ML22088A150

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Enclosure 2: Doe/Nrc Form 742C NRC Physical Inventory Listing
ML22088A150
Person / Time
Issue date: 03/31/2022
From:
NRC/NMSS/DFM/MCAB
To:
M SHOEMAKER NRC/NMSS/DFM/MCAB 3014157363
Shared Package
ML22088A141 List:
References
Download: ML22088A150 (1)


Text

NRC FORM 742C (05-2021)

MANDATORY DATA COLLECTION AUTHORIZED BY 10 CFR 30, 40, 50, 70,72, 74, 75, 150, Public Laws83-703, 93-438, 95-91 EXPIRES: 02/29/2024 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 (05-2021)

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 FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0058), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17Street NW, Washington, DC 20503; e-mail: oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.