ML22027A593
| ML22027A593 | |
| Person / Time | |
|---|---|
| Issue date: | 01/27/2022 |
| From: | Office of Nuclear Security and Incident Response |
| To: | |
| Cecere B | |
| Shared Package | |
| ML22005A062 | List: |
| References | |
| Download: ML22027A593 (2) | |
Text
Page of NRC FORM 361N (MM-YYYY)
U.S. NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER NON-POWER REACTOR (NPR)
EVENT NOTIFICATION WORKSHEET APPROVED BY OMB: NO. 3150-0238 EXPIRES: (MM/DD/YYYY)
Estimated burden per response to comply with this voluntary collection request: 30 minutes. The information provided will be used for evaluation of licensee event description, facility status and for input to the public website. Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0238), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; e-mail: oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.
NRC FORM 361N (MM-YYYY)
Continued on next page EN #
NRC OPERATIONS TELEPHONE NUMBERS: PRIMARY - 301-816-5100 or 800-532-3469, BACKUPS - [1st ] 301-951-0550 or 800-449-3694,
[2nd] 301-415-0550 and [3rd] 301-415-0553. Licensees who maintain their own ETS are provided these telephone numbers.
FAX - 301-816-5151, EMAIL - hoo.hoc@nrc.gov Notification Time Facility or Organization Name of Caller Call Back #
Event Time & Zone Event Date Power/Mode Before Power/Mode After Reactor Type Max Power Max Pulse Pulse Inserted During Event?
EVENT CLASSIFICATIONS GENERAL EMERGENCY GEN/AAEC SITE AREA EMERGENCY SIT/AAEC ALERT ALE/AAEC UNUSUAL EVENT UNU/AAEC SAFEGUARDS EVENT (73 App G)
MATERIAL/EXPOSURE INFORMATION ONLY NNF OTHER UNSPECIFIED REQMT.
(see last column)
REPORTABLE CONDITION (Varies by facility TS)
TS Deviation NPOW/ADEV TS Required S/D NPOW RPS Actuation (scram)
NPOW Offsite Notification NPOW Degraded Condition NPOW Unanalyzed Condition NPOW Specified System Actuation NPOW Safe S/D Capability NPOW Control of Rad Release NPOW Accident Mitigation NPOW Offsite Medical NPOW Loss Comm/Asmt/Response NPOW Invalid Specified System Actuation NPOW SUSPICIOUS ACTIVITY SECURITY EVENT OTHER UNSPECIFIED REQUIREMENT (IDENTIFY)
NPOW NPOW Description (Include: System affected, actuations and their initiating signals, causes, effect of event on plant, actions taken or planned, etc.) (Continue on Page 2)
NOTIFICATIONS YES NO WILL BE HQ NPR STAFF STATE(s)
LOCAL OTHER GOV AGENCIES Anything Unusual or not understood?
Yes (Explain above)
No Did all systems function as required?
Yes No (Explain above)
Mode of operation until corrected (if applicable)
Estimate for restart date:
Additional Information continued on next page?
Yes No MEDIA/PRESS RELEASE
Page of NRC FORM 361N (MM-YYYY)
U.S. NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER NON-POWER REACTOR (NPR)
EVENT NOTIFICATION WORKSHEET (Continued)
NRC FORM 361N (MM-YYYY)
EN #
RADIOLOGICAL / CHEMICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description)
Event Description (Include: Systems affected, actuations and their initiating signals, causes, effect of event on plant, actions taken or planned, etc.) (Continued from Page 1)
Liquid Release Gaseous Release Unplanned Release Planned Release Ongoing Terminated Monitored Unmonitored Offsite Release T.S. Exceeded RM Alarms Areas Evacuated Personnel Exposed or Contaminated Offsite Protection Actions Recommended
- State release path in description Release Rate (Ci/sec)
% T.S. Limit HOO Guide Total Activity (Ci)
% T.S. Limit HOO Guide Noble Gas 0.1 Ci/sec 1000 Ci Iodine 10 Ci/sec 0.01 Ci Particulate 1 Ci/sec 1 mCi Liquid (excluding tritium and dissolved noble gas) 10 Ci/min 0.1 Ci Liquid (tritium) 0.2 Ci/min 5 Ci TOTAL ACTIVITY List of Safety Related Equipment not Operational