ML20206J051

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Clarified NRC Form 241, Rept of Proposed Activities in Non-Agreement States. Activities to Be Conducted:Perform Field (in-situ) Gamma Measurements on 990503-15 at Haddam Neck
ML20206J051
Person / Time
Site: Haddam Neck File:Connecticut Yankee Atomic Power Co icon.png
Issue date: 04/30/1999
From: Rohrbacher J
DUKE ENGINEERING & SERVICES
To: Mcgrath J
NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I)
References
000685, 685, NUDOCS 9905120094
Download: ML20206J051 (3)


Text

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caincs, NRC FORM 241 U.8.NUCLEAM HEGULATORY COMMISSION 1ousjm gt p

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REPORT OF PROPOSED ACTIVITIES

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IN NON-AGREEMENT STATES tit: coo"m om"es e"*ventemei.nd s"wipei,'wn>=naion."oc"2oso"i mc"may'nw' (Please remad the irntaschons on the co,*er sheet before compretog this torrn.)

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2. TMOF REPORT 3-

'" Y""' #I Duke Engineering and Servicco REV1580N CLARIFICATION Apodss or ucENsEh (weer emen er wiw mas on en.re wesse may to We*U y

4 s icENm coNiacT Duke Engineering and Services James E. Rohrbacher (ILS0) 580 Main St.

Bo1 ton, MA 01740

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'- L^",,,,"Pe"C",i" (non netnehAdi (978) 568-2545 (978) 568-2510

8. ACTIVIMS TO DC CONDUCTED IN NON AGREEMENT STATES UNDER THE GENERAL UCENSE GIVEN IN to CFR 150 WELL t[bQGtt40 LEAX TESTING AND/OR CALfBRATIONS TgtgTHERAPY/nARADIATOR SFRVICE Q THt.M (& cup)

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X See 8ttached claElf1 Cation supplement TMAHE80RTAr10N QA PROGHAM ANNOVAL NO. e RCV Nr)

REG 6STERED A$ l)9ER OF PACKACf 4GC (CERTir'ICATES OF COMpuAACE NOS )

e CUFNT Nwl', ADDRE SS, CIT ffCOUNTY, ST ATE, ZIP CODE to WORKLOCAT10N ADOR553 (steef end Nwnearceour firetime. Ike es wnes, e.,mn a s,mn, en rac See initial filing of Form 241 See attached clarification supplement 4

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16. LOCATION REFERENCE NUMBER
14. DATES SCHEDULCD LEAVE OLAM FdR lNMAL NRC FORM 241 RLOVt 513

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FROM TO NUM9iA To GE AblGHED By tptC See See attached See attached OO%E attachec U3T ADDITIONAL WORK SITES ON SEPARATE SHFET TO INCLUDE ALL INFORMATION CONTAINED IN ITEMS 918 ABOVE,

17. U$l R@,sAGTIVE MATEkiA. WHICH WILL.DE FW%.w%ED,ew m,INb.i ALLBu. butvM.e i, 4H Mit D IN esuNMmMDsF & mig, U.n U5EU 6

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Lit.tNac trauhR ATATE direoNvA e twL v;Anc ons r0 DArE 14-5911 Massachusetts September 30, 2004 19, CERTlflCATION (MUSTBE CCMPLETFD 8Y APPUCANT)

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l. THE UNDERtGNED,HEREBY CERTIP Y THAT:

All en%rmation in this report is inse and complel4, g

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i have feed and understand the provtsson of the Denerallecense to CFR 150.20 reprinted on the cover sheet of this form set; and Iunde to commy wnh ih*9e provisions as to all byptusfuct, source, or traciel nuclear rnalerial which t possess and vee in non-Agenoment Statet or o b

under the general faense for wh>ch this repevi es Gled vnth the U.S. Nuclest Reguletery Cemenisswt I understand that adMiins,includmg storage, conducted in non. Agreements 51eles under general license 10 CFR 150.20 are timele e.

es' ender year.

I understand thei 1 may be impacted by NRC el the atae hsted worit site locations and at the Licei6ee horne office a-JJress for activities non-Ayeement $tates or oftshore waters, I am W$o aware that I wul be responsite for any fees sasoc.ved with such inspMoas, d

j I undersund thei cunduce of arv octraties not deoonbod above 6ncludmg condvet or erwties on dates or locauons d#erent from tt.ote describe w

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without NRC authorestion, may sutieet rne to enforcement actirn incksdino dvif or criminal penethes ID 0A4 MsMTWii

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A*l 37 H GAlifitN()Ns%R e R$C er MersegemWitepresentahw [f yre64tirled Name sad rsteef at James E. Rohrbacher RSO

~BE SUBJECT TO CIVit, AND/OR CRMNAL PENALTIES. NRC REGUI.AllONS REQUIRE THAT WArtrilhG. P AI,EE STATEMENTS IN THIS CERTIFICATE MA Sut%9:*a.ONS TO THE P4RC et COMPLETE AND ACCURATF IN AlL MATER 1AL RESPECT $.18 (J MAKE A WufulLY FALSE STATEMENT OR REPRESENTATON TO AffY DEPARYtAENT OR AGEr4CY O ITS JURnOiCTION D^ 4 Ap.oCNG CFFIOAL (Typsm nw hme and l* J MMURE 1 F N1 Y M1M N6b

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p' m NE05 RETURN TO REGION I

. APR-30-03 FRI 8:55

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I SUPPLEMENTAL SHEET TO l

NRC FORM 241 CLARIFICATION REPORT pstm April 30,1999 l

Ileensce: Duke Engineering and Services License: Commonwealth of Massachusetts Materials License 14-5971 Facility and nersonnellocated:

Environmental Laboratory 25 Research Dr.

Westboro, MA 01581 j

Item Sa The licensec will perform the following activities in non-agreement states:

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Perform field (in-situ) gamma measuiements j

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Item 9:

Client : ControlNumber 000685 Connecticut Yankee (Haddam Neck) 362 Indian Hollow Rd.

Ifaddam Neck, CT 06424 Item 10:

The work will be taking place off site of Connecticut Yankee for site characterization and decommissioning activities.

Item 11:

The client contact will be Pete Hollenbeck and he can be reached at (860) 267-2556 cxt

3805, Item 12:

The individuals performing the work have not been finalized, but all the authorized individuals were listed on initial application.

Rem 13; l

i APR A FR1 8:5E._.

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%e work location's cellular number (508) 849-7911 Items 14 The work was initially scheduled to be performed on May 3 through May 15.

Item 15:

The total work duration should be 13 days.

I J.lfm 16:

Reference location 000685 Item 17:

The railioactive material to be used by the licensee will consist of-Am-241 0.2 uCi Co-60 0.4 uCi Cs-137 9.7 uCi I