ML21075A334
| ML21075A334 | |
| Person / Time | |
|---|---|
| Issue date: | 03/18/2021 |
| From: | James Rubenstone NRC/NMSS/DFM/MCAB |
| To: | |
| MShoemaker - NMSS/DFM/MCA - 301.415.7363 | |
| Shared Package | |
| ML21075A325 | List: |
| References | |
| Download: ML21075A334 (1) | |
Text
NRC FORM 742C (04-2018)
MANDATORY DATA COLLECTION AUTHORIZED BY 10 CFR 30, 40, 50, 70,72, 74, 75, 150, Public Laws83-703, 93-438, 95-91 EXPIRES: 04/30/2021 U.S. DEPARTMENT OF ENERGY AND U.S. NUCLEAR REGULATORY COMMISSION PHYSICAL INVENTORY LISTING APPROVED BY OMB: NO. 3150-0058
- 1. NAME AND ADDRESS STREET ADDRESS CITY STATE ZIP CODE
- 3. INVENTORY DATE
- 2. REPORTING IDENTIFICATION SYMBOL (RIS)
- 4. LICENSE NUMBER(S)
- 5. BATCH DATA q.
PROCESS CODE a.
MATERIAL TYPE b.
COMP/FAC CODE c.
ELEMENT WEIGHT d.
ISOTOPE WEIGHT e.
DOE PROJECT NO.
f.
SCRAP PROGRAM g.
WEIGHT PER-CENT ISOTOPE h.
OWNER CODE i.
SEQUENCE NUMBER j.
BATCH NAME k.
NO. OF ITEMS l.
KEY MEASURE POINT
- m. MEASUREMENT I.D.
MEAS.
BASIS OTHER MEAS.
POINT MEAS.
METHOD n.
ENTRY STATUS o.
MBA p.
SITE IDC
- 6. TOTALS WARNING: FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.
- 7. SIGNATURE
- 8. TITLE
- 9. DATE To the best of my knowledge and belief, the information given above and in any attached schedules is true, complete, and correct.
NRC FORM 742C (04-2018)
Estimated burden per response to comply with this mandatory collection request: 2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br /> for small licensees and 6 hours6.944444e-5 days <br />0.00167 hours <br />9.920635e-6 weeks <br />2.283e-6 months <br /> for large licensees. This information is required by NRC to fulfill its safeguards responsibilities, bilateral agreements, and responsibilities as a participant in the US/IAEA Safeguards Agreement. Send comments regarding burden estimate to the Information Services Branch (T-2 F43), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0058), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.