ML22195A194

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NRC 361N (New)(07-13-2022)
ML22195A194
Person / Time
Issue date: 07/13/2022
From: Bezakulu Alemu
Policy and Oversight Branch
To:
Alemu B
Shared Package
ML22189A141 List:
References
Download: ML22195A194 (2)


Text

Page of NRC FORM 361N (07-13-2022)

U.S. NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER NON-POWER REACTOR (NPR)

EVENT NOTIFICATION WORKSHEET APPROVED BY OMB: NO. 3150-0238 EXPIRES: 10/31/2022 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 Information Services Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0238), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

NRC FORM 361N (07-13-2022)

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 PHYSICAL SECURITY MATERIAL/EXPOSURE INFORMATION ONLY NNF OTHER UNSPECIFIED REQMT.

(see last column)

REPORTABLE CONDITION (Varies by facility TS)

TS Deviation ADEV TS Required S/D ASHU RPS Actuation (scram)

ARPS Offsite Notification APRE Degraded Condition ADEG Unanalyzed Condition AUNA Specified System Actuation AESF Safe S/D Capability AINA Control of Rad Release AINC Accident Mitigation AIND Offsite Medical AMED Loss Comm/Asmt/Response ACOM Invalid Specified System Actuation AINV SUSPICIOUS ACTIVITY SECURITY EVENT OTHER UNSPECIFIED REQUIREMENT (IDENTIFY)

NONR NONR 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 (07-13-2022)

U.S. NUCLEAR REGULATORY COMMISSION OPERATIONS CENTER NON-POWER REACTOR (NPR)

EVENT NOTIFICATION WORKSHEET (Continued)

NRC FORM 361N (07-13-2022)

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