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{{#Wiki_filter:DETROIT EDISON -FERMI 2AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST01/26/16To: 00935US NRCDOCUMENT CNTRL DESKPAGE 1WASHINGTON, DC 20555Media: 8 1/2 X 11Number Cnt IssueDTC Dcc. Serial Number Page Rev Copies Lvi Date Sec StatusTPEPT EP-290001 9 1 ST 01/26/16 AFCPlease destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.
{{#Wiki_filter:DETROIT EDISON -FERMI 2 AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST 01/26/16 To: 00935 US NRC DOCUMENT CNTRL DESK PAGE 1 WASHINGTON, DC 20555 Media: 8 1/2 X 11 Number Cnt Issue DTC Dcc. Serial Number Page Rev Copies Lvi Date Sec Status TPEPT EP-290001 9 1 ST 01/26/16 AFC Please destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.
Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway,Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.
Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway, Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORM Communicate lines1.-6 verbally.(Initial Notifications) 1.El Actual Event El Drill P2.Plant C~ontact Information Fermi 2 Nuclear Power Plant: Plant Communicator:
Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORMCommunicate lines1.-6 verbally.
Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____
(Initial Notifications) 1.El Actual EventEl DrillP2.Plant C~ontact Information Fermi 2Nuclear Power Plant:Plant Communicator:
Plant Message NumberCalling From: El Control Room El TSC LI EOF LI Other_____
Call Back Telephone Number: _______________
Call Back Telephone Number: _______________
: 3. Current Classification
: 3. Current Classification
[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)
[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)This classification was declared at: Date: _______ Time:_________
This classification was declared at: Date: _______ Time:_________
: 4. Reason for Classification
: 4. Reason for Classification
[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____
[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____
El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown  
El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown / Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to Event El Yes El No 6. Protective Action Recommendations
/ Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to EventEl Yes El No6. Protective Action Recommendations
: 6. E None Recommend the following protective actions: Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s): El 1 El 2 El 3 El 4 El 5 In-Place Shelter of Area(s): El 1 El 2 El 3 El 4 El 5 Clear Lake Area(s): El 6 El 7 PAR based on Dose Calculations*:
: 6. E NoneRecommend the following protective actions:
El YES El NO pARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological Data NOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):
Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s):
From ______to _______Wind Speed (MPH):______
El 1 El 2 El 3 El 4 El 5In-Place Shelter of Area(s):
El 1 El 2 El 3 El 4 El 5Clear Lake Area(s):
El 6 El 7PAR based on Dose Calculations*:
El YES El NOpARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological DataNOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):
From ______to
_______Wind Speed (MPH):______
Stability Class: __ _Precipitation:
Stability Class: __ _Precipitation:
El Yes El NoApproved:______________
El Yes El No Approved:______________
____________
____________
__ ____Signature Print Name Date TimeSEOC Functional El Yes El No If Yes, DO NOT call counties.
__ ____Signature Print Name Date Time SEOC Functional El Yes El No If Yes, DO NOT call counties.Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________
Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________
_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC
_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC
_________
_________
_____________
_____________
__________E Auto-Dial NRC Operations CenterProvince of Ontario (Canada)
__________E Auto-Dial NRC Operations Center Province of Ontario (Canada) _________
_________
_____________
_____________
__________E Auto-Dial A. Nuclear Information S a ____________________
__________E Auto-Dial A. Nuclear Information S a ____________________
_____________________
_____________________
!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I DETROIT EDISON -FERMI 2AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST01/26/16To: 00935US NRCDOCUMENT CNTRL DESKPAGE 1WASHINGTON, DC 20555Media: 8 1/2 X 11Number Cnt IssueDTC Dcc. Serial Number Page Rev Copies Lvi Date Sec StatusTPEPT EP-290001 9 1 ST 01/26/16 AFCPlease destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.
!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I DETROIT EDISON -FERMI 2 AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST 01/26/16 To: 00935 US NRC DOCUMENT CNTRL DESK PAGE 1 WASHINGTON, DC 20555 Media: 8 1/2 X 11 Number Cnt Issue DTC Dcc. Serial Number Page Rev Copies Lvi Date Sec Status TPEPT EP-290001 9 1 ST 01/26/16 AFC Please destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.
Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway,Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.
Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway, Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORM Communicate lines1.-6 verbally.(Initial Notifications) 1.El Actual Event El Drill P2.Plant C~ontact Information Fermi 2 Nuclear Power Plant: Plant Communicator:
Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORMCommunicate lines1.-6 verbally.
Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____
(Initial Notifications) 1.El Actual EventEl DrillP2.Plant C~ontact Information Fermi 2Nuclear Power Plant:Plant Communicator:
Plant Message NumberCalling From: El Control Room El TSC LI EOF LI Other_____
Call Back Telephone Number: _______________
Call Back Telephone Number: _______________
: 3. Current Classification
: 3. Current Classification
[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)
[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)This classification was declared at: Date: _______ Time:_________
This classification was declared at: Date: _______ Time:_________
: 4. Reason for Classification
: 4. Reason for Classification
[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____
[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____
El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown  
El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown / Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to Event El Yes El No 6. Protective Action Recommendations
/ Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to EventEl Yes El No6. Protective Action Recommendations
: 6. E None Recommend the following protective actions: Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s): El 1 El 2 El 3 El 4 El 5 In-Place Shelter of Area(s): El 1 El 2 El 3 El 4 El 5 Clear Lake Area(s): El 6 El 7 PAR based on Dose Calculations*:
: 6. E NoneRecommend the following protective actions:
El YES El NO pARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological Data NOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):
Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s):
From ______to _______Wind Speed (MPH):______
El 1 El 2 El 3 El 4 El 5In-Place Shelter of Area(s):
El 1 El 2 El 3 El 4 El 5Clear Lake Area(s):
El 6 El 7PAR based on Dose Calculations*:
El YES El NOpARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological DataNOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):
From ______to
_______Wind Speed (MPH):______
Stability Class: __ _Precipitation:
Stability Class: __ _Precipitation:
El Yes El NoApproved:______________
El Yes El No Approved:______________
____________
____________
__ ____Signature Print Name Date TimeSEOC Functional El Yes El No If Yes, DO NOT call counties.
__ ____Signature Print Name Date Time SEOC Functional El Yes El No If Yes, DO NOT call counties.Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________
Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________
_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC
_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC
_________
_________
_____________
_____________
__________E Auto-Dial NRC Operations CenterProvince of Ontario (Canada)
__________E Auto-Dial NRC Operations Center Province of Ontario (Canada) _________
_________
_____________
_____________
__________E Auto-Dial A. Nuclear Information S a ____________________
__________E Auto-Dial A. Nuclear Information S a ____________________
_____________________
_____________________
!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I}}
!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I}}

Revision as of 16:14, 8 July 2018

Fermi 2 - Revision 9 EP-290001, Nuclear Plant Event Notification Form
ML16041A268
Person / Time
Site: Fermi DTE Energy icon.png
Issue date: 01/26/2016
From:
DTE Electric Company
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
EP-290001, Rev 9
Download: ML16041A268 (2)


Text

DETROIT EDISON -FERMI 2 AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST 01/26/16 To: 00935 US NRC DOCUMENT CNTRL DESK PAGE 1 WASHINGTON, DC 20555 Media: 8 1/2 X 11 Number Cnt Issue DTC Dcc. Serial Number Page Rev Copies Lvi Date Sec Status TPEPT EP-290001 9 1 ST 01/26/16 AFC Please destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.

Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway, Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORM Communicate lines1.-6 verbally.(Initial Notifications) 1.El Actual Event El Drill P2.Plant C~ontact Information Fermi 2 Nuclear Power Plant: Plant Communicator:

Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____

Call Back Telephone Number: _______________

3. Current Classification

[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)This classification was declared at: Date: _______ Time:_________

4. Reason for Classification

[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____

El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown / Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to Event El Yes El No 6. Protective Action Recommendations

6. E None Recommend the following protective actions: Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s): El 1 El 2 El 3 El 4 El 5 In-Place Shelter of Area(s): El 1 El 2 El 3 El 4 El 5 Clear Lake Area(s): El 6 El 7 PAR based on Dose Calculations*:

El YES El NO pARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological Data NOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):

From ______to _______Wind Speed (MPH):______

Stability Class: __ _Precipitation:

El Yes El No Approved:______________

____________

__ ____Signature Print Name Date Time SEOC Functional El Yes El No If Yes, DO NOT call counties.Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________

_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC

_________

_____________

__________E Auto-Dial NRC Operations Center Province of Ontario (Canada) _________

_____________

__________E Auto-Dial A. Nuclear Information S a ____________________

_____________________

!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I DETROIT EDISON -FERMI 2 AUTOMATED RECORD MANAGEMENT DISTRIBUTION CONTROL LIST 01/26/16 To: 00935 US NRC DOCUMENT CNTRL DESK PAGE 1 WASHINGTON, DC 20555 Media: 8 1/2 X 11 Number Cnt Issue DTC Dcc. Serial Number Page Rev Copies Lvi Date Sec Status TPEPT EP-290001 9 1 ST 01/26/16 AFC Please destroy or mark all revised, superseded, or cancelled documents as such. CONTROLLED stamps must be voided by lining through and initialing.

Detroit Edison EF2, C/O Info Mgmt 140 NOC, 6400 North Dixie Highway, Newport MI 48166. (734) 586-4338 OR (734) 586-4061 for questions or concerns.Ref: e58683 NUCLEAR PLANT EVENT NOTIFICATION FORM Communicate lines1.-6 verbally.(Initial Notifications) 1.El Actual Event El Drill P2.Plant C~ontact Information Fermi 2 Nuclear Power Plant: Plant Communicator:

Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____

Call Back Telephone Number: _______________

3. Current Classification

[']E Unusual Event El Alert El Site Area Emergency El General Emergency El Termination (TDF pg.]1 Required)This classification was declared at: Date: _______ Time:_________

4. Reason for Classification

[] Abnormal Rad Level/Rad Effluents El Fission Product Barrier Degradation Fermi IC Number: _ ____Fermi IC Number:_____

El Hazards and Other Conditions Affecting Plant Safety El System Malfunction Fermi IC Number: ______Fermi IC Number: _____El Independent Spent Fuel Storage Installation El Cold Shutdown / Refueling System Malfunction Fermi IC Number: ______Fermi IC Number: _____5. Radiological Release in Progress Due to Event El Yes El No 6. Protective Action Recommendations

6. E None Recommend the following protective actions: Implement the State of Michigan K! plan. All other areas monitor and prepare.Evacuation of Area(s): El 1 El 2 El 3 El 4 El 5 In-Place Shelter of Area(s): El 1 El 2 El 3 El 4 El 5 Clear Lake Area(s): El 6 El 7 PAR based on Dose Calculations*:

El YES El NO pARs are beyond 10 Miles*: El YES El NO*TDF pg 2 required and a conference call with the ORO must be complete within 15 minutes of "notification" by this form.Meteorological Data NOTE: The TPCS "Straight Line Plume Plot" is the preferred source.Wind Direction (degrees):

From ______to _______Wind Speed (MPH):______

Stability Class: __ _Precipitation:

El Yes El No Approved:______________

____________

__ ____Signature Print Name Date Time SEOC Functional El Yes El No If Yes, DO NOT call counties.Notifications Time Contacted Name Telephone No. or Select Auto-Dial Monroe County ______________________

_________E Auto-Dial Wayne County _______________________________E Auto-Dial Michigan State Police/SEOC

_________

_____________

__________E Auto-Dial NRC Operations Center Province of Ontario (Canada) _________

_____________

__________E Auto-Dial A. Nuclear Information S a ____________________

_____________________

!DTC: TPEPT DSN: EP-290001 Rev. 9 P1/1 IP: I File: 1703.10 Issued:flL621 File: 0926.09 lIP: I