ML24047A140
| ML24047A140 | |
| Person / Time | |
|---|---|
| Issue date: | 02/01/2024 |
| From: | Huda Akhavannik NRC/NMSS/DMSST |
| To: | |
| References | |
| Download: ML24047A140 (1) | |
Text
Reciprocity Applicant Inspection Evaluation & Processing Checklist Licensee Name:
License Type:
NRC / AS License Number / Issuing Entity:
Application Type:
Initial Renewal Fee Paid:
Yes No Notes from License Verification by Issuing Entity:
Request at least the following:
- License expiration date and amendment number on the current license?
- When was the licensee last inspected? Were there violations identified on the inspection? If so, what were the violations and were they corrected?
- Are there any unresolved allegations against the licensee?
- Have there been any recent or on-going events associated with the licensee?
Reciprocity Applicant Inspection Evaluation & Processing Checklist Determination of Risk Score - Risk Score = (Consequence x Likelihood)
Step 1 - Determine Potential Consequence Licensee Program Code 10 CFR Part 37 Proximity to General Public Consequence Score (select the highest from all three categories)
Priority 1 or 2 Cat 1 Quantity Work in areas accessible to general public High (5)
Priority 3 Cat 2 Quantity Fixed facilities with ability to limit access Medium (3)
Priority 4 or 5 Cat 3 or below Remote areas or areas with established access controls Low (1)
Step 2 - Determine Likelihood Licensee Inspection History (Issuing Entity and CT)
Scope of Work Other factors NMP Oversight (CT or Issuing Entity)
Likelihood Score (select the highest)
Serious Violations in recent inspection (for example a Severity Level I, II, or II)
Activity, Repair or Modification involving Source or shield (e.g.,
exchange, recovery, etc.)
- Reactive inspection based on on-going event
- Review of an allegation, as it relates to the work being conducted under reciprocity Last Inspection 5 years High (5)
Minor (Severity Level IV or NOVs)
- Repair or Modification not intended to involve source
- Work creating airborne activity
- Radiography
- Source removal in shield
- New or unique technology
- Extended duration (i.e., length of work/storage or number of visits in a calendar year)
Last Inspection 3 years but < 5 years Medium (3)
Clear Inspection Activities that do not directly affect sources of any size or directly affect sources (e.g., in-field use of portable moisture density gauges, support for materials licensees decommissioning activities)
Last Inspection <
3 years Low (1)
Risk Score = Step 1 x Step 2 = _____________
Reciprocity Applicant Inspection Evaluation & Processing Checklist RISK SCORE PRIORITY MATRIX Consequences Score Low (1)
Medium (3)
High (5)
Likelihood Score High (5)
Low (5)*
Inspection not required Medium (15)*
Inspect High (25) -
Inspect Medium (3)
Very Low (3)*
Inspection not Warranted Low (9)*
Inspection not required Medium Risk (15)*
Inspect Low (1)
Very Low (1)*
Inspection not Warranted Very Low (3)*
Inspection not Warranted Low (5)*
Inspection not required
- Supervisor discretion may be indicated for abnormal work or other considerations leading to a determination to inspect low or very low risk score licensees. Additionally, supervisor discretion may be applied to remove a licensee from inspection due to staffing / resource availability.
Is the licensee a candidate for inspection based upon Risk Score or Supervisor Discretion?
Yes No Risk Score = ______________________
Inspection Evaluation Notes:
Once a licensee has been inspected by CT under reciprocity in the calendar year, each new jobsite will be evaluated for a significant change in typical scope of work or material use. For similar job types, inspections will only be performed on a licensee once per calendar year.
CT Reciprocity Issued:
Yes No CT Reciprocity Inspection Required:
Yes No CT Reciprocity License Number (WBL):
Application Processor:
Signature:
Approved By:
(SRCP or designee):
Signature:
Reciprocity Applicant Inspection Evaluation & Processing Checklist