March 1, 2007

Ms. Kathryn Perkins, Assistant Commissioner

Division of Regulatory Services

Texas Department of State Health Services

8404 Wall Street, Room S101

Austin, TX 78754

Dear Ms. Perkins:

On February 2, 2007, the Management Review Board (MRB) met to consider the proposed final

followup Integrated Materials Performance Evaluation Program (IMPEP) report on the Texas

Agreement State Program. The MRB continued to find the Texas program adequate, but

needs improvement, and compatible with the U. S. Nuclear Regulatory Commission’s (NRC)

program. Due to the program improvement shown since the 2005 IMPEP review, the period of

Heightened Oversight of the Texas program will be discontinued and a period of Monitoring will

be implemented. Monitoring is an informal process that allows the NRC to maintain an

increased level of communication with an Agreement State program. As part of the Monitoring

process, NRC will conduct quarterly calls with the appropriate representatives from the Texas

Department of State Health Services.

Section 3.0, page 10, of the enclosed final report contains a summary of the IMPEP review

team’s findings and recommendation. We request your evaluation and response to the

recommendation within 30 days from receipt of this letter. Based on the results of this review,

the next full IMPEP review of the Texas Agreement State Program will take place in

approximately 3 years.

I appreciate the courtesy and cooperation extended to the IMPEP team during the review. 

I also wish to acknowledge your continued support for the Radiation Control Program and the

significant improvements in the administration of your program demonstrated by your staff, as

reflected in the team’s findings. I look forward to our agencies continuing to work cooperatively

in the future.

Sincerely,

/RA/

Martin J. Virgilio

Deputy Executive Director for Materials, Waste,

Research, State, Tribal, and Compliance Programs

Office of the Executive Director for Operations

Enclosure: 

Texas Final Followup IMPEP Report

cc: See next page.
-2-

cc: Charles Bell, Deputy Executive Commissioner

 Department of State Health Services

 Richard Ratliff, Radiation Protection Officer

 Department of State Health Services

 Susan Jablonski, Technical Advisor

 Commission on Environmental Quality

 Roger Mulder, State Liaison Officer

 State Energy Conservation Office

 Mike Broderick, Oklahoma

 Organization of Agreement States 

 Liaison to the MRB
March 1, 2007

Ms. Kathryn Perkins, Assistant Commissioner

Division of Regulatory Services

Texas Department of State Health Services

8404 Wall Street, Room S101

Austin, TX 78754

Dear Ms. Perkins:

On February 2, 2007, the Management Review Board (MRB) met to consider the proposed final

followup Integrated Materials Performance Evaluation Program (IMPEP) report on the Texas

Agreement State Program. The MRB continued to find the Texas program adequate, but

needs improvement, and compatible with the U. S. Nuclear Regulatory Commission's (NRC)

program. Due to the program improvement shown since the 2005 IMPEP review, the period of

Heightened Oversight of the Texas program will be discontinued and a period of Monitoring will

be implemented. Monitoring is an informal process that allows the NRC to maintain an

increased level of communication with an Agreement State program. As part of the Monitoring

process, NRC will conduct quarterly calls with the appropriate representatives from the Texas

Department of State Health Services.

Section 3.0, page 10, of the enclosed final report contains a summary of the IMPEP review

team's findings and recommendation. We request your evaluation and response to the

recommendation within 30 days from receipt of this letter. Based on the results of this review,

the next full IMPEP review of the Texas Agreement State Program will take place in

approximately 3 years.

I appreciate the courtesy and cooperation extended to the IMPEP team during the review. 

I also wish to acknowledge your continued support for the Radiation Control Program and the

significant improvements in the administration of your program demonstrated by your staff, as

reflected in the team's findings. I look forward to our agencies continuing to work cooperatively

in the future.

Sincerely,

/RA/

Martin J. Virgilio

Deputy Executive Director for Materials, Waste,

Research, State, Tribal, and Compliance Programs

Office of the Executive Director for Operations

Enclosure: 

Texas Final Followup IMPEP Report

cc: See next page.

Distribution: DCD (SP01)

Chairman Klein Commissioner McGaffigan Commissioner Merrifield Commissioner Jaczko Commissioner Lyons

DMSSA RF EDO RF LMcLean, RIV OSiurano, FSME/DILR THerrera, FSME/DMSSA

JHarris, KS KKarcagi, FSME/DMSSA SCollins, RI KCyr, OGC FCameron, OGC

AKock, OEDO TCombs, OCA (2 copies) RidsFsmeOd

ML070520468

OFC FSME/DMSSA FSME/DMSSA FSME/DMSSA FSME/DMSSA

NAME KSchneider

(telecon to AMcCraw)

AMcCraw PRathbun (KSchneider

telecon to AMcCraw)

SMoore

DATE 02/21/07 02/21/07 02/21/07 02/21/07

OFC FSME/DMSSA TechEd FSME DEDMRT

NAME JSchlueter CPoland (via email) CLMiller MJVirgilio

DATE 02/22/07 02/26/07 02/27/07 03/01/07 

OFFICIAL RECORD COPY
INTEGRATED MATERIALS PERFORMANCE EVALUATION PROGRAM

FOLLOWUP REVIEW OF TEXAS AGREEMENT STATE PROGRAM

November 13-17, 2006

FINAL REPORT

U.S. Nuclear Regulatory Commission

ENCLOSURE
Texas Final Followup Report Page 1

1.0 INTRODUCTION

This report presents the results of the followup review of the Texas Agreement State Program

conducted November 13-17, 2006. This followup review was directed by the Management

Review Board (MRB) based on the results of the September 7-16, 2005, Integrated Materials

Performance Evaluation Program (IMPEP) review.

The followup review was conducted by a review team consisting of technical staff members

from the U.S. Nuclear Regulatory Commission (NRC) and the Agreement State of Kansas. 

Review team members are identified in Appendix A. The followup review was conducted in

accordance with the February 26, 2004, NRC Management Directive 5.6, "Integrated Materials

Performance Evaluation Program (IMPEP)." Preliminary results of the followup review, which

covered the period of September 17, 2005, to November 17, 2006, were discussed with Texas

management on the last day of the review.

A draft of this report was issued to Texas for factual comment on December 14, 2006. The

State responded by letter, dated January 19, 2007, from Kathryn Perkins, Assistant

Commissioner, Division for Regulatory Services (the Division). The Management Review Board

(MRB) met on February 2, 2007, to consider the proposed final report. The MRB continued to

find the Texas program adequate, but needs improvement, and compatible with the U. S.

Nuclear Regulatory Commission’s (NRC) program. Due to the program improvement shown

since the 2005 IMPEP review, the period of Heightened Oversight of the Texas program will be

discontinued and a period of Monitoring will be implemented.

The Texas Agreement State Program is administered by two State agencies, the Department of

State Health Services (the Department) and the Commission on Environmental Quality (the

Commission). The followup review focused on the Department’s radioactive materials program. 

Organization charts for the Department are included as Appendix B. At the time of the review,

the Department regulated approximately 1,650 specific materials licenses. The Department’s

regulatory authority includes 11e.(2) byproduct material (uranium recovery activities) and

currently regulates three conventional uranium mills (three tailings impoundments closing down)

and five in-situ uranium mines (four active licenses and one revoked license). The Department

is also currently processing an application for a commercial 11e.(2) disposal facility. The review

focused on the Department’s materials program as it is carried out under the Section 274b. (of

the Atomic Energy Act of 1954, as amended) Agreement between the NRC and the State of

Texas.

The Texas Agreement State Program was initially placed on Heightened Oversight as a result

of programmatic weaknesses identified during the March 15, 2005, periodic meeting with the

Department. At the April 13, 2005, meeting, the MRB decided to place the State on Heightened

Oversight due to concerns with staff turnover, status of inspections, timeliness of reporting

events, and status of regulations within the Department. As part of the Heightened Oversight

process, the MRB requested that the Department submit a Program Improvement Plan (plan)

and that bimonthly conference calls be conducted between appropriate Department and NRC

staff to discuss the status of the Department’s actions to address the identified performance

issues.
Texas Final Followup Report Page 2

The Department submitted their plan in a letter dated May 24, 2005, to the Director of the

NRC’s Office of State and Tribal Programs (STP). In the plan, the Department identified

specific actions with projected completion dates to address all performance issues. An IMPEP

review was conducted during the period of September 7-16, 2005. On December 14, 2005,

based on the results of the September 7-16, 2005, IMPEP review, the MRB found the Texas

Agreement State program adequate, but needs improvement, and compatible with NRC’s

program. Because of the significance of the findings, the MRB directed that the State continue

on Heightened Oversight to monitor the Department’s progress in completing the actions

identified in the revised plan. The MRB directed that a followup review take place in

approximately one year.

The revised plan was submitted January 23, 2006, to the Deputy Executive Director for

Materials, Research, State, and Compliance Programs. From February 14, 2006 to October

19, 2006, NRC staff held bimonthly teleconferences with the Department to evaluate the

Department’s progress towards completing the corrective actions. Note, on October 1, 2006,

the functions of STP were merged with a portion of the Office of Nuclear Material Safety and

Safeguards to form the new Office of Federal and State Materials and Environmental

Management Programs (FSME). A listing of correspondence and summaries from the

bimonthly calls is included as Appendix C.

The followup review focused on the State’s performance in regard to four common performance

indicators: Technical Staffing and Training, Status of Materials Inspection Program, Technical

Quality of Inspections, and Technical Quality of Incident and Allegation Activities. The followup

review also included evaluation of the actions taken by the State to address the

recommendations made during the 2005 IMPEP review. Other aspects of the program not fully

evaluated as part of the followup review were discussed at a periodic meeting with the

Department. A periodic meeting with the Commission was held in conjunction with the review,

as well. The periodic meeting summaries for the Department and the Commission are included

as Appendixes D and E, respectively.

In preparation for the followup review, a questionnaire addressing the common performance

indicators, Technical Staffing and Training, Status of Materials Inspection Program, Technical

Quality of Inspections, and Technical Quality of Incident and Allegation Activities, was sent to

the Department on August 31, 2006. The Department provided a response to the questionnaire

by e-mail dated October 27, 2006. A copy of the questionnaire response can be found in the

NRC’s Agencywide Document Access and Management System (ADAMS) using the Accession

Number ML063320476.

The review team's general approach for conduct of this review consisted of: (1) examination of

the Department’s response to the questionnaire; (2) review of the Heightened Oversight

information, including status reports; (3) review of data in the Nuclear Material Events Database

(NMED) on applicable Texas incidents; (4) analysis of information from the Department’s

incident and allegation tracking system; (5) four field accompaniments of Department

inspectors; and (6) interviews with staff and management to answer questions or clarify issues. 

The review team evaluated the information gathered against the established criteria for the four

common performance indicators reviewed and made a preliminary assessment of the Texas

Agreement State Program’s performance.

Section 2.0 of this report discusses the results of the followup review of the Texas Agreement
Texas Final Followup Report Page 3

State Program. Section 3.0 summarizes the review team's findings and open

recommendations.

2.0 COMMON PERFORMANCE INDICATORS

The followup review addressed four of the five common performance indicators used in

reviewing both NRC Regional and Agreement State radioactive materials programs. The four

indicators reviewed were: (1) Technical Staffing and Training; (2) Status of Materials Inspection

Program; (3) Technical Quality of Inspections; and (4) Technical Quality of Incident and

Allegation Activities.

2.1 Technical Staffing and Training

During the followup review, the review team evaluated actions taken by the Department in

response to the finding of satisfactory, but needs improvement, made during the 2005 IMPEP

review, as well as the status of the Department’s staffing and training program.

Issues central to the evaluation of this indicator include the Department’s staffing level and staff

turnover, as well as the technical qualifications and training histories of the staff. To evaluate

these issues, the review team examined the Department’s questionnaire response relative to

this indicator, interviewed Department management and staff, and reviewed job descriptions

and training records.

The review team’s evaluation of the State’s response to Recommendation 1, from the 2005

review, is presented below.

Recommendation 1:

The review team recommends that the Department hire and retain sufficient qualified staff to

return and maintain the program at a satisfactory performance level. (Section 3.1 of the 2005

IMPEP Report)

Current Status:

The radiation control program, within the Division, consists of four units organized by function. 

The Radiation Program Officer is designated as the radiation control program director and

provides a coordinating role among the functional groups.

During the 2005 review, there were seven vacancies in the Department’s radioactive materials

program (program), including four regional inspectors. At the time of this followup review, all

four inspector vacancies and one Policy, Standard and Quality Assurance reviewer position had

been filled. There is currently one vacancy in the program. A civil engineer in the Technical

Assessments Group left the program in October 2006, and the position was posted almost

immediately. At the time of the review, no applications have been received. The review team

concluded that all inspector and license reviewer vacancies have been filled, and the program’s

regulatory activities will not be adversely affected by the single vacancy.

The qualifications of the staff were determined by examining the Department’s response to the

questionnaire, training records, and resumes and interviewing personnel. The review team
Texas Final Followup Report Page 4

found that all staff, including the new hires, are well qualified from an education and experience

standpoint. All have at least a Bachelor’s degree in a science or equivalent training and

experience. Two of the four new inspectors will complete their qualifications by December

2006. The remaining two inspectors are expected to complete partial qualifications by May

2007 and are expected to complete full training and qualifications by May 2008.

The review team noted that, at the time of this review, a qualification journal was being used for

license reviewers only. A draft qualification journal for inspectors is currently in the final stages

of review for approval. Both journals establish minimum training requirements for personnel

assigned to perform independent license reviews and inspections for materials facilities. The

qualification journals are based upon the guidance in Inspection Manual Chapter (IMC) 1246

and the Final Report of the NRC/Organization of Agreement States (OAS) Training Working

Group Recommendations for Agreement State Training Programs. The review team noted that

despite the absence of a final, documented qualification journal for inspectors, management is

well aware of the training needs of the staff. Training already completed by staff is being

tracked by the program’s Public Information Specialist. A spreadsheet is used to track training

already attended and is used to schedule for upcoming training. The review team discussed

the importance of having documented training journals for each of the staff and encouraged

program management to expedite final approval and implementation of the training journal for

the inspectors.

The technical staff is expected to receive basic training courses or equivalent within the first two

years of starting work with the Department. In addition to the training courses, inspectors are

required to demonstrate competence during supervisory accompaniments prior to being

authorized to perform inspections independently.

The Department continues to deal with potential loss of a qualified workforce because of

retirement of senior staff and managers in the near future. The Texas Legislature approved the

new health physicist classification and the appropriations to fund the increased salaries

effective September 1, 2005. The reclassification of the Department’s technical staff and the

resulting increases in salaries became effective January 1, 2006. Also, the Department

implemented a merit pool at the beginning of their Fiscal Year 2006 to award employees for

meritorious service. The Department has been working on instituting an intern program during

the past year to attract entry-level staff, but was unsuccessful. Department management

indicated that they intend to continue pursuing an intern program in the upcoming year.

The review team assessed the composition of the Texas Radiation Advisory Board (the Board). 

The Board reviews and evaluates State radiation policies and programs; makes

recommendations and furnishes technical advice to the Department, the Commission and the

Railroad Commission; and reviews and comments on proposed rules and guidelines relating to

regulation of sources of radiation. There were four vacancies within the Board during the last

IMPEP review. Currently, only one position is vacant. There have been no other changes in

the Board’s composition.
Texas Final Followup Report Page 5

The review team recognizes that significant improvements have been made in this area since

the previous review and believes that the current level of staffing will be able to sustain the

inspection timeliness and to absorb future increased demands on the program. The review

team also believes that improvements in the staffing and training will eventually result in

improving the overall program’s performance. Based on the Department’s actions and

improvements made to address Recommendation 1 of the 2005 review, this recommendation is

closed.

Based on the IMPEP evaluation criteria, the review team recommended, and the MRB agreed,

that Texas' performance with respect to the indicator, Technical Staffing and Training, was

satisfactory.

2.2 Status of Materials Inspection Program

The review team evaluated actions taken by the Department in response to the September

2005 IMPEP review findings, as well as the status of the inspections performed since the 2005

IMPEP review. The review team also evaluated the current and projected backlog of overdue

inspections, data from the Department’s inspection tracking system to determine the timeliness

of inspections, and reviewed inspection files to determine the timeliness of the issuance of

inspection results to licensees relative to the date of inspection. The review team’s evaluation

of the Department’s response to Recommendation 2, from the 2005 review, is presented below.

Recommendation 2

The review team recommends that the Department review their process for issuance of

inspection letters and develop a process that will allow the 31-day issuance goal for routine

cases to be achieved on a consistent basis. (Section 3.2 of the 2005 IMPEP Report)

Current Status

During the 2005 review, that review team found that 15 out of 29 inspection letters evaluated

were issued greater than 31 days from the completion of the inspection. By the time of this

followup review, the Department eliminated the backlog of inspection reports and has issued

the overdue inspection letters. Since March 2006, there has been an improvement in meeting

the 31-day issuance goal for routine cases. The review team noted that this has been achieved

on a consistent basis. The Department now has three fully trained quality assurance reviewers

that issue inspection letters. At the time of the 2005 IMPEP review, there were only two quality

assurance reviewers. The Department uses a database to log inspection reports submitted by

the regions and to track inspection reports. In addition, the quality assurance reviewers pay

particular attention to the due date for the inspection letters to be issued. Based on the

Department’s actions and improvements made to address Recommendation 2 of the 2005

review, this recommendation is closed.

The review team’s evaluation of the Department’s inspection priorities revealed that inspection

frequencies for each type of license were the same or more frequent than similar license types

listed in IMC 2800. The Department requires more frequent inspections for the following

license categories: all broad scope industrial and academic licenses are inspected every two

years, compared to the NRC’s two to five year intervals; self-shielded irradiators are inspected

every three years, as opposed to the NRC’s five year interval; all industrial radiography licenses
Texas Final Followup Report Page 6

are inspected annually, whereas the NRC inspects fixed industrial radiography locations every

two years; and all research and development licenses are inspected at three year intervals,

whereas the NRC inspects Type A research and development licenses every three years and

the other research and development licenses are inspected every five years.

At the time of this followup review, there were eight Priority 1, 2, and 3 inspections and 12 initial

inspections overdue. The Department staff generated a report indicating that 275 Priority 1, 2,

and 3 inspections were completed on time during the review period. The review team noted

that, additionally, 51 Priority 1, 2, and 3 inspections and 42 initial inspections were completed

overdue during the review period. The 113 overdue, or conducted overdue, inspections

represented 23 percent of the 484 core inspections performed by the Department during the

review period.

The review team noted that the Department allowed routine inspections to become overdue

while attempting to reduce the existing inspection backlog. The review team concluded that the

root causes for the continued backlog were changes in staff responsibilities, due to the

Department’s reorganization, staffing shortages, and the lack of capabilities to project future

inspections and workload due to issues with the Department’s inspection tracking system,

which could only identify those licensees whose inspections were overdue. Within the last

month, the Department has made improvements to the inspection tracking system and now has

the capability to project upcoming inspections. The review team believes that these

improvements will substantially assist the Department in achieving and sustaining a satisfactory

level of performance. In response to the draft report and during the MRB, the Department

provided the inspection backlog as of February 2, 2007, which included 12 Priority 1, 2, and 3

inspections and four initial inspections overdue.

In its response to the questionnaire and review of the files, the Department inspected 3 out of

14 candidate reciprocity licensees during the review period. The number of reciprocity

inspections performed by the Department exceeded the 20 percent criterion prescribed in IMC

1220.

The Department issued the Increased Controls to 236 licensees. The Department identified

120 licensees that needed to be inspected within the first year. As of November 13, 2006, 63

Increased Controls inspections have been performed. The Department appears to be on track

to complete all inspections within the time frames established by the NRC. The review team

evaluated the Department’s methodology for prioritization of inspections and determined that it

is compatible with the NRC’s methodology.

The review team recognizes the significant improvements made by the Department on this

common performance indicator since the 2005 review. There has been a significant reduction

of inspection backlog and the length of time that the inspections are overdue. In addition,

improvements made to the inspection tracking system now provide the Department the

capability to project future inspection due dates. In discussions with Department management

on November 16, 2006, they indicated their intention to eliminate its inspection backlog by

February 28, 2007. During the February 2007 MRB meeting, the Department reiterated its

commitment to eliminate the inspection backlog by February 28, 2007.

Based on the IMPEP evaluation criteria, the review team initially recommended that Texas’

performance with respect to the indicator, Status of Materials Inspection Program, continued to
Texas Final Followup Report Page 7

be satisfactory, but needs improvement; however, based on additional information and the

commitments provided by the State, the MRB determined that the State’s performance with

respect to this indicator was satisfactory.

2.3 Technical Quality of Inspections

The review team evaluated the inspection reports and enforcement documentation and

interviewed inspectors for 23 radioactive materials inspections conducted during the review

period. The casework reviewed included work performed by 10 of the Department’s radioactive

materials inspectors and covered a variety of license types including: academic broad scope,

medical (broad scope, diagnostic and therapy), high dose-rate remote afterloader, gamma

stereotactic radiosurgery, research and development, and industrial radiography. The review

team also evaluated the casework and supporting documentation for two Increased Controls

inspections. Appendix F lists the inspection casework reviewed, with case-specific comments,

as well as the results of the inspector accompaniments.

Based on the casework evaluated, the review team noted that the routine inspections covered

all aspects of the licensees’ radiation safety programs. The review team found that inspection

reports were generally complete, consistent, and had sufficient documentation to ensure that a

licensee’s performance with respect to health and safety was acceptable. The review team

noted that exit interviews were generally not held with appropriate licensee personnel (i.e., the

radiation safety officer or a member of management). The review team discussed this issue

with Department management and inspectors during the review. The review team also noted

that incident reports were not always present in the license files; therefore, in some cases, the

inspectors were not always able to follow up on incidents at the next inspection. This issue was

discussed with Department management during the review. During the on-site review, the

Department demonstrated a computer application recently designed by the Department that will

ensure that incident information is provided to the inspectors.

The review team’s evaluations of the Department’s response to Recommendations 3 and 4,

from the 2005 review, are presented below:

Recommendation 3:

The review team recommends that the State adhere to the policy of annual supervisory

accompaniments of all qualified inspectors. (Open recommendation from the 2001 IMPEP

Report) (Section 3.3 of the 2005 IMPEP Report)

Current Status:

The review team found that during the review period, annual inspector accompaniments have

been conducted for Calendar Year 2006 with one exception. The last accompaniment was

scheduled to be completed by the middle of December. In addition, the Department has

implemented a procedure to ensure that accompaniments will be conducted annually. Based

on the Department’s actions and improvements made to address Recommendation 3 of the

2005 review, this recommendation is closed.

Recommendation 4:
Texas Final Followup Report Page 8

The review team recommends that the State develop a process to ensure that inspections are

performed in accordance with their own performance-based inspection procedures. (Section

3.3 of the 2005 IMPEP Report)

Current Status:

In July 2006, the Department conducted training on performance-based inspection techniques.

After the training, the Department required inspectors to conduct performance-based

inspections beginning August 1, 2006. Four Department inspectors were accompanied during

inspections by a review team member during the weeks of October 18, and October 30, 2006. 

Inspector accompaniments were conducted at the following license types: radiography,

medical institutions - diagnostic and brachytherapy/teletherapy. The review team member also

accompanied an inspector on an Increased Controls inspection. The review team noted that

the inspectors applied performance-based inspection techniques during the inspections. Each

inspector demonstrated appropriate safety perspective and knowledge of the regulations. The

inspectors were well-prepared and thorough in their audits of the licensees’ radiation safety

programs.

The review team noted that the documentation in the inspection reports issued after the training

course showed that the reports documented the inspector’s observation of licensed operations

and handling of radioactive material. The inspectors documented observing workers

demonstrate or explain selected activities, if no licensed activities were being performed. 

Based on the Department’s actions and improvements made to address Recommendation 4 of

the 2005 review, this recommendation is closed.

Based on the IMPEP evaluation criteria, the review team recommended, and the MRB agreed,

that Texas’ performance with respect to the indicator, Technical Quality of Inspections, was

satisfactory.

2.4 Technical Quality of Incident and Allegation Activities

In evaluating the effectiveness of the State's actions in responding to incidents, the review team

examined the State's response to the questionnaire relative to this indicator, evaluated selected

incidents reported for Texas in NMED against those contained in the Department’s files, and

evaluated the casework and supporting documentation for 13 radioactive material incidents. A

listing of the incident casework examined, with case-specific comments, may be found in

Appendix G. The review team also evaluated the State's response to eight allegations involving

radioactive materials, including one allegation referred to the State by the NRC during the

review period.

The review team discussed the State’s incident and allegation procedures, file documentation,

NMED, and notification of incidents to the NRC’s Headquarters Operations Center with

Department managers and selected staff. The review team’s evaluation of the State’s

response to Recommendation 5, from the 2005 review, is presented below.
Texas Final Followup Report Page 9

Recommendation 5:

The review team recommends that the Department report all significant and routine events, as

well as followup event information, to the NRC in accordance with STP Procedure SA-300,

“Reporting Material Events.” (Open recommendation from the 2001 IMPEP Report) (Section

3.5 of the 2005 IMPEP Report)

Current Status

Responsibility for initial response and followup actions to radioactive material incidents and

allegations is with the Incident Investigation Program under the Division for Regulatory

Services. Written procedures exist for handling incidents and allegations, which are referred to

as “complaints” by the Department. The Department procedures require on-site investigation

for each significant incident and a timely response to allegations. All incidents and allegations

are tracked by a numerical identification system. In most cases, the identification numbers for

incidents were cross-referenced on the NMED report.

The 13 incidents the review team selected for evaluation included the following categories: 

medical event, overexposure, transportation, lost and stolen gauges, loss of material,

abandoned source, defective equipment, and loss of administrative control. The review team

found that the Department’s response to incidents was generally complete and comprehensive. 

Initial responses were prompt and well-coordinated, and the level of effort was commensurate

with the health and safety significance.

During the 2001 and 2005 IMPEP reviews, timeliness of event reporting was identified as a

weakness. The 2005 IMPEP review team evaluated the timeliness of the events reported and

noted that the Department had reported approximately 20 percent of the reportable events late

over the review period. The information provided by the Department for the February 2007

MRB indicated that 5 of 45 events had been reported late during the review period.

During the 2001 and 2005 IMPEP reviews, the review teams found that the Department had not

updated the NMED records with followup or closure information. The followup review team

discussed the issue of reporting incidents and providing followup information with the

Department management and staff. The review team identified instances of followup

information being requested from the licensee, yet the event was closed without the requested

information being provided. The review team also identified events closed within the

Department files with proper information, but the NMED records were closed without being

updated.

The review team’s evaluation of the eight allegations indicated that the Department took prompt

and appropriate action in response to the allegers’ concerns. Through review of the casework

and interviews with staff, the review team determined that the Department provided feedback to

allegers either verbally or in writing, when possible. Any alleger requesting anonymity is

informed that every effort will be made to protect his/her identity, but protection cannot always

be guaranteed. All interviewed staff were knowledgeable of the Department’s allegation

procedure. There were no performance issues identified from the review of allegation 
Texas Final Followup Report Page 10

casework. The review team did note some inconsistencies and completeness issues with some

of the allegation documentation. The comments were provided to Department management

during the review.

The review team noted that the quality of documentation and timeliness of reporting has

improved over previous IMPEP reviews; however, the review team continued to find

documentation, updating, and timeliness issues with respect to the NMED records and the

Department’s incident and allegation files. While the review team noted significant

improvements, the improvements have not been in place long enough to truly evaluate their

effectiveness and there has not been enough time for sustained performance to be exhibited. 

Thus, the review team recommends that Recommendation 5 of the 2005 review remain open.

Based on the IMPEP evaluation criteria, the review team recommended, and the MRB agreed,

that Texas' performance with respect to the indicator, Technical Quality of Incident and

Allegation Activities, continued as satisfactory, but needs improvement.

3.0 SUMMARY

As noted in Section 2.0 above, Texas’ performance was found to be satisfactory for the

performance indicators, Technical Staffing and Training, Status of Materials Inspection

Program, and Technical Quality of Inspections. Texas’ performance for the performance

indicator, Technical Quality of Incident and Allegation Activities, continues to be found

satisfactory, but needs improvement. The Department has made significant progress since the

last IMPEP review; however, the review team believes that additional time and actions are still

necessary before the Department fully reaches and sustains a level of satisfactory performance

for all performance indicators. Accordingly, the review team recommended, and the MRB

agreed, that the Texas Agreement State Program continues to be found adequate, but needs

improvement, and compatible with NRC's program. The review team recommended that the

period of Heightened Oversight continue in order to assess the progress of the State in

implementing corrective actions in a revised plan addressing the inspection backlog and the

open recommendation from this review; however, in light of the State’s progress since the

followup review, the MRB determined that the period of Heightened Oversight should be

discontinued and a period of Monitoring should be implemented. Monitoring is an informal

process that allows the NRC to maintain an increased level of communication with an

Agreement State program. As part of the Monitoring process, NRC will conduct quarterly calls

with the appropriate Department representatives. Based on the results of this review, the next

full IMPEP of the Texas Agreement State Program will take place in approximately 3 years.

RECOMMENDATION:

The review team recommends that the Department report all significant and routine events, as

well as followup event information, to the NRC in accordance with STP Procedure SA-300,

“Reporting Material Events.” (Section 2.4) (Open recommendation from the 2001 IMPEP

Report)
LIST OF APPENDIXES AND ATTACHMENT

Appendix A IMPEP Review Team Members

Appendix B Texas Organization Charts

Appendix C Heightened Oversight Program Correspondence

Appendix D Periodic Meeting Summary - Department of State Health

Services

Appendix E Periodic Meeting Summary - Commission on Environmental

Quality

Appendix F Inspection Casework Reviews

Appendix G Incident Casework Reviews

Attachment January 19, 2007 Texas’ Response from Kathryn C. Perkins

to Draft Followup IMPEP Report
APPENDIX A

IMPEP REVIEW TEAM MEMBERS

Name Area of Responsibility

Kathleen Schneider, FSME Team Leader

Periodic Meetings

Osiris Siurano, FSME Technical Staffing and Training

Periodic Meetings

Tomas Herrera, FSME Status of Materials Inspection Program

Linda McLean, RIV Technical Quality of Inspections

Inspector Accompaniments

James Harris, Kansas Technical Quality of Incident and

Allegation Activities
APPENDIX B

TEXAS ORGANIZATIONAL CHARTS

ADAMS ACCESSION NO.: ML063320476

PAGES: 23-28
APPENDIX C

HEIGHTENED OVERSIGHT PROGRAM CORRESPONDENCE

Minutes of Bimonthly Conference Calls:

1. June 24, 2005 Minutes (ML063330125)

2. August 23, 2005 Minutes (ML063330108)

3. February 14, 2006 Minutes (ML063330116)

4. April 10, 2006 Minutes (ML063330096)

5. August 7, 2006 Minutes (ML062280607)

6. October 10, 2006 Minutes (ML063330133)

Letters from/to Texas:

1. December 27, 2005 Letter to Richard B. Bays and Dan Eden, from M. J. Virgilio - Texas

Final IMPEP Report (ML053560316)

2. January 23, 2006 Letter to M. J. Virgilio from Richard B. Bays - Response to Final

IMPEP Report (ML060390294)

3. March 16, 2006 Letter to Richard B. Bays, from J. Schlueter - Comments on the Texas

Program Improvement Plan (ML060750513)
APPENDIX D

AGREEMENT STATE PERIODIC MEETING SUMMARY FOR

TEXAS DEPARTMENT OF STATE HEALTH SERVICES

DATE OF MEETING: NOVEMBER 12, 2006

A periodic meeting was held with the Radiation Control Program Officer and staff by Kathleen

Schneider, Team Leader, during the followup review pursuant to the former Office of State and

Tribal Programs (STP) Procedure SA-116, “Periodic Meetings with Agreement States Between

IMPEP Reviews.” Those topics normally documented during the periodic meeting that were

reviewed and documented as part of the followup review will not be discussed in this Appendix. 

The following topics were discussed.

1. Status of Recommendations from 2005 Report

See Sections 2.1 through 2.4 for details on Recommendations 1, 2, 3, 4 and 5. It is

practice to recommend that items and recommendations that were not reviewed as part

of the specific performance indicators during the followup review be closed at the next

IMPEP review; however, the review team recommends that Recommendation 6 be

closed at this time based on the file reviews and status of the Texas Department of

State Health Services’ (the Department’s) actions in addressing the recommendations.

a. Recommendation 6: The review team recommends that the Department develop

and implement an inspection program to verify that the QA/QC requirements in

the SS&D Registry sheets are being implemented by the manufacturer. (Section

4.2.2)

Current Status: The Department has developed an inspection program to verify

that the quality assurance/quality control (QA/QC) requirements in the sealed

source and device (SS&D) registry sheets are being implemented by the

manufacturer. The program has been in place since August 1, 2006. The

inspectors have been trained to use a check sheet to determine whether the

licensee is manufacturing sources or devices according to the QA/QC programs

submitted to the Department as part of the SS&D application. If the inspector

has any questions, they are to contact the Department’s SS&D reviewers who

are more knowledgeable of the licensees QA/QC programs. In the event that

there appears to be a significant deviation from the QA/QC program the SS&D

reviewer will perform a complete review of the manufacturers QA/QC program. 

Although this program has only been in place for three months there has not

been an opportunity to perform a review. However, based on the program put in

place by the Department, the review team believes that the recommendation has

been addressed. The review team recommends that this item be closed.

b. Recommendation 7: The review team recommends that the Department

conduct an evaluation of the uranium recovery program workload and hire the

necessary staff to adequately address the workload. (Section 4.4.1)
Texas Final Followup Report Page D.2

Department Periodic Meeting Summary

Current Status: The Department added three additional positions to the uranium

recovery program in the Technical Assessments Group. Although all three

positions were filled, a vacancy (civil engineer) occurred which has not yet been

filled. The position was posted but not filled due to a lack of applicants and an

issue with the interpretation of the authorization with the Office of the

Comptroller. Fees collected, which would cover the position, are put in the

general fund and must be appropriated for the Department.

The recent increase in the cost of uranium has caused a resurgence in the

uranium recovery industry. There is consideration in the legislation for uranium

fees that are collected to be designated as a dedicated fund for the Department

rather than being put in the general funds. The Department is continuing to

evaluate their workload in light of the resurgence of the uranium recovery

industry.

It is recommended that this item be evaluated at the next IMPEP review.

c. Recommendation 8: The review team recommends that the Department prepare

necessary supporting documentation identifying the bases for the licensing

actions associated with reclamation plans for the three conventional mills. 

(Section 4.4.4) (Open recommendation from the 2001 IMPEP report)

Current Status: The Department is continuing to work on the necessary

supporting documentation. However, with the loss of one of the civil engineer

positions, the work effort cannot continue on the previously anticipated schedule.

It is recommended that this item be evaluated at the next IMPEP review.

2. Strengths and/or weaknesses of the State program as identified by the State including

identification of actions that could diminish weaknesses.

Program Strengths: The Department continues to have well trained, experienced, and

dedicated staff members who are often called on as resources by both Federal and

other State agencies. The Department staff believes that they were very successful with

the implementation of the reorganization. 

The Radiation Control Program Officer indicated that the enforcement review committee

was an unanticipated strength of the new organization. The Regional State Agreement

Officer and the Region IV Division Director for Nuclear Materials Safety attended a

meeting during the review.

Program Weaknesses: Funding remains a significant challenge for the Department

which collects sufficient funds,; however, these fees are not dedicated to the

Department. The Department receives its funds through general appropriations.
Texas Final Followup Report Page D.3

Department Periodic Meeting Summary

3. Feedback on NRC’s program as identified by the State and including identification of

any action that should be considered by NRC.

The Department management expressed that the NRC reorganization came as a

surprise. However, they noted that there are good interactions with Region IV.

4. Status of State Program:

a. Staffing and Training: See Section 2.1.

b. Materials Inspection Program: See Section 2.2.

c. Regulations and Legislative Changes: The status of the regulation was

discussed with the staff. All regulations required for compatibility have been

issued in final and reviewed by NRC. NRC Amendment “Financial Assurance for

Materials Licensees” became due on December 3, 2006, and has not yet been

adopted. Eight amendments have comments that will need to be addressed to

meet the compatibility and health and safety categories. Staff has a schedule for

the revisions and upcoming regulations. They are presently working on the

transportation requirements, medical use of byproduct material, 2005 revisions

and radiography revisions to address NRC comments. The remaining

amendments with comments will be addressed during the four year cycle

revisions in 2010.

A proposed bill to transfer authority from the Department to the Texas

Commission on Environmental Quality over 11e.(2) material, processing and

disposal of radioactive material is being discussed. Department management

expects the State’s legislature to address this issue in January 2007. 

d. Program Reorganizations: The Department is still examining the efficiency and

effectiveness of the present organization. Some additional modifications could

be possible in the future.

e. Changes in Program Budget/Funding: The Department experienced $500,000

deficit due to the nature of the funding in Texas. The Department raised their

fees and had understood that monies collected over the appropriation

authorization would be given back to the Department. The Comptroller’s

interpretation of the authorization rider was that the monies remained in the

general fund even though the fees were sufficient to cover this deficit. 

Department representatives continue to work with Senate contacts to explore

dedicated funding for the Department

5. Event Reporting: See Section 2.4.

6. Response to Incidents and Allegations: See Section 2.4.
Texas Final Followup Report Page D.4

Department Periodic Meeting Summary

7. Information Exchange and Discussion:

a. Current State Initiatives: Discussed in the followup IMPEP Review report.

b. State’s Mechanisms to Evaluate Performance: The Department continuously

audits performance by performing peer reviews of licensing actions and SS&D

reviews. In addition, all inspection reports are reviewed by quality assurance

reviewers. The radiation control program management attend a monthly

meeting which is facilitated by the Radiation Control Program Officer to discuss

pertinent issues in order to maintain a cohesive program. The Radiation Control 

Program Officer indicated that prior to the reorganization, the staff conducted

pre-IMPEP audits and that the Department would like to reinitiate the audits. 

The Department also receives State audits.
APPENDIX E

AGREEMENT STATE PERIODIC MEETING SUMMARY FOR

TEXAS COMMISSION ON ENVIRONMENTAL QUALITY

DATE OF MEETING: NOVEMBER 15, 2006

A periodic meeting was held with Texas Commission on Environmental Quality (the

Commission) staff during the followup review pursuant to the former Office of State and Tribal

Programs (STP) Procedure SA-116, “Periodic Meetings with Agreement States Between

IMPEP Reviews.” During the meeting, the topics suggested in a letter dated August 31, 2006,

from Mrs. Schneider to Ms. Susan Jablonski were discussed.

ATTENDEES

NRC

Kathleen Schneider, Team Leader, Senior Project Manager, FSME

Osiris Siurano, Health Physicist, FSME

Commission Staff

Devane Clarke, Manager, Radioactive Material Licensing

Don Redmond, Office of Legal Services

Amie Richardson, Office of Legal Services

Commission staff were present during the introductory part of the meeting but did not 

participate in the discussion

DISCUSSION

The following is a summary of the meeting held in Austin, Texas, with Commission staff.

1. Status of State’s actions to address all open previous IMPEP review findings and/or

open recommendations.

There were no recommendations for the Commission during the 2005 IMPEP review.

2. Strengths and/or weaknesses of the State program as identified by the State or NRC

including identification of actions that could diminish weaknesses.

Strengths:

Commission management identified the staff as their major strength. In general, the

Commission staff is well-qualified and experienced.

Weaknesses:

The Commission lost one staff, a certified health physicist, who accepted another job

offer. There are constraints due to budget issues and out-of-State travel prohibitions. 
Texas Final Followup Report Page E.2

Commission Periodic Meeting Summary

Staff training in NRC courses is challenging. The Commission is willing to host a

licensing course as an alternative.

3. Feedback on NRC’s program as identified by the State and including identification of

any action that should be considered by NRC.

The Commission has an interest in NRC’s definition for NORM as a result of the Energy

Policy Act of 2005. The Commission staff believes the new definition will highly impact

their regulatory responsibilities.

There was a short discussion on NRC’s reorganization, including the new location and

name of the former STP. The status of the current initiatives of current non-Agreement

States intending to become Agreement States was also discussed.

4. Status of State Program:

a. Staffing and Training:

There is currently one open position. No additional changes have taken place

since the last Integrated Materials Performance Evaluation Program (IMPEP)

review. One staff member retired since the last IMPEP but was re-hired. There

are no timing limitations for rehiring this type of staff.

b. Materials Inspection Program:

There are some legacy sites within the State. All sites are inspected once a

year. There are no inspection backlogs.

c. Regulations and Legislative Changes:

There have not been any changes since the last IMPEP review. A proposed bill

to transfer authority from the Department to the Commission over 11e.(2)

material, processing and disposal of radioactive material will be discussed by the

State’s legislature in its next session. A short discussion on the Commission’s

regulations was held. There is no information on the NRC State Regulation

Status sheet for the following regulations:

1997-6 - License Termination Rule - there is no information on the status of the

 State’s final rule

1998-1 - Deliberate Misconduct by Unlicensed Persons - Parts 30, 40, 61, 70,

71, 150

1998-6 - Transfer for Disposal and Manifests: Minor Technical Conforming 

 Amendment - Part 20

2002-2 - Revision of the Skin Dose Limit - Part 20
Texas Final Followup Report Page E.3

Commission Periodic Meeting Summary

2003-1 - Financial Assurance for Materials Licensees - Parts 30, 40, 70

NRC staff provided an overview of NRC’s regulation review process and

information on the Regulation Toolbox on Office of Federal and State Materials

and Environmental Management Programs’ website. The Commission staff

noted that licensees are required to follow the Department’s transportation

regulations.

d. Program Reorganizations:

The Radioactive Material Licensing manager changed in July 2006.

e. Changes in Program Budget/Funding:

No changes have taken place since the last IMPEP review.

5. Event Reporting, Including Followup and Closure Information in NMED:

No incidents have been reported since the last IMPEP review. Commission staff

discussed an ongoing enforcement case where there was a release to the sewer

system. The event was not reportable to NRC. 

6. Response to Incidents and Allegations:

There are no allegations for the Commission since the last IMPEP review.

7. Emerging Technologies:

There is an application for commercial disposal of NORM from public water supplies

currently under the Commission’s review. The licensee is proposing injection wells as

their disposal strategy.

The Commission staff discussed their review of an application for a low-level radioactive

waste site which may not be completed as specified by State statutes. The application

quality was deemed inadequate and milestones were not met. The applicant requested

an extension which was granted until May 1, 2007. The State’s legislature will review

this process in view that due dates specified by law were not met. 

A request for rulemaking, from Waste Control Specialists is currently under the

Commission’s review. The licensee is requesting the State to adopt a rule that would

exempt NRC approved alternate disposals under 10 CFR Part 20.2002 from State

regulation/approval.

The Commission staff discussed the Disposal Unit Source Term (DUST) computer code

provided by NRC staff. They indicated that they were unable to use the DUST code and

provided comments. These comments will be forwarded to the Division of Waste

Management and Environmental Protection.
APPENDIX F

INSPECTION CASEWORK REVIEWS

NOTE: CASEWORK LISTED WITHOUT COMMENT ARE INCLUDED FOR COMPLETENESS

ONLY.

File No.: 1

Licensee: Laredo Regional Medical Center LP License No.: L02192

Inspection Type: Routine, Unannounced Priority: 3

Inspection Date: 6/29/06 Inspector: RW

Comment:

Conducted overdue.

File No.: 2

Licensee: Team Industrials Services, Inc. License No.: L00087

Inspection Type: Routine, Unannounced Priority: 1

Inspection Dates: 9/12/06, 10/3/06 Inspector: HD

File No.: 3

Licensee: Team Industrial Services, Inc. License No.: L00087

Inspection Type: Increased Controls, Announced Priority: 1

Inspection Date: 10/4/06 Inspector: HD

File No.: 4

Licensee: Baker Atlas License No.: L00446

Inspection Type: Routine, Unannounced Priority: 3

Inspection Date: 6/8/06 Inspector: HD

File No.: 5

Licensee: Baker Hughs Oilfield Operations, Inc. License No.: L00446

Inspection Type: Increased Controls, Announced Priority: 1

Inspection Date: 8/21/06 Inspector: HD

File No.: 6

Licensee: Cardinal Health License No.: L01911

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 3/22/06 Inspector: HD

File No.: 7

Licensee: Acuren Inspection, Inc. License No.: L01774

Inspection Type: Routine, Unannounced Priority: 1

Inspection Date: 3/10/06 Inspector: HD

File No.: 8

Licensee: Baker Hughs Oilfield Operations, Inc. License No.: L00446

Inspection Type: Routine, Announced Priority: 3

Inspection Date: 6/8/06 Inspector: HD
Texas Final Followup Report Page F.2

Inspection Casework Reviews

File No.: 9

Licensee: Kelsey-Seybold Clinic PA License No.: L00391

Inspection Type: Initial, Announced Priority: 3

Inspection Date: 2/24/06 Inspector: KZ

Comments:

a) Exit with technologist only.

b) Report issued late.

File No.: 10

Licensee: The University of Texas Medical Branch License No.: L01299

Inspection Type: Routine, Announced Priority: 3

Inspection Date: 7/19/06 Inspector: LC

Comment:

Conducted overdue.

File No.: 11

Licensee: Big Spring Hospital Corporation License No.: L00763

Inspection Type: Routine, Announced Priority: 3

Inspection Date: 9/29/06 Inspector: WK

File No.: 12

Licensee: Cardinal Health License No.: L01999

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 1/11/06 Inspector: WK

Comment:

Report issued late.

File No.: 13

Licensee: Scott and White Memorial Hospital License No.: L00331

Inspection Type: Initial, Announced Priority: 2

Inspection Dates: 1/5/06, 5/24/06 Inspector: JH

Comment:

Exit with technologist only.

File No.: 14

Licensee: Texas Oncology PA License No.: L00154

Inspection Type: Routine, Unannounced Priority: 2

Inspection Date: 6/26/06 Inspector: RW

Comments:

a) Conducted overdue.

b) Report issued late.
Texas Final Followup Report Page F.3

Inspection Casework Reviews

File No.: 15

Licensee: East Texas Medical Center License No.: L00977

Inspection Type: Routine, Announced Priority: 3

Inspection Date: 4/7/06 Inspector: SF

File No.: 16

Licensee: Val Verde Regional Medical Center License No.: L01967

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 9/28/06 Inspector: RW

Comment:

Exit with technologist only.

File No.: 17

Licensee: Baylor College of Dentistry License No.: L00323

Inspection Type: Routine, Announced Priority: 3

Inspection Date: 8/7/06 Inspector: SP

File No.: 18

Licensee: United Regional Health Care System, Inc. License No.: L00350

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 9/19/06 Inspectors: ES, SF

File No.: 19

Licensee: Weaver Services, Inc. License No.: L01489

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 10/25/06 Inspectors: SF, ES

File No.: 20

Licensee: Q Pro Technical Services License No.: L05980

Inspection Type: Initial, Announced Priority: 3

Inspection Date: 10/12/06 Inspector: RH

File No.: 21

Licensee: American X-Ray & Inspection Services, Inc. License No.: L05974

Inspection Type: Initial, Announced Priority: 1

Inspection Date: 8/23/06 Inspector: WK

Comment:

Report issued late.

File No.: 22

Licensee: Physician Reliance Network, Inc. License No.: L05896

Inspection Type: Initial, Announced Priority: 3

Inspection Date: 11/17/06 Inspector: SF
Texas Final Followup Report Page F.4

Inspection Casework Reviews

File No.: 23

Licensee: Heart Center of Dallas License No.: L05942

Inspection Type: Initial, Announced Priority: 3

Inspection Date: 8/11/06 Inspector: SP

INSPECTOR ACCOMPANIMENTS

The following inspector accompaniments were performed prior to the on-site IMPEP review:

Accompaniment No.: 1

Licensee: Doctors Hospital License No.: L01366

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 10/18/06 Inspector: SF

Accompaniment No.: 2

Licensee: South Austin Hospital License No.: L03273

Inspection Type: Routine, Announced Priority: 1

Inspection Date: 10/31/06 Inspector: RW

Accompaniment No.: 3

Licensee: Kelsey-Seybold Clinic PA License No.: L00391

Inspection Type: Routine, Announced Priority: 2

Inspection Date: 11/1/06 Inspector: KZ

Accompaniment No.: 4

Licensee: Matrix Metals LLG License No.: L00312

Inspection Type: Routine, Announced Priority: 1

Inspection Date: 11/2/06 Inspector: RH
APPENDIX G

INCIDENT CASEWORK REVIEWS

NOTE: CASEWORK LISTED WITHOUT COMMENT ARE INCLUDED FOR COMPLETENESS

ONLY.

File No.: 1

Licensee: Texas Hi Temp Alloy Processors License No.: G02273

Date of Incident: 9/21/05 Incident Log No.: I-8273; NMED - 050723

Investigation Date: N/A Type of Investigation: N/A

Comments:

a) Immediate notification to NRC required. Department notified 10/26/05, Department sent

notification to NRC on 10/28/05.

b) Documentation of investigation is missing from the State file.

File No.: 2

Licensee: MACTEC Engineering and Consulting License No.: L05490

Date of Incident: 12/12/05 Incident Log No.: I-8286; NMED - 060014

Investigation Date: N/A Type of Investigation: N/A

Comments:

a) Immediate notification to NRC required. Department notified 12/12/05; Department sent

notification to NRC 2/16/06 (66 days).

b) Closure information documented in Department file not reflected in the NMED record for

completeness.

c) Documentation of investigation is missing from the Department file.

File No.: 3

Licensee: JRJ Paving License No.: L05307

Date of Incident: 1/20/06 Incident Log No.: I-8290; NMED - 060055

Investigation Date: N/A Type of Investigation: N/A

Comments:

a) Note in file dated 3/22/06 stating licensee needs to send 30-day report. As of 11/13/06,

“still receiving info.” It appears that file was closed without all the required information.

b) Closure information is not included in Department file. Documentation of investigation is

missing from the Department file.

File No.: 4

Licensee: Memorial Herman Hospital License No.: L00650

Date of Incident: 1/10/06 Incident Log No.: I-8288; NMED - 060078

Investigation Date: 1/12/06 Type of Investigation: E-mail

Comments:

a) Twenty four-hour notification to NRC required. Department notified 1/20/06 and

Department sent notification to NRC 2/2/06 (13 days).

b) Information on prescribed organ dose and actual dose was requested of licensee. 

Information was not received, but the Department closed the file regardless.
Texas Final Followup Report Page G.2

Incident Casework Reviews

File No.: 5

Licensee: Saint-Gobain Ceramics and Plastics License No.: L04895

Date of Incident: 12/24/05 Incident Log No.: I-8296; NMED - 060088

Investigation Date: N/A Type of Investigation: N/A

Comment:

NMED record has not been updated to indicate the event is closed.

File No.: 6

Licensee: Texas Instruments License No.: G01800

Date of Incident: 2/13/06 Incident Log No.: I-8303; NMED - 0601277

Investigation Date: 2/15/06 Types of Investigations: Telephone, E-mail

File No.: 7

Licensee: Gilbert Texas Construction License No.: L04569

Date of Incident: 3/20/06 Incident Log No.: I-8313; NMED - 060225

Investigation Date: N/A Type of Investigation: N/A

Comment:

Narrative information in NMED is not correct and unclear.

File No.: 8

Licensee: Weaver Services License No.: L01489

Date of Incident: 2/15/06 Incident Log No.: I-8316; NMED - 060230

Investigation Date: N/A Type of Investigation: N/A

Comment:

Documentation of investigation is missing from the file.

File No.: 9

Licensee: Halliburton Energy Services License No.: L02113

Date of Incident: 3/27/06 Incident Log No.: I-8333; NMED - 060335

Investigation Date: N/A Type of Investigation: N/A

Comment:

Documentation of investigation is missing from the file.

File No.: 10

Licensee: Nan Ya Plastics Corp License No.: G01847

Date of Incident: 6/16/06 Incident Log No.: I-8339; NMED - 060422

Investigation Date: N/A Type of Investigation: N/A

Comments:

Documentation of investigation is missing from the file.
Texas Final Followup Report Page G.3

Incident Casework Reviews

File No.: 11

Licensee: Ben Taub General Hospital License No.: L01303

Date of Incident: 6/17/06 Incident Log No.: I-8350; NMED - 060442

Investigation Date: 6/20/06 Types of Investigations: E-mail, Telephone

Comments:

a) Effect of missing source on patients prescribed therapeutic dose compared to actual

dose received is not addressed.

b) Possible skin dose due to source next to patient for 37 hours is not addressed.

c) Immediate notification to NRC required. Department notified 6/20/06; Department sent

notification to NRC 7/12/06 (22 days).

File No.: 12

Licensee: Goolsby Testing Laboratory License No.: L03115

Date of Incident: 10/4/06 Incident Log No.: I-8365; NMED - 060629

Investigation Date: 10/6/06 Type of Investigation: On-site

Comments:

a) Extremity exposure has not been addressed.

b) Blood work performed, physician interpretation of results not addressed.

File No.: 13

Licensee: Texas Gamma Ray Licensee No.: L05561

Date of Incident: 5/1/06 Incident Log No.: I-8348; NMED - 060425

Investigation Date: 8/4/06 Type of Investigation: On-site

Comments:

a) Narrative of NMED record does not accurately reflect information in the incident file.

b) Change in total effective dose equivalent (TEDE) assigned to worker has not been

approved by Department management.

c) Department investigation file is open, however, the NMED record indicates the event is

closed.
ATTACHMENT

January 19, 2007, Letter from Kathryn C. Perkins

Texas’ Response to Draft Followup IMPEP Report

ADAMS: ML070240545