ML20132D537

Ack Receipt of Encl Rept of Proposed Activities in non-Agreement States.Agreement State License Valid for Uses Cited in 850716 Submittal

ML20132D537
Person / Time
Issue date:	07/26/1985
From:	Randy Hall NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION III)
To:	LONGVIEW INSPECTION, INC.
Shared Package
ML20132D514	List: ML20132D510 ML20132D537 ML20132D544 ML20132D560
References
NUDOCS 8509300199
Download: ML20132D537 (6)

Text

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• 2' JUL 2 61985 Longview Inspection, Inc.

P. O. Box 8204 (35 FRJ Drive)

Longview, TX. 75607 Gentlemen:

This acknowledges receipt of NRC Form-241 which you submitted to report proposed activities in nonagreement states under the authority of the general license pursuant to 10 CFR 150.20.

Your agreement state license is recognized as valid for the uses in your submittal dated July 16, 1985.

Your cooperation is appreciated.

Sincerely,

OrJginal Signed by:

R. E. H ALL" R. E. Hall, Chief Radiological and Safeguards Programs Branch

Enclosures:

1. Copy of 241

2. Copy of Materials License cc w/ enclosures:

Texas Radiation Control Program Director bec w/ enclosures:

, L. I. Cobb, NRC l- 241 File bec w/out enclosures:

l R. Bangart

,, JUL 2 91995 i

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I fM/85 8509300 99 850925 9990$03 p)"

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NRC FOHu 241 FORM APPROVED BY OMB (6011

• 3150-0013 '

10 CFR 150 ' EXPlRES: 10 31 83 U.S. NUCLEAR REGULATORY COMMISSION {

REPORT OF PROPOSED ACTIVITIES IN NON AGREEMENT STATES *

(Please read the instructions on the cover sheet before completing this forrnJ l

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1. N AME OF L1CENSEE (Person or form proposing to conduct the 2. ADDRESS OF L1CENSEE (Mailing address or otherlocation where actovottes descerbed belowl licensee may be locatedl *

, LONGVIEW INSPECTION, INC. P.O. BOX 8204 (35 FRJ Drive)

LONGVIEW, IEXAS 75607 {

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3. NAME OF PERSON AUTHORIZED BY LICENSEE TO PERFORM

1. C""

Steve'Pogue, Dale Carter, ;

Terry Burce, Brian Spark

4. DESCRIPTION OF ACTIVITIES TO BE CONDUCTED IN NON. AGREEMENT STATES UNDER THE GENER AL LICENSE GIVEN IN

.10 CFR 150.20 ,

INDUSTRIAL RADIOGRAPilY

5. LOCATIONS AT WHICH THESE ACTIVITIES WILL BE CONDUCTED AND DATES SCHEDULED.

' 5TREET ANO NUMBER OR OTHER t OCATION DATES SCHEDULEO NO.

(Goes as complete an address as possuhtel Ctiv ANO STATE y SHELL REFINERY WOODRIVER, ILLINOIS 04/29/85. 10/29/85. 180 g i

/

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6. LIST SE ALED SOURCES.OR DEVICES CONTAINING SEALED SOURCES.WHICH WILL BE POSSESSED USED. INSTALLED, SERVICED 0A TESTED 1N NON. AGREEMENT STATES. (Include deserontoon of rype and quantity af radiasctree materrat contoonedin each seated source ordeeoce.)AII 520 SN 776 Source SN 8764 22 Ci on 07/15/85.

AII 520 SN 553 Source SN 8970 44 Ci on 07/15/85,

7. NUMBER OF SPECIFIC LICENSE AND NAME OF STATE ISSUING SUCH SPECIFIC LICENSE WHICH AUTHORIZES THE UNDERSIGNED TO CONDUCT ACTIVITIESWHICH ARE THE SAME, EXCEPT FOR LOCATION OF USE, AS THOSE SPECIFIED iN ITEM 4 A80VE.(Four copres of the specofre loconse must accompany tnos report.) 3 TEXAS LICENSE #7-3720 CERTIFICATE

8. I, THE UNDERSIGNED, HEREBY CERTIFY THAT: ^" -

a. Allinformation in this report is true and complete-k' 07/16/85 LICENSEE'S N AME (TYPE OR PRIN TI S. t have read and understand the provisions of the general license 10 CFR 150.20. reprinted on the cover sheet of this form set; and I understand that I arn required to comply with these provisions as to I'ONCVIEW TNfsPECTinN_ TNc_

Cl typroduct, source, or spectat nuclear material which I possess CERTIFYlNG OFFICI AL and use m non Agreement States under the general tecense for SIGNATUR which this report is filed with the U.S. Nuclear Regulatory Com.

mission.

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c. I acnderstand that activities, inctuomg storege, conducted en non.

Agreements under general tecense 10 CFR 150.20 are limited to a tItal of 180 days m any calendar ye*'- '

VICE PRESIDENT CARNING: 18 U.S.C., Section 1001: Act of June 25,1948. 62 Stat. 749; makes it a criminal offense to make a willfully fosse staternent or repre.

sentation to any deoartment or agency of the United States as to any matter withert its jurisdiction.

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NRC 50RM 241 FORM APPROVED 8Y OM8 (6 4111 3150 0013 10 CF R 150 EXPlRES. 10-31 83 U.S. NUCLE AR REGULATORY COMMISSION REPORT OF PROPOSED ACTIVITIES IN NON-AGREEMENT STATES PLEASE READ THE INFORMA TION AND INSTRUCTIONS CONTAINED ON THIS COVER SHEET

. BEFORE COMPLETING THE A TTACHED FORM.

N .

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INSTRUCTIONS Submit this Form and the Agreement State specife leense m 18 the licensee, af ter filing this report, proposes to conduct scievisies cuadruplicate et least 3 days prior to engaging in each activity m non Agreement States not specified in this report,en amended NRC :

permitted under the General License estabhshed by Sec.150.20 of Form 241 should be filed wit % the Comm.ssion's inspection and to CF R 150. Send to: Enforcement Regional Oflice.

Direttot of the U$. Nuclear Regulatory Comminion inspection and Enforcement Regional Office listed in Appendia D of Part 20 of this No T E: activmss, incLuosme eronaos, comouerso em non asessusue chapter for the region in which the Agreement State that issued the ovatse unose tus sansman.uczass nas univso to a votat on specific license is located. ase cave m awv catanoan vsan.

Section 150.20 of 10 CFR 150 establishes a generet license authorising any person who holds a specific license from en " Agreement State" (a State with which the U.S. Nuclear Regulatory Commission has entered into an offactive agreement under subsection 274b of the Atomic Energy Act of 1954) where the licensee mamtams an office for direcemg the licensed activity and at which radiation safety records are normally maintamed, to conduct the some actwity in "Non-Agreement States" of the specific license issued by the Agree-ment State does not Irmet the authorsted actrvory to specdred onstallations or locatrons.

6 150.20 Recognition of , Agreement State licenses.

tal Sublect to the provisions of paragraph (b) of this section, any Agreement State that issued the specific license is located.The Director

• person who holds a specific license from an Agreement State where the of the Nucteer Regulatory Commision inspection and Enforcement licensee memtams en office for directing the licensed actwity and at Regional Of fice may authorise such person to commence the activity which radiation safety records are normally maintained, es hereby upon notification by telephone of intent to conduct the proposed granted a generallicense to conduct the same actwity in non Agreement activity under the general license: Proreded, however, That four copies States: Proceded That the specific license does not limit the activity of NRC Form 241 (revised) and four copies of the Agreement $ tate authorised by the license to specified instellations or locations. license shall be filed within 3 days af ter the telephone notification.

The Detector of the Nuclean Regulatory Comminion Inns,ection end -

Ibl Noivethstanding any provision to the contrary in any specific E nf orc ement Regional Of fice may waive the requirement for filing license issued by en Agreement State to s person who engages 6n ective. edditional NRC Form 241 (revised) during the remainder of the ties in a non-Agreement State under a general license provided in this calendar year followmg the receipt of the initial NRC Form 241 section, the generei license provided in this section as sublect to the (revised) from a person engaging in activities under the general license provisions of S S 30.14fdl,30.34,30.41, and 30.51 to 30 83 inclusive provided in this section; of Port 30 of this chapter; il 40.41,40.51,40.61 to 40 53 melusive, 40 71, and 40.81 of Part 40 of this chapter; and il 70.32, 70.42, (2) Shall not, m any non Agreement State. transfer or descose of 70.51 to 70.56 mcluswe, 70.81, 70.82, and 70.71 of Part 70 of this vadeoactevematerialpossessed or used unoen the generallicense provided ;

ahapter; and to the provisions of Ports 19,20,and 71 and Subpart 8 of 6n this section escept by seansfer to a person del specifically licensed by ,

Part 34 of this chapter. In addition any person who enseges in activities the Commission totoceive such material,or feel esempt from the eequire-en non-Agreement States under a general license provided in this section; ments for a license for such material under S 3014 of this chapter;  ;

itl Shell, et least 3 days prior to engseine 6n each such actrvity, #"'"""P"'""'"**'**"''*'"""**!

actwities authorised m paragraph lal of this sectior' f'or more than ISO file four capees of NRC Form 241 Irevised), " Report of Proposed days m any calendar year; Activities in Non Agreement States," and four cosues of his Agreement Stata specific license with the Director of the U.S. Nuclear Regulatory 14) Shallcomply with all terms and conditions of the specific license

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Commission inspection and Enforcement Regional Of fice listed m issued by an Agreement State encept such terms or conditions as are Appendia D of Part 20 of this chapter for the region in which the contrary to the requirements of this section.

l PRIVACY ACT STATEMENT l

Pursuant to 5 U.S.C. 552stell31, enacted 6nto law by section 3 of the Privacy Act of 19 74 (Public Law 93 579), the Iollowing state-ment is formshed to indevaduals who supply 6nformation to the Nuclear Regulatory Commission on NRC Form 241 This informatiori is memtemed m systems of records designated m NRC 3 and described at 40 Federal Register 45334 (Octobee 1.1975).

l 1 AUTHORITY - Sections St,161(b), and 274 of the Atomic Eneegy Act of 1954, es amended 142 U S.C. 2111,2201(b), and 20211.

2. PRINCIPAL PURPOSEt$l - The information on NRC Form 241 informs the Nuclear Regulatory Commission of the generallicen-see's mient to conduct actwitnes 6n non Agreement States pursuant to 10 CF R 150 20 and the locations and scheduled dates for such octivities. This 6ntormation 6s used 6n the schedulmg of comp 6 ance inspections where deemed necessarye

3. ROUTINE USE5 - The information may be used. tal to provide records to State health depariments for their mformat on and site, and ibl to provide information to Federal, $ tate, and local health oflecials, and other persons in the event of incident or esposure, for purposes of their information, mvestigation, end protecteon of public health and safety. The information may also be disclosed to en appropriate Federal, State, or local egency in the event the information indicates a violation or potentist violation of lave end in the course of en administrateve or audicial proceeding. In addition, this information may be transf erred to an appropriate Federet, State, and local agency to the entent relevant and necessary for en NRC decision or to an appropriate Federal agency to the entent eelevant and necessary for that agerw'y's decision ataout you.

4. WHETHER DISCLOSURE l$ M ANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORM ATION - Disclosure of the requested information is voluntary. If the requested intormation is not furnished. however, the mdwiduet is not authorised to conduct activities in non Agreement Stain pursuant to the generallicense m 10 CF R 150.20

5. SYSTEM M AN AGERIS) AND ADDR ESS. Director, Division of Fuel Cycle end Material Safety e , Oflite of Nuclear Material Safety and Safeguards U S. Nucteer Regulatory Commission Wethmeton, DC 20555 JL ___

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THC FC)M il 3 l 610 78)

Pcge 1 of 3 pagea l

• T. , .

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fY ' W TEXAS DEPARTMENT OF llEALTil

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RADIOACIIVE M ATERIAL LICENSE rur .iunt to the Texas Radiation Control Act and Texas Department of Ilealth regulations on radiation, and in reliance on statements and l representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess and transfer indio.tetive material listed below; and to use such radioactive material for the purposc(s) and at the place (s) designated below. Thla license is subiect to all applicahic rules, regulations and order *. of the Texas Department of IIcelth now or hereafter in effect and to any conditiona reaccified below.

LICENSEE This license issued pursuant to and in accordance with LMAPPLICATION OLE'rrER O

1. NIme Longview Inspection, Inc. Dated: September 6,1984 Attn: Norman Fergueoon signed ny. James J. Trota

2. Addr, s 35 FRJ Drive 3. License Number Amendment Number Longview, Texas 75602 v_mn na

'NtEVIOUS AMENDMENTS AHE VOID

1. Expiration Date ItADioAcrlVE MATERIAL AtmlOHlZED October 31. 1989

5. Hadioisotope 6, Form of Material 7. Maximum Activity

• 8. Authorized Use A. Ir-192 A. Goaled A. 15 ocurces A. Industrial radiography with

! courcoa (Otl not to excood Onmma Industries Model 20V ex-Model R0-13) 100 C1. each. posure d'aviceo.

B. Ir-192 B. Scaled B. 10 ocurceo B. Industrial radiograhy with nourcoa (GU not to exceed Automation Industries Model 520 Model RAG-17) 100 C1. each. exposure devices.

10. Ir-192 C. Scaled C. 5 aourcoo C. Industrial radicaraphy with Gulf courcoa (GN not to exceed Nuclear Model 10X Pipeliner ex-Model HPL-5) 100 01. each. posure deviceo.

lD. Co-60 D. Scaled D. 1 ocurce D. Industrial radiography with courcos (GI not to exceed Gamma Industries Model Gammatron Model A-4-A) 100 C1. 50 expoouro device.

Of CONTINUED ON RAGE 2, IF CIIECKED, CONDITioNfl

9. Radioactive material chall be otored only at 35 FRJ Drive, Longview, Texao.

10. The authorized place of une 10 at temporary job oites throughout Texao.

11. Tho licanooo chall comply with the provisiona of Parta 11, 12, 13, 21, 22, 31 and 41 of the Toxan Hogulationo for Control of Radiation.

12. The individual dooignated to perform the functions of Radiation Safety Officer for nctivition covered by thio liconoe 10 Norman Ferguonon.

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Nl'Nu rie$ m NIllicurlcs si Cl4herocuries CONDITIONS CONTINUED ON PAGE 2 ,

' TRC /ORid 413a '

. (10-78) *

' TEXAS DEPARTMENT OF IIEALTil l RADIOACrlVE MATERIAL LICENSE Supplementary Sheet LICENSE N UMBER AMENDMENT NUMBER 7-3720 NA

-CONTIliUED:

,5. Radio- 6. Form of 7. Maximum 8. Authorized Use isotope Material Activity

E. Co-137 E.-Sealed E. 1 source E. Survey Instrument calibration sources (GU not to ex- with Gulf Nuclear Model 10-50 Model VL-1) ceed 200 mC1. instrument calibrator.

C0!!DITIONS CONTINUED:

13. Radioactive material used for industrial radiography shall only be used by radiographero and radiographer's aeoistanto designated by Norman Fergueson and Dudley Shankleo in accordance with the licensee's training program. No individual chall be designated no a radiographer until a TRC Form 31-1,

" Radiographer Radiation uafety Training Certification", has been submitted to the Agency by the licensee to verify completion of the required radiation oafety training.

14. Scaled courceo containing radioactive material shall not be opened.

15 8saled cources of radioactive material, Nickel 63 foil, and/or plated alpha emitting cources chall be tested for leakage and/or contamination in accordance with the provisions of Texas Regulations for Control of Radiation 11 7

16. The licenace la authorized to receive, posseso and use sealed sources of Iridium-192 or Cobalt-60 where the radioactivity exceeds the maximum amount of radioactivity specified in Item 7 of this licenae provided:

A. auch_poosecolon dooo not exceed the quantity per source specified in Item 7 by more than 20% for Iridium-192 or 10% for Cobalt-60.

B. recordo of the licenoce ohow that no more than the maximum amount of radioactivity per cource specified in Item 7 of the license was ordered from the oupplier or tranoferor of the radioactive material.

C. the levela of radiation from radio 6raphic exposure devices and atorage containero do not exceed those specified in the Texas Regulations for Control of Radiation 31.101.

lC0!!DITIONSCONTINUEDONPAGE3 -

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TR0 FDP.M 41-3a ,

(10-78)

TEXAS DEPARTMENT OF IIEALTII l f. p RADIOACflVE MATERIAL LICENSE Supplementary Sheet LICENSE NUMBER AMENDMENT NUMBER 7-3720 NA CONDITIONS CONTINUED:

17. Pursuant to Texas Regulations for Control of Radiation, Part 41, the licensee is authorized to receive and possess up to 999 kilograms of depleted Uranium used as shielding material in the radiography exposure devices authorized by this license or in collimators used in radiographic operations.

18. Crank-out type exposure devices containing sealed sources of Cobalt-60 in excess of 50 curies shall be used only in conjunction with collimators and drive cables at least 35 feet in length.

19. The licensee is authorized to perform survey instrument calibration in accordance with written procedures dated September 6, 1984

20. Except as specifically provided otherwise by this license, the licensee shall possess and use the radioactive material authorized by this license in accordance with statements, representations, and procedures contained in the following:

application dated September 6, 1984, l

letter dated September 6, 1984 The Texas Regulations for Control of Radiation shall prevail over statements contained in the above documents unless such statements are more restrictive than the regulations.

l IEI FoR Tile TEXAS DEPARTMENT OF IIEALTil De October 22, 1984 X)mk b.  !

Administ hitor , IndustrialOphtionsBranch

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