ML25192A218
| ML25192A218 | |
| Person / Time | |
|---|---|
| Site: | 07000113 (SNM-0095) |
| Issue date: | 06/23/2025 |
| From: | Read A Pennsylvania State Univ |
| To: | Office of Nuclear Material Safety and Safeguards |
| Shared Package | |
| ML25192A217 | List: |
| References | |
| Download: ML25192A218 (1) | |
Text
NRC FORM 313 (09-11-2024) 10 CFR 30, 32, 33, 34, 35, 36, 37, 39, and 40 U.S. NUCLEAR REGULATORY COMMISSION APPLICATION FOR MATERIALS LICENSE APPROVED BY 0MB: NO. 3150-0120 EXPIRES': 07/31/2026 Es1imate<I bwden per respoose lo comply with lhis mandatory oollec1ion req1Jest 4.3 hotrs. Submittal of the application is necessary to determine that the appicant is quaifie<I and that adequate procedures exist to proteet the public health and safety.
Send comments regardi"G burden estima!e to the FOIA, Libra,y, and lnfonnalion Collec!ions Brnnch (T-6 A10M), U.S. Nuclear Regulatory Commisson, Washington. DC 20555-0001, cc by email to lnfooollects.Resourc,,c.gov, and the 0MB Revi<>..., al:
0MB Office of lnfonnaion and Regulatory Affars, (3150-0120), Attn: Desi< Officer foe the Nuclear Regulatr.,y Commission, 725 17th Street t/W, Washilglon, DC 20503. The NRC may not cooc!uct or sponsor, and a persoo is not required lo respond to. a colec1ion ol '1focmation unless the document requesting cc requiring the collection dispys a currently valid 0MB control numb<<.
INSTRUCTIONS: SEE THE CURRENT VOLUMES OF THE NUREG-1556 TECHNICAL REPORT SERIES ("CONSOLIDATED GUIDANCE ABOUT MATERIALS LICENSES") FOR DETAILED INSTRUCTIONS FOR COMPLETING THIS FORM: http*/Jwww nrc.goy/readlng-rmldONOHedjonliloM!ff/$cJ56.§£. SEND ONE COPY OF THE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.
APPLICATION FOR DISTRIBUTION OF EXEMPT PRODUCTS FILE APPLICATIONS WITH:
IF YOU ARE LOCATED IN:
MATERIALS SAFETY AND TRIBAL LIAISON BRANCH DIVISION OF MATERIALS SAFETY, SECURITY, STATE AND TRIBAL PROGRAMS OFFICE OF NUCLEAR MATERIALS SAFETY ANO SAFEGUARDS ILLINOIS, INDIANA, IOWA, MICHIGAN, MINNESOTA, MISSOURI, OHIO, OR WISCONSIN, SEND APPLICATIONS TO:
U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555-0001 ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS:
MATERIALS LICENSING BRANCH DIVISION OF RADIOLOGICAL SAFETY AND SECURITY U.S. NUCLEAR REGULATORY COMMISSION, REGION 111 2056 WESTINGS AVENUE, SUITE 400 NAPERVILLE, IL 60563-2657 83:PRSSMAIL Resource@oo: goy IF YOU ARE LOCATED IN:
ALABAMA, CONNECTICUT, DELAWARE, DISTRICT OF COLUMBIA, FLORIDA, GEORGIA, KENTUCKY. MAINE, MARYLAND, MASSACHUSETTS, NEW HAMPSHIRE, NEW JERSEY, NEW YORK, NORTH CAROLINA, PENNSYLVANIA, PUERTO RICO, RHODE ISLAND, SOUTH CAROLINA. TENNESSEE, VERMONT, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA,
'Nole: The preferred method to submit NRC Fonn 313 is email. Any other document (e.g., financial assurance documents) should be sent via mail.
IF YOU ARE LOCATED IN:
SEND APPLICATIONS TO:
ALASKA, ARIZONA, ARKANSAS, CALIFORNIA, COLORADO, HAWAII, IDAHO, KANSAS, LOUISIANA, MISSISSIPPI, MONTANA, NEBRASKA, NEVADA, NEW MEXICO, NORTH DAKOTA, OKLAHOMA, OREGON, PACIFIC TRUST TERRITORIES, SOUTH DAKOTA, TEXAS, UTAH, WASHINGTON, OR WYOMING, LICENSING ASSISTANCE TEAM DIVISION OF RADIOLOGICAL SAFETY AND SECURITY U.S. NUCLEAR REGULATORY COMMISSION, REGION I 475 ALLENDALE ROAD, SUITE 102 KING OF PRUSSIA. PA 19406-1415 R1DRSSMa1I Resoorce@nrc.gQv SEND APPLICATIONS TO:
MATERIALS LICENSING BRANCH DIVISION OF RADIOLOGICAL SAFETY AND SECURITY U.S. NUCLEAR REGULATORY COMMISSION, REGION IV 1600 E. LAMAR BOULEVARD ARLINGTON, TX 760114511 R4licenslna@nrc gov
'Note: The preferred method lo submit NRC Form 313 is email. Any other document (e.g..
financial assurance documents ) should be sent via mail.
"Note: The preferred method to submit NRC Form 313 is email. Any other document (e.g., financial assurar\Ce documents) shoUd be sent via mail.
PERSONS LOCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE U.S. NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS AND USE LICENSED MATERIAL IN STATES SUBJECT TO U.S. NUCLEAR REGULATORY COMMISSION JURISDICTIONS.
- 1. THIS IS AN APPLICATION FOR (Check appropriate Mem)
A. NEW LICENSE 0 B. AMENDMENT TO LICENSE NUMBER SNM-95
- c. RENEWAL OF LICENSE NUMBER
- 3. LIST ADDRESS AND/OR TEMPORARY JOB SITE (TJS) ADDRESS, IMiERE LICENSED MATERIALS WILL BE USED OR POSSESSED
- 2. NAME AND MAILING ADDRESS OF APPLICANT (Include zip code)
Pennsylvania State University 304 Old Main University Park, PA 16802
- 4. NAME OF PERSON TO BE CONTACTED ABOUT THIS APPLICATION Aaron Wilmot Radiation Science and Engineering Center University Park, PA 16802 BUSINESS TELEPHONE NUMBER 814 863 3976 I
BUSINESS CELLULAR TELEPHONE NUMBER N/A BUSINESS E*MAIL ADDRESS adw154@psu.edu SUBMIT ITEMS 5 THROUGH 11 ON 8-1/2 X 11" PAPER THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE APPLICABLE UCENSING GUIDANCE
- 5. RADIOACTIVE MATERIAL
- 6. PURPOSE(S) FOR IMilCH LICENSED MATERIAL WILL BE USED.
- a. Element and mass number; b. chemical and/or physical fonn; and c. maximlBll amount
- 7. INDIVIDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEIR TRAINING AND which will be possessed at any one time.
EXPERIENCE.
- 8. TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS.
- 9. FACILITIES AND EQUIPMENT.
- 10. RADIATION SAFETY PROGRAM.
- 11. WASTE MANAGEMENT
- 12. LICENSE FEES (Fees required only for new applications. with few exceptions')
FEE I (See 10 CFR 170 and Section 170.31)
CATEGORY
'Amendments/Renewals that Increase the scope ol the existing license to a new or higher lee category wlli require a lee.
Exempt I AMOUNT $1 ENCLOSED 0.00 PER THE DEBT COLLECTION IMPROVEMENT ACT OF 1996 (PUBLIC LAW 104-134), YOU ARE REQUIRED TO PROVIDE YOUR TAXPAYER IDENTIFICATION NUMBER. PROVIDE THIS INFORMATION BY COMPLETING NRC FORM 531: llttDs:/lwww,nrc.govlreadln_g-rm/doc:c!ill\!ons/forms/n531InfoJ!tml. FAX THE COMPLETED NRC FORM 531 TO (301) 415-6725.
13, CERTIFICATION, (Must be completed by applicant) THE APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS MADE IN THIS APPLICATION ARE BINDING UPON THE APPLICANT.
THE APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPLICANT. NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY WITH TITLE 10, CODE OF FEDERAL REGULATIONS. PARTS 30, 32, 33, 34, 35, 36. 37, 39, AND 40. ANO THAT ALL INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST Of THEIR KNOWLEDGE AND BELIEF, WARNING: 18 U.S.C. SECTION 1001 ACT OF JUNE 25, 1948 62 STAT. 749 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.
CERTIFYING OFFICER - TYPED/PRINTED NAME AND TITLE Dr. Andrew Read, Sr. VP for Research r
lGNATURE
- I J, I' I
\... J \JlJ vv FOR NRC USE ONLY TYPE OF FEE I FEE LOG I FEE CATEGORY I
$AMOUNT RECEIVED CHECK NUMBER COMMENTS APPROVED BY DATE NRC FORM 313 (09-11-2024) 6/23/2025