ML22322A131

NRC Form 653 - Transfers of Industrial Devices Report (to General Licensees)

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 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY 0MB: NO. 3150-0001 EXPIRES: 11/30/2022 (12-2019) Estimated burden per response to comply with this mandatory collection request: 36 10 CFR 32 TRANSFERS OF INDUSTRIAL 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),

DEVICES REPORT 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 (TO GENERAL LICENSEES) 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 (Continue on NRG Form 653, 653A or 6538, as appropriate) 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 Reporting Period Leidos, Inc.

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 Name of Responsible lndlvldual IBusiness Telephone Number Submitted 28 October 2022 By: Daniel Madson (RSO) r)

Voice: 858.826.9~?~-~85~28.~

TIiie of Responsible Individual eMail: madsond@/o~ /p/

Information on Device(s) Transferred \ / -I'>> ,,

7 / /

Date of Transfer Type of Device Model Number Serial Number Activity and Units L/

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)

Name of Responsible Individual IBusiness Telephone Number Title of Responsible Individual Information on Device(s) Transferred Date of Transfer Type of Device Model Number Serial Number Isotope Activity and Units NRG FORM 653 (12-2019) Page of