ML20202E885

From kanterella
Jump to navigation Jump to search
Voided Matls Licensing Action for Eg&G,Tennessee License R-01082-D02.Controls:001306 & 001307.Portions of Package Considered Proprietary & Being Withheld
ML20202E885
Person / Time
Issue date: 12/22/1998
From: Heim D
NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION II)
To:
NRC
Shared Package
ML20136E185 List:
References
001306, 001307, 1306, 1307, NUDOCS 9902030218
Download: ML20202E885 (13)


Text

. _

i

.i, i

M L

l ATTACHMENT 5 f

j VOID SHEET t

TO:

License ree Hanagement Brancn FROM:

M f

I

SUBJECT:

YOIDED APPLICATION 1

'Ih ControLJiumoer:

//[l[

/ijd[

Applicant:

7%

Date Voided:

/ d de/ 98

.i

\\

7 Reason for. Void:

0 l/10/'

b00[0fh42 (l

krG/712 E ! /98

&tJOr S r/k94e.

l1b/ N. // ~ h//MJ/P

/P b>N1

&P,

vy

)((

ldlH$

. br21 Signature Date

Attachment:

Otficial Recoro Copy of Voided Action FOR LFMB USE ONLY Final Review of VOID Completed:

Refund Authorized and processed

.)

O Q

No Refund Due I'

O Fee Exempt or Fee hot Required

.I; Comments:

Log completed Processed by:

f n n n T. P i 9902030218 981222 PDR STPRO E90TNPDR 1

~,,,,

Y& EGsG INSTRUMEN15 NaUlb919b-I TKI(7TADt0 03G G3 IN FAWENT OF ITEMS E3SCRBED BEL.OW D TMS S NOT CORRECT. PLIASE NOUY US PHOMPRY.

IWYMENT AMOLWT t_

}"-

VOUCHER NUMBER g

om ansam j

oncau, 461889 12/11/98 200.00 0.00 200.00 1

i a

d inuo >

200.00

,,.m.....:., m,...;,,,...... m.,,.,=....,,,,:.s.......,,,.

,,...,,.,,.,...,1...,.,.,,,,,. _

KEY BANK NA H

EGmG INSTRUMENTS 2Nf5S M

Na0159196

" " ~

EG&G INSTRUMENTS,INC.

801 SOUTH ILUNOIS AVENUE, OAK RIDGE, TENNESSEE 37831-2011 12/11/98 00159196

            • 200.00 PHONE: (615) 483-2121 e TELEX: 6823020
  • FAX: (615) 483-2279 PAY
    • TWD HUNDRED AND 00/100
                                                                                      • n.***#

2 4twa Am Wh Aay Ament h $2.M US NUCLEAR REGULATORY COMM.

To THE 61 FORSYTH STREET r9;Mresv e M *>gigg., !

7" SUITE 23TOS ATLANTA.CA 30303-3415

,7 3, 1 L, y

k W=R s' 00015 919 6 5u' i:0 2 L 3000 7 7s:

10 98 900 G a*

e D

e

l.

l REGION II 6

Calendar Year 1998 TRANSMITTAL FOR NRC FORM 241 & REVISION SUBMITTALS UeCQJMbef~f f7

\\

[ ]

I ITIAL 241 PACKAGE LRN

!3

'7 OO/3Oh00

[ !,

REVISION LRN

[

]

CLARIFICATION LRN C

LfC7T 9 eldholk i

l LICENSEE NAME

~ 'O I O 'I 1 d S E LICENSE STATE

/

NUMBER O N k[s CHECK NO:

Q O O.00 CHECK AMOUNT:

s FORWARDED BY:

cT A t e_.

/

Initial Revision Clarification incluces:

Form 241

'/

Fee License Copy LICENSE FEE & ACCOUNT RECEIVABLE BRANCH

~

.1.

Fee Category and Amount:

2.

Correct Fee Paid.

Submittal may processed for:

General License

. Revision Signec Date G:\\DNMS\\MLIB2\\RECIPR98\\0. FORM. FEE 4/1998

DE0. -14 %IEl 0W10 EGLG EERT k D l4A HL:423 41202 P.002 c."J ORM D l '

O. 5.N.lgt.r,An LggyL;.TCftY COutsg;CN *a*.av.te.a e c.as no.asse a.a NRf

- ' ' ~

n

.u S., *

,3 c,i e.

em

.c RE.: ORT OF FROPOSED ACTIVmES 1.~~'".". T*~~.~.~

C*." '*'""" '." "".,."*.".e.'.*.T.e e

IN NON. AGREEMENT STATES "w n c

== s***=..-~a-

.~ a

-4

.u = w a aC,,,,

r,,.

- ee en.a -

e esne us me nsawsoar en ma c ver sneet aernre e,sircune aus e,m i

==as ===== ia. a -== a. ~ = = =a.= = a==.-.

c. i

"'""*aa"*****'"*"****-

i

.s uca.ss a ta =.. : _-- o r - : =. -

[

2,77pgepggpCar

m ano.nw=ana n.n e.im a.mmer. en V

EG&G BERTH 0LE

'58'a" m' am e I't 4[1CN

~

C

.aon su ca.:cte att..-. - ---

. can orreN 100 Midland Road Ja Ehn i

c alc Ridge, n 37831-0895

.ga o 6.a.a.6EA

. "ri 5:m '- z <. 3 2 G3==se w *sa l

s,,

I m-vir.z z t.0 3 aC?'Vi IE3 701E CONQUCTFD IN NCN.4CRF8%f rT ??A?!!(;NCga TNg Gg,NgqM, LICIN$( QiVEN !N 10 CM !?Q 20 8'"'"

L."1 l wtLL LCCCWC LEAaC TESTING ANQtCR C.l4.lBAAfiCht l

1 TET1IttlapyrulLR.AC;A?CR SERVt0!

l t.'1 1

C'1

& iriE A tLosastyp

't Gk'MMt'. SO VIM /Mc d "U@ E A i Ai n ci

~d re_.r

._...m

-,_e_.~ mo_,

3 9

l AAcacCP PmV NO

  • CNCER M PI.IC13I.E l

i i

9""

- g,:::.;t>r.ia & accA513 OfviCne.re 5; Art se c oE

a ween 6cc.tnCa escRE25 (Ee.w = a.a

,e ess ee,* u O

1 a

.a r e - e e.a s

al:"

t

{h k

b b

i yO M,,, ai T&.J. a.N.4 au' id I i& womu bCCA ncre 'tConacem.u h. car.ru"I v'a e6asca msona

.a.ac.on w;c.:s;.m (SLAa=cas u.issA aG I

.e.

.-.- we a

1 3

l =' cart c4rs I' To E..CCATICN RE,.88FDeC2 NUMBER j

14 CA7Es 4CPUt.k12 CO-i asou G

wi..g 1;..

Ac.a E.sn.i; i.ac.A;. ;.e a E;;4.15T3 l

an.neanJi.*3 DE saGl.aG ET a ec 1

I 1

L- (wQ7/

I.)"O Q i

ca s

& 43 0 '-

=

t ust AcCmCNat.wCP.x s:T s CN 87.'.'LA. ATE Shf.ET 7c INCW.fCE Al.a. AFCRMAT CN CCNTAINE3 :N lTEMS S.18 ASOVE.

- e. _a c;...

..a _ c.

.e xsu6u.:. w w..a.

.aa c.a: a, ura:, m

. 4.,.......

.S

--.e e..

W2 T.;*

8e1C#14Q e. 'rfl* 8 *e@'t to.w

. ei. i e me.ea m e esamea no e.s aC 7 e 2ew.e., nr.ra ww.ec ct3sa ca n.r wsa e.,~.uscusa c c:ucac.cm. I 3,. c,..e a n s,,. o=pn.-n.cc r.ca w wsa..s i.

w w.sa

, svara

,ca.c o.,

... :o us l

.c...

7 te R-.0 L O B 2-D0 2 l

c q

'" - - *

  • a a O t*- 3 C- 0 2 1s. CIATir!c47 cu <erus IF ccustp77c av asavestri i, ips UNOERs1GNC. e.E,aggY Cga tre ? bat:

]

g.

As maormenen m ses reson.6 'ree ans emmenee 3 i ri eene ane asersrana se seemsma of me teaure userica IQ C'*I '8C esenn e en tr.e weer snous na ires derni se are t u.areisne ens i am eseusee e same a or'ese are e.epra an e se preensui sowece. er sauras nesses visensi n.cp i aossess ame.n. m non.aereenio. $lates ae a:fsnees wet.rs i

vaeer es genere seene er==:ri srm resen is rme um me u.s. *kscsar s gummir Camensana.

e i

aL e woe.rmane ira, es=.es..sammag warage. conoucios e non.,reem.,.s States omner gene st hsease 60 C:'ll '12 *: are leien go a,osa6 el 180 cars a muensar ar 5

i..sersier e mai e mee se mus.see e. a AC.s me ase.e estes ors s e can.oe,s 6,at as me L.aensee krees efice scorens 'er amad.es senere.4 e.

s e

e,um.

saam.., enene.

u. i am sese a-,. inn i
e.,eseene.es.,.ees asace.a.ao.mn suma esaemians t.C t,,.em.

c.,

er e a e, e e.,

e oin e, e.ai.e., e.

om meu e=er.= m-e =

~ L

.e.o q C a s== _ = u a -e.e u m.

e,.

.e.ge,.

, ee

.e.

k cww.w o

u

.c.n.n wa

  • amt Eelber:, R10

' [M h[,I 4 i utaanNo ness : A oces w wis C stecArt av te si;e.eC r:

.s se,en C:itw t eM is u s : : 0 cN oct wass it a caoma*t enea ? a nec teCwCNs Asma

stes essics
n.: -aC ts c:eam.r 4ao ac 1mre :N -a :artam ssrit: :l rse 0 -

j w,act 4 wit.eyt ? FALSE IWDatAT C4 REP 8EEF.NTADCN TO Nv OCPLA @T Cst ACitaCv Oft ">.( ue4TES S TA?F1 Ag =3 A,gy nAAN WITlalN l its a.mscic?cs f

j [3$k=i,

"M S Lesser MUB2/DN r

Ms

.c swu s.' "

ENCLCSURE Received in Region il NEy

/4t'y 98 cc "-

~~DE0.-i4'98iMONI,0M0[~EGks~EERTif0LD" USA ~

^^"~ ~^7TEG4234812432~

~

.~0 W ~ ~ '~ ~

~

~

P

.J',

Attachment for NRC Form 241 Johns Manville (00186) g 9.

Johns Manville 6050 River Road Waterville, OH 43566

10. Some
11. (410) 878-1241
12. Ron Biok (Johns Manville)

Rick Foster (EG&G Berthold)

13. (419) 878 1241
14. December 17 & 18,1998
15. 2 days
16. Leave Blank
17. Cs-137 500 MCI Amersham source; Co-60 500 MCI Amersham source Berthold LB 7444 Bio Lab b 1400 East Michl an Street Adrian. MI 49221 O O /3 O 7 9
11. (517) 265-7850
12. John Catepecci(Blo Lab)

Rick Foster (EG&G Berthold)

13. (517)265-7650-
14. December 16 & 17,1998
15. 2 days i
16. Leave Blank
17. Co 60 <100 MCI Berthold LB 330 Please note, the work will be sp!!! on December 17,1998, but I put 2 days for each site.

gg# gg Cc A/o /308 / /507 b c k't $ A l6 DIVISION OF ACCOUNTING AND FINANCE REQUEST FOR REFUND TO EMPLOYEE / VENDOR

' THE EMPLOYEE / VEND 0' IDENTIFIED BELOW HAS OVERPAID THE NUCLEAR RE R

COMMISSION FOR GOODS AND/OR SERVICES PROVIDED AND IS DUE A REFUND EMPLOYEE / VEND 0R/ PAYEE CODE:.

kfTk NANE:

D ADDRESS:

h ADDRESS: IOk 9

CITY: h STATE: T// ZIP: 3 7S3/ 'OO @C U

TRANS CODE: fL

~

TRANS TYPE:-

FUND:

JOB CODE:

AMOUNT:@dOd'OO TRANS TYPE: IR FUND: R1435 JOB CODE: INTR AMOUNT:

TRANS TYPE: IR FUND: R1099 JOB CODE: ADCH AMOUNT:

TRANS TYPE: IR FUND:_R1099 JOB CODE: FINE AMOUNT:

T TAL REFUND AMOUNT:8JOO ' OD

/M!d N 4b /3Ob

[?>D 7 r/b(L COMMENTS:

^

t h is9(9h

~

' (11 t,ccimmen s to 40 pharacters, including spafes) j PREPARED BY:

bk Sh DATE: /[Sh/77 AUTHORIZED BY:

[w

//c7 9 f

DATE:

~

O ORIGINAL INV. N0:

DATE PAID:

AMOUNT:

REFUND ENTERED INTO COLLECT SY:

REFUND DETERMINED BY:

DATE:

lb PLEASE ATTACH APPROPRIATE SUPPORTING DOCUMENTATION 5 AMg i$V mo

.c U 8"* - * * ~.L"..,

C @ V I

e NRC FORM 241 U. S. NUCLEAR REGUL.ATORY COMMiss;CN amoveo av tus no. aino assa s.ap,mm suoare i j

E--e----

e.

,..e,,

,e M-r=

. - -i c ev c..

e -

---.e,.i e -.. -

REPOR_i O - PROPOS D AC IVITIES 4-~

r c

i n

N in,,e -

.u,n> u :

1 m

IN NON AGREEMENT STATES c- -- oc =sumoi ~. ~ - =.ei r:ttG4lctsi on.s. w -

eae e.neet - -. oc 20 sos unc,,,,,,,,,

(Pleese reso the snstrucsons on the cover sheet Defore comcneeng tnis form I

-. e

..v~.- -,'ous.o.i t.nesemee no ?"W e

.aneum - seeamer.=aa**'esa==*.emme

..e

/i

)

g I

t. CONI AQL NWMSER neaw= GF LGEN5EE vaverna r = r. nee.ne s.wse.n ete se.vae..essn s e

.. TYPE OF REPORT J

g w,o emne - Nummer e as w

EG6G BERTH 0LD i '"'n

  • 289t** *r "*c3 7 REVtSON p

( Y, w-C

.oonE ss o.:ciusa i +-, -- - - --. c

~....,

,)g c:.AR,cATCN gg J.

' '***' C""c' 100 Mid1and Road i

  1. 8"I N b

Oak Ridge, TN 37831-0895

-acs.use.v=esa j:

a a tssia o~eav 6a gg

-5 I.Y"~ M *'2240 1

'4 U ~% U"- 2 4 3 2 9 ACT!VITIE S TC EE CONCUCTED IN NCN. AGREEMENT STATE 3 UNCER THE GENERAL UCENSE GivEN IN 10 CFR 150 20 mW WELL LCCG;NG LEAK TESTING ANOtCR CAUBRATCNS ygggygggApysiRRADIATCR SERVICE W

C3 c.JetEA gaecer

{ Xb T k; 6

))

T poRTAsLE cAUcts TRAmspORTAfioM QA PROGRAM APDSQVA( NQ g Rgy a,0 AEGISTERED As USEA OF eacKAcaNG5 (CERT 18CATE3 QF COMPLIANCE NQ$ I

! RADICGRAp*4Y "D

C 1

NO LONGER APPLICABLE i

n-

, cue ~r...e acenEss c:rwcevarv s Att Da c:oE i c woan tecAnou.ocaEss ese.--.--.---

a c-. =

., e es

....~,

c 510 0 $

=

_.rdM'4h,A h }4h S

\\ t[ D b E G S Y Y ) W C b g m.e__

}

--Q 7 5

....~A m w _ E, c _......

..E F _

h ($~~2ik-%S'b d ohnhteMtcI($*) lYMfYI.lo[94r)

(jii]"z i-6.

o k

14 CATE$ $0hEDULeg

}

"Y,'**t A 3

i 16 (CCATCN RE81*ENCE NUMSER

  • 1 I wonaCAv5 l CR* i*i AE LvE515 I

70

,A,v6 i6ae** eC A wh*L a 'C 'etC saou

=vuSE4 70 SE AS3CNEQ $v N

,a M.

O*

O oo de s=(

UST ACDtilONAL WORK S;TES ON SE. ARATE SHEET To tNCLUCE ALL INFORMATION CONTAINED IN ITEMS 316 ABCVE.

e

.. v% A ;.,

a a6 aa%a % as -055

A
64;&Lin

,ati.sm.ei-sia

.=

,.,ueeee.wie,,,e ma.ce See oas eveaaw e e.eescove ene.iAus; isa m..

.a 44 A vews; ome, seese sowres e ee ees e se a,s.e a

,ne C.s-60 % O % oo LB330 BerthoMx\\sb4 \\n=

b is 4GAEiwt*I 6Tais SPEMC.01N53 **"C** aufmoaqEs T-4 vNGERsiGug; i; ;;Novc acimr:E5 wa.*Ca. *A6 ret 14aat 64;18* 'OR LGCAi'Or* 08 W5E ^3 seEC#iEg ee argu a asovE (8.we.oo o a me sees : mee=se a, vet assamena, une

. =mc 8vm 2 11 EAreiaa hCm Gais

Cf46 wa*GE 04 es :O CATE l M*34 I

LcEmst aeuma.64 m

R-01082-D02 T a m a =' e e e 04-30-02 2

13. CERTW1 CATION.MUST EE *:MPLETED EY APOL!CAND b

' THE UNCER5iCNED. 'aEaEav CgRTirv TwAY 2

a An intornision in mes eecon is irve anc comoiese i nave seno ana unoersiane one provesen os iPe generas hcense 10 CFR iSC *O reormiee on the cove, spees os mes torm sei ano i vacersiano mat i am reoverec

~"

o como.,.am mese prov.sens as to an ovoroeuct sovece or soecies nucisar maiensi =neen s possess and use e non.agreemem States or olishore weiets unoe, me genersi secense nor neuen mes recon es fueo am me u ! Nucasar Argutatory Commessen i unoerstano snat scuenes. mcluomg storage, conouctee m non. Agreements States unoer generai heense 10 CFR 150 20 are umaec io a icina of 180 cavs m

[

c esionaat wear

.h t unoersiano inai i man te aisoeciso ev NRC as me soove hsies worn s ie ocauens ano at me L. cense, nome oiGce acoress to< acuenes penormee m c

non i.geeemem States or onsnore we ecs. I am siso aware mas a vad oe vescons.oie to< snv sees associaiec wim suca intoeciens C

a unoersiano mai conevci of an, sciamos nos cescnoee soeve. mciuomg comovet of actwaes on osies ce nocanons eine'eas irem mese

J e

womoul NRC Aumongguon may suceC1 me to enforC0 ment actson mCluonng C=a ogrimenes sensases

  • {^'*5_,, M d h fg u

C I""' " c ' " 5 "~"'''**~';"'*~**"*"**"'*'

Jami Holbert, RSO nose sTATEueNTs = T is CERTecATE wy eE sua;eCT Te CgEPECTL ANo.cR CRuNAt 9 '

winNmG ta V S C SECTCN 1001 MAKE! :T A CRP4NAL CFFENSE *:

SUBMISSCNS TC THE NRC EE COA 4pt!TE ANO ACOURATE IN ALL MATERIAL MAKE A WILL*VLtY FALSE STATEMENT CR REPRESENTATCN TC ANY CE8ARifAENT CR AGENCY OF Th ! VNITEO STATES AS TC ANY IT$.;URt3DCTCN i

A i

E l t 7-Jdf) avleeQ aet

$,GN

[$$R M.S. Lesser, MLIB2,/DNMs y,

Received Region ll NEOS ENCLOSURE;

~ac*oa m a wi

/2bc' b..S. re S

SUCm**

  • m* rQOW s e i

n -

\\

l NRC FCRM 241 U.S. NUCLEAR REGULATCRY CCMMiss;CN Ahowto e r ome no. aise.cosa g,,,

,73,.,,,

t.- -

e a

x,u,.,,

l

-- a n-no-m

..e~~

__m

,, c,,,

e

.....ee.-

~=

l R. OR O-ROPOScD AC.NITl,te

. ~ ~ ~ - ~

e

.e-

=r i

rr i

N I

- m.

e

a. am.=

..T4 r2m u s

. a

--ae.

oc = - ~. ~ * - a. - T'l~~'

g IN NON. AGREEMENT STATES ca--

r (JtSO.cott, flic. er - -

.n. 6 6 w.sa.agnea DC 20503 WaC m.,

coan.

t,

.a..

.a.

ssoa.. a (Ptease rese the ansittic2cas on fne cover sneer cerare cornpreeng this for== s wa...

.v.. cunea Que c.a a.-

g i "auo'av"*E^

~..e o, o c ~ u s,<,,. -a. _

..-=~.....'-~~'
. Type cF REPORT i

itom euna - Numov e ce 7

EG&G BERTH 0LD

_ f""'^'

  • 23a'* * **C8

'"C-i REvtseN Ff e

.,usc,. m su.--e

~...._,

y C.,,cATcN w

100 Midland Road Jami Holbert 3

b Gak Ridge,

  • N 37831-0895 me ~v

.aa a 1a.6, o,.

-5 A"U'~I+*d'.'- 2 2 4 0 l '42*M*O I"- 2 4 3 2 3 AC7:vITIES TC EE CCNOUCTED IN NCN.AGREEVENT STATE 5 UNCER TwE GENERAL LICENSE G.VEN tN 10 CFR 150 20 W

j WELL LCos;NG LEAx TESTING ANQlCR CAUERATCNS TELETNEELAPYARRADIATCR SERVtCE LO I

C3 MnEA sas.cnn "7

PORTABLE GAUGES x1 Q&ce cal\\

N atusmoat.non oa paoca u ap.acvat nc a aev =a

.gois;Enzo As usEn or **cAac.acs icI AnrcArts or coueuANCE NO3 )

g

RAOCCAAPHY i

W NO iONCEE APPLICA3LE i

/-

s cuc~1...e ccasss :cvc:v~rv start tip Cecs i e wo., tocane.ocasss,,

.a..,,,

e;..

i

. o~

~...

n... a c

Po hers.L n d us4r.i es, I n c_

i C-a dMQ8 W s3reLStred-b Q mE.

n l__

CJeveland.,0#

W//3

, _.., ~ ~. -

g m m.

.,. _ a m __ _,

m,~ic._

c.m, =,,,,, _ w_

c r

.w g

(216 h,21 - owb

\\ verm hurt /1%r k Msrun ( E GG

2. m u21-o M b CATES SOEDULEb l w* eau
  • cars 'I Ts 16 LCCATCN REr!MENCE NUMBER

$c:.

4 or.. 6 6. a~m -c.a. a f m a. a C,3 cr'

  • ia i a E : i E 515
O sou NuwSER i: BE 5SGNEC85aac en / MH an C M99 i

O o 6 / k '7 3m UST A001TIONAL WORK SITES ON SE? ARATE SHEE" TO INCLUCE ALL ;NFORMATICN CCNTAINED IN ITEMS 916 ABOVE.

e

.m~~_e_....m Osd5 p. g..m -...m.-.....

..m...m.

............ ~. -

=

-~ mg.g14 Be th kl l o mCt.

e m-e

, mm._

c

. s._ _,,. m. s_.mu ~.- s m. -a scm =_. o, m~. -

.m-~ ~. s

..E=,,,

...~..a~..~.a.-..c,._

..ct~ u ~v

... te

. s.,...ci a s :c cara U")

R-01082-D02 l

lc.am.ic~o...

l Tanaaeeaa 04-30-02 i

1s. CERT;F1 CAT:CN ruus? EE :CupLETE: Ev nor. CAun b

THE UNCER5iONEC *'E458Y C1RTilN THAT k~

a An iniaemauon sa mes eeoon es irve uo comosese

. i nave seso ano vner'siano one prov sen or me generai heense 10 CFR 150

  • seonmeo on tne cove, snee4 os m,s term s.i ano i u oersrano inaiI am reovereo n

~

o cornorr ~'m mese o'*** ens as io asi evorcouct source. or specias nucitar maierini -n.cn e possess ano use en naa 9,eemeni States or odsnore -see,s u oer ine generai acense one wn.cn m.s recon is iaea wnn tne V S Nucieat Aeguiaiory Comemsson n

6 unoerstano mai actmues. *ctuoing storage, conowcien m non-Agf eements States unoer generai i. cense 10 CFR 150 00 are amneo to a toint of 180 cars ici

[

ca.encar voar mav oe naspeciso av NRC at :ne soove testeo wors sne ecahons ano at tne Licensee nome olf.ce acotess to' sch'd'es oenormee m h

e I unoersiano mat non,,eemem staies or onsnore weiers. I am aiso awore mai i ~i ne eesecasioie ior any sees associmiec vam sucn inspecticas i unoersiano mai conowet or anv activmes noi cescrioes aoo.e. menvome conovet or acuvmes on saies o/eca f

[

maul NRC awmortfalen me, suos.Cl me io entofCament schon MCiuonng c,v.

mena. cenatises Cr.

aiE ctu,,., c m a. a sc., --..-- a,

~, :,,

.~.

w.,

y ~. w i Jami Ho1bert. RSO

/[//)Q ApA.I~

N k

2 AL3[ [TATEMENTS iN TMiS CERT *tCATE MAY !! SUBJECT *C Ch ANorCR CRIMINAL Pf ** ALT;ES NEC REGU ATcNS 2

W AR NING SUBMtSSCNS ?C 7ME NAC EE CCMPLETE AND ACC': RATE iN ALL MATERLAL srESPECT, t e U s C LECTcN 1001 MAKEg :t A CRD.eNAL CFFENSE TC MAKE A wtLLSUL'.T 'atst STATEMENT CA REPRESENTATCN TC ANY CE* ARTMENT CA AGENCY OF 7"E UNITEC STATES AS TC A iTE JURtSOtCT:CN

.A w^ E

~ i u.

s-u r-OR NRC M.S. Lesser. MLIB2./DNMS

/

/ 15 s '? 8' USE ONLY :

Received Region ll NEOS ENCLOSURE

=ac sonw a.i un 41kn e n.g

SUSPEMS2 COPY

'NRC FCRM N U. S. NUCLEAR REGULATORY CCMMISSiCN APAOvt0 SY Und NQ. alto.cosa E ~ -

e.APs y m i

i. -

n

.-.~C,,

,9 c,,,,o e-.-..e.,e~.--._

s.-

REr.,OR. Or-PROPOS D ACTMTlES

--~----.=--~~a,i, i

c N

- 6,.ama.T4 F22 U $ Numa..e R seme m.

a a

.r m

oc== ~ - ~ *=~-. -.- Z IN NON. AGREEMENT STATES c-

~~-e-a

~

Ot SO410131 Cnic..e an.a.e.a

.a. 6 e.t w.sa e a DC 2:503 asaC m..

(P!eese reso the efst/1/C00ns ett the cover siteef cefore comoreong rties term #

c.a ei.,.

, ea. a en.a as.

..es

a. e. a s.

....a o-a - -

g 4 C~1^O'na "'n#LA NU

.... v Lc a - Sa 1 r.o

- - - - - ~.-.

....n-

. TYPE OF REPORT I

g nem eu umoer to c.

w EG&G BERTHOLD

_ ! "'"^'

' 2 89'** *"

C3 h( h]

v 1 REVytGN CJ

..co E ss c, vCaNsu.-- e

. - ---n -e -.a..e ~....,

WRi,cATieu

  • "***C**'

100 Midland Road Jami Holbert

,w mN 37831-0895 Oak Ridge, A

e.cs.= *-v 6a

~

s a m.o~e~u

..a h

UT~I'$'T.2240 1 72'~3~~4 5'I"- 2 4 3 2 a ACTtVITIES TO EE CONOUCTED IN NON. AGREEMENT STATES UNOER THE GENERAL LICENSE GIVEN :N 10 CFR 150 20 I

LEAx testing ANCICR CALIBRATIONS TELETHERAPYnRRADIATOR SERVIC!

sa in WEu Lec::NG I

Ln Cn n Gir,LR t sw;uyo I

y PORTABLE GAUGES xi &rvice ca

f. mEGisaaE3 As v5ER OF **CKAGwC5 (C

~2ANSPOmf ATcN QA P4CCAAM Ap99Qvat NC 4 AE v No RADIOGRAPHY C

LO NO LONGER APPLICAELE

$ CgENI.eAME ACORE55 0'TvrCOUNTv STATE ZIP CODE

-: wenE LCCArcN AOCAEE1 (Se.m.a.===.w e.ma scsa.a Ga. a.

I gySIV(G(1VI le-E A /1 som.eee.a re., a ereco.a. a..on.

CD v

f 3

(p667% ve r A-tyw Look rvi n e_, 6 4-435%

lQ uoan syON f mONENum.o d

si ;.rNiTE.ie=ONtNww.sh 12 wore LQCATcN TEQiN '

Agt-Qaiggg ;O pf450RM wG K mes I;;:::l I hpaca.earkee ~M-12. Y l (hmeaemeJ.m.t 9 ) ?S *7 7 '* 0 h b*,

0&

&Y$0%d lIA Q

  • '*7

l 16 LOCATION REeEoENCE NUMBER k

14 CATES SCHEDULEC i

c

't I wCRuOAv5 I

.iava swaan *CR.NihAs a0 4 caw 2 5 di3vE575 O

sAOM l

wuuSER TC SE aiscNEC gv ac aj n y /fW v'a n 4 /M gw g

me C

usT AOO!TICNAL WORK SITES ON SEP ARATE SHEET T; !NCLUCE ALLINFORMATION CONTAINED IN ITEMS 916 ABOVE.

e

.e.a c..

.r....

.i3

-....-...Nceas e.v.w s...s -o.ssesse_ m..L % i.;..s.i.e.c. ; ;a.. a. ; (;,,~ ~#.m.,a; n

E eu :n soo mCJ Amershm Co +o s0om C ANrs%

.a.

U se 4GAEiwe r stars SPt;;5c b;1NSE wao awtaoAGES :.-6 vNCEascasc :: ;;wovc 4c wmE5 w.oCN *As hat 5Aut se:gs; a-a tecAaoN OF uss 45 SSE 0;FiEO iN If Eu 4 460VE rs., s es e me s.eeme.c.ase a.ws:.cs.m..a. ~.a meC 8 e is i t scLNLs m.,mwei M

. ~ tat.a.463Av5 C CAIE f

  • is l(Apeastcr.ua..

l e

R-01082-D02 T.,

..c..

04-30-02

19. CE~T1F1C ATiON iMUS T EE ::MPLE*E.R EY UOLICAND C

. TF8 UNCER5;GNED. MEE E*Y C!RM"Y NAT 2

a.

Au iniormahon a mes repon es true ano comoiete i nave eene ano unseessano one oroasen as the cenersi hcense i0 C'R tic a0 reonmeo on me cove, sneci os mes so,m sei ano a vncersiano mat i am reowrec

~~

s

o comorv =am inese pro *sens as to su trvoreove: source. or soecias nuciese maiena. wnica i couns ano use in noa greemem Siaies or olisnore weiers anoer tne generai ascense eor wmen mes resort es (neo am me V E Nucasat Aeywatorv Commess.on i wncerstano mas acwmes. *civoeng storage, conovelee m non-Agreements States unoer generai 6. cense 10 CFR 150 20 are amnee to a etas of 180 ons an

[

cas.noas vest i unoersiano mai i mav oe mspecies tiv NRC ai me soove insieo wers sue iocahons ano at me Licensee nome ost.ca acoress nor ac~ues penormee m h

o non genmem Staies or cesnose weiers. I am aise aware maii wid oe eesoons.o.e ior any sees associaiec *am suca espechoas C

i uncersiano mai conowet of an. actanues noi cescnoen soove meivomo conovci of aes=mes on caies or iocaions cine.em I, mese onenneo soo.e or w

e Cf.

emnout NRC awmongsuon may suo+ect me 10 enforcemeni act.on mciuoMg cwo or enmanas senames

/

/

D^8E

.. wg j

g c ai.F n~c cucta. a sc.

.a.ee ~ 4.

a

,:,..e-

,..m..

....,5 y

Jami Holbert, RSO g'

' L 7

W AR NING 8' AL$E STATEMENTS sN TMIS CERTIFICATE MAY SE $USJECT *O Ch ANOiCR CRIMINAL

$UBMISSICNS TC THE NRC *! CCMPLETE AND ACCURATE IN ALL Mt.TERIAL SP*CT: 18 U 5 C SE: TION 100t PAAKES :T A CRIMLNAL CFFENSE TC

~

MAKE A WILLFURT F ALSE STATEMENT OR RE*RESENTATICN TC ANY CEP ARTMENT CR AGENCY CF T.4 UNITED STATES AS TC A 675 JURIS01CTCN p

.vi v,

ScNA M.S. Lesser, MLh32,/DNMS

/ L y./97 FOR NRC e

USE ONLY -

Received Region 11 NEOS ENCLOSURE c.on

..ee D-hoh cch

en o

hP tca tnoC ts iL C

e R

t a

N tS v

tiC ynao moC O

i j

m t

lll

NRC List (cont.)

Comoanv City State Contact Phone e

t L

+

L e

D I

P

_____________._.-.._.-____.-___-_______-,_._.m.m

. m m.-.

m.

m

NRC List (cont.)

Comoany Citv State Contact Phone l

i i

t Rev. 000 Date December 29,1998 6

..