 1:15 and 2:45 a.m. on November 5, 1984. However, j the individual actually worked from 9:00 a.m. to 6:00 p.m. on that ! date. The November 6,1984 receipt / survey records also were signed by the same. individual; however, that individual did not work on I November 6, 1984. The individual stated to an NRC inspector that she was directed by the Manager of the Chicago facility to sign ; the receipt / survey records even though he knew she had not , performed the surveys on those dates. ;
- 3. The verification record for a molybdenum.99 breakthrough test I conducted on November 16, 1984 was signed by two authorized users j '
who did not participate in the verification procedure. Collectively,' these violations have been categorized as a Severity ] Level I problem (Supplement VII). l l (Civil Penalty - $10,000) IV. Violations of the October 26, 1984 Order Section V.C-.2 of the October 26, 1984 Order required that twc authorized users independently verify the performance of all tests, assays, and scrveys of NPI radiopharmaceutical products and product packages.as required b/ the NRC license. The authorized users shall, by signature, note each verification , and shall complete the verification prior to any material leaving the facility. j Contrary to the above, at the Chicago facility: l l A. On November 17, 1984 while two NRC inspectors were present, a single authorized user performed a dose calibrator constancy check, unobserved : by a second authorized user. Thus, the double check verification by i two authorized users was not performed. The dose calibrator log book showed that only one authorized user had signed the book on November 17, 1984. B. During November 2-16, 1984, many shipments were not verified by two authorized users before.those shipments left the facility. Specifically, on November 17, 1984, a licensee representative said that only 80 percent of required quality control (QC) tests were completed by shipment time i during November 2-16, 1984 because of the work load and time constraints. For example, the QC records for the first-run on November 14, 1984 showed that QC tests were performed at 7:00 a.m. and verified at 8:00 a.m.; however, first-run shipments left the facility at approximately 4:30 a.m. l C. On November 17, 1984, an individual who was not an authorized user l- performed surveys of outgoing shipments of radiopharmaceuticals and the surveys were not verified by another authorized user. In addition, wipe tests were performed by an individual who was not an authorized user and the test results were not verified by another authorized user. l NUREG-0940 II.A-108
Notice of Violation D. During November 2-17, 1984, the licensee did not perform surveys and reccrd survey results for all incoming shipments containing waste materials from customers. The licenste's survey sheet, " Incoming Ammo Box GM Surveys Greater than 0.5 mR/hr," indicates only one verification (on November 9,1984) was made for six receipts of radioactive waste from medical licensees. Collectively, violations A through 0 have been categorized as a Severity Level III problem (Supplement VI). (Civil Penalty - $5,000) V. Other Violations of the Licenses A. License Condition No. 24 of License No. 12-18044-01MD for the Chicago facility requires that all licensed material be possessed and used in accordance with statements, representations and procedures contained i in the July 15, 1981 application and other referenced documents. The application states that all radioactive material that is received will be surveyed (GM and wipe tests) and the results logged. Contrary to the above, two molybdenum-99/ technetium-99m generators received by the licensee on May 18, 1984 were neither surveyed nor logged. B. License Condition No. 10 of License No. 12-18044-01MD for the Chicago facility requires that licensed material be used only at 319 West Ontario Street, Chicago, Illinois. ' Contrary to the above, on or about June 15, 1985 the licensee prepared a unit dose of technetium-99m sulfur colloid at a hospital in Elgin, Illinois. C. Section V.C.3 of the October 26, 1984 Order states that NPI at each of its NRC-licensed facilities shall require that the manager perform a weekly audit of all NRC-licensed activities. The audit shall include a record of what was audited and the results of the audit. The audit shall verify, on a sampling basis, that required surveys, measurements, and tests were performed and that records accurately reflect the results of the surveys, measurements, and tests. Contrary to the above, the Manager of the Chicago facility did not perform an audit for the period November 2-8, 1984. In addition, the audit record for November 9-16, 1984 was inadequate because it did not address or verify that surveys, measurements, and tests had been performed and/or that they had been verified by two authorized users. D. 10 CFR 30.34(g) requires that each licensee preparing technetium-39m radiopharmaceuticals from molybdenum-99/ technetium-99m generators test the generator eluates for molybdenum-99 breakthrough in accordance with procedures specified in 10 CFR 35.14(b)(4)(1) through (iv). NUREG-0940 II.A-109
i Notice of Violation 10 CFR 35.14(b)(4)(iv) requires that any licensees using generators . , or reagent kits maintain records for three years of the molybdenum-99 test conducted on each elution from the generator for Commission inspection.
- 1. Contrary to the above, at the Des Moines, Iowa facility no written entries were made in the molybdenum-99 breakthrough records for elutions performed on many different dates between January 1 and August 27, 1984. For example, no written entries were made on January 12, February 25, March 2 April 4, May 3, and August 1, 1984. However, for ea;h of these dates either the Manager of the Des Moines facility or a registered pharmacist entered the numbers 0.35 microcuries or 1.05 microcuries of molybdenum-99 for entry into the computer.
- 2. Contrary to the above, at the Wauwatosa, Wisconsin facility on many different dates during the period July 6 to. August 23, 1984 the molybdenum-99 breakthrough records showed dashes or check marks instead of the actual test results. For example, dashes or check marks were shown for July 9-13, July 23-27, and fugust 20-23, 1984. In other instances where actual numbers were shown, licensee personnel entered the numbers 0.35 microcurie or 1.05'microcuries of molybdenum-99 for entry into the computer.
Collectively, violations A through D have been categorized as a Severity Level III problem (Supplements IV and VI). (Civil Penalty - $5,000) VI. Violations Not Assessed Civil Penalties A. Chicago Illinois - License No. 12-18044-01MD - Inspection Conducted July 26 - September 18, 1984 i 10 CFR 71.5 requires that each licensee who transports licensed material outside the confines of its plant or other place of use or who delivers licensed material to a carrier for transport shall comply with the applicable requirements of the regulations appropriate to the mode of transport of the Department of Transportation in 49 CFR Parts 170 through 189. 49 CFR 172.403(a) and (b) require and define labeling to be applied to packages containing radioactive material. 49 CFR 172.403(c) defines label categories and requires in part that (1) packages with surface radiation levels of less than 0.5 millirem I per hour be labeled " White-1," (2) packages with surface radiation levels between 0.5 and 50 millirems per hour be labeled " Yellow-II," and (3) packages with surface radiation levels greater than 50 millirems per hour be labeled " Yellow-III." u NUREG-0940 II.A-110 1 i
a6 Notice of Violation Contrary to the above, on May 19, 1984 the licensee transported outside the confines of its ' facility and delivered to Weiss Hospital in Chicago two packages containing radioactive material that were improperly labeled. ' These packages had surface radiation levels greater than 20 millirems per hour and were labeled " White-I" instead of " Yellow-II," as required. On May 20, 1984 the licensee delivered to the Imaging Center in Oak Lawn. Illinois one package containing radioactive material that was improperly labeled. Although this package had a surface radiation level of 80 millirem per hour, it was labeled " Yellow-II" instead of " Yellow-III," as required. This is'a Severity Level IV violation (Supplement V). ! B. Des Moines, Iowa - License No. 14-19990-01MD - Inspection Conducted August 28, 1984 License Condition No. 23 requires that licensed material be possessed and used in accordance with statements, representations, and procedures contained in a May 19, 1982 letter and other referenced documents. Item 7.D of the letter states that bioassays for iodine uptake will be performed once every 2-weeks. Contrary to the above, bioassays for iodine uptake were not performed once every 2 weeks. Specifically, bioassays were not performed between February 15 and March 23, 1984 and were performed only once in May and June 1984 (each of these periods exceeded the required 2 week frequency). This is a Severity Level IV violation (Supplement VI). C. Philadelphia, Pennsylvania - License No. 37-18461-01MD - Inspection. Conducted September 26 and October 3, 1984 License Condition No. 24 requires that licensed material be possessed and used in accordance with statements, representations, and procedures contained in the July 15, 1981 application and other referenced documents.
- 1. Item 6.A of the July 15, 1981 application requires that the molybdenum-99 breakthrough test results be recorded on the "Radiopharmaceutical Product Worksheet."
Contrary to the above, no mob 1 denum-99 test data were recorded on the Radiopharmaceutical N dect Worksheet for approximately 70 percent ) of the generator elut % rer 6 med from January 1 to September 27, ! 1984. From September G , lis , only 80 test results from 204 ) generator elutions were recorded on the worksheet. ! This is a Severity Level IV violation (Supplement VI).
- 2. Item 14 of the July 15, 1981 application requires that the exposure rate be measured at 3 feet from the surface of each incoming package. l I
NUREG-0940 II.A-111 I 1 I
c Notice of Violation Contrary to the above, on September 26, 1984 the exposure rate was not-measured at 3 feet from the surface of incoming packages. This is a Severity Level IV violation (Supplement VI).
- 3. Item 15 of the July 15, 1981 application recpires that Transport Index surveys be performed on all outgoing packages.
Contrary to the above, on September 26, 1984 outgoing packages with
" Radioactive White-I" labels were not surveyed at 3 feet from the surface to determine the Transport Index.
This is a Severity Level IV violation (Supplement VI).
- 4. Item 14 of the July 15, 1981 application requires that a wipe test be performed on each package and any wipeable contamination in excess of 0.01 microcurie be immediately reported to the Radiation Safety Officer.
Contrary to the above, on September 26, 1984 wipeable contamination in excess of 0.01 microcurie on the exterior surfaces of packages was not reported to the Radiation Safety Officer. This is a Severity Level IV violation (Supplement VI). D. Harrisburg, pennsylvania - License No. 37-19586-01MD - Inspection Conducted October 1, 1984
- 1. License Conditior. No. 25 requires that licensed material bc possessed and used in ' cordance with statements, representations, and procedures contained in the October 24, 1980 application and other referer.ced documents.
Item 15 of the October 24, 1980 application requires that all personnel monitor their hands, feet, and clothing before leaving a restricted area. Contrary to the above, on October 1,1984 a driver left a restricted area and did not monitor his hands, feet, and clothing. l This is a Severity Level IV violation (Supplement VI).
- 2. 10 CFR 71.5 requires that each licensee who transports licensed material outside of the confines of its plant or other place of I use or who delivers licensed material to a carrier for transport shall comply with the applicable requirements of the regulations appropriate to the mode of transport of Department of Transportation i in 49 CFR Parts 170 through 189.
r4UREG-0940 II.A-112 b
' Notice of. Violation 49CFR 173.475(1) requires that the shipper ensure by examination or appropriate tests that the external. radiation and contamination levels are within the specified allowable limits before any radioactive materials package is shipped.
Contrary to the above, on October 1,1984 external radiation surveys were not made on packages labeled " Radioactive White-I" to ensure that external radiation levels were within the specified limits. This is a Severity Level IV violation (Supplements V and VI). j Pursuant to the pros 4, ions of 10 CFR 2.201, Nuclear Pharmacy, Inc. is hereby required to submit to *.he Director, Office of Inspection and Enforce:nent,
~U.S. Nuclear Regulatory Commission, Washington, D. C. 20555, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region III, 799 Roosevelt Road, Glen Ellyn, IL 60137, within 30 days of the date of this Notice a written statement or explanation in reply, including for each alleged violation:
(1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, (3):the corrective steps that have been taken and the results achieved. (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of _the Act. 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, Nuclear Pharmacy, Incorporated may pay the civil penalties in the amount of Sixty-eight Thousand Dollars ($68,000) or may protest imposition of the civil penalties in whole or in part by a written answer. Should Nuclear Pharmacy, Incorporated fail to answer within the time specified, the Director, Office of Inspection and Enforcement will issue an order imposing the civil penalties in the amount proposed above. Should Nuclear Pharmacy, Inc. elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalties, such answer may: (1) deny the violations listed in this Notice in whole or in I part, (2) demonstrate extenuating circumstances, (3) show error in this Notice,
.or (4) show other reasons why the penalties should not be imposed. In addition to protesting the civil penalties, in whole or in part, such answer may request l
remission or mitigation'of the penalties. I In requesting mitigation of the proposed penalties, the five factors contained o in Section V.8 of 10 CFR Part 2. Appendix C should be addressed. Any written '- answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201 but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of Nuclear Pharmacy, Inc. is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty. NUREG-0940 II.A-113
(I ik e c
;-, ; Notice of Violation -
J
,' ? b.- '
L: :Upon failure to pay any- civil penalty due, which has been subsequently determined i in accordance with the applicable provisions of 10 CFR 2.205, this matter may. P4 be referred to the Attorney General . -and the penalties, unless compromised, remitted, or mitigated. may be collected by civil-action pursuant to-
'Section 234c.of the Act 42 U.S.C. 2282.
FOR THE NUCLEAR REGULATORY COMMISSION
/
. N s_M. Tay1 .. Director l
ffice of Inspection and Enforcement
-Dated at Bethesda,' Maryland.
this loNay of April 1986. i l I NUREG-0940 II.A-114 1
7 5#"%g , UNITED STATES f'- 'l NUCLEAR REGULATORY COMMISSION
$i >f REGION IV
'S # 611 RYAN Pt.AZA DRIVE, $UITE 1000 9,, ARUNoTON, TEXAS 79011 DEC 1 O 1987 Docket No. 30-19498 License No. 35 17186-02 EA 87-184 Precision iogging ind Perforating Company 220 North Broadway Cleveland, Oklahoma 74020 Gentlemen:
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRCINSPECTIONREPORTNO. 30-19498/87-01) This refers to the inspection conducted on August 18-19, 1987, at Precision Logging and Perforating Company's facilities at Cleveland, Oklahoma. During this inspection, NRC personnel identified 7 apparent violations which were subsequently discussed with you at an enforcement conference on September 22,- 1987, in Tulsa, Oklahoma. The violations identified include (a) failure to complete required surveys, (b) radiological postin unrestricted area, (d) source g not erected, inventory(c) licensed records material unsecured not available, (e) missing in an radioactive shipping labels, (f) source shipping papers not completed, and (g) licensed material stored in trucks rather than in storage wells. These violations are of concern to the NRC because they collectively demonstrate a our licensed significantOn program. breakdown in 1987, October 16, management oversight a Confirmation and control of Action Letter over y(CAL) was issued documenting your agreement to submit I request for an amendment to your materials license that will describe the additional training and auditing to be provided to improve management controls of activities. To emphasize the need to improve management controls over licensed activities, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Im Penalty in the amount of One Thousand Collars ($1,000) position for the of Civil violations described in the enclosed Nntice. In accordance with the " General Statement of ] j Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C ! (1987) (Enforcement Policy), the violations described in the enclosed Notice I have been categorized at a Severity Level III. l The base value of a civil penalty for a Severity Level 111 violation is $500. i The escalation and mitigation factors in the Enforcement Policy were ' considered. The base civil penalty amount has been increased by 100 percent because of your poor prior performance, the multiple occurrences of most of the violations described herein, and your failure to take adequate corrective actions to preclude repeat violations from the 1984 inspection. CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 II.A-115
c-. - _ - _ -
.-l; 1
. t h .
g ~ Precision Logging and. Perforating - 2. - x You are required to respond to:this letter and should follow the instructions specified sin the enclosed Notice when preparing your response. In your
~
s t response, you .should document the specific actions .taken and any additional actions'you. plan to prevent recurrence. After reviewing your response to this Notice', including.your proposed corrective actions and the results of future
- inspections, the NRC will determine whether further NRC enforcement action'is necessary to ensure compliance with NRC regulatory requirements.
In..accordance.with Section 2;790 of the NRC's " Rules of Practice," PartL2,. Title 10, Code of Federal Regulations, a copy of this letter and its enclosure
- will be:placed in the NRC Public Document Room.
i The. responses directed by this letter and the enclosed Notice are not subject
, to the clearance procedures of the Office of. Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511.
L Sincer ly, l: Yr r
, Robert D. Martin Regional Administrator p ., .
Enclosure:
z Notice of Violation and j
.-Proposed Imposition. .;
of' Civil Penalty . I 1 cc:-0klahoma Radiation Control Program Director i I s 2
;NUREG-0940 II.A-116
l J. l l' NOTICE OF VIOLATION i AND , PROPOSED IMPOSITION OF CIVIL PENALTY l Precision Logging and Perforating Docket No. 30-19498
-220 North Broadway License No. 35-17186-02 Cleveland, Oklahoma 74020 EA 87-184 j During an NRC inspection conducted on August 18-19, 1987, violations of NRC '
requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1987), the Nuclear Regulatory Commission proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. 10 CFR 20.201(b) requires that each licensee shall make or cause to be mede such surveys as: (1) may be necessar the regulations in 10 CFR Part 20 and (2)yare forreasonable the licensee to comply under the cir-with cumstances to evaluate the extent of radiation hazards that may be present. 10 CFR 20.105(b) requires, in part, that radiation levels in unrestricted areas be limited so that an individual who was continuously present in the area could not receive a dose in excess of 2 millirems in any hour or 100 millirems in any seven consecutive days. Contrary to the above, surveys had never been made in the unrestricted areas adjacent to the radioactive source stora compliance with 10 CFR 20.105(b) and 20.201(b)ge area to deternine B. 10 CFR 20.203(e) requires, in part, that areas in which specified amounts of licensed material are stored or used be conspicuously posted with a sign or signs bearing the radiation caution symbol and either the words
" CAUTION RADI0 ACTIVE PATERIAL" or "DAflGER RADI0 ACTIVE MATERIAL."
Contrary to the above, during the NRC inspection, the area of the shop in which the storage wells were located contained stored Mcensed material in the specified amounts and was not posted. C. 10 CFR 20.207(a) requires that licensed materials stored in en unrestricted area be secured against unauthorized removal from the place of storage.. As defined in 10 CFR 20.3(a)(17), an unrestricted crea is any area to which access is not controlled by the licensee for purposes of protection of individuals from exposure to radiation and radioactive materials. Contrary to the above, on August 18, 1987, an americium-beryllium sou:ce, serial no. T-222, was found by the NRC inspector to be stored in an unlockable shipping container, in an unlocked outer compartment of a truck parked in j an unlocked garage. ' I NUREG-0940 II.A-117 i I
r : i Hotice of Violation D. License Condition'14 requires that the licensee shall conduct.a physical I l; inventory every 6 months to account for all sources received and possessed under the license. Records of inventories shall be maintained for 2 years from the date of each inventory. 1 Contrary to the above, records of inventories, to account for all sources received and possessed under the license, were not available for any time during the 2 years prior to the inspection. E. License Condition 15 requires the licensee to transport licensed material
, in accordance with the provisions Of 10 CFR 71. 10 CFR 71.5(a) requires, in part, that the licensee comply with applicable requirements of the !
Department of Transportation in 49 CFR Parts 170-189. l
- 1. 49 CFR 172.403 requires that each nackage of radioactive material be I labeled, as appropriate, with a RADI0 ACTIVE WHITE-1, a RADI0 ACTIVE l YELLOW-II, or a RADI0 ACTIVE YELLOW-III label.
l t Contrary to the above, the transportation containers housing source I nos. T-222 containing 4.6 curies of americium-beryllium, 71-1-4228 containing 5 curies of americium-beryllium, and CSV-969 containing 2 curies of cesium-137, were transported during approximately the last 2 years without the appropriate labels. This is a repeat violation. j l
- 2. 49 CFR 172.200 requires that each person who transports or offers a J package of hazardous material for transport describe the material on "
a shipping paper as described in this subpart. Contrary to the above, the licensee's representative stated that shipping papers were not prepared and carried during transportation for approximately the last 4 years. This is a repeat violation. F. License Condition 16 requires that licensed material shall be possessed and used in accordance with statements, representations, and procedures contained in the application dated November 4, 1981; and letters dated October 10, 1986., and January 7,1987.
\
Section 3 of the procedures submitted with the license application requires that all sources of radioactivity be kept locked in storage unless actually in use. The letter of October 10, 1986, confirms that , storage wells are to be used. ' Contrary to the above, on August 18, 1987, a 4.6 curie americium-beryllium source, T-222; a 5 curie americium-beryllium source, 71-1-422B; and a 2 curie cesium-137 source, CSV-H50, were stored on trucks rather than in storage wells. NUREG-0940 II.A-118
L f Notice of violation l Collectively the above violations have been categorized in the aggregate ! as a Severity Level III problem (Supplements IV, V, and VI). Cumulative Civil Penalty - $1,000 (assessed equally among the violatic:u). f Pursuant to the provisions of 10 CFR 2.201, Precision Logging and Perforating i Company (Licensee) is hereby required to submit a written statement or l explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory l' Commission, within 30 days of the date of this Notice. This reply should be to a Notice of Violation" and should include for clearlyalleged each marked as a " Reply (1) admission or denial of the alleged violation, violation: , (2) the reasons for the violation if admitted, (3) the corrective steps that j have been taken and the results achieved (4) the corrective steps that will be l taken to avoid further violations, and (5) the date when full compliance will ; be achieved. If an adequate reply is not received within the time specified in j this Notice, an order may be issued to show cause why the license should not be j mo'Ified, suspended, or revoked or why such other action as nay be proper should not be taken. Consideration may be given to extending the response time l for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR l 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draf t, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Ccmmission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notice in whole or in part, (4) ( show other reasons why the penalty should not be In imposed.2)demonstrat addition to protesting the civil penalty in whole or in part, such answer may request remission or mitigation of the penalty. In requesting mitigation of the proposed penalt i Section V.B of 10 CFF Part 2, Appendix C, should (1987)y, the five factors be addressed. Any addressed written answer in acc)rdance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the Licensee > is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon f ailut e to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, end the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. NUREG-0940 II.A-119
i Notice of Violation The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, D.C. 20555 with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region IV. FOR THE, NUCLEAR REGULATORY COMMISSION
/
CL L Robert D. Martin Regional Administrator Dated at Arlington, Texas,
.This g7/ pay of December 1987.
i j I J l 1 i I 1 NUREG-0940 ;;.A-120
- p. . . . , g 3 qJg 4 g g 4 49 x
y-lNN .- en asov . Ul 9 o g UtJITED STATES t-g . NUCLEAR REGULATORY COMMISSION
.[ 5 WASHINGTON, D. C. 20656 s
'3
%,;* *.*.+ )f' JUL 87 ISO
= Docket'No.L30-19498 '
License No. 35-17186-02
' EA'87-184-
~
Precision Logging and Perforating Company
- ATTN:- Carol Spess. 0wner s
e 220 North Broadway i#- Cleveland,'0klahoma 74020 m . . ,3
- Gentlemen: g g '
SUBJECT:
ORDER l IMPOSING.ACIVILMONETARYPENALTY Z This refers to your: twoJ letters dated January 7,1988, and 'your letter dated February 15, 1983,tia response to the Notice of Violation and Proposed ! Imposition ofc. Civil Penalty sent to you by our letter dated December 10, 1987. Dur letter and Notice ~ describe. seven violations, identified during a routine
.NRC inspection < conducted August. 18-19, 1987. .To emphasize the need'to improve Lmanagement controls,over licensed activities, aLcivil penalty of One Thousand 10ollars.{$1,000)wasproposed.
In your responses, you take issue with Violations A and D and do not deny the other violations.l~In addition, you request that the proposed civil penalty be' rescinded for several stated reasons. After consideration of your responses', we have concluded'for the reasons given in the Appendix attached to the enclosed Order. Imposing Civil. Penalty that the civil penalty should be mitigated by 50 percent. Accordingly, we hereby serve the enclosed Order on Precision Logging and Perforating Company imposing a civil rnonetary penalty in the. amount of Five' Hundred Dollars ($500). We will review the effectivenen of e your corrective actions during a subsequent inspection. c , The_ NRC is-concerned that you rnay not have adequate financial resources to L ensure that you will continue to comply with NRC requirements. Accordingly,
.please provide information to this office to demonstrate that sufficient
, , resources are available to meet all requirements associated with your NRC license, with an emphasis on those NRC requirements that are associated with
- the conduct of your radiation safety program.
CERTIFIED MAIL
< RETUWRIGITT PEQUESTED NUREGJO940 11 A-121 M -. __. ___.__ - -
9gw w .
~
s .. W i'
}
/
q , r ..
/_fi - $ ..
; t '
e,. , , ,
.y.
'f
~
; Precisich;1.ogging .andj - 2'-
d' Pe'rforating Company n
.In accordance with"Section 2.790 of the NRC's-" Rules.of Practice," Part 2, t>
. Title 10, Code of Federal Regulations, a copy of.this letter and the enclosures
- will be' placed in the NRC's Public Document Room.
1
.fe' Sincerely, '
'. . 2
- i. ;
]
[ Jam
\mWM., Taylor eputy Executive
'i ba 4f
;l-~
" "',E rector for egional Operations f q
'l
- .- , Enclosuresd .As Stated j
..n
!:. .. c c : Oklahoma Radiation' Control. Program Director w I
-I l
a i 1 l i l l i i l NUREG-0940 II.A-122 1
UNITED STATES NUCLEAR REGULATORY COMMISSION In the Matter of ) PRECISION LOGGING AND PERFORATING Docket No. 30-19498 COMPANY J License No. 35-17186-02 Cleveland, Oklahoma 74020 ) EA 87-184 ORDER IMPOSING CIVIL MONETARY PENALTY I Precision Logging and Perforating Company, Cleveland, Oklahoma (the licensee) is the holder of Materials License No. 35-17186-02 issued by the Nuclear Regulatory Commission (NRC/ Commission) on December 2, 1981, and amended last j in its entirety on January 21, 1988. The license authorizes the licensee to use sealed sources for oil and gas well logging in accordance with the conditions j -specified therein. II A routine inspection of the licensee's activities was conducted on August 18 and 19, 1987. The results of this inspection indicated that the licensee had not conducted its activities in full compliance with NPC requirements. A written Notice of Violation and Proposed Imposition of Civil Penalty was served upon the licensee oy letter dated December 10, 1987. The Notice stated the nature of the violations, the provisions of the NRC's requirements that the licensee had violated, and the amount of the civil penalty proposed for the violations. The licensee responded to the Notice of Violation and Proposed Irtposition of Civil Penalty by two letters, both dated January 7, 1988. NUREG-0940 II.A-123
i In its response, the ifcensee contested Violations A and D but not the other violations. In addition, the licensee requested that the proposed civil penalty be rescinded for several stated reasons, including financial hardship. By letter dated February 16, 1988, the NRC provided the licensee with the j opportunity to submit specific financial information on the company's recent profit.and loss and its net worth. The licensee submitted this information by letter dated February 15, 1988. III After consideration of the licensee's response and the statements of fact, explanation, and argument for mitigation contained therein, the Deputy Executive Director for Regional Operations has determined as set forth in the Appendix to this Order that the violations occurred as stated, but that the civil penalty proposed in the Notice of Violation would constitute an excessive financial hardship for the ifcensee, and therefore should be mitigated by 50 percent. IV In view of the foregoing and pursuant to Sections 81, 161b, 182, and 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205, IT IS HEREBY ORDERED THAT: The licensee pay a civil penalty in the amount of Five Hundred Dollars ($500) within 30 days of the date of this Order, by check, draft, or money NUREG-0940 II.A-124
g ^v, , o ~ g.7, (
< .. )
I' 1 l
. order, payable to the' Treasurer of the United States and mailed to the j Director, Office of. Enforcement, U.S. Nuclear Regulatory Comission.
~ ATTN:: Document Control Desk, Washington, D.C. 20555. J VI f
The licensee may request a hearing within 30 days of the date of this Order. A , 1 request for..a hearing should be clearly marked as a " Request for an Enforcement
. Hearing" and.shall' be addrer. sed to the Director, Office of Enforcement, U.S.
. Nuclear Regulatory Comission, ATTN:
- Document Control Desk, Washington, D.C.
20555, with a: copy to the Regional Administrator, U.S. Nuclear Regulatory .g-Comission, Region IV. y. If a hearing is requested, the Comission will issue an Order designating the time and place of the' hearing. If the licensee fails to request a hearing within 30 ~ days of the date. of this Order, the provisions of Section IV.A. of thisI0rdershallbeeffectivewithoutfurtherproceedings. If payment has not i been made.by that time, the matter may be referred to the Attorney General for l collection. 4 . In the event the licensee requests a hearing as provided above, the issues to l be considered at such hearing shall be: I w i
.NUREG-0940 II.A-125 l l
o ;
W & > h t.'. f.m ,. 4-(
^
~
(a) whether the Licensee wcs in violation of Violations A and D of the Commission's requirements as set forth in the Notice of Violation and Proposed Imposition of Civil Penalty referenced iniSection II LA A above, and
-(b) .whether, on the bas'is of the admitted violations', this Order should be sustained.
FOR THE NUCLEAR REGULATORY COMMISSION ne 7 mes . Taylor, D ty Executive Director Regional Ope ations
' "3 -
Dated at.Rockville, Maryland, this 7th day of_ July 1988. 1
-(
b NUREG-0940 II.A-126
l APPENDIX EVALUATIONS AND CONCLUSIONS l 1 1 On December 10, 1987, a Notice of Violation and Proposed Imposition of Civil Penalty (NOV) was issued for violations identified during an NRC inspection. Precision Logging and Perforating Company responded to the Notice by two letters dated January 7,1988, and by subsequent- statement of the corporate financial status sent by letter dated February 15, 1988. In its response, the licensee claimed that two of the violations should not have been cited. In addition, the licensee requested that the proposed civil penalty be rescinded for several reasons, including financial hardship. The NRC's evaluation and conclusion regarding the licensee's arguments are as follows: I. Restatement of Violation A 10 CFR 20.201(b) requires that each licensee shall make or cause to be made such surveys as: (1) may be necessary for the licensee to comply with the regulations in 10 CFR Part 20 and (2) are reasonable under the ] circumstances to evaluate the extent of radiation hazards that may be i present. 10 CFR 20.105(b) requires, in part, that radiation levels in unrestricted areas be limited so that an individual who was continuously present in the
)
area could not receive a dose in excess of 2 millirems in any one hour or in excess of 100 millirems in any seven consecutive days. l Contrary to the above, surveys had never been made in the unrestricted ] areas adjacent to the radioactive source storage area to determine compliance with 10 CFR 20.105(b) and 20.201(b). Sumary of Licensee's Respor.se The licensee contends that the violation should not have been cited. The licensee claims.that previous surveys revealed no reading above 2 millirems in any hour, and since the number of sources and the other factors did not vary, it did not realize that it was necessary to make additional surveys. NRC Evaluation of Licensee's Response The licensee admits that no previous surveys were recorded. During the NRC inspector's survey of the storage area, the licensee's representative stated, when asked, that he had never performed such a survey and knew of no records of anyone having performed one previously. During the Enforcement Conference, the licensee's representatives acknowledged this violation. Given these statements and the absence of records of previous surveys, the NRC has no evidence that such surveys were performed. Because no basis has been submitted in the licensee's response that would support withdrawal of the violation, the violation remains as stated. NUREG-0940 II.A-127
l ' Appendix ' Restatement of Violation B 10 CFR 20.203(e) requires, in part, that areas in which specified emounts of licensed material are stored or used be conspicuously posted with a sign 'or. signs bearing the radiation caution symbol and either the words ,
" CAUTION RADI0 ACTIVE MATERIAL" or " DANGER RADI0 ACTIVE MATERIAL."
Contrary to the above, during the NRC inspection, the area of the shop in which the storage wells were located contained stored licensed material in the specified amounts and was not posted. Sumary of Licensee's Response The licensee does not deny the violation. NRC Evaluation of Licensee's Response Since the licensee does not deny the violation, the violation remains as stated. Restatement of Violation C 10 CFR 20.207(a) requires that licensed materials stored in an unrestricted area be secured against ur. authorized removal from the place of storage. As defincc? in 10 CFR 20.3(a)(17), an unrestricted area is any area to which access is not controlled by the licensee for purposes of protection of individuals from exposure to radiation and radioactive materials. Contrary to the above, on August 18, 1987, an americium-beryllium source, serial no. T-222, was found by the NRC inspector to be stored in an unlockable shipping container, in an unlocked outer compartment of a truck parked in an unlocked garage. Summary of Licensee's Response The licensee does not deny the viola non. NRC Evaluation of Licensee's Response Since the licensee does not deny the violation, the violation remains as stated. Restatement of Violation D License Condition 14 requires that the licensee shall conduct a physical inventory every 6 months to account for all sources received and possessed under the license. Records of inventories shall be maintained for 2 years from the date of each inventory. I Contrary to the above, records of inventories, to account for all sources received and possessed under the license, were not available for any time during the 2 years prior to the inspection. NUREG-0940 II.A-128 L
Appendix Summary of Licensee's Response The licensee contends that this violation should not be cited. The licensee claims that it has maintained leak test procedures on each source and used the sources at least monthly. The licensee argues that the leak tests as well as use of the sources constitutes inventories, and that while the regulation may be appropriate to a large company, it should not be enforced in this case because it has complied with the intent of the regulation through its leak test records. NRC Evaluation of Licensee's Response The violation was not that inventories were not performed, but rather that proper records of these inventories were not maintained. Additionally, while records of leak tests and inventories may be combined, the leak test record in itself does not provide all the information required by the inventory record. In addition to indicating the date of inventory and the quantity and type of material, an inventory record includes the location of the licensed material and the individual conducting the inventory. Furthermore, the NRC emphasizes that the regulation applies to all licensees, regardless of their size, and that a licensee is expected to comply with NRC regulations, not what they perceive as "the intent" of the regulations. Because no basis has been provided by the licensee for withdrawal of the violation, the violation remains as stated. Restatement of Violation E License Condition 15 requires the licensee to transport licensed material in accordance with the provisions of 10 CFR 71. 10 CFR 71.5(a) requires, in part, that the licensee comply with applicable requirements of the Department of Transportation in 49 CFR Parts 170-189.
- 1. 49 CFR 172.403 requires that each package of radioactive material be labeled, as appropriate, with a RADI0 ACTIVE WHITE-1, a RADI0 ACTIVE YELLOW-II, or a RADI0 ACTIVE YELLOW-III label.
Contrary to the above, the transportation containers housing source Nos. T-222 containing 4.6 curies of americium-beryllium, 71-1-422B containing 5 curies of americium-beryllium, and CSV-969 containing 2 curies of cesium-137, were transported during approximately the last 2 years without the appropriate labels. This is a repeat violation.
- 2. 49 CFR 172.200 requires that each person who transports or offers a package of hazardous material for transport describe the material on a shipping paper as described in this subpart.
Contrary to the above, the licensee's representative stated that shipping papers were not prepared and carried during transportation for approximately the last 4 years. This is a repeat violation. NUREG-0940 II.A-129
/
Appendix Summary of Licensee's Response The licensee does not deny the violation. NRC Evaluation of Licensee's Response Since the licensee does not deny the violation, the violation remains as stated. Restatement of Violation F License Condition 16 requires that licensed material shall be possessed and used in accordance with statements, representations, and procedures contained in the application dated November 4,1981; and letters dated October 10, 1986, and January 7, 1987. Section 3 of the procedures submitted with the license application requires that all sources of radioactivity be kept locked in storage unless actually in use. The letter of October 10, 1986, confirms that
- torage wells are to be used.
Contrary to the above, on August 18, 1987, a 4.6 curie americium-beryllium source, T-222; a 5-curie americium-beryllium source, 71-1-422B; and a 2-curie cesium-137 source, CSV-H50, were stored on trucks rather than in storage wells. Summary of Licensee's Response The licensee does not deny the violation. NRC Evaluation of Licensee's Response Since the licensee does not deny the violation, the violation remains as stated. II. Summary of Licensee's Request for Mitigation The licensee contests the proposed civil penalty for two basic reasons. These can be summarized as follows: (1) The severity of the violations does not warrant a penalty. In this connection, the licensee argues that l l the statement in the December 10, 1987, cover letter transmitting the Notice of Violation that these violations collectively demonstrate a significant breakdown in management oversight and control over its licensed program is erroneous, and that the violations do not constitute a health
, physics problem but a procedural problem and, as such, do not warrant a cumulative civil penalty in the amount proposed. (2) In light of the financial hardship experienced by the licensee as a result of the current economic depression being experienced by the oil industry, and the expense which the licensee has undergone in order to " accommodate the enforcement actions which resulted from the inspection " the proposed civil penalty is excessive.
NUREG-0940 II.A-130
Appendix NRC Evaluation of Licensee's Request for Mitigation Regarding the licensee's request for mitigation of the civil penalty based on its contention that the severity of the violations does not warrant a penalty and that the violations do not constitute a health physics problem but a procedural problem, the NRC maintains that the severity of the violations do warrant a penalty because the violations collectively demonstrate a significant breakdown in the licensee's oversight and control of its radiation safety program. In addition, the NRC considers these violations to be more than procedural problems and proposed a penalty to emphasize that the NRC considers these violations to be a serious matter, and to emphasize the need to take timely and comprehensive corrective actions. The NRC expects licensees to maintain a high level of compliance with NRC requirements. The base civil penalty was increased by 100 percent because of the licensee's poor prior performance, the multiple occurrences of most of the violations, and the licensee's failure to take adequate corrective actions to preclude repeat violations identified during the previous inspection. The NRC Enforcement Policy recognizes that a licensee's ability to pay is a proper consideration in determining the amount of the civil penalty. The licensee's financial information submitted in its February 15, 1988 letter demonstrates that imposition of a civil penalty in the amount
. proposed would create a severe financial burden. In light of the licensee's current financial situation, the penalty is being mitigated by 50 percent.
III. NRC Conclusion The NRC staff has carefully reviewed the licensee's response and the financial information submitted by the licensee, and has concluded that the violations occurred as stated. However, the NRC has determined that in light of the licensee's financial situation, the proposed civil penalty should be mitigated by 50 percent. NUREG-0940 II.A-131
# 'o g UNITED STATES
[ g NUCLEAR REGULATORY COMMISSION
$ t WASHINGTON, D. C. 20655
/
SEP 4 41987 License No. 29-20777-01 Docket No. 30-22063 EA 87-156 Precision Materials Corporation ATTN: Marvin Rosenblum Chairman of the Board S10 Thornall Street Suite 310 Edison, New Jersey 08837 Gent'emsn:
Subject:
ORDER MODIFYING LICENSE (EFFECTIVE IMMEDIATELY) Enclosed is an Order Modifying License (Effective Imediately) requiring actions, as specified therein. In accordance with 10 CFR 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosed Order will be placed in the NRC's Public Document Room. The response directed by the accompanying Order is not subject to the clearance procedures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, PL 96-511. Sincerely, J s M. Tayl e xecutive Director for Regional Operations
Enclosure:
As stated CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 II.A-132
L, l UNITED STATES NUCLEAR REGULATORY COMISSION Precision Materials Corporation ) Docket No. 30-22063 Replogie Avenue ) License No. 29-20777-01
'Mine Hill, New Jersey 07801 ) EA 87-156 ORDER MODIFYING LICENSE (EFFECTIVE IIHEDIATELY)
I I Precision Materials Corporation (the " licensee") is the holder of Byproduct Material License No. 29-20777-01, which authorizes the licensee to possess a maximum of 2,000,000 curies of cobalt-60 as sealed sources for use in a custom designed OMEGA trradiator for irradiation of certain materials. The license was issued by the Nuclear Regulatory Commission (the "Comission" or "NRC") on March 29, 198S, was most recently amended on January 28, 1986, and is due to expire on March 31, 1990. The licensee currently possesses approximately 320,000 curies of cobalt-60 installed as sealed sources in the irradiator, as well as approximately 30 cubic feet of contaminated resins from the irradiator's pool water demineralized cleanup system. The resins, which are stored in containers above the irradiator cell, apparently were contaminated when the sources.were originally obtained at the facility since the casks used to transport the sources were contaminated. II On July 22-23, 1987, an NRC inspection was conducted at the licensee's facility in Mine Hill, New Jersey. Although no violations of NRC regulatory requirements were identified during the inspection, the NRC did learn that 1 NUREG-0940 II.A-133 I A
3 1
---- - - --- m hY ,
li
}
_ A <
,- n; l 3 ,
pry 2-t: c i e t t < ry water fros'the.irradiator pool was leaking from an unidentified location in the !
.q
. pool.- The NRC inspectors'obtained samples of the pool water directly from the j L" pool.and also from the.dominera11rer cleanup. system. Analysis of those samples' 4
found no radioactivity above background, indicating that the encapsulated. cobalt-60 sources stored in the pool were'not leaking. 4 . 1
-i
. 'During'the exit" interview'at the conclusion of the inspection, the inspectors j
, were informed by.the licensee's President that the corporation (1) had ;
ins'ufficient financial resources to continue ' normal operation of the facility. - (2) .was. anticipating that it' would defacit on its debts, and (3) was considering entering bankruptcy proceedings. ' In view of-these inspection findings with respect to the leaking irradiator pool, and the licensee's apparent-financial difficulties, the NRC Region I,
- sent a Confirmatory Action Letter to the licensee on August 6,1987, to confirm commitments ~made by the licensee's Comptroller, who was also one of.the
' 4 licensee's three Radiation Safety Officers, in a telephone conversation with j Region I on August. 5,1987. . Specifically, the licensee comitted to:
~
f 1.- ' Initiate daily monitoring of the irradiator pool water to assure mainte-p nance of appropriate water level and detection of any radioactive contami-nants. record the-results of the monitoring, and promptly submit all data o collected through September 1, 1901 to the NRC Region I office, with an j assessment of the cause of the water leakage as well as planned corrective l H actions; and, l 7 .'NUREG-09'40 ' .II.A-134 p. b I
.r
o . f 3-t l2. . Proeptly notify the NRC Region I office of any decision to terminate licensed activities, and conform with the requirement:: of.10 CFR 30.36(b) regarding such termination. III Subsequently, on August 26, 1987, NRC Region I received a telephone call from the licensee's President indicating that the three designated Radiation Safety Officers for the facility.fi.e., the President, Vice-President and Comptroller), who are the three individuals with primary technical knowledge concerning operation.of the facility, would be resigning as employees of Precision Materials Corporation by September 4, 1987, and that none of the remaining employees had sufficient technical knowledge concerning the facility and its associated safety controls to permit continued operation. As a result, NRC Region I contacted the licensee's Chairman of the Board on August 27, 1987, and he indicated that he'was unaware of these planned resignations. In light of'the uncertainty among the licensee's corporate officers toward operation of the facility, tb NRC initiated a conference call on Auw.;t 28, 1987, with the licensee's President (who is also one of the four ! members of the Board of Directors), the Chairman of the Board, the Chairman's i attorney, and a third Board member, to address the licensee's intentions j concerning continuation of licensed activities. During this conference call,
. licensee representatives did not agree on any particular course of action, and 1
t
- NUREG-0940 II.A-135 l
i i . I
4 the Chairman of the Board and the other Board member both indicated that they (1) had very little knowledge of the technical operation of the facility or the technical aspects of licensed activities; (2) were unaware that the Fresident ' and other individuals at the facility with knowledge of facility operation were planning to resign; and (3) could not, on such short notice, provide any ) 1 decision or plan concerning the future of licensed activities at their ) l facility, i q Subsequently, on August 31, 1987, NRC Region I personnel met at the licensee's facility with the licensee's President, Vice President, the fourth member of the Board of Directors (who did not participate in the August 28, 1987 conference call) and representatives of, and attorneys for Midlantic National Bank, the primary creditor of the facility. The Chairman of the Board and j l remaining Board member were aware of this meeting, but had stated during the August 28, 1987 conference call that they could not attend. The meeting was i conducted to discuss the licensee's plans for the facility, including control and disposition of the radioactive material. At the meeting, the NRC was informed that (1) water was leaking from the irradiator pool at a rate of approximately 20 gallons / hour, (2) one of the Radiation Safety Officers i f (Comptroller) had resigned, effective August 28, 1987, and (3) the other two haiation Safety Officers (President and Vice President) intended to resign effective September 4, 1987 after placing the irradiator in a shutdown status , at that time. No other licensee re esentative was present to indicate what arrangements, if any, had been made for maintaining the facility in a shutdown status beyond September 4; obtaining qualified replacement personnel; amending l NUREG-3940 II.A-136
5 the license in light of the departure of key technical personnel required by the license; or developing plans for control and removal of the radioactive material. During the August 31, 1987 meeting, the Midlantic Bank representatives orally agreed to support the salaries of certain of the current technical and admini-strative staff at the facility until September. 11, 1987 in order to provide more time to resolve issues affecting the disposition of the radioactive material, and in order to permit the licensee to initiate negotiations with other parties for prompt removal and transfer of the radioactive sources from the facility to an authorized recipient. IV fn light of the current financial status of this licensee, the planned resig-nations of the President and Vice President (the two remaining Radia. ion Safety Officers), the apparent lack of sufficient technical knowledge of facility operation by any remaining employee, officer or director of the corporation, and the continuing problem of water leakage from the irradiator pool, the NRC no longer has reasonable assurance that use or storage of licensed material at this facility will be performed safely and in accordance with the terms of the license. Therefore, I have determined that operation of the irradiator should be suspended, and the license should be modified to require that arrangements be made to either provide a basis for resumption of operations, as set forth in Section V below, or to prenptly transfer all licensed material to an authorized NUREG-0940 II.A-137
i ! h 6 recipient. Further, pursuant to 10 CFR 2.204, I have determined that public
~ health and safety requires that these actions be made immediately effective.
V l 1 Accordingly, pursuant to Sections 81, 161b., 161c., 1611., and 161o., 182, and j 186 of the' Atomic Energy Act of 1954, as amended, and the Commission's regulations in 10 CFR 2.204 and 10 CFR Part 30, IT IS HEREBY ORDERED, EFFECTIVE IP91EDIATELY,- l THAT LICENSE NO. 29-20777-01 IS MODIFIED AS FOLLOWS:
)i A. Operation of the irradiator is suspended as of close of business September 8, 1987. All radioactive sources shall be placed and maintained in their storage pcsition in the irradiator pool until-such time as the sources are placed in NRC-approved storage casks or shipping casks; 5
1'_. B. Within 7 days of the date of this Order, the licensee shall place all radioactive sources in NRC-approved storage casks or shipping casks; l C. Until such time as the sources are placed in NRC-approved storage or shipping casks, the licensee shall perform daily monitoring of the irradiator pool to determine and maintain the water level and detect any radioactive contaminants, and shall notify by phone at 215-337-5280 the Director, or his designee, Division of Radiation Safety and Safeguards, NRC Region I, of the results of the monitoring by close of business of I the next business day. l NU' REG-0940 II.A-138
b g , ,
-7 O. Within 30 days of the date of this Order, the beensee shall either:
- 1. Previde the Regional Administrator, NRC Region I, with a basis for resumption of licensed activities in the form of an applicatfen to amend License No. 29-20777-01, and include,-as part of that basis:
a.. Qualifications of personnel.who will be responsible for opera- l tion of the facility, and for assuring that the facility is operated safely and in accordance with NRC regulations and the conditions of the license;
- b. . Plans for performing necessary repairs to the irradiator pool prior to any resumption of operations; and
- c. A description of financisi resources available to the corporation to allow it to hire qualified persor.nel, effect necessary repairs,
.and to resume and conduct licensed activities in a safe manner; or l
- 2. -Transfer.the radioactive sources to another NRC or Agreement State
.J licensee authorized to receive these sources, and provide the i j
Regional Administrator, NRC Region I, in writing, a plan for assuring that all radioactive waste is transferred to an authorized recipient, the facility is decontaminated in accordance with the NUREG-0940 II.A-139
w c. 3 8 y. y requirements set forth in 10 CFR 30.36, and approval _for release i of the facility.for unrestricted use is obtained from the Regional Administrator, NRC Region I. ] I E. Notify the Director, Division of Radiation Safety and Safeguards, NRC Region I, by telephone..at least 24 hours prior to any movement of the sources from the' pool and/or the facility. The Regional' Administrator,~NRC Region I, may relax or terminate any of these conditions for good cause. VI The licensee or any other person adversely.affected by this Order may request a hearing within 30 days after issuance of this Order. Any answer to this Order.or'any request for hearing shall be submitted.to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, Washington, D.C. 20555. Copies shall also be sent to the Assistant General Counsel for Enforcement at the same: address and to the Regional Administrator, U.S. Nuclear Regulatory
; Commission, Region I, 631 Park Avenue, King of Prussia, Pennsylvania 19406.
If'a person other than the licensee requests a hearing, that person shall set forth with particularity the manner in which the petitioner's interest is adversely affected by this Order and should address the criteria set forth in
.10 CFR-2.714(d). Upon the failure of the licensee to answer or request a hearing within the specified time, this Order shall be final without further
~NUREG-0940 II.A-140 o
l 9 proceedings. AN ANSWER TO THIS ORDER OR REQUEST FOR HEARING SHALL NOT STAY THE I MEDIATE EFFECTIVENESS OF THIS ORDER. If a hearing is requested, the Commission will issue an order designating the time and place of any hearing. If a hearing is held, the issue to be considered at such hearing shall be whether this Order should be sustained. FOR THE NUCLEAR REGULATORY COMMISSION J s M. Tay1 , Deputy Executive Director for Regional Operations Dated at Bethesda, Maryland this @ ay of September 1987 9 l l NUREG-0940 II.A-141 l
L
,(p ena %, UNITED STA*Es y '
; NUCLEAR REGULATO'4Y COMMISSION g j W AS*NOTON,9. C. 20555 .
k * * " * ,/ FEA 1 0 raos Docket No.: 30-22063 License No.: 29-20777-01 EA 87-156 Precision Materials Corporation I Replogie Avenue ! Mine Hill, New Jersey 07801 Gentlemen: l
SUBJECT:
ORDER REVOKING LICENSE On September 4, 1987, the NRC issued an Orde* Modifying License (Effective Immediately) to Precision Materials Corporation (PMC). The Order required (1) the suspension of operation of the irradiator at your facility, (2) place-ment of the radioactive sources in NRC approved storage or shipping casks and daily monitoring of the irradiator pool until such storage was accomplished, ; (3) either submittal of a plan to the NRC for resumption of operations, or transfer of the radioactive sources to en authorized recipient (and submittal of a plan to the NRC for subsequent shipment of waste, decontamination of ine faci 1Nr and release of the facility for unrestricted use), and (4) prcviding i telephone notification to the NRC prior to any movement of sources from the pool and/or facility. Since that time, the NRC has confirmed that you have ceased operations, transferred all NRC licensed radioactive sources to an authorized recipient, successfully decontaminated the facility so that it could be released for unrestricted use, and transferred all waste generated 1 during the cleanup effort to an authorized disposal site. Accordingly, all terms of the Order have been met. By letter dated December 22, 1987, the NRC notified you that no plan had been submitted by PMC for resumptien of licensed activities, and that unless a plan was submitted within 10 days of the date of that letter, the NRC would take action to terminate the NRC license for the PMC facility. Since we bave not, as of this date, received from PMC any plan for resumption of licensed activities, in accordance with our letter dated December 22, 1987, we are terminating this license by issuance of the enclosed " Order Revoking Licer,se". In accordance with 10 CFR 2.790 of the NRC's " Rules of Practice", Part 2 Title 10, Code of Federal regulations, a copy of this letter and the enclosed Order will be placed in the NRC's Public Document Room. Sincerely,
. _ _ _ , _ /
. /k W EIesM.Tay1 Deputy Executive Director
'for Regional Operatier:s
{ [
Enclosure:
As stated I NUREG-0940 II.A-142
~ - - - - - - - - - - ' - - - - -- --
r c44 a ( . 4 4: a
- l. '
UNITED STATES NUCLEAR REGULATORY _ COMMISSION 4 4 m Precision Materials poration- ) Docket No. 30-22063
.Replogie Avenue- ) License No. 29-207.77-01 LMine. Hill .New Jersey 07801. ). EA 87-156 " ~
- ORDER REVOKIllG LICENSE I
. Precision Materials Corporation.(the " licensee") is the holder of Byproduct Material License No.:29-20777-01, which authorizes the licensee to possess a maximum'of. 2,000,000 curies of cobolt-60 as sealed sources for use in a custom 3.o . designed OMEGA frradiator for irradiation of certain materials. The license was issued by the. Nuclear Regulatory Comission (the " Commission" or "NRC") or.
. March 29, 1985., was most recently amended on January 28, 1986, and is due to expire on March 31, 1990. The licensee currently does not possesses'any radio-active material, having transferred all licensed material to an authorized recipient as of December'15, 1987.
II
- On September 4. 1987, the NRC issued an Order Modifying License (Effective l Immediately) to the licensee which required (1) the suspension of operations i
at the facility, (2) placement of the radioactive sources in NRC approved j 1 storage or shipping casks and daily monitoring of the storage pool until Tuch storage was accomplished; (3) either submittal of a plan to the NRC ]
.for resumption of operations, or transfer of the radioactive sources to an '
authorized recipient (and submittal of a plan to the NRC for subsequent shipment of waste, decontamination of the facility and release of the facility forl unrestricted use); and (4) telephone notification to the NRC prior to any , l
. movement of the. sources from the pool and/or the facility. i NUREG-0940 II.A-143 l
nj i m l 2 ) i j The Order was issued because the NRC no longer had reasonable assurance that 4 use or stortce of licensed material at the facility sould be performed safely and in accordance with the. terms of the license, given the financial status of the licensee, the planned resignations of the President and Vice President (the then two remaining Radiation Safety Officers), the apparent lack of sufficient technical knowledge of facility design and operation by any remaining employee, officer or director of the licensee, and a continuing probler of water leakage l from the irradiator pool. l 1 III
]
i Since the Order Modifying License was issued on September 4, 1987, the NRC has confirmed that the licensee has ceased operations, transferred all NRC licensed radioactive sources to an authorized recipient, successfully decontaminated the facility so that it can be released for unrestricted use, transferred all waste generated during the cleanup effort to an authorized recipient, and no longer employs individuals qualified to engage in licensed activities. By letter dated December 22, 1987, the NRC notified you that no plan had been submitted by PMC for resumption of licensed activities, and that unless a plan was submitted within 10 days of the date of that 'etter, the NRC would take l action to terminate the NRC license for the PMC acility. As of this date, the licensee has not submitted any plan for resumption of licensed activities. 10 CFR 30.61(b) provides, in part, that any license may be revoked because of l conditions revealed by an inspection or other neans which would warrant the Commission to refuse to grant a license on an original application. As part l of those requirements for an original application, as set forth in 10 CFR 30.33, l l NUREG-0940 II.A-144 , . 1
y 3 an applicant must be qualified by training and experience to use the material
#or the purpose requested in the license in such a manner as to protect he01th and minimize danger to life or property. Presently, this licensee has no licenred material or qualified individuals to use the material in such a manner as to protect the public health and safety and to minimize danger to life or property. Moreover, notwithstar; ding the opportunities to submit a plan for resumpt. ion of licensed activities in response to the NRC Order of September 4, 1987 and an NRC 1.etter deted December 22, 1987, the licensee has not made any submittals to the d." which describe such a plan. Permitting resumption of licensed activities under these circumstances would be contrary to the public health and safety and keeping the license in effect serves no purpose. Therefore, I have deterrined that the public health, safety and interert, require that this license should be revoked.
IV
\
Accordingly, pursuant to Sections 81, 161(b) and (1), 182, and 186 of the Atomic Energy Act of 1954, as amended, and the Commission's regulations in 10 CFR 30.61. IT IS HEREBY ORDERED THAT LICENSE No. 29-20777-01 IS REV0KED. V The licensee or any other person adversely affected by this Order may request t l a hearing within 30 days after issuance of this Order. Any answer to this j j Order or any request for hearing shall be submitted to the Director, Office l l NUREG-0940 II.A-145 l _ _ _ _ __ A
p -
"x ,
g t_ 4u. a. Tk ' . [;. ~t
- F.
O s {,[;- S 4 i.
^
;.) Y k
"o~ ,
i
, of. Enforcement, U.S. Nuclear Regulatory Comission, Washington, D.C. 20555.
$ Copies shall also be sent to the Assistant General Counsel for Er.forcement at the same address .nd to the Regional Administrator, U.S. Nuclear Regulatory.
, Commission, Region I,-475 Allendale Road, King of Prussia, Pennsylvania 19406. If a person other than the licensee requests a hearing, that person shall set forth with particularity the manner in which the petitioner's interest is adversely"affected by this Order and should address the criteria
, set forth in 10 tJR 2.714(d). Upon the failure of the licensee to answer or
- request a hearing within the specified time, this Order shall be final witho'ut further proceedings..
't If a hearing is requested, the Commission will issue an order designating
'the time and place of any hearing.
If a hearing is held, the issue.to be considered at such heiring shall be whether this Order should be sustained. FOR THE NUCLEAR REGULATORY COMMISSION 4 4'>
;. == :s .
/JeesM.Tayl#,-DeputyExecutive
{ / Director for regicnal Operations Dated at Bethesda, Maryland Thislp_tkdayofFebruary~1983
'HUREG-0940 II.A-146 9 l I ,
l
V W ;)
' ~ ~' ~~ ~~~~ --'-~~-~ ~ - -
J Y y-f ys a ;o ,
,s a
bl 4, F
' . UNsT ED ST ATES y /pa at
- t. , '
, Sg / NU CLEAR REGULATORY COMMISSION
_. I %; 4. REcl0N H [. ' " 3 7js toiuAnstrTA sintet s w
.Q r '
.ArtaNTA ceovcia3o323 y
P
%9....,f' g 3g g x ,
'?
# l00ckrt'No. 030-00522
' License.No.- 45-11367-01'
.EA.88-308' St. Mary'sLHe'11tal
? ATTN:- Sister Pat Eck ,.
- j
~
Chief Operating Officer q"i A, O~ ' w Department of, Radiology 5801:Bremo Avenue. Richmond, Virginia 23226 a Gentlemen:- 45U8JECTf 1 NOTICE OF. VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY
- (NRC' INSPECTION. REPORT NO. 45-11367-01/88-01)
,p his rNfers to the Nuclear;Regulat'ory Conenission (NRC) inspection conducted by
<S; Waldron atLthe St.-Mary's Hospital-on December 7, 1988. The inspection included aL review:of the' circumstances surrounding 1the exposure of' a' hospital
& yorker to' radiation onjNovember. 25, 1988. The report documenting this inspec-P* tion;was r.ent to you'.by letter dated December 23 1968.. As a result of this-xinspectinrm significant failures to comply with NRC regulatory requirements were11dentified..andt accordingly, NRC concerns relative to.the inspection Y(g. ?' findings were' discussed in an Enforcement Conference held on January 4, 1989. i K ,yThe.jletter summarizing this Conference was sent to you. on January 12, 1989.
- q + The11olations described in the' enclosed Notice of Violation and Proposed Limpositionlof Civil Penalty-(Notice) involved a written procedure which was .
E ' inadequate:to ensure'that=no=one'was present in the. teletherapy treatment room , j N 4 during the' testing of the.. door interlocks .'a significant ; failure to maintain positive control .over entry intola high radiation . area, and the failure to~ Jprovide, instruction and trainiog to housekeeping personnel on p'rocedures for J workinglin 'an: area where. radioactive materials are used. The violations g " resulted 1n 7 a hospital _ housekeeper entering an unlocked cobalt-60 treatment
&c room to resupply linen'while two' technologists, in an adjacent control area, l L7 h Jinitiated the beam on the cobalt-60 treatment unit to test the door interlock
' system. ' As a result, the housekeeper received radiation; exposure of i
i i a approximately 60 millirems when the cobalt-60 teletherapy source was exposed l while she was in the treatment room. Even though the housekeeper apparently ) ? came no' closer than three feet to the primary beam, the potential for j
' significant radiation e.voosure was present. The NRC is deeply concerned that j
.J
@p U~.your' ' occurenceoperating procedur2s by requiring the-technologist did not contain to verify provisions.to that unauthorized persons prevent such an ) (g 1 ,(were not!present in the treatment = room during tests of the . teletherapy source. l
;Your attention is directed toward ensuring that such procedures are developed 'j T
% andLimplemented and that technologists are thoroughly trained in such procedural J Os 0 requirements. - Such an event' is indicative of a lack of control cf licensed - 1 c 4 M Y NOREG-0940: ' I1.A-147 \ l }Q$' r v, g , I g." L
+ , y
St. Mary's Hospital 15 M material by your radiation safety management staff. The NRC views such lack of control as a very serious matter and insists licensees exercise proper control dver their radiation safety programs to ensure that unintentional exposures do not occur. This problem was further compcunded by the fact that the hospital housekeeping staff had not received proper training and instruction in radiation l safety procedures. The NRC is encouraged, however, by your recognition of this problem and your comprehensive action to preclude recurrence. Those actions include revision of the employee orientation program, and procedural amendments, which included increased use of available safety equipment, both of which should contribute to a more effective radiation safety program. To emphasize the importance of managing and maintaining an effective radiation safety program, I have been authorized, af ter consultation with the Director, Office of :nforcement, and the Deputy Executive Director for Nuclear Materials safety, Safeguards, and Operations Support, to issue the enclosed Notice of Violation and Proposed Impositicn of Civil Penalty in the amount of One Thousand Two Hundred Fifty Dol h rs ($1,250) for the violations described in the enclosed Notice. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions " 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), ) the violations described in the enclosed Notice have been categorized as a Severity Level III problem. The base value of a civil penalty for. a Severity Level III violation or problem is $2500. The NRC Enforcement Policy allows for reduction of a civil penalty under certain circumstances. In this case, the base civil penalty was reduced by 50 percent. The partial mitigation due your comprehensive corrective action and prior performance was off set by the escalation warranted for the duration of the training violation. ; i You are required to' respond to this letter and the enclosed Not' ice and should i follow the instructions specified therein when preparing your response. In I your response, you should docurrent the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your , response to this Notice, including your proposed corrective actions and the i results of future inspections, the NRC will determine whether further NRC ! enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Tractice," Part 2 Title 10, Code of Federal Regulations, a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Of fice of Management and Budget as required by the Paperwork Reduction Act of 1980. Pub. L., No. 96-511. i i o N1) REG-0940 II.A-143 i , t 4 ___ _ _ _ _ _
4, j St. Mary's Hospital FLrB i s 1999 i b.
'. Should you have any questions concerning this letter, please contact us.
I
)
j Sincerely,
, q )
% alcolm L. rnst Acting Reg onal Administrator
Enclosure:
Notice of Violation and Proposed Imposition. of Civil Penalty
.cc w/ encl:
l- Commonwealth of Virginia r i e i
<l NUffEG-0940 11.A-149 l
'o - __ _ __ __b
; ~ u-9 ,
p& m ilh y [J S NOTICE OF VIOLATION M ' AND PROPOSED'IMPOSITIDT0F CIVIL PENALTY ) l St. Mary's' Hospital Docket No. 030-00522
!= Richmond, Virginia License No. 45-11367-01 -4 EA 88-308- i j )
~
;.During the Nuclear Regulatory Commission (NRC) inspection conducted on ,
December 7.-1988, violations of NRC requirements were identified. In accor- 1
. dance with the " General Statement of Policy and Procedure for NRC Enforcement ,
Actions," ,10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Comission ) proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy
; Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10.CFR 2.205. The 1 4 particular violations -and associated civil penalty are set forth below: .
A. 10 CFR 35.21(a) requires the licensee to ensure that radiation safety j activities are being performed in accordance with approved procedures and
~
i regulatory requirements in the daily operation of its byproduct material program through the Radiation Safety Officer. 10.CFR 35.21(b)(2)(viii) requires the RSO to establish and implement written procedures for performing checks of survey instruments and other safety equipment. ) 1 Contrary to the above, as of April 1, 1987, the effective date of this regulation, the licensee's written procedures for testing the safety a interlocks on the door to the teletherapy treatment room were inadequate in that the procedure did not provide a method for ensuring that the treatment room was unoccupied when the source was exposed for the interlock test. The lack of such a- procedure resulted in a worker being uninten-tionally exposed to radiation while supplying linen in the teletherapy h
- treatment room on November 25,1988, when the technologist initiated the l Co-60 source to test' the treatment roam door interlock.
1 B. 10 CFR 20.203(c)(2)(111) requires that each entrance to a high. radiation , area be maintained locked except during periods when access to the area is required, with pos',tive control over each individual entry. i Contrary to the above, on November 25, 1988, the licensee did not lock l the entrance to the cobalt-60 teletherapy treatment room, a high ! l radiation area, when access to the room was not required, and positive control over entry was not exercised. L C. License Condition 24 A. requires the licensee to conduct its program in accordance with a letter dated January 29, 1985. The letter states that Y Appendix H of the Regulatory Guide for Preparation of Applications for Medical Teletherapy Programs, Task TM 608-4, March 1982, will be followed for Personnel Training. [ NUREG-0940 II,A-150 f I
Notice of Violation 2
' Appendix H requires that all personnel including housekeeping receive proper instruction in:
- a. Areas where radioactive material is used.
- b. Potential hazards associated with radioactive material.
- c. Radiological safety procedures appropriate to their respective duties.
Employees are to receive the instruction upon initial employment, before frequenting areas where licensed material is used. Contrary to the above, from 1984 until December 7,1988, the licensee did not instruct housekeeping personnel in radiation safety procedures as rcquired. These violations have been categorized in the aggregate as a Severity Level III problem (Supplement VI). Civil Penalty - $1,250 (Assessed equally among violations). Pursuant to the provisions of 10 CFR 2.201, St. Mary's Hospital (Licensee) is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a " Reply to a Notice of Violation" and should include for each violation: (1) admission or denial of the violation, (2) the reasons for the violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps which will be taken to avoid further violations, and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation. Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or the cumulative amount the
. civil penalties if more than one civil penalty is proposed, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a No+. ice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part, (2) demonstrate extenuating circumstances, (3) show error NUREG-0940 !I.A-151
Notice of Violation 3 in thic Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. In requesting mitigatien of the proposed penalty, the six factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201 but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty. Upon failure to pay the penalty due, which has been subsequently determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282. The responses to the Director, Office of Enforcement, noted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of-Enforcement, U.S. Nuclear Regulatory Comission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II. FOR THE NUCLEAR REGULATORY COMMISSION Ma e im L. st A tiY1g P.egional Administrator j Dated at Atlanta, Geor gia this 15Mday of February 1989 1 i l 1 NUREG-0940 II.A-152 i l _ _ _ _ _ _ _ _ _ _ _ _ _ _
o v.n. 3 . Y ,' ) L u m
/ ,o,, UNITED STATES
[ ] > a NUCLEAR REGULATORY COMMISSION wassuwaTow, o.c. 2oses l 7 OCT 301987
\
Docket flo: 30-20132 License No:; 35-21272-01~' EA 87-204 Tracer Profiles, Inc.
' ATTN:. Mr. James M. Gibson s President 100 L Rockwell Building 84 Oklahoma City, Oklahoma 73128 Gentlemen:'
C
SUBJECT:
ORDER SUSPENDING LICENSE (EFFECTIVE IIHEDIATELY) AND ORDER TO SHOW CAUSE Enclosed islan Order, effective immediately, suspending your byproduct material license. In addition, the Order requires that you show cause why your license should not be revoked. In accordance with Section 2.790 of the NRC's " Rules of Practice " Part 2,'
-Title 10,' Code of Federal Regulations, a copy of this letter and the enclosure will be placed in the NRC's Public Document Room.
The responses directed by.this letter and accompanying Order are not subject to the clearance procedures of the Office of Management and Budget, as required by the Paperwork Reduction Act of 1980, PL 96-511. Sincerely, is , J mes M. TayleV, Deputy Executive Director for Regional Operations.
Enclosure:
As stated ec: Oklahoma Radiation Control Program Director Mr. James M. Gibson 1516 Cherry Lane Oklahoma City, Oklahoma 73127 Mr. Jack T. Carter, Jr. 204 Harrogate Yukon, Oklahoma 73099 CERTIFIED MAIL ITTUIDFITtTTPT REQUESTED . .NUREG-0940 II.A-153
~
f~ , j
,t In the Matter of )'
)
TRACER PROFILES, INC. ) Docket No. 30-20132 1 100 N. Rockwell, ) License No. 35-21272-01 i Building 84 ) EA 87-204 Oklahoma City, Oklahoma 73128 ) I L ORDER SUSPENDING LICENSE (EFFECTIVE IMMEDIATELY) l AND ORDER TO SHOW CAUSE I l 1 Tracer Profiles, Inc. (the licensee) is the holder of Byproduct Material License Ho. 35-21272-01 issued by the Nuclear Regulatory Commission (the i Comission/NRC) pursuant to 10 CFR Part 30. The license authorizes the use of byproduct material for the conduct of oil and gas well tracer studies and a l is due to expire on February 28, 1988. The license specifies that licensed material shall be used by or under the supervision and in the physical i presence of James H. Gibson (President), Jack T. Carter, Jr. (Vice President), i Barney P. O'Toole,-Alexander A, Palmer, Mtiton Rose, or Kevin J. Palmer, 1 II ) l l l On March 5-6, 1987, en NRC inspection was conducted at Tracer Profiles, Inc., i Oklahoma City, Oklahoma. During the inspection violations of HRC requirements were identified. On March 26, 1987, an enforcement conference was conducted with Mr. Jack T. Carter, Jr. to discuss the violations. Mr. Carter was the sole licensee representative 5 at the enforcement conference. Mr. Carter explained that he and Mr. Gibson were currently the only employees of Tracer i NUREG-0940 11.A-154
' Tracer Profiles, Inc. I Profiles, Inc. Prior to and following the enforcement conference, the licensee i
agreed to specific corrective actions as enumerated in Confirmatory Action Letters (CALs) dated March 13 and April 22, 1987. l The. specific corrective actions that the licensee agreed to consisted of the following:.
- 1. Obtaining.the services of a consultant who is trained and experienced in the radiation protection aspects of tracer use in oil / gas wells. Submit the name and qualifications of the consultant to the Region IV office and the date of first visit to the Tracer Profiles, Inc. facility within one month of receipt of the April 22, 1987 letter.
- 2. lingaging this consultant to audit operations, review procedures and license requirements, develop management controls to ensure compliance with
. license requirements, and prepare a report of findings, which would be forwarded to NRC Region IV within 20 days of the completion of the audit.
- 3. Engaging this consultant to perform a follow up audit within 6 months of the first audit and report findings, which would be forwarded to NRC Region IV within 20 days of the completion of the audit.
l L< l '
.4.. Obtaining calibrated radiation survey instrumentation before undertaking any g
operations involving radioactive materials.
.m i
\
7;NUREG-0940 ,
.II.A-155 1
Tracer Profiles, Inc. 5. Submitting to Region IV, for approval, supplemental information regarding procedures for storage of radioactive materials at the facility. )
- 6. Upon rsceipt of each new shipment of radioactive material, surveying the radioactive materials storage area to verify that levels of radiation in unrestricted areas, as specified in 10 CFR 20.105, were not exceeded.
Results of this survey are to be recorded.
- 7. Submitting the results of wipe samples taken after vacating the former address of 8236 S. W. 5th Street, Oklahoma City, Oklahoma.
- 8. Surveying and decontaminating equipment as required by operating procedures.
- 9. Obtaining records of missing personnel monitoring reports not available at the time of inspection and maintaining them for NRC inspection.
Subsequently, a Notice of Violation (NOV) was issued on June 8, 1987. In the NOV, the violations were categorized in the aggregate as a Severity Level III problem. A civil penalty, which is generally proposed for a Severity Level III problem, was not proposed because of the licensee's good enforcement history and the licensee's agreement'to implement the above-described extensive corrective actions. The NOV specified that the licensee was to reply to the NRC within 30 days of the date of the letter transmitting the NOV. NUREG-0940 II.A-156
9& 40 g YIA **Th' IMAGE EVALUATION <lI4,, g ,..,-.,< , - ((///
<> r, l.0 EE 2 F:W au llp>==a U llllb l,j l.8 1.25 1.4 1.6 4 150mm >
- 6" >
0?LJ+ .v,,yv,,//
/ f4 .
of : j m ,,@&
- A
l Tracer Profiles, Inc. The licensee failed to respond to the CALs and NOV. Following numerous unsuccessful. attempts to contact the licensee by telephone, the N".C Region IV
. wrote to the licensee on July. 16, 1987. On July 20, 1987, Mr. Gibson telephoned the NRC Region IV office and advised that he was unaware of Mr. Carter's whereabouts and his commitments to the NRC and the subsequent NOV.
Mr. Gibson did, however, agree to take actions to resolve the matter. In a subsequent telephone conversation on July 23, 1987, Mr. Gibson comitted to the following actions:
- 1. To personally take control of the licensed program and to safeguard any radioactive material in the possession of Tracer Profiles, Inc. This was to include the securing of licensed material in locked storage until such time as NRC approves resumption of operations with sources.
- 2. To personally supervise any work conducted under the license.
- 3. To respond to the NOV within 20 days of receipt of the letter transmitting the commitments.
- 4. Within 20 days of receipt of the letter transmitting the comitments, to
. initiate the actions described in the CAL of April 22, 1987 concerning the use of a consultant to audit the program within the time frames specified.
NUREG-0940 II.A-157
hI n j l 1
-Tracer Profiles Inc. 1 V
r;
- 5. To amend the license to name Mr. Gibson, rather than Mr. Carter, as the I- Radiction Safety Officer. )
b i These actions were formalized in a CAL dated July 31, 1987. To date, Mr. Gibson has failed to respond to the July 31, 1987 CAL. Moreover, the licensee has vacated its offices and apparently moved to a new and unknown l location, which is unauthorized if radioactive material'is possessed. I III The licensee's. failure to fulfill commitments made to the NRC demonstrates an untrustworthiness and unwillingness to comply with the NRC regulatory L requirements which.cannot be tolerated. Therefore, I lack the requisite [ reasonable assurance that the licensee will comply with Commission requirements in the future. I have determined that the public health, safety, and interest require that License No. 35-21272-01 be suspended, effective immediately, as described below. 4 IV Accordingly, pursuant to Sections 81, 161(b), 161(1) and 182, of the Atomic Energy Act of 1954, as amended, and the Commission's regulations in 10 CFR 2.202 and 10 CFR Part 30, IT IS HEREBY ORDERED, EFFECTIVE IMMEDIATELY, THAT: NUREG-0940 II.A-158 e_-
' Tracer Profiles. Inc. j l
A. License No. 35-21272-01 is suspended pending further Order and the .l
?icensee shall cease and desist from any use of byproduct material in its pot, session.
B. The licensee shall place all byproduct material in its possession in locked storage and notify the NRC Region IV office of compliance in writing within 20 days of tha date of this Order. C. The licensee shall show cause why License No. 35-21272-01 should not be revoked. The Regional Administrator, Region IV mJy relax or rescind any of the above provisions for good cause shown by the licensee. V Pursuant to 10 CFR 2.202(b), the licensee may show cause why this Order should not have been issued by filing a written answer under oath or affirmation within 20 days of the date of issuance of this Order, setting forth the matters of fact and law on which the licensee relies. The licensee may answer this Order, as.provided in 10 CFR 2.202(d), by consenting to the provisions specified in Section IV above. Upon failure of the licensee to file an answer within the specified time, the Deputy Executive Director for Regional Operations may issue without further notice an Order revoking License No. 35-21272-01 and requiring transfer of all materials possessed under License No. 3521272-01 to an individual authorized to possess such material. NUREG-0940 II.A-159
7 l y Tracer Profiles. Inc. j The licensee or any other. person who has an interest adversely affected by this Order may request a hearing on this Order within 20 days of the date of its
, issuance. Any answer to this Order or request for hearing shall be submitted to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comission.
Washington, D.C. 20555. Copies also shall be sent to the Assistant General
. Counsel for Enforcement,.0ffice of General Counsel at the same address and to the Regional Administrator, NRC Region IV, 611 Ryan Plaza Drive, Suite 1000, Arlington, Texas 76011. If a person other than the licensee requests a hearing, that person shall set forth with particularity the manner in which the petitioner's interest is adversely affected by this Order and should address the criteria set forth in 10 CFR 2.714(d). An answer to this Order or a request for hearing shall not stay the imediate effectiveness of this Order.
If a hearing is requested, the Comission will issue an Order desig.iating the time and place of any hearing. If a hearing is held, the issue to be considered at such a hearing shall be whether this Order should be. sustained. FOR THE NUCLEAR REGULATORY COMMISSION
- //
J
~W , Deputy s M. Tay1
/ Executive Director for Regional Operations
/
L. Dated at.Bethesda, Maryland, this 3o V-day of October 1987 l NUREG-0940 II.A-160 l . - - _ _ . - _ _
k 4
./ % UMTED STATES E ' ,S NUCLEAR MEGULATORY COMMIS$10N E
I AEOf0N 1 476 ALLENDALE ROAD
***** KfNQ OF PRUSSIA, PENN8YLVANIA 19406 December 29, 1988 Docket'No. 030-17063 License No. 37-19159-01 EA 88-274 Urban Engineers, Inc.
ATTN: Robert C. Olson President 300 North Third Street Philadelphia, Pennsylvania 19106 Gentlemen:
Subject:
NOTICE OF' VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY (NRC Inspections Nos. 30-17063/88-01 and 30-17063/88-02) This letter refers to the two NRC inspections conducted on October 31 - November 2, 1988, and November 29, 1988, of activities authorized by NRC License No. 37-19159-01. The first inspection was conducted at a temporary field site in Havertown, Pennsylvania. During that inspection, the report of which was delivered to you on November 10,'1988, a violation of NRC require-ments was identified. The violation, its underlying causes and your corrective actions, were discussed with Mr. John E. McCann of your staff at an enforcement conference in the Region I office on November 21, 1988. Subsequent to the conference, a second inspection was conducted at your office in Erie, Pennsylvania, as well as at additianal field sites in Erie, Allentown and Philadelphia, Pennsylvania, during which additional violations of NRC require-ments were identified. The findings of that inspection were discussed with Mr. F. D' Alba and Mr. L. ,Gupta of your staff at the conclusion of the inspection, and are described in the inspection report sent to you on December 12, 1988. The violations, which are described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty, involved: (1) two examples of a failure to secure or maintain constant surveillance over two nuclear density gauges being used and/or stored in unrestricted areas at the Havertown field site on October 31,.1988 (the first gauge, while unsecured, was damaged when run over by a steamroller); (2) use of a nuclear gauge by an individual at a field site in Erie prior to the individual receiving sufficient training and certification to use.this gauge; (3) failure to place the shipping papers, accompanying a gauge to the field site in Erie, ;n the proper location within the transport vehicle; (4) failure to perform leak tests of certain gauges in Erie at six month intervals, as required; and (5) failure to maintain records of the required semi-annual physical inventories of nuclear gauges. The NRC recognizes that the significance of the individual violations is low. However, when viewed collectively, the violations represent a significant lack of management attention to, and control of, activities authorized by your license. For example, although the majority of gauges possessed under your i CERTIFIED MAIL I RETURN RECEIPT REQUESTED NUREG-0940 II.A-161 l 1 _ _ i
Urban Engineers, Inc. 2 license are located at field sites associated with the Philadelphia home of fice, the Radiation Safety Officer (RS0), who is located in Erie, was not knowledgeable of activities being performed at those locations. Further, the RSO had not provided any training to technicians or conducted audits of the use of the gauges at those locations to ensure these activities were coriducted rafely and in accordance with the terms of your license, l
)
Accordingly, to emphasize the need for increased and improved management attention to activities authorized by your license, I have been authorized, after consultation with the Director of Enforcement and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the amount of Five Hundred Dollars (5500) for the five violations described in the enclosed Notice, In accordance ) with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 1 10 CFR Part 2, Appendix C (1988) (Enforcement Policy), the five violations are l classified in the aggregate as a Severity Level III problem to focus on the underlying cause, namely a lack of adequite control of the licensed program. I The base civil p.nalty amount for a Severity Level III violation or problem is 1 5500. The escalation and mitigation factors described in the Enforcement Policy I were considered and no adjustment to the civil penalty amount is considered l appropriate. In addition to the violations, the NRC also has a concern regarding certain statements made to the NRC by a technician during the first inspection, as described in the inspection report (See NRC Insi; tion Report 030-17063/88-01 i at page 3.) Although a violation is not being issued for this matter, the NRC { emphasizes the importance of the completeness and accuracy of any statements 1 or representations made by licensee personnel to NRC representatives. Similar matters in the future may result in enforcement action. You are required to respond to this letter and the enclosed Notice and you should follow the instructions specified in the Notice in preparing your response. In your response, you should document the specific actions taken to correct the violations and any additional actions you plan to prevent recurrence. Further, you should describe in detail the specific actions taken to improve control of licensed activities, and in particular, specify how the actions planned will ensure that: (1) the Radiation Safety Officer exercises increased control and oversight of licensed activities, in accordance with the represen-tations made in your license application dated September 21, 1979; and (2) personnel are held accountable whenever violations of NRC requirements f [ occur. After reviewing your response, including your proposed corrective f actions and the results of future inspections, the NRC will determine whether further enforcement action is necessary to ensure compliance with NRC regulatory requirements. Furthermore, you should be aware that any recurrence of these violations may result in higher civil penalties, or in suspension and/or revocation of your license. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations, a copy of this letter and the enclosed Notice will be placed in the NRC's Public Document Room. l NUREG-0940 II.A-162 1 l ' ) l - - - - - - - 1
.. . .r-I ,
-. Urban Engineers,LInc. 3 f
.The responses directed by this-letter and-the enclosed Notice are not subject to the clearance procedures'of the Office of Management and Budget as: required'
' by the Paperwork . Reduction Act of 1980, PL 96-511.
Sincerely, William T. Russell-Regional Administrator.
. Encl o su're: .
Notice of Violation and Proposed Imposition of Civil Penalties cc w/ enc 1: Public Document Room (PDR)
~
Nuclear. Safety:Information Center (NSIC) Commonwealth of Pennsylvania Francis 0' Alba,-Vice President
'502 West 7th Street Erie, Pennsrivania 16502 Li Gupta, Radiation Safety Officer 502 West 7th Street-Erie, Pennsylvania 1650:
NUREG-0940. II.A-163 i
NOTICE OF VIOLAT1.ON AND PROPOSED IMPOSITION OF CIVIL PENALTY , 1 1 Urban Engineers, Inc. Docket No. 030-17063 j Erie, Pennsylvania License No. 37-19159-01 EA 88-274 i During NRC inspectior.s corducted on October 31 - November 2, 1988, and on November 29, 1988, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory ) Commission proposes to impose a civil penalty pursuant to Section 234 of the ; Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. i The particular violations and associated civil penalty are set forth below: A.10 CFR 20.207(a) requires that licensed materials stored in an unrestricted
. area be secured against unauthorized removal from the place of storage. 10 CFR 20.207(b) requires that licensed materials in an unrestricted area and
, not in storage be under constant surveillance and immediate control of the licensee. As defined in 10 CFR 20.3(a)(17), an unrestricted area is any area access to which is not controlled by the licensee for purposes of protection of individuals from exposure to radiation and radioactive materials. ;
' Contrary to the above, I
- 1. on October 31, 1988, a Troxler nuclear density gauge, containing I approximately 8 millicuries of cesium-137 and 50 millicuries of I americium-241, was located at a highway construction site in Havertown, Pennsylvania, an unrestricted area, and the gauge was not secured from unauthorized removal and was not under the immediate control of the j licensee. j l
- 2. on October 31, 1988, another Troxler nuclear density gauge, also I containing approximately 8 millicuries of cesium-137 and 50 millicuries l of americium 241, was located in an unlocked and unsecured construction !
storage shed at the same highway construction site in Havertown, Pennsylvania, an unrestricted area, and the gauge was not under constant surveillance and immediate control of the licensee. B. Condition 11 of License No. 37-19159-01 limits the use of licensed material to individuals who have satisfactorily completed the manufacturer's training course or to individuals who are under the supervision and in the physical presence of another individual who has satisfactorily completed the manufacturer's training course. i I NUREG-0940 II.A-164 i l I
Notice of Violation 2 l u Contrary to the above, froir, September 1987 to October 10, 1988, an individual periodically used licensed material (nuclear gauges) prior to successfully completing the manufacturer's training course on October 10, 1988. During that time, this individual also was not under the supervision and in the physical presence of an individual who had completed the manufacturer's training course. C-.10 CFR 71.5(a) requires that no licensee deliver any licensed material to a l carrier for transport without complying with the applicable requirements of ! the regulations appropriate to the mode of transport of the Department of Transportation in 49 CFR Parts 170-189. 49 CFR 177.817(e) requires, in part, that when the driver of a vehicle transporting hazardous' material is at the vehicle's controls, the shipping paper must be within his immediate reach while he is restrained by the lap belt and either readily visible to a person entering the driver's compartment or in a holder which is mounted to the side of the door on the driver's side of the vehicle. Contrary to the above, on November 29, 1988, the shipping paper accompanying a hazardous material (nuclear gauge containing radioactive material) to a field site in Erie, Pennsylvania was neither readily visible to a person i entering the driver's compartment nor was it in a holder which was mounted to the side of the door on the driver's side of the vehicle. Specifically, the shipping paper for the moisture density gauge was located in the bottom of a transport case in the rear of the vehicle. 1 D. Condition 13 of License No. 37 19159-01 requires that sealed source:, containing byproduct material be tested for leakage and/or contamination at intervals not to exceed six months. Contrary to the above, on several occasions, the tests f or leakage of the sealed sources were done at intervals that exceeded six months. Specifically, source No. 10057 was tested on March 4, 1986, October 23, 1986, September 21, 1987, and June 23, 1988, and source No. 12297 was tested on October 26, 1987 and May 20, 1988, all of which were intervals greater than six months. E. Condition 15 of License No. 37-19159-01 requires that a physical inventory be conducted every 6 months to account for all devices received and possessed under the license, and records of the inventories be maintained for two' years from the date of each inventory. Contrary to the above, as of November 29, 1988, the physical inventories conducted of the sealed sources did not include sources utilized from the Philadelphia Office, and records of the inver, tories that were performed were not maintained for any of the licensee's business locations. These violations have been categorized in the aggregate as a Severity Level III Violation. (Supplements IV, V, and VI) Cumulative Civil Penalty-$500 (assessed equally among the violations.) NUREG-0940 II.A-165
Notice of Violation 3 p
.Pursuantj to the provisions 'of- 10 CFR 2.201, Urban Engineers, Inc. (Licensee) is hereby required.to submitia written statement or explanation to the :
Director, Office.of Enforcement,'U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice. This reply should be clearly marked as a E " Reply to a Notice of Violation" and should include for each alleged violation: (1) admission.or denial of the alleged violation, (2) the reasons for the
~ violation if admitted, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps that will be.taken to avoid further violations', and (5) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. . Consideration may be given to extending the response time for good.
cause shown. Under the authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be submitted under oath or affirmation.
.Within the same time as provided for the n sponse required above under 10 CFR 2.201, the' Licensee may pay the civil penalty by letter to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a check, draft, or .
money order payable to the Treasurer of the United States in the amount of the civil penalty proposed above, or the cumulative amount of the civil penalties 1 if more than.one civil penalty is proposed, or may protest imposition of the '
. civil penalty in whole or in part by a written answer addressed to the
. Director, Office of Enforcement, Nuclear Regulatory Commission. .Should the Licensee fail to answer within the time specified, an order imposing the civil penalty will be issued. Should the Licensee elect to' file an answer in accordance with 10 CFR 2.205 protesting the' civil penalty, in whole or in part, such answer should be clearly marked as an " Answer to a Notice of Violation" and may: (1) deny the violations listed in this Notice in whole or in part,
.(2); demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other' reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation of the penalty. a In requesting mitigation of the proposed penalty, the six factors addressed in !
Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer in accordynce with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g. citing page and paragraph numbers) to avoid repetition. The attention of the Licensee is directed to the other provisions of 10 CFR 2.205, regarding the procedure for imposing a civil penalty. Upon failure to pay any civil penalty due which subsequently has been deter- i mined in accordance with the applicable provisions of 10 CFR 2.205, this matter ! may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c. NUREG-0940 II.A-166 = _ _ _ - _ _ _ _ _ .
9 ,' ; ? i Notice.of Violation 4 The responses to the Director, Office of Enforcement, noted above (Reply to a Not_ ice of, Violation, letter with payment of tivil penalty, and Answer. to a Notice of.. Violation) should be addressed to: Director, Office of Enforcement, U.S.-' Nuclear Regulatory _ Commission, ATTN: Document Control Desk, Washington, D.C. - 20555 with a copy to the Regional Administrator, U.S. _ Nuclear Regulatory _ Commission, Region I, 475 Allendale Road, King of Prussia, Pennsylvania 19406. FOR THE NUCLEAR REGULATORY COMMISSION h h'n=1AA William T. Russell Regional Administrator
' Dated at King of Prussia.. Pennsylvania this 2 7 day N of. December.1988 l
NUREG-0940 11.A-167
[" e- ""*'$*', UNITED STATES {* . }*I NUCLEAR REGULATORY COMMISSION j WASHINGTON, D. C. 20555 e
'S9 ,o FEB 2 : SS8 W
Docket No. 030-01391 License No. 12-01087-07 EA 88-42 istration VeteransAdm4n,Jr.MedicalCenter Edward Hines. ATTN: Mr. John Fears 1 Director Hines, IL 60141 Gentlemen:
SUBJECT:
ORDER TO SHOW CAUSE WHY LICENSE SHOULD NOT BE MODIFIED, EFFECTIVE IMMEDIATELY Enclosed is an Order to Show Cause why your license should not be modified to control the involvement of Mr. Mark Niemiro in uses of materials authorized under your license. We met with you regarding this matter in an Enforcement Conference on January 27. 1988. As you are aware, resolving the issue of Mr. Niemiro does not resolve NRC's regulatory concerns at your facility. We expect that ycu will centinue to provide the strong management oversight of your radiation safety program as you described to our Region III staff in the meeting of February 2, 1988 at the Regioral Office, and to improve the management atmosphere, communications and conduct of licensed activities at the facility. If you desire, the NRC will meet with you to discuss these matters further. In accordance with 10 CFR 2.700 of the NRC's " Rules of Practice," Part 2, Title 10 Code of Federal Regulations, a copy of this letter and the l enclosed Order will be placed in the NRC's Public Document Room. Sincerely,
/
[ O-
, y mes M. Ta r. Deputy Executive Director for Regional Operations Enclosure. Order to Show Cause Why License Should Not Be Modified Effective Immediately cc w/ enclosure:
Mr. Mark Niemiro, Edward Hines, Jr. Medical Center State of Illinois ) Veterans Administration Washington, DC CERTIFIED MAIL Rt.IURN klaiPT REQUESTED l NUREG-0940 II.A-168
- w y
UNITED. STATES NUCLEAR REGULATORY COMMISSICN 4 In the Matter of- '
).
4
.. .. . . , )
VETERANS ADMINISTRATION ) Docket No. 030-01391 EDWARD HINES, JR. MEDICAL CENTER ). . License No. 12-01087 : Hines,.IL 60141- ) EA 88-42
)
ORDER TO SHOW CAUSE WHY LICENSE SHOULD NOT BE MODIFIED, EFFECTIVE IMMEDIATELY I
- Edward Hines, Jr. Medical Center (Veterans Administration), Hines, Illinois, (licensee /VA Hines)-is the holder of specific byproduct material license of broad scope No. 12-01087-07-(the license) issued by the Nuclear Regulatory Commission'(Commission /hRC) pursuant to 10 CFR Parts 30, 33 and 35. The license authorizes the licensee to use: (1) byproduc.t material listed in Groups I through VI'of Schedule A, 10 CFR 35.100 (ur. der the new revised 10 CFR Part 35 this material is identified in Subparts D, E, F,'and G) for diagnostic and therapeutic procedures; (2) any byproduct material between Atomic Nos. 'l and 83, inclusive, and (3) xeron-133.for blood flow and pulmonary function studies. The license was originally issued on October 15, 1958, was most recently renewed on September 24, 1985, and expires en September 30, 1990. q II q
.From December 16, 1986 through January 22, 1987, and February 10 through November 4, 1987, NRC inspections and investigations here conducted at VA Hines. As a result of those inspections and investigations, it appears that 1 the following occurred:
NUREG-0940 II.A-169
A. On August 14, 1986, Regien III received an anonymous allegation that three diagnostic misadministration occurred at VA Hines during the week of August a-8, 1986, and those misedministrations were not reported to the NRCasrequiredby10CFR35.43.2/ It was further alleged that Dr. Maynard L. Freeman, Assistant Chief, Nuclear Medicine Service, VA Hines, was notified of the three misedministrations by the Acting Chief Technologist for that week (the Assistant Chief Technologist), but took no action to ensure that those ents were reported. The hRC subsequently verified that these misa/ ministrations did occur. On August 24, 1987, an ORDER TO SHOW CAUSE WHY : CENSE SHOULD NOT BE MODIFIED, EFFECTIVE IMMEDIATELY was issued which, among other actions, renoved Dr. Freeman's authority to use or supervise the use of licensed materials at VA Hines due to his involve-ment in those events. A hearing is pending on the removal of Dr. Freeman. B. On October 29, 1986, the Director, VA Hines, ordered an investigation into the three alleged unreported misadministration. Regarding the first alleged misadministration, the V.A. Investigatory Board concluded on December 1, 1986, that the evert did not involve a misadministration. That conclusion was based, in part, on statements of Mr. Niemiro, the nuclear medicine technologist involved in the alleged misadministration. Regarding the first alleged misadministration, Mr. Niemiro informed the Board that Dr. Freeman gave him verbal instructions to perform a brain scan instead of a bone scan as indicated on the written order for that 2 The Commission's regulations have since been revised. The requirements for reporting mistcainistrations are presently set forth in 10 CFR 35.33. NUREG-0940 II.A-170
l l l l patient. Mr. Niemiro further advised the Boara that he properly j administered the br.ain scan as directed and nothing unusual, including f a misadministration, occurred during the test. l i C. From December 16, 1986, through January 22, 1987, NRC Region III conducted an inspection into the circumstances surrounding the three alleged ! unreported misadministration. Regarding the first alleged misadministra-tion, the NRC inspectors concluded that a misadministration could not be substantiated due to conflicting statements provided by the involved individuals. Mr. Niemiro stated to the NRC inspectors that: (1) Dr. Freeman verbally instructed him to perforn a brain scan on the patient; l l (2) he performed a brair scan on the patient; and (3) he did not give two injections of any type of material to the patiert. D. From February 10 through November 4, 1987, the NRC Office of Investigations conducted an investigation into the circumstances surrounding the three alleged unreported misadministration. Regarding the first misadminis- k l tration, the NRC investigation concluded that, on August 4, 1986, Mr. Niemiro was directly involved in the injection of a patient who was q I scheduled for a bone scan but received a brain scanning agent. Without further consultation with an authorized user, Mr. Niemiro subsequently injected the patient with a bone scanning agent. E. Mr. Niemiro testified under oath that be injected a brain scanning agent by mistake and, when he realized that a mistake had been made, he panicked l and injected a bone scanning agent to cover up the mistake. In addition, Mr. Niemiro testified that he had never been instructed by Dr. Freeman to NUREG-0940 II.A-171
a I i l
)
perform a-brain' scan'rather than a bone' scan. The' brain scanning material
. dose calibration ticket'is missing, and Mr. Niemiro testified that he may have discarded that dose calibration ticket because he knew that a nistake i had been made and he did.not want the ticket in the file. Further, l
j Mr. Niemiro testified that he falsely stated to the V.A.' Investigatory ! Board and to NRC inspectors that he remembered Dr. Freeman telling him to I inject a. brain scanning agent because Dr. Freeman stated to the Chief of the' Nuclear Medicine Department in Mr. Niemiro's presence that he had 'l given such an instruction, and Mr. Niemiro-feared contradicting Dr. Freeman. Thus, regarding the first misadministration, it appears that Mr. Niemiro, the involved nuclear medicine technologist: (1) in an effort to mask the prior injection of an NRC licensed nuclear scanning agent, injected a second NRC licensed nuclear scanning agent withcut consulting an authorized user contrary to VA Fines License Condition Nos. 12A and 20; (2) discarded records l reflecting injection of one of the scanning agents; and (3) falsely
' represented the facts surrounding the misadministration to the NRC inspectors d and a VA Hines Investigatory Board. l r
4 III Although the actions that are described in Section II occurred some time ago, upon further review, the actions of Mr. Niemiro demonstrate there is no lcnce reasonable assurance that without additional oversight he can be relied on to comply with Commission requirements concerning the use of licensed materials and to be cendid with the Comission. i NUREG-0940 I'I.A-172 l ___-_________a
Licensees must adhere strictly to radiation safety requirements so that the medical use of NRC-licensed material does not create a radiation hazard to workers and members of the public. The proper and competent performance of licensee employees is essential to ensuring the safe conduct of licensed activities. The NRC in its investigation and inspection process must be able to obtain complete and accurate information from licensee employees in order to carry out NRC's statutory mission. Therefore, the public health, safety, and interest require that License No. 12-01087-07 be mcdified to prohibit the involvement of Mr. Niemiro in licensed activities without further centrol. Furthermore, I have determined pursuant to 10 CFR 2.201(c) that no prior notice is required and pursuant to 10 CFR 2.202(f) that the public health, safety and interest require that this Order should be immediately effective. IV Accordingly, pursuant to Sections 81, 161b, 1611, 1610, 182, and 186 of the Atomic Energy Act of 1954, as amended, and the Commission's regulations in 10 CFR 2.202 and 10 CFR Parts 30 and 35, IT IS HEREBY ORDERED, EFFECTIVE IMMEDIATELY THAT: License No. 12-01087-07 is modified by adding the following conditions: A. Mr. Mark Niemiro may only engage in activities involving the administration of NRC licensed material to humans so long as, prior to the administration, another nuclear medicine techno1cgist or authorized user verifies in writing: NUREG-0940 II.A-173
- 1. that the patient is the incividual for whom the dosage is prescribed;
- 2. that it is the prescribed phannaceutical; and
- 3. that the dosage of the pharmaceutical is properly measured !
and complies with the prescription within hospital measurement . error < limits. i The documentation of the verification shall include the date of each item that was verified and the signature of the person making the verification. If the verification is'nct contained on the standard hospital forms associated with the administration, the documentation of the verifications shall be retained as long as this requirement remains in effect. B. VA Hines shall provide a written report to the NRC Regional Administrator, Region III, certifying that the verificatiers have been performed and describing Mr. Niemiro's performance as L it involves administration of radiepharmaceuticals and other radiological safety activities. The first report is to be provided within 30-days of the date of this Order and bimenthly thereafter. 1 il l l C. Following the submission of the sixth report required by condition j B, above, the licensee may request in writing, including reasons ! i therefore, removal of conditions A and B above. NUREG-0940 II.A-174 L_ _ _. __
D. The Regional Administrator, Region III, may relax or terminete the above conditions in writing for good cause. V The licensee or Mr. Niemiro may show cause why thfs Order should not have been issued and should be vacated by filing a written answer under oath or affirma-tion within 30 days of the date of this Order which seis forth the matters of fact and law on which the licensee or Mr. Niemiro relies. The licensee or Mr. Niemiro may answer as provided in 10 CFR 2.202(d) by consenting to this Order. If the licensee fails to answer within the specified time or consents to this Order, this Order shall be final unless Mr. Niemiro shows cause why the Order should not have been issued or requests a hearing. VI The licensee, Mr. Niemiro, or any other person adversely affected by this l Order may request a hearing within 30 days after issuance of this Order. Any answer to this Order or any request for hearing shall be submitted to the Director, Office of Enforcement, U.S. Nuclear Regulatory Comissicn, Washingter., DC 20555. Copies shall also be sent to the Assistant General Counsel for Enforcement at the same address and to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region III, 799 Roosevelt Road, Glen Ellyn. Illinois 60137. If a person other than the licensee or Mr. Niemiro requests a hearing, that person shall set forth with particularity the manner in which the petitioner's interest is adversely affected by the Order and should address the criteria set forth in 10 CFR 2.714(d). Upon the failure of the NUREG-0940 II.A-175
[, , , 't-1 L f: L l licensee. Mr. Niemiro or any other person aNersely affected by this Order to answer or-request a hearing within the specified time, this Order shall be final without further proceedings. AN ANSWER TO THIS ORDER OR A REOUEST FOR HEARING SHALL NOT STAY THE IMMEDIATE EFFECTIVENESS OF THIS ORDER. If a hearing is requested, the Comission will issue an order. designating the time and place of any hearing. If a hearing is held, the issue to be considered at the hearing shall be whether this Order should be sustained. FOR THE NUCLEAR REGULATORY COMMISSION
/ _
J es M. uty Executive Director-for Regional Operations Dated at Bethesda, Maryland, this 25thday of February 1988 i NUREG-0940 II.A-176
' ~
' ~ - ~ - ~ ~
pt PRjf ; .
; ,y , ,-.t. ,
a 'l [L$ i ' s
- y. 4 UNITED STATES -
p' j ,
;, NUCLEAR REGULATORY COMMISSION t -U ti ! - WASHINGTON, D. C. 20066 I
**N gg 3 41987 :
'd; ' Docket NS T30-14697
-License No. 35-18229-01.
'EA No. 87 Well Logging, Inc.-
ATTN: Mr..Rell:Schwab-Post Office Box 506 Nowata, Oklahoma. 74048 Gentlemen:. 4
SUBJECT:
CONFIRMATORY ORDER MODIFYING LICENSE AND NOTICE OF VIOLATION (NRC INSPECTION REPORT NO. 30-14697/87-01)
- ; This refers to the inspection conducted on May 14, 1987, at the Well Logging, Inc. facility in Nowata, Oklahoma. .A routine unannounced radiation safety inspection by Mr. Larry Ricketson'of the activities authorized by NRC Materials
. License 35-18229-01 discovered violations which collectively de.nonstrate a significant breakdown in management oversight and control of the Licensee's-
. radiation safety program.. During an enforcement conference conducted on-June 12, 1987, in Region IV offices the findings of the NRC inspection were
. discussed with~you. At that time, you submitted for consideration correcti/a actions taken and planned to preclude future recurrence. ,
'As a result of our inspection, eleven violations of NRC requirements have been
' identified. The violations include: .(1)' failure to survey storage locations, (2) failure to survey job sites, (3' failure to survey transportation. vehicles, (4) failure to maintain records of W 11zation of licensed material (5) use of a survey instrument not in calibration, (6) unauthorized use of licensed .
. material. (7). failure to leak test sealed sources at the required interval, 1
- (8) failure.to maintain complete. records of personnel monitoring results, l (9) failure to material,'(10) properly label containers used to transport radioactive failure to maintain documentation showing the results of special I form materials testing, and (11) failure to perform physical inventories.. l Please note that after discussion with you at the enforcement conference, the first.three violations listed above rega'rding f611ure to conduct surveys have 1
replaced the first two apparent violations rioted in the inspection report regarding failure to maintain records of surveys. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions,' 10 CFR Part 2 A.ppendix C (1987), the violations described in the enclosed Notice have been classified in the aggregate at a Severity Level III. . A civil penalty is considered for a Severity Level III i violation. - However, I have decided that a civil penalty will not be proposed in this case because of'your prior performance and extensive corrective actions. You have conrnitted to hirt a consultant to perform audits of your operations, , review procedures and license requirements, develop management controls i to ensure compliance with'11m nse requirements, provide on-the-job training, and prepare written reports to be submitted to the NRC. CERTIFIED MAIL RETURN RECEIPT REQUESTED NUREG-0940 II.A-177
1
?Well Logging, Inc. i In the interest of the public health and safety and to ensure continued 1
implementation of your corrective actions, I have determined that your comitment to implement certain actions should be confirmed by the enclosed Order.. We will review the findings of the consultant and the effectiveness of the it.plemented actions during subsequent inspections. s You are required to respond to this letter and should follow the instructions ' specified in the enclosed Notice when preparing your response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewing your response to this Notice, including your proposed corrective actions and the results of future inspections, the NRC will determine whether further.NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. In accordance with Section 2.790 of the NRC's " Rules of Practice," Part 2, Title 10, Code of Federal Regulations,-a copy of this letter and its enclosure will be placed in the NRC Public Document Room. The responses directed by this letter and the enclosed Order and Notice are'not
' subject to the clearance procedures of the Office of Management and Budget as .
required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. i Sincerely,
/
J mes M. Tay1 eputy Executive Director for Regional Operations
Enclosures:
- 1. Confirmatory Order Modifying License
- 2. Notice of Violation l!
cc: Oklahoma Radiation Control Program Director ! I i NUREG-0940 II.A-178
UNITED STATES NUCLEAR REGULATORY COMMISSION IN THE MATTER OF; )- Well Logging, Inc. ) Docket No. 30-14697 P. O. Box 506 ) License No. 35-18229-01 i Nowata, Oklahoma 74048
) EA 87-99 CONFIRMATORY ORDER MODIFYING LICENSE I- !
Well Logging, Inc. (Licensee) holds Byproduct Material License No. 35-18229-01, which authorizes the Licensee to possess and use sealed sources for down-hole ! logging. The license was issued on June 18, 1985. I l II On May 14, 1987, a routine unannounced radiation safety inspection was conducted of the Licensee's facilities. As a result of the inspection, eleven violations of NRC requirements have been identified. The violations include: (a) failure to survey storage locations, (b) failure to survey job sites, (c) failure to survey transportation vehicles, (d) failure to maintain records of utilization of licensed material. (e) use of a survey instrument not in calibration, (f) unauthorized use of radioactive material (g) failure to leak ' test sealed sources at the required interval, (h) failure to maintain complete records of personnel monitoring results, (i) failure to properly label containers used to transport radioactive materials (j) failure to maintain documentation showing the results of special form material testing, and (k) failure to perform physical inventories. The NRC is concerned that the circumstances surrounding the above violations collectively reflect a significant breakdown in management oversight and inadequate control over the safe use of licensed material. On June 19, 1987, Region IV issued a Confirmation of Action Letter documenting the Licensee's corritments to retain NUREG-0940 II.A-179
a consultant to: audit the Licensee's operations, review procedures, reexamine license requirements, develop :nanagement controls, and provide additional on-the-job training for those individuals using licensed material. The consultant shall further conduct a follow-up audit within 6 months of the initial audit with the report findings forwarded to NRC Region IV. In addition, the Licensee agreed to maintain the sealed sources in secure storage until the license is amended authorizing a designated user. Because of the importance of these comitments to the safe and appropriate use of licensed material, I have determined that the public health and safety require that the Licensee's comitments should be confirmed by an immediately effective Order. III In view of the foregoing and pursuant to Sections 81, 161b, 1611, and 161o of the Atomic Energy Act of 1954, as amended (Act), and the Comission's regulations in 10 CFR 2.204 and Part 30, IT IS HEREBY ORDERED THAT:
- 1. The Licensee shall obtain the services of a consultant who is trained and experienced in the radiation protection aspects of sealed source use in l oil / gas wells. The Licensee shall submit the name and qualifications of 1
l the cons 01 tant to the Regico IV office and the date of first visit to the Licensee's facility within one month of receipt of this letter.
- 2. The Licensee shall engage this consultant to audit operations, review procedures and license requirements, develop management controls to ensure NUREG-0940 II.A-180
compliance with license requirements, and prepare a report of findings, which the Licensee will forward to NRC Region IV within 20 days of the completion of the audit.
- 3. The Licensee shall engage this consultant to provide additional on-the-job training for any individuals who will use licensed material during oil or gas well logging techniques under field conditions. This training will include source handling and survey techniques under field conditions.
- 4. The Licensee shall engage this consultant to perform a follow up audit within 6 months of the first audit and report those findings to NRC Region IV within 20 days of the completion of the audit. The consultant would be expected to state that operations are in compliance with NRC requirements, personnel have been adequately trained, and management controls are in place.
- 5. The Licensee shall keep thr scaled sources in secure storage until the license is amended authorizing a designated user of licensed material.
The Regional Administrator, Region IV, or his designee may relax or rescind any of the above provisions after a period of one year and upon demonstration by the licensee of good caere shown and petition fcr amendment to the license. l The licensee or any other person adversely affected by this Order may request a l hearing within 20 days of the date of this Order. A request for a hearing l l NUREG-0940 II.A-181 1
g 1 n l ( ,
.4 hl:
-should be clearly marked as n'" Request for an Enforcement Hearing" and shall be-addressed to the Director, Office of Enforcement, U. S. Nuclear Regulatory Commission -ATTN:' Document Control Desk, Washington, D. C. 20555, with a copy y ,
[ to' the Regional Administrator U. S. Nuclear Regulatory Commission, Region IV. l If a. person other than the. licensee requests a hearing, that person'shall set ; forth with.' particularity the manner in which the petitioner's inte. rest is .l adversely affected by this Order and should address the criteria set forth in 10 CFR 2.714(d). A REQUEST FOR HEARING SHALL NOT STAY THE It94EDIATE 'j EFFECTIVENESS OF THIS ORDER.
.I l
)
' If a hearing is requested by the Licensee or any person who has an interest' adversely affected by this Order, the Commission will issue an Order ;
I designating the time and place of any such hearing. If a hearing is held, the j l issues to be considered at such hearing shall be whether this Orc!er should be j i
< sustained. -
FOR THE NUCLEAR REGULATORY COMMISSION
\ g^ l e as M. Taylor -Deputy Executive Director or Regional Operations Dated at Bethesda, Maryland, this p ay of August 1987.
I NUREG-0940 II.A-182
l I NOTICE OF VIOLATION Well Logging, Inc. Docket No. 30-14697 Post Office Box 506 License No. 35-18229-01 Nowata, Oklahoma 74048 EA 87-99 During an NRC inspection conducted on May 14, 1987, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2. Appendix C (1987), the violations are listed below: A. License Condition 18 requires, in part, the Licensee to use the licensed material in accordance with the Licensee's license application dated 1 July 27, 1978, and letter dated May 28, 1985. l
- 1. A section of the appli:ation entitled " Radiation Surveys" of the i licensee's " Operating Instructions and Emergency Procedures Manual" l submitted wit) the application letter dated May 28, 1985 requires ,
the Licensee to conduct monthly radiation surveys of storage l facilities, to conduct radiation surveys of job sites, and to ; conduct radiation surveys of vehicles used to transport licensed ! material when in use or on a monthly basis when not being used. I 1 (a) Contrary to the above, radiation surveys were not performed at ! storage facilities from July 1982 to the date of the inspection. (b) Contrary to the above, radiation surveys of job sites were not ! performed from November 16, 1981 to the date of the inspection. l (c) Contrary to the above, radiation surveys were not performed on l the vehicle used to trensport licensed material from November 16, l 1981 to the date of the inspection. , l
- 2. Iten 11 of the license application dated July 27, 1978 requires that survey meters be calibrated at approximately 6-month intervals.
Contrary to the above, the Licensee's survey instrument, which had been used during the period of January to September 1986, had not been calibrated within a 6-month period prior to its use.
- 3. Procedure G, " Records Management," of the application letter requires that records of utilization of licensed materials be maintained.
Contrary to the above, licensed material was utilized from November 16, 1981 to the date of the inspection, but no records were maintained. B. License Condition 12 requires that licensed mate *ial shall be used by er under the supervision of and in the physical presence of either of two specifically named individuals. Contrary to the above, licensed material had been used by an individual not named on the license without the supervision or physical presence of either named individual. NUREG-0940 II A-183
Notice of Violation C. License Condition 13 rcquires the Licensee to perform leak testing of sealed sources at intervals not to exceed every 6 months. Contrary to the above, sealed sources (numbers 71-1-446B and 71-1-255G) had not been tested for leakage between Ji.nuary 20, 1984 and October 22, 1985, and between October 22, 1985 and October 20, 1986, i D. 10 CFR 20.401(a) requires the Licensee to maintain records of personnel monitoring. Also, License Condition 18 requires that the Licensee use licensed material in accordance with the Licensee's application letter of May 28, 1985. Procedure E, " Personnel Monitoring Procedures," of the application letter requires the Licensee to maintain such records until their disposal is authorized by the NRC. Contrary to the above, personnel monitoring records were not available I for the seriods from April 15 to June 14, 1966, July 15 to August 14, 1986, and Octo>er 15 to December 14, 1986. E. License Condition 17 requires the Licensee to transport licensed material in accordance with the provisions of 10 CFR Part 71 10 CFR 71.5(a) requires the Licensee to comply with the applicable requirements of Department of Transportation in 49 CFR Parts 170-189.
- 1. 49 CFR 172.403 requires that transportation containers for radioactive materials be properly labeled.
Contrary to the above, on May 14, 1987, transportation containers for radioactive materials were not labeled.
- 2. 49 CFR 173.469 requires that documentation verify special form materials possessed by the licensee meet specified test requirements.
Contrary to the above, on May 14, 1987, the NRC inspector found that the Licensee had no documentation verifying that special form materials meet these specified test requirements. F. License Condition 16 requires that the Licensee conduct a physical inventory every 6 months to account for all sealed sources received and possessed under the license. Contrary to the above, no inventories had been conducted frnm August 1905 to the date of the inspection. Collectively the above violations have been categorized in the a as a Severity Level III problem (Supplement V and Supplement VI)ggregate Pursuant to the provisions of 10 CFR 2.201, Well Logging, Inc. is hereby required to submit a written statement or explanation to the U.S. Nuclear Regulatory Commission, ATTN: Document Control Dcsk, Washington, D.C. P0555 with a copy to the Regional M:ninistrator, Region IV, within 30 days of the date of the letter transmitting this Notice. This reply, should be clearly NUREG-0940 II.A-184
I I Notice of_Yiolation ) marked as a " Reply to a Notice of Violation" and should include for each
-violation: (1) the reason for the violation if admitted. (2) the corrective i steps that have been taken and the results achieved, (3) the corrective steps that will be taken to avoid further violations, and (4) the date when full compliance will be achieved. If an adequate reply is not received within the time specified in this Notice, an order may be issued to show cause why the license should not be modified, suspended, or revoked or why such other action i as may be proper should not be taken. Where good cause is shown, consideration l will be given to extending the responsc time. 1 1
FOR THE NUCLEAR REGULATORY COMMISSION
/
bWV nes M. Tayl#8, Deputy Executive Director
/Jfor Regional Operations Dated a Bethesda, Maryland, this ay of August 1987.
NUREG-0940 II.A-185
k UNITED STATES
/go.m at%
f ' .c (
/ i NUCLEAR REGULATORY COMMISslON REGION H
$ J '. ' l j 101 MAR!ETTA STREET N W.
g fe ye ATL ANT A, GEORGI A 30323
% . . .' .4 / .
rea ei inse i Docket No. 030-20233 I License No. 47-23066-02 I EA 88-297 West Virginia University Hospitals, Inc. ATTN: Mr. Bernard G. Westfall President Medical Center Box 6401 Morgantown, West Virginia 26506-6401 Gentlemen: 1
SUBJECT:
NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY l (NRC INSPECTION REPORT NO. 47-23066-02/88-01) This refers to the Nuclear Regulatory Comission (NRC) inspection conducted by L. Franklin at_Morgantown, West Virginia, on November 15-16, 1988. The inspec-tion included a review of the circumstances surrounding the loss of licensed material at the conclusion of a brachytherapy treatment. The report documenting this inspection was sent to you by letter dated December 7,1988. As a result of this inspection, significant failures to comply with NRC regulatory require-ments were identified, and accordingly, NRC concerns. relative to the inspection findings were discussed in an Enforcement Conference held on December 13, 1988. The letter summarizing this Conference was sent to you on December 15, 1988. These violations described in the enclosed Notice of Violation and Proposed Imposition of Civil Penalty involved a failure to control licensed material, a failure to inventory radioactive sources after return to the vault, a failure to notify the Commission in a timely manner regarding the loss of licensed material, and the failure to wear the proper dosimetry during the handling of sources. During a brachytherapy treatment on September 11, 1988, the medical physicist representing the Radiological Safety Department failed to fnllow established procedures which resulted in the loss of licensed material. This loss. occurred during transport of licensed material to a designated storace area. In addition, this representative failed to perform a required inventery at the storage location. The loss of material occurred on September 11, 10P8, was not discoverad by the licensee until October 18, 1988, and was not reported ,
'to the NRC until October 28, 1088. '
To emphasize the need for effective control of radioactive material, I havo been authorized, after cons 91tation with the Director, Office of Enforcement, and the Deputy Executive Director for Regional Operations, to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in *% amount of Two Thousand Five Hundred Dollars ($2,500) for the violations described in the enclosed Notice, in accordance with the " General Staterar' of Policy and Procedure for NRC Enforcement Actions," 10 CFR Part 2, Append < C NUREG-0940 II.A-186
West Virginia University FEB 011923 Hospital, Inc. (1988) (Enforcement Policy), the violations described in the enclosed Notice have been categorized in the aggregate as a Severity Level III problem (Supple-ment VI). The base value of a civil penalty for a Severity Level III violation is $2500. The escalation and mitigation factors in the Enforcement Policy were considered, and oc adjectment ne: been deemed appropriate. Although mitigation was warranted for your prior good performance, it was offset by the significance attributable to the duration of the violation. Specifically, the loss of the sources was not detected for approximately five weeks because of the failure to perform a required inventory. Additionally, there was also the delay in reporting the loss to the NRC once it was detected. You are required to respond to this letter and the enclosed O . ice and should follow the instructions specified therein when preparing ycur response. In your response, you should document the specific actions taken and any additional actions you plan to prevent recurrence. After reviewina your response to this Notice, including your proposed corrective actions anc ne results of future inspections, the NRC will determine whether further NRC enforcement action is necessary to ensure compliance with NRC regulatory requirements. The responses directed by this letter and its enclosure are not subject to the clearance procedures of the Office of Management and Budget as required by the Paperwork Reduction Act of 1980, Pub. L. No. 96-511. Should you have any questions concerning this letter, please contact us. Sincerely,
.~ - -n , ;3* . . . . _
Malco-im L. Ernst Acting Regional Administrator
Enclosure:
Notice of Violation and Proposed Imposition of Civil Penalty cc w/ encl: State of West Virginia NUREG-0940 II.A-187
V NOTICE OF VIOLATION j AND i PROPOSED IMPOSITIDN OF CIVIL PENALTY i I West Virginia University Hospitals, Inc. Docket No. 030-20233 iorgantown, West Virginia license No. 47-23066-02 , EA 88-297 During the Nuclear Regulatory Commission (NRC) inspettion conducted on November 15-16, 1988, violations of NRC requirements were identified. In accordance with the " General Statement of Policy and Procedure for NRC Enforce- l ment Actions," 10 CFR Part 2, Appendix C (1988), the Nuclear Regulatory Commis-sion proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below: A. 10 CFR 20.207(b) requires that licensed material in an unrestricted area and not.in storage shall be tended under the constant surveillance and immediate control of the. licensee. Contrary to the above, on September 11, 1988, the licensee transported Iridium-192 brachytherapy sources from a patient's room through the unrestricted areas of the hospital to the storage area and did not maintain constant surveillance or control during the transport. This resulted in the loss of one nylon ribbon containing six 1 millicurie sources of Iridium-192. B. 10 CFR 35.406(a) requires that promptly after removing them from a patient, the licensee shall return the brachytherapy sources to the storage area, and count the number returned to ensure that all sources taken from the storage area have been returned. Contrary to the above, on September 11, 1988, after removing the sources from the patient, the licensee returned brachytherapy sources to the storage area and failed to make the required count. C. License Condition 21 requires the licensee to conduct its program in accordance with the statements, representations, and procedures contained in the documents, including enclosures, referenced in the application dated May 22, 1984, the Radiation Safety Manual dated December 1981, and letter dated December 20, 1985.
- 1. The Radiation Safety Manual, Section 9.7.6, requires, when transporting radionuclides from one part of a building to another, the use of a tightly closed container.
Contrary to the above, on September 11, 1988, a licensee representa-tive failed to use a tightly closed container, in that, he failed to place the lid on a transport pig prior to transporting Iridium-192 brachytherapy sources within the hospital. NUREG-0940 II.A-188
l Notice of Violation ,
\
2.. ' Item 20(d) of the letter dated December 20, 1985, requires that radiation exposure to.the-hands of.. persons handling brachytherapy ; sources be'obtained by the use of ring badges containing'thermo- l luminescent-dosimeters. Contrary to the abcve,' on September 9,1988, a physician handled brachytherapy sources without wearing. ring TLD badges. D. 10 CFR 20.402(a)(1) requires.that each licensee shall report to the, Commission, by telephone, immediately after it determines that a loss or theft of. licensed material has occurred in such quantities and under such
. circumstances that it appears to the-licensee that a substantial hazard- .
may result:to persons in unrestricted areas. l Contrary to the above,. the licensee failed to promptly report the loss of one' nylon ribbon containing six one-millicurie Iridium-192 sources. This
- loss occurred in such quantities and under such circumstances that it i was determined that the loss. presented a substantial hazard to persons .in .
unrestricted areas. The. loss occurred on September 11,.1988, the licensee !
- was aware of the loss on'0ctober 18, 1988, and did.not notify the Commission of the;1oss until October 28, 1988. !
' These violations have'been evaluated in the aggregate as a Severity' l Level . III -problem '(Supplement VI). l Cumulative civil penalty - $2,500 (assessed equally among the violations). ;
pursuant to the provisions of 10 CFR 2.201, West Virginia University Hospital, i Inc., is_ hereby required to submit a written statement or explanation to the ! Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 l days of.the date of this Notice. This reply should be clearly marked as a !
" Reply to a Notice of Violation" and should include for each violation: 1 (1) admission or denial of the violation, (2) the reasons for the violation if '
admitted, (3).the corrective steps that have been taken and the results achieved,
. (4) the corrective steps which will be taken to avoid further violations, and
. (5) the date when full compliance will be achieved. If an adequate reply is !
not received within the time specified in this Notice, an order may be issued i to show cause why the license should not be modified, suspended, or revoked or l why such other action as may be proper should not be taken. Consideration may l l- .be given to extending the response time for good cause shown.. Under the j L ' authority of Section 182 of the Act, 42 U.S.C. 2232, this response shall be i submitted under oath or affirmation. I Within the same. time as provided for the response required above under 10 CFR 2.201, the licensee may pay. the civil penalty by letter addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, with a i check, draft, or money order payable to the Treasurer of the United States in i the amount of the- civil penalty proposed above, or the cumulative amount the i civil penalties if more than one civil penalty is proposed, or may protest imposition of the civil penalty in whole or in part by a written answer addressef
' to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission.
NUREG-0940- 11.A-189 _ _ . _ = . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ - _ _ - _ _ _ _ _ _ _ _ ___
i 4 Notice of Violation Should the-licensee fa*1 to ar.swer within the time 'specified,- an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 ' protesting the civil penalty, in whole or in part, scch answer should be clearly marked as an " Answer to a Notice of Viola-tion" and may: (1) deny the violations listed in this Notice in whole or in - part, (2) demonstrate extenuating circumstances. (3) show error in-this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty, such answer may request remission or mitigation
- of the penalty.
In requesting mitigation of the proposed penalty, the five factors addressed in Section V.B of 10 CFR Part 2, Appendix C (1988), should be addressed. Any written answer.in accordance with 10 CFR 2.205 should be set'forth separately ) from the- statement .or explanation in reply pursuant to 10 CFR 2.201 but may ' incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the.Other provisions of 10.CFR 2.205 regarding the procedure'for imposing a civil penalty. Upon. failure to. pay the penalty due, which has been subsequently determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted,
- or mitigated, may be collected by civil action pursuant to Section.234c'of the. 3 Act, 42 U.S.C. 2282.
The responses to the Director, Office of Enforcement, poted above (Reply to a Notice of Violation, letter with payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555, with a copy to the Regional Administrator, Region II. COR THE NUCLEAR REGULATORY COMMISSION
.' W Palcolm L. Ernst s(
Ac'.ing Regional Administrator Dated at Atlanta, Georgia this and day of February 1989 NUREG-0940 II.A-190 i
NRC FO ,M 335 U.S. NUCLE AR REGULATORY COMMISSION 1. REPOR7 NUMBE R SYAuet' UT,04"dfdgs%,$"I""- '
- m. 32w BIBLIOGRAPHIC DATA SHEET is,, ,meruc,,o= o,, re, ,,,m,; NUREG-0940
- 2. TOLE AND SUBTMLg Vol. 8, No. I Enforcement Actions: Significant Actions Resolved 3. DATE REPORT PUBLISHED uoNiw , tan
' Quarterly Progress Report June l1989 January - March 1989 .. ,,N OR GR ANT NuMsE R l i
- 5. AUTHOR (S) 6. T'rPE OF REPORT Office of Enforcement Staff-
- 7. PE R100 COv E R E D tincrus,ve 0,resi B. FORMi G RG NIZAT SON - N AME AND ADDR E SS ter Nnc. orowtor Onvoseen. Otr e ac or negron, v.s Nucent negulatory Commasoon. sadmentmo scoress. it contracnor. orovuov Office of Enforcement U.S. Nuclear Regulatory Commission Washington, D.C. 20555
- 9. ONS R G ORGANIZATION - NAME AND ADDRESS tor knc, tror 'some ns ern wiir ontractor.orovose c knC Divwon. Ortwo or nueson. uS Nuctw noeuterary commtunon.
Same as above
- 10. SUPP' EME NTARY NOTES
- 11. ABSTRACT (200weava or sus This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January - liarch 1989) and includes copies of letters, Hotices, and Orders sent by the Nuclear Regulatory Comission to licensees with respect to these enforcement actions. Also
' included are-a number of enforcement actions that had been previously resolved but not published in this NUREG. It is anticipated that the
-information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication.
1
- 12. K E Y WORDS/DE SCR PT ORS fust words or parenes sans .nu assese ,.w,,rner: #n socerme me nvoorv.s is avanasativ siaituihi j Unlimited 1 Technical Specifications, Radiographer. Quality Assurance, "'"'""'""'"'"""
Radiation Safety Program, Safety Evaluation (Thn Pagel Unclassified a rno, n.,,oro l Unclassified Ib. NUMBER OF PAGE S 16 PRICE NIC FORM 335 (2491 eg.5,couganau t pRIhrgn prr s cE ,19g g.241 99'l:00099
- 7. ,% $ $ $ mg g,g$ $ n$$ $ $
g g k . " 4(fjf ffW$Q&a Md% f 9%pr hk w~$$pp hk $,Mq&ng dME%k A a Lj QQf OM,,s,NN_a,w_y;_u$ 1 .n+w.p.4.% g N _gnQ_NM.g$ , % n s y w w_ w _a g g u ,e g.y eg_g!wwegmeg$pg;wymp%mywn , w_ygMMMp$fsd m , + g f n 'N 7 MMfS6sPW O Yh uw ff( g %
/n%yDM&sn shtm 9 4 [ M
%W4b D 3 % # %s 4 Q M h & @,&nw M 2f Y N fs % i N M M ym Apd W
# dpyppwn$&jsp &g M % &
A . 'Ssty afghd&&q:yGl1$@ky#sy@#Mw%iW"M;a e g 4 ~d GkWig# tM& VMf5 4 M AN;LRsa %M
$ #:WN$ir WMD "M %w Mygn u$/gw#+3 - , , !a$% 4g+ede @@@^@T@$n@wngWms wem q Aw r . -w w MO . WM "e%'w ,w.me% s hcow? ,W.p M6N?th1MwW Wh&J *M nc- b .
~~
s n arh' M ~ *. Mk h#g,#MMk t Meh & W H
- mh@%@hN@ev$$hhhkMsd,Y
? @d l@ $*[.5 hiwn
'&o Fmb wupo W 7:~w&w; w w<& '
e< ,; ., .e s a me'" ws : A,
#" e+:
4 w emQf . ~ 3em. h 'm' ' L , , . . . n Q < c. n '2
..->e , ,
~ \
. ~ n M %. :1 k, dAp$$,@pNy n
Ipi aw#5MJ%p%QC4 MMfb, gg7 ' n ' dl' *%iMDid 4-- k"dC ' ' 1
?
c, wMn i Sii s
! $ : 1. g
,,~ ' '
wkban hh avym???: kkh Yk ?k? , ha
$M t WX O?$fRWM 1 & [RdP $?N&WUW, 5 * ,
O fs; MR- un ',",: J Y
~
WA -* J
- d
, a y$h&$$?p(
N' h
, W
,h kEklh
^
,, I
.g g . % m . m hhkY
~
a
- f. '
YlQ R G M jf_ >
,w <
stMnk+ wims y ,y +> hh[y , <b ' ch mn g- vgp
. &asQ ;m.< :
8 s
+-
s y ;;
! ) ..,.,i ym.1 mms s Nd#
=-
~ ca w;3%
.= ' OpkW -w a.n
, m w -
. r; n c..
- s. = ,...}}