ML20127F979
| ML20127F979 | |
| Person / Time | |
|---|---|
| Site: | 03030178 |
| Issue date: | 12/30/1992 |
| From: | Prange B NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION V) |
| To: | |
| References | |
| 50-23695-01, 50-23695-1, 571698, NUDOCS 9301210107 | |
| Download: ML20127F979 (17) | |
See also: IR 05000236/1995001
Text
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.. U.S. NUCLEAR REGULATORY COMMISSION
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,; Amendment No. 1
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MATERIALS LICENSE
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- Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Pubhc Law 93 -438), and 'litle 10,
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Code of federal Regulations, Chapter I, Parts 30,31,32,33,34,35,40 and 70, and in reliance on statements and representations .
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heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, .!
source, and special nuclear matenal designated below; to use wch material for the purpose (s) and at the pbce(.) designated below;to l
T deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the appheable Part(s) This ;
license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is i
- _ subject to all applicable rules, regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any. l
1 conditions specified below. i
El . _ . . _ i
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In accordance with application 3
dated September 26, 1992 i
1. Admiralty Testing Services 3. Ucense number 50-23695-01 is amended ;
in its entirety to read as follows: l
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2. P.O. Box 7193 r i ~ - -
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l Ketchikan, AK 99901 , N-!- 4. Expiration date Dacember 31, 1997 lpt-
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5. Docket or
] Reference No. .
030-30178
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' 6. Byproduct, source, and/or ,
7. Chemical and/or physical ( 8. Maximum anwunt that licensee j
special nuclear material form < imay possess at any one time
under this license
A. Cesium 137 A. Sealed Sources A. Not to exceed 10
(TroxlerOwg. .. t ' millicuries
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A-102112)
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B. Americium 241 8. Sealed neutron sources B. Not to exceed 50 pt
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(TroxlerDwg. -
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A-102451) -
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A. and B. For use in a Troxler Model 3400 Series Moisture-Density gauge to-measure
properties of construction materials. g V *
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CONDITIONS;
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10. Licensed material may be used at 2869 South-Tongass Avenue, Ketchikan, Alaska 99901 i
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and at temporary job sites- of the licensee anywhere in the United States where the F-
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U. S. Nuclear Regulatory Commission maintains jurisdiction for regulating the use of
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licensed material. [j
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- l l . . Licensed material shall be used by, or under the supervision and in the physical . g;
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presence of, Mark T. Johnson or individuals who have successfully coinpleted the . t;
l- manufacturer's training program for gauge users and who have been designated by the (
l Radiation Protection Officer, Mark T. Johnson. The licensee shall maintain records. (
b of individuals designated as users. ;i
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j 12. Scaled sources containing licensed material shall not be opened. B
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50-23695-01 p
M ATERIALS LICENSE nockn or 1Ghrena numb
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SUPPLEMENTARY SHEET 030-30178 8>
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Amendment No. 1
CONDITIONS
(continued) !
13. A. The source (s) specified in Item (s) 7.A. and 7.B. shall be tested for leakage
and/or contamination at intervals not to exceed 6 months. Any-source received i;l
from another person which is not accompanied by a certificate indicating that l 1
a test was performed within 6 months before the transfer shall not be put into j j
use until tested.
B. Any source in storage and not being used need not be tested. When the source
is removed from storage for-use or transfer to another person, it shall be j
. tested before use or transfer. f k> l
C. The test shall be capable of detecting the presince of 0.005 microcurie of 11
l radioactive material on the test sample. If the test reveals the presence of j
- 0.005 microcurie or more of removable contamination,'the source shall be
removed from service and decontaminated, repaired, or disposed of in ,
q accordance with Commission regulations. A report shall be filed within-5 days !
q of the date the leak test result is known with the U. S. Nuclear Regulatory
Commission, Region V, Radioactive Materials Safety Branch,1450 Maria Lane,
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I Walnut Creek, California _94596. __The _ report shall specify tne source involved,
the test results, and corrective action taken. Records of leak test results
l shall be kept in units of microcuries and shall be maintained for inspection
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g, by the Commission. Records may be disposed of following Commission ,
inspection. j
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D. The licensee is authorized to collbct leak-test samples for mlysis by
Troxler Electronic Laboratories.. Inc. or tests for leakage ana/or
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contamination shall be performed by persor.s specifically licensed by the
Commission or an' Agreement State to perform such services.
4.
4l 14. The licensee shall conduct a physical inventory every six (6) months to account for M{
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Ri Records of the -
all sources shall
inventories and/or bedevices received
maintained for twoand p(ossessed under the license.2) years from th
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1 The licensee may transport licensed material in accordance with the provisions of 10
% CFR Part 71, " Packaging and Transportation of Radioactive Material".
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U.S. NUCLE AR REGULATORY COMMISSION OF PAGE$ h
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MATERIALS LICENSE g,g, g ,7,,, ,,, ,,,,w, I
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SUPPLEMENT ARY SHEET 030-30178- >
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Amendment No. 1
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, CONDITIONS
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8 16. Except as specifically provided otherwise in this license, the licensee shall
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l conduct its program in accordance with the statements, representations, and
procedures contained in the documents including any enclosures, listed below. The i
Nuclear Regulatory Commission's regulations shall govern unless the statements,
representations and procedures in the licensee's application and correspondence are 6
more restrictive than the regulations.
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A. Application dated September 26, 1992 h
B. Letter dated December 19, 1992 'c >
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FOR THE U. S. NUCLEAR REGULATORY COMMISSION
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4l DEC 3 01992 o
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By: D RIM Marw,.
[Date BethA.PrangeJ
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q! _ Sr.HealthPhysicist(Licensing)
q; Radioactive Materials-Safety Branch
4; Region V
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DEC s o ,gy
Docket No. : 030-30178
License No.: 50-23695-01
Control No.: 571698
Admiralty Testing Services
P.O. Box 7193
Ketchikan, AK 99901
Attention: Mark T. Johnson
Enclosed is the NRC license renewal which you requested.
Please review the enclosed document carefully and be sure that you understand all
conditions. If there are any errors or questions, please notify us so that we
can provide appropriate corrections and answers.
Any future correspondence relating to your license should specifically reference
your license and docket numbers to expedite your inquiry.
Sincerely,
Beth A. Prange
Sr. Health Physicist (Licensing)
Radioactive Materials Safety Branch
Enclosure: Attachment A
Amendment No. I to License No. 50-23695-01
1
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Distribution
bec w/ original concurrence, copy of license and original correspondence:
License docket folder
bec w/ copy of license and correspondence:
Inspection folder
bec w/ copy of license:
Reading file
bec w/ correspondence and 2 copies of license:
Shirley Crutchfield, LFMB, MNBB 4503
License only:
State of AK
KPrendergast JMontgomery DSkov B nge
/ / / / / / 12 /30/42
REQUEST COPY REQUEST COPY REQUEST COPY REQUEST COPY
YES a NO O YES O NO O YES a NO O YES a NO R'
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12-19-92-
U.S. Nuclear Regulatory Commision
-Region V
1434 Maria Lane, Suite 210
Walast Creek , Calif. 94596 ,
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Re: Licease No. "A-23695-81 '
Cestrol No. 571698
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Dear Beth:
As requested this is in response to your letter dated 11-20-92.
1. Admiralty Testing Services is committed to insuring that our guage
will be stored at 2869 5. Tongass Ave when met la use. It will never be
left samattended and will be stored in a secure area when met la use.
2. Leak tests will be performed by myself at six meath intervals
utilizing a Trexler leak test kit. Smears will be seat to Trexler
Laboratories at P.O. box 12057 -Research Triangle Pk. N.C. 27799.
Investery will be conducted at six month latervals with records being
kept for 2 years. coc wsr wit 2ww uwPc vuutec
3. Amy maintamance er clemains of the guage will be performed with
the radioactive source in the shellded posities.
4. Transportation of the guage will be conducted la accordance with the
requirenents of D.O.T.
5. Anyone using the guage vill be provided with written operating and
emergency precedures. Users will also wear and be informed of
precedures for personal dosimeter devices when verking with the
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guage. They will mise be lastructed in the correct transportation, leak
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testing sad emergency precedures.
Pleau feel free to contact me with any question.
,
-Sincerely
Admiralty Testing Services
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Mark T. John () sea
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NOV 2 01932
Docket No.: 030-30178
License No.: 50-23695-01
Control No.: 571698
Admiralty Testing Services
P.O. Box 7193
Ketchikan, AK 99901
Attention: Mark T. Johnson
This is in reference to your request dated September 26, 1992, for renewal of
your byproduct material license. Because there have been many changes in your
program since you submitted the application dated July 23, 1987, we are asking
you to describe your current program in its entirety. In order to complete
our review, we need the following additional information:
1. You should submit a commitment that the gauge will be locked in a secure
storage area such as at your 2869 S. Tongass Avenue address when not in
use. You should also state that the gauge will never be left unattended
in the field. This is necessary to assure that unauthorized persons do
not have access to the gauge. Refer to Item 9 of the enclosed guide.
2. You should describe how your 6-month leak tests will be performed. Refer
to Item 10.3 of the enclosed guide.
It should be noted that License Condition 14. also requires you to
conduct a physical inventory at 6-month intervals. Records must be
retained for 2 years.
3. You should submit a commitment that any maintenance you will perform
(such as cleaning) will be done with the radioactive source in the safe
shielded position. Refer to Item 10.4 of the enclosed guide.
4. You should describe your safety procedures for transporting your gauge.
Refer to Item 10.5 of the enclosed guide.
5. You should describe your operating and emergency procedures. Refer to
Item 10.6 of the enclosed guide.
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We will continue the review of your renewal request upon receipt of this
information. In order to continue prompt revf ew of your application, we
request that you submit your response to this letter within 30 calendar days
from the date of this letter. Please reply in duplicate, and refer to Mail
Control No. 571698.
Sincerely,
Beth A. Prange
Sr. Health Physicist (Licensing)
Radioactive Materials Safety Branch
Enclosures: Portable gauge licensing guide
0.0.T. Handbook
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- (FOR LIMS USE)
- -INFORMAT10N FROM LTS p3,
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BC,TWE E N:
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License fee Management Branch. ARM : Prograra Code: 03121 ,
and : Status Code: 2
- Fee Category: 3P 1722 (,. j
-Regional Licensing Sections
- -Esp. Date: 19920930
l ? L3 ll: 07
- Fee Connents:
- Decom Fin Assur Reqd: N
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llCENS[ ff E TRANSMITTAL
A. REGION
1. APPLICATION ATTACHED
Applicant [ Licensee: ADMIRALTY T[511NG SERV.
Received Date: 920930
Docket No: 3030178
Control No.: 571698
License No.: 50-23695-01
Action Type: Renewal
2. Fit ATTACHED
Amount:
l Check No.:
3. COMMENTS
Si ned
i Oake / /D -ppy U
B. LIC[NSE FE[ MANACIMENT BRANCH (Check when milestone 03 is entered /_g)
1. fee Category and Amount: 3[ hMo
2. Correct Fee Paid. Application may be processed for:
Amendment
Renewal 7
License
3. 01HER
Signed /
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/ \o,, UNITED STATES
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a NUCLEAR REGULATCRY COMMISSION
E < ,I REGION V
g higo MARIA LANE SUITE 210
WALNUT CREEK, CALIFORNIA Mtio6-5308
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OCT t 6 sq
Docket No.: 030-30178
License No.: 50-23695-01
Control No.: 571698
Admiralty Testing Services
P.O. Box 7193
Ketchikan, AK 99901
SUBJECT: LICENSE RENEWAL APPLICATION
This is to acknowledge receipt of your application for renewal of the
material (s) license identified above. Your application is deemed timely
filed, and accordingly, the license will not expire until final action has
been taken by this office.
Any correspondence regarding this renewal application should reference the
control number specified above and your license number.
Sincerely,
$ 0. ffiz 2.
Beth A. Frange
Sr. Health Physicist (Licensing)-
Nuclear Naterials and
Fuel Fabrication Branch
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RECEgED
(1241) U.S. NUCLE AR Rt GULATNb$bWSION 1. APPLICATION FOR;
(Check and/or complete as sopropnare/
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APPLICATION FOR BYPRODUCT 3AblAk L E SE
INDUSTRIAL a. NEW LICE NSE
See attached instructions for deraus
b AYTNDVENT TO
LICE NSE NUMBE R
Completed appl.c8tions are f.ie>J m dantocate nith the D:aisioh of fvH C$cie ank %teoa! Safety.
Offee of Notlear %terd $#erv. and Safeguards. U S Nuctear Rega!atory Commmion'
Wssh ngron. DC 20555 or anplaations rwy be fotni m person at the Comm; won's artice at
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1717 H Street, NW, mshmyton. D C or 1315 Eastern A venue. Silver Soring. %ryland. ggm
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2 APPLlCANT'S N AME //nsterarson. /,rm, pe son. etc / 50-2.% RS-01 V
kDPligA1.TY TEST s% SrJ2,QcES 3. N AME AND TITLE OF PERSON TO BE CONT ACTED
REGARDING THIS APPLICATION
MA9K L ZC M SQJL WW T W(t60Y
TE LEPHONE NUMBE R ARE A CODE - NUMBE R E XTE NSION
TELEPHONE NVMEkR: ARE A CODE - NUMBE R E XTE NSION
9 o 1 - %2. 5 - Ip_45 clot - 2.2.s - to'45
4. APPLIC AN T'S MAILING ADDR ESS //nclude 2,p Codf/
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(Address to which NRC corresponder,ce notices butietens, etc. 5. STREET ADDRESS
(include Zip Codel WHERE LICENSED MATERIAL k.lLL E USED -
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hould be sent >
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N T d ' N M ( M q of Kere-* KA4 AL AsvA
Fu g V % m T o p _L % 5r. w .le n cm s. ,
(tF MORE SPACE IS NEEDED FOR ANY ITEM USE ADDITIONAL PROPERLY KEYED PAGES.)
6. INDIVIDUAL (S) WHO WILL USE OR DIRECTLY SUPERVISE THE USE OF LICENSED MATERI AL
(See items 16 and 17 for required training end expenence of each Indivx. fusi named belowl
FULL N AME I TITLE
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7. RADIATION PROTECTION OFFICER
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Attach a resume of pc s4W1 t&mng a
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16 and 17 and desenbe h[s erwonsibnir.gs.w3 J zew_15_ _ . . _ . . . .
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8. LICENSED MATERIAL P. L NL WG ELNC----
L ELEMENT NAME OF MANUFs
CHEMICAL % QF--
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N MASS NUMBER PHYSICAL FORM MODEL NUM 3EW TOlfRC N f1 PM m " " ' ^ m '
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(IISea<ed Source / VITY PER SOURCE WHICH WILL
BE POSSESSED AT ANY ONE TIME
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Constructors Testing Laboratory ; -
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TRAINING COURSE FOR Tile SE OP NUCLEAR TESTING EQUIPMENT.
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k. 'f . SUBJECTS INCLUDED IN THIS COURSE WERE AS FOLLOWS:- .f
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Radiological Safety ll MCW
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Radioactivity measurement standardination
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.>- '1. Principles and practices of radiation S.
%i protection. and monitoring techniques and t .
p. H 2. Leak testing procedures. instruments. i p&
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i 3. INatisematice ~ and calculations basic to 6. ' Accident and incident procedures. i
7. ' Procedures for nuclear gauge storage
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the use and measurement of
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Qi. radioactivity. and transportat.io.n.
8.. General safety prceautiona.
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i 4 5 4. ' Biological effects of radiation. Q 4l**-
Gauge Operation' .:
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1. Instrunent theory Field application ! ? ~
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>~ Q : Operating procedures S. Gauge calibration L>W+
.Mai enance .
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DATE
William,F. Troxler
PRESIDENT -
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3. INSTRUCTOR
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k ADMIRALTV' TESTING SERVICES
Construction Materials Testing
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P.O. Box 7193 Ketchiksn, Alaska 99901
9-26-92
U.S. Nuclear Regulatory Commission
Regles 5
1450 Maria Lane
Yalaut Creek, Calif,94596
Atta: Gregory P. Tuhas
Subject: Response te letter dated 9-9-1992
This is la response to your letter concerning license 30-23693-01. The
first thing I would like to de is apologize for taking se long te get back
to you. I just returned from a project la a remote estime villiage en the
west coast of Alaska (Pistinum). I was scheduled to be en the project for
a short duration (approx. ene week) however it turned late a six week
stay. The remeteness_of this site made it impossible to respond untill
new. I hope that you understand that it is met that I place a low priority
em this actima it was just that it was impossible to correspond from this
site. I realize the severity of this and understand that this is a serious
subject. Below I would like to respond to the Items la your letter.
~
Da June gth 1988 Mr. Paul Zurakowski performed an inspection.
During that laspecties Paul was latermed that Therme Bay was a
temporary constructica site. The constructica site was a project om a
remote read constructica project appres.15 miles from the community
of Therme Bay. Due to remeteness of the project we agreed that my
records would be stored at Seethcoast Constructica effice la Ketchikan
which was our main headquarters for verk throughout Alaska. Since
the project was to be a 1 year plus project I gave him a address to
correspond to me with in Therme Bay. I them seat a letter to your offices
explalaing that I would he la Thorne Bay and lacluded an address te-
contact me through. I aise indicated la this letter that my records voeld-
he stored la Ketchikan at Southcoast constructions office. The project
la Thermo Bay turned late a 3 year plus project. Each year an additiemal
phase was aquired by Southcoast constructies and I was requested to
stay em. Da my original license I had my permanent certified storage
site at a former asseclates laboratory at BC02 ber 7387 Palmer Ak,99645.
I considered all the projects I have been en slace to be temporary
construction sites.
Soils Testing Concrete Testing Asphalt Testing Pile Tes ting _,
PrwfessionalServicer at Conwelitive Prices
l
_ _ _ _ ._ _ _ _ _ _ _ _ - .
.. E
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. __ _ . _ _ _ _ __ _ _ _ _ . _ . . _ _ _ _ . _ _ _ _
.
I hevo v:rked cc these roc:ta sites for the last 4 to 5 y:ars.- . ;
- * contimoesty. .Durlag the last couple of years I have worked la both
I Ketchikaa and Therme Bay with a shift of aest of the verk la Ketchikaa.
As discussed with J.L. Meatsomery during his laspectica of July Id.
1992 my permensat address has shifted te my P.O. Box la Ketchikaa.
-
I still have my P.O. ben la Therme bay but have met utilised it for quite
some time. I ales told Mr. Meatgemory that slace I was going to be
applying for a removal en my license at the end of September that I
would show my address to be my current P.O. ben la Ketchikaa where I
am currently recievlag correspondance. I have just seat la my remeval
form with the correct address.
I am currently back la Ketchikaa and have gone through my files.
Some hev part of my files are alssing which shev leak tests and
exposure records. I am still trying to locate these records. I
understand the importance of malatalalag these records and have
included copies of a leak test that I just seat la along with request for
sev film badges. I am the sole avaar of my business with me employees
and solo user of the guage. I use the guage sa a very ilmited basis
sometimes met uslag it for months at a time. However when it does
became necessary to utilize the guage I must have it available Le .
perform my job. It is impossible to anticipate when it will be required.
In response to the transportstloa of the guage between Therme Bay
and Ketchikaa I have located Hazardens shipping forms which I did fill
est whom transporting the guage. The guage was transported by myself
en a sea passenger vessel evned by myself. I have lacluded copies of
these forms hereia.
In summary I venid just like to state that I an a small buslaess that
would 11ke to continue to be permitted to utilize this guage. I can assure
you that I understand the importance of maintalag complete records and
maklag sure to keep 11aes of communication open with the NRC. In the
future I will make a more concentrated effort to make sure that I comply
with the requirments of the conditions of the license. If you have any
additional questions please feel free to contact me at 907-225-1045 or P.O.
Box 7193 Ketchikan Ak. 99901 Thank you for your paticace and
understanding.
Slacerely
Admiralty Testing Services
b
Mark T. Joh a
Owner
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,:-
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SHIPPER'S DECLARATION FOR DANGEROUS GOODS
55pper
l Air Waybill No
% Atl i. i U' s (qb i
Page of Pages
Shipper s Reference Number
fort *One')
Consignee
MkuL \ .h, q q o,13
Iwo completed and Srgned copies of this Declaration must WARNING
t>e handed to the operator
'
TRANSPORT DETAILS Failure to comply in all respects with the applicable
5 . Dangerous Goods Regulations may be in breach of
T hiS Shipment it within the Airport of Departure the applicable law, subject to legal penalties This
hmitations presentied for Declaration must not, in any circumstances, be
.
1!!!P* eien nan col <cotses completed and/or signed by a consolidator, a
forwarder or an IATA cargo agent.
h, A A RCRAFT fE i A
AIRCR AF T ONLY
,h +
ment hoe ee/m non as/<cew/
Airport of Destination
(NON R ADIO ACTIVE lR ADIO ACTIVE l
[
&
fy y N ATURE AND OUANTITY OF DANGEROUS GOODS (see sub-Section 81 of IATA Dangerous Goods Regulations)
W, * *
.. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......-............................................
,
- i' h Dangerous Goods identif tcation
e'h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UN
. . . . . .
Ouentity Paciong Authon2ation
1 ; Hazard '
pi Class ' or
Pcw Shwng Name & , 10
Subsid . No
N: .f. ..p............................................. . . . . . . . .
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_____-______.____._____L._______--------
Additional Handhog information
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rk T -M i L'A N kQ ytcRe f _4;/ 34
I hareby declare that the contents of this consignment are fully and Name/ Title of S!gnatory
accurately descnbed above by proper shipping name and are classified. g 7 g Jr n~f
packed, marked and labelled, and are in all respects in the proper Place and Date I
condition for transport by air acenrding to the applicable International and "" 4 ;
,
i National Government Regulations. NT A b ~
Signature g;"
(see wornmg above] .. /c s
- i- i t 3l'
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F-83 DET AILE D
,
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._ . . .
, ,
LcakTcst Analysis NOTES
.dion'uclide: h I 7/ Md 34 I
,
Removable Activity 1. Follow proc:dures as d;fintd in
%'67 your leak test kit instructions.
>urce Serial: Beta Gamma Alpha 2. Fill out this form and the bag
jt. Model: TC O G %' 5 label with required information
st* Sstial-' Wn -
-
-
-
PCI uCi where applicable. Seal the filter
its of Wipe: ,'l - v b -1 ' paper in the plastic bag. Place
dividu11's Name: MAL- h E the plastic bag and this form in
the pre-addressed envelope.
12 phone: %7 ~M "'0"5 3. Removable activity will be re.
Certification
ported in uCl. A value of "0"
EASE TYPE oR PRINT LEGIBLY - Date: Indicates less than .00005 pCl.
l$ IS voVR RETURN ADDRES$ LABEL 4. Federal and State regulations
require that sealed sources be
removed from service and re.
,
ports filed if removable activity
A D N i(7 A q
,,
I ._f, T . brj g$ is greater than .005 uCl.
5. Due to the potential hazard,
- , , _
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a i9 7 Troxter recommends that an
'
additional wipe be made if re-
K T,Q movable activity exceeds .0005
, A^w . .
-\ * 1 -t . , ) u Cl.
6. You will be notified by telephone
collect if the test yields greate-
.sw Ei ctrome Laoorstones.inc., P.O. Bos 12057, Reteerch Triangio Park. N C.27709 919t$4W41 Telex 579474 than .00t PCI removable activ".s
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