ML21022A182
| ML21022A182 | |
| Person / Time | |
|---|---|
| Site: | North Anna  |
| Issue date: | 12/31/2020 |
| From: | Mladen F Dominion Virginia Power, Virginia Electric & Power Co (VEPCO) |
| To: | Office of Nuclear Material Safety and Safeguards |
| References | |
| 20-454, GL-700115-26 | |
| Download: ML21022A182 (11) | |
Text
Vm.GINIA ELEc:rruc AND PoWER CoMPANY RICHMOND, VIR.GINIA 23261 December 31, 2020 pir~qtor, ~~
qf N1:1clear Materi~I Safety an~ Saf~4~rc:!$
ATTN: Qocume11t Cor,trol Desk/GLTS l.). ~- Nucle~r R~gu!atory Commi~iori
\\/yai;hi,-igton, DC 20555,-0001 Serial NP:
70-4?4 NAPS/DPM Docket Nos. 50-338/3~9 License Nos. NPf-4/7 VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)
'NORTH ANNA 'POWER STATION UNITS 1 AND 2 ANNUAL RE:GISTRA TION OF GENERALLY LICENSED DEVICES r*
.Ill ?tCco,rdance with 10 GFR 31.5, ~nclosed is NRG Form 664, General !-i~nse R~i~trij~ipr:1 1 for r~gistra,tion of ~~f1erally licensed devi~s maintained ~t Nort~ Anna Power Station.
If you have a,-iy que~tions, please C9ntact Mr. G. R. Simmons at (540) 8~4-?107.
Sincerely)
Fr~ Mlac:1.er, Sit~ Vice. President Enclosur~
Commitments made in this letter: None.
I
~
cc:
U. S. Nucl~ar Regulatory Commission ATTN; DocU,ment Control pesk Wa~hingtql'1, pc ~0555-0001 U. S. Nuclear Regulatory Commission R~gion II
~~rqyis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atla11t~ µ~orgia ~0303-1 g57
- NR,C $enior R~si<;l~llt !n~pector North Arina Poy.,er ~H9tjon
TO:
SUBJECT:
UNITED STATES NUCLEAR REGULA TORY COMMISSION WASHINGTON, D.C. 20656-0001 November 30, 2020 Users of Devices Subject to General License Registration ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices. Information about the general license registration program is available NRC website:
http://www.nrc.gov/materials/miau/general-use/toolkit.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:
Director, Office of Nuclear Material Safety and Safeguards ATTN: Document Control Desk/GL TS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: Commission regulations (10 CFR 170.31, Category 3Q) require that you submit a registration fee with each registration on an annual basis. The registration fee is subject to change yearly, and you are required to submit the fee that is in effect as of the date of this letter. An invoice for the current amount due will be sent to you under separate cover. If you have any questions about the fee or the invoice, please contact the License Fee Billing Help Desk at 301-415-7554 or e-mail at fees.resource@nrc.gov.
NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.,
Attachment:
NRC Form 664 - General Licensee Registration and Instructions I,
Sincerely,
~ Dlgltally signed by Donald B.
Donald B. Lowma~~man
(:1 Date: 2020.11.19 15:44:48 -05'00' U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials Safety Licensing and Tribal Liaison Branch r
INSTRUCTIONS FOR COMPLETING NRC FORM 664 "GENERAL LICENSEE REGISTRATION" Review all six sections of this registration form. If any information is incorrect or missing, make corrections in the applicable boxes. If you have more devices than space provided in the form, copy the form before starting, as needed. Use black ink and print in CAPITAL LETTERS. Start information in the first box provided. If the information contains a number with a dash(-) or a decimal point(.), include the dash or decimal point as an individual character. Use the "121" character to represent the number O (zero).
Verify information about the devices by reviewing the label on the outsjde of the device. For safety reasons, DO NOT TRY TO TAKE APART any device to verify this information. If you are uncertain how to identify the device's label, contact the device's manufacturer or an authorized service agent for this information. Also, contact the manufacturer for any additional information about NRC requirements. You may also review 10 CFR 31.5 and other applicable regulations on the NRC web site at http://www.nrc.goy/reading-rm/doc-collections/cfr/, or review specific information about the general licensee project at https://www.nrc.gov/
materials/miau/general-use/toolkit.html Note to specific licensees: If you believe the device(s) listed on the registration form are possessed under your specific license, then verify the device label does not state the device is subject to a general license. If the labels indicate the device is subject to a general license, then complete the registration form as instructed below. If not, complete the registration as instructed below, however, in Section 2, follow the instructions for "not in possession of deviceD and complete one Section 4 page per device transferred to your specific license.
Section 1 - General Licensee Information. Provide the requested information about you, the general licensee.
On Page 1, provide the street address/location where your device(s) are used. For portable devices, provide the storage location. P.O. Box addresses are not allowed.
Do not write in the box marked For NRC Use Only.
On Page 2, provide the name, business telephone number, business e-mail address and title of the individual responsible for your device(s), and a mailing address where correspondence about your device(s) can be sent.
The mailing address should be specific to the physical location where the devices are used and/or stored (P.O.
boxes may be used if this is the only available mailing address). The individual indicated in this section as responsible for your device(s) must also verify and sign the form In Section 5.
Section 2 - Devices Subject to Registration. This section lists each device subject to registration and in your possession, according to NRC records. Devices subject to registration include those containing at least one of the radionuclides listed in Table 1, with the activity indicated, at the time of manufacture.
Table 1. Criteria for R istration Radionuclide Activity greater than or equal to:
Strontlum-90 Radlum-226 Cobalt-60 Curium-244 Americium-241 and Californium-252 Ceslum-137 10 millicurie Use the codes from Table 2 when correcting isotope information for devices in this section. If you do not possess a device on this list, blacken the "not in possession of device" circle, and provide the relevant information in Section 4. Note that each device is assigned a unique six-digit number called the NRC Device Key.
Table 2. ls9tope Codes for Sections 2 and 3 Radionuclide Code for form Radionuclide Code for form Americium-241 AM241 Curium-244 CM244 Californium-252 CF252 Strontium-90 SR90 Cesium-137 CS137 Radium-226 RA226 Qobalt-60 CQ60 Section 3 - Additional Devices. If you have other generally licensed devices (not listed in Section 2) that meet the conditions for registration listed in Table 1, provide information about each additional device. Before starting, copy this section as needed for your additional devices. Also indicate how you acquired each device by blackening the proper circle.
When entering isotope and unit information for your device(s), use the codes listed in Table 2 of Section 2 for isotope information, and use the codes from Table 3 for unit information:
Table 3. Unit Codes for Section 3 Unit Code for form Unit Code for form oicocurie PCI becquerel BQ nanocurle NCI kllobecquerel KBQ microcurie UCI megabecquerel MBQ millicurie MCI aioabecquerel GBQ curie Cl terabecauerel TBQ POUnd LB microaram UG milligram MG kilogram KG gram G
Section 4 - Not in Possession of Device. Use this section to report any devices that are listed in Sections 2 or 6, but that you no longer possess. Before starting, copy this section as needed for additional devices that are not In your possession. Enter the NRC Device Key, as listed in Section 2 or 6. Blacken the circle (choose only one) that best describes the disposition of the device and complete the rest of the section as appropriate.
Section 5 - Certification and Signature. The responsible individual must certify, sign, and date Section 5.
Section 6 - Devices Not Subject to Registration. This list contains information about devices that NRC records indicate are in your possession, but are not subject to registration. If you no longer have one or more of the listed devices, you are required to make a transfer report to NRC in accordance with 1 O CFR 31.5 (c)(8) or (9), as applicable. You may use Section 4 for this purpose. This section does not list any static eliminators containing polonium-210 (Po-210), or luminous exit signs containing tritium (H-3). These devices are not subject to registration, and are not included in this section in an effort to reduce the length of this form.
RETURN THE COMPLETED FORM IN THE ENCLOSED ENVELOPE WITH PROPER POSTAGE.
11111111 1111111111111111111 11111111111111111111 111111111111111 IIII IIII I 11111111111111111 llll 111111111111111111 GL-700115-26 11/19/2020 SECTION 1 PAGE 1 of 2 NRC FORM 664 (11 - 2020) 10CFR315 U.S. NUCLEAR REGULATORY COMMISSION GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 0MB EXPIRATION DATE: 09/30/2022 Estimated burden per response to comply with this mandatory colJaction request 20 mmutes NRC WIii uea thlS mforma!Jon to track general licensees and thetr devices to ensure a higher level of davlC8 a=untab1hty Sand comments regarding burden estimate to the FOIA, Library, and lnformabon CollectJoos Branch (T-6 A10M), U S Nuclear Regulatory ComrTIJSSlon, Vllashmgton, DC 20555-0001, or by e-mail to lnfocollects.Resource@nrc gov, and the 0MB rev16W81' at 0MB Office of Information and Regulatory Affairs, (3150-0198), Attn Desk Officer for the Nuclear Regulatory CommlSelon, 726 17th Street NW, 'Mlshmgton, DC 20603; e-mail*
01ra sublJ}JSSIOn@omb eop gov The NRC may not conduct or sponsor, and a parson IS not required to respond to, a collecbon of 1nforma!Jon unless the document requestuig or requinng the collectJon d1eplays a currently va/Jd 0MB control number Complete all six sections of this registration form. tf any of the preprinted Information Is Incorrect, provide the changes in the appllcable boxes. USE CAPITAL LETTERS.
General License Registration Number tL'.!-~00.11.5i:)p'1 SECTION 1 - GENERAL LICENSEE INFORMATION Enter the company name and the street address for the physlcal locatlon of use for your device(s). For portable devices, specify the primary storage locatlon. Do not use P.0. Boxes.
Company Name:
DOMINION VIRGINIA POWER I I I I I I I I I I I I I I I I I I I I I-I' Department" NORTH ANNA POWER STATIO I I I I I I I I I I I I I I I I I I I I I Address Line 1:
1022 HALEY DRIVE I I I I I I I I I I I I I I I I I I I I,I I I I Address Line 2:
END OF ROUTE 700 I I I I I I I I I I I I I I I I I' I I I I I I l City:
MINERAL I I I I I I I I I I I I I I I I I I I I I I I I State:VA rn Zip Code: 231174527 I I J I I I - j I I.I I
11111111 11111111 11111111111 11111 1111111111 111111111111111111111111 IIII I 11111111111111111 llll 111111111111111111 GL-700115-26 11/19/2020 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)
SECTION 1 PAGE 2 of 2 Enter the name, telephone number and tltle of the person who is the responsible lndlvldual for the devlce(s).
Last Name: SIMMONS I_ I I I I I I I I. I I I I I I I 1* I f _ I I I I I First Name: GEORGE Middle Initial: R I I.. I I I. I I.
-.I I I I
.I
.I I D
- Business Telephone Number:
(540) 894-2107 Extension:
I I *1 II I.I ll I I. I r I I l 1* I -I Business E-mail Address:
litle:
RAD PROTECTION MANAGER I.I I I I. I I I I
- 1.
.I
,:1
- l.. I,I I 1*
I. I J l I t *1 Enter the mailing address where correspondence regarding your device(s) should be sent.
Department NORTH ANNA POWER STATION I I I I I I I I I I -*1
- 1 I
1* I I r-I I I I I I *1 Address Line 1:
1022 HALEY DRIVE I I I I I I I l I I I I I I I I I I I I I I I 1*
Address Line 2:
END OF ROUTE 700 I I I I r_
I~ I I.
I. I J.I I
I_
J.I I:* l I.I. l I I. I City:
MINERAL I_
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- 1 I I I I I I I I I I I I
- 1 I.I I I* l State: VA DJ Zip Code: 231174527 j
I I [ [ ;:. ] I I J [
1111111111111111 IIIIII IIIII 11111111111111111111 IIII 1111111111111111111 I llllllll llll 11111111111111111 GL-700115-26 11/19/2020 SECTION 2 - DEVICES SUBJECT TO REGISTRATION Our records Indicate that you have these devices. Please update the Information as neC8888ry.
NRC Device Key 595614 (Internal Control Number)
Distributor/Distributed By:
Metorex Incorporated r I I I I -.I I I I I I I l -I.
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1- _ J J J I 1
- 1-.,1 Distributor License Number:
29-30342-02G I
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- 1 1
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- 1
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Manufacturer name:
METOREX, INC 1
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I I I I r ! I I I I I I I f
1*
Device Model (Not Source Model): OOPS I I I I I I I I I 1-I I I r _ I I I *1 I I I_ I' I I_
Device Serial Number:
128018 I I I I I I I I I I 1 I I I I l
,- - I
- 1 I I I r -I Transfer Date:
08/12/1999 SECTION 2 PAGE 1 of 1
[I]ITJI I I' 'I I E] Not In possession of device (Also complete Section 4.)
MM DD YYYY Isotope (e.g. AM241)
Activity (e.g. 1005)
Unit (e.g. mCi) 1 AM241 30 mCI 111111 1111111111111
,-----,--11---.------,11 2
CD109 10 mCi I I I I I I I I I I I I I I I I I I I
.-----.--1 I ---.-----,I I 3
lr-----r-1-1 -1
---.-----,I I I I I I I I I I I I I I I I I I I 4
I I I I I I I I I I I I I I I I I I I I I I I 5
r-----r-1 1-..---1 -.-----,I I I I I I I I I I I I I I I I I I I 6
r-----r-1 1-..---1 -.-----,I I I I I I I I I I I I I I I I I I I
1111111111111111 11111111111 11111 IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII GL-700115-26 11/19/2020 I llllllll llll 11111111111111111 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION SECTION 3 PAGE 1 of 1 Provide information about other devices you have that are subject to registration. Do not report speclflcally llcenaed devices.
Manufacturer Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I
_I Initial Transferor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor License Number (if known)
I I I r I I I I I I I I I I Device Model Number (Not Source Model)
I I I I I I I I I I I I I I I I I I I I I I I I I I I I Device Senal Number I I I I I I I I I I I I I I I I I I I I I I I I I I How acquired and date (e.g.,
0 Manufacturer/Initial Transferor listed above
_,-,---,, r----i-,.----,
from a_ distributor/manufacturer, 0 Other General Licensee Date Transferred: [IJ,DJ I*. I J. I I other licensee, other source)?
- 1.
- 2.
- 3.
- 4.
- 5.
- 6.
- 7.
- 8.
- 9.
- 10.
Isotope (e g. AM241)
O Other Sources MM DD YYYY {
Activity (e g. 100)
Unit (e g. mCi)
I I I l I
11111111 11111111 11111111111 11111 111111111111111 IIII 111111111111111 IIII I llllllll llll 11111111111111111 GL-700115-26 11/19/2020 SECTION 4 - NOT IN POSSESSION OF DEVICE Provide infonnatlon about devices listed in Section 2 or 6, but no longer In your possession.
Part 1
.-------.--~~~
Transfer Date:
- ~c::nK;~:r6)
_I J _,
I I I I I
,l I tm I.
I I r MM DD YYYY Location of the Device:
SECTION 4 PAGE 1 of 1 0 Whereabouts Unknown (Complete Part 1 only) 0 Transferred to another general licensee (Complete Parts 2 and 3) 0 Never Possessed the Device (Complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) 0 Returned to Manufacturer (Complete Part 1 only)
(Complete Part 2)
Part 2 License Number of Recipient (if transferred to a specific licensee):
I r r I 1 I I I I I - -1 l *1 I
Company Name:
I I I I I I I I I I I I I I I, I I J I I 1-I I I I I I I Department I I I I I I r I I I I -, I I I -, I r I I I -, I I I I I I Address Line 1
- I I I I I I r I I I I I I I I I I I I I 1-I I
.I I I I Address Line 2:
I I I I I I r.,
I r I I I I I I -,
I J I I r r, _ I I I City:
r I r I ' I,- I I -,
I I I I I I 'I I I I I I r I I I I State: DJ Zip Code: I I I I I I - ~
I I I Part 3 Enter the name of the indivldual responsibe for this device:
Last name:
I I r I I I I *1 r I I I I I I I,- l I -, I I I I I I I I First name:
Middle Initial:
1*11111 *11111111 D
~~~:~ Telephone j_
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_J l I I I IJ I I J J Extension: ],------.,------1 1.-----,1__,l---,I
Title:
I I I I I r I I I I I I I 1*
1
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I 111111111111111 11111111111 11111 111111111111111 IIII IIIIII IIIII IIII IIII GL-700115-26 11/19/2020 I hereby certify that:
SECTION 5 - CERTIFICATION I llllllll llll 11111111111111111 SECTION 5 PAGE 1 of 1 A
All information contained in this registration is true and complete to the best of my knowledge and belief.
- 8.
A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.
C.
I am aware of the requirements of the general license, provided in 10 CFR 31.5.
(Copies of applicable regulations may be viewed at the NRC website at:
hrz. -~~~-9
-:g-nn/do<XOllections/cfi")
~ -----====
/,;1)7/4 I
SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1)
DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.
11111111 1111111111111111111 11111 1111111111 11111 1111111111111111111 IIII I 11111111111111111 111111111111 GL-700115-26 11/19/2020 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 1 of 1 NRC Device Key:
547351 Manufacturer License No:
MD-31-076--01 Manufacturer Name: CONCO SERVICES CORP.
Model Number: 101 Isotope* Nl63 NRC Device Key:
689428 Manufacturer Name: GE ION TRACK Model Number. ITEMISER Ill Isotope: Nl63 NRC Device Key:
707159 Manufacturer Name: METOREX, INC.
Model Number: 880 Isotope: CD109 NRC Device Key:
825331 Serial #:
N596 Transfer Date:
02/15/1994 Activity: 5 Unit mCi Manufacturer License No:
20-15525-048 Serial #:
09-8424 Activity: 10 Manufacturer License No:
Senal #:
128018 Activity: 10 Transfer Date:
06/30/2003 Unit mCi Transfer Date:
02/27/2002 Unit mCi Manufacturer License No:
12-04933-048 Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B310000 Isotope: BA 133 Serial #:
DG08129527 Activity: 20 Transfer Date:
07/20/2012 Unit:
uCi