ML20195F354
| ML20195F354 | |
| Person / Time | |
|---|---|
| Site: | 03034945 |
| Issue date: | 05/28/1999 |
| From: | Hernandez M NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV) |
| To: | |
| References | |
| 467128, 50-27622-01, 50-27622-1, NUDOCS 9906140309 | |
| Download: ML20195F354 (20) | |
See also: IR 05000276/2022001
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U.s. NuCLEA*1 REGULATORY C MISSION
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MATERIALS LICENSE
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Purzuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code
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of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,36,39,40, and 70, and in reliance on statements and representations
heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct,
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source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s) designated below; to
deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license
thill be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all
cpplicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified
below.
L;censee
1. Buzdor Engineering
3. Lcense number 50-27622-01
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2. 3705 Arctic Boulevard, #1593
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4. Expiration date April 30,2009
Anchorage, Alaska 99503
5. Docket No. 030-34945
Reference No.
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6. Byproduct, source, and/or special,'
7. Chemical and/or physical form
8.. Maximum amount that licensee may
nuclear material
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possess at any one time under this
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license
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A..[No single source to exceed
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A, Cesium-137
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SehledEuTces reg stered
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Especified in the certificate of
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h T t Agrhement. State and"
,nregistration issued by NRC
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%cgorated ir) ac '. compatible gau.ging de]vice
for an Agreement State
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B. Sealedwurces registerede '
B No single source to exceed
either with NRC under
the maximum activity
3 10 CFR 32.210.or @ith an
specified in the certificate of
Agreeme'nt State and
registration issued by NRC
incorporated in a
or an Agreement State
compatible gauging device
as specified in item 9 of
this license
9,
Authorized use
A. and B. To be used, for measuring physical properties of materials, in compatible portable Boart
Longyear Company (formerly Campbell Pacific Nuclear Company) and/or Troxler Electronic
Laboratories, Inc., gauging devices that have been registered either with NRC under 10 CFR
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32.210 or with an Agreement State and have been distributed in accordance with an NRC or
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Agreement State specif;c license authorizing distribution to persons specifically authorized b
an NRC or Agreement State license to receive, possess, and use the devices.
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9906140309 990528
ADOCK 03034945
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OfflCIAL RECORD C0n
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NRC, FORM 3{4A -
u.S. NUCLEAR RE2uLAToRY Commission
PAGE 2
cd 4
PAGEs
Ucense Number
50-27622-01
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MATERIALS LICENSE
oxket or Reference Number
SUPPLEMENTARY SHEET
030-34945
CONDITIONS
10. Radioactive material shall be used only at the following:
A.
700 West 58th Avenue, Suite B., Anchorage, Alaska.
B.
Temporary job sites anywhere in the United S_tates where the U.S. Nuclear Regulatory Commission
maintains jurisdiction for regulating licensed material,-including areas of exclusive Federal
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jurisdiction within Agreement States.
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if the jurisdiction status of a Federal facility within an Agreement Sta 1s unknown, the licensee should
contact the federal agency controlling the job site in question to deter}i$ne whether the proposed job site
is an area of exclusive Federaljurisdiction. Authorization for use,pLradioactive materials atjob sites in
Agreement States not under excl,usive Federaljurisdiction shalfbp obtained from the appropriate state
regulatory agency.
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Licensed material _s' hall only be used'by, or'u' der the'supdrvision and'in'the physical presence of,
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individuals who have received (e tr' i'niggIdeiinibed'iii application dated February 1,1999.
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The Radiation Safety Offi .
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Before assuming thhduties
esponsibilijies_asHSO
this licens'e, future RSOs shall have
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successfully completb'd one oT ' 4raI3In~gfcoldseWescribed in Orite'ria in Section 8.8 of
NUREG-1556, Volume 1, dated Mafi997,3(ile ' '1 +0'
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Sealed sources shall be tested for leakage and/or contamination at intervals not to exceed the
intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an
Agreement State.
B.
In the absence of a certificate from a transferor indicating that a leak test has been made within the
intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an
Agreement State prior to the transfer, a sealed source or detector cell received from another person
shall not be put into use until tested.
C.
Sealed sources need not be leak tested if they are in storage and are not being used. However,
when they are removed from storage for use or transferred to another person, and have not been
tested within the required leak test interval, they shall be tested before use or transfer. No sealed
source shall be stored for a period of more than 10 years without being tested for leakage and/or
contamination.
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u.S. NUCLEAR REluLAToRY CoMMISSloN
PAcC 3
of 4
PAGEs
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Ucense Nurmer
50-27622-01
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MATERIALS LICENSE
Dock or Reference Number
SUPPL.EMENTARY SHEET
030-34945
D.
The leak test shall be capable of detecting the presence of 0.005 microcurie of radioactive material
on the test sample. If the test reveals the presence of 0.005 microcurie or more of removable
contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance
with 10 CFR 30.50(b)(2), and the source shall be removed immediately from service and
decontaminated, repaired, or disposed of in accordance with Commission regulations. The report
shall be filed within 5 days of the date the leak test result is known with the U.S. Nuclear Regulatory
Commission, Region IV,611 Ryan Plaza;Drivg guite 400, Arlington, Texas 76011, ATTN: Director,
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Division of Nuclear Materials Safety. The report shalbspecify the source involved, the test results,
and corrective action taken.'. b "
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E.
Tests for leakage and/or cbntamination shall be performed by hersons specifically licensed by the
Commission or an Agreement State to perform such services. In'sddition, the licensee'is authorized
to collect leak test sarnples_but not perform the analysis; analysis ofTeak test samples must be
performed by persons speciQcally licensed by the Com
'iiion or an'A'greement State to perform
such services.
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ate (n lihall not be opened or sources remove
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14. Sealed sources or source rods cont'aini
. license
detached from source rods or gaugej.by@e EM"
t_a's specificalf[ authorized.
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, jnwegtoryevery,
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15. The licensee shall conduct a p
account for all sources a~nd/or
received and p
essed%mder the license.
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ed cordainer design {ed to prevent unauth
16. Each portable gauge shall have a
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accidental removal of the s'eaied source fromM,$edYsition..The gauge or its container must be
locked when in transport, storage, or when notMer the direct surveillance of an authorized user.
authorization from NRC before making any charig$FRka
17. Except for maintaining labeling as re i ed by 10
0 or 71, the licensee shall obtain
es in the sealed source, device, or source-device
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combination that would alter the description or specifications as indicated in the respective Certificates of
Registration issued either by the Commission pursuant to 10 CFR 32.210 or by an Agreement State.
18. Any cleaning, maintenance, or repair of the gauges that requires detaching the source or source rod
from the gauge shall be performed only by the manufacturer or other persons specifically licensed by the
Commission or an Agreement State to perform such services.
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19. The licensee is authorized to transport licensed material only in accordance with the provisions of 10 CFR Part 71, " Packaging and Transportation of Radioactive Material.
20. A.
If the licensee uses unshielded sealed sources extended more than 3 feet below the surface, the
licensee shall use surface casing that extends from the lowest depth to 12 inches above the surface
' and other appropriate procedures to reduce the probability of the source or probe becoming lodged
below the surface. If it is not feasible to extend the casing 12 inches above the surface, the
licensee shallimplement procedures to ensure that the cased hole is free of obstruction before
making measurements.
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NR,C FORM 374A
u.S. NUCLEAR REIutAToRY CoMMISSloN'
PAGE
4
of 4
PAGEs
License Number
50-27622-01
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L
MATERIALS LICENSE
D ekd a RWmce Nt'nter
SUPPLEMENTARY SHEET
030-34945
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B.
If a sealed source or a probe containing sealed sources becomes lodged below the surface and it
becomes apparent that efforts to recover the sealed source or probe may not be successful, the
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licensee shall notify the U. S. Nuclear Regulatory Commission and submit the report required by 10
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CFR 30.50(b)(2) and (c). The licensee shall not abandon the sealed source or probe without
obtaining the Commission's prior written consent.
21. In addition to the possession limits in item 8, the licen_see shall further restrict the possession of licensed
material to quantities below the minimu'm limit specified in 1,0 CFR 30.35(d) for establishing
decommissioning financial assurance. '
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22. Except as specifically provided]~otherwise in this license, the licensee shall con
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accordance with the stateme'nts, representations, and procedures corithined in the documents, including
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any enclosures, listed be[ low. ,The Nuclear Regulatory Commissipn's regillations shall govern unless the
statements, representations, an(p~ ocedures in the licenseejs1pplication and correspondence are more
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restrictWe than the regulations. { %
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Application datedfebruary 1, b99 h
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FOR THE U.S. NUCLEAR REGULATORY COMMISSION
MAY 2 81999
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By
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Christi Hernandez
6
Nuclear Materials Licensing Branch
Region IV
Arlington, Texas 76011
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UNITED STATES
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NUCLEAR REGULATORY COMMISSION
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REGloN IV
611 RYAN PLAZA DRIVE, sulTE 400
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ARLINGTON, TEXAS 76011-8064
May 28,1999
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Buzdor Engineering
ATTN: John A. Buzdor, P.E.
Radiation Safety Officer
3705 Arctic Blvd. #1593
Anchorage, Alaska 99503
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SUBJECT: NEW LICENSE
Please find enclosed License No. 50-27622-01. You should review this license carefully and be
sure that you understand all conditions.
NRC expects licensees to conduct their programs with meticulous attention to detail and a high
standard of compliance. Because of the serious consequences to employees and the public
which can result from failure to comply with NRC requirements, you must conduct your program
involving radioactive materials in accordance with the conditions of your NRC license,
representations made in your license application, and NRC regulations. In particular, note that
you must:
1.
Operate in accordance with NRC regulations 10 CFR Part 19, " Notices, instructions and
Reports to Workers: Inspection and Investigations," 10 CFR Part 20, " Standards for
Protection Against Radiation," and other applicable regulations.
2.
Possesc *adioactive material only in the quantity and form indicated in your license.
3.
Use radioactive material only for the purpose (s) indicated in your license.
4.
Notify NRC in writing of any change in mailing address (no fee required if the location of
radioactive material remains the same).
5.
Request and obtain written NRC consent before transferring your license or any right
thereunder, either voluntarily or involuntarily, directly or indirectly, through transfer of
control of your license to any person or entity. A transfer of control of your license
includes not only a total change of ownership, but also a change in the controlling
interest in your company whether it is a corporation, partnership, or other entity. In
addition, appropriate license amendments must be requested and obtained for any other
planned changes in your facility or program that are contrary to your license or contrary
to representations made in your license application, as well as supplemental
correspondence thereto, which are incorporated into your license. A license fee may be
charged for the amendments if you are not in a fee-exempt category.
6,
Maintain in a single document decommissioning records that have been certified for
completeness and accuracy listing all the following items applicable to the license:
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Onsite areas designated or formerly designated as restricted areas as defined in
10 CFR 20.3(a)(14) or 20.1003.
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Buzdor Engineering
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Onsite areas, other than restricted areas, where radioactive materials in
quantities greater than amounts listed in Appendix C to 10 CFR 20.100120.2401
have been used, possessed, or stored.
Onsite areas, other than restricted areas, where spills or other unusual
occurrences involving the spread of contamination in and around the facility,
equipment, or site have occurred that required reporting pursuant to 10 CFR 30.50(b)(1) or (b)(4), including areas where subsequent cleanup procedures
have removed the contamination.
Specific locations and radionuclide contents of previous and current burial areas
within the site, excluding radioactive material with half-lives of 10 days or less,
depleted uranium used only for shielding or as penetrators in unused munitions,
or sealed sources authorized for use at temporary job sites.
Location and description of all contaminated equipment involved in licensed
operations that is to remain onsite after license termination.
7.
Submit a complete renewal application, or termination request at least 30 days before
the expiration date on your license. You will receive a reminder notice approximately
90 days before the expiration date. Possession of radioactive material after your license
expires is a violation of NRC regulations.
8.
Request termination of your license if you plan to permanently discontinue activities
involving radioactive material.
You will be periodically inspected by NRC. Failure to conduct your program in accordance with
NRC regulations, license conditions, and representations made in your license application and
supplemental correspondence with NRC will result in enforcement action against you. This
could include issuance of a Notice of Violation; imposition of a Civil Penalty; or an Order
suspending, modifying, or revoking your license as specified in the " General Statement of
Policy and Procedure for NRC Enforcement Actions" (Enforcement Policy), NUREG 1600,
Rev.1.
You are hereby also on notice that the NRC Office of Investigations Region IV Field Office is
continuing its investigation of activities conducted by Buzdor Engineering. Based on the results
of that investigation, the NRC may decide that enforcement action, including any of the actions
identified above, is warranted.
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Buzdor Engineering
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Should you have any questions concerning this letter, you may contact me at (817) 860-8106.
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Ouestions specific to your license should be directed to Ms. Christi Hernandez at
(817) 860-8217.
Sincerely,
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C gDwight D. Chamberlain, Director
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j Division of Nuclear Materials Safety
Docket: 030-34945
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License: 50-27622-01
Control: 467128
Enclosures: As stated
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Buzdor Engineering
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DOCUMENT NAME: S:\\DNMS\\50-27622.mic
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To receive copy of document, Indicate in box: "C" = Copy without enclosures *E" = Copy with enclosures "N" = No copy
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DOCUMENT NAME: P:\\50-27622.MLC
To receive copy of document, Indicate in box: 'C" = Copy without enclosures "E" = Copy with enclosures "N" = No copy
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U. S. NUCLEAR REGULATORY COSIINS$lON
APPROv50 sY OMS: to. 3m4u
EAPtRESwm
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Esemated tNrden per response to Comply with hp e)formatert Collecison
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to CFR 30. 32. 33
request T hours Sutirrwmel of the sopiceton as easeeery to essermme thel
34 35 30. 39 and 40
the appicart e qweised and tnei ===*e procedres eoet to protect the
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putAc hoseh one se9ety Forward commente regenen0 tiureen eetmeio to tie
tiformehon end Recorde Mmegemord Grancti (T4 F33). U S Nutdoor
APPLICATION FOR MATERIAL LICENSE
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Recuction Prolert 4315H120),'"'Oece of hamrmesmer and Euages,
Weehneion, DC 20503 NRC may twl Conduct or nimmor, and a person e
not reaped to respond to, en awarmeson comechen wresse R esploys e
curently vand Ones controlnumber
fNSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPUCATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING
APPLICATION SENDTWOCOP:ES OF ThE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.
APPLICATION POR DISTUBSUTION OF EAeMPT PRODUCTS FILE APPUCATIONS MTH:
er YOU ARE LOCATSD W:
DM4CN OF INDUSTRIAL AND MEDICAL NUCLEAR 5AFE TV
ILUNOIS. NeDIANA, IOWA, MICH4AN, Mle6NE90TA, MISSOURA, OteO, OR wtSCONSIN,
OFFICE OF NUCLEAR MATERMLS SAFETY AND SAFEQUARDS
SEND APPUCATIONS TO:
0 $ NUCLEAR REOULATCRY COMMIS$0N
WASHWGTON, DC 20S$64001
MATERIALS UCENSING SECTCN
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ALL OTHER P81480808 FILE APPUCAT10888 AS FOLLOW 9:
801 WARRENVILLE RD
17 YOU ARE LOCATSO IN;
USLE, IL 80632-4361
CONNECTICUT, OSLAWARE. 05TUUCT OF COLutBSIA, tLANet MARYLAND,
ALASKA. AINZONA, ARKANSAS, CAUFORNLA, COLORADO, HAWAll, IDAHO, KANSAS,
taASGACNUSETTS, NSW NA40PSNeRE, NEW JSRSEY, DeEW YORE (, Pesete0YLVANIA,
LOUISaANA abONTANA, NEERASRA, NEVADA, NEW t#EXCO, NO88TH DAKOTA,
RNOCE WLAND, OR VSRe00NT, GEND APPUCATIONS 70.
OKLANOslA ORSOON, PAcrec TitWST TERRITOfutt, SOUTH DAKOTA, TEXAS, UTAH,
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WASHINGTON, Oft WYOeseNG, SSND APPUCATIOD80 TO:
LICENSMO AS$1STANT SECTON
NUCLEAR MATERIALS SAFETY ORANCH
NUCLENt MATERALS UCENSWO SECTON
U S NUCLEAR NEQUtATORY COMM4880N. REOsON t
U S NUCLEAR REGULATORY COMMIS$ON REGON IV
4TS ALLENCALE ROAD
011 RYAN PLAZA DRIVE. SUITE 400
IUNG OF PRUS$1A, PA 194001415
ARLpeOTON TX 78011 4084
ALABAtlA, PLORICA, OSORG6A, RENTUCKY, GNSS1004 ppt. NORTH CAROUNA, PUERTO
RICO, SOUTH P ABN shda TSeINSSSEE, VIRCMIA, VIRGIN ISLANDS, OR WEST VNtelestA,
GEND APPUCATIONS TO:
ATLANTA FEDERAL CENTER
U S NUCLEAR REGULATORY COMMISSON REGOle is
4
St FORSYTH STREET & W, SurTE 23786
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ATLANTA, OEOROM 3030H418
PSRSONS LOCATSO IN AORSSaIENT STATSS SEseD APPuCATIONS TO THE U.S. NUCLEAR RBOULATORY CORBtNSO40N ONLY IF THEY WISH TO POSSESS AND USE UCENSED
IRATERIAL IN STA700 SUSJSCT TO U.S teUCLEAR RSOULATORY COtstMSSON JURISCeCTIONS,
1.
THet :S AN APPLCATION FOR (Check empeggmese tem)
2 NAME AND MAILWO ADO 8tESS OF APPUCANT (Mciune bp cace)
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$ % 85 h([ W,MQ,,, M ,\\/b. 4 55 %
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AMENDMENT TO LICENSE NUheSER
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RENEWAL OF UCENSE NUMBER
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3 ADDRES$(ES)WHtRE LCENSED MATER AL WILL DE USED OR POSSESSED
d NAME OF PERSON TO SE CONT ACTED ABOUT THIS
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SUSMIT 61 EMS S THftOUON 11 ON S.1/2 X it" PAPER TNE TYPE AND SCOPE OF INFORMATION TO SE PNOVIDED IS DESCRISED W THE LICENSE APPLCATIOss OUIDE
8 RADeOACTNE MATERIAL.
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PURPOSE (S) FOR WH4CH LTENSED hMTERAL WILL DE USED
a Elem.eril.ed mese nweer, tp emmrel enslior preysses norm. and c mewumum amotril
en s N. Posseemed M e,, one ilme
7 WDMOVAL(1) RESPONSSLE FOR RADATON SAFETY PROGRAM AND THEIR
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11tAhtpeQ EXPEReENCE
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10. RADmitON SAFETY PROGRAM
12 UCENSEE FEES (See f0 CFR f 70and Secean s 70 79
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FEE CA1EGORY
13 CERTIFICATON 84A,ef Se composeday emiecent) TME APPUCANT UNDERSTANDS THAT ALL STATEheENTS AND REPRESENTATONS MADE IN TH16 APFL'CATON ARE SMDING
UPON THE APPLICANT
THE APPUCANT AND ANY OFFICML EXECUTwsG THIS CERTIFICATION ON SEMALF OF THE APPUCANT, NAMED IN ITEM 2 CERTIFY THAT THIS APPLICATION IS PREPARED IN
CoopORMtTY wtTM TITLE 10. CODE OF FEDERAL REGULATIONS. PARTS 30,32. 33. 34,36,36,30 AND 40. AND THAT ALL INFORMATON CONTAINED HEREIN 'S TRUE AND
CORRECT TO THE DEST OF TNElR KNOWLEDGE ApeO BEUEF
WMtNWG 10 U S C SECTION 1001 ACT OFJUNE 28. itse 82 STAT 749 MADES (T A CRIMINAL OFFENSE TO MAKE A WILLFULLY F ALSE STATEMENT OR 8tE*RESENTATION TO
ANY DEPARTMENT Oft AOENCY OF THE UNffED STATES As TO ANY MATTER WITHiN (TS JURsDeCTION
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DATE
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TYPE OF FEE
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DATE
PRWTED ON RECYCLED PAPER
edtC FORM S16161987)
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Attachment to NRC Form 313 - Appendix B
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5. Radioactive Material
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Element and mass numbers are Cesium-137 and Americium-241
Cesium-137, chemcal and/or physical form are sealed sources in compatible gauges as
specified in Sealed Source and Devloe Registration Sheet. Quantity is not to exceed maximurn
- activity per source as specified in Sealed Source and Device Registration Sheet.
Aneridum-241, chemicaland/or physical form are sealed neutron sources in compatible gauges
as specified in Sealed Source and Device Registration sheet. Quantity is not to exceed
maximum activity per source as specrhed in Sealed Source and Device Registration Sheet.
6. Purposefs) For Which Licensed Material Will Be Used
Licensed Material Cesium-137 and Ameridum-241 would be used to measure physical
properties of materials,i.e., the moisture and density of soils.
7. IndivMada) P N a=8hia For
P="=!'=.
Safety
Pissie. . And Ths:r T4.k.s
T
Experience
John A. Buzdor, PE, is the proposed Radiation Safety Officer (RSO). Mr. Buzdor's training
course certificate from Troxler Eledronic Laboratories is attached.
Before being named as the RSO, future RSO's will have successfully completed one of the
trakiing courses described in Criteria in the section entitled " Individual (s) responsible for
radetion safety program and their training and experience - Radiation Safety Officer in
NUREG-1556, Volume 1, dated May 1997.
8. Training For individual (s) Wortdng in or Frequenting Restricted Areas
Before using licensed materials, authorize users will have successfully completed one of the
training courses described in Criteria in the section entitled " Individual (s) responsible for
radiation safety program and their training and experience - Radiation Safety Officer in
NUREG-1556, Volume 1, dated May 1997.
9. Facliities and Equipment
No response required.
BuZDOR ENGINEERING
CONSTRUCTION TESTING AND SPECIAL INSPECTION
f
-
.
.
.
.
,
.
.
.
.
Attachr'nent to NRC Form 313 - Appendix B
10. Radiation Safety Program
.
Buzdor Engineering win either possess and use or have access to and use, a radiation survey
meter that meets the Criteria in the section entitled " Radiation Safety Program - Instruments" in
-
i
!
NUREG-1556, Volume 1, dated May 1997, in the event of an incident
Physical inventories win be conducted at intervals not to exceed six months, to account for all
l
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sealed sources and devices received and possessed under this license.
l
Buzdor Engineering win maintain, for inspection by NRC, documentaton demonstrating that
unmonitored individuals are not likely to receive a radiation dose in excess of 10% of the
allowable limits in 10 CFR Part 20 or we win provide dosimetry processed and evaluated by a
,
NVLAP-approved processor that is exchanged at a frequency recommended by the processor.
Buzdor Engineering win implement and maintain the operating and emergency procedures in
Appendix H of NURAG 1556, Volume 1, dated Ma 1997, and provide copies of these
procedures to all gauge users and at ead job site.
titemately, operating and emergency
procedures will be developed, implemented an maintained an will meet the criteria in the section
I
entitled " Radiation Safety Program - Operating and Emergency Procedures" in NUREG-1556,
Volume 1, dated May 1997.
Leak tests win be performed at intervals approved by the NRC or an Agreement State and
spedfied in the Sealed Source and Device Registration Sheet. Leak tests wlN be preformed by
l
an organization authorized by NRC or an Agreement State to provide leak testing services for
j
other licensees or using a leak test kit supplied by an organization authorized by NRC or an
Agreement State to provide leak test kits to other licensees and according to the kit supplier's
'
Instructions.
l
Buzdor Engineering win implement and maintain procedures for routine mainteriance of our
gauges according to ead manufadurer's recommendaSons and instructions,
j
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Buzdor Engineering win send the gauge to the manufacturer or other person authorized by NRC
or an Agreement State to perform non-routine maintenance or repair operations that require the
removal of the source or source rod from the gauge.
l
11.Wanta Management
No response required.
l
BuZDOR ENGINEERING
CONSTRUCTION TESTING AND SPECIAL INSPECTION
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BUZDOR ENGINEERING
-
January 30,1999
,
.
Nuclear Materials Lloensing Section
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U.S. Nuclear Regulatofy Commission, Region IV
' '" 7
611 Ryan Plaza Drive, Suite 400
77-
Arlington,TX 76011-8064
~'
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Buzdor Engineering
'
Application For Meterial License
Greetings:
Attached is Buzdor Engineering's application for material license (NRC Fcrm 313).
Also
attached is our dieck #1007 for $730.00, per fee category 3P.
Buzdor Engineering is a construction testing laboratory and has plans to purchase
moistureklensity gauges. The undersigned has 15 years experience operating, maintaining
and transporting moistureAjensity gauges for PSI /Pittsburgh Testing Laboratory and EBA
Engineering.
Please expedite this application, as time is enbcal to our success. If there are questions or
additionalinformation is required, please contact us.
Sincerely,
Buzdor Engineering
-
n
B
or, PE
Senior rojectEngineer
!
I
ANCHORAGE 3705 Arctic Blvd., #1593 99503
HCO2 Box 7710 99645 PALMER
TEL- (907)746-15M
INTERNET: buzdor @ alaska. net
FAX: (907)745-5545
b
407128
,
,
.
U. S. NUCLEAR LEGULATORY COMMIS$10N
APPROVED DV Ome: NO. 31004120
EXPIRESW31n999
(5 1997)
Emanmed tourcen pw response M comply weh Cue rifension anedson
10 CF R 30. S2, 33
request 7 hours8.101852e-5 days <br />0.00194 hours <br />1.157407e-5 weeks <br />2.6635e-6 months <br /> Submmel of the oppication is necessary to estermsie that
34,34, M 38 and 40
the opphcant a quellfed and that adequate procmases east *o proled tie
ptMic haean and selety Forward comments regardin0 Insderi eetsmate lo lho
Hormaten and Recorde Menegament Branch (T4 F33), U S Nucteer
APPLICATlON FOR MATERIAL LICENSE
ae'-v c="'num WoWienem DC 261, and M Ihe Paperwork
Rem Protiid (3154 0120), Offce of Management and Budget.
.
Weehengton, DC 20603 NRC may not conas:t or sponsor, and a person a
not requred to roepond to, en ellormation collecten unisse 11 deploye e
curently valid OMB control number
INSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING
APPLICATION SEND TWO COPIES OF THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.
j
APPUCATION FOR DISTRieUTION OF EXEMPT PRODUCTS FILE APPUCATIONS WITH:
IF YOU ARE LOCATED IN;
DIVISON OF INDUSTRIAL AND MEDICAL NUCLEAR SAFETY
ILUNOIS,IND6ANA lOWA, MICHIGAN, MINNESOTA, MISSOURI. OHlo, OR WISCONSIN,
1
OFFICE OF NUCLEAR MATERIALS SAFETY AND SAFEGUARDS
SEND APPUCATIONS TO:
U S NUCLEAR REGULATORY COMMISSON
WASHINGTON, DC 20555M1
MATERALS UCENSING SECTON
"
^ " "
"
" " '
"'
"
ALL OTHER PERSONS FILE APPUCAflONS AS FOLLOWS:
B01 WARRENVILLE RD
D YOU ARE LOCATED IN
USLE, IL 60532 4351
CONNECTICUT, DELAWARE, DISTRICT OF COLUNSIA, MAINE, MARYLAND.
ALASKA, ARIZONA, ARKANSAS, CAUFORNIA, COLORADO, HAWAll, IDAHO, KANSAS,
MASSACHUSETTS, NEW HAMPSHIRE, NEW JERSEY, NEW YORK, PENNSYLVANIA,
LOUISLANA MONTANA, NEBRASKA, NEVADA, NEW MEXICO, NORTH DAKOTA,
RHOOE ISLAND, OR dERMONT, SEND APPUCATlONS TO:
OKLAHOMA, OREGON, PACIFIC TRUST TERRITORIES, SOUTH DAKOTA, TEXAS, UTAH,
WASHINGTON, OR WYOUING, SEND APPUCATIONS TO:
UCENSING ASSISTANT SECTON
NUCLEAR MATERIALS SAFETY BRANCH
NUCLEAR MATERIALS LICENSING ftECTON
U $ NUCLEAR REGULATORY COMMISSON. REGION 1
U S NUCLEAR REGULATORY COMMISSION. REGION IV
475 ALLENDALE ROAD
611 HYAN PLAZA DRIVE, SUITE 400
KWG OF PRUSSIA, PA 19408 1415
ARUNGTON. TX 76011 4064
ALABAMA, FLO14DA, GEORGIA, KENTUCKY, M4SSISSIPPI, NORTH CAROUNA, PUERTO
RICO, SOUTH CAROUNA, TENNESSEE, VlftGINLA, VIRGIN ISLANDS, OR WEST VIRQiN6A,
SENO APPUCATIONS TO:
ATLANTA FEDERAL CENTER
U S NUCLEAR REGULATORY COMMISSON, REGION 13
81 FORSYTH STREET S W, SUITE 23T85
ATLANTA, GEORGIA 30303 3415
PERSONS LOCATED IN AGRESMENT STATES SEND APPUCATIONS TO THE U.S. NUCLEAR REQULATORY COMMISSION ONLY BF THEY WISH TO POSSESS AND USE UCENSED
MATEftlAL IN STATES SUSJECT TO U.S. NUCLEAR REGULATOftY COMMISSION JURISDicflONS.
1
THIS IS AN APPUCATON FOR (ChecA apprepnefe dem)
2 NAME AND MAR ING ADDRESS OF APPLICANT pncfucle Zep cocle)
T NEW UCENSE
,
Qg {
SW85 AtZm 3M ,-# \\5%
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AMENDMENT TO UCENSE NUMBER
B
h@MQ
[Qr,*
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_C
RENEWAL OF LICENSE NUMDER
3 ADDRESS (ES) WHERE UCENSED MATERIAL WILL BE USED OR POSSESSED
4 NAME OF PERSON TO BE CONTACTED ABOUT THIS
BiliEDOC FN&vNEERML
[w""'*" A . Buq3 oe.
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700 W. Ebm Aygr, m vc, 3
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SUBMIT ITEMS 6 THROUGH 11 ON S 112 X 11* PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE UCENSE APPUCATON GUIDE.
5 RADIOACTIVE MATERIAL.
e Elemani and mese rusnber; b chemical endtar phrecal form, and c. maimmum amount
6.
PURPOSE (S) FOR WHICH UCENSED MATERIAL WILL BE USED
which wie be possessed at any one tune
7.
INDIVIDUAL (S) RESPONSIBLE FOR RADIATON SAFETY PROGRAM AND THEIR
l
TRANING EXPERIENCE
8 TRAINING FOR NDIVIDUALS VORKING IN OR FREOUENTING RESTRICTED AREAS
S FACILITIES AND EOUIPMENT
10 RADIATION SAFETY PROGRAM
12 LICENSEE FEES (See 10 CFR f 70 end Seccan 170 31)
3P
l
8730 1
FEE CATEGOelY
13 LERTIFICATION (Mumf be compfefedby especent) THE APPLICANT UNDLASTANDS THAT ALL STATEMLNTS AND REPRESENTATIONS MADE IN THIS APPUCATON ARE BINDING
'
UPONTHE APPUCANT.
THE /PPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPUCANT, NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN
CONFORMITY WITH TITLE 10. CODE OF FEDERAL REGULATIONS, PARTS 30,32,33. 34,35, M 39 AND 40, AND THAT ALL INFORMATON CONTAINED HEREIN IS TRUE AND
CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF.
WARNING 18 U S C. SECTON 1001 ACT OFJUNE 25,1948 82 STAT. 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATON TO
ANY DEPARTMENT OR AOENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION
, ,
CERTIFYMG OFFICER - TYPED /PR110ED NAME AND TITLE
dohn A hiot
SCRECl
i m
i
DATE
FOR NRC USE ONLY/ /
/ /
TYPE OF FEE
FEE LOG
FEE CATEGORY
AMOUNT RECEIVED
CHECK NUMBER
C
$
APPROVED BY
DATE
l
i
NRC FORM 313 (51997)
PRINTED ON RECYCLED PAPER
b
a87128
-
-
.
-
-
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.
,
.
,
,
, Attamment to NRC Form 313 - Appendix B
.
5. Radioactive Matadal
.
Element and mass numbers ere Cesium-137 and Amerldum-241
Cesium-137, semical and/or physical form are sealed sources in compatible gauges as
spoolfied in Sealed Source and Device Registration Sheet. Quantity is not to exceed maximum
activity per source as specified in Sealed Source and Device Registration Sheet.
i
Anericium 241, Momical and/or physical form are sealed neutron sources in compaNne gauges
as specified in Sealed Source and Device Registration sheet Quantity is not to exceed
maximum activity per source as spedfied in Sealed Source and Device Registration Sheet.
I
S. Purpaamfa) For Widch Licanand Material Will Ba used
Licensed Material Cesium-137'and Amerldum-241 would be used to measure physical
properties of materials,i.e., the moisture and density of soils.
7. Individualfa) Rampanaltda For Radiation Safety Program And their Training
Experience
John A. Buzdor, PE, is the proposed Radiation Safety Offloor (RSO). Mr. Buzdor's training
course certificate from Troxier Electronic Laboratories is attached.
Before being named as the RSO, future RSO's will have successfully completed one of the
training courses described in Criteria in the section entitled " Individual (s) responsible for
radiation safety program and their training and experience - Radiation Safety Officer in
NUREG 1556, Volume 1, dated May 1997.
8. Training For individualia) Worldng in or Frequenting Restricted Armaa
,
Before using licensed materials, authorize users will have successfully completed one of the
training courses described in Criteria in the section entitled " Individual (s) responsible for
radiation safety program and their training and ' experience - Radiation Safety Officer in
NUREG-1556, Volume 1, dated May 1997.
B. Facialties and Equipment
,
No response required.
I
- BUZDOR ENGINEERING
CONSTRUCTION TESTING AND SPECIAL INSPECTION
1
F
.
.
.
-
.
-
'
.
.
.
. Attadwnent to NRC Form 313 - Appendix'B
10. fladiation Safety Program
'
Buzdor Enginsedng wit alther possess and use or have access to and use, a radiation survey
'
- -
meter that meets the Criteria in the secton entitled " Radiation Safety Program - Instruments" in
NUREG-1556, Volume 1, dated May 1997, in the event of an incident.
Physical inventories win be conducted at intervals not to exoped six months, to account for aN
sealed sources and devices received and possessed under this Noense.
Buzdor Engineenng win maintain, for inspedion by NRC, documentaton demonstrating that
unmanitored individuals are not likely to recorve a radiabon dose in excess of 10% of the
allowable limitsin 10 CFR Part 20 or we wiu provide dosimetry processed and evaluated by a
~ NVLAP-approved processor that is exchanged at a frequency recommended by the processor.
Buzdor Engineering wlN implement and maintain the operating and emergency procedures in
Appendix H of NURAG 1556, Volume 1, dated May 1997, and provide copies of these
procedures to aN gauge users and at eam job site. Allemately, operating and emergency
procedures win be developed, implemented an maintained an win meet the cribens in the section
entitled " Radiation Safety Program - Operating and Emergency Procedures" in NUREG-1556,
Volume 1 dated May 1997.
Leak tests will be pedormed at intervals approved by the NRC or an Agreement State and
specified in the Sealed Source and Device Registration Sheet. Leak tests wlN be preformed by
an organization authorized by NRC or an Agreement State to provide leak testing services for
other licensees or using a leak test kit supplied by an organizaton authorized by NRC or an
Agreement State to provide leak test kits to other licensees and according to the kit supplier's
instruccons.
Buzdor Engineering wiH implement and maintain procedures for routine maintenance of our
gauges according to each manufadurer's recommenda6ons and instruchons.
Buzdor Engineering wlN send the gauge to the manufacturer or other person authorized by NRC
or an Agreement State to perform non-routine maintenance or repair operations that require the
removal of the source or source rod from the gauge.
11. Waste bannagement
No response required.
Su2 DOR ENGINEERING
CONSTRUCTION TESTING AND SPECIAL INSPECTION
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EUZDOR ENGINEERING
.
January 30,1999
,
Nuclear Materials Ucensing Section
FEB g5
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U.S. Nuclear Regulatory Commission, Region IV
-
611 Ryan Plaza Drive, Suite 400
]~~
A.2ngton, TX 76011 8064
-
Burdor Engineering
Application For Material License
Greetings:
1
Attached is Buzdor Engineenng's application for material license (NRC Form 313).
Also
attached is our deck #1007 for $730.00, per fee category 3P.
Buzdor Engineering is a construction testing laboratory and has plans to purchase
moisture / density gauges. The undersigned has 15 years experience operating, maintaining
and transporting moistureMensity gauges for PSI /Pittsburgh Testing Laboratory and EBA
Engineering,
j
,
Please expedite this application, as time is critical to our success. If there are questions or
additional information is required, please contact us.
Sincerely,
Buzdor Engineering
Johri A.
z or, PE
Senior Pr '
Engineer
.
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ANCHORAGE 3705 Arcbc Blvd., #1593 99503
HCO2 Box 7710 99645 PALMER
TEL: (907)746-1593
INTERNET: buzdor @ alaska. net
FAX: (907)745-5545
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