ML18002A475
| ML18002A475 | |
| Person / Time | |
|---|---|
| Issue date: | 04/20/2018 |
| From: | David Cullison NRC/OCIO |
| To: | |
| Baker S - 287- 9059 | |
| References | |
| OMB 3150-0027 | |
| Download: ML18002A475 (5) | |
Text
Page 1 of NRC FORM 7 U. S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0027 EXPIRES: (MM/DD/YYYY)
(MM-YYYY) 10 CFR 110 Estimated burden per response to comply with this mandatory collection request: 2.4 hours4.62963e-5 days <br />0.00111 hours <br />6.613757e-6 weeks <br />1.522e-6 months <br />. This submittal is reviewed to ensure that the applicable statutory, regulatory, and policy considerations are satisfied. Send comments regarding burden estimate to the Information Services Branch (T-2 F43), U.S. Nuclear Regulatory APPLICATION FOR NRC EXPORT OR IMPORT Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0027), Office of Management and LICENSE, AMENDMENT, RENEWAL, Budget, Washington, DC 20503. If a means used to impose an information collection does not display a OR CONSENT REQUEST(S) currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to (See Instructions on Pages 4 and 5) respond to, the information collection.
Date Received PART A. FOR NRC USE ONLY Public OR Non-Public License Number Docket Number Adams Accession Number PART B. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, RENEWALS, OR CONSENT REQUESTS (If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)
- 1. Name and Address of Applicant/Licensee 1a. Name of Applicant's Contact 1b. Applicant's Reference Number 1c. Office Telephone Number 1d. Office Facsimile Telephone Number 1e. Applicant's E-mail Address Export (Parts B, C, E) Amendment/Renewal Current License Number:
- 2. Type of Action Requested (Check one)
Import (Parts B, D, E) Consent Request (Parts B, C): Current License Number:
- 3. Contract Number(s) 4. First Shipment Date 5. Last Shipment Date 6. Proposed Expiration Date PART C. TO BE COMPLETED FOR EXPORT LICENSES, AMENDMENTS, OR RENEWALS (If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)
- 7. Name(s)/Address(es) of U. S. Suppliers and/or 8. Name(s)/Address(es) of Intermediate 9. Name(s)/Address(es) of Ultimate Foreign other U. S. Parties to the Export Foreign Consignee(s) Consignee(s) 7a. Function(s) Performed/Service(s) Provided 8a. Intermediate Use(s) 9a. Ultimate End Use(s)
- 10. Description of Radioactive Materials, Sealed Sources, Nuclear Facilities, 10a. Maximum Total Volume/ 10b. Max Enrichment 10c. Max Isotope Equipment, or Components; for Nuclear Equipment include Total Dollar Value Element WGT (KG), or or WGT% WGT (KG) of Equipment for Export Total Activity (TBq)
- 11. Foreign origin (or obligations by country and, if known, by percentage of maximum total volume)
NRC FORM 7 (MM-YYYY)
Page 2 of NRC FORM 7 U. S. NUCLEAR REGULATORY COMMISSION (MM-YYYY) 10 CFR 110 APPLICATION FOR NRC EXPORT OR IMPORT LICENSE, AMENDMENT, RENEWAL, OR CONSENT REQUEST(S) (Continued)
License Number Docket Number Adams Accession Number Public OR Non-Public PART D. TO BE COMPLETED FOR IMPORT LICENSES, AMENDMENTS, OR RENEWALS (If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)
- 12. Name(s)/Address(es) of Foreign Suppliers and/or 13. Name(s)/Address(es) of Foreign or U. S. 14. Name(s)/Address(es) of Ultimate other Foreign Parties to Import Intermediate Consignee(s) U. S. Consignee(s) 12a. NRC Export License Number(s) (if applicable) 13a. License Number(s) / Expiration Date(s) 14a. License Number(s) / Expiration Date(s) 13b. Intermediate Use(s) 14b. Ultimate End Use(s)
- 15. Description of Radioactive Materials, Sealed Sources, Nuclear Facilities 15a. Maximum Total Volume/ 15b. Max Enrichment 15c. Max Isotope Element WGT (KG), or or WGT% WGT (KG)
Total Activity (TBq)
- 16. Foreign obligations (By country and by Percentage of Maximum Total Volume)
PART E. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, RENEWALS OR CONSENT REQUEST(S)
(If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)
- 17. Additional Information provided on pages 3, 4, and/or separate sheets? 17a. Copies of Recipient's Authorizations Provided?
Yes No Yes No
- 18. CERTIFICATION:
I, the applicant's authorized official, hereby certify that this application is prepared in conformity with Title10, Code of Federal Regulations, and that all information provided is correct to the best of my knowledge.
18a. Print Name and Title of Authorized Official 18b. Signature -- Authorized Official 18c. Date NRC FORM 7 (MM-YYYY)
Page 3 of NRC FORM 7 U. S. NUCLEAR REGULATORY COMMISSION (MM-YYYY) 10 CFR 110 APPLICATION FOR NRC EXPORT OR IMPORT LICENSE, AMENDMENT, RENEWAL, OR CONSENT REQUEST(S) (Continued)
License Number Docket Number Adams Accession Number Public OR Non-Public Additional Information (Reference applicable block numbers from page 1 and/or page 2 for each entry)
NRC FORM 7 (MM-YYYY)
U. S. NUCLEAR REGULATORY COMMISSION INSTRUCTIONS FOR PREPARATION OF NRC FORM 7, APPLICATION FOR NRC EXPORT OR IMPORT LICENSE, AMENDMENT, RENEWAL OR CONSENT REQUEST(S)
General Instructions: A completed, signed original NRC Form 7 may be mailed to the Deputy Director, Office of International Programs, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or hand-delivered to the Deputy Director at 11555 Rockville Pike, Rockville, Maryland 20852.
Refer to Title 10 of the Code of Federal Regulations, Part 110, for specific NRC export/import licensing requirements. For each license, amendment or renewal application, identify all foreign and domestic locations where exports or imports will be handled, sorted, repackaged and/or processed in any way. Provide information on quantities, forms, and other characteristics of the radioactive materials, sealed sources, nuclear facilities and equipment to be exported or imported and indicate how they will be used by each of the parties listed. If more space is needed to complete any of the items on this form, use the continuation pages first, and then attach additional sheets. Reference appropriate BLOCK number(s) for each entry on all additional sheets. All applicants should avoid submitting proprietary information unless absolutely necessary, as NRC is required to make copies of all applications received available to the public. If proprietary information must be submitted, follow procedures in 10 CFR 2.390, otherwise, such information could be publicly disclosed and/or processing of an application could be significantly delayed.
An application for a specific license to export or import or a request for an exemption from a licensing requirement must be accompanied by the appropriate fee in accordance with 10 CFR Part 170. The fee schedules are provided in §§ 170.21 and 170.31.
The reference IMEX should be included on your form of payment. A license application will not be processed unless the specified fee is received.
NOTE: FOR CONSENTS FILL OUT BLOCKS, BLOCK 4. Enter the anticipated date of the first shipment (1a-,2,8,9,10,10a,17,18) (MM/DD/YYYY).
BLOCK 5. Enter the anticipated date of last shipment PART A. FOR NRC USE ONLY (MM/DD/YYYY).
PART B. TO BE COMPLETED BY ALL APPLICANTS FOR BLOCK 6. Enter a proposed license expiration date ALL LICENSES, AMENDMENTS, RENEWALS, OR CONSENT (MM/DD/YYYY), to accommodate export activities. Note that REQUEST(S)
NRC licenses are typically issued for 1-5 years.
BLOCK 1. Enter name and complete physical address of the corporation or other entity with direct control over distribution of NOTE: For amendments and renewals, provide only the new or proposed export(s) or import(s), and where required records will be changed information, as appropriate, in PART C and/or PART D.
maintained and can be inspected. Post Office Box Numbers or (For example, enter names and addresses of parties or names of divisions or departments within a legal entity are NOT consignees, only if they need to be added to, deleted from, or acceptable entries for this BLOCK. their information needs to be changed. If seeking to increase the volume or quantity of material or equipment, specify the additional increment, and, if applicable, indicate what the new, BLOCKS 1a-e. Provide name and contact information identifying combined cumulative total will be.)
the best party to answer questions about an application. Applicants should use BLOCK 1b to assign their own reference number to identify application documents. PART C. TO BE COMPLETED BY APPLICANTS FOR EXPORT LICENSES, AMENDMENTS, RENEWALS, OR CONSENTS BLOCK 2. Indicate the TYPE OF NRC LICENSING ACTION requested by checking: BLOCK 7. Enter names of U. S. supplier(s) and other U. S.
parties to export not listed in BLOCKS 1, 8, OR 9. Provide
- EXPORT if applying for a new export license.
complete physical address(es) where correspondence should be
- IMPORT if applying for a new import license. sent and where export(s) can be inspected. Post Office Box Numbers are NOT acceptable entries for this BLOCK.
- AMENDMENT OR RENEWAL if applying to modify or extend an export or import license previously issued by NRC (and not yet NOTE: U. S. transport/shipping service provider and/or expired). Include NRC license number in space provided. If NRC commercial carrier; do not need to be listed as "Other" U. S.
receives an amendment/ renewal application at least 30 days or Parties on the application. These entities are not parties-in-more before the license expires, its terms will remain valid and, if interest to an export license. They serve only as transporters of circumstances permit, it can continue to be used until NRC the nuclear material or commodity being exported and their legal completes action on the amendment or renewal application. responsibility from a regulatory standpoint is limited to complying with NRC's and the Department of Transportation's transportation requirements. If applicants list transport/shipping service
- CONSENT REQUEST if submitting a request for the NRC to providers or commercial carriers on their applications, they can obtain government-to-government consent to authorize shipment(s) be identified on the export license if issued, but that does not of Category 1 quantities of byproduct material. Include NRC convert them into legally responsible formal parties-in-interest to license number in space provided.
the license. Carriers are not relevant to the NRC's review of an export application to determine whether the statutory BLOCK 3. If known, provide contract number(s), which may nonproliferation criteria have been met.
be useful references for example, if reviewers need to contact recipients or other parties listed on the application.
U. S. NUCLEAR REGULATORY COMMISSION INSTRUCTIONS FOR PREPARATION OF NRC FORM 7, APPLICATION FOR NRC EXPORT OR IMPORT LICENSE, AMENDMENT, RENEWAL OR CONSENT REQUEST(S) (Continued)
BLOCK 7a. Describe functions to be performed and/or services to PART D. TO BE COMPLETED BY APPLICANTS FOR IMPORT be provided by any U. S. parties listed in BLOCK 7. LICENSES, AMENDMENTS OR RENEWALS BLOCKS 8-9. Enter names and physical address(es) for each BLOCK 12. Enter name(s) and address(es) of foreign supplier(s) intermediate and each ultimate foreign location. Post Office Box or exporter(s).
Numbers are NOT acceptable entries for these BLOCKS.
BLOCK 12a. For import(s) originally exported under a specific BLOCKS 8a and 9a. Describe how each consignee will use NRC license, enter that license number.
export(s), including functions to be performed and/or services to be provided. BLOCKS 13a and 14a. Enter NRC or Agreement State Materials License number(s) including expiration date(s) (MM/DD/YYYY)
BLOCK 10. Describe key characteristics including physical and for each U.S. consignee, authorizing receipt, possession, use or chemical forms, etc., of radioactive materials (i.e., source, special distribution.
nuclear or byproduct materials including sealed sources or devices and radioactive waste), nuclear facilities, or equipment, uranium, or BLOCK 15. Describe key characteristics including physical thorium, and provide chemical form (e.g., U3O8, Th-227). Identify and chemical forms, etc., of radioactive materials (i.e., source, and provide total volume in kilograms of ores containing 0.05% or special nuclear or byproduct materials including sealed sources more of source material (e.g., tantalum, niobium) and specify or devices and radioactive waste), and nuclear facilities. For source material contained. Identify special nuclear material as radioactive waste, identify and provide maximum total volume in plutonium, high enriched uranium (> 20% U-235) or low enriched kilograms for each non-radioactive material (e.g., contaminated uranium (<20% U-235) and specify chemical form (e.g. UF6, U02). steel) involved, and for each radioactive material contained, including its physical and chemical forms for each radioactive Identify Appendix L byproduct materials by name and form, source, special nuclear or byproduct material. Identify including maximum total activities and types of sealed sources and/ responsible, and provide industrial process, route(s) of transit, as or devices to be exported over the license life. Identify Appendix P well as the status of arrangements for disposition in the U.S.,
materials by name and form, including maximum total quantities e.g., any agreement by a low-level waste compact or State to activity in Terabecquerels (TBq) and types of sealed sources and/or accept for management or disposal. For nuclear facilities, devices to be exported on a per shipment basis. For radioactive provide total quantities; types; names, design power or annual waste, identify and provide maximum total volume in kilograms for capacity rating; and the estimated combined total dollar value.
each non-radioactive material involved, physical and chemical forms for each radioactive material, if exported for the purposes of BLOCK 15a. For source and/or special nuclear material, provide disposal in a land disposal facility as defined in 10 CFR Part 61, a maximum total volume/element weight over license life in disposal area as defined in Appendix A to 10 CFR Part 40, or an kilograms. For Appendix L byproduct material, including that equivalent facility; route(s) of transit, forms of management and which is in the form of radioactive waste, provide maximum total ultimate disposition. For nuclear facilities, provide total quantity; activity over license life in TBq.
types; names, design power or annual capacity rating; and the estimated combined total dollar value. For nuclear equipment, BLOCKS 15b-c. For special nuclear material including that identify all items by name, total quantity and function and provide which is in the form of radioactive waste, provide maximum the estimated combined total dollar value. enrichment/weight % and maximum total isotope weight over license life in kilograms.
BLOCK 10a. For source material, provide maximum total volume/
element weight over license life in kilograms. For special nuclear BLOCK 16. Identify each country and the percentage of the material, provide maximum total element weight over license life in maximum total volume that may be obligated to them (require kilograms. For each Appendix L byproduct material listed, provide U. S. Government action, e.g., prior notification).
maximum total activity over license life in Terabequerels (TBq). For each Appendix P material listed, provide maximum total activity per PART E. TO BE COMPLETED BY ALL APPLICANTS shipment in Tbq.
BLOCKS 10b-c. For special nuclear material including as BLOCK 17. Check YES or NO to verify whether or not additional radioactive waste, provide maximum weight % (enrichment) and information is being provided using the space provided on the total isotope weight over license life in kilograms. continuation pages and separate sheets.
BLOCK 11. For proposed exports or imports (of source or special BLOCK 17a. Check YES or NO to verify whether or not copies of nuclear material or nuclear facilities or equipment). Identify each domestic recipients' authorizations required for Appendix P country of origin of equipment or materials, and any other countries materials (see Part 110.32 requirements) are included with the that have processed the material prior to its import into the United application.
States, and, if known, the percentage of the maximum total volume that may be obligated to a foreign country (requires U. S. BLOCKS 18a-c. An authorized official of the legal entity Government action, e.g., prior notification). applying for the License, Amendment or Renewal, must certify