ML20212C872

Matls Licensing Package for Amend 26 to License 50-14102-01 for State of Alaska Dept of Transportation & Public Facility.Control:467330

ML20212C872
Person / Time
Site:	03007710
Issue date:	09/02/1999
From:	Gaines A NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV)
To:
References
467330, 50-14102-01, NUDOCS 9909220179
Download: ML20212C872 (18)

See also: IR 05000141/2002001

Text

{{#Wiki_filter:e 4 - u.S. NUCLEAR REGULATORY COMMtsslON Amendment No. 26 MATERIALS LICENSE l Purzuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code 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, 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 rpplicable Part(s). This license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, ts Emended, and is subject to all applicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions spec.'ied below. ucensee in accordance with letters dated August 23,1999, and September 2,1999 1. State of Alaska 3. Ucense number 50-14102-01 is amended in i Dept. of Transportation & Public Fac. nRF les gir,ety to read as foiiows: - 2. Headquarters Materials , . \\[ 4. FYpiM/ date July 31,2001 .jJ 5. Docket No%p07710 5800 E. Tudor Road Anchorage, Alaska 99507-1225 Reference No. Q 6. Byproduct, source, and/or special)') 7. Chemical and/or physical form 8. mum amount that licensee may possess at any one time under this nuclear material Q. s , N license A. Cesium-137 A ,Se M o Not to exceed 10 - D- 'i , - (Tr[xl,er Dw millicuries per source ._ D ' 0;cnk ~@ , K. ggfi:f &" Sealed neut < N Not to exceed 50 ,/ [[$ B. Americium-241

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N millicuries per source , ources ( ler b /& -102451 C h jheu [,, \\o C. Americium-2/1 d , , , ' C. Not to exceed 330 s s/(Troxler Dw millicuries per source No. -100337 5 Revision Bk h , )N D. Americium-241 D. Sealed sources D. Not to exceed 100 (Troxler Dwg. No.A- millicuries per source 100608) E. Cesium-137 E. Sealed sources E. Not to exceed 10 (Campbell Pacific millicuries per source Nuclear Model CPN- 131) F. Americium-241 F. Sealed neutron F. Not to exceed 50 sources (Campbell millicuries per source Pacific Nuclear Model CPN-131) O G. Americium-241 G. Sealed neutron G. Not to exceed 50 sources (Campbell millicuries per source 9909220179 990902 Pacific Nuclear Model PDR ADOCK 03007710 CPN-131) C PD ~ ,R ML40 , . . . i 0FFIClaf_ prcnon ennv .

. . NRC FORM 374A u.S. NUCLEAR REGULATORY COMMISSION PAGE 3 of 5 PAGEs Ucense Number 50-14102-01 MATERIALS LICENSE DxM or Reference Number SUPPLEMENTARY SHEET 030-07710 Amendment No. 26 6. Byproduct, source, and/or special 7. Chemical and/or physical form 8. Maximum amount that licensee may nuclear material possess at any one time under this license H. Cesium-137 H. Sealed sources H. Not to exceed 11 Humboldt Scientific, millicuries per source Inc. Dwg. No. 220064 D [ 0 f~'B H E rs , A 1 Sealed sources'f f 1. Not to exceed 44 I. Americium-241 . C Humboldt Scientific,f millicuries per source ! inc. Dwg. No 220067 / . 4 (q J. J. Califomium-252 J. Sealed neutron Not to exceed 66 D sources Troxler Dw ' . , microcuries per source /4/ (5 No.105560 ~ ., K. Califomium-25 Sealed peutr'o 1;) k Not to exceed 100 l ' sopsfroxlNyidO58,62 f ,Dwg.

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microcuries per source e ,,, h ' i m 6- @ ,h,ck 31!tiEl .b ' < / , ' I,p$' d 4/ 9. Authorized use g* - ' e ' i , ,g i f' t il A. For use in Troxler Model 45 od 4640 t 'lu% surg ropert es o ma er a s. s( ~ , A. and B. For use in Troxle{Pjodel 340 eri construction materi'als) W , ,1 C. For use in Troxler Model 2,226 or 32'41 gauges to measure arphalt content of construction materials. , D. For use in Troxler Model 3241 Series gauges to measure asphalt content of construction materials. E. and F. For use in Campbell Pacific Nuclear Model MC Series gauges to measure properties of construction materials. G. For use in Campbell Pacific Nuclear Model AC-2 gauges to measure properties of construction materials. H. and I. For use in Humboldt Scientific, Inc. Model 5001 series gauges to measure properties of construction materials. J. For use in Troxler Model 3400 series gauges to measure the properties of materials. K. For use in Troxler Model 3242 asphalt content gauges to measure properties of construction materials.

. . NRC FORM 374A U.s. NUCLEAR REGULATORY COMMISSION PAGE 3 of 5 PAGEs Ucense Number 50-14102-01 MATERIALS LICENSE DwM or Reference Number 030-07710 SUPPLEMENTARY SHEET Amendment No. 26 CONDITIONS 10. Licensed material may be used at the licensee's facilities located at 5800 East Tudor Road, Anchorage, Alaska; 2301 Peger Road, Fairbanks, Alaska; Mile 7 Old Glacier Highway, Juneau, Alaska; and may be used at temporary job sites of the licensee anywhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdictiogor regulating the use of licensed material. Qb ' ' C G j, Licensed material shall onlyt yused by, or under the s(0pervision of and in the 11. A. b individuals who have received the training described in lettePdated September 2,1999. Vfficer for this license is Robert L. Farmer.O \\ g j B. The Radiation Safet C. Before assuming tM/dutiQnd r ponsibilities as RS fdhlicen'sh, future RSOs shall have successfully completed one 'qf th. ning courses (je bed in Criteriain Section 8.8 of NUREG- 1556, Volume 1 dated May 1997.; < MCM E9. /)* L x ? :.: O j ' Sealed sources ab detect r eks s IMbd or ikdge.and/or coltamination at intervals not i 12. A. to exceed 6 monthYor at er liiterfdislia." sec} e certificate of registration referred to l - f' [_'h}. j[l ' * in 10 CFR 32.210.m ,~ v

- rn A shall be tested for leakage a(nty aM,, ces designed to emit alpha particles Notwithstanding Paragraph l se B. , gR f '"/l ais not to exceed 3 months. ntam () ~

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L , In the absence of a certific5fe from a transfer $ indicating that)a leak test has been made within C. 6 months prior to the transfer, a sealed source or, detector cell received from another person shall not be put into use until tested. ' ~ !r 4 ' D. Sealed sources need not be lesk tested if: (i) they contain only hydrogen-3; or (ii) they contain only a radioactive gas; or (iii) the half-life of the isotope is 30 days or less; or i (iv) they contain not more than 100 microcuries of beta and/or gamma emitting material or not more than 10 microcuries of alpha emitting material; or (v) they are not designed to emit alpha particles, 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 or detector cell shall be store? for a period of more than 10 years without being tested for leakage and/or contamination.

. NRC FORM 374A u.s. NUCLEAR REIULAToRY Commission PAGE 4 of 5 PAGEs License Number 50-14102-01 l MATERIALS LICENSE D det w Refece Nunce 0.30-07710 SUPPLEMENTARY SHEET Amendment No. 26 E. 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 j 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 P (z rip Suite 400, Arlington, Texas 76011, ATTN: Directer, Division of Nuclear Materials Safg.m eportThbt cify the source involved, the test results, and corrective action taken. F. The licensee is authoriz'ed o collect leak test samples for analy isyy Troxler Electronics Laboratory or Microtec Services Alternatively, tests for leakage and/or contami, nation may be performed by persons specifically licensed _by the Commission or an Agre ent State to perform such services. , 14 % ., ,y " 13. Sealed sources or detector cells nt f @/Plicensed matp pW shall not be opened or sources removed ^ l'E from source holders byjhe license \\,i ...:1 0 3 1 , - 14. The licensee shall conduct a ph si 3 nthjto, account for all sources and/or devices , , received and possess'e'd unde ~ MW / / ,[ QF 7 - r m 1>; 15. Each portable gauge s all hav rjocked taine esigned' t6 prevent unauthorized or n. The jauge or its container must be accidental removal of the' sealed ield si m{ct surveillance of an authorize locked when in transport, storage, nw, r o- u s 16. Except for maintaining labeling as required by 10tFR Part 20 or 7.,1, the licensee shall obtain authorization from NRC before makingny changes irl the,g'as indicated in the respecti ated source, device, or source-device combination that would alter the descriptio r specifications Registration issued either by the Commission pu'rs'uant to 10 CFR 32.210 or by an Agreement State. 17. The licensee may remove the source rod from portable gauges for the purposes of cleaning, maintenance, or repair of the gauge (s)in accordance with procedures outlined in letter dated February 15,1991. 18. 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." 19. The licensee shall not use sealed sources or probes containing sealed sources at depths exceeding 3 feet below the surface. 20. In addition to the possession limits in item 8, the licensee shall further restrict the possession of licensed material to quantities below the minimum limit specified in 10 CFR 30.35(d) for establishing decommissioning financial assurance.

_ _ _ _ _ _ _ _ _ - - - _ _ _ _ _ _ _ - _ _ _ _ _ _ _ - _ _ _ _ _ _ _______ . NRC FORM 374A u.s. NUCLEAR RE2uLAToRY CoMMISsloN PAGE 5 of S PAGEs License Number 50-14102-01 MATERIALS LICENSE W or Reference Number ~ SUPPLEMENTARY SHEET 030-07710 Amendment No. 26 21. Except as specifically provided otherwise in this license, the licensee shall conduct its program in accordance with the statements, representations, and procedures contained in the documents, including any enclosures, listed below. The Nuclear Regulatory Commission's regulations shall govem unless the statements, representations, and procedures in the licensee's application and correspondence are more restrictive than the regulations. .a Dp Letter dated May 31,1991 y*~ '

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' - C- [j(, A. Letter dated February 15,1991 C, ' B. 4 C. Letter dated June 10,199,1[ i ,. D. Letter dated October 5-1992 ri E. Letter dated May 28,1997 ' ',#, e F. Letter dated Septerntidr 18J997 , G. Letter dated OctobM.30,19Q8% ^ H. Letter dated February 25,1999 /.. ' 1 < , . ' y ' k% .}. 3 ,-

- m , I a o ~ , FOR THE U.S. NUCLEAR REGULATORY COMMISSION ~ )- b D:te WD 9 looo By ~~ ~- Anthony D.Kaines, Health Physicist Nuclear Materials Licensing Branch ' Region IV Arlington, Texas 76011 .

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g* "*% uNrTED STATES '

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NUCLEA' t REGULATORY COMMISSION - .f, REGK)N N ~% % l ,8 61b RYAN Pl.AZA DRNE, SulTE 400

A,RLINGToN, TEXAS 76011 8064 September 2,1999 State of Alaska Department of Transportation & Public Facilities Headquarters Materials ATTN: Robert L. Farmer Radiation Safety Officer 5800 E. Tudor Road Anchorage, Alaska 99507-1225 i SUBJECT: LICENSE AMENDMENT Please find enclosed Amendment No. 26. to License No. 50-14102-01. You should review this license carefully and be sure that you understand all conditions. If you have any questions, you may contact me at (817) 860-8252. NRC expects licensees to conduct their programs with meticulous attention to detail and a i high standard of compliance. Because of the serious consequences to employees and the public that can result from failure to comply with NRC requirements, you must conduct your radiation safety program according to the conditions of your NRC license, representations ' made in your license application, and NRC regulations. In particular, note that you must: 1. Operate by NRC regulations 10 CFR Part 19, " Notices, instructions and Reports to Workers: Inspection and Investigations," 10 CFR Part 20, " Standards for Protection l Against Radiation," and other applicable regulations. 2. Notify NRC in writing of any change in mailing address. ) I 3. By 10 CFR 30.36(b) and/or license condition, notify NRC, promptly, in writing, and request termination of the license; a. When you decide to terminate all activities involving materials authorized under the license; or b. If you decide not to complete the facility, acquire equipment, or possess and use authorized material. 4. Request and obtain a license amendment before you: a. Change Radiation Safety Officers; b. Order byproduct material more than the amount or form authorized on the } license; c. Add or change the areas or address (es) of use identified in the license application or on the license; or d. Change the name or ownership of your organization. 5. 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.

= . 4 s , 2- In addition, please note that NRC Form 313 requires the applicant, by signature, to verify that j the applicant understands that all statements contained in the application are true and correct { to the best of the applicant's knowledge. The signatory for the application should be the i licensee or certifying official rather than a consultant. NRC will periodically inspect your radiation safety program. Failure to conduct your program according to NRC regulations, license conditions, and representations made in your license application and supplemental correspondence with NRC may 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. Thank you for your cooperation. , l Sincerely, c Y ' - Anthony D Gaines i Health Physicist Nuclear Materials Licensing Branch Docket: 030-07710 License: 60-14102-01 Control: 467330 Enclosures: As stated

. . Y, -3- DOCUMENT NAME: P:\\coveritr\\50-14102.1cl To receive copy of document, indicate in box: "C" = Copy wthout endoeures "E" = Copy wth endosures "W' = No copy RIV:NMLB ADGaines 8 9/2/99 ) OFFICIAL RECORD COPY ., i

. p , . ' - . . . . .2 ua o - Tour xNours, sov5 won A A 6 6 . _ o 2 DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES 5000t TuoanRoAD STA Tin @E DENQN & BVQhEBING SBW3CES DIVislON ANCHOMAGL ALASxA 906071225 NEADQUARTBt3 ACATERIALS (907) 269-6230 (FAX 269-6221) Unites States Nuclear Regulatory Commission Region IV Harris Tower 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-8064 June 17,1999 Attn: Charles Cain Branch Chief-Licensing i Re: Amendment to license 50-14102-01 Dear Mr. Cain: Please amend the following State of Alaska, Department of Transportation /Public Facilities Materials License: License Number 50-14102-01 Docket Number 030-07710 Amendment Number 25 To amend item to read: 11. A. Licensed material shall be used by, or under the supervision of and in the physical presence of, Patrick H. Harmon, Maureen Lee, Robert L. Farmer, or personnel who have successfully completed the training program as described below: j 1. State of Alaska, Department of Transportation /Public Facilities Nuclear Gauge Training Course. ' 2. Troxler Electronics Corp. Nuclear Gauge Training Course. 3. Great Northern Densometer Training Course (letter from NRC ' attached). E 467330 @[F[lW7fi%f [] g. - - V DNMS l

, . . .. . - . . 4. Any training course listed by the NRC as qualified for instruction for operators of moisture-density and asphalt content gauges. Should you have any questions, or comments please contact me at (907) 269-6246. Sincerely, MW- Robert L. Farmer, R.L.S. Statewide Radiation Safety Officer , Cc: Eric G. Johnson, P.E. RLF/rlf

UNI [ED STATES o, ' 8 ' t, NUCLEAR REGULATORY COMMISSION g WASHINGTON. D C. 205$5 , %, ...../ APR 2 41990 430!a Great Northern Densometer . .c ATTfh Mr. Jerry Roa'ch ' ,f 2572 Collie Hill Way Anchorage, Alaska 99504 Gentlen'en: /, We have evaluated your request dated l' arch 7,1990, to be listed as a qualified instructor'fo.r operators of moisture-density and asphalt content gucges containing license material, and find your proposed course acceptable. This acceptance is based on the following conditions: , 1. That the course instructor shall be fir. Jerry Roach". 2. That the course outline as described ir. letter dated March 7,1990 shall be followed, and 3. That a passing test score of your proposed test shsil,be 75 percent. , If you have any questions on this matter, you may contact the undersigned directly on 301-492-3416. Sincerely, 7WPf - . Michael A. Lamastra, Section Leader Commercial Section Medical, Academic, and Consnercial Use Safety Branch Division of Industrial and Medical Nuclear Safety, HMSS . Ib 467330

r . . m a m - TOwyKNoness, eovBauan A A A A d_ _a _ _ DEPARTMENT OF TRANSPORTATION AND PUBUC FACluTIES E000 E. TUDOM ROAD STATEn9EDRENW & BVGNEB9NG BBMMS DMB40w ANCHORAGL ALASKA 90E071226 NEADOUARTBt3 ACA195tALS (907)260-8230 IFAX2004231) Unites States Nuclear Regulatory Commission ' Region IV Harris Tower @~lg 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-8064 August 23,1999 Attn: Charles Cain Branch Chief-Licensing Re: Amendment to license 50-14102-01 Revised 8-23-99 Dear Mr. Cain: ) On June 17,1999 a (attached) letter from S' tate,of Alaska, Department of Transportation /Public Facilities was forwarded to you requesting an Amendment to: ) License Number 50-14102-01 i Docket No. 030-07710 Amendment #25. Please be advised that I request that the aforementioned June 17,1999 letter be withdrawn for item 1 to 4, and that the following contents of this August 23,1999 letter be considered a request to change License Number 50-14102-01, to Amendment #26 in accordance with NUREG-1556, Volume 1. To amend item Number 11 to read (Begin Statement): State of Alaska, Radiation Safety Officers shall conduct all operations in accordance with NUREG-1556, Volume 1, Item 8 and Appendix D. "Before obtaining licensed materials, the proposed Radiation Safety Officer (RSO), 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

. . ' Consolidated Guidance about Material Licenses: Program-Specific Guidance about Portable Gauge Licenses,' dated May 1997"; and "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) Respcasible for Radiation Safety Program and Their Training and Experience - Radiation Safety Officer' in NUREG-1556, Volume 1, ' Consolidated Guidance about Material Licenses: Program Specific Guidance about Portable Gauge Licenses,' dated May 1997. (End of Statement) Should you have any questions, or comments please contact me at (907) 269-6246. . Sincerely, w/ Robert L. Farmer, R.L.S. State Radiation Safety Officer Cc: Eric G. Johnson, P.E. RLF/rlf , .

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mm. _ i ) SEP -21999 u j u FACSIMILE TRANSMITTAL FORM State of Alaska

5 Department of Transportation and Public Facilities - Statewide Design & Engineering Services Division

Headquarters Materials or a. 5800 E. TUDOR ROAD ANCHORAGE. ALASKA 99507 1225 TELEPHONE: (007) 260-6230 FACSIMILE: (907) 269-6231 DATE: _ ~77 h PAGES (INCLUDING COVCR SHEET) TO:

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F SEP-02-99 THU 10:21 HQ MATERIALS FAX N0, 92690231 P.02/03 ' ' " " " * * * ' * * * * q : - 7 =~ : c . -. -- 7 q ,n - ' ,' ' ~'

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s Q2 b _ ;_- . _ _ - [ O:) ." I _,$ .. . ' @ -. DEPARThetNT OF TRANSPORTAT60N AND PUBUC FACluTES , 5000 E. TUDOMRCAO , sva rtmne sterew a menenneve samcss omsmu Amwonnac ALAsxa sesor.122s , wAoovaarnes mreuus tsonsesssse FAxseatssn Unites States Nuclear Regulatory Commission Region IV m- -- - Harris Tower 611 Ryan Plaza Drive, Suite 400 Arlington, TX 760118064 gp 21999 September 2,1999 ' i Mtm Tony Oaines Charles Cain Branch Chief Licensing Re: Amendment to license 50-14102-01 requested June 17,1999. Letter dated August 23,1999 requesting a revision 6 letter dated June 17,1999. Letter dated September 2.1999 requesting a revision to letter dated August 23, 1999. Dear Mr. Cain: Please revise the State of Alaska, Department of Transportation'Public Facilities request for a Amendment to License 50-14102-01, requested June 17,1999, revised August 23, < 1999 ttnd revised this date, September 2,1999 by the addition of the following statement: "Before using licensed materials, authorized users will have successfully completed one of the training courses described in Criteria in the section entitled ' Training for Individuals Working in or Frequenting Restricted Areas' in NUREO-1556, Volume 1 ' Consolidated Guidance about Materials Licenses: Program-Specific Guidance about Portable Gauge Licenses.' dated May 1997." State of Alaska, Department of Transportation /Public Facilities is licensed by the U.S. Nuclear Regulatory Commission as: License Number 50-14102-01 Docket No 030-07710 Amendment #25.

SEP-02-99 THU 10:22 HQ MATERIALS EAX NO. 82698231 P.03/03

.. Should you have any questions, or comments please contact me at (907) 269-6246. Sincerely,L _, _ _ _ - Robert L. Farmer, R.L.S. {7~7r- m w-~~ _._ . State Radiation Safety Omcer

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- , . NRC FDRM 577 U.S. NUCLEAR REIULATORY COMM2SION . ATTN: RITA MESSIER 301415 4067 U.S. Nuclear Regulatory Commission LICENSE FEE REQUIREMENTS Ucense Fee and Accounts Receivable Branch P. O. Box 964514 St. Louis, MO 83196 4514 TYPE OF ACTION NEW LICENSE RENEWAL OF LICENSE STATE OF ALASKA Q AMENDMENT TO LICENSE DEPT. OF TRANSPORTATION & PUBLIC FACILITIES A*ITN: ROBERT L FARMER, R.LS. REQUESTED DATE RADIATION SAFETY OFFICER 06/17/1999 5800 E. TUDOR ROAD LICENSE NUMBER ANCllORAGE, AK 99507-1226 50-14102-01 CONTROL NUMBER 467330 L APPLICATION FEE DUE IL FEE NOT REQUIRED Your request for a licensing action is subject to the fee (s) in the category (ies) Check Enclosed is your check which noted below in accordance with Section 170.31 of 10 CFR Part 170. Number accompanied your request. The Payment of the fee is required prior to the issuance of the license, renewal, or fee is not required because: amendment. Check We received your check listed in gb APPLICATION RENEWAL AMENDMENT Number payment of the fee. 3P s s s 340.00 $ 5 5 Date of The Licensing staff has informed Request us that your request is to be g g g Control considered as a continuation of the $ $ $ Number request listed. S S $ $ $ 5 Date of Your request was combined, prior g g g Request to review, with the request listed. 5 $ $ Control 8 5 5 Number S $ $ lit. CHECK RETURNED FEE (s) DUE s 340.00 Check Enclosed is your check which was PAYMENT RECEIVED $ Number retumed to us by the bank for: AMOUNT DUE $ 340.00 INSUFFICIENT FUNDS Q Your request was received without the prescribed application ACCOUNT CLOSED OTHER ] We received your check listed below. Payment of the additional fee MAIL THE REPLACEMENT CHECK TO THE ADDRESS LISTED AT THE Check Number noted above is required. TOP OF THIS FORM AND REFERENCE THE ABOVE CONTROL $ Amount NUMBER. 1 Your request will increase the scope of your license program. IV. LICENSE ISSUED WITHOUT THE REQUIRED FEE Therefore, your request is subject to the application fee (s) noted above. License The listed license was issued Refer to Section 170.31 and Footnote 1(d)(2). Number without the required fee being nd nt collected. The fee required is Your license expired prior to the receipt of your application for renewal. Therefore, your request is subject to the application fee (s) noted above. Date Refer to Section 170.31 and Footnote 1(a). Issued

MAKE PAYMENT OF THE FEE (S) TO THE U.S. NUCLEAR The scope of your licensed program was increased. Therefore, your REGULATORY COMMISSION AND MAIL THE PAYMENT TO THE request is subject to the application fee (s) noted in Section 1 of this form. ADDRESS LISTED AT THE TOP OF THIS FORM. IF WE DO NOT Refer to Section 170.31 and Footnote 1(d)(2). RECEIVE A REPLY FROM YOU WITHIN 30 CALENDAR DAYS FROM THE DATE LISTED BELOW, WE SHALL ASSUME THAT YOU DO NOT Because of the urgency of your request, the license was issued without WISH TO PURSUE YOUR APPLICATION AND WILL VOID THIS remittance of the prescribed fee noted in Section 1 of this form. ACTION. SIGNATURE - UCENSE FEE ANALYST LFDCB l LFDCJ Distnbution: Pending Cy REMessier P OC/DAF/LFARB S/F (LF-3.2.7) RITA MESSIER 7n/99 't Ob/Q N cc: RegionIV 07/07/1999 ' NRC FORM 577 (5-1998) PMAED oN RECYCLED PAPER This form was designed using informs j }}