ML20134H038

Ack Receipt of Repts of Proposed Activities in Non-Agreement States & Receipt of Initial Recognition Fee as Required by 10CFR150.20(b) & 10CFR170.31 on 970117

ML20134H038
Person / Time
Issue date:	01/27/1997
From:	Dan Collins NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION II)
To:	Wheeler P PENSACOLA TESTING LABORATORIES, INC.
Shared Package
ML20134H041	List: ML20134H038 ML20134H055 ML20134H088
References
NUDOCS 9702110130
Download: ML20134H038 (8)

Text

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9 January 27. 1997 Pensacola Testing Laboratories. Inc. .

ATTN: Patrick A. Wheeler. President '

Radiation Safety Officer '

217 East Brent Lane  !

Pensacola. Florida 32503 1

SUBJECT:

RECOGNITION OF RECIPROCITY - CALENDAR YEAR 1997

Dear Mr. Wheeler:

This acknowledges receipt of your Reports of Proposed Activities in Non-Agreement States (NRC Form 241) dated January 17, 1997, and recei)t of the initial recognition fee as required by 10 CFR 150.20(b) and 10 CFR 170.31 (Category 16 - Reciprocity).

License Number 1176-2 (radiography) issued by the. State of Florida is j recognized as valid for use in non-Agreement States for up to 180 days in calendar year 1997 only. License Number 1176-1 (portable gauges) issued by the State of Florida is recognized as valid for use in non-Agreement States for up to 180 days in calendar year 1997 only until receipt of a renewed license from the State of Florida. We accept the renewal acknowledgement letter to you f:om the State of Florida dated December 13. 1996. Please provide us with a renewed license when issued.

We have assigned a Location Reference Number-(LRN) to each site you have reported. New activities should be reported on the enclosed NRC Form 241 marked as a revision. Revisions should be faxed to NRC Region II three days in advance of the proposed activity, along with the fee for the revision.

There is no limit to the number of activities re)orted at one time, and one fee is charged without regard to the number on t1e revision page.

Clarifications change already-reported information or cancel jobs: they require no fee. Please indicate the already-assigned LRN for the site.

Licensed activities at Exclusive Federal Jurisdiction areas which are within the boundaries of Agreement States (including your state) are under the jurisdiction of the NRC and should be reported to us via the Form 241. We have enclosed a procedure for you to use in seeking determination of .the status of federal areas. We have enclosed information on contacting other Agreement States for your convenience. We have enclosed a listing of the Radiation Protection Officers at each of the locations you have reported.

This listing may not be current due to changes in staff at the facilities.

Some NRC regulations may differ from those of your Agreement State. You are responsible for the content and compliance with NRC regulations while I[

conducting work within NRC jurisdiction. Wehaveenclosedcopjesofthe pertinent regulations for your use. The regulations your license and procedures are required to be available so that staff who are pccupationally exposed to radiation can view them on the way to or from licensed activities.

9702110130 970127 PDR STPRC ESGGEN

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The Commission may, at its option, conduct an inspection of your activities. l Enclosed is a copy of NUREG 1600. " General Statement of Policy and Procedures i for NRC Enforcement Actions." We shall notify the appropriate NRC offices and i Non-Agreement States of your proposed activities.  !

i Our fax numbers are (404) 331-7437/5559. My telephone number is (404) l 331-5624. Please call should you have questions.

Sincerely, i

/s/ l David J. Collins. Health Physicist Materials Licensing / Inspection Branch 2 Division of Nuclear Materials Safety

Enclosures:

1. NRC Form 241 w/LRNs

2. Radiation Protection Officer listing

3. Blank Form 241 (carbon set & fax)

4. 10 CFR Parts 19, 20, 21, 30, 34. 71, 150. 170 l

5. Form NRC-3 /

6. NUREG 1600 General Statement of Policy and Procedures for NRC Enforcement Actions

7. Exclusive Federal Jurisdiction Identification Procedure

8. Agreement State Listing Distribution (w/o Enclosures 3-8):

Public Document Room grrier p! r rfes q e . p!! _nsg[

SIGNATURE k4h NAME /0JCollins , ster DATE 01 / 97 01/.2[d 01 / / 97 01 / / 97 01 / / 97 01 / / 97 corn Yts (NO) Yts NO vtS NO YES NO YES NO YES NO l OFFICIAL RECORD COPY DOCUMENT NAME: G:\DNMS\MLIB2\RECIPR97\PENSACOL.LTR and includes transmittal letters for state of Florida and bases on list l J

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, NRC F RM 241 U. 5. NUCLEAR REOULATORY COMMISSION tswe,ed Aren.vro av e. Arent s.

u,,d oWu' No. assoeots-nri,,es-se

e. mtos mor d*, inen.eno.on ,,s,uoiss en.n., ,

a c' a 'a request 10 menutes This npHfrenon is requered so thal NRC may schedule waspottion of i

i ihe en.,hes to enau,e th.t the, .,e enn.,nu ,,, .ren.d.,ee -,,, ,,,,u per.e,Is .n, I REPORT OF PROPOSED ACTlVITIES *"= a'

• eaae hes*" aad a 'e'v '

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to the informata and Recosde Managemoni banch (16 r31) U S tJuclear Requininey IN NON AGREEMENT STATES c--'" *""'"*a oc 2* * -"*"'*"

(31%O 0013). Onsre of Managernent and Budget. *"4Washington,

'" '"' "*~"*DC"d="rtC 20'iO3 N may not (Pfeese rend the Instructions ort the cover sheet before completusg this tomt 1 cond"rt o' *eo"'o'. *"4 a t'm'n" he net **wmed t" ***en"d '*

• r***r'*"" nt *dn'~"t*""

unless 11 desplays e evnenvy vahd OMB control number 1

He Os tiu nst E neon ry t.,m emen.mg fn cemeruef ine .-,,v,t., oe.r"'*' '**8

2. TYPE OF REPORT 3. COfd l ROL NUMBER if 3111AL (Lenn> Blanlu - Number fn be

}{ aufpnorf by NRC)

PENRACOIA TERTTNC 1.ARORATOR1ER_ TNC. RIV'S'OU

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• var.mi.me wensee m., e'e w.,e o CtARlrICA1 TON 217 EAST BRENT LANE 'i C'C"*C' PENSACOLAs FL 32503 JATRICK A. WHEELER fl lit t #18vf 4L NUMDf R J I ALLIMsLi tJUMDlH finekort* Area Cowiel (Enr hnte Aron Centel 904-477-5100 904-477-1310 8 ACTIVlilES TO BE CONDUCTED IN NON AGREEMENT STATES UNDER THE GENERAL UCENSE GIVEN IN 10 CFR 150 20

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WELL LOGGtt40 LEAK TESTlHO AtJDrOR CAltRRATIONS i 1Ft E THFRAPY/IRRADIATOR SERVICE

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OTHER (Spar /fyl PORT ABLE GAUGES l X

1R AP19F'Ortf AttOrl OA f'riqqrt AM AF'f nov At 13n a syv pso pr mit sur D Aq lrer n r)T f' Art ( AntlJns (r ( nist gr Alf St Of Cr)MellArsr'F Noq )

9 Ct irp4f NAMF, Af1DRF$$ Clivir'OI RJTY. St AIF. Fle cnOF in wonK loc Allor# AnpftFSS (4eef entf Number av ather inrahnn (;,ve nt enmroe0e an aMene av efereefmns ne pnen.Me l SEE ATTACHMENT SEE ATTACllMENT i

i tt I HWH+ R 13 wonw a rr Afiou ntre pariAn Aensenmir:n tn t rnr rweM Wnnu H 8t]1 4tg A IF i l e n e w& Ho*M u SEE ATTACHMENT SEE ATTACHMENT REE ATTACHMF*Ti td DATES SCHEDULED 16 LOCATION REFERENCE fAf ADER WOR DAYS fI N 10 it ave lit AHM CillallAL NHG f Ottu 241 pt 011 SIS HIfMRF R IO BF A991GNF()Bf Hnc SEE ATTACHMENT SEE ATTACHMENT SEE

\TTACHMEt T LIST ADDITIONAL UORK SITES ON SEPARATE SHEET TO INCLUDE ALL INFORMATION CONTAINED IN ITEMS 916 ABOVE.

61 LI5I RADevALHvE MAIE RIAL Artik H MLL BElv55E5M D, USE D. it454 ALL ED SERveLIO. OR 1E sif D 64 hou AMi l Mi Hi 56 AIL 5 (8arkwfe efesentfenn of rfo pe enaf guenfefir nf torfmacfme mehir.ef ses*rf snurree av devres in f* u*ed l C5-137 (UP TO 10 MCI) AM241: Be (UP TO 50 MCI) tw e4HL.LMLN1 bl AIL MtLN IC LLENSL WHICH AUlHVHilt S IHL UI400 RSIGril D 10 LUtiLAJL1 ACitvilpf S W6 te'_H AHi IHf SAMF. t 7(.E f *I e f wt I(iL A IK we r W USF es SrTCir tED si if f M 8 ABOVE (F our copees of the specshe brense must accompany the pubs' HRC f oem 7411 LeCf HSF NUMH( R STAIF f Rf tlR A lgr lN ()A lf 10f AL tiSAGI DAv4 IO DAlf I176-1 FLORIDA 12/3I/96

19. CERTIFICATION (MUST BE COMPLETED B Y APPLICANT)

I, THE UNDERSIONED, HEREBY CERTIFY THAL-a Alt information in this report is true end complete b i have read and understand the provision of the Deneral license 10 CF R 150 20 ecprinted on the cover sheet of this Imm set, and I understand that I am required to compty with these provisions as to sti byproduct. source, or spectat nuclear material which I possess and use in non Agreement Sintes or ottshnee waters under the generet i6 cense for which this ecport is filed with the U S Nuclear Regulatory Commininn )

e I understand that setivities, including storage, contfurted in non-Ageemments Sintes under ganeral firense 10 CFR 150 20 are limited to a intal nf ifl0 days in calendar year d I understand that I may be inspected by NRC at the above listed wnek slie locations and at itie Licensen horne office address for 'artivities perfnenw ef in nnn-Agipement States or offshore watms I am afsn aware that I will ba responsibin fnr any fees nunciated with such inspnctinns a $ understand that conduct of any activilles not described above, including conduct of activities on dates os inentinns diftetent from those riescribert abnyn nr w6thout NRC authoviintmn, may subject me to entntcoment action, including civit at esiminnt penalties u st tiI mG 08 f lCE R 84S0 e: Management Representa9ve (f >rerf hra'ed N8** ead I*) 'dGH A k'r4 DAlf PATRICK A. WHEELER, PRESIDENT /RSO / I/17/97 WA',NING FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CtVil AND/OR CRIMINAL PENALTIES NRC REGULATIONS REOutRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS 18 U S C. SECTION 1001 MAkES 1i A CRIMINAL OFFEN#E TO MAkE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGEflCY OF THE UNITED STATES AS TO ANY fAATTER WITHIN ITS JURISDICTION

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FOR C ** n JHL g b^

• USE LYj i n,,,a , co,,,n, g,o,,1,on Specialist y,} , '/

p,(,,jppy Hnc e oeM :at t* *al USNRC Region 11

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_ o, PEll8ACOLA TESTil1G LABOMATOnlEB, if 40, 217 East Brent Lane, Pensacola, FL 32503 Phone (904) 477-5100 - Fox (904) 477 1310 ATTACllMENT TO NRC FORM 241 This list is in reference to boxes 9, 10, 11, 12, 13, 14, and 15 on NRC Form 241. Dates, times, and Clients are not prearranged at this time. Pensacola Testing Laboratories, Inc. may perform portable gauge work at the following federal work sites:

1. Pensacola NAS J d. f Pensacola, FL

2. Whiting Field J f. 7 Milton, FL

3. Wrihrt. Field Mery Cstar. FL

4. Eglin AFB .3 7 o Ft. Walton Beach, FL

5. Coastal Systems Station 27/ Panama City, FL

6. Pascagoula Naval Station.374 Pascagoula, MS

7. Corry Field J7J Pensacola, FL

8. Saufley Field J7F Pensacola, FL

9. Tyndall AFB J7f Panama City, FL

10. US Coast Guard Station 474 Pensacola, FL

11. US Coast Guard Station 377 Mobile, AL

12. US Coast Guard Station .37f Panama City, FL .

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f ENCLOSURE 2 .

Radiation Protection Officers Pensacola Naval Air Station Safety and Occupational Health Manager ATTN: Mr. Ken Goodrich 904-452-3445 safety office 191 Radford Boulevard Fax 904-452-8145 ,

Pensacola. Florida 32508-5000 t Naval Air Station Whiting Field ATTN: Ms. Gloria Rodgers 904-623-7180 Safety Manager Fax 904-623-7141 Safety Office Building 1401 Milton. Florida 32570 Eglin Air Force Base ATTN: Captain Krista Wenzel 904-883-8607 ext 256 Radiation Safety Officer Fax 904-883-8668 Fort Walton Beach, Florida 32542 Bioenvironmental Engineering Office attached to hospital Coastal Systems Station ATTN: Terry Malanphy 904-235-5620 Radiation Safety Officer Fax 904-235-5111 Panama City. Florida 32407-7001 Naval Station Pascagoula ATTN: Alton Montgomery 601-761-2023 Safety Officer Fax 601-761-2040 Singing River Island Pascagoula. Mississippi 39567-5000 Naval Air Station Corry Field ATTN: Mr. Russell Dempsey 904-452-6825/6824 Safety Manager (Code OSH) Fax 452-6688 640 Roberts Avenue Pensacola. Florida 32511-5138 Commanding Officer NETTMSA ATTN: N42 (Mr. Tom Dillon) 904-452-1778 6490 Saufley Field Road Fax 452-1645 Pensacola. Florida 32509-5237 f

O O 5

Bioenvironmental Engineering l ATTN: Captain K. Patel 904-283-7139 ? I 325 AMDS/SGPB Fax 904-283-7596  ;

340 Magnolia Circle. Stop 46

. Tyndall Air Force Base. Florida 32403-5612 l 1

. US Coast Guard Station 904-453-8282 station phone  ;

i c/o Pensacola Naval Air Station  !

Safety and Occupational Health Manager j ATTN

Mr. Ken Goodrich l 191 Radford Boulevard Pensacola. Florida 32508-5000 l I US Coast Guard j ATTN: LCDR Brian Goettler. Chief 334-639-6170 Facility Engineering Division Fax 334-639-6169 ,

Aviation Training Center (FACENG)

Mobile. Alabama 36608-9682 .

Officer in Charge USCG

Panama City Station ATTN: Petty Officer Larry Perkins 904-234-4228  ;

Station Engineer Fax 234-4228 l l 1700 Thomas Drive  :

Panama City. Florida 32407-5898 i

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I NRC FORM 241 U. S. Nt R REGULATORY COMMISSION "'nove o er o_ o siso4013 EAPaREs ht30199 l gg Estimated tiv a.= p r ve. pense to com:4, with ih s enendxic,, esorm-tim coeiert on

'e c". ose -i te n i ea m,,= on re, u,,w.. .tnnC.,.,.o ,-t. .,

th. .+t...to . .th.t ,... , .c.p ,,, .c, d.n<e h .,ol.e .., to, REPORT OF PROPOSED ACTIVITIES a'a

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iso,ma" .' ruae he='ta

• d * ' 'r.n.'. e,,'d ca Ram.a"t* o

• • oa'd a

• ama'*

to .o nen.dsu.n..e ,,o, r3s o s e,w' '.d

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IN NON AGREEMENT STATES c"""""

(3550 0013), CWrer *"."e"t I'*a oc 2** * "* * ** ~~" "'d""-

M.n.gement .ad fluriget. W hington. DC 20501 '*'*"

NRC m.y ant (r' lease read the irsstructforts ort the cover sheet t>efore completrng this form ) 6 not 'ni "*** to " c"*" ** *"*"'ma*"

• • ".M uni is it *' v e eu.*".4

'".o".'o' d spi a vend

.ntiv s*mo"o'Me coni,'as numtie,'e"d **

• i ecMt u towest e as won a, s- e,,mme e enna.re n * .n +e, new,,.e e.'W 3. CONIROL NUMBER

2. TYPE OF REPORT tLeave Blank ~ Number to t,e tt81tlAL aulgnett t>y NRCl PENSACOLA TESTING LABORATORIES. INC. _

"M'OH e uonE ss u m ost r ,M. -, .+v.... m nn m.hm, ewe r.,, ~, e w . ,n CLAnir CAirON

% t r:f N9f l Crwit ACI 217 EAST BRENT LANE PENSACOLA FL 32503 9 PATRICK A. WHEELER a iiti enuut Huunt H 7 f AwMitt ,

(herhet. Are. f,&l finrh& A,r.tavuut (4weef it 904-477-5100 904-477-1310 B ACTMTIES TO BE CONDUCTED IN NON-AGREEMENT STATES UNDER THE GENERAL LICENSE GIVEN IN 10 CFR 150 20 WELL LOGGif JG LEAK TESTitlG AtJD'OR CAtIDRAflot34 1Ft F THFRAF'Y/IRRADIA10R SFRVICE OTHER # 5pmr #yJ PORT ABLE GAUGES in At: spont Atrin oA t'nnqn AM Ar t'nnvAt tr) a nry no nr nicer ne t) Ag irern or rArx Anieans tv r new r Air g nr roMeliAurr NOt t X NO. 0821. REV. NO. 0 6717. 9032. 9033 9 CtirrJf NAMF. ADOnFSS CrtysCotp4Tv. $1 ATF. 71t'COOF Gwe .e f n WORK t or Af rytJ AfM)Rf'SS,,m(.%e.f

,~,,e,..+,*,,,,..r ...,- msorf Alumber a, nihe, b .hnn SEE ATTACHMENT SEE ATTACHMENT i s wLui L eL,e.t P,euus uuusi n ,2 wonx iocatriu if apaciAu Aouramir o i')t's nr twtM worri, ti (h.eamte A Crwfef Woun 1 Are pnrhs.fr oL.aseuee 0,wfe) u ie Poe,en esouio u SEE ATTACHMENT SEE ATTACHMENT SEE ATTACHMENT ,

14 DATES SCHEDULED "E "

WORK DAv$

18 LOCATION RFFERENCE NUMDER l f in WA 10 t f Avt 91 AHM i QH lulilAt NHG f ORM 24i Hr Qi af SIS HilMRr n to[W A9900tJrt)FiV uitC SEE ATTACHMENT SEE nTTACHMENT Ll5T ADDITIONAL WORK SITES ON SEPARATE SifEET TOINCLUDE ALL INFORMATION CONTAINED INITEMS 9-16 ADOVE.

U 4151 fiAvevA SE D 0R 1E SIEu au sou Aout I Mt ul SI Alf 5 re,* oem.cIs.E MAIE et,on H4AL, cr ewe .e i,u..WHeve ev or ,. Wit.t.n.n.F.v.55L.5.

BE. .. 5,FO.e,.U,en

- , *- en.,ilm.l e e AL,L,ED. LER vsL.I D,.,.y IRIDIUM 192 16 eGRE EMENf bl AIL $PLCN IC L.lLENSL WHICH AVvHOHilES f Ht Uuut HSaGut D IO CorOJLt ACliviuF S WHICH ARE IHf SAMF. E ECI Pl f uR i fLA IK wa OF USE. A5 SPECW IE D tH ITEM 6 ABOVE (F ou, copies of th. spersfic license must .ccomp.ay the imh.I IJRC r um 241 )

iIC E tJ50 HUMkf it STATE f Wi'#R A K)N DAlf 01 AL USAni DAv$ 10 DAll' II76-2 FIORIDA APRIL 30 1999

19. CERTIFICATION (MUST BE COMPLETED BY APPLICANT)

1. THZ UtJDERStGNED, HEREBY CERTIFY THAT-e All information in this seport is true and complete b I have send and understand the provision of the ceneral license 10 CFR 150 20 repsinled on the enves sheet of this tosm sei. and t understand that I men required to comply w6tti Umse provisions as to att byproduct, snurre, or special nuciene melmial which ! pottats and use in nnn A veement 0 States ne offnbrwe waters under the generat liennse for which this report is filed w6th it e U S Nucient Reputatary Commistinn c t understand that activities, including storega, ennducted in nr.n Ag eements States under General tiennsa 10 CTR 150 70 men limitmlin n infai nf 1t10 days in ralendar year d I understand that i may be inspected by NRC at ttie above listed work slin locations and at the Licensen home offke address fnt 'prtivities portovened in non Agreement States or offshore watees I am almo ownie that I wilt t>e respnnaible tne any face nasociated with such in* pact 6nns e i understand that conduct of any activities not desesibed above, including conduct of activities on dates ne lewations different fenen thnsa descelbe,t nhnva or without NRC authorization, may subject me to entoncement action, includmg civil or celminal pensities u o i . ,,us on a n .. n so ., M. . me,, no ..e,.. e , ,,, . ... , ~.m . n,w woA inue - om PATRICK A. WHEELER, PRESIDENT /RSO / b 1/17/97 WARNtNG. FALSE STATEMENTS IN THIS CERTIrtCATE MAY BE SUBJECT TO CML APID/OR CRIMINAL PENALTIES NRC REGUt ATIONS REQUtRE THAT SUDM!SStONS TO THE NRC BE COMPLETE AtJD ACCURATE DJ ALL MATERIAL RESPECTS 18 U S C. SECTION 1001 MAKES IT A CRIMit4AL OFFEtJ9E 10 MAKE A WILLFULtY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY Or THE UNITED STATES AS TO ANY MATTER wtTHiff fT3 JURtSDICTION () n /

Avu w l m On m ,,,c.c. .en~..e.e ,,,w wua *< j oa FOR NRC David J Conins * ~

USE ONLY ;

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, Radiaton Speciahst b' -

unc aonM Pei te ant USNRC Region 11

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/ pet 4SACOLA TE STit4 G LABOnATOFilES, It10. v'v 217 East Brent Lane. Pensacoln, FL 32503 Phono (904) 477 5100 A'I"rAClit1Et!T To tJRC FORM 241

• 1 1

i This list is in reference to boxes 9, i

10, 11, 12, 13, 14, and 15 on flRC Form 241. Dates, Times, and Clients are not prearranged at this time. Pensacola Testing Laboratories, Inc.

radiographic work at the following federal work sites: may perform

! 1. Pensacola 11AS 000.377 Pensacola, FL l

2. Whiting Field ***JFO Pensacola, FL

3. Hen 4btwt F i ^4<l 14ar-ye bheM4,

, 4. Eglin AFB o poJ#/ Fort Walton Beach, FL

5. Coastal Systems Stationm381. Panama City, FL

6. Pascagoula 11aval Statiorw 6383Pascagoula, MS

7. Corry Field 0063 ff Pensacola, FL

8. Saufley Field *

• o J P5" Pensacola, FL l 9. Tyndall AFB 8**Jf6 Panama City ,FL

10. US Coast Guard StationddoJt? Pensacola, FL

.j 11. US Coast Guard Stationa*osta Mobile, AL j

12. US Coast Guard Stationo**3t? Panama, City, FL i

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