ML040620693
| ML040620693 | |
| Person / Time | |
|---|---|
| Site: | Millstone  |
| Issue date: | 02/18/2004 |
| From: | Dominion Nuclear Connecticut |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| 000055407 | |
| Download: ML040620693 (72) | |
Text
To Facility Address From Date/Time Trans No.
Total Items:
DOCUMENT CONTROL DESK MP Department : 806 NUC REGULATORY COMMISSION (0140)
DOCUMENT CONTROL DESK WASHINGTON, DC 20555 NDS CONT DOCUMENTS 02/18/04 09:18 000055407 Transmittal Group Id: 04049DT-2 00020 PASSPORT DOCUMENT TRANSMITTAL Page:
1 11lN INK!! l0 llll1 I l1HE Item
- 0001
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- 0003
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- 0008 Facility MP MP MP MP MP MP MP MP Type PROC PROC PROC PROC PROC PROC PROC PROC Sub HP HP HP HP HP HP HP HP Document Number/ Title Sheet Revision Doc Date RPM 4.8.5."
006 01 EMERGENCY RADIOLOGICAL EQUIPMENT MAINTENANCE INSPECTION RPM 4.8.5-002'-
003 01 EMERGENCY OPERATIONS FACILITY TEAM 2 KIT RPM 4.8.5-003 3' 003 01 EMERGENCY OPERATIONS FACILITY TEAM 3 KIT RPM 4.8.5-004 003 01 EMERGENCY OPERATIONS FACILITY TEAM 4 KIT RPM 4.8.5-005
003 01 EMERGENCY OPERATIONS FACILITY TEAM 5 KIT RPM 4.8.5-009 007 01 EMERGENCY OPERATION FACILITY RPM 4.8.5-011,--'
005 01 UNIT 2 CONTROL ROOM RPM 4.8.5-013A -
005 02 ENVIRONMENTAL LABORATORY Copy #
Media P
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000 01 P
01 UNIT 2 PERSONNEL DECON ROOM EMERGENCY PERSONNEL DECON KIT IN
To Facility Address
- DOCUMENT CONTROL DESK
- MP Department : 806
- NUC REGULATORY COMMISSION (0140)
DOCUMENT CONTROL DESK WASHINGTON, DC 20555
- NDS CONT DOCUM
- 02/18/04 09:18 PASSPORT DOCUMENT TRANSMITTAL Page:
2 E1i0hEll 10W11 From Date/Time ENTS Trans No.
- 00005 Total Items: 00020 5407 Transmittal Group Id: 04049DT-2 Item
- 0010
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- 0014
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- 0018 Facility MP MP MP MP MP MP MP MP MP Type PROC PROC PROC PROC PROC PROC PROC PROC PROC Sub HP HP HP HP HP HP HP HP HP Document Number I Title Sheet Revision Doc Date RPM 4.8.5-016
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003 01 SAP TEAM 2 KIT RPM 4.8.5-017 o
003 02 SAP LOCKER RPM 4.8.5-019 002 01 VAP/SAP AMBULANCE KIT RPM 4.8.5-020 006 01 UNIT 3 CONTROL ROOM RPM 4.8.5-021 `
006 02 TECHNICAL SUPPORT CENTER RPM 4.8.5-022A--
004 01 TECHNICAL SUPPORT CENTER TSC KIT RPM 4.8.5-022B 005 02 OSC ASSEMBLY AREA BLDG 475 1ST FLOOR RPM 4.8.5-024 001 01 UNIT 3 PERSONNEL DECON ROOM EMERGENCY PERSONNEL DECON KIT RPM 4.8.5-025 003 01 NAP TEAM 2 KIT Copy #
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Copies 01 01 01 01 01 01 01 01 01
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PASSPORT DOCUMENT To
- DOCUMENT CONTROL DESK Facility
- MP Department : 806 TRANSMITTAL Address
- NUC REGULATORY COMMISSION (0140)
DOCUMENT CONTROL DESK WASHINGTON, DC 20555 Page:
3 From NDS CONT DOCUMENTS Ihimhmmf Date/Time
- 02/18/04 09:18 Trans No.
- 000055407 Transmittal Group Id: 04049DT-2 Total Items: 00020 Item Facility Type Sub Document Number / Title Sheet Revision Doc Date Copy #
Media Copies
01 NAP LOCKER
000 01 P
01 GOSHEN FIRE DEPARTMENT Please check the appropriate response and return form to NDS Bldg 475/3 Millstone Power Station or Fax to 860-440-2057.
7 All documents received.
Documents noted above not received (identify those not received).
I no longer require distribution of these documents.
Date:
Signature:
02/27103 Approval Date
- 03/07/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 Writer Jean Olsen:
Rev. No.
Minor Rev.
Initiator Bridget Robertson I
O
Title:
E rhWQrxV l~kologi (Al,ui nait Voac n
ce ol and loaihmrf efit6z For NeDocuffients: Document is QA LY DH
Title:
o Revision 0 Minor Revision O Cleanup Revision El Biennial Review o Cancel-^
O Void (Do Not Use) 0 Expire 0 Superceded By..
Comments:
E Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, r003-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-01 1 rO05-01; 4.8.5-13A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002-01; 4.8.5-020, rOOG-01; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-1 Associated ARs Reviews Print Sign Date Department E l Cm1° 1
1N~z 0
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-¢a" n6.0 len
.Wei7 two WC 9 Att 3 Req. 0 Yes O No Licensing Basis / RCD (AM. Johnson (50.59 Screen Req. 0 Yes [0 No)
Tech independent AM. Johnson Validation None E Field - Use E Simulated Performance -
E Table Top and E Comparison MP-O5-DC-SAPO1-004 Use MP-05-DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
AN None O NuclearTraining E0 Briefing O Familiarization
[E SOR Review and Anproval n SORC Review and Approval I5I Denartment Head Review and Approval Approval El DisaPproval E NpA
-A.M. Johnson (1) Department Head Sign/Date (1) Department Head Approval Sign (1) SOR Sign/Dateo Je L /L&¶ (2)
SORC Meeting Number (2) Departmenpproval Sin '_.
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,(3)
SORC Approval Sign Approval Date: OA //a /
Effective Date: 1)
_/
/q 0 4 MP-05-DC-FAP01.1-005 Rev. 001/
Page 1 of -.
MILLSTONE NUCLEAR POWER STATION HEALTH PHYSICS OPERATIONS PROCEDURE A
Emergency Radiologic and Inspe Iuipment Maintenance
[Ref. 6.2]
I DA Ig qD Approval Date:
Effective Date:
0o //OL q Level of Use L
Information
I Millstone All Units Health Physics Operations Procedure Emergency Radiological Equipment Maintenance and Inspection [Ref. 6.2]
TABLE OF CONTENTS
- 1.
PURPOSE..........................
3
- 2.
PREREQUISIT'ES...........................
3
- 3.
PRECAUTIONS..........................
4
- 4.
INSTRUCTIONS..........................
5 4.1 Inventory Package Preparation...........................
- .5 4.2 Kit or Locker Inventories............
6 4.3 Equipment Restoration..........
7 4.4 Documentation..........................
8
- 5.
REVIEW AND SIGNOFF..........................
9
- 6.
REFERENCES.............
9
- 7.
SUMMIARY OF CHANGES 10 Level of Use l I Information I k
A RPM 4.8.5 Rev. 006-01 1 of 11
A ATTACHMENTS AND FORMS RPM 4.8.5-001, "Emergency Response Facility Readiness Check Report Form" RPM 4.8.5-002, "Emergency Operations Facility, Team 2 Kit" RPM 4.8.5-003, "Emergency Operations Facility, Team 3 Kit" RPM 4.8.5-004, "Emergency Operations Facility, Team 4 Kit" RPM 4.8.5-005, "Emergency Operations Facility, Team 5 Kit" RPM 4.8.5-009, "Emergency Operations Facility" RPM 4.8.5-011, "Unit 2 Control Room" RPM 4.8.5-013A, "Environmental Laboratory" RPM 4.8.5-015, "Unit 2 Personnel Decon Room Emergency Personnel Decon Kit" RPM 4.8.5-016, "SAP Team 2 Kit" RPM 4.8.5-017, "SAP Locker" RPM 4.8.5-019, "VAP/SAP Ambulance Kit" RPM 4.8.5-020, "Unit 3 Control Room" RPM 4.8.5-021, "Technical Support Center Locker" RPM 4.8.5-022A, "Technical Support Center TSC Kit" RPM 4.8.5-022B, "OSC Assembly Area Kit and Locker Building 475, 1st floor" RPM 4.8.5-024, "Unit 3 Personnel Decon Room Emergency Personnel Decon Kit" RPM 4.8.5-025, "NAP Team 2 Kit" RPM 4.8.5-026, "NAP Locker" RPM 4.8.5-027, "Security Station Emergency Dose Rate Equipment Kit" RPM 4.8.5-028, "Goshen Fire Department" Level of Use l RPM 4.8.5 Information Re.
060
- 1. PURPOSE 1.1 Objective This procedure ensures that the emergency radiological monitoring and protection equipment and other specified supplies at the Emergency Response Facilities are available when needed. It also ensures that the equipment is found in appropriate quantities, and is maintained in its proper operating condition, as required by Unit 2 Technical Specification 6.12 and Unit 3 Technical Specification 6.8.4 (b).
1.2 Discussion This procedure is provided to ensure that:
The minimum quantity of equipment is found at the locations specified on the inventory forms. [Ref. 6.7 and 6.9]
Radiological equipment is found to be in satisfactory working condition.
Respiratory equipment has been inspected using guidance from RPM 2.3.4, "Inspection and Maintenance Process for Respiratory Protection Equipment."
1.3 Frequency This procedure is to be completed in first, second, third, and fourth quarter of each year. The intent is to be as consistent as possible in the time frame of each inspection; avoid scheduling in January of the first quarter and June of the second quarter. This procedure shall also be completed on a post drill and on an as needed basis. [Ref. 6.7 and Ref. 6.8]
- 2. PREREOUISITES 2.1 General N/A 2.2 Documents 2.2.1 RPM 2.3.4, "Inspection and Maintenance Process for Respiratory Protection Equipment" Level of Use I
RMv.80-
'RM.-,IRev. 006-01 Information A"
-3fl
S 2.3 Responsibilities 2.3.1 Radiation Protection Supervisor - Services approves and makes changes to RPM 4.8.5-001 through 4.8.5-028.
2.3.2 Emergency Plan Coordinator approves changes to RPM 4.8.5-001 through 4.8.5-028. [Ref. 6.7]
2.4 Definitions 2.4.1 Emergency Response Facility (ERF) - Facilities containing emergency equipment (including radiological monitoring and protection equipment) which are activated in the event of an incident class ALERT or above classification. The station ERFs include:
Emergency Operations Facility Technical Support Center Control Rooms North Access Point Assembly Area South Access Point Assembly Area
- 3. PRECAUTIONS N/A I
Level of Use Information RPM 4.8.5 Rev. 006-01 4 of 11
- 4. INSTRUCTIONS 4.1 Inventory Package Preparation 4.1.1 RECORD the following on RPM 4.8.5-001:
Date Reason for Inventory Kits to be Inventoried 4.1.2 For each kit or locker to be inventoried, SELECT and DATE the corresponding form from RPM 4.8.5-002 through 4.8.5-028.
I Level of Use Informationl Al 3/4 h
RPM 4.8.5 Rev. 006-01 5 of 11
4.2 Kit or Locker Inventories [Ref. 6.8 and 6.10]
4.2.1 SELECT a kit or locker and PERFORM inventory as follows:
CHECK and RECORD quantity found.
REMOVE unnecessary items from kit or locker.
Where indicated on form, RECORD instrument serial numbers and calibration due dates.
- IE kit contains potassium iodide tablets, PERFORM the following:
- lE potassium iodide tablets will expire prior to the next quarterly inventory, REPLACE tablets.
Where indicated on form, RECORD expiration date of potassium iodide tablets.
REPLACE the following on dates indicated on form:
Batteries TLD badges Finger rings
- lE kit or locker contains respirators, PERFORM the following:
Refer To RPM 2.3.4, "Inspection and Maintenance Process for Respiratory Protection Equipment," and VERIFY respiratory equipment tags are correct.
Where indicated on form, RECORD inspection date.
- lE kit or locker contains equipment with batteries or sources, ENSURE the following:
Equipment is operable Calibration due dates are current Battery condition is satisfactory Source response is satisfactory Level of Use WI oA4d RPM4.8.5 Information 1
IF any equipment is found missing OR is removed, RECORD the following information on RPM 4.8.5-001:
Kit and, if applicable, section title Description of deficiency Actions to be taken to correct deficiency 4.3 Equipment Restoration 4.3.1 WHEN all items have been checked, RESTORE equipment as follows:
- a.
VERIFY all Ludlum 177 meters are on and plugged in.
- b. VERIFY all equipment other than Ludlum 177 meters are off.
- c.
PLACE stop watches in "RUN" mode to relieve spring tension.
- d. Neatly REPLACE equipment in storage location.
4.3.2 RESTORE any missing or removed equipment within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />.
[Ref. 6.10]
4.3.3 IE any equipment cannot be restored within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />, INFORM RPS - Services.
4.3.4 IF any missing or removed items are restored prior to sending RPM 4.8.5-001 to RPS -
Services, PERFORM the following:
- a.
RECORD date deficiency was corrected on RPM 4.8.5-001.
- b. RECORD date equipment was returned on the applicable kit or locker inventory form.
- c.
RECORD quantity of equipment returned on applicable kit or locker inventory form.
RPM 4.8.5 Leve ofUse
~
'~tN
'~T
~Rev.
006-01 Information
~J ol
4.4 Documentation 4.4.1 RECORD any inventory comments on RPM 4.8.5-001.
4.4.2 SIGN and DATE completed kit or locker inventory form.
4.4.3 IF there are more kits or lockers to be inventoried, Go To Section 4.2.
4.4.4 WHEN all kits or lockers have been inventoried, SIGN and DATE RPM 4.8.5-001.
4.4.5 COMPILE completed kit or locker inventory form(s) and RPM 4.8.5-001 and SUBMIT package to RPS - Services for review.
RPS -
4.4.6 REVIEW RPM 4.8.5-001 and inventory forms for inventory Services deficiencies.
4.4.7 WHEN any missing or removed item is restored, PERFORM the following:
- a.
RECORD date deficiency was corrected on RPM 4.8.5-001.
- b. RECORD date equipment was returned on the applicable kit or locker inventory form.
- c.
RECORD quantity of equipment returned on applicable kit or locker inventory form.
4.4.8 REVIEW and SIGN inventory form(s).
4.4.9 REVIEW and SIGN RPM 4.8.5-001.
4.4.10 SEND a copy of RPM 4.8.5-001 to Station Emergency Plan Coordinator.[Ref. 6.7 and 6.8]
4.4.11 SEND inventory forms to HP Calibration Laboratory to be filed.
Calibration 4.4.12 FILE inventory forms and RPM 4.8.5-001.
Technician Level of Use Information RPM 4.8.5 Rev. 006-01 8 of 11
- 5. REVIEW AND SIGNOFF 5.1 The review and signoff for this procedure is located on RPM 4.8.5-001 through 4.8.5-030, of this procedure.
- 6. REFERENCES 6.1 NUREG-0654, FEME-REP-1, Rev. 1, "Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants,"Section II, Part H 6.2 NUREG-0737, "Supplement 1 to NUREG-0737 - Requirements for Emergency Response Capability (Generic Letter No. 82-33)," dated December 17, 1982.
6.3 Millstone Nuclear Power Station Emergency Plan, Appendix E, "Emergency Equipment," Rev.17, June 1995.
6.4 EPPCR-94-22, "Emergency Planning and Health Physics Improvements" 6.5 EPPCR-95-05, "Silver Zeolite Cartridges" 6.6 EP-95-023, "Operational Support Center Change," T. J. Dembek dated January 6, 1995.
6.7 NOV VIO 50-245,336,423/97-81-02 and CR M3-97-4483 6.8 NU Letter A02567, Combined Inspection No. 50-245; 50-336; 50-423, "MNPS, Unit Nos. 1, 2, & 3 Response to Notice of Violation," dated September 18, 1982, specifies frequencies of inventories, operations checks, change out and replacement schedule for items having limited shelf life. It also specifies replacement for instruments taken for calibration and collectively states that finger rings will be provided in the on-site emergency monitoring team kits and at the EOE 6.9 NU Letter, dated 12/27176. Emergency Plan equipment is on an inventory list.
6.10 NU Letter, dated 12/27/76. Emergency Plan equipment is replaced in a timely manner.
6.11 Unit 2 Technical Specification 6.12 6.12 Unit 3 Technical Specification 6.8.4(b) l..
Use Ik
.1...,,AfghRPM 4.8.5 Level of Use CTN Rev. 006-0 Information 9fl L
6.13 Memo EP-98-127, "Implementation of Millstone Emergency Plan Revision #24," from Mark White to Millstone HP Management Personnel 6.14 USNRC Emergency Preparedness Position (EPPOSI) on Emergency Plan and Implementing Procedures Changes 6.15 MP-HPO-99081, "Closure of AIR 99006430-01," from A. S. Klotz to H. W Siegrist, dated May 21, 1999.
- 7.
SUMMARY
OF CHANGES 7.1 Updated procedure title of RPM 2.3.4.
7.2 Deleted RPM 4.8.5-010, "Unit 1 Control Room Kit and Locker," and RPM 4.8.5-014, "Unit 1 Personnel Decon Room Emergency Personnel Decon Kit," because the facilities are no longer used.
7.3 Updated form title changes in RPM 4.8.5-001.
7.4 Changed the title of RPM 4.8.5-009 from "Emergency Operations Facility Locker" to "Emergency Operations Facility." Deleted unnecessary verbiage in header row.
7.5 Reformated RPM 4.8.5-011 to better differentiate between the Kit and the Locker.
7.6 Changed the title of RPM 4.8.5-013A from "Overwater Team Monitoring Kit and Locker" to "Environmental Laboratory." Reformated to differentiate between the Kit and the Locker.
7.7 Changed the title of RPM 4.8.5-020 from "Unit 3 Control Room Kit and Locker" to "Unit 3 Control Room." Reformated to differentiate between the Kit and the Locker.
7.8 Changed the title of RPM 4.8.5-021 from "Technical Support Center Locker" to "Technical Support Center." Reformated to differentiate between the TSC and the Locker. Added a third source plaque, intended for use with RMT Kits 6,7, 8 at Goshen Fire Department (RPM 4.8.5-028), to the Locker.
7.9 Moved and changed the title of RPM 4.8.5 - 022B from "Technical Support Center TCS Locker" to "OSC Assembly Area, Bldg 475, 1st floor." Reformated to differentiate between the OSC, the Locker, and Conference Room 475/102. Added a source plaque to the Emergency Locker. Added an Area Radiation Monitor and an Electronic Dosimetry Reader.
RPM 4.8.5 AI of Use NZ.... 'PI irmationRe.06 1
I 10 of 11
7.10 Created new RPM 4.8.5-028, "Goshen Fire Department," consisting of three new RMT kits (Team 6,7, and 8).
7.11 References 6.7, 6.8, 6.9, and 6.10 are no longer NRC commitments.
Summary of Changes, Revision 006-01 7.12 Revised instances of replacing TLD badges and Finger Rings in the months of April and October to replacing them biannually and leaving a blank space for the correct date on the forms which follow. This change will accommodate changes in dosimetry vendors. This is corrective action to AR 03008293-02. Clover leafs were removed to reflect status changes in Regulatory Commitment Record as modified in revision 006 of this procedure.
RPM 4.8.5-002, -003, -004, -005, -009, -011, -013A, -016,
-019,-020, -021, -022A, -022B, -025, -028.
7.13 Changed replacement date for Silver Zeolite Cartridges from a set date of January 1, 2006 to replacement by that date on forms which follow. This is also corrective action to AR 03008293-02.
RPM 4.8.5-002, -003, -004, -005, -009, -011, -013A, -016,
-017, -019, -020, -021, -022A, -022B, -025, -026, -028.
7.14 The frequency of this procedure was changed January, April, July, September to the first, second, third, and fourth quarter of each year.
This allows the scheduling of the inspection to be more flexible. This is corrective action to AR 03008293-03.
7.15 Changed brand names to reflect generic items, e.g., mild soap instead of Ivory soap. These changes were made to RPM 4.8.5-015 and -024. This is corrective action to AR 03008293-04.
Level of Use Information MW AC.
REVWW RPM 4.8.5 Rev. 006-01 11 of 11
02127103 Approval Date 03107103 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 -o02l Writer.
Jean Olsen, Rev. No. l Minor Rev.
Initiator Bridget Robertson l
0 oo l
Title:
Emeqoy~gOpgrafiyectn5
&WvK; For New Documfents: Document is QA El OH
Title:
I O Revision, 0 Minor Revision 0 Cleanup Revision 0 Biennial Review o Cancel-Void (Do Not Use) 0 Exptre 0 Superceded By:-
Comments:
0 Administrative Correction FLS.
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-01 1, rO05-01; 4.8.5-13A, rOO5-02; 4.8.5-015, rOQO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002-01; 4.8.5-020, rOO6-01; 4.8.5-021, rO06-02; 4.8.5-022A, r004-01; 4.8.5-022B, rO05-02; 4.8.5-024, r001-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs Reviews Print Sign Date Department.
se Iios lt2 LP3qe~.
CB jg 2aLrf-.0(sen
____k4t WC 9 Att 3 Req. El Yes O No LUcensing Basis / RCD
.r.
(50.59 Screen Req. 0 Yes 0 No)
ID ] (.,M J~nson
A?.
//30/W1-RP Tech Independent AM. Johnson Validation 0 None E Field -Use I
Simulated Performance-E Table Top and
[]- Comparison MP-05-DC-SAPO1004 Use MPO5DC-SAP01-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
0 None El Nuclear Training 0 Briefing El Familiarization E SOR Review and Approval Fn SORC Review and Approval I5I Department Head Review and Approval Approval E Disapproval 0 WA
-A.M. Johnson
& 4
'Cl/o (t) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR Sign/Date -
J..
UtLaL (2) SORC Meeting Number (2) Departmen pproa Sign 9r (3)
SORC Approval Sign I
pproval Date:
A//0 Effective Date: 1) *uc? 0
,9 MP-05-DC-FAP01.1-005 Rev. 001 Page 1 of
Oa lida Et Approval Date 6[Iq_ /6 t__
Effective Date Emergency Operations Facility Team 2 Kit Date:
.l Quantity.
Returned Item Description Q
- t.
Required As Found Quantity. -Date.
Portable Count Rate Meter 1
Serial No.
Date Due__
DIG-5 Portable Scaler-1 Serial No.
Date Due RO-2A Or Equivalent 1
Serial No.
Date Due Portable Air Sampler (12 volts) 1 Serial No.
Date Due_
Batteries, Spares For Survey Meters 3 Sets Batteries Replaced (4th quarter)
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
TLD Badges (Replace Semi-annually) Date Due 4
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due_
8 Dosimeters (Low Range) Date Due 4
Dosineters (High Range) Date Due 4
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter) 1 Set Smears (Pkg of 50)
Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
Coin Envelopes 12 Silver Zeolite Cartridges (Replace 4th quarter.2005) 4 Rain Gear (Sets) 2 Sets Surgical Gloves (Pairs) 6 Ballpoint Pens 2
Markers, Felt Tip 2
Barrier¶Tape I
Thpe 1
Screwdriver 1
I G IdG Idl Id I
RPM 4.8.5-002 Rev. 003-01 Page 1 of 2
Item Description Stopwatch Screwdriver Stopwatch Forceps Scissors Stapler Box Of Staples Clipboard With Paper RMT No. 2 EPP Notebook Bottle of Potassium Iodide Thblets (Expiration Date:
)
On-Site Field Monitoring Map Inventoried By:
Date:
Reviewed By:
Date:
RPM 4.8.5-002 Rev. 003-01 Page 2 of 2
p.
I2270 02/27103 Approval Date Procedure Action Request 03/07/03 Effective Date Document No.:
RPM 4.8.5 -003 lWriter.
Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson l C 3 l
Title:
nwernecy roi os Fact t t t3 For New Documents: Document is QA El DH
Title:
o Revision 0 Minor Revision 0 Cleanup Revision 0 BIennial Review O Cancel; Void (Do Not Use)
O E.qree 0 Superceded By:.
Comments:
O Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, r003-01; 4.8.5-005, rO03-01; 4.8.5-009, r007,01; 4:8.5-011, rO05-01; 4.8.5-13A, rO05-02; 4.8.5-015, r00O-01; 4.8.5-016, rO03-01; 4.8.5-017, r003-02; 4.8.5-019, r002-01; 4.8.5-020, rO6-01; 4.8.5-021, rO06-02; 4.8.5-022A, r004-01; 4.8.5-022B, rO05-02; 4.8.5-024, r001-01; 4.8.5-025; r003-01; 4.8.5-026, rO03-02; 4.8.5-028, r0001 /
Associated ARs __/
Reviews Printl Sign Date Department.
E l
- 9 A
WC 9 Att 3 Req. E Yes O No Licensing Basis I RCD M. JomonO (50.59 Screen Req. 0 Yes 0 No)
____/___R Tech Independent A.M. John s
on Validation CD None Field -Us
[ Simulated Perl ormance -
II Table Top and El-Comparison MP.O54DC-SAPO1-004 Use MPA054DC-SAP01-004 Walk-through (minimum of two)
Print Silgn-Date Coordinator Member O Nuclear Training O3 Briefing Ia Denartment Head Review and APnrovai
Approval Date
&d/LIq/o a
Effective Date.
)
Emergency Operations Facility Team 3 Kit Date:
Quantity Returned Item Description Required AsFound. Quantity Date:
Portable Count Rate Meter 1
Serial No.
Date Due__________
DIG-s Portable Scaler Serial No.
Date Due________
RO -2A or Equivalent 1
Serial No.
Date Due__________
ASP-1I/P -270 or Equivalent Serial No.
Date Due________
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due____
Batteries, Spares For Survey Meters 4 Sets Batteries Replaced (4th quarter)
Dosimeters (Low Range) Date Due.
2 Dosimeters (High Range) Date Due
- 2
. Dosimeter Charger - Batteries Replaced (4th quarter)
I Batteries, Spares For Charger Batteries Replaced (4th quarter)
I Set TLD Badges (Replace Semi-annually) Date Due 2
Smears (Pkg of 25) 1 Filters, Particulate (Pkg of 50) 1
. Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6.
Thpe I
Silver Zeolite Cartridges (Replace 4th quarter 2005) 4 Calculator, Extra Battery (N/A Solar) Batteries 1
Replaced (4th quarter)
Surgical Gloves (Pairs).
6 Coin Envelopes 12 Rain Gear (Sets) 2 Sets Ballpoint Pens
- 2 Markers, Felt Tip 2
Screwdriver Stapler
=
RPM 4.8.5-003 Rev. 003-01 Page 1 of 2 l1a IdS IdS Ida
.ICI
I Quantity Returned
~Item Description.
Item Des o.Required As Found Quantity Date Box of Staples 1
Scissors 1
. Stopwatch 1
Forceps.
1 Keys For Fox Island Wildlife Area 2
Clipboard With Paper I
RMT No. 3 EPP Notebook-1 Map Of Sample Locations 1
Bottle of Potassium Iodide 7bblets (Expiration Date:
)
1 Inventoried By:
Reviewed By:
Date:
Date:
T RPM 4.8.5-003 Rev. 003-01 Page 2 of 2
t 02/27/03 Approval Date 03107/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 - 0 0 Lk Writer.
Jean Olsen Rev. No.
Minor Rev.
Initiator Bridget Robertson I O:5 I 0 T
9 fle:
OpMaenc ioyS rXpoj I
ec iT am 1 v+ 4 For New Documents: Document is QA LJ DH
Title:
O Revision, 0 Minor Revision E Cleanup Revision El Biennial Review E3 Cancel-Voild (Do Not Use) 0 Expire 0 Superceded By:
Comments:
El Administrative Correction FLS:_
The followirig forms have been revised with this procedure and follow. with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, r003-01; 4.8.5-004, rO03-01; 4.8.5-005, r003-01; 4.8.5-009, rO07-01; 4;8.5-011, rO05-01; 4.8.5-13A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rO06-01; 4.8.5-021, rOO6-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, r003-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-01 Associated ARs
/
Reviews Print Sign Date Departmentl CYV$ s-blsapliu-413 d~atmos Udgg s0
-C
_I__s___.
0(sen 9 11Ald 70 WC 9 Att 3 Req. O Yes 0 No 5
Licensing Basis / RCD
,AM. Johnson (50.59 Screen Req. i Yes E No)
Tech Independent
__A.M.
Johnson//3//30/oY Validation 1
None El Field - Use E Simulated Performance -
E Table Top and C-Comparlson MP SAPO01004 Use MPO05.DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
0 None El Nuclear Training 0 Briefing El Familiarization i5 SOR Review and Approval n
SORC Review and Approval 5 DePartment Head Review and Approval Approval El Disapproval W
-AM. Johnson e i*6.~~dZ(1)
Depaitrnent Head SIgn/Date (1) Department Head Approval Sign (1) SOR SigntDate (2) SORC Meeting Number (2) DepartmeMPVSppoval Slgn (3) SORC Apprval Sign Approval Date: 0A A4 Effective Date:
11q1/0/ q4t MP-05-DC-FAPoI.1-005 Rev. 001 Page 1 of
Approval Date 0911gloq
.Effective Date Emergency Operations Facility Team 4 Kit
-Date:
Quantity
-Returned Item Descriptionl.
t D
Required, As Found Quantity Date Portable Count Rate Meter 1
Serial No.
Date Due____
DIG-5 Portable Scaler 1
Serial No.
Date Due__________
RO-2Aor Equivalent 1
Serial No.
Date Due________
ASP-1/HP-270 or Equivalent Serial No.
Date Due_
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due____
Batteries, Spares For Survey Meters 4 Sets Batteries Replaced (4th quarter)
Dosimeters (Low Range) Date Due__
2 Dosimeters (High Range) Date Due 2
Dosimeter Charger -. Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger' 1 Set Batteries Replaced (4th quarter)
TLD Badges (Replace Semi-annually) Date Due _
2 Stopwatch 1
Forceps 1
Smears (Pkg of 25)
Filters, Particulate (Pkg of 50) 1 Bags, ClearPlastic 4x6 12 Bags, Clear Plastic 6x12 6
._=
Thpe 1
Silver Zeolite Cartridges (Replace 4th quarter 2005) 4 Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 6 Coin Envelopes 12 Rain Gear (Sets) 2 Sets Ballpoint Pens 2
. Markers, Felt Tip 2
RPM 4.8.5-004 Rev. 003-01 Page 1 of 2 I0 I0 I0
Quantity Returned Item Description Required As Found Quantity Date Screwdriver 1
Stapler 1
Box of Staples Scissors 1
Clipboard With Paper 1
RMT No, 4 EPP Notebook 1
Map of Sample Locations Bottle of Potassium Iodide Tablets (Expiration Date:
)
1 Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-004 Rev. 003-01 Page 2 of 2
A 02/27/03 Approval Date 03/07/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 -C0 5
Writer Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson 00 5 O l
Title:
~
(Qp~cmia s KtU~
T.c~6'it For New Documents: Document is QA El DH Tile:
o Revision
- Minor RevIsion Cleanup Revision E Biennial Review 0 CancelT OVold (Do Not Use) 0ETxpire O Superceded BY-Comments:
0 Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, r003-01; 4.8.5-005, r003-01; 4.8.5-009, r007-01; 4;8.5-01 1, rO05-01; 4.8.5-13A, r005-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002-01; 4.8.5-020, rO06-01; 4.8.5-021, rOO6-02; 4.8.5-022A, r004-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01 -01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rOCO-Ol Associated ARs
/
Reviews Print Sign Date Department.
.l El G7vs - biscsplikv Uaq03 sds
- pP 12 G
WC 9 Att 3 Req. El Yes O No Licensing Basis / RCD K Johnson (50.59 Screen Req. 0 Yes 0 No)
_________R Tech independent A.M. Johnson Y K Validation None []Field -Use
[ Simulated Performance-Table Top and 5 Comparison MP-054DC-SAPOlW004 Use MP4O5-DCSAP0I-004 Walk-through (minimurn of two)
Print Sign Date Dept Coordinator Member Training:
El None 0 Nuclear Training El Briefing El Familiarization
[1 SOR Review and Approval Fn SORC Review and Approval l
Department Head Review and Approval Approval E1 Disapproval WA
-A.M. Johnson eg~k, (1)
Department Head Sign/Date (1) Department Head Approval Sign (1) SOR
, Sign/Date J
U(2)
SORG Meeting Number (2) Department p
DroVal Sign 0
- (3) SORC Approval Sign Approval Date
&AR/1?
/
Effective Date:
1q10 q
MP-05-DC-FAPO1.1-005 Rev. 001 j
Page 1 of {
(%2~ I/?,KO'4 OA// q1Y-Effective Date Approval Date.
Emergency Operations Facility Team 5 Kit Date:
Quantity.
Returned Item Descriptionl tt Required' AsFound Quantity Date-Portable Count Rate Meter 1
Serial No._
Date Due________
DIG-5 Portable Scaler 1
Serial No.
Date Due RO-2A or Equivalent 1
Serial No.
Date Due_ ___
ASP-1/HP-270 orEquivalent.
Serial No.
Date Due_
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due Batteries, Spares For Survey Meters
. 4 Sets Batteries Replaced (4th quarter)
Dosimeters (Low Range) Date Due 2
Dosimeters (High Range) Date Due 2
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger 1 Set Batteries Replaced (4th quarter)
._1 TLD Badges (Replace Semi-annually) Date Due_
2 C
Smears (Pkg of 25)
I.
Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
'ape 1
Silver Zeolite Cartridges (Replace 4th quarter 2005) 4 i
Calculator And Extra Battery (N/A Solar) 1 i
Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 6 Coin Envelopes 12 Rain Gear (Sets) 2 Sets Ballpoint Pens 2
Screwdriver.
Markers, Felt Tip 2
Stapler 1
RPM 4.8.5-005 Rev. 003-01 Page 1 of 2
Quantity Returned Item Description Required As Found Quantity Date Box of Staples 1
Scissors 1
Stopwatch 1
Forceps 1
Clipboard With Paper 1
RMT No. 5 EPP Notebook 1
Map of Sample Locations 1
Bottle of Potassium Iodide Tablets (Expiration Date:
)
Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-005 Rev. 003-01 Page 2 of 2
4 02/27/03 Approval Date 03107/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 - 009 Writer:
Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson 055 0
Title:
emeren OperaJn5 Rcty For New Documents: Document is QA EJ DH
Title:
o Revision 0 Minor Revision 0 Cleanup Revision 0 Biennial Review O Cancol 3 Vold (Do Not Use)
Q3 Eisre O Superceded By Comments:
0 Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-01 1, rO05-01; 4.8.5-13A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03401; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rO06-01; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-01 Associated ARs
_/
Reviews Print Sign Date Department.
19 RC.
WC 9 At 3 Req. O Yes O No Ucensing Basis / RCD 1
A -
Johnson (50.59 Screen Req. 0 Yes 03 No)
Tech Independent A.M.Johnson_
//30M0Y Validation 0 None Field -Use Simulated Performance -
El Table Top and rl Comparison MP-054)C-SAPO1004 Use MP-05-DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator 7
Member Training:
El None El Nuclear Training O Briefing El Familiarization El SOR Review and Approval Approval E Disapproval El
-AM.A Johmnsn 14*
J3°/l p2s71 n
SORC Review and Approval MIa Department Head Review and ApDroval W/A
- m.
(1) Department Head Approval Sign MP-05-DC-FAP01.1-005 Rev. 001 Page 1 of___
I ATS Ih0Co ec DJatoe Effective Date Approval Date.
.Date:
Quantity.
Returned Itemn Description As Quantity Date Found.
Dosimeters (0-1r) Date Due 50 Dosimeters (0-50r) Date Due 10 TLD Badges (Replace Semi-annually) Date Due 50 Finger Rings [Ref6.81 (Replace Semi-annually) Date Due 25 Dosimeter Charger - Batteries Replaced (4th quarter) 2 Spare Batteries For Charger - Batteries Replaced (4th quarter) 2 Sets 1 Respirators - Date Inspection Due 50 Respirators with Charcoal Cartridges 10 Date Inspection Due_
Complete Sets Of PCs 20 Rubber Shoe Covers (Pair) 20.
Rubber Gloves (Pair) 40 Smears (Box).
8 Smear Folders (Box) 8
. Scissors 6
Radiation Ribbon (Rolls) 20 Duct 7hpe (Rolls) 12.
Vinyl Gloves (Boxes) 2 Cotton Gloves (Pair) 5(=
e Radiation Area Signs 20 A High Radiation Area Signs 20 Contaminated Area Signs 20 Airborne Radioactivity Signs 20 Hoods 50 Booties, Plastic (Pair) 50
- Step-off Pads 10 Radioactive Material Stickers With Labels 50
- Paper Suits 75 Iic 1c3 la RPM 4.8.5-009 Rev. 007-01 Page 1 of 4
Emergency Operations Facility I
I Quantity Returned I
Item Description Required I As Found 1 Quantity. Date U.
110 Volt Air Samnplers 1
51 I
I
.I
- No.
Serial No.
Date Due 1I 2
3 4
5 12 Volt Air Samplers No.
Serial No.
Date Due I
2 3
4 5
I D
I I*
I Silver Zeolite Cartridges (Replace by 4th quarter 2005) la Particulate Filters 100 I
I E-140/HP-210 or Equiv,ilent I
5.I I
I I
No.
Serial No.
Date Due I
1 1
2 4
5 a -
a a
RO-2A or Equivalent No.
Serial No.
Date Due i
31
-s 1
2
- 3 4
5 6
7
.5 i
.5 RPM 4.8.5-009 Rev. 007-01 Page 2 of 4
Emergency Operations Facility I
Quantity Returned Item Description
.Quantity.R.t
.r.
Required As Found Quantity Date PS-2-2IHP-210 or Equivalent 3
No.
Serial No.
Date Due
.*g tI Ha 2
~
3 Teletectors or Equivalent 2
No.
Serial No.
Date Due 3
I e
11 2
+ *: :::~+,
DIG-s or Equivalent 2
Io.
Serial No.
Date Dueqa ASP-9V lt P270 or Equivalent 3
No.
Serial No.
Date Due SpareBatteri r
-2
=
Sparel Batteries FRepilae(thectorter 25St C
Cell Batteries Replace (4th quarter) 1 Source Plaque 5
Screwdriver1 I
I RPM 4.8.5-009 Rev. 007-01 Page 3 of 4
.1 Quantity Returned Facility Item Description Required As Found Quantity Date Area Radiation Monitor 1
Serial No.
Date Due_______
Friskers At Entrances Tb EOF 2
Model Serial No.
Due Date i.-MM Friskers In Decon Room 2
Model Serial No.
Due D Portal Monitor 1
Serial No.
Date Due CamD1 Due Serial No.
.Date Due
- Inventoried By:
Reviewed By:_
- Date:
Date:
RPM 4.8.5-009 Rev. 007-01 Page 4 of 4
02127/03 03107103 Effective Date Approval Date Procedure Action Reauest Document No.:
RPM 4.8.5 -b Writer:
Jean-Olsen.
Rev. No. l Minor Rev.
Initiator Bridget Robertson 005 l 01
Title:
L
}
Q tl (lnJ 2 (Oonfro I 'Room)
For New Documents: Document is QA L DH
Title:
O Revision 0 Niinor Revision 0 Cleanup Revision 3 Biennial Review o Canceli O Vold (Do Not Use) 0 Expire a Superceded By:
Comments:
0 Administrative Correction FLS._
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-011, r005-01; 4.8.5-13A, rO05-02; 4.8.5-015, rOO0-01; 4.8.5-016, rO03-01; 4.8.5-017, r003-02; 4.8.5-01 9, r002-01; 4.8.5-020, rO06-01; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rOO5-02; 4.8.5-024, r001-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rOO0-01 Associated ARs Reviews Print Sign Date Department cb19 6 cnO(Sen Q)~i ZW 02-A f390 WC 9 Att 3 Req. O Yes C No El Ucensing Basis / RCD 1
ACM. Johnson (50.59 Screen Req. 0 Yes 0 No)
_________________R Tech Independent A.M. Johnson//3 Validation 0 None I Field -Use
] Simulated Performance -
E Table Top and D. Comparison MP-05-DC-SAP01004 Use MP-D5-DC-SAP01I-004 Walk-through (minimum of two)
Print Sign Date Dep Coordinator Member Training:
El None O Nuclear Training El Briefing O Familiarization 5 SOR Review and ADproval F SORC Review and Approval bI Denartment Head Review and Approval Approval 5 Disapproval D WA
-A.M. Johnson t-t jA/
(1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR
, Slgn/Date (2)
SORC Meeting Number (2) Departmeo va Sign
.' V
`
(3) SORC Aproval Sign Approval Date: OA/AR/o Effective Date: o RI//T/0 MP-05-DC-FAPo1.1-005 Rev. 001 l
~Pagel1 of J
fi
\\
D /lW/O OAIIWO0t Approval Date Date:
Effective Date Unit 2 Control Room Quntt Returned Item Description Quatit______
Required As Found Quantity Date Team I Kit Portable Count Rate Meter Serial No.
Date Due DIG-S Portable Scaler 1
Serial No.
Date Due_
RO-2A or Equivalent 1
Serial No.
Date Due Air Sampler 110 Volt Serial No.
Date Due_
Batteries, Spares For Meters -Batteries Replaced (4th quarter) 3 Sets Dosimeters (Low Range) Date Due_
3 Dosimeters (High Range) Date Due_3 Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries,Spares For Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annually) Date Due 3
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due 6
Stopwatch 1
Screwdriver 1
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
Plastic Bags 6x12 5
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Coin Envelopes 5
Forceps 1
Particulate Filters (Pkg of 12) 1 Smears (Pkg of 50) 1 Ballpoint Pens 2
Markers, Felt Tip 2
Surgical Gloves (Pairs) 8 Rain Gear (Sets) 4 Clipboard With Paper 1
RMT No. 1 EPP Notebook 1
On-Site Field Monitoring Map 1
.Id iciG Ida lai RPM 4.85-011 Rev. 005-01 Page 1 of 2
I Item Description I
Quantity l
Returned I Required I As Found l Quantity l Date.I Emergency Locker Portable Count Rate Meter 2
- 1. Serial No.
Date Due
- 2. Serial No.
Date Due________
Ieletector or Equivalent 1
Serial No.
Date Due____
Batteries Spares For Survey Meters 3 Sets Batteries Replaced (4th quarter)
Dosimeters (High Range) Date Due 10 Dosimeters (Accident)
Date Due 3
Dosimeter Charger 1
Batteries Replaced (4th quarter)
Batteries Spare For Charger 1 Set Batteries Replaced (4th quarter)
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due 10 Plastic Booties (Pairs) 8 Cotton Gloves (Pairs) 8 Paper Coveralls (Sets) 4 PCs Complete Sets 10 Respirators With Charcoal Canisters 12 Date Inspection Due Scott Air Paks 2
Survey Forms I Set Source Plaque 1
1ic 1a Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-011 Rev. 005-01 Page 2 of 2
0 2 2 7 0
0 3 0 7 02/27103
-03/07/03 Approval Date Effective Date Procedure Action Request Document No.:
RPM 4.8.5 -o f;?A Writer.
Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson C>5 02 Tte: Cn Aonnmnio La-o~-Tt2 ry For New Documents: Document is QA El DH
Title:
O Revision, 0 Minor Revision E Cleanup Revision 0 Biennial Review O Cancel.
E Vold (Do Not Use)
O Expire E Superceded By:
Comments:
O Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, r007-01; 4;8.5-011, r005-01; 4.8.5-13A, r005-02; 4.8.5-015, rOO0-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02401; 4.8.5-020, rO0G-o6; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs
/
Reviews Print Sign Date Department.
El El GIsb Is -janb.
-(
sen C
WC 9 Att 3 Req. O Yes 0 No Ucensing Basis / RCD Johnson (50.59 Screen Req. 0 Yes 0 No)
________________R Tech Independent iA.M.Johnson Validation 3 None 0 Field - Use E Simulated Performance-
] Table Top and Cl Comparison MP-054DC-SAPO1I004 Use MP-054DC-SAP01-4 Walk-through (minimurn of two)
Print Sign Date Dept Coordinator I
Member Training:
El None El Nuclear Training El Briefing El Familiarization El SQR Review and Approval n SORC Review and APproval 64 Department Head Review and Approval Approval E Disapproval I WA
-A.M. Johnson Z
Ž (1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR Sign/Date (2) SORC Meeting Nunber (2) Departmnen proval Sign
'V (3)
SORC Approval Sign Approval Date:
Effective Date: 1 ?/qf69LM MP-05-DC-FAPO1.1-005 Rev. 001 lI-.
Page 1 of
A o
//Date Eft Approval DateI
.OSOL6/zk Effectlive Date Environmental Laboratory I
Date:
.Quantit Returned Item Description tyu
~
1 Reuie ItemDescriptionRequired l As Found Quantity. Date Overwater Kit Portable Count Rate Meter 1
Serial No.
Date Due______
DIG-5 Portable Scaler1 Serial No.
Date Due____
RO-2A or Equivalent 1
Serial No.
Date Due____
ASP-1/HP-270 or Equivalent 1
Serial No.
Date Due______
Portable Air Sampler (12 Volts) 1 Serial No.'
Date Due____
Batteries, Spares For Survey Meters 4 Sets Batteries Replaced (4th quarter)
Dosimeters (Lowv Range) Date Due ______2
. Dosimeters (High Range) Date Due 2
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, SparesFor Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annually) Date Due 2
- Stopwatch 1
. Forceps.
1 Smears (Pkg of 25) 1 Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6'
'12 Bags, Clear Plastic 6x12 6
.I pe 1
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Calculator, Extra Battezy (N/A Solar) 1 Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 6 Coin Envelopes 12
.la
.1i 1(a 1d la RPM 4.8.5-013A Rev. 005-02 Page 1 of 2
Quantity Returned Item Description.
Ite. DRequired As Found Quantity Date Rain Gear (Sets) 2 Sets Ballpoint Pens 2
Markers, Felt Tip.
2 Screwdriver 1
Stapler 1
Box of Staples 1
Scissors 1
Clipboard With Paper 1
Overwater Team EPP Notebook 1
Map of Sample Locations 1
Bottle of Potassium Iodide Tablets (Expiration Date:
)
1 Overwater Team Emergency Locker All Weather Suit 2
Battery Powered Lantern (Replace battery 2nd quarter, 2008) 1 Flashlight.
2 Spare Batteries for Flashlights (D-Cell) 2 Sets Respirators with Charcoal Cartridges 6
Date Inspection Due:
Complete set of PCs 6
Source Plaque 1
01(
Inventoried By:
Date:
Reviewed By:
Date:.
RPM 4.8.5-013A Rev. 005-02 Page 2 of 2
r 02/27/03 03/07103 Effective Date Approval Date Procedure Action Request Document No.:
RPM 4.8.5 - o Writer.
Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson coO O l
Title:
k1iiF 2 PetrSb'I~ k onl rn eerencj Tsr u-e ThQ ri k.--
For New Documents: Document is QA LO DH Tile:
(J O Revislon,
Minor Revision 0 Cleanup Revision
[
Biennial Review O Cancel
(:I Vold (Do Not Use)
O Expire O Superceded By, Comments:
O Administrative Correction FLS._
The followirig forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-01 1, rO05-01; 4.8.5-13A, r005-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-01 9s, rO02-01; 4.8.5-020, r006-01; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, rOO3-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-01 Associated ARs
/
Reviews Print Sign Date Department E l_
[9 I 1
6n.
Olsen W
X diIA4A i3 WC 9 At 3 Req. O Yes 0 No E.
LUcensing Basis / RCD A.M. Johnson (50.59 Screen Req. 0 Yes 0 No)
VM.
Jhnson Tech Independent A.M. Johnson
//31?/,5 fR Vaildatlon HeNone l Field - Use El Simulated Pertormance-El Table Top and C
Comparison MP054DC-SAPO1-004 Use MP-05-DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
0 None 0 Nuclear Training El Briefing 0 Familiarization El SOR Review and ADProval n
SORC Review and Approval 5 DePartment Head Review and Approval Approval E]
Disapproval W
NA Aprv Elhnso Disappovl (1) Department Head Sign/Date (1) Department Head Approval Sign
-A.Johns on e ' '
(1) SOR
/
Sign/Date (2)SORC Meeting Number (2) Department roval Sign (3)SORCApproval Sign
__I Approval Date:
Effective Date:
MP-05-DC-FAPO1.1-005 Rev. 001.
Page 1 of f
Approval Date 6S/q./&
Effective Date Unit 2 Personnel Decon Room Emergency Personnel Decon Kit Date:
Quantity Returned Item Description RF lRequired lAsFound Quantity Date Fingernail Brushes 12 Mild Soap, Bars 24 Abrasive Soap, Bars 12 Razors 24 Skin lotion, Bottles 2
Shampoo, Bottles 24 Shaving Cream, Cans 2
IG 1(d Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-015 Rev. 000-01 Page 1 of I
02/27/03 03/07/03 02/27/03 03107103 Approval Date Effective Date Procedure Action Request Document No.:
RPM 4.8.5- 016 Writer Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson I
O 01o
Title:
SAP PlLam 2 Kg&
For New Documents: Document is QA El DH
Title:
o Revision, 0 Minor Revision a Cleanup Revision 0 Biennial Review o Cancel-O Vod (Do Not Use)
E Etxpire 0 Superceded By:
Comments:
0 Administrative Correction FLS._
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, r003-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, r003-01; 4.8.5-009, rO07-01; 4;8.5-011, rO05-01; 4.8.5-1 3A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rOO6-01; 4.8.5-021, rOO6-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, r001-01; 4.8.5-025, rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs
/
Reviews Print Sign Date Department
.i
'-O_
Cyzss -
%>i u ~m1h 2 WC 9 Att 3 Req.
O Yes O No El Ucensing Basis / RCD 1
Johnson (50.59 Screen Req. 0 Yes 0 No)
_________R Tech Independent A.M Johnson
,o(
L/30 0e Validation ED None [] Field -Use SimulatedPerformance-E TablelTopand
], Comparison MP-05-DC-SAPOI-004 Use MP-05-DC-SAP01-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
El None El Nuclear Training El Briefing El Familiarization
[l SOR Review and Approval n
SORC Review and ADproval 1 Department Head Review and Approval Approval n Disapproval WA N/A A.M. Johnson C
(1) Department Head Slgn/Date (1) Department Head Approval Sign (1) SOR
/
Sign/Date (2)
SORC Meeting Number (2) Departmen iroyal Sign Y_
_(3)
SORC Approval Sign
__1 Approval Date: D9 //I 1/14 Effective Date: 0 2//e7/6aLf MP-05-DC-FAPO1.1-005 Rev. 001/
Page 1 of L r-
Approval Date e
O, Effective Date SAP Team 2 Kit Date:
. D Quantity Returned
.te De o
Required As Found Quantity Date Portable Count Rate Meter Serial No.
Date Due DIG-5 Portable Scaler Serial No.
Date Due_
RO-2A or Equivalent 1
Serial No.
Date Due_
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due_
Batteries, Spares For SurveyMeters 3 Sets Batteries Replaced (4th quarter)
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
TLD Badges (Replace Semi-annually) Date Due 4
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due 8
Dosimeters (Low Range) Date Due_4 Dosimeters (High Range) Date Due 4
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter)
I Set Smears (Pkg of 50) 1 Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
Coin Envelopes 12 Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Rain Gear (Sets) 2 Sets Surgical Gloves (Pairs) 6 Ballpoint Pens 2
Markers, Felt Tip 2
Barrier Thpe 1
Tape 1
Id I I Ida Ida I
RPM 4.8.5-016 Rev. 003-01 Page 1 of 2
Quantity Returned Item Description Required As Found Quantity Date Stopwatch 1
Screwdriver 1
Forceps
. Scissors
. Stapler 1
. Box of Staples 1
Clipboard With Paper and Survey Forms 1
RMT No. 2 EPP Notebook Bottle of Potassium Iodide Tablets (Expiration Date:
)1 On-Site Field Monitoring Map 1
Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-016 Rev. 003-01 Page 2 of 2
I 02/27/03 Approval Date 03/07/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 - 0 t Writer.
Jean Olsen.
Rev. No.
Minor Rev.
initiator Bridget Robertson 0 o
Title:
SA-o
~-
For New Documents: Document is QA O DH
Title:
O Revision 0 Minor Revision O Cleanup Revision O BiennIal Review O Cancel-O Void (Do Not Use)
O Expire
[ Superceded By:
Comments:
0 AdminIstrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-011, rOO5-01; 4.8.5-13A, r005-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-41; 4.8.5-017, r003-02; 4.8.5-019, rO02-01; 4.8.5-020, rOO6-01; 4.8.5-021, r006-02; 4.8.5-022A, rO04-01; 4.8.5-022B, r005-02; 4.8.5-024, r001 -01; 4.8.5.025, r003-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs Reviews Print Sign Date Department Gvss -
4 teY
'si IS jfani.O((scrn
____1gl P
WC 9 Aft 3 Req. O Yes O No
]
Ucensing Basis I RCD A.M. Johnson (50.59 Screen Req. 0 Yes 0 No)
A Jn //_______RP Tech Independent AM. Johnson
-/t -
r R
Validation ED None I Field - Use El Simulated Performance -
E Table Top and
] Comparison MP-054)C-SAPOI-004 Use MP-054DG-SAPOI-004 Walk-through.
(minimum of two)
Print Sign Date j
Dept Coordinator Member Training:
0 None El Nuclear Training 0 Briefing Ol Farniliarization 0 SOR Review and Anproval ln SORC Review and Aporoval i3 Denartment Head Review and Approval Approval El Disapproval El W
-A.M. Johnson ti t
(1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR
'SignlDate
_z (2) SORC Meeting Number (2) Departmeroal S
V 3SORCApproval Sign Approval Date: OA//R/O Effective Date: ()>f/c/
1 L MP-05-DC-FAPO1.1-005 Rev. 001 Page 1 of
Approval Date 0622/f V Effective Date SAP Locker Date:
i Quantity Returned t
Required As Found Quantity Date'.
RMT Kit No. 2 1
RM-14 or Equivalent 1
Serial No.
Date Due________
110 Volt Air Sampler '
Serial No.
Date Due____
Radiation Area Signs 3
Respirators With Charcoal Filters 5
Date Inspection Due.
Emergency Lanterns (Replace battery 2nd quarter, 2008) 5 Silver Zeolite Cartridges (Replace by 4th quarter 2005) 4 Particulate Filters 50 Extension Cord 1
PCs Complete Sets 6
Source Plaque 1
I1
..dl Inventoried By:
Date:
Reviewed By:
Date:
RPM 4.8.5-017 Rev. 003-02 Page 1 of 1
k 02/27103 03107/03 Effective Date Approval Date Procedure Action Request Document No.:
RPM 4.8.5 -O(q l Writer Jean Olsen l Rev. No. l Minor Rev.
Initiator Bridget Robertson l 002 l o f
Title:
VA? /SA#P AhAa ce For New Documents: Document is QA El DH
Title:
E Revision 0 Minor Revision E Cleanup Revision 0 Biennial Review 0 Cancel-0 Void (Do Not Use) 0 Expire E Superceded By:
Comments:
0 Administrative Correction FLS:_
The following forms have been revised with this procedure and follow with a separate PAR for each fQrm: RPMs 4.8.5-002, rO03-01; 4.8.5-003, r003-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-011, rO05-01; 4.8.5-13A, r005-02; 4.8.5-015, rOO0-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002-01; 4.8.5-020, rOO6-01; 4.8.5-021, rO06-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025; rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs
/
Reviews Printl Sign Date Department-El El GVS5 - I-iaplig
&V4ip 44Vs bt&Y s WC 9 Att 3 Req. E Yes O No O
,Lcensing Basis / RCD 1
kM. Johnson (50.59 Screen Req. 0 Yes 0 No)
__________________R Tech Independent A.M. Johnson Validation None E Field - Use Q Simulated Performance -
E Table Top and E-comparison MP-054DC-SAPOI-004 Use MP-05-DC-SAPOI-004 Walk-through (minimum of two)
Print Sign Date Depi Coordinator Member Training:
El None El Nuclear Training El Briefing El Familiarization El SOR Review and Approval n
SORC Review and Aporoval 1 Department Head Review and Approval Approval El Disapproval E WA A.M. Johnso 6
/
(1) Department Head Sign/Date (1) Department Head Approval Sign (1) SOR Sign/Date (2) SORC Meeting Number (2) Departme nt3ppRval Sign r
_V_
(3) SORC Ap royal SIg Approval Date: aA 11 04 Effective Date:
0
)
4? 0//q' 4 MP-05-DC-FAPO1.1-005 Rev. 001
/
Page 1 of L
Approval Date A figk Effective Date/
VAP/SAP Ambulance Kit I.
Date:
Quantity Returned Item DescriptionI t Required As Found Quantity'. Dater Paper Coveralls 3
Rubber Shoe Covers (Pair) 3 Plastic Booties (Pair) 3 Rubber Gloves (Pair) 3 Surgical Gloves (Pair) 3 TLD Badges (Replace Semi-annually) Date Due 4
Dosimeters (Low Range) Date Due 4
Dosimeter Charger 1
Batteries Replaced (4th quarter)
Batteries, Spare For Charger 1
Batteries Replaced (4th quarter)
Cotton Gloves (Pair) 3 Plastic Rain Suits 3
Herculite Sheet I
Radiation Area Sign 1
Emergency TLDs (Replace Semi-annually) Date Due_
24 Duct Thpe (Roll) 1 Waste Bag I
'10 10 IG 10 Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-019 Rev. 002-01 Page 1 of 1
I 02/27/03 Approval Date 03/07103 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 - OZO Writer Jean Olsen, Rev. No. l Minor Rev.
Initiator Bridget Robertson 0
I)(
l)
Title:
tLnitt 3 Coracol Vcoron For New Documents: Document is QA DH
Title:
O Revision 0 Mnor Revision O Cleanup Revision 0 Biennial Review O Cancel.
O Void (Do Not Use)
El Expire 0 Superceded By:
Comments:
0 Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4.8.5-011, rO05-01; 4.8.5-13A, rOOS-02; 4.8.5-015, rO00-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rOO6-01; 4.8.5-021, rO06-02; 4.8.5-022A, r004-01; 4.8.5-022B, rOO5-02; 4.8.5-024, rO01-01; 4.8.5-025,.r003-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-01 Associated ARs
/
Reviews Print Sign Date Departmentl
- El cyv%
t vB i
1 WC 9 Att 3 Req. O3 Yes 0 No Licensing Basis / RCD 7
yoson (50.59 Screen Req.
0 Yes [0 No)
_____________Y_-RP Tech Independent AM. Jnson//3/
Validation None [
Field -Use E Simulated Performance -
[
Table Top and El Comparison MP-05-DCSAPO1004 Use MP-054DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date Dept Coordinator Member Training:
El None El Nuclear Training El Briefing El Familiarization El SOR Review and ADDroval n SORC Review and Approval ba Department Head Review and Approval Approval El Disapproval E WA
-A.M. Johnson (s'
t 30/oP (1) Department Head Slgn/Date (1) Department Head Approval Sign (1) SOR
/
Sign/Date (2) SORC Meeting Number (2) Departrne proval Slgn r
. (3)
SORC Approval Sign Approval Date:
Effective Date:
11q10 q-MP-05-DC-FAP01.1-005 Rev. 001
/
Page 1 of L
I
@I)A1/ d q Approval Date Effective Date Unit 3 Control Room Date:
Quantity Returned Item Description
.t.
ecp nRequired As Found Quantity Date Teaml Kit Portable Count Rate Meter Serial No.
Date Due DIG-5 Portable Scaler 1
Serial No.
Date Due RO-2A or Equivalent 1
Serial No.
Date Due Air Sampler 110 Volt 1
Serial No.
Date Due Batteries, Spares For Meters - Batteries Replaced (4th quarter) 3 Sets Dosimeters (Low Range) Date Due 3
Dosimeters (High Range) Date Due __
3
. Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries,Spares For Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annually) Date Due_
4 Finger Rings [Ref.6.8] (Replace Senui-annually) Date Due 8
Stopwatch I
Screwdriver 1
Calculator, Extra Battexy (N/A Solar)
I Batteries Replaced (4th quarter)
Plastic Bags 6x12 5
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Coin Envelopes 5
Forceps 1
Particulate Filters (Pkg 4th quarter 12) 1 Smears (Pkg of 50) 1 Ballpoint Pens 2
Markers, Felt Tip 2
Surgical Gloves (Pairs) 8 1(3 laI a ila ici ic@
la RPM 4.8.5-020 Rev. 006-01 Page 1 of 2
. Quantity Returned Item Description Required As Found Quantity Date Rain Gear (Sets) 4 Clipboard With Paper 1
RMT No.1 EPP Notebook 1
On-Site Field Monitoring Map 1I=
Emergency Locker RM-14 orEquivalent 2
- 1. Serial No.__
Date Due
- 2. Serial No.
Date Due_
Teletector or Equivalent Serial No.
Date Due Batteries Spares For Survey Meters 1 Set Batteries Replaced (4th quarter)_
Dosimeters (High Range) Date Due 10 Dosimeters (Accident) Date Due 3
Dosimeter Charger-Batteries Replaced (4th quarter)
I Batteries Spare For Charger - Batteries Replaced (4th quarter) 1 Set Finger Ring [Ref.6.8] (Replace Semi-annually) Date Due 10 Plastic Booties (Pairs) 8 Cotton Gloves (Pairs).
8 Paper Coveralls (Sets) 4 PCs Complete Sets 10 Respirators With Charcoal Canisters 12 Date Inspection Due Scott Air Pals 2
Survey Forms 1 Set Extension Cord 1
Source Plaque I
id id~
Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-020 Rev. 006-01 Page 2 of 2
I 02127/03 03107103 Approval Date Effective Date Procedure Action Request Document No.:
RPM 4.8.5 -0 Z I Write-r Jean Olsen Rev. No. I Minor Rev.
Initiator Bridget Robertson G
cO& I echnicfo' S P(Aine For New Documents: Document is QA OL DH
Title:
n Revision Minor Revision 3 Cleanup Revision 03 Blennial Review O cancel.
3 Vold (Do Not Use)
O Expire O Superceded By:
Comments:
El Administrative Correction FLS._
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, r007-01; 4;8.5-011, rO05-01; 4.8.5-13A, rOO5-02; 4.8.5-015, rO00-01; 4.8.5-016, rO03-01; 4.8.5-017, r003-02; 4.8.5-019, r002-01; 4.8.5-020, rO06-01; 4.8.5-021, r006-02; 4.8.5-022A, rO04-01; 4.8.5-022B, r005-02; 4.8.5-024, r001-01; 4.8.5-025; rO03-01; 4.8.5-026, rO03-02; 4.8.5-028, rOOO-01 Associated ARs Reviews Print Sign Date Department.
El Grs5
- IISM Ig-
§ Mat VBCoI b-PY RC>
_at__'6.(___
WC 9 Att 3 Req. O Yes O No iUcensing Basis / ROD (50.59 Screen Req. 0 Yes O No)
Tech Independent
/A.M.
Jo3/r Validation None [: Field -Use
] Simulated Performance'-
i-Table Top and E Comparison MPO0.DCSAPOI004 Use MP-054DC-SAP01004 Walk-through (minimum of two)
Print Sign Date l
Dept Coordinator Member Training:
E None El Nuclear Training E Briefing El Familiarization
. l SOR Review and ApDroval n SORC Review and Approval I5I Deoartment Head Review and Approval Approval El Disapproval El kAM. Johnson
( (1) Department Head Slgn/Date (1) Department Head Approval Sign (1) SOR
/
Sign/Date (2) SORO Meeting Number (2) Departme roval Sign '
'V 3SORC Approval Sign Approval Date: M ARA)1o 1 Effective Date:
) //a f61L/
MP-05-DC-FAPO. 1-005 Rev. 001
/
r Page 1 of a
DApol Da te Approval Date 02o1/q1/O Effective Date Technical Support Center Date:
QuantityReturned Item Description
._Required lAs Found Quantity Date Technical Support Center Locker RM-14 orEquivalent 3
- 1. Serial No.
Date Due
- 2. Serial No.
Date Due
- 3. Serial No.
Date Due Teletector or Equivalent Serial No.
Date Due_
RO-2A or Equivalent Serial No.
Date Due_
110 Volt Air Sampler Serial No.
Date Due_
Batteries, Spare For Meters Batteries Replaced (4th quarter) 1 Set Radiation Area Signs 12 Respirators With Charcoal Filters 20 Date Inspection Due Emergency Lanterns (Replace battery 2nd quarter 2008) 5 Paper Coveralls 20 Survey Forms 1 Set PCs (Sets) 20 Dosimeters (Low Range) Date Due 4
Dosimeters (High Range - 5R) Date Due 20 Dosimeters (Accident) Date Due 3
Dosimeter Charger Batteries Replaced (4th quarter) 1 Battery, Spare For Charger Batteries Replaced (4th quarter) 1 Source Plaque 3
TLD Badges (Replace Semi-annually) Date Due 4
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due 8
Smears (Pkg of 50) 1 Stopwatch 1
ic:
IG2 I1.
1.
RPM 4.8.5-21 Rev. 006-02 Page I of 2
.. Quantity Returned Item Description Required. As Found Quantity Date.,.'
Forceps Screwdriver 1
Particulate Filters (Pkg of 50) 1 Clear Plastic Bags 6x12.
5 Silver Zeolite Cartridges (Repalce By 4th quarter 2005) 4 Calculator, Extra Battery (N/A Solar)
I I Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 12 Coin Envelopes 5
Rain Gear 4 Sets Ballpoint Pens 12 Markers, Felt Tip 12 Scissors 1.
Stapler.
1 Clipboard with paper 1
On-Site Field Monitoring Map I
RMT Procedures and Forms 1
Potassium Iodide Tbles (Exp. Date.'
)
l 1
Technical Support Center Area Radiation Monitor Serial No.
Date Due_
Electronic Dosimetry Reader 1I.
.SCBA
-6;=
Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.85-21 Rev. 006-02 Page 2 of 2
02127/03 Approval Date
- 03/07/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 - °.Z DA Writer Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson 00A I0
Title:
TemclSyr--Q rTC
+
For New Documents: Document is QA O DH
Title:
o Revision,
Minor Revision 0 Cleanup Revision 0 Biennial Review E Cancel-.
OVold (Do Not Use)
O Expre O Superceded By:
Comments:
O Administrative Correction FLS.
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-01 1, rOO5-01; 4.8.5-13A, rOO5-02; 4.8.5-015, rOQO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rO06-01; 4.8.5-021, r006-02; 4.8.5-022A, rO04-01; 4.8.5-022B, r005-02; 4.8.5-024, r001-01; 4.8.5-025, r003-01; 4.8.5-026, r003-02; 4.8.5-028, rOOO-01 Associated ARs Reviews Print Sign Date Department.
T El-.__
WC 9 Att 3 Req. E3 Yes O No El LUcensing Basis / RCD r
k Johnson (50.59 Screen Req. 0 Yes O No) a r
t 7
4 0
RP Tech Independent AM. Johnson//o/
Validation None E Field-Use Simulated Performance -
a] TableTopand ElComparison MP-05-DC-SAPO1-004 Use MP-054DCSAPOI-M04 Walk-through, (minimum of two)
Print Sign Date Dept Coordinator Member Training:
El None El Nuclear Training El Briefing El Familiarization El SOR Review and ApDroval n SORC Review and Approval '
5I DeDartment Head Review and Approval Approval a Disapproval E N/A
-AM. Johnson (1) Department Head Slgn/Date (1) Department Head Approval Sign (1) SOR 7
Sign/Date J g
=.
N u
/,,
(2) SORC Meeting Number (2) Department proval Sign.
/
/ (3) SORC Approval Sign
__/_
Approval Date: OAAR/ 1 41/
Effective Date: ( 6i'f/' )L, MP-05-DC-FAPO1.1-005 Rev. 001
/
Page 1 of 4
b O-Alqlov I - ---
Approval Date e
Effective Date Technical Support Center TSC Kit Date:
Quantity Returned Item DescriptionI.
Item DesrRequired As Found Quantity Date Portable Count Rate Meter 1
Serial No.
Date Due DIG-5 Portable Scaler 1
Serial No.
Date Due__________
RO-2A or Equivalent Serial No.
Date Due__
11XV Air Sampler Serial No.
Date Due Batteries, Spares For Survey Meters 3 Sets Batteries Replaced (4th quarter)
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter) *_
TLD Badges (Replace Semi-annually) Date Due 4
Finger Rings [Ref.6.8] (Replace Semi-annualy) Date Due 8
Dosimeters (Low Range) Date Due 4
Dosimeters (High Range) Date Due 4
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter)
I Set Smears (Pkg of 50) 1 Filters, Particulate. (Pkg of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
CoinEnvelopes 12 Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Rain Gear (Sets) 2 Sets Surgical Gloves (Pairs) 6 Ballpoint Pens 2
Markers, Felt rip 2.
Barrier.Thpe 1
Duct Tape (Roll) 1 I) 10 10 I
I0 10 1G RPM 4.85-022A Rev. 004-01 Page 1 of 2
i Quantity Returned Item Description Required As Found Quantity Date Screwdriver 1
Stopwatch.
1
- Forceps, Scissors 1
Stapler 1
Box of Staples 1_l Clipboard With Paper 1
On-Site Field Monitoring Map 1
Inventoried By:
Date:
Date:
Reviewed By:
RPM 4.8.5-022A Rev. 004-01 Page 2 of 2
-r 02/27103 Approval Date 03107/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5-ZL, Writer Jean-Olsen, Rev. No.
Minor Rev.
Initiator Bridget Robertson 00o5 o...
0sc AssemVv Afo-,A W0 475 Ist fi cor For New Documents: Docum nt is QA L DH e:
O Revision 0 Minor Revision 3 Cleanup Revision 0 Biennial Review O Cancel:
- O Vold (Do Not Use)
E Expire O Superceded By:
Comments:
0 Administrative Correction FLS:
The followirig forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, r003-01; 4.8.5-004, r003-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4.8.5-011, rOO5-01; 4.8.5-13A, r005-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002;-01; 4.8.5-020, rO06-01; 4.8.5-021, rOO6-02; 4.8.5-022A, r004-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025, r003-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs
/
Reviews PrInt Sign Date Department.
-b I s O6
,iiikd~q IO WC 9 Att 3 Req. O Yes O No Ucensing Basis / RCQ Johnson (50.59 Screen Req. i Yes O No) 6 Tech Independent
/AN.
JohnsonF Validation None E Feld - Use E Simulated Performance -
E Table Top and D. Comparison MP.05-DC-SAP01004 Use MP-05-DC-SAP01-004 Walk4hrough (minimrnu of two)
Print Sign Date Dept Coordinator Member 21-Training:
0 None El Nuclear Training O Briefing El Familiarization El SOR Review and Approval n SORC Review and Anoroval I5l Department Head Review and ApDroval Approval El Disapproval WA
-A.M. Johnson g
i' (1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR SigntDate
-1 (2) SORG Meeting Nurnber (2) Departmen vwrwal Sign 3
i Approval Date: 0AAR1,91-1 Effective Date:
1 q
(
MP-05-DC-FAPO1.1-005 Rev. 001
/
Page Iof
I.,
a "If X
Approval Date ulm/lotf Effective Date OSC Assembly Area, Bldg 475, 1st floor Date:
. Quantity, Returned Item Description t
__Required lAs Found Quantityie Date 1 WSC Portable Count Rate Meter-1 Serial No.
Date Due_
DIG-5 Portable Scaler 1
Serial No.;
Date Due_
R0-2AorEquivalent 1
Serial No.
Date Due_
110V AirSampler 1
Serial No.
Date Due_
Batteries, Spares For Survey Meters 3 Sets Batteries Replaced (4th quarter)
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
TLD Badges (Replace Semi-annually) Date Due_
4 Finger Rings [Ref.6.8] (Replace Semii-annually) Date Due_
8 Dosimeters (Low, Range) Date Due_
4 Dosimeters (High Range) Date Due 4
Dosimeter Charger Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger Batteries Replaced (4th quarter) 1 Set Smears (Pkg Of 50) 1 Filters, Particulate (Pkg Of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
Coin Envelopes 12 Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Rain Gear (Sets) 2 Sets Surgical Gloves (Pairs).
6 Ballpoint Pens 2
Markers, Felt-Tip 2
Barrier Thpe 1
Tape (Roll}..1 1ic id~
laD laD ta 1G 1
RPM 4.8.5-022B Rev. 005-02 Page 1 of 2
Quantity Returned Item Description..
Item DescrRequired As Found Quantity.. Date
. Screwdriver 1
Stopwatch 1
. Forceps 1
Scissors 1
Stapler 1
. Box Of Staples 1
Clipboard With Paper 1
On-Site Field Monitoring Map 1
.. Emergency Locker 1
Source Plaque I
1A I
I II
-0 Conference Room 475/102 Area Radiation Monitor.
1 Serial No.
. Date Due_
Electronic Dosimetry Reader 1
I
,I' Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-022B Rev. 005-02 Page 2 of 2
I jA 02/27/03 03/07/03 Approval Date Effective Date Procedure Action Request 2
Document No.:
RPM 4.8.5 0 )V-k Writer.
Jean-Olsen Rev. No.
Minor Rev.
Initiator Bridget Robertson x (
o(
Title:
v'_ PTs~idlcnro irrpc er~oruei ndn Kl For New Documents: Document is OA EL DH
Title:
O Revislon, 0 Minor Revision Cleanup Revision 0 Biennial Review O Cancel-0 Void (Do Not Use) 0 Expire 0 Superceded By.
Comments:
0 Administrative Correction FLS:_
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4:8.5-01 1, rOO5-01; 4.8.5-13A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, r002-01; 4.8.5-020, rOO6-01; 4.8.5-021, rOO6-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025; r003-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-0, Associated ARs I
Revlews Print Sign Date Department-E l E l 13i t390 ES
.ia
. O tsexn
__~
WC 9 Att 3 Req. E3 Yes 0 No E l
_~~~~~~
_V ___I/
k I LUcensing Basis / RCD (50.59 Screen Req. 0 Yes 0 No) 07/ k~.
Johnson 1/:?,kI R P Tech independent A.M. Jnon/
Validation 0 None E Field - Use ED Simulated Performance -
I] Table Top and 5-Comparison MP-05-DC-SAPO1004 Use MP-05-DC-SAPOI-004 Walk-through.
(minimum of two)
Print Sign Date 1
Dept Coordinator Member Training:
0 None O Nuclear Training El Briefing El Familiarization
[] SQR Review and Approval n
SORC Review and APnroval I5I Department Head Review and ApDroval Approval E Disapproval El WA AM. Johnson 6 (1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR SlgrVDate (2) SORC Meeting Number (2) Departmn ppval Sign
/
(3) SORC Approval Sign Approval Date:
// A Effective Date:
11f f106f MP-05-DC-FAP01.1-005 Rev. 001 Page I of L
Approval Date 0)2116716V Effective Date Unit 3 Personnel Decon Room Emergency Personnel Decon Kit Date:
Quantity Returned Item DescriptionI.
.te De o Required As Found Quantity Date.
Fingernail Brushes 12 Mild Soap, Bars 24 Abrasive Soap, Bars 12 Razors 24 Skin lotion, Bottles 2
Shampoo, Bottles 24 Shaving Cream, Cans 2
1la
.. dl Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-024 Rev. 001-01 Page 1 of 1
02/27/03 Approval Date I!
03107/03 Effective Date 1'
Procedure Action Re~utest Document No.:
RPM 4.8.5 - 0 25 Writer Jean Olsen.
Rev. No.
Minor Rev.
Injiator Bridget Robertson 0
3 o 1
Title:
NAP Tea 2 2 &
For New Documents: Document is QA El DH
Title:
o Revisiorn,
Minor Revision 0 Cleanup Revision 0 Biennial Review 3 cancel:
YVold (Do Not Use) 3 Expire 0 Superceded Byr Comments:
0 Administrative Correction FLS:
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rO03-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, r003-01; 4.8.5-009, r007-01; 4.8.5-011, rO05-01; 4.8.5-13A, r005-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, r003-02; 4.8.5-019, rO02-01; 4.8.5-020, r006-01; 4.8.5-021, rO06-02; 4.8.5-022A, r004-01; 4.8.5-022B, r005-02; 4.8.5-024, r001-01; 4.8.5-025, rO03-01; 4.8.5-026, r003-02; 4.8.5-028, 1000-0 Associated ARs I
Reviews Print Sign Date Department El CjrS5,s
- bIs4VIi&qL t
44Ci9124
?Ut)s icp1i m
_sdq WC 9 Alt 3 Req. O Yes 0 No Ucensing Basis I RCD (50.59 Screen Req. 1 Yes 0 No) 6____,__________
Tech Independent A.M. Johnson Validation None E] Field - Use E Simulated Performance -
El TablelTopand 5.Comparison MP-05-DC-SAPOIO004 Use MP05-DC-SAPOI-004 Walk-through (minimun of two)
Print Sign Date Dep Coordinator Member Training:
E None E Nuclear Training
[I Briefing El Familiarization El SQR Review and ADProval f SORC Review and Approval E Department Head Review and Approval Approval El Disapproval El WA
-A.M. Johnson t (1) Department Head Sign/Date (1) Department Head Approval Sign (1) SOR Sign/Date (2) SORG Meetin Number (2) Departme royal Sign A
(3) SORC Approval Sign Approval Date:
/0 /
Effective Date: 0 e l q/7/') (/o MP-05-DC-FAPO1.1-005 Rev. 001 Page I of /
Approval Date O /Q1/6 4/
Effective Date NAP Team 2 Kit Date:
l Quantity Returned Ite D
o lRequired As Found Quantity Date Portable Count Rate Meter 1
Serial No.
Date Due_
DIG-5 Portable Scaler 1
Serial No.
Date Due_
RO -2A or Equivalent 1
Serial No.
Date Due Portable Air Sampler (12 Volts) 1 Serial No.
Date Due______
Batteries, Spares For Survey Meters 3 Sets Batteries Replaced (4th quarter)
Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
TLD Badges (Replace Semi-annually) Date Due 4
Finger Rings [Ref.6.8] (Replace Semi-annually) Date Due_8 Dosimeters (Low Range) Date Due 4
Dosimeters (High Range) Date Due 4
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter)
I Set Smears (Pkg of 50) 1 Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6 12 Bags, Clear Plastic 6x12 6
Coin Envelopes 12 Silver Zeolite Cartridges; (Replace By 4th quarter 2005) 4 Rain Gear (Sets) 2 Sets Surgical Gloves (Pairs) 6 Ballpoint Pens 2
Markers, Felt Tip 2
BarrierTape 1
Tape 1ic IG, la~
laI1 I
RPM 4.85-025 Rev. 003-01 Page 1 of 2
Quantity Returned Item Description,.
.tem D o
lRequired As Found Quantity Date Screwdriver 1
Stopwatch.
1 Forceps 1
Scissors 1
Stapler.
1 Box of Staples 1
Clipboard With Paper And Survey Forms 1
RMT No. 2 EPP Notebook 1
Bottle of Potassium Iodide Thblets (Expiration Date:
)
1 On-Site Field Monitoring Map 1
Inventoried By:
Reviewed By:
Date:
Date:
RPM 4.8.5-025 Rev. 003-01 Page 2 of 2
02 0
02127t03
-03/07103 Approval Date Effective Date Procedure Action Request Document No.:
RPM 4.8.5-O2(o Writer Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson 0c23
_o z
Title:
f neNA P L-.0 J<-
=
For New Documents: Document is QA EO DH
Title:
O Revision Minor Revision C leanup Revision
[
Biennial Review o Cancel-0 Vold (Do Not Use)
O Expire O Superceded By.
Comments:
0 Administrative Conrection FLS:_
The followirig forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, r003-01; 4.8.5-003, rO03-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, rO07-01; 4;8.5-011, rOO5-01; 4.8.5-13A, rO05-02; 4.8.5-015, rO00-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, r006-01; 4.8.5-021, r006-02; 4.8.5-022A, 1004-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01-01; 4.8.5-025; r103-01; 4.8.5-026, rO03-02; 4.8.5-028, rO00-01 Associated ARs
/
Reviews Print Sign Date Department E l El GyV55. -bl> ik-is W t" bo WC9Att3Req. OYes ONo Licensing Basis I RCD Johnson (50.59 Screen Req. 0 Yes 0 No)
C TechIndependent A._
/3M.
Johnson/3 i
R Validation None 5 Field - Use E
Simulated Performance -
[
Table Top and El Comparison MP45-DC-SAP01 004.
Use MP-05-DC-SAPO1I004 Walk-through.
(minimum of two)
Print Sign Date l
Dept Coordinator Member Training:
El None El Nuclear Training 0 Briefing El Familiarization E SOR Review and Approval n SORC Review and Approval 1On Department Head Review and Approval Approval I]
Disapproval El NA
-AM. Johnson 4
i/
(1) Department Head Sign/Date (1) Department Head Approval Sign (1) SQR
/
Sigr/Date (2) SORC Meeting Number (2) Departmen royal Sign'r (3) SORC Approval Sign Approval Date:
ho Effective Date: p
//67/
/4 MP-05-DC-FAPOl.1-005 Rev. 001
/
l, Page 1 of /
I IA
// lo C
-pra Dqloaefeie Effective Date" Approval Date NAP Locker Date:
Quantity Returned Item DescriptionI.
t DsrpinRequired As Found Quantity Date RMT Kit No.2 1
RM-14 or Equivalent 1
Serial No.
Date Due_
110 VoltAir Sampler Serial No.
Date Due_
Radiation Area Signs 3
Respirators With Charcoal Filters 5
Date Inspection Due Emergency Lanterns (Replace battery 2nd quarter 2008) 5 Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Particulate Filters 50 Extension Cord 1
PCs Complete Sets 6
Source Plaque1 I
.1lala 10 Inventoried By:
Date:
Reviewed By.
Date:
RPM 4.8.5-026 Rev. 003-02 Page 1 of 1
a1.
02127103 Approval Date 03107/03 Effective Date Procedure Action Request Document No.:
RPM 4.8.5 W
OlD riter Jean Olsen.
Rev. No.
Minor Rev.
Initiator Bridget Robertson I 00 (
O 0
For New Documents: Document is QA [l DH Ttle:
Ci Revision 10 Minor Revision 0 Cleanup Revision E0 Biennial Review O Cancel:
3 Void (Do Not Use) 0l Expire El Superceded By Comments:
I Administrative Correction FLS:_
The following forms have been revised with this procedure and follow with a separate PAR for each form: RPMs 4.8.5-002, rOO3-01; 4.8.5-003, r003-01; 4.8.5-004, rO03-01; 4.8.5-005, rO03-01; 4.8.5-009, r007-01; 4;8.5-01 1, rOO5-O; 4.8.5-13A, rO05-02; 4.8.5-015, rOOO-01; 4.8.5-016, rO03-01; 4.8.5-017, rO03-02; 4.8.5-019, rO02-01; 4.8.5-020, rO06-01; 4.8.5-021, rOO6-02; 4.8.5-022A, rO04-01; 4.8.5-022B, rO05-02; 4.8.5-024, rO01 -01; 4.8.5-025, rOO3-01; 4.8.5-026, rO03-02; 4.8.5-028, rO0O-01 Associated ARs
/
Reviews Print Sign Date Department WC 9 Att 3 Req. Q Yes O No Uicensing Basis / RCD Johnson (50.59 Screen Req. 0 Yes 0 No)
_//________
RP Tech Independent AM. Johnson//3/
Validation None I Field-Use I
Simulated Performance -
1] Table Top and 0- Comparison MP-05-DC-SAP01-004 Use MP-054DC-SAPO1-004 Walk-through (minimum of two)
Print Sign Date l
Dept Coordinator Member Training:
0 None El Nuclear Training O Briefing 0 Familiarization I SOR Review and Approval n SORC Review and Anproval ra DeDartment Head Review and Approval Approval ] Disapproval El WA A.M. Johnson 1 44a7/o (1) Department Head SignrDate (1) Department Head Approval Sign (1) SOR SigniDate (2) SORC Meeting Number (2) Departmen royal Sign
- g.
.(3)
SORC Approval Sign Aproval Date: OA Effective Date:
- U/e7/
MP-05-DC-FAPO1.1-005 Rev. 001 Page 1 of L VI
D9 A11,- k A AvDE//p/tD
.Effective bate Approval Date Goshen Fire Department Date:
_QuaReantityuDae Item Description Required i As Found Quantity l.Dat Team 6 Kit' Portable Count Rate Meter 1
Serial No.-
Date Due_
DIG-S Portable Scaler Serial No.
Date Due RO-2A or Equivalent Serial No.
Date Due_
ASP-1/HP -270 or Equivalent 1
Serial No.
Date Due_
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due_
Batteries, Spares For Survey Meters 4 Sets Batteries Replaced (4th quarter) l_._l_..
Dosimeters (Low Range) Date Due 2
Dosimeters (High Range) Date Due 2
Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annualy) Date Due 4
Smears (Pkg of 25) 1 Filters, Particulate (Pkg of 50) 1 Bags, Clear Plastic 4x6.
12 Bags, Clear Plastic 6x12 6
Tape 1
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 6 Coin Envelopes 12 Rain Gear (Sets) 2 Sets Ballpoint Pens 2
Markers, Felt Tip, 2
Screwdriver.
1=
RPM 4.85-28 Rev. 000-01 Page 1 of 4 idG
Quantity Returned Item Description.
I Dct Required As Found Quantity; Date Stapler 1
Box of Staples Scissors.:
1 Stopwatch 1
Forceps:
1 Clipboard With Paper 1
RMTEPP Notebook 1
Map of Sample Locations 1
Bottle ofJPotassium Iodide Tablets (Expiration Date:
)
1
.Team 7 Kit Portable Count Rate Meter Serial No.
Date Due____
DIG-S Portable Scaler 1
Serial No.
Date Due_
RO-2A or Equivalent 1
Serial No.
Date Due_
ASP-1/HP-270 orEquivalent1 Serial No.
Date Due____
Portable Air Sampler (12 Volts) 1 Serial No.
Date Due______
Batteries, Spares For Survey Meters 4 Sets' l
Batteries Replaced (4th quarter)
.l_
Dosimeters (Low Range) Date Due 2
Dosimeters (High Range) Date Due 2
Dosimeter Charger - Batteries Replaced (4th quarter)
I I
Batteries, Spares For Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annually) Date Due 4
I Smears (Pkg of 25) 1 Filters, Particulate (Pkg of 50) 1 Bags, Clear-Plastic 4x6 12 Bags, Clear Plastic 6x12 6
Tape 1
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 I
Calculator, Extra Battery (N/A Solar) 1 I
Batteries Replaced (4th quarter).._.
RPM 4.8.5-28 Rev. 000-01 Page 2 of 4
Quantity Returned Item'Description e
D Required As Found Quantity. -.Date Surgical Gloves (Pairs) 6 Coin Envelopes 12 Rain Gear (Sets)-
2 Sets Ballpoint Pens 2
Markers; Felt Tip 2
Screwdriver.
1 Stapler
.1 Box of Staples 1
Scissors 1
Stopwatch 1
Forceps 1
Clipboard With Paper 1
RMT EPP Notebook
.1 Map of Sample Locations 1
Bottle of Potassium Iodide Thblets (Expiration Date:
)
1 Team 8 Kit Portable Count Rate Meter 1
Serial No.
Date Due_ ___
DIG-5 Portable Scaler 1
Serial No.
Date Due____
RO-2A or Equivalent 1
Serial No.
Date Due ASP-1/HP-270 or Equivalent 1
Serial No.
Date Due Portable Air Sampler (12 Volts)
Serial No.
Date Due Batteries, Spares For Survey Meters 4 Sets Batteries Replaced (4th quarter)
Dosimeters (Low Range) Date Due 2
Dosimeters (High Range) Date Due
.2 Dosimeter Charger - Batteries Replaced (4th quarter) 1 Batteries, Spares For Charger - Batteries Replaced (4th quarter) 1 Set TLD Badges (Replace Semi-annually) Date Due 4_=
Smears (Pkg of 25) 1
=
RPM 4.8.5-28 Rev. 000-01 Page 3 of 4 i a
.1 -
la k3
Quantity Returned Item Descrption e
DRequired As Found Quantity Date Filters, Particulate (Pkg of 50) 1 Bags, ClearPlastic 4x6.
12 Bags, Clear Plastic 6x12 6
Thpe 1
Silver Zeolite Cartridges (Replace By 4th quarter 2005) 4 Calculator, Extra Battery (N/A Solar) 1 Batteries Replaced (4th quarter)
Surgical Gloves (Pairs) 6 Coin Envelopes 12 Rain Gear (Sets) 2 Sets Ballpoint Pens' 2
Markers, Felt Tip 2
Screwdriver 1
Stapler 1
Box of Staples 1
Scissors 1
Stopwatch 1
Forceps 1
Clipboard With Paper 1
RMT EPP Notebook 1
Map of Sample Locations 1
Bottle of Potassium Iodide Tablets (Expiration Date:
)
1 1(ic la Inventoried By:
Reviewed By:
Date:
Date:
i RPM 4.85-28 Rev. 000-01 Page 4 of 4