ML16041A268

Revision 9 EP-290001, Nuclear Plant Event Notification Form

ML16041A268
Person / Time
Site:	Fermi
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 PAGE 1 DOCUMENT CNTRL DESK 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Number Page Rev Copies Lvi Date Sec Status TPEPT EP-290001 9 1 ST 01/26/16 AFC Please destroy or mark all revised, superseded, or cancelled documents as such.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.

1. El Actual Event (Initial Notifications)

El Drill Plant C~ontact Information P2.

Nuclear Power Plant: Fermi 2 Plant Communicator: Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____

Call Back Telephone Number: _______________

3.

[']E Unusual Event El Alert El Current Classification Site Area Emergency El General Emergency El Termination (TDFpg.]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 requiredand 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 S

A. Nuclear Information 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 PAGE 1 DOCUMENT CNTRL DESK 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.

1. El Actual Event (Initial Notifications)

El Drill Plant C~ontact Information P2.

Nuclear Power Plant: Fermi 2 Plant Communicator: Plant Message Number Calling From: El Control Room El TSC LI EOF LI Other_____

Call Back Telephone Number: _______________

3.

[']E Unusual Event El Alert El Current Classification Site Area Emergency El General Emergency El Termination (TDFpg.]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 requiredand 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 S

A. Nuclear Information a ____________________ _____________________

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