GL-727336-26, GL Annual Registration for Magellan Midstream Partners, L.P
| ML21025A305 | |
| Person / Time | |
|---|---|
| Issue date: | 11/30/2020 |
| From: | Don Lowman Office of Nuclear Material Safety and Safeguards |
| To: | Aston W Magellan Midstream Partners, L.P. |
| References | |
| GL-727336-26 | |
| Download: ML21025A305 (12) | |
Text
Vendor:
Docket 727336 Flscal Year:
Quarter Period:
MAGEli.AN MIDSTREAM PARTNERS, L.P.
ONE WIWAMS CENTER OTC-8 TULSA, OK 74121-2186 Invoice Number LFB 21-0921 Invoice Date Nov 30, 2020 Remit To:
10/01/2020 - 09/30/2021 10/01/2020 - 09/30/2021 Office of the Chief Flnanc1al Officer U.S. Nuclear Regulatory Commission P,O. Box 979051 St. Louis, MO 63197 Invoice Due Date Dec 30, 2020 Invoice Amount
$600.00 For questions, contact (301) 415-7554 or by email at fees.resource@nrc.gov. For NRC debt collection procedures, mdudmg interest and penalty provisions, see 31 U.S.C. 3717; 31 CFR Parts 900 - 904; AND 10 CFR Part 15. Addlt10nal terms and conditions are attached.
Make checks payable to 'fhe U.S. Nuclear Regulatory Commission. The NRC also currently accepts credit card payments of up to $24,999.99. For payment by credit card, go to Pay.Gov, search for "U.S. Nuclear Regulatory Commission Fees" and enter the requIrecLmformatlon. Interest will accrue from the Invoice date at an annual rate of 1%. Interest will be waived 1f payment Is received by the due date. Please reference the invoice number on the remittance.
43 of 248
TO:
SUBJECT:
UNITED STATES NUCLEAR REGULA TORY COMMISSION WASHINGTON, D.C. 2055~01 November 30, 2020 Users of Devices Subject to General License Registration ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices. Information about the general license registration program is available NRC website:
http://www.nrc.gov/materials/miau/general-l:lse/toolkit.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package.. Mail the completed package in the enclosed envelope to:
Director, Office of Nuclear Material Safety and Safeguards ATTN: Document Control Desk/GL TS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: Commission regulations (10 CFR 170.31, Category 3Q) require that you submit a registration fee with each registration on an annual basis. The registration fee is subject to change yearly, and you are required to submit the fee that is in effect as of the date of this letter. An invoice for the current amount due will be sent to you under separate cover. If you have any questions about the fee or the invoice, please contact the License Fee Billing Help Desk at 301-415-7554 or e-mail at fees.resource@nrc.gov.
NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.
Attachment:
NRC Form 664 - General Licensee Registration and Instructions Sincerely,
~ Digitally signed by Donald B.
Donald B. Lowmar:,~~man 1/
- Date: 2020.11.19 15:44:48 -05'00' U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials *Safety Licensing and Tribal Liaison Branch
', 1.
INSTRUCTIONS FOR COMPLETING NRC FORM 664 "GENERAL LICENSEE REGISTRATION" Review all six sections of this registration fonn. If any information is incorrect or missing, make corrections in the applicable boxes. If you have more devJces than space provided in the fonn, copy the form before starting, as needed. Use black ink and print in CAPITAL LETTERS. Start infonnation in the first box provided. If the information contains a number with a dash (-} or a decimal point(.), include the dash or decimal point as an individual character. Use*the "0" character to represent the number o (zero).
Verify information about the devices by reviewing the label on the outsjde of the device. For safety reasons, DO NOT TRY TO TAKE APART any device to verify this information. If you are uncertain how to identify the device's label, contact the device's manufacturer or an authorized service agent for this infonnation. Also, contact the manufacturer for any additional infonnation about NRC requirements. You may also review 10 CFR 31.5 and other applicable regulations on the NRC web site at http://www.nrc.goy/reading-nn/doc-collections/cfr/, or review specific infonnation about the general licensee project at https://www.nrc.gov/
materials/miau/general-use/toolkit.html Note to specific licensees: If you believe the device(s) listed on the registration fonn are possessed under your specific license, then verify the device label does not state the device is subject to a general license. If the labels indicate the device is subject to a general license, then complete the registration fonn as instructed below. If not, complete the regi'stration as instructed below, however, in Section 2, follow the instructions for "not in possession of device" and complete one Section 4 page per device transferred to your specific license.
Section 1 - General Licensee lnfonnatlon. Provide the requested infonnation about you, the general licensee.
On Page 1, provide the street address/location where your device(s) are used. For portable devices, provide the storage location. P.O. Box addresses are not allowed.
Do not write in the box marked For NRC Use Only.
On Page 2, provide the.name, business telephone number, business e-mail address and title of the individual responsible for your device(s), and a mailing address where correspondence about your device(s) can be sent.
The mailing address should be specific to the physical location where the devices are used and/or stored (P.O.
boxes may be used if this is the only available mailing address). The individual indicated in this section as responsible for your device(s) must also verify and sign the form in Section 5.
Section 2 - Devices Subject to Registration. This section lists each device subject to registration and in your possession, according to NRC records. Devices subject to registration include those containing at least one of the radionuclides listed in Table 1, with the activity indicated, at the time of manufacture.
T bl 1 Crite. f R
lstraf a e.
mt or eg:.
10n Radionuclide ActMty greater than or equal to; Strontlum-90, Radium-226 3.7 meoabeCQuerel. (0.1 mlllicurte).
Cobalt-60 Curium-244, Americium-241 and Califomlum-252 37 megabecquerel (:1 milllcurle J Cesium.,137 370 me:*-1:-: -uere.1,(10 mllllc4rie)
Use the codes from Table 2 when correcting isotope infonnation for devices in this section. If you do not possess a device on this list, blacken the "not in possession of device" circle, and provide the relevant information in Section 4. Note that each device is assigned a unique six-digit number called the NRC Device Key.
a e -. S00~
es or C
ons.an T bl 2 I t Cod 1
Secti 2 'd3 Radionuclide Code for fonn Radionuclide Cocte for-form Amenclum-241 AM24'1 Cunum-244 CM244 Callfomium-252 CF252 Strontium-90 SR90 Cesium-137 CS.137 Radlum-226 RA226 Cobalt-60 coeo Section 3 - Additional Devices. If you have other generally licensed devices (not listed in Section 2) that meet the conditions for registration listed in Table 1, provide information about each additional device. Before starting, copy this section as needed for your additional devices. Also indicate how you acquired each device by blackening the proper circle.
When entering isotope and unit information for your device(s), use the codes listed in Table 2 of Section 2 for isotope information, and use the codes from Table 3 for unit information:
Table 3. Unit Codes for-Section 3 Unit Code for fonn Unit Code for fonn picocurle POI.
becQOerel BQ nanocurle NCI kllobecquerel
, KBQ mlcrocurie UCI
- meoabecq(lerel MBQ mllllcurie MCI oioabecquerel GBQ curie Cl terabePQuerel TBQ pound LB microaram UG mlllioram MG kilogram KG gram G
Section 4 - Not In Possession of Device. Use this section to report any devices that are listed in Sections 2 or 6, but that you no longer possess. Before starting, copy this section as needed for additional devices that are not In your possession. Enter the NRC Device Key, as listed in Section 2 or 6. Blacken the circle
( choose only one) that best describes the disposition of the device and complete the rest of the section as appropriate.
Section 5 - Certification and Signature. The responsible individual must certify, sign, and date Section 5.
Section 6 - Devices Not Subject to Registration. This list contains information about devices that NRC records indicate are in your possession, but are not subject to registration. If you no longer have one or more of the listed devices, you are required to make a transfer report to NRC in accordance with 10 CFR 31.5 (c)(8) or (9), as applicable. You may use Section 4 for this purpose. This section does not list any static eliminators containing polonium-210 (Po-210), or luminous exit signs containing tritium (H-3). These devices are not subject to registration, and are not included in this section in an effort to reduce the length of this form.
RETURN THE COMPLETED FORM IN THE ENCLOSED ENVELOPE WITH PROPER POSTAGE.
1111111111111111 IIIIII IIIII IIIII IIIII 11111111111111111111111111111 IIII GL-727336-26 11/20/2020 111111111111111111 IIII IIIIIII Ill llll llll SECTION 1 PAGE 1 of 2 U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 664 (11 - 2020) 10CFR31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 0MB EXPIRATION DATE: 09/30/2022 Estimated burden per response to comply with this mandatory collection request 20 minutes NRG win use this mformatlon to track general licensees and their devices to ensure a higher level of device accountabIlrty. Send comments regarding burden estimate to the FOIA, Library, and lnforma!Jon Collectlons Branch (T-6 A1 OM), U S Nuclear Regulatory Com1TUSS1on, \\/llashIngton, DC 20555-0001, or by e-mail to lnfocollects Resource@nrc gov, and the 0MB reviewer at 0MB Office of lnforma!Jon and Regulatory Affairs, (3150-0198), Attn Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, 'MlshIngton, DC 20503, e-mail*
otra subrn1ss10Q@omb eop gov The NRG may not conduct or sponsor, and a person JS not required to respond to, a collectJon of information unless the document requesting or requInng the collection displays a currently valid 0MB control number Complete all six sections of this registration form. If any of the preprinted Information Is incorrect, provide the changes In the appllcable boxes. USE CAPITAL LETTERS.
General License Registration Number
- GL:..,z21.33s~2s\\
SECTION 1 - GENERAL LICENSEE INFORMATION Enter the company name and the street address for the physical location of use for your devlce(s). For portable devices, specify the primary storage location. Do not use P.O. Boxes.
Company Name:
MAGELLAN MIDSTREAM PARTNERS, L.P.
I I 1-I I I I I I I I I I I
- 1 I I I I I I Department:
I I I
I I
I I I I I I I I I I I I I -I I I Address Line 1:
1691 ROUND TOP ROAD I
.I I I I I I
I I I I I I I
I I ] I I
1-I Address Line 2:
I I I I I
I I I I I I
I I I I I
I I I I I
City:
CHEYENNE I I I I I I I
.I I I I. I I I I I I I I I I l l I State:Wf rn Zip Code: 82009 I I I I I I -.I I
I
11111111 IIIIII II llllll 111111111111111 lllll lllll llll 1111111111111111111 111111111111111111 IIII IIIIIII Ill llll llll GL-727336-26 11/20/2020 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)
SECTION 1 PAGE 2 of 2 Enter the name, telephone number and title of the person who Is the responsible individual for the devlce(s).
Last Name: ASTON
.1 I I I I r I I I I f I I I I I r I I I I I I l First Name: WILLIAM Middle Initial: M I I I I I I' I I I I I J I I D Business Telephone Number:
(918) 574-7303 Extension:
I 1
- I 11 I. I JI r I I I I.I
.I r *1 I
Business E-mail Address:
Title:
RADIATION SAFETY OFFICER I.I l I I. I I I I I. J
.I I I.I I I I.I J I l I *1 Enter the malling address where correspondence regarding your<tevlce(s) should be senl Department:
I I I I I I I I I I I
- 1 I I I I I I *I' I I I I r
. Address Line 1:
ONE WILLIAMS CENTER OTC-8 1_
1 1
1 1
1 1
1 1
1 1
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1 1
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1 1
- 1.
_1 Address Line 2:
I f I.I I 1.. I I r I :I
.I I I J l I. t J
.I
- 1 I I,
.I City:
TULSA I I I I I I I I I I I I I I I*
- 1 I I l I I 1. I r State: OK ((] Zip Code: 741212186 I J l I [ r 7* 'I I I 1:
I
I IIIIIII IIIIII II llllll 111111111111111 11111 111111111111111 IIIII IIII IIII I llllllll llll 11111111111111111 GL-727336-26 11/20/2020 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records Indicate that you have these devices. Please update the information as necessary.
PAGE 1 of 1 NRC Device Key 735580 (Internal Control Number)
Distributor/Distributed By:
BSI Instruments, Inc I I I I I.I I I I I I I I I I I I l I I I I I *1 Distributor License Number.
37-21226-02G I I I I I' I I I I I I I *1 I
Manufacturer name:
BSI INSTRUMENTS I I I I I *1 I 1 I I I I I I f I I I I I I I I I Device Model (Not Source Model): LB 7442 I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number ED 199A I I I I I I I I I I I I I I I 1 I I I I I I I I Transfer Date:
11/15/2006 MM DD YYYY Isotope (e.g. AM241)
Activity (e.g. 1005)
D Not In possession of device (Also complete Section 4.)
Unit (e.g. mCi) 1 CS137 50 mCi 111111 11111111!!!!!,~,~1, 2
,---,-I 1--,--1 -1,----,I I I I I I I I I I I I I I I I I I I 3
~I 1--,--1 --r----1 ~I I I I I I I I I I I I I I I I I I I 4
I I I I I I I I I I I I I I I I I I I I I I I 5
,---,-I 1--,--1 -1,----,I I I I I I I I I I I I I I I I I I I.
6 I I I I I I I I I I I I I I I I I I I I I I I
11111111 IIIIII II llllll 111111111111111 11111 111111111111111111111111 IIII I 11111111111111111111111111111 GL-727336-26 11/20/2020 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION SECTION 3 PAGE 1 of 1 Provide lnfonnatlon about other devices you have*that are subject to registration. Do not report speclflcally licensed devices.
Manufacturer Name I I I I I I I I I I I I I, l I I I I I I I I I I I I I I Initial Transferor Name I I I I I I I I I I I I I I I t I I I I I I I I I I I I Initial Transferor License Number (if known)
I I I I I I I I I I I I I Device Model Number (Not Source Model)
I I I I I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number I I I I I I I I I I I I I I I I I I I I I I I I I I How acquired and date (e.g.,
Q Manufacturer/Initial Transferor listed above from a distributor/manufacturer, o Other General Licensee Date Transferred: rn.rn I I j I I other licensee, other source)?
Isotope (e.g. AM241)
- 1.
I 2*
I I 3*
I I
- 4.
- 5.
- 6.
- 7.
- 8.
- 9.
- 10.
0 Other Sources MM DD YYYY Activity (e.g. 100)
I I
I I I I I
I I I I I I
I I I I
I f
Unit (e.g. mCI)
I I I
I I
I I
I
._____.__..______.__.____,____'------'--'_____.________.____.____.J I
._____.___.__I l'-----'------,.._____.___.__.__'---'--'-------'I
.-----.----,---,I
._____.__..___I l~-----'-------'----'---'-------'-------------'I I I
11111111 IIIIII II llllll 11111111111111111111111111111111111111111111 IIII I llllllll llll 11111111111111111 GL-727336-26 11/20/2020 SECTION 4 - NOT IN POSSESSION OF DEVICE Provide Information about devices listed In Section 2 or 6,ebut no longer in your possession.
Location of the Device:
SECTION 4 PAGE 1 of 1 0 Whereabouts Unknown (Complete Part 1 only) 0 Transferred to another general licensee (Complete Parts 2 and 3) 0 Never Possessed the Device (Complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) 0 Returned to Manufacturer (Complete Part 1 only)
(Complete Part 2)
Part 2 License Number of Recipient (If transferred to a specific licensee):
I r l I I I I *1
- 1 I"
1-I -1 I
Company Name:
I I I I I I *1 I I I I I l r r 'I I I.
r I r I I I I I r I Department:
I I I I I I I I I 1* I I *1 I t *1 1: l I I 1 * *1 I I I I I I Address Line 1:
I I I I I 1*
r I. l r I I I I.
- 1
'I I I l I I ' I I I' I I I l Address Line 2:
I I I I I I r I I I r I I r l l I l j I r r r J l I I' I City:
I I I I I I r I I I r l I I l
- 1
- 1 I I *1 I I
- r r 'I I I I state: [D Zip Code: I I I I
- I l -'I I l r I Part 3 Enter the name of the indivlduai responslbe for this device:
Last name:
I
- 1 r I I 1* I
- 1 r* r *1
- 1 I I :I
- 1 r I 'I I I I I *1 I I I First name:
Middle Initial:
I *1 I I I r *1 I [ I *1 I :1 l D
~~~~~~ Telephone I.
1
- 1 r*,1 1. 1
- JI I.
1 _ J [ Extension: *1.,....---,* I,----,-;: :1------.1-:---""T,, *1--,J Trtle:
I I I I I I I I I r
- 1 I l I 1*
--1 I' I t *1 1* I l I 1
- I I I
I 111111111111111 1111111111111111 IIIII IIIII IIIII IIII 111111111111111 IIII GL-727336-26 11/20/2020 I hereby certify that:
SECTION 5 - CERTIFICATION I llllllll llll 11111111111111111 SECTION 5 PAGE 1 of 1 A
All information contained in this registration is true and complete to the best of my knowledge and belief.
- 8.
A physical inventory of the devices subject to registration has been completed, and the device Information on this form has been checked against the device labeling C.
I am aware of the requirements of the general license, provided in 10 CFR 31.5.
(Coples of applicable regulations may be viewed at the NRG website at:
http://www.nrc.gov/reading-nn/doc-collections/cfr)
SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1)
DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRG REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRG BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.
I 111111111111111 llllll 111111111111111 lllll lllll llll 1111111111111111111 I 11111111111111111 111111111111 GL-727336-26 1112012020 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 1 of 1 NRC Device Key:
Manufacturer License No.
Manufacturer Name*
Model Number.
Isotope:
Serial#:
Transfer Date Unit: