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{{#Wiki_filter:Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION | {{#Wiki_filter:Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-XXXX EXPIRES: (MM/DD/YYYY) | ||
(MM-YYYY) OPERATIONS CENTER 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-2 F43), U.S. Nuclear Regulatory e-c'')R REGN% | |||
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-2 F43), 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-XXXX), Office of Management and Budget, Washington, DC 20503 lf 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. | NON-POWER REACTOR (NPR) Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov and to the Desk Officer, 5 EVENT NOTIFICATION Office of Information and Regulatory Affairs, NEOB-10202, (3150-XXXX), Office of Management and Budget, WM Washington, DC 20503 lf a means used to impose an information collection does not display a currently valid OMB 4°. VVORKSHEET control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information | ||
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. | ***** collection. | ||
FAX - 301-816-5151, EMAIL - hoo.hoc@nrc.gov Notification Time Facility or Organization Unit Name of Caller/Title Call Back # | EN # | ||
Event Time & Zone Event Date Power/Mode (At Time of Event) | NRC OPERATIONS TELEPHONE NUMBERS: PRIMARY - 301-816-5100 or 800-532-3469*, BACKUPS - [1st ] 301-951-0550 or 800-449-3694*, | ||
Power/Mode (At Time of Notification) | [2nd] 301-415-0550 and [3rd] 301-415-0553. *Licensees who maintain their own ETS are provided these telephone numbers. | ||
Reactor Type Max Power Max Pulse Pulse Inserted During Event EVENT CLASSIFICATION REPORTABLE CONDITION (varies by facility TS) | FAX - 301-816-5151, EMAIL - hoo.hoc@nrc.gov Notification Time Facility or Organization Unit Name of Caller/Title Call Back # | ||
Offsite Medical AMED GENERAL EMERGENCY GEN/AAEC TS Deviation ADEV Loss Comm/Asmt/Resp ACOM SITE AREA EMERGENCY SIT/AAEC TS Required S/D ASHU Invalid Specified System Act AINV ALERT ALE/AAEC RPS Actuation (scram) ARPS ]jjjjjjj | Event Time & Zone Event Date Power/Mode (At Time of Event) Power/Mode (At Time of Notification) | ||
Degraded Condition ADEG 111 MATERIAL/EXPOSURE B???? ]jjjjj Unanalyzed Condition AUNA INFORMATION ONLY NNF ]jjjjj Specified System Actuation AESF OTHER UNSPECIFIED REQMT (see last column) | Reactor Type Max Power Max Pulse Pulse Inserted During Event EVENT CLASSIFICATION REPORTABLE CONDITION (varies by facility TS) Offsite Medical AMED GENERAL EMERGENCY GEN/AAEC TS Deviation ADEV Loss Comm/Asmt/Resp ACOM SITE AREA EMERGENCY SIT/AAEC TS Required S/D ASHU Invalid Specified System Act AINV ALERT ALE/AAEC RPS Actuation (scram) ARPS Suspicious Activity | ||
Safe S/D Capability AINA OTHER UNSPECIFIED REQUIREMENT (IDENTIFY) | ]jjjjjjj UNUSUAL EVENT UNU/AAEC Offsite Notification APRE Security Event SAFEGUARDS EVENT (73 App G) Degraded Condition ADEG 111 MATERIAL/EXPOSURE B???? ]jjjjj Unanalyzed Condition AUNA INFORMATION ONLY NNF ]jjjjj Specified System Actuation AESF OTHER UNSPECIFIED REQMT (see last column) Safe S/D Capability AINA OTHER UNSPECIFIED REQUIREMENT (IDENTIFY) | ||
Control of Rad Release AINC NONR 1111 Accident Mitigation AIND NONR Event Description (Include: Systems affected, actuations and their initiating signals, causes, effect of event on plant, actions taken or planned, etc.) (Continue on Page 2) | Control of Rad Release AINC NONR 1111 Accident Mitigation AIND NONR Event Description (Include: Systems 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 NOTIFICATIONS YES NO BE Anything Unusual or not understood? Yes (Explain above) No HQ NPR STAFF Did all systems function as required? Yes No (Explain above) | ||
STATE(s) LOCAL ]jj Mode of operation until corrected (if applicable) | STATE(s) | ||
OTHER GOV AGENCIES | LOCAL ]jj Mode of operation until corrected (if applicable) | ||
]jj Estimate for restart date: | OTHER GOV AGENCIES ]jj Estimate for restart date: | ||
MEDIA/PRESS RELEASE jjjji] Additional Information continued on next page? Yes No NRC FORM 361N (MM-YYYY) Continued on next page Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION (MM-YYYY) OPERATIONS CENTER NON-POWER REACTOR (NPR) | MEDIA/PRESS RELEASE jjjji] Additional Information continued on next page? Yes No NRC FORM 361N (MM-YYYY) Continued on next page | ||
EVENT NOTIFICATION WORKSHEET (Continued) EN # RADIOLOGICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description) | |||
LJ Liquid Release LJ Gaseous Release I 1 Unplanned Release I I Planned Release LJ Ongoing Li Terminated I I Monitored Unmonitored H Offsite Release LI T.S. Exceeded LJ RM Alarms LI Areas Evacuated Personnel Exposed or Contaminated Offsite Protection Actions Recommended "State release path in description Release Rate (Ci/sec) | Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION (MM-YYYY) OPERATIONS CENTER NON-POWER REACTOR (NPR) | ||
% T.S. Limit HOO Guide Total Activity (Ci) | EVENT NOTIFICATION WORKSHEET (Continued) EN # | ||
% T.S. Limit HOO Guide Noble Gas 0.1 Ci/sec 1000 Ci iodine 10 pCi/sec 0.01 Ci Particulate 1 pCi/sec 1 mCi Liquid (excluding tritium and dissolved | RADIOLOGICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description) | ||
LJ Liquid Release LJ Gaseous Release I 1 Unplanned Release I I Planned Release LJ Ongoing Li Terminated I I Monitored Unmonitored H Offsite Release LI T.S. Exceeded LJ RM Alarms LI 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 pCi/sec 0.01 Ci Particulate 1 pCi/sec 1 mCi Liquid (excluding tritium and dissolved 10 pCi/min 0.1 Ci noble gas) | |||
Liquid (tritium) 0.2 Ci/min 5 Ci Total Activity List of Safety Related Equipment not Operational 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) | |||
NRC FORM 361N (MM-YYYY)}} | NRC FORM 361N (MM-YYYY)}} | ||
Revision as of 00:09, 20 October 2019
| ML19057A169 | |
| Person / Time | |
|---|---|
| Issue date: | 03/26/2019 |
| From: | NRC/OCIO, NRC/OGC |
| To: | |
| ANNETTE STANG | |
| Shared Package | |
| ML19039A205 | List: |
| References | |
| Download: ML19057A169 (2) | |
Text
Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-XXXX EXPIRES: (MM/DD/YYYY)
(MM-YYYY) OPERATIONS CENTER 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-2 F43), U.S. Nuclear Regulatory e-c)R REGN%
,.
NON-POWER REACTOR (NPR) Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov and to the Desk Officer, 5 EVENT NOTIFICATION Office of Information and Regulatory Affairs, NEOB-10202, (3150-XXXX), Office of Management and Budget, WM Washington, DC 20503 lf a means used to impose an information collection does not display a currently valid OMB 4°. VVORKSHEET control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information
- collection.
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 Unit Name of Caller/Title Call Back #
Event Time & Zone Event Date Power/Mode (At Time of Event) Power/Mode (At Time of Notification)
Reactor Type Max Power Max Pulse Pulse Inserted During Event EVENT CLASSIFICATION REPORTABLE CONDITION (varies by facility TS) Offsite Medical AMED GENERAL EMERGENCY GEN/AAEC TS Deviation ADEV Loss Comm/Asmt/Resp ACOM SITE AREA EMERGENCY SIT/AAEC TS Required S/D ASHU Invalid Specified System Act AINV ALERT ALE/AAEC RPS Actuation (scram) ARPS Suspicious Activity
]jjjjjjj UNUSUAL EVENT UNU/AAEC Offsite Notification APRE Security Event SAFEGUARDS EVENT (73 App G) Degraded Condition ADEG 111 MATERIAL/EXPOSURE B???? ]jjjjj Unanalyzed Condition AUNA INFORMATION ONLY NNF ]jjjjj Specified System Actuation AESF OTHER UNSPECIFIED REQMT (see last column) Safe S/D Capability AINA OTHER UNSPECIFIED REQUIREMENT (IDENTIFY)
Control of Rad Release AINC NONR 1111 Accident Mitigation AIND NONR Event Description (Include: Systems affected, actuations and their initiating signals, causes, effect of event on plant, actions taken or planned, etc.) (Continue on Page 2)
WILL NOTIFICATIONS YES NO BE Anything Unusual or not understood? Yes (Explain above) No HQ NPR STAFF Did all systems function as required? Yes No (Explain above)
STATE(s)
LOCAL ]jj Mode of operation until corrected (if applicable)
OTHER GOV AGENCIES ]jj Estimate for restart date:
MEDIA/PRESS RELEASE jjjji] Additional Information continued on next page? Yes No NRC FORM 361N (MM-YYYY) Continued on next page
Page of NRC FORM 361N U.S. NUCLEAR REGULATORY COMMISSION (MM-YYYY) OPERATIONS CENTER NON-POWER REACTOR (NPR)
EVENT NOTIFICATION WORKSHEET (Continued) EN #
RADIOLOGICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description)
LJ Liquid Release LJ Gaseous Release I 1 Unplanned Release I I Planned Release LJ Ongoing Li Terminated I I Monitored Unmonitored H Offsite Release LI T.S. Exceeded LJ RM Alarms LI 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 pCi/sec 0.01 Ci Particulate 1 pCi/sec 1 mCi Liquid (excluding tritium and dissolved 10 pCi/min 0.1 Ci noble gas)
Liquid (tritium) 0.2 Ci/min 5 Ci Total Activity List of Safety Related Equipment not Operational 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)
NRC FORM 361N (MM-YYYY)