ML22322A131
| ML22322A131 | |
| Person / Time | |
|---|---|
| Issue date: | 10/28/2022 |
| From: | Office of Nuclear Material Safety and Safeguards |
| To: | Madson D Leidos |
| References | |
| Download: ML22322A131 (1) | |
Text
NRC FORM 653 (12-2019) 10 CFR 32 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY 0MB: NO. 3150-0001 EXPIRES: 11/30/2022 TRANSFERS OF INDUSTRIAL DEVICES REPORT (TO GENERAL LICENSEES)
(Continue on NRG Form 653, 653A or 6538, as appropriate)
Estimated burden per response to comply with this mandatory collection request: 36 minutes. NRG requests quarterly reports to keep apprised of device movements. Send comments regarding the burden estimate to the lnfomnation Services Branch (T-6 A10M),
U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to lnfocollects.Resource@nrc.gov, and to the Desk Officer, Office of lnfomnation and Regulatory Affairs, NEOB-10202, (3150-0001), Office of Management and Budget, Washington, DC 20503. If a means used to impose an infomnation collection does not display a currently valid 0MB control number, the NRG may not conduct or sponsor, and a person is not required to respond to, the infomnation collection.
For each "licensee" to whom a device(s) has been transferred during the reporting period, supply the following:
Name of Vendor Leidos, Inc.
Reporting Period From To License Number 07/01/2022 09/30/2022 Intermediate Person(s) (if any)
Name of Intermediate Persons(s)
Name of Responsible Individual Tille of Responsible Individual Business Telephone Number Name of Intermediate Persons(s)
Name of Responsible Individual Tille of Responsible Individual Business Telephone Number General Licensee Information Name of General Licensee Malling Address at the Location of Use (No P.O. Boxes, include zip code)
- No distributions to report ****
11-------------------....-----------l Submitted 28 October 2022 r)
Name of Responsible lndlvldual I
Business Telephone Number By: Daniel Madson (RSO)
TIiie of Responsible Individual Date of Transfer Name of Intermediate Persons(s)
Name of Intermediate Persons(s)
Name of General Licensee Name of Responsible Individual Title of Responsible Individual Date of Transfer NRG FORM 653 (12-2019)
Type of Device Voice: 858.826.9~?~-~85~28.~
eMail: madsond@/o~ /p/
Information on Device(s) Transferred Model Number Serial Number Intermediate Person(s) (if any)
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Activity and Units Name of Responsible Individual Tille of Responsible Individual Business Telephone Number Name of Responsible Individual Tille of Responsible Individual Business Telephone Number General Licensee Information Malling Address at the Location of Use (No P.O. Boxes, Include zip code)
I Business Telephone Number Information on Device(s) Transferred Type of Device Model Number Serial Number Isotope Activity and Units Page of