ML20234C476

Application for Renewal of License SNM-515,authorizing Use of Pu-239 for Instrument Calibr &/Or Checking

ML20234C476
Person / Time
Site:	07000571
Issue date:	09/01/1987
From:	Dooley G INTERIOR, DEPT. OF, BUREAU OF MINES
To:
Shared Package
ML20234C421	List: ML20234C417 ML20234C439 ML20234C444 ML20234C461 ML20234C476
References
NUDOCS 8801060237
Download: ML20234C476 (2)

Text

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e NRC FORM 313 U S. NUCLEAR REGULATORY COMMISSION IS El 3 g,O,V,o APPR EDBYOMB 10 CF R 30,32,33,34, 35 'a*

• APPLICATION FOR MATERIAL LICENSE Es,,.. sin l

IN3TRUCTIONS: ME THE s,PPROPRIATE LICENSE APPLICATQN GUIDE FOR DETAILEO INSTRUCTIONS FOR COMPLETING APPLtCAtlON. SEND TWO COPIES OF THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIF!EO BELOW, FEDERAL AGENCIES FILE APPLK AtlONS WITH:

IF YOU ARE LOCATED IN; l

U.S. NUCLE AR REGULATORY COMMISSION IL UNOlt, WDI ANA, IOWA, MICHIG AN, HINNE86 f A, MISSOURA, OHlo, OR OlVISION OF FUEL CYCLC AND MATERIAL $AFETY,NMS$

WISCONSIN, $END A?PLICATIONS TO:

WASHINGTON, DC 20666 U.8 NUCLE AR REGULATORY COMM18SION, REGION ill 1

ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS,it YOU ARE M ATE RI ALS LICENslNG SECTION I

LOCATEDIN:

799 ROOSEVELT ROAD GLEN ELLYN,IL 60137 CONNECTICUT, DELAWARE, DISTRICT OF COLUM8tA. MAINE, MARYLAND, MAS $ACHUSETTS. NEW HAMP6 HIRE, NEW JERSEV. NEW YORK, PENNSYLVANIA, AR K ANSA 5. COLOR ADO, IDAHO, K ANSA.4, Loul8t A N A. MONT AN A, NE SR ASK A, 1

FnHODE 18&AND, OR VERMONT, SEND APPLICATIONS TO:

NEW ME XICO, NORTH DAKOT A. OK LAMOMA, SOUTH DAt;DT A. TE.XAS, UT AM, OR WYOMING, SEND APPLICATIONS TO, U.S. NUCLE AR REGULATORY COMMIS510N. REGION I NUCLEAR MATERI AL SECTION B U S NUCLE AR REGULATORY COMMISSION, REGLON IV 831 PARK AVENUE MATERIAL RADIATION PROTECTION SECTION KING OF PRU$$tA,PA 19406 611 RYAN PLAZA DRIVE.8UfTE 1000 ARLINGTON,Tx 76011 l

1 ALABAMA, FLORIDA, OEORQl A, KENTUCK V, MISSifl$lPPl. NORTH CAROLINA, PUERTO RICO, SOUTH CAROLINA. TE NidS$1E, VIRGINIA, VIRGlH t3(ANDS, OR ALAAK A, ARIZONA, CALIFORNIA, HAWAll, NEVADA, OR EGON, W A$HINGTON.

WEST VIRGtNIA, $END APPUCATIONS TO:

AND U.S TERRITORIES AND POSSESS 40NS IN THE PACIFIC, SEND APPLICATIONS TO:

U S NUCLE AR REGULATORY COMMISSION. REGION il MATERIAL R ADIATION 1ROTECTION SECTION U.S NUCLE AR REGULATORY COMut3SION, REGION V 101 MARIETTA STREET,SulTE 2900 MATERI AL RADIATION PROT ECTION SECTION ATLAN; A, GA 30323 1450 MARIA LANE, BulTE 210 i

WALNUT CREEK,CA 94696 l

i PE RSONS LOCATED IN AGREEMENT $T ATES SEND APPUCATIONS TO THE U.S. NUCLEAR REGULATORY COMMi&SION ONLY lF THEY WisH TO POSSESS AND USE LICENSED MATERIAL IN ST ATE 8 8U6 JECT TO U.S. HUCLE AR REQUL ATOR Y COMMl8830N JURl8 DICTION.

1. THIS 15 AN APPLICATION FOR (Chad appropreer fem)

2. NAME AND MAILING ADDRESS OF APellCANT fincludele Codel l

U.S. Department of the Interior A. NEW uCENSE

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Bureau of Mines i

B AMENDMENT TO LICENSE NUMBER SNM-515 1450 SW Queen Avenue l

C, RENEWAL OF LICENSE NVM86R Albany, Oregon 97321

3. ADDRES$1E$1WHERE LICENSEO MATERIAL WILL BE USED OR POSSESSED.

Bureauor Mines 1450 SW Queen Avenue Albany, Oregon 97321 l

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4. NAME OF PERSON TO DE CONT ACTED ABOUT THis APPLICATION TELEPHONE NUMSER i

Boyd D Nash FTS 420-5883 l

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$U8MIT ITEMS 5 THROUGH 11 ON $4 a 11" PAPER, THE TYPE AND SCOPE OF INFORMATION TO BE P810VIDED 18 DESCRIBED IN THE LICENSE APPLICATION GutDE.

5, RAOICACTIVE MATERIAL e Eiement and mess number, tt chemical and/or ohys. cal form, and a manimum amount 6 PURPOSpl$) FOR WHICH LICEN8ED MATERI AL WILL DE USED.

Which will be posset.ed 88 86V one time 7-fpg

8. TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED ARE A$.

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, AMOUNT 11,IWA$Te SNM-0515 PDR

,2. uCENsE E F EEusee,o CF R 90 end s-ren,ml, FEE CATEGORY l ENCLOSED $

13. CERTIFICATION (Must ce comp #ereder sophcent/ THE APPuuANT UNDERSTAND 5 THAT ALL ST ATEMENTS AND REPRESENTATIONS MADE IN TH18 APPLICATION ARE BINDING UPON TNE APPUCANT THE APPUCANT AND ANY OFFICIAL ERECUTING THilCERYlFICATION ON flEHALF OF THE APPLICANT,N AMED IN ITEM 2 CERTIFY THAT THIS APPUCATION 18 PREPARED IN CONFORMITY WITH TITLE 10 CODE OF FEDERAL REGULATIONS, PARTS 30,32,33,34,35, AND 40 AND THAT ALL INFORMATION CONTAINED HEREIN, 18 TRUE AND CORRECT TO THE BE$T OF THEIR KNOWt EDGE AND BELIEF.

i WARNING.18 U S C SECTION 1001 ACT OF JUNE 25,1948,62 STAT 749 MAKE81T A CRIMINAL OFFENSE TO MAKE A WILLFULLY F ALSE STATEMENT OR REPRESENTATION

'i TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES As TO ANY MATTER WITHIN 17$ JURISDICTION j

SIGN ATURE 4cHTiF YING OF F ICE R TYPED / PRINT ED N AME TITLE DATE 04ginst Signe<'

• GEORGE J. DOOLu..... George J Dooley III Research Director

$@ - l E Se VOLuteTARY l CONOWC DAT A a AW a PI CLIPTs o NUMBER OF EMPLOYEES (Torer for 6, WOULD YOU BE WILLING TO FURNISH COST INFORMATION (Joner end/or sestr nourst j <$260K

$1M,3 SM 8#'M fechfF sagludini opffide contractors)

ON THE bCONOMIC IMPACT OF CURRENT NRC REGULA1,0N5 OR ANY FUTURE PRO *0 SED NRC REGULATIONS THAT MAY AFFELT YOUP (NRC regular /onspermir 5260K#a00K -

f 3 SM-7M n re par mwnemmew w hnenceoween@mem WW M i

the enerry in confidences I"#8#

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PRIV ACY ACT STATEMENT ON THE REVER$E

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r Application for Material License (continued) l 1

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5.

Plutonium 239; Plated alpha standards; 2 micrograms 6.

To be used for instrnment calibration and/or checking.

7.

Boyd D Nesh completed a course in Radiochemistry at Idaho State University in 1958.

He also took the Radiation Safety Specialist training given by Oklahoma State University in 1980. He tas both a B.S. and M.S. degree in chemistry. He is currently the Safety Manager and RPO at tne Albany Research Center, Bureau of Mines, Albany, Oregon. He has been in these capacities for 6 years e 8.

Noone other than Mr. Nash is currently involved with.the radiation

program, 9.

Eberline survey meter, PRM-7; Eberline survey meter, E-530; Eberline survey meter PAC 4G-3; Eberline scaler, ratemeter ESP-1.

10.

The licensee shall comply with the provisions of Title 10, Chapter 1, Code of Federal Regulations, Part 19,"N otices, Instructions and Reports to Workers; Inspections" and Part 20, " Standards for Protection J

Against Radiation."

11.

Plated sources will be returned to the manufacturer or transferred to another licensee prior to termination of the license.

12.

Government licensee.

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