ML19259A985

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Forwards Relevant Forms & Instructions to Provide Description of QA Controls Exercised for Receipt,Use & Transfer of Radioactive Material Handled Under NRC License 31-18182-01
ML19259A985
Person / Time
Site: 07100261
Issue date: 12/27/1978
From: Amoruso A
NAVY, DEPT. OF
To:
NRC OFFICE OF NUCLEAR MATERIAL SAFETY & SAFEGUARDS (NMSS)
References
NUDOCS 7901150166
Download: ML19259A985 (23)
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Text

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DEPARTMENT OF THE NAVY hk USS SIMON LAKE AS 33

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a FPO NEW YORK 09501 33/04:mk

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Ser /5W 27DEC M Fron: Commanding Officer, USS SIMON LAKE (AS-33)

To:

Director, Office of Nuclear Material Safety and Safeguards, Nuclear Regulatory Commission, Washington, D.C. 20555 Subj: Quality Assurance Plan for Radioactive Material Shipping Packages Re f:

(a) COMSUELANT ltr 9893 serial 6477 of 30 November 1978 (b) Title 10, Code of Federal Regulations, Part 71.51 Encl:

(1) USS SIMON LAIC Instruction 9900.2F " Operating and Emergency Procedures Applicable to Radioactive By-Product Material" and relevant excerpts from enclosures.

(2) USS SIMON LAKE Repair Department form " CHECK-OFF List for Inspection

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and Preventive Maintenance of Radiographic Equipment".

-(3) USS SIMON LAKE Repair Department Form " Radiography Isotope Leak Test Record".

(4) USS SIMON LAKE Repair Department Forn " Radiography Quarterly

-'E Audit Plan" (5) Excerpt from USS SIMON LAKE NRC By-Product Material License -

31-18182-01 (Formerly 08-00038-20)

(6) USS SIMON LAKE Repair Department Form "Raceipt and Transfer of Radioactive By-Product Material" 1.

Re ference (a) directs the submission of a quality assurance plan for shipping and stowage containers meeting the criteria of reference (b).

2.

Enclosures (1) through (6) aie submitted for approval and to provide a description of the Quality Assurance controls exercised by USS SIMON LAKE for the receipt, use, and transfer of radioactive material handled under NRC license number 31-18182-01 (formerly 08-00038-20).

3.

In that USS SIMON LAKE is an end user of the packaging, the controls described in the enclosures ensure that the quality of the packaging is maintained while in the custody of this activity.

A. P. AMORUSO Copy to:

COMSUBLANT (N45)

THIS DOCUMENT CONTAINS NAVNUPWRU, Port Hueneme p

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s ITEM 6(a) DESCRIPTION OF FACILITIES (NDT) 1 A.

The radiographic sources listed in item 4 will be stowed in a shicided shooting and storage vault (see figures I, II, III and figure data sheet) which is located in the Nondestructive Test Shop (Compartment 3-100-1-Q) i which is located on the third deck, just off the centerline to starboard between frames 100 and 104 (see figures IV, V and VI).

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Permanent radiation warning signs are mounted in the radiography l

facility and adjacent areas. Temporary radiation warning signs, portable varning lights and a 2 mrem isodose boundary line will be established whenever a radiographic source is exposed.

C.

In addition radiographic sources listed in item 4 will be used on board ships tended by SIMON LAKE and SIMON LAKE support facilities.

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AS33/6/76 RECEIPT AND TRANSFER OF RADIOACTIVE BY-PRODUCT MATERIAL 1.

ISOTOPE 2.

SOURCE ACTIVITY (CURIES) 3.

SOURCE SERIAL NO.

4.

DATE RECEIVED 5.

RECIEVED FROM NRC LICENSE H 6.

RECIEVED BY (RADIOGRAPHER) 7.

DATE SHIPPED 8.

SHIPPED TO NRC 1IFFN9F 4 9.

SOURCE ACTIVITY (CURIES) 15 SHIPPED BY (RADIOGRAPHER) 11.

REMARKS:

RADIOGRAPHIC SAFETY OFFICER SF2TICP *ADIOGFAPHER b

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SitDM 11E INST 9900.2F Cl-2 3 aovaier 1975 (g) Open the oqupler asserrbly and disengage the connectors.

We Podel 533 Ir 192 sealed source will have a locking sleeve actuating pin which is pressed toward the botton of the storage container to disengage the source from the drive cable.

In itxlel 496 Co 60 sealed source the source is disengaged with a spring r61 ease tool by inserting it into the grooves applying a slight

' pressure to release the spring. The drive cable can then be pulled out of the i pigtail. CAUTION:

INSURE TIIAT 'HE SOUPCE IS NOr PULIED OUP OF TIE S'IOPIG CrtTfAINER MIIIE DISENGAGING TIIE SOURCE FluM TIE DRIVE CABIE.

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(h) Unscrew the source tube fran the storage container and replace the cap. Attach the source identification tag to this channel.

(2)

Installing a new source in the Technical Operations Model 533 and 496 Gamm Ray Projectors:

(a) Af ter rcnnving the old source the drive cable should be extending slightly past the source tube.

Pmov.e the tag pertaining to the new source and attach it to the projector.

luove the cap and attach the source tube.

(b) Ccnnect the source pigtail to the drive cable by firmly pressing the male and female ends together. Grasp the end of the source pigtail and the end of the drive cable and test for positive connection. Connect the source ttic to the storage container.

(c)

Petract the source into the projector. Tne indicating light on the Podel 533 and 496 projectors should indicate " stored". CAUrICN: DO NOT I

RELY ON TIESE INDICATING LIGITS. SURVEY 'HE PIGTECIOR WITH A PADIATION SURVEY INSTRD W P.

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(d) Disconnect the source tube frcm the exposure device and insert the plugs and the lock as required in the securing operations for the projector being used.

(e) Replace the cap on the empty channel of the storage container.

Peplace the cover, the screw, and seal. The source changer, after source replacement shall be nonitored to insure that dosages prescribed in D.O.T. 55 and C.F.R Title 10, Sectton 34.21 are not exceeded. Prior to shipnent of the source exchange in accordance with C.F.R. 146.19-1 Paca K, a Radioactive Type III Inbel (1-16) shall be gited on to the sMpping c;ntamer using contact ccmant und copies of DD Form 1149 shall be enclosed in an envelop.ittached to Hv; nutside t

of the container.

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11. Paintenance of Records

'Ihe Padiographic Safety Officer shall maintain the reo3rds required by a.

10CFR34 for inspection by the corrmission at the address specified on the licence.

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b.

The Padiographer will be respcasible for making the required entries

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and ensuring the accuracy and completeness of each individual records as follcws:

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(1) Qu ir t tn ly un ontaty in accordance with 10CFR34.26. A physical inventory shall tu conducted cvecy three nonths for all sealed souraas.

Individual sealed sources shall be inventoried upon receipt. 7ne following l

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-information will be recorded for each sealed sourca:

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SlM.ON py2 17C,P 9900.2F CH-2 s..~.a.

.. s (3) Any ternct filed with the AEC will to so premred that n uini of individtuis who have roccived exposure to radiation will be listed in a separate part of the report.

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Ioss or theft of radioactive source.

If the source cannot be located macdiately notify NAVEII:XSYSC0ti, Code 4805 and the nearest USAEC Regulatory Operations Regional Office by telephone and/or message after its occurance becomes known. Within 30 days a written report shall be,subnitt.ed to the director of Regulatory Operations, USAEC, Washington, D.C. 2054 5 via NAVELEXSYSCOM, Code 4805 with a copy to the nearest USAT Regulatory Operations Rcgierul OffI r describing mterial involved, circumstances under which loss occurruo, staum.t of the disposition or probable disposition of licensed material involved, act iut.s which have or will be taken to remver the mterial, and measures which have ac will be taken to prevent recurrence of loss of licensed mterial.

10 Source Roolacanent Procedures for Cobalt 60 and for Iridium 192 with Tech Ops Models 414, 416, and 650, a.

Picker Panoramic Ray Projector (Tech-Ops) Model 533 and 496. Prior to commencing operations for source replact5 rent, using the procedures outlined below, the Radiographic Safety Officer shall be notified.

(1) The equipnent is designed so that the source replacanent may be safely accomplished by the user in the field. By arrangement with Technical Operations, renewal sources will be shipped, either at regular intervi s (directed by the half life of the source) or as an individual order. Shirrent of renewal sources is mde in specially designed shieldcd containers. This container has two separate source pockets, one containina the renewal source and the other empty.

(a) Cut the seal, rarove the screws, and open the cover of the source changer.

(b) Unscrew and rarove the cap from the empty cbpmter, The source changer my be positioned horizontally for optimtm ease of operation.

(c) Open the coupler asscrbly to make a positive visual check to insure that the channel is empty. If the channel is not empty, the pigtall frca the installed source cable will be seen.

(d) Position the source changer close to the exposure device and connect the source tube fran the exposure device to the anpty channel of the source changer.

(e) Crank the old source into the source changer. The indicating light should indicate "open".

i (f) Using a radiation survey instrument, insure that the source is i

in the chamber and the radiation level is no greater than 200 mrem /nr on the f

surface.

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(a) Control mechanism of Mobd 496 pro,iedot is always connected, i

J'/>[!unlesssourcehasbeenremoved.

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while unlock.lur.

, n capsule 10 not l projector and connecting wipe test tool to insure that ' -

haccidentlyexpost.dduringthisoperation.

(b) The control mechanism of Model 533 prejtdor must be

connected and placed in operate position to use.

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(5) By uain;; the control mechanism, expone and dmet source l capsule in and out of uipe test tool several times, taking che not to force I'

capsule against PLUG "A".

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(6) Retract source capsule back into projector and c cure projector.

o fron (7) Wearing rubber gloves and apron, remove wipe test toni t

'; projector and place in a polyethylene bag. Tape' off top of bag.

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(8) Transfer polyethylene bag, with vipe test tool inside, to Radiological Control Division for inspection.

. 'j (9) Radiological Control Division dinansemble wipe test tool.

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.t (a) Count the gauze from the wipe test tool in'the CP-75//UD leRadiac Computer Indicator. Compare with count rate of standard SR 90-Y 'JO i

. reference sources calibrated by the National Bureau of Standards to find the

. degree of, if any, leakage present.

(10) Record results of leak test on Quarterly Inventory and 1."ah lTestLog.

b.

During the transfer of. wipe test tool and or swabs and during ortuil leak testing, both environmental monitoring instrumet to will be utilined and all safety precautions as defined in the Operating and Emergency Proutduri'.

Will bo strictly adhered to, t

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Procedures, l

SIMON LAFE II;f,T 9900.2 '(scrics) Operating and Emergency

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apply while conducting aource leak tests..

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'(1) Leak teating devico (2) Swipo paper

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(3) Cottoa avaba

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(4) Rubber gloves and aprons.

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(6) Tweezers

",3 (7) 71nger gauge

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(8) CP-297/UD Radiac Computer Indicator Il, (9)' Monitoring equipment (a) IIt97/PD pocket dosimeter and film badge (perso (b) Ali/?LR-27Q and AN/PDR-43A (environ 3.

Leak Test Af ter the need for leak testing has been established the a.

following procedure will be followed:

(1) 1;otify the Radiological Control Officer and Radiog Safety 0fficer of proposed leak teot.

(2) Establich controlled " Restricted Arca", " Radiatio l

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.anh Radiution Area" around shielded shooting and storage vau t, J

~in the Operating and Emergency, Procedures.

(3) Anacriole wipe test tool,(Sketch 1). PLUG "A"

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onnector.

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= wipe test tool directly to projector source tu o c

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h-ITEM 6(1) Li%K TESTING PROCEDURES (NDT)

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The replacement of any scaled sourco footened to or cont @ ed in n radiographic expooura devico, leak t'coting, reoair tagging, fit any nealed e

l ooucco or radiographic d Wico 'shall borpofformed only'by pornons.ppecifically i

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authorized to do so.

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Leak tests will be performed under the supervinion of the Radiographic

' ','; Safety Officer.

(See Itca 6(f) for training and experience of r"rnonnel I

qualified to perform le.ik tests).

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Each acaled source ire tested for leakage.at intervals not to c:xecd 01::

.F months. 'In the abocaco of a certificate from a transferor that a Icak teot I

has.bocn mado within six months priot.to the transfer, the scaled nource l

i shall not.bo put into use until leak tested.

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To determine-if a ocaled source capoule is leaking the outside syrface of the capoulo uhall be swiped using a device similar to the San Francioco Naval Shipyard (Mare Island) device designed for this purpose.

(Figure 1).

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2.

Count the swipd in the CP-297/UD Radia'c'C'6mputer Indicator and comparo with the count fate of standard Sr 90-Y 90 reference soureco

' calibrated by the Nation d Bureau of, Standards to find the degree of Icakago present.

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3.

If the leak teot' reveals the presence of' radioactivity is more

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than 0.005 uc, tho sealed sourco will be removed from service.

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4.

Tha cource and devico shall then be decontaminated and/or dispoacd.

'A report shall'bc filed within 5 days of the test with the AEC, Region I Directorato of Regulatory Operations, 631 Park Avenye, King of Pruosia, i

,g Pennoylvania, 19406 via NAVELEXSYSCOM, Code 4805. The report should include the equipment involved, test results, and corrective action.

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Recordo of leak tent.resulto are kept in unito of microcurico and l

maintained by the Radiological Control Division for inspection by the AEC.

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_ PROCEDURE f

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Safety Precautions j

i Personnel engaged in leak testing a scaled source will wear a.

i rubber glovco and aprono and exerciso care to provent skin contact with

,i 1' leak tooting tools and equipment.

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b.

All cource leak testo will be pr.rformed in the chielded I'

l nhooting and' ocorago vault described in item 6(a)...

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. ION LAKE INST 9900.2F Al December 1974 (3) Damage to connectors and source changer mating components.

J (4) Proper labeling, in accordance with reference (a).

n (5) Cleanliness and preservation, shall be free of rust, grease, oil, i

dirt, etc.

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i (6) Any damage to container which' may impair its proper and safe use.

Radiography Storage Vault in compartment 3-100-1-Q.

Inspection and c.

preventive maintenance should be performed as follows:

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o (1) Inspect and test interlocking alarm system (access to vault).

and check calibration'date of gamma alarm. a

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(2) Inspect, test, t,

(3) Proper labeling, in accordance with reference (a).

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(4) Preservation and cleanliness.

(5) Possible damage which may effect radiation levels outside vault.

d.

Technical Operations Beam Collimator, Model 527.

Inspection and preventive maintenance should be performed as follows:

(1) Changes in the operating characteristics of the device. -

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(2) Damage to the device which may impair its normal and safe operation.

~.. n.d (3) Proper labeling, in accordance with reference (a)'.

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I (4) Preservation and cleanliness.

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(5) Lubrication of height adjustment section.

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SIMON LAKE INST 9900.2F 17 December 1974 (b) Visual Inspection. The source shield assembly shall be inspected for damage which may impair its normal and safe operation. The shipping plug The shall be installed into the source tube at all times when not in use.

Model 533 Projector storage cover shall be installed over the control cable i

J connector at all times when not in use.

(c) Proper labeling, in accordance with reference (a).

i (d) Proper operation of the locking device. The correct operation of g-the lock and selector level for the Model 533 Projector is explained in the

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projector operating manual.

(e) Possible shielding defects such as cracks resulting from movement of projector.

(5) Signal Circuit and Lamps. The signal circuit shall be hooked up prior to operating projector and inspected for proper operation prior to each use and during required inspections and maintenance. Replace batteries and lamps as necessary, using the type required by the projector operating manual or equivalent.

(6) Source Tube and Signal Circuit Wiring (a) Cleanliness. The source tube and signal circuit wiring shall be free of any oil, grease, corrosive liquids or organic solvents injurious to gneopreneandpolyethylene.

(b) Visual Inspection. The source tube and signal circuit wiring shall be inspected for any damage which may impair its normal and safe operation.

Avoid any excessive twisting or bending of tube and wiring. Do not drag tube e

and wiring over dirty, oily, greasy or rough surfaces.

Replace plastic caps on source tube section connectors when not in NOTE:

use to prevent damage to connector and to prevent foreign objects from entry into tube.

I (c) Clips or bands. Clips or bands are located at 12 to 15 inch intervals along the tube length to hold the signal circuit wiring to the source tube. Inspect to insure that these clips or bands are present and located or spaced as indicated.

b.

Technical Operation Models 414 and 650 Source Changers for use with Iridium 192 source and Technical Operation Model 416 Source Changer for use with Cobalt 60 source. Inspection and preventive maintenance should be performed as follows:

(1) Possible shielding defects, (shifting of shielding, cracking, etc).

(2) Proper positioning of source. Radiation limits shall not exceed that specified in reference (a).

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SDti dG 111ST 9900.2t 17 L'cember 1974 4.

Inspection and Preventive Maintenance i

Technical Operations Model 533 Projector and Cont.rol Assembly for use a.

with Iridium 192 source and Technical Operations Model 496 Projector and Control

,,l Assembly for usa with Cobalt 60 source. Inspection and preventive maintenance should be performed as follows:

I (1) Handle and Drive Box Assembly (a) Cleanliness and preservation. Remove the cover of the handle unit by removing four (4) screws and wash the gaar box mechanish with acetone or (j

a non-corrosive solvent. After completely drying the unit, lubricate the gearing mechanism with a uni-temperature grease or a three in one spray oil.

'l (b) Visual Inspection. The drive gear assembly shall be checked to ascertain the condition of the geared wheel. If the gear is found to have 1

excessively worn edges, it must be replaced. Inspection will also be made at this time for any grooving or wear in the gear case assembly.

(2) Source Drive Cables (a) Cleanliness and preservation. Care shall be taken to keep the conduit free and clean of any corrosive liquids or organic solvents injurious to neoprene and polyethylene. Avoid all contact with dirty, oily, greasy and rough surfaces. Do not drag conduit around. Maintain control caps on source connector (Model 533 Projector) when not in use.

Ib)VisualInspection. The source drive cables shall be inspected i

for wear or damage. The appearance of wear or damage will indicate that increased resistance will be noted in the control unit on a continuing basis. Damage can be prevented by assuring that the control assembly is coiled and uncoiled properly during each use and protected against physical abuse when in use. Avoid bending excessively. Clips or bands are located at 12 to 15 inch intervals along the cable length. Inspect to insure that the clips or bands are present and located or spaced as indicated.

i (3) Control Cable and Source Connector (for Model 533 Projector only)

!j (a) Cleanliness and preservation. Care shall be taken to keep the connector free of any corrosive liquids and dirt.

(b) Visual Inspection. Connector shall be inspected for indications of m r on tha fing2r, 'eformation of the fin;2:3 and condition of th, joint between the source connes ir and cable. Maintain control cable cap on source cable connector at all ti as when not in use.

(4) Source Shield Assembly (a) Cleanliness and preservation. The source shield assembly shall

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be free of grease, oil, dirt, etc.

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SIMON LAKE INST 9900.2F 17 December 1974 INSPECTION AND MAI'NTENANCE PROCEDURES APPLICABLE TO AEC BY-PPODUCT MATER LICENSE 08-00038-20 1.

Subject Equipment Technical Operations Model 533 Projector for use with Iridium 192 source.

a.

b.

Technical Operations Model 496 Projector for use with Cobalt 60 source.

f Technical Operations Model 414 and 650 Source Changer for use with c.

Iridium 192 source.

Technical Operations Model 416 Source Changer for use with Cobalt 60 d.

source.

Technical Operations Collimator Model 527 for use with Iridium 192 and c.

Cobalt 60 source.

f.

Radiography Storage Vault in Compartment 3-100-1-0.

2.

Frequency of Inspections The operating and physical condition of radiographic equipment shall be a.

The inspected by thc. Radiographer prior to use each day that it is used.

condition of the equipment will be documented on the check of f list, Tab I to

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this enclosure.

s, Quarterly the Padiographic Safety Officer, with the assistance of the b.

senior Radiographer, shall inspect to verify that preventive maintenance actions are being performed and to determine the extent of deterioration and whether operation of the equipment has been effected by wear, corrosion, or physical

abuse, Special or non-routine inspections shall be performed when conditions c.

warrant.

3.

Check Off List for Inspection and Preventive Maintenance The inspection and preventive maintenance check off list, Tab I, shall a.

be utilized to document all inspections and preventive maintenance actions noted in paragraph 2 above. The check off list shall be retained in the Non-Destructive Test Laboratory and is subject to inspection by the AEC.

Equipment found to be unsatisfactory should be reported using the format shown in Tab 2.

b.

Strict adherence to all safety precautions for radiation protection of personnel as set forth in AEC Rules and Regulations, Title 10, Parts 20, 30, and 34, referred to as reference (a) in paragraph 4 below, shall be followed in

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the performance of inspection and maintenance on radiography equipment.

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Enclosure (1)

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y Com uti USS SIMOD 1.AKE (AS 33)

FPO NEW YORK 09501 SIMON LAKE INST 9900.2F AS33/04:ss 17 December 1974 USS SIMON LAKE INSTRUCTION 9900.2F_

l Operating and Emergency Procedures Applicable to AEC By-Prod Subj 08-00038-20 (Radiography)

License No.

(a) Title 10, Code of Federal Regulations, Chapter 1, (Atomic Ene Part 20 (Standards for Protection Against Radiation); Part 30 Reft (Licenair.g of By-Product Material) and Part 34 (Radiation Safety Bequirements for Radiographic Operations) i 4

(1) Opercting and Emergency Procedures Applicable to AEC By-Product Encl:

Material License 06-00038-20 (2) Inspection and Maintenance Procedurco Applicable to AEC By-Pro Material Licenne 08-00038-20 To promulgate operating and emergency procedures and inspection l License No.

and maintenance procedures appliccbic to AEC By-Product M 1.

Purpose.

08-00038-20 radiography.

SIMON LAKE INST 9900.2E.

2.

Cancellation.

Reference (a) includes those parts of the Code of Federal ble Regulations which pertain to r.ie Atomic Energy Commission 3.

Backnround_.

lienble and inspection and maintenance procedures for the use of sealed sources app to the subject license.

to the subject license be provided by the applicant.

The Radiographic Safety Of ficer is responsible through i l applicoble to 4.

Re spons ibility.

the chain of command for the safe use of all by-product mater a 08-00038-20, AEC By-Product Material License No.

The Radiographic Safety Of ficer vi.1.1 maintain these operating and t

Any ewigency procedures nnd innpection and maintenance ptocedures curren.08-00038-20 (R 5

A tion.

for amending AEC Dy-Product Material License No.its procedures shall require roepiest gr yhy) or changes to thin Instruction and/ot These togt'ests will be prier approval by the AtomLc Energy Commissten.

The forwarded via Commander, Naval Electronica System Command (Code 4805).

Radiographic Safety Of ficer will also insure that each a

& h' yg SANI RD N. LEVEY j

(See SIMON LAKE INST 5216.1B) l D1 n.r Lbution:

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s DATE CHECK OFF LIST F0F INSPECTION AND PREVENTIVE MAINTENANCE OF RADIOGRAPHIC EQUIPMENT 1.

1.

Frequency of inspection maintenance are indicated by the following sysbols:

D-Prior to use each day that it is used.

Q-Quarterly.

TECH. OPS. MODEL 333 AND 496 PROJECTOR AND ASSOCIATED EQUIPMENT-INSPECTION OR PREVENTIVE MAINTENANCE FREQUENCY INDICATE SAT /UNSAT 1.

Handle & Drive Box Assembly; a.

Cleanliness & Preservation and lubrication Q.

SAT /UNSAT b.

Visual Inspection of Drive Gear Assembly Q

SAT /UNSAT 2.

Source Drive Cable; a.

Cleanliness & preservation D

SAT /UNSAT b.

Visual Inspection of Source Drive' Cable D

~"' SAT /UNSAT

~

3 control Cable & source Connector; a.

Clennliner e Preservation D

SAT /UNSAT b.

Visual Inspection of Connector D

SAT /UNSAT 4.

Source Shield Assembly Projector; a.

Cleanliness & Preservation D

SAT /UNSAT b.

Visual Inspection of Connector D

SAT /UNSAT c.

Proper Labeling D

Sat /UNSAT d.

Operation of Locking Block D

SAT /UNSAT e.

Shielding Condition D

SAT /UNSAT 5

Signal Circuit & Lamps; a.

Proper Operation D

SAT /UNSAT 6.

Source Tubo & Signal Curcuit Wiring; a.

Clean *

..e t 3 D

SAT /UNSAT b.

Vis 2-

'.nspection for Damage D

SAT /UNSAT c.

E tr 4 Bands Properly T! ;(

'd D

SAT /UNSAT SIGNATURE OF PERSON IERFORMING PREVENTIVE MAINTENANCE 4

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Enclosure (2)

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a DATE TECH. OPS. 414 & 650 SOURCE CHANGER FOR USE WITH IR 192 SOURCE AND TECH. OPS. MODEL 416 SOURCE CHANGER FOR USE WITH CO 60 SOURCE INSPECTION OR PREVENTIVE

414, 416, 650 MAINTENANCE FREQUENCY INDICATE SAT /UNSAT 1.

Shielding condition D

SAT /UNSAT 2.

Proper positioning of source D

SAT /UNSAT 3

Visual inspection for damage of connectors & mating components D

SAT /UNSAT 4.

Proper Labeling D

SAT /UNSAT 5

Cleanliness-preservation D

SAT /UNSAT 6.

Visual inspection for damage (general)

D SAT /UNSAT

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SIC"^TURE OF PERSON PERFORMING PREVENTIVE MAINTENANCE t

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'T DATE TECH. OPS. BEAM COLLIMATOR, MODEL 527 INSPECTION OR PREVENTIVE ~

MAINTENANCE FREQUENCY INDICATE SAT /UNSAT 1.

Changes in operating charac.teristics of' device D

SAT /UNSAT 2.

Visual inspection for damage (general)

D SAT /UNSAT 3

Proper Labeling D

SAT /UNSAT 4.

Preservation & Cleanliness D

SAT /UNSAT 5

Lubrication D

SAT /UNSAT L' A ': i

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Signature of person performing preventive maintenance

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7 DATE RADIOGRAPHY STOWAGE VAULT IN COMPARTMENT 3-100-1-Q INSPECTION OR PREVENTIVE MAINTENANE FREQUENCY INDICATE SAT /UNSAT 1.

Inspect & test Alarm System D

SAT /UNSAT 2.

Inspect, test & check calibration date of gamma

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alarms D

SAT /UNSAT 3

Proper labeling D

SAT /UNSAT 4.

Preservation & cleanliness D

SAT /UNSAT 5

Visual inspection for damage (general)

D SAT /UNSAT Signature of person performing preventive maintenance 9

S l

8 Enclosure (i) I 2

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REPORT OF UNSATISFACTORY CONDITION OF RADIOGRAPHIC EQUIPMENT

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1.

Any component found to be unsatisfactory as a result of inspection or preventive maintenance shall be listed below.. List actual discrepancies and corrective action required. This component shall not be used until replaced or repaired.

2.

Upon completion of corrective action and prior to utilizing the affected equipment, the Radiographic Safety Officer and the Senian Radiographer will be notified.

CORRECTIVE DATE ITEM DISCREPANCY ACTION CORRECTED SIGNATURE Y

F 3

This inspection and/or preventive maintenance was performed under the D-Dailey (Prior to each use)

, Quarterly

, requirement.

Enclosure (2) _

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s RADIOGRAPHY ISOTOPE LEAK TEST RECORD ISOTOPE SERIAL DATE OF RESULTS OF NEXT LEAK RADIOGRAPHERS TYPE NUMBER LEAK TEST LEAK TEST TEST DUE SIGNATURE P

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EACH SEALED SOURCE SHALL BE LEAK TESTED IN ACCORDANCE WITH THE " CODE OF v

FEDERAL REGULATIONS" TITLE 15, PARAGRAPH 34.25 (1) AT INTERVALS NOT TO EXCEED SIX MONTHS OR (2) IN THE ABSENCE OF A CERTIFICATE FROM A TRANSFEROR THAT A LEAK TEST HAS NOT BEEN MADE WITHIN SIX MONTHS PRIOR TO THE TRANSFER.

ALL READINGS SHALL BE RECORDED IN MICRO-CURIES.

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PG I OF 6

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R'ADIOGRAPHY QUARTERLY AUDIT PLAN DATE

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L 'REF:

A.

INSTRUCTION 6-G OF NRC (AEC) FORM 313R.

. fft B.

PARAGRAPH 34.11 (d) OF THE " CODE OF FEDERAL REGULATIONS" TITLE 1# PART 34, ATTRIBUTE SAT UNSAT DATE REMARKS A.

COMMISSION REGULATIONS:

'!T 1.

STANDARDS FOR PROTECTION

  • ~~

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AGAINST RADIATION:

ARE PROVISIONS OF TITLE 15 a.

PART 25 CFR BEING FOLLOWED WITH REGARD TO THE FOLLOWING; (1)

EXPOSURE OF INDIVIDUALS TO RADIATION IN RESTRICTED AREAS Y

(2)

DETERMINATION OF ACCUMULATED DOSE (3)

EXPOSURE TO MINORS (4)

PERMISSIBLE LEVELS OF RADIATION IN UNRESTRICTED AREAS (5)

SURVEYS

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(6)

PERSONNEL MONITORING

[.

(7)

CAUTION SIGNS, LABELS,.

SIGNALS AND CONTROLS (8)

INSTRUCTION OF PERSONNEL:

POSTING OF NOTICES TO EMPLOYEES (9)

RECORDS OF SURVEYS AND RADIATION MONITORING 6

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PG 2 OF 6 SAT UNSAT DATE REMARKS ATTRIBUTE

t 1,.,.

(15)

REPORTS OF THEFT OR LOSS OF

c. ? '

LICENSED MATERIAL (11)

NOTIFICATION OF INCIDENTS (12)

REPORTS OF OVER EXPOSURES

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(13)

PERSONNEL AND MONITORING

_$ 1 REPORTS (14)

REPORTS OF PERSONNEL EXPOSURE ON TERMINATION OF EMPLOYMENT OR WORK 2.

RULES OF GENERAL APPLICABILITY TO LICENSING OF BY PRODUCT MATERIAL.

'a.

ARE THE PROVISIONS OF TITLE If PART 35 CFR BEING FOLLOWED WITH RF",ARD TO THE FOLLOWING; u

(1)

TERMS AND CONDITIONS OF THE LICENSES (2)

APPLICATIONS FOR RENEWAL OF LICENSES

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(3)

APPLICATIONS FOR AMENDMENT OF LICENCES (4)

RECOPDS (5)

INSPECTIONS p

o E

(6)

TESTS E

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E 3.

LICENSES FOR RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS 8

FOR RADIOGRAPHY OPERATIONS

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e PG 3 OF 6

.c' SAT UNSAT DATE REMARKS

. ;[$,c ATTRI UTE i

pr e-ARE THE PROVISIONS OF TITLE:15 a.

PART 34 CFR BEING FOLLOWED WITH REGARD TO THE FOLLOWING; (1)

LIMI'S ON LEVELS OF RADIATION

'T~

FOR 'tADIOGRAPHIC EXPOSURE.

DEVICES AND STORAGE CONTAINERS.,

LOCKING OF RADIOGRAPHIC 7

(2)

EXPOSURE DEVICES AND STORAGE CONTAINERS (3)

STORAGE PRECAUTIO.NS (4)

RADIATION SURVEY INSTRUMENTS C5)

LEAK TES TING, REPAIR,-TAGGING, w

OPENING, MODIFICATION AND REPLACEMENT OF SEALED SOURCES (6)

QUARTERLY INVENTORY (7)

UTILIZATION LOGS (8).INSECTTION AND MAINTENANCE OF 7-RADIOGRAPHIC EXPOSURE DEVICES AND STORAGE CONTAINERS (9) ' LIMITATIONS OF RADIOGRAPHERS.

p l f (Ig)

OPERATING AND EMERGENCY PROCEDURES M

8 S

(11)

PERSONNEL MONITORING CONTROL m

,3 (12)

SECURITY DURING RADIOGRAPHIC OPERATIONS

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PG 4 OF 6 t

SAT UNSAT DATE REMARKS ATTRIBUTE (13)

POSTING DURING RADIOGRAPHIC OPERATIONS (14)

RADIATION SURVEYS AND SURVEY.

RECORDS DURING RADIOGRAPHIC OPERATIONS 3.

SIMON LAKE OPERATING AND EMERGENCY PROCEDURES 1.

ARE THZ PROVISIONS OF SIMON LAKE INST. 995g.5 (SERIES) BEING FOLLOWED IN REGARD TO THE FOLLOWING; OPERATING PROCEDURES FOR USE OF a.

'a TS 1216 A/UD RADIAC CALIBRATOR b.

EMERGENCY PROCEDURES FOR USE OF TS 12I6 A/UD RADIAC CALIBRATOR 2.

ARE THE PROVISIONS OF SIMON LAKE INST. 9955.2 (SERIES) BEING FOLLOWED IN REGARD,TO THE FOLLOWING; OPERATING PROCEDURES FOR USE OF a.

MODEL 496 PANORAMIC GAMMA PROJECTOR (TECH / OPS) PICKER CORPORATION b.

OPERATING PROCEDURES FOR USE OF f'

MODEL 533 PANORAMIC GAMMA y

PROJECTOR (TECH / OPS) PICKER m

l CORPORATION 2:

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3 PG 5 OF 6 ATTRIBUTE SAT UNSAT DATE REMARKS c.

OPERATING PROCEDURES FOR THE USE OF THE TECH / OPS MODEL 527 RAY COLLIMATOR d.

PRECAUTIONS TO BE TAKEN WHEN RADIO-ISOTOPES ARE USED ABOARD SHIP e.

INSTRUCTIONS FOR THE USE OF RADIATION SURVEY INSTRUMENTATION f.

INSTRUCTIONS FOR CONTROLLING ACCESS TO RADIOGRAPHY AREAS m

g.

INSTRUCTIONS FOR SECURITY OF SOURCES DURING STOWAGE AND EXPOSURE h.

INSTRUCTIONS FOR USE OF PERSONNEL MONITORING EQUIPMENT 1.

INSTRUCTIONS FOR TRANSPORTING s

SOURCE TO FIELD LOCATION j.

EMERGENCY rROCEDURES k.

SOURCE REPLACEMENT PROCEDURES FOR COBALT 65 AND FOR IRIDIUM 192 3

g-WITH TECH / OPS MODEL 414 AND TECH /

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OPS MODEL 655 SOURCE CHANGERS

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MAINTENANCE RECORDS 2,

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