ML20202B880

Ack Receipt of NRC Form 241,dtd 990111 & Filing Fee in Listed Amount,Submitted to Rept Proposed Activities in Non-Agreement States Under Authority of General License, Per 10CFR150.20

ML20202B880
Person / Time
Issue date:	01/13/1999
From:	Kinneman J NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I)
To:	Guzik S AFFILIATION NOT ASSIGNED
Shared Package
ML20202B833	List: ML20202B828 ML20202B880
References
000327, 000328, 327, 328, NUDOCS 9901290219
Download: ML20202B880 (10)

Text

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475 ALLENDALE ROAD KING oF PRusslA. PENNSYLVANIA 19406-1415 January 13,1999 Mr. Stephen Guzik Radiation Safety Officer Thermo Fibertek, Inc.

436 Quaker Road P.O. Box 7010 Queensbury, NY 12804

SUBJECT:

APPROVAL OF PROPOSED ACTIVITIES IN NON-AGREEMENT STATES (NRC FORM 241) FOR CALENDAR YEAR 1999

Dear Mr. Guzik:

This acknowledges receipt of NRC Form 241 dated January 11,1999, and the $1,100 filing fee, which you submitted to report proposed activities in Non-Agreement States under the authority of the general license pursuant to 10 CFR 150.20.

In the future, please use the NRC Form 241 and mark the appropriate box for submitting revisions and clarifications. Please fax your revision or clarification and a copy of the appropriate fee to (610) 337-5393.

The NRC Form 241 must include specific changes, such as locations, dates of work and personnel. Work locations are subject to NRC inspection ir*, accordance with requirements for a general license.

The total days of usage / storage through this reciprocity request is 4 days. If you have any questions, please call Cheryl Buracker on (610) 337-5093 or Rebecca Brown on (610) 337-5260. Your cooperation is appreciated.

Sincerely, I

John D. Kinneman, Chief 912Oggo Nuclear Materials Safety Branch No. 2 i

PDR Division of Nuclear Materials Safety License No. NY-2812-4049 Control Nos. 000327-000328

Enclosure:

NRC Form 241 cc:. State of Wisconsin DOCUMENT NAME:

P:

To receive a copy of this document, Indicate in the box: *C" = Copy without attachment / enclosure "E" = C 0FFICE DNMS/LAT DNMS/LAT m [d DNMS

/.,

opy with attachment / enclosure "N" = Ne NAME CBuracker/ckb.

SVillar-(d)t/

M GDKinnem6(S DATE 01/13/99 C P6 01/ J /9 7 71/ N /99" 01/

/99 01/

/99

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0FFICIAL RECORD MPY

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.t't 11 '99 12:30 ER AES ElG SYSTEt15 518 793 9392 TO 916103375393 P. 03413 Fc.cm 241 Continued -(2) Additional Requests:

I 9

U.S. Paper Mills 800 Fort Howard Ave.

DePere, WI 54115.

10 U.S. Paper Mills i

800 Fort Howard Ave.

i DePere, WI 54115 No.1 Paper Machine

Contact:

Mark Velicer 11.

(920)336-4229 12.

Keith Carlton, Mike Rifleman, John Neun & Ed Higdon 13-(920) 336-4229 14.

From: 1/26/99 To:

1/26/99 15 1 Day 10.

l 9

U.S. Paper Mills 69 Washington Street Menosha, WI 54952 10.

U.S. Paper Mills 69 Washington Street Menar.ha, WI 54952 No.1 Paper Machine

Contact:

Todd Schumacher 11.

(920)725-7115 12.

Keith Carlton, Mike Rifleman, John Neun & Ed Higdon 1.'

(920) 725-7115 14 From: 1/27/99 Wg g

To:

1/27/99 1 '. -

1 Day 10

++ TOTAL PAGE.03

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) PUR50' ' TO THE LM3R LAW AND INOU1 TRIAL CoOE RULE 38. AND IN REUANCE ON STATEMf NTS AND Rf 9RESENTAfiONS HERETOFORE MADE s ' "HE LiCENRE DEllGNATED SELOW. A OCEN5L t$ HERESY r$1UED AUTHORIZING $UCH LICENSEE To emG. PO51E55. USS AND { TRANY 1 "ACICACTIVE MATERIAL ($) Of$3GNATED BELOW; AND TO USC $UCH RAoe0ACTivC MATERIAus)(OR 701 FORPO$tft) AND AT 1HE l PLACL P- 'd51cNAfff SELow. 79t1 LICENSE II SustfCT TO Att APPUCASLE RULES, REGULAftON1, AND Ostg(Pt Ftw CR Mt PtASTER I'd E78ECT ',* ALL APPRUrvlATE REGL'LATORY AGENCICs AND TO ANY CONDITIONS SPECiFIED BELOW 6

1. NAME OF t-N5tE

3. U4LNW NVPA kR TEIN:521762323 Thermo Fibertek,Inc.

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s. RAoiOAcTL MATERIALS

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. a. MAxiMuu ouaNTsTY LICENSEE MAY POS$ESS (element an m 455 numtC AT ANY Otif. It'f t A. Americium 241 A. Scaled Sources A. Nm to exceed (Amersham models i:'O millicurics AMCP1 and AMCP6, per witcc. Isotope Products model GFS,. or BEBIG model Am 1.POS) 9. luthorimL'gg: Conditicas 6.A. i For possession and use in NDC Systems Model 104P Portable Mar s Gauge for the purpose of measuri ag the mass of paper, water and fabrics on paper machina i 10. A. Licensed material shall be stored at the location indic ted in CMtica 2 and may be teed at temporary job sites of the licensee anywh :c wit!du The Swe of New i York, where the Depamnent of Labor exercises jurisdic:icn. l B. OvCmight smrage at ether locations shall be in accordance with s:n' mnm referenced in Condition E of the license, provided that wch stm me. may not be in a residence, or in an attached garage except within a vehicle. /.ny s chicle used for storage shall be driven only for purposes associa:M with use nr rort of the contained radioacuve material, by a person qualificd to use th wn di, and na passengers shall be carried unless they are also involved in wP mnh this license, Vehicular storage shall only be allowed if no othe stornra p a ibic j and shall not exceed five (5) consecutive nights unten authorium, to acced this limit is obtained fmm the Depamnent. DOSH 248 V 090 4

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3. Liceme Number 28l.4049 Sa. Ref. No. 1

h. Amend. No. _--

(Conditice 10 condnued.) C. Under no circumstances shall radioactive material authorized f~ 'hh license be transferred to the custody of any person or fmn other th:m the licensee. or be used or stored by another person or firm or its employees: urtess tbx r:rson or firm possesses a valid license to possess and use such radioactive matca i'i. I1. Licensed material shall be used by, or under the supervision of.13 m%n P. Guzik (Radiation Safety Officer), by licensee personnel traincd and ccrtified by the manufacturer. The licensee shall :naintain a complete and accurate record of the qualifica: ions of each pmon permitted to use radiation sources under this license. 12. Scaled sources containing radioactive materials shall not be opened or removed from . devices. 13. A. The licensee is not authorized to dismantle, repair or affect any chanm in the source holders / devices. B. The licensee shall net dter labels attached to source holders or d: icca, and shall maintain labels in legible condition at all times. 14. The licensee shall i::struct per;ons who mgage in work tmdct the license, in accordance with section 38.27(c) of Code Rule 38. Such instruction shall include the licceseis operating and era:rgency procedures, and other information contained in documentr, i corporated in Ccndition 20. 15. The licensee shall conduct a physical inventory every six (0) months to account for all devices received and possessed under the License. The rect rds of the inycutories shall be mnintained for three (3) ye:Is from the date of the inventory for imftction by the Depamnent, and shall include the quantities and kinds oflicerced materis!. Wnufacturer's Nrene and Model No., location of devices, the date of the inventory and the name of the person who performed it. t' A. The licensee shall maintain a utilintion log containing the ident5mtion of devices used, dates rcnoved and returned to storage, the locanen of use, and the identity of user. B. The log shall be kept at the location of storage and sha!! contain rumcient detail to enable the licensee to inform the Depamnent at any timt of the &r;t location of each device. Dos *4 243 9 1490

ti l 07 ' " 98:22 FR f4ES E16 SY51EM3 518 793 9392 TO 9 E1032.5.ai4 P.1011a a ~ $7 ATE OF NEW YORK D(PARTMENT o8 LA802 I } c!vc!ce c.e sucW Awo Hr.A:.TH U RADIOACTIVE MATERIALS UCENSE u P"" uf 3 Pages . Ucense Numher 28.J 2-4049 Sa. Ref. No. l., it Amend. No. 8 17 Current copics of the following documents shall be maintained at temporary job sites for Department inspection: i) The manufacturer's instruction manual and the licmsce's op - -ting and emergency procedures. ii) A copy of the results of the latest test for leat: age and/or contamination performed on the sealed sources, I 18. In the event that a theft. loss or other serious incident does occur, the Departnent shall bc notified immediately by telephone and subsquent information segaired by the liccusee shall I be apacd as it is received. All device users must carry the NYSDOL's current telcphouc ntunber in their emergency procedures. 19. The licensee shall ensure that all persons authorized to use portable devices coulply with safe use and maintenance procedures and that they do not ! cave a device unattended or meccured alf w time, even for a few minutes. 20. Except as specifically provided othetwise in this License, the licensee shall conduct its propan in accordance with the statements, representation and procedures certtained in the documents, including any enclosures, listed below. The Deparmw2t's RemIntions shall i govern, unless the statements, representation and procedures in the licensec' applien' ion and co Tespondence are more restrictive than the Regulations. ) A. Application dated March 27,1998, signed by J.E. Beigstedt. Vice l'r esident.. l B. Letter dated May 18,1998, signed by Stephen Guzik, Radiadon Sarc+v Officer. James J. McGo'rna COMMISSIONEP. OF LA!"E N n hlc ~ !. ATE: s5 26 96 by: Clayton J. Ilradt .3:wp Associate Radiophyscist DC5H-243 v.* 911

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