ML20013E524

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GL Registration from Dominion Virginia Power
ML20013E524
Person / Time
Site: North Anna  Dominion icon.png
Issue date: 12/10/2019
From: Lane N, Simmons G
Dominion Virginia Power
To:
Office of Nuclear Material Safety and Safeguards
References
GL-700115-25
Download: ML20013E524 (8)
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Text

V Dom1rnon Energy V1rg1rna North Anna Power Statmn 1022 Haley Drwe, Mineral, VA 23117 Domm1onEnergy com a

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Dominion December 11, 2019 Director, Office of Nuclear Material Safety Serial No.19-482 and Safeguards NAPS/DPM ATIN:GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001 VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS 1 AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Fann 664, General License Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. G. R. _Simmons at (540) 894-2107.

Sincerely,

/\./?_. 0z N. Larryclane Site Vice President Enclosure Commitments made in this letter: None.

cc: U. S. Nuclear Regulatory Commission ATIN: Document Control Desk Washington, DC 20555-0001 U. S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta Georgia 30303-1257 NRC Senior Resident Inspector North Anna Power Station I

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IIHl~I IIIIII II ltllll lllll lllll lllll lllll lllll llll llllll lllll llll llll Illllllll l l -1111111111111111'11111111111 GL-700115-25 SECTION 1 11/05/2019 PAGE 1 of 2 N~C FORM 664 (04 - 2019) U.S. NUCLEAR REGULATORY COMMISSION 10CfR315 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 0MB EXPIRATION DATE: 04/30/2019 Esbmated burden per response to oomply wrth thlS mandatory collecbon request 20 minutes NRC will use this mformabonto track general hcencees and their devK:es to ensure a higher level of device acoountab1l1ty Send oomments regarding burden esumate to the FOIA, Privacy, and lnformauon Collecllon Bra rich (T-6A 1OM), U S Nuclear Regulatory Comm1SSl0fl, V\lashmgton, DC 205555-0001, or by 111temet e-mail to lnfocollects Resource@nrc gov, and to the Desk0fficer, Office of lnformatJoo and Regulatory Affairs, NEOB-10202, (3150-0196), Office,of Management and Budget, \o'lashmgton, DC 20503 If a means, used to impose an mformalJon oollecbon does not display a currently valid 0MB oontrol number, the NRC may not oonduct or sponsor, and a person 1s not reqwed to respond to, the mformabon collecbon Complete all six sections of this registration form. If any of the preprinted information Is incorrect, provide the changes in the applicable boxes, USE CAPITAL LETTl=RS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-700115-25 Enter the company name and the street address for the physical 1ocation of use for your device(s). For portable devices, specify the primary storage location. Do not use P.O. Boxes'.

Company Name DOMINION VIRGINIA POWER I I I I I I I I I I I I I I *I I- I I- I J- I I I Department: NORTH ANNA POWER STATIO I I I I I I I I I I I I I I I I I I I I- I I I Address Line 1: 1022 HALEY DRIVE I I I I -1 I I I I I I .J I I I I I I I I I I I Address Line 2* END OF ROUTE 700 I I I I I I I I I I I I I I I I I I I I I I I City MINERAL I I I I 1- I I I I I I I I I I I :l I I I I I I I State: VA rn Zip Code. 231174527 I I I I I I .--I-,-1-1.----,-1--,1

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11/05/2019 SECTION 1 .-

PAGE 2 of 2

- * . SECTION 1 - GE_NERAL LICENSEE INFORMATION (Continued)

Enter th& name, telephone number and title of the person who Is the responsible individual for the device(s).

  • Last Name: SIMMONS I -I I- I I I
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First Name: GEORGE * . Middle Initial. R

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  • Business Telephone*Number. (540) 894-2107 Extension* ,
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  • RAD PROTECTION MANAGER _ . : .

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Enter the mailing address where correspondence regarding your device(s) should be sent.

Department* - NORTH ANNA POWER STATION I 1. I - I* I I I* I I I I I I I I I I *1 I I I -.I I- I Address Line 1: *1.022 HALEY DRIVE

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Address Line *2: ' ENb OF ROUTE 700 1- I I .-. I- , :1 1* *1 -1 l- -1*

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~* 11111111111111111111111111111111111111111111111111111111111111111111 Illllllll llll 11111111111111111 GL-700115-25 11/05/2019 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please updtae the infonnatlon as necessary. PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number) -

D1stnbutor/Dustnbuted By. Metorex Incorporated ~,

I I I I I I I I I I I I I I I I I I I I I I I I Distributor License Number. 29-30342-028 I I I I I I I I I I I I I I Manufacturer name. METOREX, INC

-I I I t I I I I I I I I I I I I I I I I I I I I Device Model (Not Source Model). OOPS I I I I I I I. I I I I I I I I I I I I I I I I I Device Sena! Number 128018 I I I I I I I I I I I I I I I I I I I I I I I I Transfer Date. 08/12/1999 D

[IJITJI I I I I Not In possession of device (Also complete Section 4.)

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- - .- '.* , -. SECTION 3 -. ADDITIONAL DEVICES SUBJECT TO REGl~T_RAHON . PAGE of 1 1

- Provide informatlon-a'boµt othe~ devices you have that are subject to registration. Do not rep~rt specifically licensed devices. , , .*

- M~nufa;ture~ Name _. * . . -. _ . - . -  :. _.. . *:.. - * *.

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  • 11/05/2019 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide infonnation about devices listed In Section 2 or 6, but no longer in your possession. PAGE 1 of 1 -

MM DD YYYY Location of the De1J1ce 0 VVhereabout~ Unknown (Complete Part 1 only) ' 0 Transferred to another general licensee (Complete Parts 2 and 3) 0 Never Possessed the DeVJce (Complete Part 1 only) 0 Transferred to a Specrfic Licensee (Not the manufacturer) 0 Returned to Manufacturer (Compl~te Part 1 only) (Complete Part 2)

Part 2 License Number of Rec1p1ent (1f transferred to a specific licensee)

I I I I I I I I I I I I I I Company Name.

I I I I I I I I I I I I I I I I I I I I I I 1- I I I I I Department I I I I I I I I I 1- I I I I I - I I I I I I I I I I I I I Address Line 1*

I I I I I I I I I I I I I I I *-1 I I I I I I I I I I I I Address Line 2:

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Part 3 Enter the name of the individual responsibe for this device: * :

Last name I I r I I I I I I I I I I I I I I I I I I I I I I I I I First name. Middle Initial:

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GL-700115-25 SECTION 5

, *

  • SECTION 5 - CERTIFICATION.

11/05/2019 PAGE 1 of 1 I hereby certify that A '-All information con,tained in this registration is true and complete to the best of my knowledge and cGehef.

B A physical inventory of the aev1ces subject to registration has been co~pleted,* and the device information on this form has *been checked against the device labeling.

C. I_ am aware of_~he requirements of the general license, provided*m 10 CFR 31 5.

(Copied of appli~ble ~egulations may be viewed at the NRC *website at.* .

-rm/doc-collections/cfr) *.-.

SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed ln'Sectlon 1) *DATE

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'WARNING . . FALSE STATEMENTS.MAY BE,SUBJECTTO CIVIL AND/OR CR.IMINAL PENALTIES' NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLE'fE AND ACCURATE IN AIJL MATERIAL ASPECTS. 10 U.S.C SEGTION 1'001 MAKES ITA CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATIER IN ITS JURISDICTION t ~-

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1110512019

\ *sECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION - _. *-_PAGE *1.*of 1*

NRC Device Key: 547351 Manufacturer License No MD-31-076-01 Manufacturer Name CONGO SERVICES CORP.

Model Number. 101 Senal #: N596 Transfer Date. 02/15/1994 Isotope* Nl63 Activity* 5 Unit mCi NRC Device Key:* 689428 Mar:iufacturer License No* 20-15525-046 Manufacturer Name- GE ION TRACK Model Number. ITEMISER Ill Serial # 09-8424 Transfer Date: 06/30/2003 Isotope Nl63 Activity. 10 Unrt niCi NRC Device Key:' 707159 Manufacturer License No:

Manufacturer Name:. METOREX; INC:

Model Number. 880 Serial#: 128018 Transfer Qate: 02/27/2002 Isotope: CD109 Activity. 10 Unit myi.

  • NRC Device Key: 825331: * -Manufacturer License No. 12-04933-048 Manufacturer Name- PERKINELMER LIFE SCIENCES --

Model Number. B310000 Serial#: DG08129527

  • Transfer Date* 07/20/201'2 Isotope: BA 133 Activity: 20 Unit' uCi

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