Regulatory Guide 10.7: Difference between revisions

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{{Adams
{{Adams
| number = ML13350A227
| number = ML003740382
| issue date = 02/28/1977
| issue date = 08/31/1979
| title = Guide for the Preparation of Applications for Licenses for Laboratory Use of Small Quantities of Byproduct Material
| title = Guide for Preparation of Applications for Licenses for Laboratory & Industrial Use of Small Quantities of Byproduct Material
| author name =  
| author name =  
| author affiliation = NRC/OSD
| author affiliation = NRC/RES
| addressee name =  
| addressee name =  
| addressee affiliation =  
| addressee affiliation =  
Line 10: Line 10:
| license number =  
| license number =  
| contact person =  
| contact person =  
| document report number = RG-10.007
| document report number = RG-10.7 Rev 1
| document type = Regulatory Guide
| document type = Regulatory Guide
| page count = 8
| page count = 20
}}
}}
{{#Wiki_filter:..:U.S. NUCLEAR REGULATORY  
{{#Wiki_filter:Aep ft!m"  1171 U.S. NUCLEAR REGULATORY COMMISSION
COMMISSION  
                                        REGULATORY GUIDE
FebruarySREGULATORY
                                        OFFICE OF STANDARDS DEVELOPMENT
GUIDEbOFFICE OF STANDARDS  
                                                                                REGULATORY GUIDE 10.7 GUIDE FOR THE PREPARATION OF APPUCATIONS FOR UCENSES
DEVELOPMENT
                                        FOR LABORATORY AND INDU1STRIAL USE OF SMALL                                                                                                         *R
REGULATORY  
                                                      QUANTmES OF BYPRODUCT MATERIAL
GUIDE 10.7GUIDE FOR THE PREPARATION  
                                    1. INTRODUCTION                                                      10 CFR Part 170 to determine the amount of fee This guide describes the type of information                                                  that must accompany the application. Review of needed by the NRC staff to evaluate an                                                            the application will not begin until the proper appl              fee is received by the NRC.
OF APPLICATIONS
FOR LICENSESFOR LABORATORY  
USE OF SMALL QUANTITIES
OFBYPRODUCT
MATERIAL.


1977
cation for a specific license for laboratories and industries using millicurie quantities of by                              3. FILING AN APPLICATION
      product material (reactor-produced radionu clides). This type of license is provided under Title 10, Code of Federal Regulations,                                          for            An applicant for a byproduct material Part 30. "Rules of General Applicability                                                          isotopes) license should complete Form (radio-j                          NRC
                                                                                    to Do              3131 (see the appendix to this guide).' AUl mestic Licensing of Byproduct Material items on the application form should be com Paragraph. 20 1(c) of 10 CFH Part 20. "Stand                                                  pleted in sufficient detail for the NRC to deter ards for Protection Against Radiation,"                                                          mine that the applicant's equipment, facilities, states            and radiation protection Program are adequate that      "    .  persons engaged                    in  activities          under licenses issued by the Nuclear Regulatory                                                        to protect health and minimize danger to life Com              and property.


===1. INTRODUCTION===
mission pursuant to the Atomic Energy Act of
This..guide describes the type of information needed by the NRC staff t1 evaluate an application
    19.54, as amended, and the Energy Reorganiza tion Act of 1974 should, in addition to comply                                                        Since the space provided on Form NRC-3131 ing with the requirements set forth in                                                            is limited, the applicant should append addi this          tional sheets to provide complete information.
.. fforea specific license for laboratories using millicurie quantities of hbproduct material (reactor-produced radionuclides).
This type of license is provided for..under Title 10. CodeofrFederalRegulations.


Part 30.-Rules of General Applicability to Licensing ofByproduct Material.-
part, make every reasonable effort to maintain radiation exposures, and releases of                                                             Each separate sheet or document submitted radio active materials in effluents to unrestricted                                                    with the application should be identified by a areas, as low as is reasonably achievable"                                                        heading indicating the appropriate item number (ALARA).                Regulatory Guide R. 10, "Operating                                        (on Form NRC-3131) and its purpose radiation, safety instructions).                                         (e.g.,
S.Paragraph
    Philosophy for Maintaining Occupational Radia tion Exposures As Low As Is Reasonably Achievable,", provides the NRC staff position                                                        The application should be completed in trip on this important subject. License applicants                                                    licate. The original and one copy should be should give consideration to the ALARA philos                                                    mailed to the Division of Fuel Cycle and Mate ophy, as described in Regulatory 3uide                                                            rial Safety, Office of Nuclear Material
20.1(c)-of
                                                                                    8. 10,                                                                                     Safety in the development of plans for work                                                              and Safeguards, U.S Nuclear Regulatory with                                                                                      Com licensed radioactive materials.                                                                  mission. Washington, D.C. 20555. One copy of the application, with all attachments, should be
10 CFR Part 20. "Standards for Protection Against Radiation."
                                  2. LICENSE FEES                                                    retained by the applicant since the license will require, ab a condition, that the institution An application fee is required for most types                                                follow the statements and representations o)f Licenses                                                                                                                                                                    set The applicant should refer to                                        forth in the application and any supplement
states that"..persons engaaed in activities under licenses issued hythe Nuclear Regulatory Commission pursuant to theAtomic Energy Act of 1954. as amended, and the* .Energy. Reorganization Act of 1974 should. in addi-,ton tocomplying with the requirements set forth inthis part, make everv-reasonuhle effort to maintain.
  §170 31,                                                                                          it                                                                                to
                        "Schedule of Fees for Materials Licenses and Other Regulatory Services,"
                                                                                        of
                                                                                                        'Applications    (or" medical uses should be submitted on Form
    *1 "I*s '-n1dcate substantave changes from previoub                      .'.ue                NRC-313M.      and applications for use of selled sources in rad- raphy should beasu              I.      1ri NRC-313R
                      USNRC REGULATORY GUIDES
ttagu0tory Guide -a-einu                                                                          Comments should be sent to the Secretary of the Commen.


.diation exposures.
to "-,,be mndineao .a bleeto                    uRgulatory                                                                          U.S tuim
"nothOd"acOc*ap to the NRC soft of C                                                                                                              Conomatin Wwa Wo              0 C 2066 Atteintion OoClea leamenting 'vec1fac prts of the                                                                                              SW
        ,    rsion's regulations. to deline*te *eh*MKK        used by the staff on evalu-          The guides we rilsuidm the foliowu      Itan hoad dairnons
"'lng  'pcftIc rippicants        W-11-16r~ Guides Regulatory        Or postulated ae rnt accidents, gubseaae orfor fto Proside guidance Pliecs with them is riot raqaujed Maihods and regulaions.    and corntt        I Power Reactors ookn      dffere f        fyro tmhose                                                        6 Products set out in fth guides will be erLcaputAte rf the provide                                          2 Resarch and Test Reactors                      7 Transoration requiste to the isuance or continuance of                        a basie for tie woiadngs        3 Fuels and Martialo Feotms a perrNt    or licanse by the          4 Enovrwnen'ta                                  8 OccuoiaaonWs and Sittru                          .          Health Coa'-mHaon
                                                                                                  5 M410"ifis am Plant Protection                  0 Gililrt    and Fiancial Revew Comnnts i tlrr*s an*d      suggestiOns andWu-des            tor nprOvernts    ,n thee guades are encouraged at            placement        an etutomat.c wet Uae resa    as s*pWoprAte.  to aCrorrmodante commentd            Requests foror s-g*e  copies ofd*'Uued  Iuades fivhaCh
                                                                                                                                      *r*butiorist  t*or aglerngy bi eWoduced, copaes            or for of ftureL guaee nO tO ref*i fcr'e      information or sotae                                                      n spi    fc dvisons should be nuide a wating This guide *awasred              mosta                                                            to the U S  Nuclear Regulefory ComrnmraTtn      Wasthington    D C 205Mu of  sobstant"    curnmrents re..a. ed fromr the public and addrtional                                                                              Alteanon    Deoitor.  ONvror,  of staf reiew              Tochn,~i into~rraitocn and Dorumlent Control


and rleases of radioactve
4. CONTENTS OF AN APPLICATION                                model number of each sealed or plated            source should be specified        It a source will be  used in Most items of Form NRC-313r are self                                  a gas chromatograph. gauge, or other            device.
.materials:
n einlucLnts to unrestricted arcas.as-low as iis reasonabhl ahtcvahich"
(A LAR_). Rcgu titatol3'
SGude-8.10.


" )Operating.
explanatory (see instructions with the form).                            the manufacturer and model number                of the The following comments apply to the indicated                            device should be specified numbered items of the form.


Philosophv IrI Maintaining"
Item 8E and Item 9 The use to be made of'
Occupational Radiation Exposures AssLow As IsReasonabhh Achiev.,,  
    Items 2 and 4. Specify the applicant corpo                            the radioactive        materials should be clearly ration or other legal entity by name and                                  described      Sufficient detail should he given to address of principal office. Individuals should                          allow a determination of the potential for expo be designated as the applicant only if the use                            sure to radiation and radioactive materials both of the byproduct material is not connected with                          of those working with the materials and of the the individual's employment with a corporation                            public or other entity              If the applicant. is an individual, the individual should be specified                                Items 10 and 11.    Specify for each radiation by full name and address, including state and                              detection instrument the manufacturer's name zip code                                                                -and model number, the number of each type of instrument      available,    the type of radiation Item 5. Specify the street address of the                            detected (alpha, beta, gamma, or neutron).
provides thc*RC staffposition on thi. iamirta l1_subject.
location of use if the address differs from the                          the sensitivity range (milliroentgens per hour one given in Item 4. If use is to be at more                              or counts per minute). the window thickness in
                                                                                    2 than one location, the specific address of each                          mg/cm . and the type of use. The type of use should be given            Describe the extent of use                    would      normally  be    monitoring,  surveying, and the facilities and equipment at each                                  assaying, or measuring.


License applicants should g-, 0on;'. 60tion to the A LA RAphilos inWRegulatory Guide 8.10. inI v Fln tif 01ans for work with licensedra ct b~6uial'° 2. LICENSE FEESAn application
location.      A post office box address is not acceptable.                                                                    Describe the instrument calibration proce dure. State the frequency, and describe the Item 6 Specify the names of the persons who                          methods and procedures for the calibration of will directly supervise the use of radioactive                            survey and monitoring instruments, as well as material or who will use radioactive material                            any other instruments and systems used in the without supervision                                                      radiation protection program, such as measur ing instruments used to assay sealed-source Item 7. Specify the name of the person who                            leak-test samples (see Item 15). contaminationi will be designated as the radiation protection                            samples (e.g..      air samples. surface "wipe"
'fee. is required for most types oflicenses.
  officer. 2 Thispj5erson should be responsible for                         samples), and bioassay samples (see Item 12)
  implementing the radiation safety program and therefore readily available to the users in case                              An adequate calibration of survey instru of difficulty and should be trained and experi                            ments usually cannot be performed with built enced in radiation protection and in the use                              in check sources        Electronic calibrations that
1 and handling of radioactive materials. In a                              do not involve a source of radiation are also small      program      not    requiring a        full-time            not adequate to determine the proper function ing and response of all components of an radiation protection officer, the duties of the radiation protection officer may be assigned to                          instrument.


The applicant should refer -to §170.31."Schedule of Fees.for Materials Licenses."
one of the persons named under Item 6 of Form I NRC-3131.        Note, however, that it must be                              Daily or other frequent checks of survey instruments      should be supplemented every established that the person acting as radiation protection officer will have the opportunity to                          6 months with a two-point calibration on each devote sufficient time to the radiation safety                            scale of each instrument with the two points aspects of the program for the use of                                    separated by at least 50% of the scale Survey radioactive materials.                                                    instruments should also be calibrated following repair. A survey instrument may be considered Items BA, B, C, and D. Describe the byprod                            properly caiibrated when the instrument read uct material by isotope, chemical and/or physi                            ings are within +/-10 percent of the calculated or cal form, and activity, in millicuries or micro                            known values for each point checked Readings curies      A separate possession limit for each                          within +/-20 percent are considered acceptable if nuclide should be specified              Possession limits                a calibration chart or graph is prepared and requested should cover the total anticipated                              attached to the instrument inventory,          including stored materials and If the applicant proposes to calibrate his waste, and shouid be commensurate with the needs    and    facilities    for safe                survey instruments, a detailed description of applicant's planned calibration procedures should be sub handling mitted    The description of calibration proce dures should in(lude, as a minimum:
of 10* "CFR Part 170 to determine the amountof fee thatmust accompany the application.
        If the use of sealed or plated sources is con tempiated,        the isotope, manufacturer,              and a The manufacturer and model          number of
      'The terms radiation protection  officer" and  "radioiogrcal each radiation source to be used, safety officer" are synonv.aoul
                                                                    10 7-2


Review of the ap-plication will not Iwgin ut, il the proper fee is receivedby the NRC.3. FILING AN APPLICATION
b. The nuclide and quantity of radioactive        milliroentgens,        the frequency of reading, and material contained in each source,                     the procedures for maintaining and calibrating the devices should be specified.
A licenew application for by product nmuterial should he suhmitted tfi Form NRC 313* ",'Applica- lion for Byproduct Miaterial


====l. iLcnsC ====
c The accuracy of the source(s).         The traceability of the source to a primary standard          If personnel monitoring will not be used, the should be provided.                                    applicant should submit calculations or docu mentation from radiation surveys demonstrating d The step-by-step procedures, including            that it is unlikely that any individual will associated radiation safety procedures, and            receive a dose equal to or greater than that indicated in 10 CFR Part 20.
(%L ibe appeu-di\ to this guide). All items on the zpplicuaiib6 formshould he completed in sutTicicnt dotuil for thc NRCit) determine thatil fit  uppikil ntls:"t'qUipllellt.


facilities.
e The name and pertinent experience of each perstin who will perform the calibrations.            The applicant should show that the need for bioassays has been thoroughly considered and If the applicant intends to contract out the        should establish the adequacy of the proposed calibration of instruments, the name, address,        bioassay program in relation to the proposed and license number of the firm should be speci        program of use of radioactive material. Bio fied together with the frequency of calibration.      assays are normally required when individuals The applicant should contact the firm that will work with miUicurie quantities of hydrogen-3, perform the calibrations to determine if infor          iodine-125, or iodine-131 depending on the mation concerning calibration procedures has            type of work, equipment, and procedures fol been filed with the Commission. If information          lowed Regulatory Guide 8.20, "Applications of concerning calibration procedures has not been          Bioassay for 1-125 and 1-131," and a document filed, it should be obtained and submitted.            entitled "Guidelines for Bioassay Requirements for Tritium"- may be consulted. Other mate Quantitative measuring instruments used to        rials may also be used in physical or chemical monitor the adequacy of containment and con forms and under conditions that present an tamination control such as those used for mea opportunity for uptake by the body through suring leak test, air, effluent, bioassay, work area, and equipment contamination samples              ingestion, inhalation,, or absorption                    A bio
  3hould usually be calibrated prior to each use.        assay program to determine and control the The procedures and frequency for calibration            uptake of radioaetive material should be con of such instruments should be submitted and            sidered and discussed in relation to each such material,      procedure, etc,              Regulatory Guide should include:                                        8 9, "Acceptable Concepts Models. Equations, a The name of the manufacturer and model          and Assumptions for a Bioassay Program."
                                                                                                                      may.


and rai~oio~to reanare ade-qultte it) protect,ý,
number of each of the standards to be used,             he consulted.
iL~lth Andrii~tsn~imi datnger to lifeand proprt'.
"hc.h spce' provided on Form NRC-313 isirhmited1. applctant should append additional to provide complete information.


F:achse .paratc sheet or document subLtllted with the ap-plicalion should he identified by a heading indicating the appropriate item number (on Form NRC-313)and its purpose (e.g.. radiation safety instructions).
b. The nuclide and quantity of radioactive              The criteria tc be used in determining the material contained in each of the standard            need for hiioassays, the type and frequency of bioassays that will be performed, and the sources,                                                                                                              bio assay procedures should be specified and c A statement of the accuracy of each of the      described in detail              If a commercial bioassay standard sources. The source accuracy should          service is u., be used, the name and address of be. as a minimum, +/-5 percent of the stated            the firm should be provided.
The applica.tion should lie completed in triplicaite.


The original and one copy should he mailed to:Radioisotope:,  
value and traceable to a primary standard, such as that maintained by the National Bureau              Bioassays may not be substituted for other of Standards.                                          elements of a safety program such as air moni toring and dispersion control (hoods, glove d. Step-by-step calibration procedures and,       boxes.      etc ) and for well-thought-out and if appropriate, associated radiation safety pro        well-executed handling procedures cedures, and                                        T
Licensing Branch. Division of FuelCvyec aod MIatertal Safety. Office of NuclearMaterial Safety and Safeltuards.
                                                            Item 13    The facilities and equipment for e. The name and pertinent experience of           each site of use should be described in detail.


U.S. NuclearRegulatory Commission.
each person who will perform the instrument            The proposed facilities and equipment for each
"calibrations                                          operation to be conducted should be adequate to protect health and minimize danger to life Item 12    Personnel monitoring is required to    and property In describing available fa. ilities ensure .- mplianee with §§20 101 and 20 202 of        and      equipment.        the following          should      be
10 ('FR Part 20. Personnel monitoring is also        included, as appropriate:
required if a person enters a high radiation area (greater than 100 millirems per hour). If              a Physical plant, laboratory.                  or working p'.sonnel monitoring equipment will be used,          area facilities Fume hoods glove boxes, waste the ndine of the organization furnishing film          receptacles, spenjal sinks, ventilation and con badge or thermoluminescent do.<'imeter (TLD)          tainment systems. effluent filter systems, and service      and  the  frequer ,    for changing badges, dosumeter.-, etc        sh,uld be specified        jA copy may  be  obtained  by a written request Nuclear Regulatory                                      to hte U S
If pocket chambers ur pocket dosimeters will be                                C'.mmision.  Office .)f Nuclear ?ateruidJ
                                                      Safety and Safeguaro,        Div-tsaon of Fuel CycLe and Materi.la used.      the useful range of the devi(e.       in  Safety. Washington    !      20555, A:'enton    Director. office of Nuclear Material Saifet, ant Safeguards


Washington.
arr permi.,sible The a,.                hlc ju    o,;it,        .
  hd , pnf O  1 7'.I i  I I !;
                              '        d t &#xfd; , -i hl'  j~t .  .  o h n        upon *h- radionu-Lide '
                                                                                    d    Release into air or water in oncentrationf'
        A drawing or sketch should be submitted in conformance with &sect;20 106 of 10 ('FR Part 20
showing the location of all such equipment and Possible exposure to persons offsite Limits the the relationship of areas where radioactive                                    amount that may be released materi:is will be handled to unrestricted areas where rad'ioactive materials will not be handled                                    e Treatment or disposal by incineration in In those programs where radioactive material                                    conformance with &sect;20 305 of 10 CFR Part 20
may become airborne or may be included in air                                  This must be specifically                    approved by the br-ne effluents, the drawing or -ketch should                                  Commission also include a schematic description of the ven tilation system annotated to show airflow rates,                                    f Other methods specifically approved by differential pressures,                    filt ration and other
                                                                                'he Commission pursuant to &sect;20.302 of 10 CFR
effluent treatment equipment                            and air and            Part 20
effluent monitoring instruments                            Drawings or sketches should be drawn to a specified scale,                                        Item 15 or dimensiLons should be included on each drawing or sketch. Each drawing or sketch                                          a    Survey Program. Commission regulations should be labeled to specify the location of the                                require that surveys be made to determine if facilitles and equipment depicted with respect                                  radiation hazards exist in a facility in which to the address(es) given in Item 5 of Form                                      radioactive materials are used or stored (see NRC-3131                                                                        &sect;20.201 of 10 ('FR Part 20)                    A survey should include the evaluation of external exposure to F- C(ontainets, devices. protective clothing.                              personnel,        concentrations of a-iruorne radio auxiliary shielding, general laboratory equip                                    active material in the facility, and radioactive ment. a. r sampling equipment. etc . actually                                    effluents from the facility Although a theoreti employed in the daily use of material Special                                    cal calculation is often used to demonstrate provisions for shielding and containment to                                      compliance with regulations regarding airborne minimize personnel exposure should be de                                        or external radiation, it cannot always be used scribed            Storage      containers          and    facilities        in Lieu of a physical survey should provide both shielding and security for materials                                                                              Except for those cases where sources of radiation      and radioactive material are well c      The number.          type.      and length of remote                known and accurately and precisely controlled, handling devices                                                                it will usually be necessary that a physical survey be made with appropriate detection and d If respiratory protective equipment will                                  measurement            instruments        to      determine        the be used to limit the inhalation of airborne                                    nature and extent of radiation and radioactive radioactive material, the provisions of &sect;20.103                                material or, as a minimum, confirm the results of 10 CFR Part 20 should be followed and                                        of a theoretical determination appropriate information should be submitted A    radiation      protection        program should include      the  following      surveys        for radioactive Item 14          The procedures for disposing of                            contamination and radiation.


D.C. 20555.One copy of the application.
byproduct material waste should be described Under NRC regulations, a licensee may dispose                                          (I) In laboratory or plant areas (e g of waste in the following ways                                                  checking for contamination on bench tops, han dling and storage equipment, clothing, hands)
        a Transfer to a person properly licensed to receive such waste in conformance with para                                            (2) While work is being done with radiation graph 20.301(a)            of  10 CFR Part 20            The name            or radioactive materials (e.g , breathing zone of the firm (which should be contacted in                                      air surveys,          general air surveys, personnel Luncluding eyes and advance to determine any Limitations that the                                  exposure measurements.


with all attachments.
firm may ,iave on acceptance of waste) should                                  extremities,        checking shutters and "'ontain ment)
    be given f, Release into a sanitary sewer in confor                                        (3) in areas associated with disposal or mance          With    &sect;20 303          of      t0 CFR      Part 20          release of radioactive materials (e g . checking Depending on water usage. releases rf up to I                                      'The  NRC  has  proposed  an  amendment        .*hat would delete curie per year are permitted                                                    $20 304 of 10 CFlt Part 20 (43 F'R Ssi77        December 4. 19i 8)    If this amendent      is adopted.    all b,,ne.ls    of radionuclides in accord~ance with    120 304 of 10 CFR Part        20 wil require NRC
          c  Buria, i" soil in contformance with &sect;20 304                            approval f    10 (-FR Part 20          Up to 12 hurials per year
                                                                            10 7-4


should he retained by the applicant, since the licensewill require.
disposal containers and disposal sites; liquid,                              Agency's Technical Report Ses gas, and solid effluents, filters and filter-duct                                                                                No 120,
                                                                                  "Monitoring of Radioactive Contamination am systems)                                                                    Surfaces. "'
          The frequency of surveys will depend on                                    b. Records Management Progrm. Provision the nature of the radioactive mrterials and for keeping and reviewing record of surveys;
    their use. However, surveys should be per materials inventories; personnel exposures;
    formed prior to the use of radioactive materials receipt, use, and disposal of materials, in order to establisl a baseline. The surveys                                                                                        etc.,
                                                                                  should be described. Persons responsible for should be repeated when radioactive materials keeping and reviewing records should be iden are present, when the quantity or type of tified.


as :t condition.
material present changes,              or when changes occur in their containment systems cr methods                c Sealed-Source          Leak-Test of    use.    Repetitive        surveys may                                                                                  Procedures.


that the institution follo-wthe stLtcmenits and representations set forth in the ap-plication and any stIpplememt to it.* Form N R C-13 Was foirmerly designated Form ALEC-313.
also      be        Sealed sources containing more than 100 micro necessary to control the location of radioactive curies of a beta or gamma emitter or more than materials in the handling system and in the           10 microcuries of an alpha emitter must be leak case of the use of sealed sources outside a        tested at 6-month intervals. Leak testing of shielded container.


Exisling copies or F:osrm AIEC.-313 m:A, still hb use
alpha-particle-emitting sources containing more For operations involving materials in gas,                              than 10 microcuries of an alpha emitter Is liquid, or finely divided forms, the                                          required at 3-month intervals. If a commercial survey            firm is to perform the leak tests, the program should be designed to monitor the                                                                                              name, adequacy of containment and control                                          address, and license number of the firm of the                                                                    should materials involved. "he program should                                        be submitted If the tests are to be performed include            using a commercial "kit," the nme of the kit air sampling, monitoring of effluents, and sur          manufacturer or distributor and the kit moe veys to evaluate contamination of personnel, I facilities,    and equipment                                                designation should be given. If the applicant Physical effluent
!measurements are essential to determine                                        intends to perform his own leak tests without compli ance with Appendix B to 10 CFR Part 20.                                       the use of a commercial kit, the following information should be submitted:
        The description of an air sampling program should include the area where samples                                                (1) Qualifications    of  personnel        who  will will be taken,    the frequency of sampling, and the                                perform the leak test, location of the sampler with respect to workers'
  breathing zones Assays performed to evaluate                                        (2) Procedures and materials to be used in air samples and the methods used to                                          taking test samples, relate results to actual personnel exposures should also be described                                                                    (3) The type, manufacturer's name, model number, and radiation detection and measure The      effluent      monitoring        program                      ment characteristics of the instrument for                                                                  to be releases to unrestricted areas should encom                                  used for assay of test samples, pass all airborne and liquid radioactive material releases        Theoretical evaluations                should be                    (4) Instrument        calibration        procedures, supplemented by stack monitoring, water                                      including calibration        source characteristics.


====d. USNRC REGULATORY ====
sam pling, and other environmental monitoring                                    make, and model number, and ap propriate        for    the     planned      and        potential releases                                                                            (5) The method, including a sample calcu lation, to be used to convert instrument read For    operations        involving      only      sealed          ings to units of activity, e.g. . microcuries.
GUIDES CAI~~r .jui,uki Is W. wrt to It', 5m'routy tr ttv Ci.. t mswn.tUf tim.le iof,Rewlimka G...k .ri-w t..elf to dilcisLso
..fs.Ie -o,Ia.ble to the utisbtc flwtithods Ulm*, C ..... ...,%u-. Vd- nl M ....o. 1) C. O.d *i't.. .. o-airmmultle to low NRC sulst of mtIflenrq
'.010.s Itan at 03l COMM3w' Woinch.tOt4t10 t*~1 flts. ,1t wt &#xfd;~t by It.I stif %WC11C Ifflibleeril I, I- ju .rt.3~ I .t3 ,,to Tam" ty o .0 .1ofrm olttui..~
Mac tilm , n, to ifrtle awato nirr t i tn 4ilic..so.


Olovuliirey GutcirWit not ,ttu~itut..  
sources,       a survey program should include evaluation and/or measurement of radiation levels for storage and use configurations.                                         d. Instructions to Personnel.
l0r e.,wPsUIitM1.


'e not Ijo Vitth thnro 0, not feitu,111..
When                                                        If a number of sources are used in devices having "on"                                      individuals will use radioactive
.Pr. ~~aqnf ~,tI.11.S the~s & t eC.1 w tuu- i d tfrm ,llanjlo w le t.1 .. Ihe qu .33 willto, AMIc. .1. ru-t....
"off" positions, both positions                                  and                                                      materials under should be eval                  the supervision of one or more of those persons uated at the tune of installation                Supplemental              named in Item 6 of Foim NRC-3131,         written surveys should be performed following                                        instructions should be prepared any                                                        and submitted changez. in operation, shielding, or use                                    with the license application in the form in which they will be distributed to those working The types,         methods,       and frequency of                  with radioactive materials.
P sI Itf-y ntso i.O55.I1C0t4th a'l at they ji or id ani WIWI It~e CaInv! ni ..jrlt in JIM stuoo~nn"u oat Smioriit
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===4. CONTENTS ===
These instructions surveys should be described in the application                              should cover, but not necessarily
OF AN APPLICATION
.'*uidance may be obtained from the                                                                                         be limited to:
Most items of Form NRC-313 are sclf-explanator:
                                                          National Council on Radiation Protection Report                                              (1) The availability. selection, No    1
(se instructions with the form). The following cornments apply to the indicated numbered items of th.form.hIem 1(a). Specify the applicant corporation oother legal entity by name and address of principaoffice. Individuals should be designated as the applicant only if the use of the byproduct material is noconnected with the individual's employment withcorporation or other entity. If the applicant is an individual, the individual should be specified by fulname and address, including state and zip code.hem 1(h). Specify the street address of the locatiorof use if the address differs from the one given in itcrrI(a). If use is to be at more than one location.


thispecific address of each should be given. Describe thiextent of use and the facilities and equipment at eacalocation.
===0. and use of===
"Radiological Monitoring Methods and Instru                                  laboratory apparel and safety-related ment-s,'      and the International Atomic Energy                                                                                    equip ment        and devices (e g. , laboratory gloves, and remote pipetting                              coats,
  'CopIes  may  be  ob asnedi devices).
                                  rrM    NCRp  P ublicaon,      P o Box 4867    Washun                                                              6Copies may be ohrain--
                      . D (    20008                                                                    from "'IPUiB    in.    P 0
                                                                            New .'jrx N"Y      0                                    Box 433,
                                                                                                                              'oei
                                                                      10 7-5


A post office box address is not acceptable Item 4. Specify the names of the persons who wildirectly supervise the use of radioactive material oiwho will use radioactive material without supervi.sion.hem 5. Specify the name of the person who will htdesignated as the radiation protection officer.*
(2) Limitations and conditions to be met in                (12) The use of radioactive materials in handling liquid or uncontained (unencapsu                    animals. If radioactive materials will be used in
Thisperson should be responsible for implementing th(radiation safety program and therefore readilyavailable to the users in case of difficulty and shouldbe trained and experienced in radiation protectior and in the use and handling of radioactive materials.
                                          1asdioactive      animals,        instructions  concerning    such  use lated,        dispersible, or volatile)
                                                                          be  prepared  and  submitted  with  the materials and special laboratory equipment to                should license application.       Such instructions should be used in working with these types of mate rials. For example, the instructions should                  include (a) specification of the facilities to be explain when operations with materials should                used to house the animals, (b) instructions to be confined to a radiochemical fume hood or                  be provided to animal caretakers for handling animals,      animal wastes,    and carcasses, (c)
glove box and should specify the use of appro priate shielding and remote handling equipment              instructions to appropriate personnel for clean when energetic beta- or gamma-emitting mate                  ing and decontaminating animal cages, and (d)
rials are to be used.                                      methods to be used to ensure that animal rooms will be locked or otherwise secured unless
        (3) The performance of radiation survey              attended by authorized users of radioactive and monitoring procedures          or each area in         materials. A description of animal handling and housing facilities should be included uLnd'.
which radioactive materials are to be used.


Ite't 6(a i amdl 1b. Describe the byproduct rnatcriaby isotope, chemical and/or physical form. and ac.tivity. in millicuries or microcurics.
Item 13 of Form NRC-3131.


A separate pos.session limit for each nuclide should be specified Possession limits requested should cover the total an.ticipated inventory, including stored materials andwaste. and should be commensurate with the appli-cant's needs and facilities for safe handling.
(4) Safely precautions to be observed in the movement of radioactive materials between                      (13) Emergency procedures. These instruc tions should be addressed to all persons in aV.


If the use of sealed or plated sources is con-templated, the isotope.
buildings, rooms, and areas within rooms.


manufacturer, and modelnumber of each sealed or plated source should be If a source will be used in a gaschromatograph, gauge, or other device. the manufac-turer and model number of the device should bespecified.
laboratory or facility areas where radioactive!
                                                              materials will be used and should cover actions :
          (5) Safety requirements for storage of including labeling of          to be taken in case of such accidents involving!
  radioactive materials, radioactive materials as spills, fires, release or containers of radioactive materials and posting loss of material, or accidental contamination of and securing areas where radioactive materials                                                these  instructions personnel.        Specifically, are to be stored. This should include the stor                                specify immediate actions to be should (a)
  age of contaminated laboratory equipment such as glassware.                                                taken in order to prevent or limit the contami nation of personnel and areas, e.g.. the shut ting down of ventilation equipment, evacuation
          (6) Requirements for posting of areas in which radioactive materials are used.                       of contaminated and potentially contaminated i areas, containment of any spills of radioactive material, (b) give the telephone numbers of in
          (7) The availability and use of personnel dividuals to be notified in case of emergency.


Item 7. The use to be made of the radioactive materials should be clearly described.
monitoring devices, including the recording of and (c) instruct personnel in proper entry, radiation exposures and the procedures to be decontamination, and recovery operations for I
  followed for the processing of personnel moni contaminated facilities. (Note: Only properly toring devices such as thermoluminescent dosi trained individuals should attempt decontamina meters .and film badges in order to obtain per              tion and recovery operations. )
  sonnel monitoring results
                                                                      (14) Requirements and procedures for pick
            (8) Waste disposal procedures to be fol ing up, receiving, and opening packages (see lowed, including limitations on the disposal of              &sect;20.205 of 10 CFR Part 20).
    liquid or other dispersible waste to the sani- tary sewer      and proceaures  for the LoUeLLLZI,
    storage, and disposal of other wastes                          Items 16 and 17.      A resume of the training and experience of each person who will directly
            (9) The maintenance of appropriate rec              supervise the use of material, who will use ords as required by 10 CFR Part 20 and                      material without supervision, or who will have
    10 CFR Part 30.                                            responsibilities for radiological safety should be submitted. The resumi should include the
            (10) The requirements for and the method            type (on-the-job or formal course work), loca of performing or having appropriate sealed                  tion, and duration of the training. Training source leak tests performed.                                should cover (a)        principles and practices of radiation protection, (b) radioactivity measure
            (11) Good radiation safety practices, in            ments, standardization,        and monitoring tech cluding the control of contamination, specifica            niques and instruments, (c) mathematics and tion of acceptable removable and fixed contami              calculations basic to the use and measurement nation levels tor both restricted and unre                  of radioactivity, and (d) biological effects of stricted areas, prohibition of smoking and the              radiation. The description of the use of radio consumption of food or beverages in areas                  active materials should include the specific iso where radioactive materials may be used, and                topes handled, the maximum quantities of mate prohibition of the frequent transfer of poten                rials    handled,    where the    experience    was tially contaminated equipment between poten                  gained, the duration of experience, and the tially contaminated areas and unrestricted                  type of use The qualifications, training, and areas.


Sufficient detail should be given to allow a determination of thepotential for exposure to radiation and radioactive materials of both those working with the materials and the public,*The terms "radiation protection officer"
10 7-6
and-radiological safety officer"
are synonymous.


items 8 and 9. A resume of the training and ex-perience of each person who will directly supervise y the use of material, who will use material without-supervision, or who will have responsibilities forc radiological safety should be submitted.
xiprrinr.*            )4&#xfd;each terson should be commensu
          ,I:- w~th J1, mnatriwl arnd its use                                            only have a background or, forma! traming r, as proposed          all areas described in T            ,    'TphPb-ation        The amount and type of                                                   tern 16 of F<orm NR&#xfd;
                    'a:      ir'd      'xpe; ien(-'                                      3131 but should also h.ive -xten*,*&#xfd;n-- expe- with      radiation    and
                        ,e a raaterial.:                                                  working      with  rad*oactrve,    material    an i r1aliu1red to support a                                                                            a
      ,i('rrmIJ atin      I          ,f _ad-quauy by the Commission                      thorough working knowledge of the eqip


The resumeshould include the type (on-the-job or formal coursework), location, and duration of the training.
====u. rmenrt====
      .'.        ,,.r mar kru dly with (.,rtain factors                                  required to handle the material safely
              .            -      t -n:.&#xfd;h    c h as technical assistants
    :ir~i iab.--rit,;r-                 workers will use radioactive                              5.  AMENDMENTS      TO IhJENSES
    materials in the absenct: of persons specified
      *."*',           a. , specification of the                                           Licensees are required to cor.duct 4heir pr.


Train-r ing should cover(1)  
training of such persc.rne! ',hould include                                                          grams in accordance with statements, (a)     instruction in                                                            renr&#xfd;.
principles and practices ofradia-I tion protection:  
    I IAf , -, qs:            fr 1.                                                    sentations. and procedures contained In"udinr,      topics covered and                                                                in &#xfd;tie by whom taught                        hb) on-the-job training in use                license application and su.:P)>rtive aocuments
(2) radioactivity measurements,
    ,-If radlio,-tivt materials, and                                                      The license must therefore be amended (c) determination.                                                                if the of compeienciy to work without                                                        licensee plans to make any changes the presence of                                                          in faclt supervisory (ersOnnel                                                                ties, equipment (including. monitoring and sur vey instruments), procedures, personnel        or
" standardization, and monitoring techniques and in-t struments,  
        "The is' of mitrocurie quantities of a few                                      byproduct material t(; Le used nonvolaile radioactive materials by a person with a minimum of training                                                              Applications for license amendments may and experience                                                                        e under precisely specified and                                                        filed either on the applicatior form or roliled conditions subject to the carefully con                                    form.    The    application. should identify kn ler!tr surveillance of                                                                  1o
(3) mathematics and calculations basic tothe use and measurement of radioactivity, and (4)-biological effects of radiation.
        -,Ompetent              and adequately trained radiation                      license by number and should clearly de ;,.r t-.
  protection officer may be justified.                                                  the exact nature of the charges, mum training and experience                                        Such mini                                                      additions, c"r may consist of a            deletions. References to previously e: hours of training and experience                                                                                                submitted information and documents should
  ,f crne or more radioactive materials in the use                                      specific and should identify be clear and similar to                                                the pertinent the use proposed in the -tpplication                                                  information by date, page. and under the                                                paragraph s&#xfd;upervision and tutorship of a Licensed user.


The description of theI use of radioactive materials should include thespecific isotopes handled, the maximum quantities ofmaterials handled, where the experience was gained,n the duration of experience, and the type of use. Thequalifications, training, and experience of eachperson should be commensurate with the materiale and its use as proposed in the application.
===6. RENEWAL OF A LICENSE===
      Persons using millicuzri quantities of a num Oer of radionuclideq for general                                                        An application for renewal of laboratory                                                a License should tracer                work        under      unspecified                            be filed at least 30 days prior conditions                                              to the expiration should have more extensive training                                                  date This will ensure that and expe                                            the license does not rience and, depending on the                                                         expire until final action on the exact nature of                                                   application ha6 ih.. proposed program of use                                                          been taken by the NRC as of radionuclides,                                                  provided for in zay        need to have completed formal                                            paragraph :30 37(b) of i9 CFP
                                                                  course work                                                Part 30.


Theamount and type of training and experience withradiation and radioactive materials required to sup-port a determination of adequacy by the Commission i will vary markedly with certain factors.The use of microcurie quantities of a few non-volatile radioactive materials by a person with ae minimum of training and expcrience under precisely specified and carefully controlled conditions subjectto the surveillance of a competent and adequately y trained radiation protection officer may be justified.
at !he college or university level covering the areas listed under Item i6 of                                                           Renewal applications .hould Form NRC-3131.                                                       Le filed on Form NRC-3131,      appropriately The use of larger                                                                                                    suppI-mented,        and quantities of material                should contain compjete (dpproaching a curie) under                                                                                           and up-to-date infor conditions where a              mation about the applicant's potential exists for significant                                                                                          current program.


I Such minimum training and experience may consistof a few hours of training and experience in the use ofone or more radioactive materials similar to the useproposed in the application under the supervision I and tutorship of a licensed user.Persons using miillicurie quantities of a number ofradionuclides for general laboratory tracer work un-der unspecified condition should have more exten-sive training and experier.ce and, depending on theexact nature of the proposed program or use ofradionuclides, may need to have completed formal-course work at the college or university level coveringthe areas listed under Item 8 of Form NRC-313.The use of larger quantities of material (ap-proaching a curie) under conditions where a potential exists for significant loss and ingestion, inhalation, orabsorption of the radioactive material by those work.ing with the material is normally done under carefully controlled conditions using specialized equipment.
loss and inges uon. inhalation, or absorption                                                            In order to facilitate the review of the radio                                                        process, t+/-e a,-tive material by those working                                                    application for renewal should with rnal is normaUy done under carefuoly the mate                                        without be submitte.j controlled                   reference      to previously
:onditionrs                using         specialized                                 documents and information                      submitted equipment.      A                                          If such referene-5 person whO is to use radioactive                                                      cannot be avoided, they materials inde                                            shoild be clear -ad pendently unnde                        these conditions should hot                    specific and      should identify        the per'tnp-.*.n information by date, page, and paragraph.


Aperson who is to use radioactive materials inde.pendently under these conditions should not onlyhave a background of formal training in all areas ofItem 8 of Form NRC-313 but should also have exten.sive experience working with radioactive materialand a thorough working knowledge of the equipment required to handle the material safely.10.7-2I
10) 7-7
l Items 10 and II. Specify for each radiation detec-tion instrument the manufacturer's name and modelnumber, the number of each type of instrument available, the type of radiation detected (alpha. beta.or gamma), the sensitivity range (milliroentgens perhour or counts per minute),
the window thickness inmg/cm2.and the type of use. The type of use wouldnormally be monitoring, surveying, assaying, ormeasuring.


Describe the instrument calibration procedure.
APPENDIX A
Form NRC-31 3 (I)                                                                                                                          Form Apifroed by GAO
                                                                                                                                            B- ll32S(1tOS79)
                                                    U.S. NUCLEAR REGULATORY 0O111611ON
  iO CFR 30
                                                    INSTRUCTIONS FOR PREPARATION OF
                                            APPLICATION FOR BYPRODUCT MATERIAL LICENSE
                                                                    FORM NRC-313 (I)
                                                                GENERAL INFORMATION
      An applbcant lot a "Byproduct Material (Radioisotopes) License."                  3  Broad License (research and development)-"Laceingm              Guie should complete Form NRC-313 (1) m detail and submit in duplicate                        for Type-A Licenses of Broad Scope for Resmarch and )evelop to the U.S Nuclear Regulatory Commission. The applicant should                            ment ,"
  endeavor to cover his entire radmastope program with one application, if possible. However, separate applhcationk should be submitted for                  4. Licensing Guides for the performance of well l            g eperatsoaa.


State the frequency.
gamma irradiators. Applicatmlos for medical uses should be submitted
  ^n Form NRC-313 (M) aad applications for use of scaled sources m                      S  Licunrin guide to: the use of scaled sourcs in portable and stint radiography should be submitted on Form NRC-313R. Supplemental                            portable gauging devices'
  sheets may be appened when necessary to provide complete mfoi mation. Item 18 must be completed on all applicatsios. Submission                    The Comm!son charges fees for filing of appblcaloa for hveoaes as of an incomplete application will often result en a delay in issuen*u ,t/        specified in Section 170 12, Title 10 Code of Fedwal Regitleioma.


and describe the methods andprocedures for the calibration of survey and monitor-ing instruments, as well as any other instruments andsystems used in the radiation protection program.such as measuring instruments used to assay scaled-source leak-test samples (see Item 14). contamination samples (e.g., air samples, surface "wipe' samples).
the license because of the correspondence necessary to obtain inhr                Part 170. The applicant should refer to Section 170.31, Scaleduh. uf rnrionrequested on the applicatron                                                fees Ior materialsIlc'n srs. to determine what fee should accompany the application No action can be taken on applications until fees are NOTE      When the application incldde: one oi the special sises listed          paid. ('hecks or money orders should be made payable to the U.S.
and bioassay samples (see Item 12).An adequate calibration of survey instruments usually cannot be performed with built-in checksources.


Electronic calibrations that do not involve asource of radiation arc also not adequate to deter-mine the proper functioning and response of all com-ponents of an instrument.
below the applicant should request tihe appropruate pamphlet wlhch                Nuclear Regulatory ( ommassion.


Daily or other frequent checks of survey instru-ments should be supplemented every 6 months with atwo.point calibration on each scale of each instru-ment with the two points separated by at least 50% ofthe scale. Survey instruments should also becalibrated following repair. A survey instrument maybe considered properly calibrated when the instru-ment readings are within +/-10 percent of thecalculated or known values for each point checked.Readings within- +/-20 percent are considered accep-table if a calibration chart or graph is prepared andattached to the instrument.
provides additionul instructions rwo ,opr," of the ,ompleted Irorm NR(-313 (e) and two copies of I  Industrial Radiography "'LIcensitng Requirements for Industrial          ea.h atticlimeni thlicc-o should he eCnito the Division of I rael Cycle Radiography'" (use. application I orm NRC'-31 3R for Radi                mnd i*iterial Silely. Ottice of Nuclear Material Safety and Safeguards.


If the applicant proposes to calibrate his survey in-struments, a detailed description of planned calibra-tion procedures should be submitted.
ography).                                                                IS Ni.lcat Regpilatury Commilsion Washington. DC 20555 One sopy liukiu bc retained for the appliLant's file            Applications may
        2 Laboratory and Industrial Uses i Small Quantitis-"G(uidc for              Ji.s be hited in person at the Comnitssion's office at 1717 H Street.


The description of calibration procedures should include, as aminimum:a. The manufacturer and model number of eachradiation source to be used.b. The nuclide and quantity of radioactive material contained in each source,c. The accuracy of the source(s).  
Preparation ol Applications for Liboratory and Industrial                N %,. Wishington. D C or at 7915 1 astern Avenue. Silver Spring.
The traceability of the source to a primary standard should beprovided.


d. The step-by-step procedures, including as-sociated radiation safety procedures, ande. The name and pertinent experience of eachperson who will perform the calibrations.
Uses of Small Quantities of Bypr-rduLt Material."                        M*r5 land EXPLANATION OF FORM NRC-313 (1)
      I-orm NR('-313 fl) is desgned for use in supplying information Thc actual s*ies of use should be listed as indicated. Per on program, nt varying complesty          fhc applicant should provide                        tijnent A[A  ilihlie such as field oflfis lot portable gauges or complete information on his proposed program or the possession devicei should be identified in Item S by Street. Address.


If the applicant intends to contract out the calibra-tion of instruments, the name, address, and licensenumher of the Firm should be specified together
and use of licensed material I or those items that do not apply. indicati.
%% iththe frequency of calibration.


The applicant shouldcontact the firm that "rill perform the calibration.
City and Stait          Temporar, field locations of use should As N.A  (not appli.able)
                                                                                                be specified as "'temporary job sites of the pplicani" and list the States throughout which the tempora i job sites will Item No he h1,laed      Attach additional properli, keyed sheet if miort spas  is needed I      Sell -exphndlory The -applicant'" i Ilhe organil.ation ii person legall ivc,                6      Sell    \'eplanatory ponibk for possession and ue of the licensed materials specified in the application
                                                                                        7      rhc "Radiation Protection Officer' is the nanied uilividual sho is expected to coordinatc the safe use of the licensed
      3      Sell-explanatory materi~al spekilied in the application and who will ensure srmphanme w!lh the applicable parts of Title 10. ('ode of
      4      SelU-tiplanalory I cderal Regulations I0 7-9


todetermine if information concerning calibration procedures has been filed with the Commission.
A      List by name Ca,1iraditisotope it, he pose-r*ned and ised Attach .red~bonsa        pi.perl% keyed sh-,.tsit  11    a    '
            under the license 1, ample                                                            needed
                                                                                            1I    Stale tile u      itf  cacti II, cnsed material hlated in 9 V 8..
                                                            B                                      and D
                l)    lodtne-I31        (l)    Iodide t21  lodassc-
* t
                                        12)    lodinated Humani Scruti Albunpin I* etcript1ion ti
                                                                                                    .Urct*
                                                                                                                    c tllcmtainre* an*d/or device% in ,vJjjh sealed e in Iltem h will be stored or uted. I %ample listd i
                13)  Krypton-85        13)  (.as
              141  Cesium-I 7        (4l  Sealed SouC1.


Ifinformation concerning calibration procedures hasnot been filed, it should be obtained and submitted.
A
                                                                                                          II I 1      Source housing              Io Curp D)
              0I)  Nof Appliuable    41) 10    mihd:icurie..
              (2)  N  A                    I aillicurnic                                                      Model 1-278 I,)                      (2)
                    N  A                    I inillIhuric I4)                      (4)    2 sou*icul ISO                              10 18      SeIf-.xplanatory        (I at those items that do not apply Model Z-78              mitlit. tolne Cacti                                  indicate a* N A (not applicable)
                                                                PRIVACY ACT STATEMENT
Pursuant to 5 U S.( 55 2af*l(3). 'niacted into law by set,.lon 3 of the I'IVaLvy Act of 1974 (Public: Law 93-579). the Iollowing .-titcileti IS furrnishcd to rndividual% who surply information to the Nuclear Regulatory Commis*ion on I orms NRC-313M, NR(-3 13A, NR(-3131 or NR(_'- 313R I his mformalion is mainiained in a system of re!eoid designated as NRC-3 and descrihed at 40 1 ederal Register 45 114 (Otlober I. 1975)
I AUTHORITY SIio n,81 and 1614b) of the Atomic Inerpy Act of 1954. a, amended (42 U.S.(                          2111 and 2201ib(1
2  PRINCIPAL PURPOSI"S) The informatmon is e:valuated It, the HKC staif pursuant to the ritleria set forth in 10 ( I R Parts 30-36 to determine whether the application meet, the requircmenti of the Atomic I nergy Act uo 1954. as amctindsd. ap the C('ommisoon's rclgulsaions. lot the issuanice of a byproduct maleril license or amendment thereof
3 ROUTINF tjSI S "he informawn itay be:used (0; to provide reuord& to State heaithk c.kpirtmeusi fop the intormpaipanand useand 4h)to provide intformation t4 I ederal. Stiart. and k),.al heafth officials and other p*;rsons in the event of incident of xposutic por thiir trifortnatilon, mvemiwzliarn.


Quantitative measuring instruments used tomonitor the adequacy of containment and con-tamination control such as those used for measuring leak test. air. effluent.
ind protection (it the publitc health and safety The nfotinalicn ma, dlv) be ditslotd to approptiate I .Jeral. Stile and local ait.ticies in the event that the information indicale* a vio~Ltioon of ptenlti viol*iAt          of law and in the course of in ad"ministrative o luli cuialproceeding In Addition. this inlormation    ri ay be transfeared to An approprate IFederal. State. or kical agency to i'c esxhint relevant and neest*,.ry f>r a NR(
  dn, ison or to an appropriate I ederal agnev to the .xtent relevant and ne                  lot that afenty'%dcJtioun about sou
                                                                                          ,LcesAfy                                            A npli tit the hin"sc issued will routinely he placed in the NRC's Puhlic Doument Room. 1717 H Street. N W, Washington. DA
4  WHI T1,11II      DIStLOSLRI. IS MANDATORY OR VOLUNTARY AND. III FCT ON INDIVIDUAL 01 NOT PROVIDIN(; INI.ORMA rION
    Dit..losurc of the requested infrrmnation is voluntary It the request information is not furnished. hno*,w.vr. ti apptiation  "          horiI, producl mat 'rial lhcense or 3mendmenl thereof, will not he proceied
5  SYSTIM MANAGFRISI ANI) ADDRI SS Dir."tor Division ti I ucl (Clee .aid Matarial Sat*t*.                      Ofti,    ol Nu, tear Material Saetly a4ad S.afeguidf,.
    ki S Nuclear Regulallory ( ommission. Washington. D ( 2055
                                                                                10 7-10


bioassay, suork area. andcquipnient contamination samples should usually hecalibrated prior to each use. The procedures and fre-quency for calibration of such instruments should hesubmitted and should include:a. The name of the manufacturer and modelnumber of each of the standards to he used.h. The nuclide and quanity of radioactiVc material contained in each of the standard sources.c. A statement orthe accuracy of each of the stan-dard sources.
FORM NRC-313            I            -U.S. NUCLEAR REGULATORY COMMUON                                            1. APPLICATION FOR:
        (1-79)
                                                                                                                            (Chec* and/or conYiDe a             opeteJ
        10 CFH 30
                  APPLICATION FOR BYPRODUCT MATERIAL LICENSE
                                                        INDUSTRIAL                                                                 


The source accuracy should be. as aminimum.
====a. NEW LICENSE====
      See erached 'nsrucrt,os for details b. AMENDMENT TO.


+/- 5 percent of the stated value andtraceable to a primary standard, such as that main-tained by the National Bureau of Standards.
L ICEiNSE NUUMBE
      n'fli)leted .p* is-i,,tins are tlile' in d(i/*    otre with the Division of FIuel C'*rle and Material Safetr,.
    Offit r I'f Nit, lear Material Safetv. o.in Safeguards U.S. Noclear Regulatory Commisusion.


d. Step-by-step calibration procedures and. if ap-propriate.
Washington. DC 20555 or app/i,.*i5              'nay he, fed    in person at the Comnrnision's office at                      c  RENEWAL OFF
    I77 H Strepr N&#xfd;W. Washinqtol/ 0            ,'" or 7915 Fastern Avenue. Silver Sprinq. Marylayri.


associated radiation safety procedures.
2. APPLICANT'S NAME (institution. firm, person, etc.)                               


ande. The name and pertinent experience of eachperson who will perform the instrument calibrations.
===3. NAME OF PERSON TO B===


hem 12. Personnel monitoring is required if aperson is likely to receive in a calendar quarter 313millirems to the body. 4.69 rems to the estremities.
==E. CONTACT==
ED REGARDING THIS
                                                                                            APPLICATION
      TELEFPHONE NUMBER            AREA CODE - NUMBER EXTE.NSION.                            LEPNONE NUMBER            AREA CODE -- FJUMBER EXTENSION
  4APPLICANT'S MAILING ADDRESS (Include Zip Code)B                                        STREET ADDRESS WHERE LICENSED MATERIAL WILL BE USED
                                                                                            fIncludeO EECode)
                      (IIF MORE    SPACE IS NEEDED FOR ANY ITEM. USE ADDITIONAL PROPERI y                                        V'lVV%      bAfICC
  6. INDIVIDUAL(S) WHO WILL USE OR DIRECTLY SUPERVISE THE USE OF LICENSED MATERIAL
        (See Items 16 and 77 for required Frainingand experience of ech indjividul n4,,d              be low)
                                      FULL NAME                                                                              TITLE
  Ib C.


or1.88 reins to the skin (lowcr limits apply to those un-der 18 years of age: see ,20.101 and 20.202 of 10CFR Part 20). Personnel monitoring is also requiredif a person enters a high radiation area (greater than100 millirems per hour). If personnel monitoring equipment will be used. the name of the organization furnishing film badge or thermoluminescent dosimeter (TLD) service and the frequency forchanging badges, dosimeters.
7. RADIATION PROTECTION OFFICER                                                    I Attach e resume of person's trainingend exper.ence a outline if items I 16 and   17 and describe his responsib*t*tievs under Item 15.


etc.. should bespecified.
_____S.                                           LICENSED MATERIAL
I    L                  ELEMENT                                CHEMICAL                  NAME OF MANUFACTURER                        MAXIMUM
                                I  N                            NIRAND                                        ,              MILLICURIES AJ4DOMMEALED
    N                MASS NUMBER                            PHYSICAL FORM                      MODEL NUMBER                    SOURCES AND MAXIMUM ACTI.


If pQcket chambers or pocket dosimeters will be used, the useful range of the device, in mil-liroentgens.
(if Sealed Source)            VITY PER SOURCE WHICH WILL
  NO.                        A                                                                          CO                  BE POUSESSED AT ANY ONE TVME I
                                                                            UC                                                                      0
                                            _                                                                                                                      -4
!(31 DESCRIBE USE OF LICENSED MATERIAL
(21 I                  17
                                                                                                                                                          _33 F*IMNRC    313 i 1 -791---
                                                                                                                                                        _  ____
                                                                                10.7-11


the frequency of reading, and theprocedures for maintaining and calibrating thedevices should be specified.
9. STORAGE OF SEALED SOURCES
    SCOftTAINtSR      AND/OR DEVICE IN WHICH EACH SEALED                    NAME OF MANUFACTURER                      MODEL NUMefifR
It      SOURCE WILL BE STORIED OR USED
I                                A.                                                      B.                                    C.


If personnel monitoring will not be used, the appli-cant should submit calculations or documentation from radiation surveys that demonstrate that it is un-likely that any individual will receive a dose equal toor greater than that indicated in the preceding paragraph.
12)
(3)
(4)
                                            10. RADIATION DETECTION INSTRUMENTS
-               TYPE          MANUFACTURER'S          MODEL              NUMffR                RADIATION                SENSITIVITY
L                OF                  NAME            NUMIBR            AVAILABLE              DETECTED                    RANGE
M          INmsTRMmNT                                                                          (alpha.beta.          (fnbllfoenr.mrno/hour S                                                                                            gamma. neurron)            or counts/mmnure)
                  A                                      C                  D                    E                          F
121
(31
                                      11. CALIBRATION OF INSTRUMENTS LISTED IN ITEM 10
0E.    CALINRATDO NY SERVICE COMPANY                                  [0b. CALIBRATED BY APPLICANT
        NAME. ADORESS. AND FREQUENCY                                      Attach a Speorate sheet describing method, frequency Mnd staMdards used for caibratinginhtrumwen.


The applicant should show that the need for bioas-says has been thoroughly considered and should es-tablish the adequacy of the proposed hioassayS010.7-3 Iprogram in relation to the proposed program of useof radioactive material.
12. PERSONNEL MONITORING DEVICES
                        TYPE                                            SLPPLIER                                  EXCHANGE FREOUENCY
        fCheft* and/of cran)te as ^wP(OP-o-                         (Seiwce Company)                                          C
                                                                                                                              C
                          A,
0111 FIL*ISADIGE                                                                                                  0  MONTHLY
D12) THERMILUVMINESCENCE
                                                                                                                  0 QUARTERLY
          DO1308ITTER (TLD0
                                                                                                                  D OTHER (Specdy)
    S0011  OTHiER  (Sw,_y)
            13. FACMILTtMS AND EQUIPMENT (Check          were appropriate and attch      annotated sketch(es) and description(s).
                                                                                              dMany). ETC
  0    a LABORATORY FACILITIES. PLANT FACILITIES, FUME HOODS (Include foltreon, CONTAINERS.  SPECIAL SHIELDING  (fixed and/lor teorpoarry), ETC
  D    b&#xfd; STORAGE    FACILITIES
  0    c REMOTE HANDLING TOOLS OR EQUIPMENT. ETC
  0l d RESPIRATORY PROTECTIVE EQ4JIPMENT. ETC
                                                          1q. v1 PaiLr.IK .  ,GMl_
      Na
      --.    OF CONMERCIAL WAST6 DISPOSAL SERVICE EMPLOYED
                                                                                  A DETAILED DESCRIPTION OF METHODS WHICH WILL
  b tF COMMtRCIAL WASTE DISPOSAL SERVICE IS NOT EMPLOYED. SUBMIT
                                                                              OF THE TYPE AND AMOUNT OF ACTIVITY INVOLVED IF
      "85  US6D FOR D46POSING OF RADIOACTIVE WASTES AND ESTIMATES
                                                                                      BE RETURNED TO THE MANUFACTURER. SO STATE.


Bioassays are normally re-quired when individuals work with millicurie
TE    APPLICAlION IS FOR SEALED SOURCES AND DEVICES AND THEY WILL
4uun-tities of hydrogen-3.
FO"M NOC 313 0 1-794
                                                                  10.7-12


iodine-125.
INFORMATION REOUIRED FOR ITEMS 15, 16 AND 17 Describe in detail the information required for Items 15, 16 and 17.                    Begin each item on a separate page and key to the application as follows:
          15.  RADIATION PROTECTION PROGRAM. Describe the radiation protection program as appropriate for the material to be used including the duties and responsibilities of the Radiation Protection Officer, control measures, bioassay procedures fit needed), day-to-day general safety instruction to be followed.


or iodinc-131 depending on the type of work, equipment, andpiocedures followed.
etc If the application is for sealed source's also submit leak testing procedures, or if leak testing will be performed using a leak test ki0, specify manufacturer and model number of the leak test kit.


Other materials man also beused in physical or chemical forms and under condi-tions that present an opportunity for uptake by thebody through ingestion.
16.  FORMAL TRAINING IN RADIATION SAFETY. Attach a resume for each individual named in Items 6 and 7 Describe individual's formal training in the following areas where appliable. Indude the name of person or institution providing the training, duration of training, when training was received, etc a. Principles and practices of radiation protection.


inhalation, or absorption.
b Radioactivity measurement standardization and monitoring techniques and instruments.


Abioassay program to determine and control the up-take of radioactive material should be considered anddiscussed in relation to cach such material.
c. Mathematics and calculations basic to the use and measurement of radioactivity d    Biological effects of radiation.


procedure.
17.  EXPERIENCE. Attach a resume for each individual named in Items 6 and 7. Describe individual's work experience with radiation, including where experience was obtained. Work experience or on the-job training should be commensurate with the proposed use. Include list of radioisotopes and maximum activity of each used.


etc. Regulatory Guide 8.9. "Acceptable Concepts.
1


Models. Equations.
===8. CERTIFICATE===
                                                    (This trem must be completed try appiicant)
                    Th e .ippl* canr and any official exocurJng this Ofril',cate on behalf ot the applicant named in /rem 2, certify that this application is prepared in confotmitry with Title 10, Code of Federal Regulations Parr 30I and that all 'nformation contained herein including any suPplements atrtached hereto is true and correct ro the best of our knowleade and belief.


and Assumptions for aBioassay Program."'
WARNING 18 U.S.C Section 1001, Act of June 25. 1948; 62 Stai 749; makes it a crimnal offense to            nmke a willtully taiae stltemt or repreentation to any department or agency of the United States as to any matter within its ourisdiction.
may be consulted.


The criteria to he used in determining the need forbioassays, the type and frequency of bioassays thatwill he performed, and the bioassay procedures should be specified and described in detail. If a com-mercial bioassav service is to be used, the name andaddress of the firm should be provided.
LII. FNSE FEE REQUIRED
    (See Secton 170.3? 10 CFR                                              j0    ERTIFYING OFiCiAL
                                                                            c. NAME (Type or print)
  11 LICENSE    FEE CATEGORY                                                d  TITLE
12; LICENSE    FEE eNC.:LOSED        $                                    e DATE
F0RM NRC-313      1 11 791
                                                                      10 7-13


ilioassaf.s may not he substituted for other cle-ments of a safety program such as air monitoring anddispersion control (hoods. glove boxes. etc.) and for%tell-thought-out and ssell-cxecuted handlingprocedures.
_1..
        .                              UN TED STATES
            0                NUCLEAR REGULATORY COMMISSION
                                    WASHINGTON, D. C. 20555 July 1984
                                            [[kRATA
                            REGULATORY GUIDE 10.7,      Revision 1 GUIDE FOR THE PREPARATION OF APPLICATIONS
                                                                      FOR
                  LICENSES FOR LABORATORY AND INDUSTRIAL USE
                                                                    OF SMALL
                            QUANTITIES OF BYPRODUCT MATERIAL
  Regulatory Guide 10.7, Revision 1, provides directions for using Form NRC-313I
  in preparing applications for licenses for laboratory and industrial use of small quantities of byproduct material.


liem 13. The equipment and facilities for each siteof use should be described in detail. The proposedequipment and facilities for each operation to be con-ducted should he adequate to protect health andminimize danger to life and property.
The NRC is now using a new NRC Form
  313 for all byproduct material applications Form NRC-313I.                                   and is discontinuing the use of The NRC is developing Revision 2 of Regulatory conform to the new NRC Form 313.                                        Guide 10.7 to Until Revision 2 is issued, this errata sheet provides the information needed to use the new NRC Form 313.


In describing available equipment and facilities, the following typesot information should be included, as appropriate:
The new NRC Form 313 does not have space for providing the information requested in Items 5 through 11.    Please provide the information on 8-1/2 x
a. Physical plant. laboratory, or working areafacilities.
                                                                              11 inch paper.


Fume hoods, glove boxes, waste recep.taces, special sinks, ventilation and containment systems, effluent filter systems, and all processing, work. and protective clothing change areas should bedescribed.
In the left-hand column of the following table are listed items of the old Form NRC-3131, most of which are also called out in Regulatory Guide 10.7, Revision 1. The right-hand column identifies the corresponding item of the new NRC Form 313 in which responses should be made.


b. Containers.
Guide and Old Form NRC-3131 New NRC Form 313 Item  1*
Item                                                      Item 1
      2 Item                                                      Item 2
      3 Item                                                      Item 4
      4 Item                                                      Item 2
      5 Item                                                        Item 3
      6 Item                                                        Item 8
      7 Item  8                                                    Item 7 Items 5 and 6 Item 9 Item 10                                                    Item 9 Item 11                                                    Item 10
                                                            Item 10


devices.
itei  12                                          Iter; 10
Item  13                                          Item  9 Item  14                                          Item  11 Item  15                                          Item  10
Item 16                                          Items 7 and 8 Item 17                                          Item 7 Item 18*                                          Items 12 and 13
*Not called out in Regulatory Guide 10.7, Revision 1.


protective clothing, aux-iliary shielding, general laboratory equipment, airsampling equipment, etc., actually employed in thedaily use of material.
The following cross-reference table may be helpful to you:
New NRC Form 313                                  Old Form NRC-3131 Item  1                                            Item 1 Item  2                                            Items 2 and 4 Item 3                                            Item 5 Item 4                                            Item 3 Item 5                                            Items 8A, B, C, and D
Item 6                                            Item 8E
Item 7                                            Items 7, 16, and 17 Item 8                                            Items 6 and 16 Item 9                                            Items 9 and 13 Item  10                                          Items 10, 11, 12, and 15 Item 11                                          Item 14 Item  12                                          Items 18a(1) and (2)
Item 13                                          Items 18b, c, d, and e  ,,L_
Item  14                                          N/A
                                        2


Special provisions for shielding and containment to minimize personnel exposureshould be described.
NRC 'OPV              313
            8'              32 33 34                                                                                                                                            US. NUCLEAR REGULATORY COMMISSION
                                                                                                                                                                                                      APPROVED BY OM8
                                                                                                                                                                                                      3150-0120
                  ...                                                                APPLICATION FOR MATERIAL LICENSE                                                                                  Elxpir,. 5-31-87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR
                                                                                                                                                                COMPLETING APPLICATION          SEND TWO COPIES
        )' 'HE ENTIRE COMPLETED APPLICATION TO THE NRC
                                                                                              OFFICE SPECIFIED BELOW.


c. Storage containers and facilities.
FEDERAL AGENCIES FILE APPLICATIONS WITH
                                                                                                                          IF YOU ARE LOCATED IN:
              "I S NUCLEAR          REGULATOR Y COMMISSION
                                                                                                                          ILLINOIS, INDIANA, IOWA. MICHIGAN, MINNESOTA, MISSOURI
              3)IVISION      OF FLEL CYCLE AND MATERIAL SAFETY. NMSS                                                                                                                        OHIO, OR
                                                                                                                          WISCONSIN. SEND APPLICATIONS TO
            WASHINGTON              DC 20555 U S. NUCLEAR REGULATORY COMMISSION, REGION III
      ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS,
                                                                                    IF YOU ARE                                MATERIALS LEIUCENSTNG
      LOCATED IN                                                                                                                                          SECTION
                                                                                                                              799 ROOSEVELT ROAD
      CONNECTICUT. DELAWARE, DISTRICT OF COLUMBIA, MAINE, MARYLAND,                                                            GLEN ELLYN. IL 60137 MASSACHUSETTS, NEW JERSEY, NEW YORK, PENNSYLVANIA,
      On VERMONT. SEND APPLICATIONS TO,                                                    RHODE ISLAND.                  ARKANSAS, COLORADO, IDAHO, KANSAS, LOUISIANA, MONTANA,
                                                                                                                          NEW MEXICO, NORTH DAKOTA, OKLAHOMA, SOUTH DAKOTA,                        NEBRASKA
                                                                                                                                                                                              TEXAS, UTAH,
                  S NUCLEAR REGULATORY COMMISSION. REGION I
            NUCLEAR MATERIAL SECTION B                                                                                    OR WYOMING, SEND APPLICATIONS TO:
            63! PARK AVENUE                                                                                                    U.S. NUCLEAR REGULATORY COMMISSION. REGION IV
            KING OF PRUSSIA. PA 19406                                                                                        MATERIAL RADIATION PROTECTION SECTION
                                                                                                                              611 RYAN PLAZA DRIVE. SUITE 1000
      ALARAMA FLORIDA GEORGIA KENTUCKY, MISSISSIPPI, NORTH CAROLINA,                                                          ARLINGTON, TX 76011 PUERTO RICO, SOUTH CAROLINA, TENNESSEE, VIRGINIA, VIRGIN
      WEST VIRGINIA. SEND APPLICATIONS TO:                                                      ISLANDS. OR              ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA, OREGON,
                                                                                                                          AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND            WASHINGTON,
                                                                                                                                                                                                  APPLICATIONS
            'J.S NUCLEAR REGULATORY COMMISSION, REGION
                                                                                  II
                                                                                                                          TO:
            MATERIAL RADIATION PROTECTION                      SECTION
              'I MARIETTA STREET, SUITE 2900                                                                                U.S NUCLEAR REGULATORY COMMISSION, REGION V
                                                                                                                              MATERIAL RADIATION PROTECTION SECTION
          ATLANTA. CA 30323
                                                                                                                              1450 MARIA LANE. SUITE 210
                                                                                                                              WALNUT CREEK, CA 94596 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
                                                                                                JURISDICTION.


These shouldprovide both shielding and security for materials.
I THIS IS AN APPLICATION FOR [Chock o'opritare itEm)
                                                                                                                      2. NAME AND MAILING ADDRESS OF APPLICANT (Includ.Zip Code)
                  A    NEW LICENSE
                  B AMENDMENT TO LICENSE NUMBE9
  ? AJDRESSiES! WHERE LICENSED MATERIAL WILL
                                                                            BE USED OR POSSESSED.


d. The number, type. and length of remote handl-ing devices.* A copy of this guide may he obtained by a written requestto the U.S. Nuclear Rcgulatory Commission.
4 NAME OF PERSON TO B


Washington.
==E. CONTACT==
ED ABOUT THIS APPLICATION
                                                                                                                                                                                TELEPHONE NUMBER
  SUBMIT ITEMS 5 THROUGH II                        ON  EN , 11  PAPER      THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED
                                                                                                                                              IS DESCRIBED IN THE LICENSE APPLICATION GUIDE
  E      RADIOACTIVE MATERIAL
                    Er'iinlband      5 nunibr aort.    b Ihencal]
                                                      tft      andlor OnyIsciI        and c.  mano'" ionn            6.  PURPOSEIS) FOR WHICH LICENSED MATEPIAL WILL
        ,.rlcn wi,' be oo$$s~sec at any onn tinie                                                                                                                                      BE USED
        'NDIVIDUALiSi RESPONSIBLE FOR RADIATION SAFETY
        TRA        '&#xfd;ING AND EXPER:ENCE                                              PROGRAM AND THEIR
                                                                                                                      8. TRAINING FOR INDIVIDUALS WORKING IN OR FREOUENTING
                                                                                                                                                                                                RESTRICTED AREAS
          ACILITIES AND EQUIPMENT                                                                                    10.  RADIATION SAFETY PROGRAM
          WASTE MANAGEMENT                                                                                            12 LICENSEE FEES (Saw ro CFR          I70nd  S*eefon 170.31)
                                                                                                                                                                              WAMOUNT
                                                                                                                      FEE CATEGORY                                            ENCLOSED $
          C'ERTIFICATU0N              !AMiistbecornolotedbyaDphcandJ THE APPLICANT UNDERSTANDS
                                                                                                                THAT ALL STATEMENTS AND REPRESENTATIONS
                                                                                                                                                                          MADE IN THIS APPLICATION ARE
          Hl -ING .PO.,            Tn5 APPLICANT
          "-.E APPLICANT AND ANY OFFICIAL EXECUTING THIS
          cRyFPARLD :N CONFORMITY WITH TITLE                                        CERTIFICATION ON BEHALF OF THE APPLICANT NAMED
                                                                    I0. CODE OF FEDERAL REGULATIONS,          PARTS 30,32, 33,34,35. AND 40 AND      IN ITEM 2, CERTIFY THAT THIS APPLICATION IS
                                                                                                                                                          THAT ALL INFORMATION CONTAINED HEREIN
            'S'RI E AND CORRECT TO THE BEST OF THEIR KNOWLEDGE
                                                                                            AND BELIEF
          PIARNING I6 &#xfd;                -C SECTION I001 ACT OF JUNE 25 1948.62 STAT 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY
                  T-AY DEPARTMENT OR AGENCY OF THE UNITED STATES                                                                                                      FALSE STATEMENT OR REPRESENTATION
                                                                                          AS TO ANY MATTER WITHIN ITS JURISDICTION
          .',R*J-'EH*T ...                  I.%GO:CSR                      TYPEDIPRNTEO NAME                                          IIL                                                        DT
          $SOO.


D).C. 20555., Attention:  
-,-I                  *          TMIO
Director.
                                                                    8NUMBER OF EMPLOYEES (Totalio d WOULD YOU BE WILLING TO FURNIH COST
                                                                  $  ~ ittrn aciityPx~iJ~nECJttdfCflt*Ct,,)
                                                                                                                        ON THE ECONOMIC IMPACT OP CURRENT NRC REGULATIONS
                                                                                                                                                                              INFORMATION ('Jolls, anditeho,,
                                                                                                                                                                                              OR ANY FUTURE
        I 251K -500K                          S'5V35  7M                                                                PROPOSED NRC REGULATIONS THAT MAY AFFECT
                                                                                                                        it t0O1eCitip,~lCn YDU? (NRC iwecilationn,'pi.n4 nena o iera~r~i,,.,ion.i,                 e-r,Ihld to
    :     5520K - 50K                        s7m - 1M            c NUMBER OF BEDS                                      th poyin        contidenlcs)
          S-50K            V>NO
                            V,..A              J                                                                            YES
                                                                                                        FOR NRC USE ONLY
            3          i            'SE LOG  0P5                FEE CATEGORY                COMMENTS                                                                                  APPROVED By
                    2
4.',            "  .  ECE    .'C                  CHECK  NUMBER
                                                                                                                                                                                        DATE
        ;'v"""*ACT        S
                            A
                            S      AT. T
                                  Y>TIE'T  0O4 THE E REVERSE
                                                        REV


Office of Standards Development.
PRIVACY ACT STATEMENT
Pjrsuant to 5 U.S.C. 552a(e)(3), enacted into law by section 3 of the Privacy Act of 1974 JPublic Law 93-579), the follow
!ng statement is furnished to individuals who supply information to the Nuclear Regulatory Commission on NRC
                                                                                                                          Form
313. This information ;s maintained in a system of records designated as NRC-3 and described at 40 Federal Register
                                                                                                                          45334 (October 1, 19751.


lIent 14.a. Survey Program.
1 AUTHORITY: Sections 81 and 161(b) of the Atomic Energy Act of 1954, as amended (42 U.S.C. 2111 and 2201 (bll
2 PRINCIPA


Commission regulations re-quire that surveys be made to determine if radiation hazards exist in a facility in which radioactive materials are used or stored (see &sect;20.201.
==L. PURPOSE==
(S): The information is evaluated by the NRC staff pursuant to the criteria set forth ;n 10
                                                                                                                            CFR
    Parts 30, 32, 33, 34, 35 and 40 to determine whether the application meets the requirements of the Atomic Energy Act of
    1954, as amended, and the Commission's regulations, for the issuance of a radioactive material license or amendment thereof.


10 CFRPart 20). A survey should include the evaluation ofexternal exposure to personnel, concentrations of air-borne radioactive material in the facility, andradioactive effluents from the facility.
3. ROUTINE USES: The information may be (a) provided to State health departments for their information and use, and (b) provided to Federal, State, and local health officials and other persons in the event of incident or exposure, for their information, investigation, and protection of the public health and safety. The information may also be d1,s closed to appropriate Federal, State, and local agencies in the event that the information indicates a violation or potent:ai vwo'at~on of iaw and !n the course of an administrative or judicial proceeding. In addition, this information may be trans ferred to an appropriate Federal, State, or local agency to the extent relevant and necessary for an NRC decision or to an appropriate Federal agency to the extent relevant and necessary for that agency's decision about you.


Although atheoretical calculation is often used to demonstrate compliance with regulations regarding airborne orexternal radiation, it cannot always be used in lieu ofa physical survey.Except for those cases where sources of radiation and radioactive material are well known and ac-curately and precisely controlled.
4&#xfd; WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVID
    ING INFORMATION: Disclosure of the requested information is voluntary. If the requested information is not furn ished, however, the application for radioactive material lik.ense, or amendment thereof, will not be processed. A request that :nformation be held from public inspection must be in accordance with the provisions of 10 CFR 2.790. Withhold ing from public inspection shall not affect the right, if any, of persons properly and directly concerned need to inspect the document.


it will usually benecessary that a physical survey be made with ap-propriate detection and measurement instruments todetermine the nature and extent of radiation andradioactis material or, as a minimum, confirm theresults of a theoretical determination.
5. SYSTEM MANAGER(S) AND ADDRESS:                U.S. Nuclear Regulatory Commission Director, Division of Fuel Cycle and Material Safety L
                                                Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555 NRC FORM 313


A radiation protection program should include thefollowing surveys for radioactive contamination andradiation:
I NRC
(I) In laboratory areas (e.g., checking for con-tamnination on bench tops, handling and storageequipment, clothing, hands, etc.).(2) Whilc work is being done with radiation orradioactivc materials (e.g.. breathing zone air sur-veys: general air surveys;
                                                                                                                                                                      US NUCLEAR REGULATORY COMMISSION
personnel exposuremeasurements, including eyes and extremities:
        84 APPROVED BY OD4E
check-ing shutters and containment.
          C F 1,4"3,       &#xfd;    1                                                                                                                                                            3150-0120
                                                                              APPLICATION FOR MATERIAL LICENSE                                                                                E-pis    55-31.87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING
                                                                                                                                                                      APPLICATION      SEND TWO COPIES
      )l THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED
                                                                                                            BELOW.


etc.).(3) In areas associated with disposal or releaseof radioactive materials (e.g., checking disposal con-tainers and disposal sites: liquid, gas, and solid ef-fluents:
[
filters and filter-duct systems:
    "FEDERALAGENCIES FILE APPLICATIONS WITH
etc.).The frequency of surveys will depend on the natureof the radioactive materials and their use. However.surveys should be performed prior to the use ofradioactive materials in order to establish a baseline.
            - S NUCLEAR REGULATORY COMMISSION
          ilVISION O FUEL CYCLE AND MATERIAL SAFETY. NMSS
          WNASHINGTON.           DC 20555 IF YOU ARE LOCATED IN
                                                                                                                    ILLINOIS, INDIANA, IOWA, MICHIGAN. MINNESOTA. MISSOURI, OHIO. OR
                                                                                                                    WISCONSIN. SEND APPLICATIONS TO:
                                                                                                                        U S. NUCLEAR REGULATORY COMMISSION. REGION III
    ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS. IF YOU ARE                                                          MATERIALS LICENSING SECTION
    LOCATED IN                                                                                                          799 ROOSEVELT ROAD
    CONNECTICUT. DELAWARE. DISTRICT Ol- COLUMBIA. MAINE. MARYLAND.                                                      GLEN ELLYN. IL 60137 MASSACHUSETTS, NEW JERSEY NEW YORK. PENNSYLVANIA, RHODE ISLAND,
    OPRVERMONT. SEND APPLICATIONS TO.                                                                               ARKANSAS COLORADO, IDAHO, KANSAS. LOUISIANA, MONTANA, NEBRASKA,
                                                                                                                    NEW MEXICOO,NORTH DAKOTA, OKLAHOMA, SOUTH DAKOTA. TEXAS, UTAH.


The surveys should be repeated when radioactive materials arc present, when the quantity of materialpresent changes, or when changes occur in their con-tainment systems or methods of use. Repetitive sur-veys may also be necessary to control the location ofradioactive materials in the handling system and intic case of the use of sealed sources outside a shieldedcontainer.
OR WYOMING. SEND APPLICATIONS TO:
              S NUCLEAR REGULATORY
        NUCLEAR MATERIAL SECTIONCOMMISSION.        B
                                                                    REGION IO
                                                                                                                      U.S. NUCLEAR REGULATORY COMMISSION, REGION IV
        631 PARK AVENUE
        KING OF PRUSSIA. PA 19406                                                                                    MATERIAL RADIATION PROTECTION SECTION
                                                                                                                      611 RYAN PLAZA DRIVE, SUITE 1000
    ALABAMA. FLORIDA, GEORGIA. KENTUCKY. MISSI.SIPPI, NORTH CAROLINA,                                                 ARLINGTON.TX 76011 PUERTO RICO, SOUTH CAROLINA. TENNESSEE, VIRGINIA, VIRGIN ISLANDS,
                                                                                                  OR              ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA. OREGON, WASHINGTON.


For operations involving materials in gas, liquid,or finely divided forms, the survey program should bedesigned to monitor the adequacy of containment and control of the materials involved.
WEST VIRGINIA. SEND APPLICATIONS TO
                                                                                                                  AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND APPLICATIONS
        'J S NUCLEAR REGULATORY COMMISSION. REGION II                                                            TO:
        MATERIAL RADIATION PROTECTION                      SECTION
        ',71 MARIETTA STREET. SUITE 2900                                                                              U.S. NUCLEAR REGULATORY COMMISSION REGION V
                                                                                                                      MATERIAL RADIATION PROTECTION SECTION
        ATLANTA GA 30323
                                                                                                                      1450MARIA LANE, SUITE 210
                                                                                                                      WALNUT CREEK. CA 94596 PERSONS LOCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE
                                                                                              U.& NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS
                                                                                                                                                                                  AND USE LICENSED MATERIAL
  IN STATES SUBJECT TO U.S. NUCLEAR REGULATORY COMMISSION JURISOICTION.


The programshould include air sampling, monitoring of effluents,
THIS IS AN APPLICATION FOR lChoek aWmpriste it")
010.7-4 and surveys to evaluate contamination of personnel, facilities, and equipment.
                                                                                                                2. NAME AND MAILING ADDRESS OF APPLICANT (OncludeeZ Code)
              A NEWLICENSE
              8    AMENDMENT          TO LICENSE NUMBER_
              C RENEWAL OF LICENSE NUMBER
      A--A)DRESSIES! WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED
4 NAME OF PERSON TO B


The description of an air sampling program shouldinclude the area where samples will be taken, the fre-quency of sampling, and the location of the samplerwith respect to workers'  
==E. CONTACT==
breathing zones. Assays per-formed to evaluate air samples and the methods usedto relate results to actual personnel exposures shouldalso be described.
ED ABOUT THIS APPLICATION
                                                                                                                                                                    J TELEPHONE NUMBER
SUBMIT ITEMS S THROUGH 1 I ON E'i                      11 - PAPER      THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED
                                                                                                                                                    IN THE LICENSE APPLICATION GUIDE
5    RADIOACTIVE MATERIAL
      a E emeni and mass 'iunibet" b c&#xfd;hen,cal end/or physlcls for,. end c.


The effluent monitoring program for releases tounrestricted areas should encompass all airborne andliquid radioactive material releases.
n*,binusn 60.mn            6    PURPOSEIS) FOR WHICH LICENSED MATERIAL WILL BE USED
      &#xfd;t,'      -C 11b5, Qosssed at anv one ti-e NIDIVNIUAL(S, RESPONSIBLE
                                                  FOR RADIATION SAFETY PROGRAM
      TRA,.,ING AND EXPERIENCE                                                          AND THEIR
                                                                                                                8    TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS
        SACITIES AND EQUIPMENT
                                                                                                                10    RADIATION SAFETY PROGRAM
"    W
      WASTE MANAGEMENT
                          N12.


Theoretical evaluations should be suppLmcnted by stackmonitoring, water sampling, and nther environmen- tal monitoring appropriate for thc planned andpotential releases.
LICENSEE FEES (See I0CFR 170andSection 170.31/
                                                                                                                                                                    iAMOUNT
                                                                                                                FEE CATEGORY                                        jENCLOSED      $
        ""ErTIF'CATION              (Must beomo/eredby*Phl/cAntJ THE        APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS
                                                                                                                                                                MADE IN THIS APPLICATION ARE
        8,,'E NGNUPON T.IE APPLICANT
          "iE    APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION
      PRFPAIIED ;N CONFORMITY WITH TITLE 10, CODE OF FEDERAL
                                                                                                ON BEHALF OF THE APPLICANT NAMED IN ITEM


For operations involving only sealed sources, asurvey program should include evaluation and/ormeasurement of radiation levels for storage and useconfigurations.
===2. CERTIFY THAT===
                                                                                                                                                                        THIS APPLICATION IS
                                                                                      REGULATIONS, PARTS 30.32 33. 34 35. AND 40 AND THAT ALL
      &#xfd;S TOIJE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND                                                                                              INFORMATION CONTAINED HEREIN
                                                                                        BELIEF
          .ARNINC. IS, U SC SECTION 1001 ACT OF JUNE 25. 1948, 62 STAT
                                                                                          749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE
      Tr A%' ULEPARTMENT OR AGENCY OF THE UNITED STATES AS                                                                                                          STATEMENT OR REPRESENTATIO.N
                                                                                      TO ANY MATTER WITHIN ITS JURISDICTION
              .i" i      E.(*T'    'NTI OFFICER                    I TYPED/PRINTED NAME                                      ITITLE                                                    DATE
                                            P                                              14 V      UNTAAY ECONOMIC DATA
                                    N'..
                                      R      Pb                NUMBER OF EMPLOYEES        (Tote/i'1o,        d WOULD YOU BE WILLING TO FURNISH COST INFORMATION
                                          SIM    I SM          ...      fre                                                                                                        r(JOI8e,.doCImffh., ,
                                                                                              .                    ON THE ECONOMIC IMPACT OF CURRENT NRC REGULATIONS                                        5 OR ANY FUTURE
          25271K                        S35kEV7M                                                                PROPOSED NRC REGULATIONS THAT MAY AFFECT YOU' (NRC mru1/tionsjDenrmt It to Dfrorect coifdent"e1 Commn'itl or finncil-Drorietli/--,iiOrmet~on furniShod to S5OOK          /501K                M  1DM            NUMBER OF BEDS                                              c
      5j '&#xfd;OK IV                        -ISIOM
                                                                                                                        E
                                                                                                    FOR NRC USE ONLY
  ' p            I(F            (FE LOG                    FEE CATEGORY            COMMENTS                                                                                  APPROVED    BY
AV.              ".-FCEiTE            TO      CHECK          =NUMBER
                A'&#xfd;    S    TMENT Ory THE REVERSE


When sources are used in deviceshaving "on" and "ofr' positions.
PRIVACY ACT STATEMENT
                                                                            Privacy Act of 1974 (Public Law 93-579), the follow Pursuant to 5 U.S.C. 552a(e)(3). enacted into law by section 3 of the to the Nuclear Regulatory Commission on NRC Form
,g statement is furnished to individuals who supply information as NRC 3 and described at 40 Federal Register 45334
313. This information is maintained in a system of records designated (October 1, 1975).
                                                                      Act of 1954, as amended (42 U.S.C. 2111 and 2201(b)).
1, AUTHORITY: Sections 81 and 161(b) of the Atomic Energy CFR
                                                                  by the NRC staff pursuant to the criteria set forth in 10


both positions should be evaluated at the time of installation.
===2. PRINCIPA===


Sup-plemental surveys should be performed following anychanges in operation, shielding, or use.The types. methods.
==L. PURPOSE==
(S): The information is evaluated                                                  of  the  Atomic    Energy  Act  of the application meets the requirements Parts 30, 32, 33, 34, 35 and 40 to determine whether                                            material    license  or amendment for the issuance of a radioactive
    1954, as amended, and the Commission's regulations, thereof, information and use;
                                                    (a) provided to State health departments for their
3. ROUTINE USES: The information may be                                                                      of  incident or exposure, and other persons in the event and (b) provided to Federal, State, and local health officials                                The  iformation      may also be dis of the public health and safety.


and frequency of surveysshould be specified.
for their information, investigation, and protection                                            irdicates  a  violation  or potential in the event that the information closed to appropriate Federal, State, and local agencies                                          this  information    may  be trans or judicial proceeding. in addition, violation of law and in the course of an administrative                                    necessary  for  an  NRC    decision  or to to the extent relevant and ferred to an appropriate Federal, State, or local agency                                            about    you.


Guidance may be obtained fromthe National Council on Radiation Protection Report No. 10. "Radiological Monitoring Methodsand Instruments,*'
and necessary for that agency's decision an appropriate Federal agency to the extent relevant NOT PROVID
and the International AtomicEnergy Agency's Technical Rcport Series No. 120."Monitoring of Radioactive Contamination on Sur-faces."*b. Records Management Program.
                                                          VOLUNTARY AND EFFECT ON INDIVIDUAL OF
4. WHETHER DISCLOSURE IS MANDATORY OR                                                        the  requested    information    is not furn information is voluntary. If ING INFORMATION: Disclosure of the requested                                                  will  not  be  processed.   A request material license, or amendment      thereof, ished, however, the application for radioactive                                    the provisions  of  10  CFR  2,790.   Withhold must be in accordance with that information be held from public inspection                                        and  directly  concerned    need  to  inspect if any, of persons properly ing from public inspection shall not affect the right, the document.


Provision forkeeping and revicwing records of surveys:
U.S. Nuclear Regulatory Commission
materials inventories:  
  5. SYSTEM MANAGER(S) AND ADDRESS:
per'sonnel exposures;
                                                    Director, Division of Fuel Cycle and Material Safety Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555 NRC FORM 313
receipt.


use. anddisposal of materials.
NRBC *'*RM 313 US NUCLEAR REGULATORY COMMISSION
        '84C-I 3C 32 33 34 APPROVED BY Om B
                                  ...    0APPLICATION                                              I        FOROR MATERIAL
                                                                                                                      M31M0-0120            LICENSE                                                  E ....  5-31-87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS
                                                                                                                                                        FOR COMPLETING APPLICATION              SEND TWO COPIES
    )I THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.


etc.. should be described.
FEDERAL AGENCIES FILE APPLICATIONS WITH
                                                                                                                        IF YOU ARE LOCATED IN
                  NS  U'CLEAR REGULATORY COMMISSION                                                                    ILLINOIS. INDIANA. IOWA, MICHIGAN, MINNESOTA. MISSOURI. OHIO, OR
          'JIVISION OF FUEL CYCLE AND MATERIAL SAFETY. NMSS
                                                                                                                      WISCONSIN, SEND APPLICATIONS TO
        WASHINGTC!q. DC 20555 ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS. IF YOU ARE                                                              U S. NUCLEAR REGULATORY COMMISSION. REGION III
                                                                                                                            MATERIALS LICENSING SECTION
  LOCATED IN
                                                                                                                            799 ROOSEVELT ROAD
                                                                                                                            GLEN ELLYN, IL 60137 CONNECTICUT. DELAWARE, DISTRICT OF COLUMBIA, MAINE. MARYLAND,
  MASSACHUSETTS. NEW JERSEY,                      NEW YORK, PENNSYLVANIA. RHODE ISLAND,                              ARKANSAS. COLORADO, IDAHO. KANSAS, LOUISIANA, MONTANA, NEBRASKA.


Persons responsible for keeping and reviewing records should be identified.
OR VERMONT. SEND APPLICATIONS TO.                                                                                    NEW MEXICO, NORTH DAKOTA. OKLAHOMA. SOUTH DAKOTA, TEXAS, UTAH.


c. Emergency Procedures.
.S NUCLEAR REGULATORY COMMISSION, REGION I                                                                OR WYOMING, SEND APPLICATIONS TO:
        NUCLEAR MATERIAL SECTION B
                                                                                                                            U.S. NUCLEAR REGULATORY COMMISSION. REGION IV
        631 PARK AVENUE
                                                                                                                            MATERIAL RADIATION PROTECTION SECTION
        KING OF PRUSSIA. PA              19406                                                                            611 RYAN PLAZA DRIVE. SUITE 1000
                                                                                                                            ARLINGTON, TX 76011 ALABAMA FLORIDA GEORGIA. KENTUCKY, MISSISSIPPI, NORTH CAROLINA.


The applicant shouldsubmit written emergency procedures for-employees in case of spills. fires, release or loss of material, oraccidental contamination of personnel, including decontamination procedures and the names ofpersons who arc to be notified in an emergency.
PUERTO RICO, SOUTH CAROLINA. TENNESSEE, VIRGINIA, VIRGIN ISLANDS, OR
  WEST VIRGINIA. SEND APPLICATIONS TO                                                                                ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA. OREGON, WASHINGTON,
                                                                                                                      AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND APPLICATIONS
        'J S NUCLEAR REGULATORY COMMISSION, REGION It                                                                TO:
        MATERIAL RADIATION PROTECTION SECTION
        101 MARIETTA STREET. SUITE 2900                                                                                    U.S. NUCLEAR REGULATORY COMMISSION, REGION V
                                                                                                                            MATERIAL RADIATION PROTECTION SECTION
        AILANTA. GA 30323
                                                                                                                            1450 MARIA LANE. SUITE 210
                                                                                                                          WALNUT CREEK. CA 94596 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 JURISOICTION.


d. Sealed-Source Leak-Test Procedures.
1 THIS IS AN APPLICATION FOR (Chock a'Copioreewt*t*                ,                                              2. NAME.AND MAILING ADDRESS OF APPLICANT (Includ.Zip Code)
              A      NEW LICENSE
              B    AMENDMENT TO LICENSE NUMBE_
              C    RENEWAL OF LICENSE NUMBER
    ADORESSIESI WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED
4 NAME OF PERSON TO B


Sealedsources containing more than 100 microcuries of abeta or gamma emitter or more than 10 microcuries of an alpha emitter must be leak tested at 6-month in-tervals.
==E. CONTACT==
ED ABOUT THIS APPLICATION
                                                                                                                                                                          jTELEPHONE    NUMBER
SUBMIT iTEMS S TIROUGH 11 ON 8' , 11 'PAPER                          THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN
                                                                                                                                                                THE LICENSE APPLICATION GUIDE.


Leak testing of alpha-particle-emitting sources containing more than 10 microcuries of an*Copies may be obtained from NCRP Publications, P.O.Box 4867. Washington.
S    R-&#xfd;DIOACTIVE MATERIAL
                  aEcment ecll mass numbe.    b checal eImnd/orDfhys,Col 1orm.Iad    c  mTlS-.n,    anooIt          6.    PURPOSEBS) FOR WHICH LICENSED MATEPIAL WILL BE USED
          h    .ch
                -Ii,    o oos$ese4 at a"ny one tlme INDIVIDUALIS, RESPONSIBLE FOP
                                                      RADIATION SAFETY PROGRAM AND
      TRA 'IG            AND EXPERIENCE                                                          THEIR
                                                                                                                    8, TRAINING FOR INDIVIDUALS WORKING IN OR FREQUEN'ING RESTRICTED AREAS
        AC:IITIES AND EQUIPMENT
                                                                                                                  10.    RADIATION SAFETY PROGRAM
                                                      WASTE~~~    MNGMT
                                                                                                                    "12 LICENSEE FEES (See ?0CFRt 1tTOrsdlSteor, 170.31)
                                                                                                                  FEE CATEGORY                                            AMOUNT
                                                                                                                                                                          lENCLOSED  $
  j    '7EPTIFICATION              fMus'beomplvridbVyliclnrJ THE APPLICANT UNDERSTANDS THAT Al L
                                                                                                                            TATEMENT              R*         ....      .        .          -
        BIN' -. 3 -PTEN                APPLICANT                                                                                        . AND      tP1EUNTI          MADE IN THIS APPLICATION ARE
        -'E APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF
                                                                                                              OF THE APPLICANT. NAMED IN ITEM 2. CERTIFY THAT THIS APPLICATION IS
            AEPARED :% CONFORMITY WITH TITLE 1


D.C. 20008.69Copies may be obtained from UNIPUB. Inc.. P.O. Box433. New York. N.Y. 10016.alpha emitter is rcqliired at 3-month intervals.
===0. CODE OF FEDERAL===
                                                                                          REGULATIONS, PARTS 30.32.33, 34, 35. AND 40 AND THAT ALL INFORMATION
        ,F'IJ          AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF                                                                                                      CONTAINED HEREIN
      VARNINC                16 u S C SECTION 1301 ACT OF JUNE 25. 1948, 62 STAT 749 MAKES IT A CRIMINAL
        "TC,  ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER
                                                                                                                              OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION
                                                                                                            WITHIN ITS JURISDICTION
    SNn.*                'E*T .         C
                                        GOFliCS                      'TYPEDIPRINTED NAME                                              TITLE                                                        DATE
                                                                                                  14VLUNTARY ECONOMIC DATA
                          A. A  ,*:- R CE'PTS          I      NUMBER OF EMPLOYEES (Tor              for al          d    WOULD YOU BE WILLING TO FURNISH COST INFORMATION                                  o rtIOII. -noo      stfhow,,,
                  1
                "'SI'K                      vM 5v            emt,    fci,ty  -excluoingOrsdi  conftrlcrors        ON THE ECONOMIC IMPACT OF CURRENT NRC REGULATIONS OR ANY FUTURE
        S251K          NOOK                                                                                            PROPOSED NRC REGULATIONS THAT MAY AFFECT YOU' (NRCmoIlerio$s S 5MS    ?M                                                                  Irt ro votcr                                                                          pe-.r confidenrti& commerns*I Or frinolal-oroorrr. --*t,,tofrnltton f-rnlthld to
        $5500K - 750K                    S7M -0M          c NUMBER OF BEDS                                                  py  ,nConfidrce)
        S 50K          'V                    S
                                            '0M                                                                F          YES                                                          NO
                                                                                                      FOR NRC USE ONLY
      "PE-        F6.            FEEFOG                  PEECATEGORY                  COMMENTS                                                                                    APPROVED By
      .     . T... CE "'E.D                    CHECK NUMBER
    .4    .     A'T STATEMFNT ON THE REVERSE


If acommercial firm is to perform the Irak tests, thename. address.
PRIVACY ACT STATEMENT
                                                                                                                  93-579), the follow Pursuant to 5 U.S.C. 552a(e)(3), enacted into law by section 3 of the Privacy Act of 1974 (Public Law Commission    on NRC Forrr inq staxement is furnished to individuals who supply information to the Nuclear Regulatory described at  40  Federal Register 45334
313. This information is maintained in a system of records designated as NRC-3 and (October 1 1975).
                                                                                                  (42 U.S.C. 2111 and 2201(b)).
1. AUTHORITY: Sections 81 and 161(b) of the Atomic Energy Act of 1954, as amended staff pursuant to the criteria set forth in 10 CFR


and license number of the firm shouldhe submitted, If the tests arc to be performed using acommercial
===2. PRINCIPA===
"kit." the name of the kit manufacturer or distributor and the kit model designation shouldbe given. If the applicant intends to p.rform his ou nleak tests without the use of a commercial kit, the fol.lowing information should be submitted:
I) Qualifications of personnel who will performthe leak test.(2) Procedures and materials to be used in tak-ing test samples.(3) The type manufacturer's name. modelnumber, and r;4iajiin detection and measurement characteristics o the'nstrument to be used for assayof test samples.(4) lnstruwment calibration procedures.,
including calibration source characteristics.


make. and modelnumber, and(5) The method, including a sample calculation.
==L. PURPOSE==
(S): The information is evaluated by the NRC
                                                                                    the requirements of the Atomic Energy Act of Parts 30, 32, 33, 34, 35 and 40 to determine whether the application meets of a radioactive material license or amendment
    1954, as amended, and the Commission's regulations, for the issuance thereof.


to be used to convert instrument readings to units ofactivity.
health departments for their information and use;
3. ROUTINE USES: The information may be (a) provided to State other persons in the event of incident or exposure, and (b) provided to Federal, State, and local health officials and and safety. The information may also be dis for their information, investigation, and protection of the public health that the information indicates a violation or potential closed to appropriate Federal, State, and local agencies in the event In addition, tt'fs information may be trans violation of law and in the course of an administrative or judicial proceeding.


e.g.. microcurics.
relevant and necessary for an NRC decision or to ferred to an appropriate Federal, State, or local agency to the extent that agency's decision about you.


hctm 15. The procedures for disposing ofbyproduct material waste should be described.
an appropriate Federal agency to the extent relevant and necessary for AND EFFECT ON INDIVIDUAL OF NOT PROVID
4, WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY
                                                                          is voluntary. If the requested information is not furn ING INFORMATION: Disclosure of the requested information amendment thereof, will not be processed. A request ished, however, the application for radioactive material license, or with the provisions of 10 CFR 2.790. Withhold that information be held from public inspection must be in accordance persons properly and directly concerned need to inspect ing from public inspection shall not affect the right, if any, of the document.


UnderNRC regulations, a licensee may dispose of waste inthe following ways:a. Transfer to a person properly licensed to receivesuch waste in conformance with paragraph
5. SYSTEM MANAGER(S) AND ADDRESS:               U.S. Nuclear Regulatory Commission Director, Division of Fuel Cycle and Material Safety Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555}}
20.301(a)
of 10 CFR Part 20. The name of the firm (whichshould be contacted in advance to determine an%limitations that the firm may have on acceptance ofwaste) should be given.b. Release into a sanitary sewer in conformance with &sect;20.303 of 10 CFR P:trt 20. Depending on waterusage. releases of up to I curie per year are permitted.
 
c. Burial in soil in conformance with &sect;20.304 of 10CFR Part 20. Up to 12 burials per year are permissi- ble. The allowable quantity depends upon theradionuclide.
 
d. Release into air or water in concentrations inconformance with &sect;20.106 of 10 CFR Part 20. Possi-ble exposure to persons offsite limits the amount thatmay he released.
 
e. Treatment or disposal by incineration in confor-mance with &sect;20.305 of 10 CFR Part 20. This must bespecifically approved by the Commission.
 
f. Other methods specifically approved by theCommission pursuant to &sect;20.302 of 10 CFR Part 20.E010.7-5
 
===5. AMENDMENTS ===
TO LICENSESS. RENEWAL OF A LICENSELicensees are required to conduct their programsin accordance with statements, representations, andprocedures contained in the license application andsupportive documents.
 
The license must therefore beamended if the licensee plans to make any changes infacilities, equipment (including monitoring and sur-vey instruments),
procedures, personnel, orbyproduct material to be used.Applications for license amendments may be filedeith.r w. the application form or in letter form. Theapplication should identify the license by number andshould clearly describe the exact nature of thechanges, additions, or deletions.
 
References topreviously submitted information and documents should be clear and specific and should identify thepertinent information by date, page. and paragraph.
 
An application for renewal of a license should befiled at least 30 days prior to the expiration date. Thiswill ensure that the license does not expire until finalaction on the application has been taken by the NRCas provided for in paragraph
30.37(b)
of 10 CFR Part30.Renewal applications should be filed on FormNRC-313, appropriately supplemented, and shouldcontain complete and up-to-date information aboutthe applicant's current program.In order to facilitate the review process, the ap-plication for renewal should be submitted withoutreference to previously submitted documents and in-formation.
 
If such references cannot be avoided.
 
theyshould be clear and specific and should identify thepertinent information by date, page, and paragraph.
 
S00I10.7-6 OAPPENDIXForm AIC-313 UNITED STATES ATOMC eNerGY COCMISSION
10 CIA 30 APPLICATION
FOR BYPRODUCT
MATERIAL
LICENSE 'e"" " oUSSTRUCT"OF4S.-Complate Horns 1 through 16 if this Is an iritiil applic4alon of an application for henewal of a license.
 
Informiaton contaled an r.vius applicatlOnls (dd with the CommItf4ah n with respect to Items 0 through 15 mey be incoporlteo by reflerence promded rterences at# ci.so andispiochc.
 
Use supplemental shoets whire nTcussaty.
 
Item 15 must be completed on all Maii two copies Wo U S Atomic Energy Comms-ioa. Washington.
 
D.C.. 20545, Attention:
Matiials Branch. Direclorate of ULcensing.
 
upon approval of this application.
 
the applicaml win an AECByproduct Material Lcn"s. An AEC Byproduct Material Uclnts Is Issued In accordance with the general requirements contained in Tnl 10. Code of Fed-ratl Flegulation.
 
Pail 30, and the Is subject to Title 10, Code of Federal Rgplatioti4.
 
Pan 20. and the ft ptovisions ot Tifle 10. Code ofFederal Regulations, PaiR 170. The license fee cateqory should be staled in Haem 16 and the appropriate lee enclosed.
 
(See Nloe in Instrueloen sheoel1. (a) kAME AND STRET AlOMlSS OF APPIUCANT.
 
(htitutftbi.
 
Iran. tiloagH per. 11.1 StWall ADD* SSIISI AT WHiiCa 57P500UCI
.AIIIIAt WJLl U LJ*IO sifSoo. 0rC baciw* D Code mod blofphof.
 
nvmber1 I &Wsitk...
11. &via.%ZFCO.
 
I2. DIPAX1XINI
TO UISE itSOUOV kAUTINIAt
 
===3. PRIVIOtJI ===
SIINIL MUMMIES[$)
fit ika'a m. pM Vo P..af k~~isi ~~phm.; -daf aid 9-. &#xfd; IS
 
===4. INDIVIDUAL ===
US~IRIS.
 
(Naue O~d irffet Of..dsia
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Pa"tC"0#N
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MAT11RIAL.'
it sewwwa lb) OUMICAL AND/Oft PKTSICAL
FO"M ANP MAAVMUM NUM29S Or s~AQUICL111 Of 1ACM C~iLMiCAL
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1RAINING
AND EXPERIENCI:
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NAMED IN ItEM 4 evi..I.nnO
AesI ..e'I ____* TYPE OF TRAININGa 1"..P0 o:j p tfcs Fyes Ida Yes Nolo5d~oact..lp
-tt,@* sandacfS.d:a o 1. NIQ '. a-''il -o'do- SO40oI'.O'
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(ITICTION
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====s. aJpohINFOPLAATFON ====
TO S1 SUBMITTED
ON ADDITIONAL
SHIRTS IN DUPLICATE
13 FACIIIII
AND EQUIPMENT
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(This Item must be completed by applicant)
40 11`11 APPLICANT1 AND ANY OFFICIAL.
 
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NAMED IN ITEMA 1. CERTIFY THAT 1THIS AMIIC.A1TON
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61.15.11-P100
1973-043.126/21
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Latest revision as of 10:12, 28 March 2020

Guide for Preparation of Applications for Licenses for Laboratory & Industrial Use of Small Quantities of Byproduct Material
ML003740382
Person / Time
Issue date: 08/31/1979
From:
Office of Nuclear Regulatory Research
To:
References
RG-10.7 Rev 1
Download: ML003740382 (20)
v • d • e


{{#Wiki_filter:Aep ft!m" 1171 U.S. NUCLEAR REGULATORY COMMISSION 

                                        REGULATORY GUIDE
                                        OFFICE OF STANDARDS DEVELOPMENT
                                                                               REGULATORY GUIDE 10.7 GUIDE FOR THE PREPARATION OF APPUCATIONS FOR UCENSES
                                       FOR LABORATORY AND INDU1STRIAL USE OF SMALL                                                                                                         *R
                                                     QUANTmES OF BYPRODUCT MATERIAL
                                    1. INTRODUCTION                                                      10 CFR Part 170 to determine the amount of fee This guide describes the type of information                                                  that must accompany the application. Review of needed by the NRC staff to evaluate an                                                             the application will not begin until the proper appl               fee is received by the NRC.

cation for a specific license for laboratories and industries using millicurie quantities of by 3. FILING AN APPLICATION 

     product material (reactor-produced radionu clides). This type of license is provided under Title 10, Code of Federal Regulations,                                          for             An applicant for a byproduct material Part 30. "Rules of General Applicability                                                          isotopes) license should complete Form (radio-j                           NRC
                                                                                    to Do              3131 (see the appendix to this guide).' AUl mestic Licensing of Byproduct Material items on the application form should be com Paragraph. 20 1(c) of 10 CFH Part 20. "Stand                                                  pleted in sufficient detail for the NRC to deter ards for Protection Against Radiation,"                                                           mine that the applicant's equipment, facilities, states             and radiation protection Program are adequate that      "    .   persons engaged                    in   activities           under licenses issued by the Nuclear Regulatory                                                         to protect health and minimize danger to life Com              and property.

mission pursuant to the Atomic Energy Act of 

    19.54, as amended, and the Energy Reorganiza tion Act of 1974 should, in addition to comply                                                        Since the space provided on Form NRC-3131 ing with the requirements set forth in                                                            is limited, the applicant should append addi this          tional sheets to provide complete information.

part, make every reasonable effort to maintain radiation exposures, and releases of Each separate sheet or document submitted radio active materials in effluents to unrestricted with the application should be identified by a areas, as low as is reasonably achievable" heading indicating the appropriate item number (ALARA). Regulatory Guide R. 10, "Operating (on Form NRC-3131) and its purpose radiation, safety instructions). (e.g., 

   Philosophy for Maintaining Occupational Radia tion Exposures As Low As Is Reasonably Achievable,", provides the NRC staff position                                                         The application should be completed in trip on this important subject. License applicants                                                    licate. The original and one copy should be should give consideration to the ALARA philos                                                    mailed to the Division of Fuel Cycle and Mate ophy, as described in Regulatory 3uide                                                            rial Safety, Office of Nuclear Material
                                                                                   8. 10,                                                                                      Safety in the development of plans for work                                                              and Safeguards, U.S Nuclear Regulatory with                                                                                       Com licensed radioactive materials.                                                                   mission. Washington, D.C. 20555. One copy of the application, with all attachments, should be
                                 2. LICENSE FEES                                                    retained by the applicant since the license will require, ab a condition, that the institution An application fee is required for most types                                                 follow the statements and representations o)f Licenses                                                                                                                                                                     set The applicant should refer to                                         forth in the application and any supplement
  §170 31,                                                                                          it                                                                                to
                        "Schedule of Fees for Materials Licenses and Other Regulatory Services,"
                                                                                        of
                                                                                                       'Applications    (or" medical uses should be submitted on Form
    *1 "I*s '-n1dcate substantave changes from previoub                      .'.ue                 NRC-313M.       and applications for use of selled sources in rad- raphy should beasu               I.       1ri NRC-313R
                      USNRC REGULATORY GUIDES

ttagu0tory Guide -a-einu Comments should be sent to the Secretary of the Commen.

to "-,,be mndineao .a bleeto uRgulatory U.S tuim 

"nothOd"acOc*ap to the NRC soft of C                                                                                                              Conomatin Wwa Wo               0 C 2066 Atteintion OoClea leamenting 'vec1fac prts of the                                                                                              SW
       ,    rsion's regulations. to deline*te *eh*MKK         used by the staff on evalu-           The guides we rilsuidm the foliowu       Itan hoad dairnons
"'lng   'pcftIc rippicants        W-11-16r~ Guides Regulatory        Or postulated ae rnt accidents, gubseaae orfor fto Proside guidance Pliecs with them is riot raqaujed Maihods and regulaions.    and corntt        I Power Reactors ookn       dffere f        fyro tmhose                                                         6 Products set out in fth guides will be erLcaputAte rf the provide                                          2 Resarch and Test Reactors                      7 Transoration requiste to the isuance or continuance of                        a basie for tie woiadngs         3 Fuels and Martialo Feotms a perrNt    or licanse by the           4 Enovrwnen'ta                                   8 OccuoiaaonWs and Sittru                          .          Health Coa'-mHaon
                                                                                                 5 M410"ifis am Plant Protection                  0 Gililrt     and Fiancial Revew Comnnts i tlrr*s an*d      suggestiOns andWu-des             tor nprOvernts    ,n thee guades are encouraged at             placement        an etutomat.c wet Uae resa     as s*pWoprAte.   to aCrorrmodante commentd             Requests foror s-g*e  copies ofd*'Uued   Iuades fivhaCh
                                                                                                                                     *r*butiorist  t*or aglerngy bi eWoduced, copaes            or for of ftureL guaee nO tO ref*i fcr'e      information or sotae                                                      n spi    fc dvisons should be nuide a wating This guide *awasred               mosta                                                             to the U S   Nuclear Regulefory ComrnmraTtn      Wasthington    D C 205Mu of  sobstant"     curnmrents re..a. ed fromr the public and addrtional                                                                              Alteanon     Deoitor.   ONvror,   of staf reiew              Tochn,~i into~rraitocn and Dorumlent Control

4. CONTENTS OF AN APPLICATION model number of each sealed or plated source should be specified It a source will be used in Most items of Form NRC-313r are self a gas chromatograph. gauge, or other device.

explanatory (see instructions with the form). the manufacturer and model number of the The following comments apply to the indicated device should be specified numbered items of the form.

Item 8E and Item 9 The use to be made of' 

   Items 2 and 4. Specify the applicant corpo                            the radioactive        materials should be clearly ration or other legal entity by name and                                  described       Sufficient detail should he given to address of principal office. Individuals should                           allow a determination of the potential for expo be designated as the applicant only if the use                             sure to radiation and radioactive materials both of the byproduct material is not connected with                           of those working with the materials and of the the individual's employment with a corporation                             public or other entity               If the applicant. is an individual, the individual should be specified                                 Items 10 and 11.     Specify for each radiation by full name and address, including state and                              detection instrument the manufacturer's name zip code                                                                 -and model number, the number of each type of instrument      available,    the type of radiation Item 5. Specify the street address of the                             detected (alpha, beta, gamma, or neutron).

location of use if the address differs from the the sensitivity range (milliroentgens per hour one given in Item 4. If use is to be at more or counts per minute). the window thickness in 

                                                                                    2 than one location, the specific address of each                           mg/cm . and the type of use. The type of use should be given             Describe the extent of use                    would       normally   be    monitoring,   surveying, and the facilities and equipment at each                                   assaying, or measuring.

location. A post office box address is not acceptable. Describe the instrument calibration proce dure. State the frequency, and describe the Item 6 Specify the names of the persons who methods and procedures for the calibration of will directly supervise the use of radioactive survey and monitoring instruments, as well as material or who will use radioactive material any other instruments and systems used in the without supervision radiation protection program, such as measur ing instruments used to assay sealed-source Item 7. Specify the name of the person who leak-test samples (see Item 15). contaminationi will be designated as the radiation protection samples (e.g.. air samples. surface "wipe" 

 officer. 2 Thispj5erson should be responsible for                         samples), and bioassay samples (see Item 12)
 implementing the radiation safety program and therefore readily available to the users in case                               An adequate calibration of survey instru of difficulty and should be trained and experi                            ments usually cannot be performed with built enced in radiation protection and in the use                              in check sources         Electronic calibrations that

1 and handling of radioactive materials. In a do not involve a source of radiation are also small program not requiring a full-time not adequate to determine the proper function ing and response of all components of an radiation protection officer, the duties of the radiation protection officer may be assigned to instrument.

one of the persons named under Item 6 of Form I NRC-3131. Note, however, that it must be Daily or other frequent checks of survey instruments should be supplemented every established that the person acting as radiation protection officer will have the opportunity to 6 months with a two-point calibration on each devote sufficient time to the radiation safety scale of each instrument with the two points aspects of the program for the use of separated by at least 50% of the scale Survey radioactive materials. instruments should also be calibrated following repair. A survey instrument may be considered Items BA, B, C, and D. Describe the byprod properly caiibrated when the instrument read uct material by isotope, chemical and/or physi ings are within +/-10 percent of the calculated or cal form, and activity, in millicuries or micro known values for each point checked Readings curies A separate possession limit for each within +/-20 percent are considered acceptable if nuclide should be specified Possession limits a calibration chart or graph is prepared and requested should cover the total anticipated attached to the instrument inventory, including stored materials and If the applicant proposes to calibrate his waste, and shouid be commensurate with the needs and facilities for safe survey instruments, a detailed description of applicant's planned calibration procedures should be sub handling mitted The description of calibration proce dures should in(lude, as a minimum: 

        If the use of sealed or plated sources is con tempiated,        the isotope, manufacturer,               and a The manufacturer and model           number of
      'The terms radiation protection   officer" and  "radioiogrcal each radiation source to be used, safety officer" are synonv.aoul
                                                                    10 7-2

b. The nuclide and quantity of radioactive milliroentgens, the frequency of reading, and material contained in each source, the procedures for maintaining and calibrating the devices should be specified.

c The accuracy of the source(s). The traceability of the source to a primary standard If personnel monitoring will not be used, the should be provided. applicant should submit calculations or docu mentation from radiation surveys demonstrating d The step-by-step procedures, including that it is unlikely that any individual will associated radiation safety procedures, and receive a dose equal to or greater than that indicated in 10 CFR Part 20.

e The name and pertinent experience of each perstin who will perform the calibrations. The applicant should show that the need for bioassays has been thoroughly considered and If the applicant intends to contract out the should establish the adequacy of the proposed calibration of instruments, the name, address, bioassay program in relation to the proposed and license number of the firm should be speci program of use of radioactive material. Bio fied together with the frequency of calibration. assays are normally required when individuals The applicant should contact the firm that will work with miUicurie quantities of hydrogen-3, perform the calibrations to determine if infor iodine-125, or iodine-131 depending on the mation concerning calibration procedures has type of work, equipment, and procedures fol been filed with the Commission. If information lowed Regulatory Guide 8.20, "Applications of concerning calibration procedures has not been Bioassay for 1-125 and 1-131," and a document filed, it should be obtained and submitted. entitled "Guidelines for Bioassay Requirements for Tritium"- may be consulted. Other mate Quantitative measuring instruments used to rials may also be used in physical or chemical monitor the adequacy of containment and con forms and under conditions that present an tamination control such as those used for mea opportunity for uptake by the body through suring leak test, air, effluent, bioassay, work area, and equipment contamination samples ingestion, inhalation,, or absorption A bio 

 3hould usually be calibrated prior to each use.        assay program to determine and control the The procedures and frequency for calibration            uptake of radioaetive material should be con of such instruments should be submitted and             sidered and discussed in relation to each such material,      procedure, etc,              Regulatory Guide should include:                                        8 9, "Acceptable Concepts Models. Equations, a The name of the manufacturer and model          and Assumptions for a Bioassay Program."
                                                                                                                      may.

number of each of the standards to be used, he consulted.

b. The nuclide and quantity of radioactive The criteria tc be used in determining the material contained in each of the standard need for hiioassays, the type and frequency of bioassays that will be performed, and the sources, bio assay procedures should be specified and c A statement of the accuracy of each of the described in detail If a commercial bioassay standard sources. The source accuracy should service is u., be used, the name and address of be. as a minimum, +/-5 percent of the stated the firm should be provided.

value and traceable to a primary standard, such as that maintained by the National Bureau Bioassays may not be substituted for other of Standards. elements of a safety program such as air moni toring and dispersion control (hoods, glove d. Step-by-step calibration procedures and, boxes. etc ) and for well-thought-out and if appropriate, associated radiation safety pro well-executed handling procedures cedures, and T 

                                                           Item 13     The facilities and equipment for e. The name and pertinent experience of           each site of use should be described in detail.

each person who will perform the instrument The proposed facilities and equipment for each "calibrations operation to be conducted should be adequate to protect health and minimize danger to life Item 12 Personnel monitoring is required to and property In describing available fa. ilities ensure .- mplianee with §§20 101 and 20 202 of and equipment. the following should be 10 ('FR Part 20. Personnel monitoring is also included, as appropriate: required if a person enters a high radiation area (greater than 100 millirems per hour). If a Physical plant, laboratory. or working p'.sonnel monitoring equipment will be used, area facilities Fume hoods glove boxes, waste the ndine of the organization furnishing film receptacles, spenjal sinks, ventilation and con badge or thermoluminescent do.<'imeter (TLD) tainment systems. effluent filter systems, and service and the frequer , for changing badges, dosumeter.-, etc sh,uld be specified jA copy may be obtained by a written request Nuclear Regulatory to hte U S If pocket chambers ur pocket dosimeters will be C'.mmision. Office .)f Nuclear ?ateruidJ 

                                                      Safety and Safeguaro,        Div-tsaon of Fuel CycLe and Materi.la used.       the useful range of the devi(e.        in  Safety. Washington     !      20555, A:'enton    Director. office of Nuclear Material Saifet, ant Safeguards

arr permi.,sible The a,. hlc ju o,;it, . 

  hd , pnf O  1 7'.I i  I I !;
                             '        d t ý , -i hl'   j~t .  .  o h n         upon *h- radionu-Lide '
                                                                                   d     Release into air or water in oncentrationf'
        A drawing or sketch should be submitted in conformance with §20 106 of 10 ('FR Part 20

showing the location of all such equipment and Possible exposure to persons offsite Limits the the relationship of areas where radioactive amount that may be released materi:is will be handled to unrestricted areas where rad'ioactive materials will not be handled e Treatment or disposal by incineration in In those programs where radioactive material conformance with §20 305 of 10 CFR Part 20 may become airborne or may be included in air This must be specifically approved by the br-ne effluents, the drawing or -ketch should Commission also include a schematic description of the ven tilation system annotated to show airflow rates, f Other methods specifically approved by differential pressures, filt ration and other 

                                                                                'he Commission pursuant to §20.302 of 10 CFR

effluent treatment equipment and air and Part 20 effluent monitoring instruments Drawings or sketches should be drawn to a specified scale, Item 15 or dimensiLons should be included on each drawing or sketch. Each drawing or sketch a Survey Program. Commission regulations should be labeled to specify the location of the require that surveys be made to determine if facilitles and equipment depicted with respect radiation hazards exist in a facility in which to the address(es) given in Item 5 of Form radioactive materials are used or stored (see NRC-3131 §20.201 of 10 ('FR Part 20) A survey should include the evaluation of external exposure to F- C(ontainets, devices. protective clothing. personnel, concentrations of a-iruorne radio auxiliary shielding, general laboratory equip active material in the facility, and radioactive ment. a. r sampling equipment. etc . actually effluents from the facility Although a theoreti employed in the daily use of material Special cal calculation is often used to demonstrate provisions for shielding and containment to compliance with regulations regarding airborne minimize personnel exposure should be de or external radiation, it cannot always be used scribed Storage containers and facilities in Lieu of a physical survey should provide both shielding and security for materials Except for those cases where sources of radiation and radioactive material are well c The number. type. and length of remote known and accurately and precisely controlled, handling devices it will usually be necessary that a physical survey be made with appropriate detection and d If respiratory protective equipment will measurement instruments to determine the be used to limit the inhalation of airborne nature and extent of radiation and radioactive radioactive material, the provisions of §20.103 material or, as a minimum, confirm the results of 10 CFR Part 20 should be followed and of a theoretical determination appropriate information should be submitted A radiation protection program should include the following surveys for radioactive Item 14 The procedures for disposing of contamination and radiation.

byproduct material waste should be described Under NRC regulations, a licensee may dispose (I) In laboratory or plant areas (e g of waste in the following ways checking for contamination on bench tops, han dling and storage equipment, clothing, hands) 

       a Transfer to a person properly licensed to receive such waste in conformance with para                                            (2) While work is being done with radiation graph 20.301(a)             of   10 CFR Part 20            The name             or radioactive materials (e.g , breathing zone of the firm (which should be contacted in                                       air surveys,           general air surveys, personnel Luncluding eyes and advance to determine any Limitations that the                                   exposure measurements.

firm may ,iave on acceptance of waste) should extremities, checking shutters and "'ontain ment) 

   be given f, Release into a sanitary sewer in confor                                         (3) in areas associated with disposal or mance           With     §20 303          of      t0 CFR       Part 20           release of radioactive materials (e g . checking Depending on water usage. releases rf up to I                                      'The   NRC   has   proposed  an   amendment        .*hat would delete curie per year are permitted                                                    $20 304 of 10 CFlt Part 20 (43 F'R Ssi77        December 4. 19i 8)     If this amendent       is adopted.    all b,,ne.ls     of radionuclides in accord~ance with    120 304 of 10 CFR Part         20 wil require NRC
         c   Buria, i" soil in contformance with §20 304                            approval f    10 (-FR Part 20           Up to 12 hurials per year
                                                                           10 7-4

disposal containers and disposal sites; liquid, Agency's Technical Report Ses gas, and solid effluents, filters and filter-duct No 120, 

                                                                                 "Monitoring of Radioactive Contamination am systems)                                                                     Surfaces. "'
         The frequency of surveys will depend on                                    b. Records Management Progrm. Provision the nature of the radioactive mrterials and for keeping and reviewing record of surveys;
    their use. However, surveys should be per materials inventories; personnel exposures;
   formed prior to the use of radioactive materials receipt, use, and disposal of materials, in order to establisl a baseline. The surveys                                                                                         etc.,
                                                                                 should be described. Persons responsible for should be repeated when radioactive materials keeping and reviewing records should be iden are present, when the quantity or type of tified.

material present changes, or when changes occur in their containment systems cr methods c Sealed-Source Leak-Test of use. Repetitive surveys may Procedures.

also be Sealed sources containing more than 100 micro necessary to control the location of radioactive curies of a beta or gamma emitter or more than materials in the handling system and in the 10 microcuries of an alpha emitter must be leak case of the use of sealed sources outside a tested at 6-month intervals. Leak testing of shielded container.

alpha-particle-emitting sources containing more For operations involving materials in gas, than 10 microcuries of an alpha emitter Is liquid, or finely divided forms, the required at 3-month intervals. If a commercial survey firm is to perform the leak tests, the program should be designed to monitor the name, adequacy of containment and control address, and license number of the firm of the should materials involved. "he program should be submitted If the tests are to be performed include using a commercial "kit," the nme of the kit air sampling, monitoring of effluents, and sur manufacturer or distributor and the kit moe veys to evaluate contamination of personnel, I facilities, and equipment designation should be given. If the applicant Physical effluent !measurements are essential to determine intends to perform his own leak tests without compli ance with Appendix B to 10 CFR Part 20. the use of a commercial kit, the following information should be submitted: 

        The description of an air sampling program should include the area where samples                                                (1) Qualifications     of   personnel         who   will will be taken,     the frequency of sampling, and the                                perform the leak test, location of the sampler with respect to workers'
 breathing zones Assays performed to evaluate                                         (2) Procedures and materials to be used in air samples and the methods used to                                           taking test samples, relate results to actual personnel exposures should also be described                                                                    (3) The type, manufacturer's name, model number, and radiation detection and measure The      effluent       monitoring        program                      ment characteristics of the instrument for                                                                  to be releases to unrestricted areas should encom                                   used for assay of test samples, pass all airborne and liquid radioactive material releases        Theoretical evaluations                 should be                    (4) Instrument        calibration         procedures, supplemented by stack monitoring, water                                       including calibration         source characteristics.

sam pling, and other environmental monitoring make, and model number, and ap propriate for the planned and potential releases (5) The method, including a sample calcu lation, to be used to convert instrument read For operations involving only sealed ings to units of activity, e.g. . microcuries.

sources, a survey program should include evaluation and/or measurement of radiation levels for storage and use configurations. d. Instructions to Personnel.

When If a number of sources are used in devices having "on" individuals will use radioactive "off" positions, both positions and materials under should be eval the supervision of one or more of those persons uated at the tune of installation Supplemental named in Item 6 of Foim NRC-3131, written surveys should be performed following instructions should be prepared any and submitted changez. in operation, shielding, or use with the license application in the form in which they will be distributed to those working The types, methods, and frequency of with radioactive materials.

These instructions surveys should be described in the application should cover, but not necessarily .'*uidance may be obtained from the be limited to: 

                                                          National Council on Radiation Protection Report                                               (1) The availability. selection, No     1

0. and use of

"Radiological Monitoring Methods and Instru laboratory apparel and safety-related ment-s,' and the International Atomic Energy equip ment and devices (e g. , laboratory gloves, and remote pipetting coats, 

  'CopIes  may   be  ob asnedi devices).
                                 rrM    NCRp  P ublicaon,       P o Box 4867    Washun                                                               6Copies may be ohrain--
                      . D (    20008                                                                    from "'IPUiB    in.     P 0
                                                                            New .'jrx N"Y       0                                    Box 433,
                                                                                                                             'oei
                                                                     10 7-5

(2) Limitations and conditions to be met in (12) The use of radioactive materials in handling liquid or uncontained (unencapsu animals. If radioactive materials will be used in 

                                          1asdioactive      animals,        instructions   concerning    such   use lated,         dispersible, or volatile)
                                                                         be   prepared   and   submitted   with  the materials and special laboratory equipment to                should license application.        Such instructions should be used in working with these types of mate rials. For example, the instructions should                  include (a) specification of the facilities to be explain when operations with materials should                used to house the animals, (b) instructions to be confined to a radiochemical fume hood or                  be provided to animal caretakers for handling animals,       animal wastes,     and carcasses, (c)

glove box and should specify the use of appro priate shielding and remote handling equipment instructions to appropriate personnel for clean when energetic beta- or gamma-emitting mate ing and decontaminating animal cages, and (d) rials are to be used. methods to be used to ensure that animal rooms will be locked or otherwise secured unless 

        (3) The performance of radiation survey              attended by authorized users of radioactive and monitoring procedures           or each area in          materials. A description of animal handling and housing facilities should be included uLnd'.

which radioactive materials are to be used.

Item 13 of Form NRC-3131.

(4) Safely precautions to be observed in the movement of radioactive materials between (13) Emergency procedures. These instruc tions should be addressed to all persons in aV.

buildings, rooms, and areas within rooms.

laboratory or facility areas where radioactive! 

                                                             materials will be used and should cover actions :
         (5) Safety requirements for storage of including labeling of           to be taken in case of such accidents involving!
 radioactive materials, radioactive materials as spills, fires, release or containers of radioactive materials and posting loss of material, or accidental contamination of and securing areas where radioactive materials                                                 these   instructions personnel.        Specifically, are to be stored. This should include the stor                                 specify immediate actions to be should (a)
 age of contaminated laboratory equipment such as glassware.                                                taken in order to prevent or limit the contami nation of personnel and areas, e.g.. the shut ting down of ventilation equipment, evacuation
          (6) Requirements for posting of areas in which radioactive materials are used.                        of contaminated and potentially contaminated i areas, containment of any spills of radioactive material, (b) give the telephone numbers of in
          (7) The availability and use of personnel dividuals to be notified in case of emergency.

monitoring devices, including the recording of and (c) instruct personnel in proper entry, radiation exposures and the procedures to be decontamination, and recovery operations for I 

  followed for the processing of personnel moni contaminated facilities. (Note: Only properly toring devices such as thermoluminescent dosi trained individuals should attempt decontamina meters .and film badges in order to obtain per               tion and recovery operations. )
  sonnel monitoring results
                                                                     (14) Requirements and procedures for pick
           (8) Waste disposal procedures to be fol ing up, receiving, and opening packages (see lowed, including limitations on the disposal of              §20.205 of 10 CFR Part 20).
   liquid or other dispersible waste to the sani- tary sewer       and proceaures  for the LoUeLLLZI,
   storage, and disposal of other wastes                           Items 16 and 17.      A resume of the training and experience of each person who will directly
           (9) The maintenance of appropriate rec               supervise the use of material, who will use ords as required by 10 CFR Part 20 and                       material without supervision, or who will have
    10 CFR Part 30.                                             responsibilities for radiological safety should be submitted. The resumi should include the
           (10) The requirements for and the method             type (on-the-job or formal course work), loca of performing or having appropriate sealed                   tion, and duration of the training. Training source leak tests performed.                                should cover (a)        principles and practices of radiation protection, (b) radioactivity measure
           (11) Good radiation safety practices, in             ments, standardization,        and monitoring tech cluding the control of contamination, specifica             niques and instruments, (c) mathematics and tion of acceptable removable and fixed contami              calculations basic to the use and measurement nation levels tor both restricted and unre                  of radioactivity, and (d) biological effects of stricted areas, prohibition of smoking and the               radiation. The description of the use of radio consumption of food or beverages in areas                   active materials should include the specific iso where radioactive materials may be used, and                 topes handled, the maximum quantities of mate prohibition of the frequent transfer of poten                rials    handled,     where the     experience    was tially contaminated equipment between poten                  gained, the duration of experience, and the tially contaminated areas and unrestricted                  type of use The qualifications, training, and areas.

10 7-6

xiprrinr.* )4ýeach terson should be commensu 

          ,I:- w~th J1, mnatriwl arnd its use                                             only have a background or, forma! traming r, as proposed          all areas described in T            ,     'TphPb-ation         The amount and type of                                                   tern 16 of F<orm NRý
                   'a:       ir'd      'xpe; ien(-'                                       3131 but should also h.ive -xten*,*ýn-- expe- with      radiation    and
                        ,e a raaterial.:                                                  working      with   rad*oactrve,     material     an i r1aliu1red to support a                                                                             a
     ,i('rrmIJ atin      I           ,f _ad-quauy by the Commission                       thorough working knowledge of the eqip

u. rmenrt

      .'.        ,,.r mar kru dly with (.,rtain factors                                   required to handle the material safely
             .             -      t -n:.ýh     c h as technical assistants
    :ir~i iab.--rit,;r-                 workers will use radioactive                              5.   AMENDMENTS      TO IhJENSES
    materials in the absenct: of persons specified
     *."*',            a. , specification of the                                            Licensees are required to cor.duct 4heir pr.

training of such persc.rne! ',hould include grams in accordance with statements, (a) instruction in renrý. 

    I IAf , -, qs:             fr 1.                                                     sentations. and procedures contained In"udinr,       topics covered and                                                                 in ýtie by whom taught                         hb) on-the-job training in use                 license application and su.:P)>rtive aocuments
   ,-If radlio,-tivt materials, and                                                      The license must therefore be amended (c) determination.                                                                if the of compeienciy to work without                                                        licensee plans to make any changes the presence of                                                          in faclt supervisory (ersOnnel                                                                 ties, equipment (including. monitoring and sur vey instruments), procedures, personnel        or
        "The is' of mitrocurie quantities of a few                                       byproduct material t(; Le used nonvolaile radioactive materials by a person with a minimum of training                                                               Applications for license amendments may and experience                                                                        e under precisely specified and                                                         filed either on the applicatior form or roliled conditions subject to the carefully con                                     form.    The     application. should identify kn ler!tr surveillance of                                                                   1o
        -,Ompetent               and adequately trained radiation                       license by number and should clearly de ;,.r t-.
  protection officer may be justified.                                                  the exact nature of the charges, mum training and experience                                        Such mini                                                      additions, c"r may consist of a            deletions. References to previously e: hours of training and experience                                                                                                 submitted information and documents should
 ,f crne or more radioactive materials in the use                                      specific and should identify be clear and similar to                                                 the pertinent the use proposed in the -tpplication                                                  information by date, page. and under the                                                paragraph sýupervision and tutorship of a Licensed user.

6. RENEWAL OF A LICENSE

     Persons using millicuzri quantities of a num Oer of radionuclideq for general                                                         An application for renewal of laboratory                                                a License should tracer                work         under       unspecified                            be filed at least 30 days prior conditions                                               to the expiration should have more extensive training                                                   date This will ensure that and expe                                             the license does not rience and, depending on the                                                          expire until final action on the exact nature of                                                    application ha6 ih.. proposed program of use                                                          been taken by the NRC as of radionuclides,                                                  provided for in zay         need to have completed formal                                             paragraph :30 37(b) of i9 CFP
                                                                 course work                                                Part 30.

at !he college or university level covering the areas listed under Item i6 of Renewal applications .hould Form NRC-3131. Le filed on Form NRC-3131, appropriately The use of larger suppI-mented, and quantities of material should contain compjete (dpproaching a curie) under and up-to-date infor conditions where a mation about the applicant's potential exists for significant current program.

loss and inges uon. inhalation, or absorption In order to facilitate the review of the radio process, t+/-e a,-tive material by those working application for renewal should with rnal is normaUy done under carefuoly the mate without be submitte.j controlled reference to previously

onditionrs using specialized documents and information submitted equipment. A If such referene-5 person whO is to use radioactive cannot be avoided, they materials inde shoild be clear -ad pendently unnde these conditions should hot specific and should identify the per'tnp-.*.n information by date, page, and paragraph.

10) 7-7

APPENDIX A Form NRC-31 3 (I) Form Apifroed by GAO 

                                                                                                                                           B- ll32S(1tOS79)
                                                    U.S. NUCLEAR REGULATORY 0O111611ON
  iO CFR 30
                                                   INSTRUCTIONS FOR PREPARATION OF
                                           APPLICATION FOR BYPRODUCT MATERIAL LICENSE
                                                                    FORM NRC-313 (I)
                                                                GENERAL INFORMATION
      An applbcant lot a "Byproduct Material (Radioisotopes) License."                   3  Broad License (research and development)-"Laceingm               Guie should complete Form NRC-313 (1) m detail and submit in duplicate                         for Type-A Licenses of Broad Scope for Resmarch and )evelop to the U.S Nuclear Regulatory Commission. The applicant should                            ment ,"
  endeavor to cover his entire radmastope program with one application, if possible. However, separate applhcationk should be submitted for                   4. Licensing Guides for the performance of well l            g eperatsoaa.

gamma irradiators. Applicatmlos for medical uses should be submitted 

  ^n Form NRC-313 (M) aad applications for use of scaled sources m                       S  Licunrin guide to: the use of scaled sourcs in portable and stint radiography should be submitted on Form NRC-313R. Supplemental                            portable gauging devices'
  sheets may be appened when necessary to provide complete mfoi mation. Item 18 must be completed on all applicatsios. Submission                     The Comm!son charges fees for filing of appblcaloa for hveoaes as of an incomplete application will often result en a delay in issuen*u ,t/         specified in Section 170 12, Title 10 Code of Fedwal Regitleioma.

the license because of the correspondence necessary to obtain inhr Part 170. The applicant should refer to Section 170.31, Scaleduh. uf rnrionrequested on the applicatron fees Ior materialsIlc'n srs. to determine what fee should accompany the application No action can be taken on applications until fees are NOTE When the application incldde: one oi the special sises listed paid. ('hecks or money orders should be made payable to the U.S.

below the applicant should request tihe appropruate pamphlet wlhch Nuclear Regulatory ( ommassion.

provides additionul instructions rwo ,opr," of the ,ompleted Irorm NR(-313 (e) and two copies of I Industrial Radiography "'LIcensitng Requirements for Industrial ea.h atticlimeni thlicc-o should he eCnito the Division of I rael Cycle Radiography'" (use. application I orm NRC'-31 3R for Radi mnd i*iterial Silely. Ottice of Nuclear Material Safety and Safeguards.

ography). IS Ni.lcat Regpilatury Commilsion Washington. DC 20555 One sopy liukiu bc retained for the appliLant's file Applications may 

       2 Laboratory and Industrial Uses i Small Quantitis-"G(uidc for               Ji.s be hited in person at the Comnitssion's office at 1717 H Street.

Preparation ol Applications for Liboratory and Industrial N %,. Wishington. D C or at 7915 1 astern Avenue. Silver Spring.

Uses of Small Quantities of Bypr-rduLt Material." M*r5 land EXPLANATION OF FORM NRC-313 (1) 

      I-orm NR('-313 fl) is desgned for use in supplying information Thc actual s*ies of use should be listed as indicated. Per on program, nt varying complesty          fhc applicant should provide                         tijnent A[A  ilihlie such as field oflfis lot portable gauges or complete information on his proposed program or the possession devicei should be identified in Item S by Street. Address.

and use of licensed material I or those items that do not apply. indicati.

City and Stait Temporar, field locations of use should As N.A (not appli.able) 

                                                                                               be specified as "'temporary job sites of the pplicani" and list the States throughout which the tempora i job sites will Item No he h1,laed       Attach additional properli, keyed sheet if miort spas   is needed I      Sell -exphndlory The -applicant'" i Ilhe organil.ation ii person legall ivc,                6      Sell    \'eplanatory ponibk for possession and ue of the licensed materials specified in the application
                                                                                        7       rhc "Radiation Protection Officer' is the nanied uilividual sho is expected to coordinatc the safe use of the licensed
      3       Sell-explanatory materi~al spekilied in the application and who will ensure srmphanme w!lh the applicable parts of Title 10. ('ode of
     4       SelU-tiplanalory I cderal Regulations I0 7-9

A List by name Ca,1iraditisotope it, he pose-r*ned and ised Attach .red~bonsa pi.perl% keyed sh-,.tsit 11 a ' 

           under the license 1, ample                                                             needed
                                                                                           1I     Stale tile u      itf  cacti II, cnsed material hlated in 9 V 8..
                                                           B                                      and D
               l)    lodtne-I31        (l)    Iodide t21   lodassc-
  • t
                                       12)    lodinated Humani Scruti Albunpin I* etcript1ion ti
                                                                                                   .Urct*
                                                                                                                    c tllcmtainre* an*d/or device% in ,vJjjh sealed e in Iltem h will be stored or uted. I %ample listd i
               13)   Krypton-85        13)   (.as
              141   Cesium-I 7         (4l   Sealed SouC1.

A 

                                                                                                          II I 1      Source housing               Io Curp D)
              0I)   Nof Appliuable     41) 10     mihd:icurie..
              (2)   N   A                     I aillicurnic                                                      Model 1-278 I,)                      (2)
                    N   A                     I inillIhuric I4)                      (4)    2 sou*icul ISO                              10 18      SeIf-.xplanatory         (I at those items that do not apply Model Z-78               mitlit. tolne Cacti                                   indicate a* N A (not applicable)
                                                                PRIVACY ACT STATEMENT

Pursuant to 5 U S.( 55 2af*l(3). 'niacted into law by set,.lon 3 of the I'IVaLvy Act of 1974 (Public: Law 93-579). the Iollowing .-titcileti IS furrnishcd to rndividual% who surply information to the Nuclear Regulatory Commis*ion on I orms NRC-313M, NR(-3 13A, NR(-3131 or NR(_'- 313R I his mformalion is mainiained in a system of re!eoid designated as NRC-3 and descrihed at 40 1 ederal Register 45 114 (Otlober I. 1975) I AUTHORITY SIio n,81 and 1614b) of the Atomic Inerpy Act of 1954. a, amended (42 U.S.( 2111 and 2201ib(1 2 PRINCIPAL PURPOSI"S) The informatmon is e:valuated It, the HKC staif pursuant to the ritleria set forth in 10 ( I R Parts 30-36 to determine whether the application meet, the requircmenti of the Atomic I nergy Act uo 1954. as amctindsd. ap the C('ommisoon's rclgulsaions. lot the issuanice of a byproduct maleril license or amendment thereof 3 ROUTINF tjSI S "he informawn itay be:used (0; to provide reuord& to State heaithk c.kpirtmeusi fop the intormpaipanand useand 4h)to provide intformation t4 I ederal. Stiart. and k),.al heafth officials and other p*;rsons in the event of incident of xposutic por thiir trifortnatilon, mvemiwzliarn.

ind protection (it the publitc health and safety The nfotinalicn ma, dlv) be ditslotd to approptiate I .Jeral. Stile and local ait.ticies in the event that the information indicale* a vio~Ltioon of ptenlti viol*iAt of law and in the course of in ad"ministrative o luli cuialproceeding In Addition. this inlormation ri ay be transfeared to An approprate IFederal. State. or kical agency to i'c esxhint relevant and neest*,.ry f>r a NR( 

  dn, ison or to an appropriate I ederal agnev to the .xtent relevant and ne                   lot that afenty'%dcJtioun about sou
                                                                                         ,LcesAfy                                             A npli tit the hin"sc issued will routinely he placed in the NRC's Puhlic Doument Room. 1717 H Street. N W, Washington. DA

4 WHI T1,11II DIStLOSLRI. IS MANDATORY OR VOLUNTARY AND. III FCT ON INDIVIDUAL 01 NOT PROVIDIN(; INI.ORMA rION 

   Dit..losurc of the requested infrrmnation is voluntary It the request information is not furnished. hno*,w.vr. ti apptiation   "           horiI, producl mat 'rial lhcense or 3mendmenl thereof, will not he proceied

5 SYSTIM MANAGFRISI ANI) ADDRI SS Dir."tor Division ti I ucl (Clee .aid Matarial Sat*t*. Ofti, ol Nu, tear Material Saetly a4ad S.afeguidf,. 

   ki S Nuclear Regulallory ( ommission. Washington. D ( 2055
                                                                               10 7-10

FORM NRC-313 I -U.S. NUCLEAR REGULATORY COMMUON 1. APPLICATION FOR: 

       (1-79)
                                                                                                                           (Chec* and/or conYiDe a             opeteJ
       10 CFH 30
                  APPLICATION FOR BYPRODUCT MATERIAL LICENSE
                                                       INDUSTRIAL

a. NEW LICENSE

      See erached 'nsrucrt,os for details b. AMENDMENT TO.

L ICEiNSE NUUMBE 

      n'fli)leted .p* is-i,,tins are tlile' in d(i/*     otre with the Division of FIuel C'*rle and Material Safetr,.
    Offit r I'f Nit, lear Material Safetv. o.in Safeguards U.S. Noclear Regulatory Commisusion.

Washington. DC 20555 or app/i,.*i5 'nay he, fed in person at the Comnrnision's office at c RENEWAL OFF 

    I77 H Strepr NýW. Washinqtol/ 0             ,'" or 7915 Fastern Avenue. Silver Sprinq. Marylayri.

2. APPLICANT'S NAME (institution. firm, person, etc.)

3. NAME OF PERSON TO B

E. CONTACT

ED REGARDING THIS 

                                                                                           APPLICATION
      TELEFPHONE NUMBER            AREA CODE - NUMBER EXTE.NSION.                            LEPNONE NUMBER            AREA CODE -- FJUMBER EXTENSION
  4APPLICANT'S MAILING ADDRESS (Include Zip Code)B                                         STREET ADDRESS WHERE LICENSED MATERIAL WILL BE USED
                                                                                           fIncludeO EECode)
                     (IIF MORE     SPACE IS NEEDED FOR ANY ITEM. USE ADDITIONAL PROPERI y                                        V'lVV%       bAfICC
  6. INDIVIDUAL(S) WHO WILL USE OR DIRECTLY SUPERVISE THE USE OF LICENSED MATERIAL
        (See Items 16 and 77 for required Frainingand experience of ech indjividul n4,,d              be low)
                                     FULL NAME                                                                              TITLE
 Ib C.

7. RADIATION PROTECTION OFFICER I Attach e resume of person's trainingend exper.ence a outline if items I 16 and 17 and describe his responsib*t*tievs under Item 15.

_____S. LICENSED MATERIAL I L ELEMENT CHEMICAL NAME OF MANUFACTURER MAXIMUM 

                                I   N                             NIRAND                                        ,               MILLICURIES AJ4DOMMEALED
    N                MASS NUMBER                            PHYSICAL FORM                      MODEL NUMBER                    SOURCES AND MAXIMUM ACTI.

(if Sealed Source) VITY PER SOURCE WHICH WILL 

 NO.                         A                                                                           CO                   BE POUSESSED AT ANY ONE TVME I
                                                                            UC                                                                       0
                                            _                                                                                                                       -4

!(31 DESCRIBE USE OF LICENSED MATERIAL (21 I 17 

                                                                                                                                                         _33 F*IMNRC     313 i 1 -791---
                                                                                                                                                       _  ____
                                                                                10.7-11

9. STORAGE OF SEALED SOURCES 

   SCOftTAINtSR       AND/OR DEVICE IN WHICH EACH SEALED                    NAME OF MANUFACTURER                       MODEL NUMefifR

It SOURCE WILL BE STORIED OR USED I A. B. C.

12) (3) (4) 

                                           10. RADIATION DETECTION INSTRUMENTS

- TYPE MANUFACTURER'S MODEL NUMffR RADIATION SENSITIVITY L OF NAME NUMIBR AVAILABLE DETECTED RANGE M INmsTRMmNT (alpha.beta. (fnbllfoenr.mrno/hour S gamma. neurron) or counts/mmnure) 

                  A                                       C                   D                     E                           F

121 (31 

                                      11. CALIBRATION OF INSTRUMENTS LISTED IN ITEM 10

0E. CALINRATDO NY SERVICE COMPANY [0b. CALIBRATED BY APPLICANT 

       NAME. ADORESS. AND FREQUENCY                                      Attach a Speorate sheet describing method, frequency Mnd staMdards used for caibratinginhtrumwen.

12. PERSONNEL MONITORING DEVICES 

                       TYPE                                            SLPPLIER                                  EXCHANGE FREOUENCY
       fCheft* and/of cran)te as ^wP(OP-o-                         (Seiwce Company)                                           C
                                                                                                                              C
                         A,

0111 FIL*ISADIGE 0 MONTHLY D12) THERMILUVMINESCENCE 

                                                                                                                 0 QUARTERLY
          DO1308ITTER (TLD0
                                                                                                                  D OTHER (Specdy)
   S0011  OTHiER  (Sw,_y)
           13. FACMILTtMS AND EQUIPMENT (Check          were appropriate and attch      annotated sketch(es) and description(s).
                                                                                             dMany). ETC
 0    a LABORATORY FACILITIES. PLANT FACILITIES, FUME HOODS (Include foltreon, CONTAINERS.   SPECIAL SHIELDING   (fixed and/lor teorpoarry), ETC
 D    bý STORAGE     FACILITIES
 0    c REMOTE HANDLING TOOLS OR EQUIPMENT. ETC
  0l d RESPIRATORY PROTECTIVE EQ4JIPMENT. ETC
                                                         1q. v1 PaiLr.IK .   ,GMl_
     Na
      --.     OF CONMERCIAL WAST6 DISPOSAL SERVICE EMPLOYED
                                                                                 A DETAILED DESCRIPTION OF METHODS WHICH WILL
 b tF COMMtRCIAL WASTE DISPOSAL SERVICE IS NOT EMPLOYED. SUBMIT
                                                                              OF THE TYPE AND AMOUNT OF ACTIVITY INVOLVED IF
     "85  US6D FOR D46POSING OF RADIOACTIVE WASTES AND ESTIMATES
                                                                                      BE RETURNED TO THE MANUFACTURER. SO STATE.

TE APPLICAlION IS FOR SEALED SOURCES AND DEVICES AND THEY WILL FO"M NOC 313 0 1-794 

                                                                  10.7-12

INFORMATION REOUIRED FOR ITEMS 15, 16 AND 17 Describe in detail the information required for Items 15, 16 and 17. Begin each item on a separate page and key to the application as follows: 

          15.  RADIATION PROTECTION PROGRAM. Describe the radiation protection program as appropriate for the material to be used including the duties and responsibilities of the Radiation Protection Officer, control measures, bioassay procedures fit needed), day-to-day general safety instruction to be followed.

etc If the application is for sealed source's also submit leak testing procedures, or if leak testing will be performed using a leak test ki0, specify manufacturer and model number of the leak test kit.

16. FORMAL TRAINING IN RADIATION SAFETY. Attach a resume for each individual named in Items 6 and 7 Describe individual's formal training in the following areas where appliable. Indude the name of person or institution providing the training, duration of training, when training was received, etc a. Principles and practices of radiation protection.

b Radioactivity measurement standardization and monitoring techniques and instruments.

c. Mathematics and calculations basic to the use and measurement of radioactivity d Biological effects of radiation.

17. EXPERIENCE. Attach a resume for each individual named in Items 6 and 7. Describe individual's work experience with radiation, including where experience was obtained. Work experience or on the-job training should be commensurate with the proposed use. Include list of radioisotopes and maximum activity of each used.

1

8. CERTIFICATE

                                                    (This trem must be completed try appiicant)
                    Th e .ippl* canr and any official exocurJng this Ofril',cate on behalf ot the applicant named in /rem 2, certify that this application is prepared in confotmitry with Title 10, Code of Federal Regulations Parr 30I and that all 'nformation contained herein including any suPplements atrtached hereto is true and correct ro the best of our knowleade and belief.

WARNING 18 U.S.C Section 1001, Act of June 25. 1948; 62 Stai 749; makes it a crimnal offense to nmke a willtully taiae stltemt or repreentation to any department or agency of the United States as to any matter within its ourisdiction.

LII. FNSE FEE REQUIRED 

   (See Secton 170.3? 10 CFR                                               j0    ERTIFYING OFiCiAL
                                                                            c. NAME (Type or print)
 11 LICENSE    FEE CATEGORY                                                 d  TITLE

12; LICENSE FEE eNC.:LOSED $ e DATE F0RM NRC-313 1 11 791 

                                                                      10 7-13

_1.. 

        .                              UN TED STATES
            0                NUCLEAR REGULATORY COMMISSION
                                   WASHINGTON, D. C. 20555 July 1984
                                           [[kRATA
                            REGULATORY GUIDE 10.7,      Revision 1 GUIDE FOR THE PREPARATION OF APPLICATIONS
                                                                      FOR
                 LICENSES FOR LABORATORY AND INDUSTRIAL USE
                                                                    OF SMALL
                            QUANTITIES OF BYPRODUCT MATERIAL
  Regulatory Guide 10.7, Revision 1, provides directions for using Form NRC-313I
  in preparing applications for licenses for laboratory and industrial use of small quantities of byproduct material.

The NRC is now using a new NRC Form 

  313 for all byproduct material applications Form NRC-313I.                                    and is discontinuing the use of The NRC is developing Revision 2 of Regulatory conform to the new NRC Form 313.                                         Guide 10.7 to Until Revision 2 is issued, this errata sheet provides the information needed to use the new NRC Form 313.

The new NRC Form 313 does not have space for providing the information requested in Items 5 through 11. Please provide the information on 8-1/2 x 

                                                                             11 inch paper.

In the left-hand column of the following table are listed items of the old Form NRC-3131, most of which are also called out in Regulatory Guide 10.7, Revision 1. The right-hand column identifies the corresponding item of the new NRC Form 313 in which responses should be made.

Guide and Old Form NRC-3131 New NRC Form 313 Item 1* Item Item 1 

      2 Item                                                       Item 2
      3 Item                                                       Item 4
      4 Item                                                       Item 2
      5 Item                                                        Item 3
      6 Item                                                        Item 8
      7 Item   8                                                    Item 7 Items 5 and 6 Item 9 Item 10                                                     Item 9 Item 11                                                     Item 10
                                                           Item 10

itei 12 Iter; 10 Item 13 Item 9 Item 14 Item 11 Item 15 Item 10 Item 16 Items 7 and 8 Item 17 Item 7 Item 18* Items 12 and 13

  • Not called out in Regulatory Guide 10.7, Revision 1.

The following cross-reference table may be helpful to you: New NRC Form 313 Old Form NRC-3131 Item 1 Item 1 Item 2 Items 2 and 4 Item 3 Item 5 Item 4 Item 3 Item 5 Items 8A, B, C, and D Item 6 Item 8E Item 7 Items 7, 16, and 17 Item 8 Items 6 and 16 Item 9 Items 9 and 13 Item 10 Items 10, 11, 12, and 15 Item 11 Item 14 Item 12 Items 18a(1) and (2) Item 13 Items 18b, c, d, and e ,,L_ Item 14 N/A 

                                       2

NRC 'OPV 313 

           8'               32 33 34                                                                                                                                            US. NUCLEAR REGULATORY COMMISSION
                                                                                                                                                                                                      APPROVED BY OM8
                                                                                                                                                                                                      3150-0120
                 ...                                                                APPLICATION FOR MATERIAL LICENSE                                                                                  Elxpir,. 5-31-87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR
                                                                                                                                                               COMPLETING APPLICATION           SEND TWO COPIES
        )' 'HE ENTIRE COMPLETED APPLICATION TO THE NRC
                                                                                              OFFICE SPECIFIED BELOW.

FEDERAL AGENCIES FILE APPLICATIONS WITH 

                                                                                                                          IF YOU ARE LOCATED IN:
              "I S NUCLEAR           REGULATOR Y COMMISSION
                                                                                                                          ILLINOIS, INDIANA, IOWA. MICHIGAN, MINNESOTA, MISSOURI
              3)IVISION       OF FLEL CYCLE AND MATERIAL SAFETY. NMSS                                                                                                                         OHIO, OR
                                                                                                                          WISCONSIN. SEND APPLICATIONS TO
            WASHINGTON               DC 20555 U S. NUCLEAR REGULATORY COMMISSION, REGION III
      ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS,
                                                                                    IF YOU ARE                                MATERIALS LEIUCENSTNG
      LOCATED IN                                                                                                                                           SECTION
                                                                                                                              799 ROOSEVELT ROAD
     CONNECTICUT. DELAWARE, DISTRICT OF COLUMBIA, MAINE, MARYLAND,                                                            GLEN ELLYN. IL 60137 MASSACHUSETTS, NEW JERSEY, NEW YORK, PENNSYLVANIA,
     On VERMONT. SEND APPLICATIONS TO,                                                    RHODE ISLAND.                   ARKANSAS, COLORADO, IDAHO, KANSAS, LOUISIANA, MONTANA,
                                                                                                                          NEW MEXICO, NORTH DAKOTA, OKLAHOMA, SOUTH DAKOTA,                        NEBRASKA
                                                                                                                                                                                              TEXAS, UTAH,
                 S NUCLEAR REGULATORY COMMISSION. REGION I
            NUCLEAR MATERIAL SECTION B                                                                                    OR WYOMING, SEND APPLICATIONS TO:
           63! PARK AVENUE                                                                                                    U.S. NUCLEAR REGULATORY COMMISSION. REGION IV
           KING OF PRUSSIA. PA 19406                                                                                         MATERIAL RADIATION PROTECTION SECTION
                                                                                                                             611 RYAN PLAZA DRIVE. SUITE 1000
     ALARAMA FLORIDA GEORGIA KENTUCKY, MISSISSIPPI, NORTH CAROLINA,                                                          ARLINGTON, TX 76011 PUERTO RICO, SOUTH CAROLINA, TENNESSEE, VIRGINIA, VIRGIN
     WEST VIRGINIA. SEND APPLICATIONS TO:                                                      ISLANDS. OR               ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA, OREGON,
                                                                                                                         AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND            WASHINGTON,
                                                                                                                                                                                                 APPLICATIONS
           'J.S NUCLEAR REGULATORY COMMISSION, REGION
                                                                                 II
                                                                                                                         TO:
           MATERIAL RADIATION PROTECTION                       SECTION
              'I MARIETTA STREET, SUITE 2900                                                                                 U.S NUCLEAR REGULATORY COMMISSION, REGION V
                                                                                                                             MATERIAL RADIATION PROTECTION SECTION
          ATLANTA. CA 30323
                                                                                                                             1450 MARIA LANE. SUITE 210
                                                                                                                             WALNUT CREEK, CA 94596 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
                                                                                                JURISDICTION.

I THIS IS AN APPLICATION FOR [Chock o'opritare itEm) 

                                                                                                                      2. NAME AND MAILING ADDRESS OF APPLICANT (Includ.Zip Code)
                 A     NEW LICENSE
                 B AMENDMENT TO LICENSE NUMBE9
  ? AJDRESSiES! WHERE LICENSED MATERIAL WILL
                                                                            BE USED OR POSSESSED.

4 NAME OF PERSON TO B

E. CONTACT

ED ABOUT THIS APPLICATION 

                                                                                                                                                                               TELEPHONE NUMBER
 SUBMIT ITEMS 5 THROUGH II                         ON  EN , 11  PAPER      THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED
                                                                                                                                             IS DESCRIBED IN THE LICENSE APPLICATION GUIDE
 E      RADIOACTIVE MATERIAL
                    Er'iinlband      5 nunibr aort.    b Ihencal]
                                                      tft      andlor OnyIsciI         and c.   mano'" ionn            6.   PURPOSEIS) FOR WHICH LICENSED MATEPIAL WILL
       ,.rlcn wi,' be oo$$s~sec at any onn tinie                                                                                                                                      BE USED
        'NDIVIDUALiSi RESPONSIBLE FOR RADIATION SAFETY
       TRA        'ýING AND EXPER:ENCE                                               PROGRAM AND THEIR
                                                                                                                      8. TRAINING FOR INDIVIDUALS WORKING IN OR FREOUENTING
                                                                                                                                                                                                RESTRICTED AREAS
          ACILITIES AND EQUIPMENT                                                                                    10.   RADIATION SAFETY PROGRAM
         WASTE MANAGEMENT                                                                                            12 LICENSEE FEES (Saw ro CFR           I70nd  S*eefon 170.31)
                                                                                                                                                                             WAMOUNT
                                                                                                                     FEE CATEGORY                                             ENCLOSED $
          C'ERTIFICATU0N               !AMiistbecornolotedbyaDphcandJ THE APPLICANT UNDERSTANDS
                                                                                                               THAT ALL STATEMENTS AND REPRESENTATIONS
                                                                                                                                                                         MADE IN THIS APPLICATION ARE
          Hl -ING .PO.,             Tn5 APPLICANT
          "-.E APPLICANT AND ANY OFFICIAL EXECUTING THIS
         cRyFPARLD :N CONFORMITY WITH TITLE                                         CERTIFICATION ON BEHALF OF THE APPLICANT NAMED
                                                                   I0. CODE OF FEDERAL REGULATIONS,           PARTS 30,32, 33,34,35. AND 40 AND      IN ITEM 2, CERTIFY THAT THIS APPLICATION IS
                                                                                                                                                          THAT ALL INFORMATION CONTAINED HEREIN
            'S'RI E AND CORRECT TO THE BEST OF THEIR KNOWLEDGE
                                                                                           AND BELIEF
         PIARNING I6 ý                 -C SECTION I001 ACT OF JUNE 25 1948.62 STAT 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY
                 T-AY DEPARTMENT OR AGENCY OF THE UNITED STATES                                                                                                       FALSE STATEMENT OR REPRESENTATION
                                                                                          AS TO ANY MATTER WITHIN ITS JURISDICTION
         .',R*J-'EH*T ...                  I.%GO:CSR                       TYPEDIPRNTEO NAME                                          IIL                                                         DT
         $SOO.

-,-I * TMIO 

                                                                    8NUMBER OF EMPLOYEES (Totalio d WOULD YOU BE WILLING TO FURNIH COST
                                                                 $  ~ ittrn aciityPx~iJ~nECJttdfCflt*Ct,,)
                                                                                                                        ON THE ECONOMIC IMPACT OP CURRENT NRC REGULATIONS
                                                                                                                                                                             INFORMATION ('Jolls, anditeho,,
                                                                                                                                                                                             OR ANY FUTURE
       I 251K -500K                          S'5V35   7M                                                                PROPOSED NRC REGULATIONS THAT MAY AFFECT
                                                                                                                        it t0O1eCitip,~lCn YDU? (NRC iwecilationn,'pi.n4 nena o iera~r~i,,.,ion.i,                 e-r,Ihld to
   :      5520K - 50K                        s7m - 1M             c NUMBER OF BEDS                                      th poyin        contidenlcs)
         S-50K            V>NO
                            V,..A               J                                                                            YES
                                                                                                        FOR NRC USE ONLY
           3           i             'SE LOG   0P5                FEE CATEGORY                COMMENTS                                                                                  APPROVED By
                    2

4.', " . ECE .'C CHECK NUMBER 

                                                                                                                                                                                        DATE
        ;'v"""*ACT         S
                           A
                           S       AT. T
                                  Y>TIE'T   0O4 THE E REVERSE
                                                       REV

PRIVACY ACT STATEMENT Pjrsuant to 5 U.S.C. 552a(e)(3), enacted into law by section 3 of the Privacy Act of 1974 JPublic Law 93-579), the follow 

!ng statement is furnished to individuals who supply information to the Nuclear Regulatory Commission on NRC
                                                                                                                          Form

313. This information ;s maintained in a system of records designated as NRC-3 and described at 40 Federal Register 

                                                                                                                         45334 (October 1, 19751.

1 AUTHORITY: Sections 81 and 161(b) of the Atomic Energy Act of 1954, as amended (42 U.S.C. 2111 and 2201 (bll 2 PRINCIPA

L. PURPOSE

(S): The information is evaluated by the NRC staff pursuant to the criteria set forth ;n 10 

                                                                                                                           CFR
   Parts 30, 32, 33, 34, 35 and 40 to determine whether the application meets the requirements of the Atomic Energy Act of
   1954, as amended, and the Commission's regulations, for the issuance of a radioactive material license or amendment thereof.

3. ROUTINE USES: The information may be (a) provided to State health departments for their information and use, and (b) provided to Federal, State, and local health officials and other persons in the event of incident or exposure, for their information, investigation, and protection of the public health and safety. The information may also be d1,s closed to appropriate Federal, State, and local agencies in the event that the information indicates a violation or potent:ai vwo'at~on of iaw and !n the course of an administrative or judicial proceeding. In addition, this information may be trans ferred to an appropriate Federal, State, or local agency to the extent relevant and necessary for an NRC decision or to an appropriate Federal agency to the extent relevant and necessary for that agency's decision about you.

4ý WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVID 

    ING INFORMATION: Disclosure of the requested information is voluntary. If the requested information is not furn ished, however, the application for radioactive material lik.ense, or amendment thereof, will not be processed. A request that :nformation be held from public inspection must be in accordance with the provisions of 10 CFR 2.790. Withhold ing from public inspection shall not affect the right, if any, of persons properly and directly concerned need to inspect the document.

5. SYSTEM MANAGER(S) AND ADDRESS: U.S. Nuclear Regulatory Commission Director, Division of Fuel Cycle and Material Safety L 

                                                Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555 NRC FORM 313

I NRC 

                                                                                                                                                                     US NUCLEAR REGULATORY COMMISSION
       84 APPROVED BY OD4E
         C F 1,4"3,        ý    1                                                                                                                                                            3150-0120
                                                                             APPLICATION FOR MATERIAL LICENSE                                                                                E-pis    55-31.87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING
                                                                                                                                                                      APPLICATION       SEND TWO COPIES
     )l THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED
                                                                                                            BELOW.

[ 

    "FEDERALAGENCIES FILE APPLICATIONS WITH
           - S NUCLEAR REGULATORY COMMISSION
         ilVISION O FUEL CYCLE AND MATERIAL SAFETY. NMSS
         WNASHINGTON.            DC 20555 IF YOU ARE LOCATED IN
                                                                                                                   ILLINOIS, INDIANA, IOWA, MICHIGAN. MINNESOTA. MISSOURI, OHIO. OR
                                                                                                                   WISCONSIN. SEND APPLICATIONS TO:
                                                                                                                       U S. NUCLEAR REGULATORY COMMISSION. REGION III
   ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS. IF YOU ARE                                                          MATERIALS LICENSING SECTION
   LOCATED IN                                                                                                          799 ROOSEVELT ROAD
   CONNECTICUT. DELAWARE. DISTRICT Ol- COLUMBIA. MAINE. MARYLAND.                                                      GLEN ELLYN. IL 60137 MASSACHUSETTS, NEW JERSEY NEW YORK. PENNSYLVANIA, RHODE ISLAND,
   OPRVERMONT. SEND APPLICATIONS TO.                                                                               ARKANSAS COLORADO, IDAHO, KANSAS. LOUISIANA, MONTANA, NEBRASKA,
                                                                                                                   NEW MEXICOO,NORTH DAKOTA, OKLAHOMA, SOUTH DAKOTA. TEXAS, UTAH.

OR WYOMING. SEND APPLICATIONS TO: 

             S NUCLEAR REGULATORY
        NUCLEAR MATERIAL SECTIONCOMMISSION.         B
                                                                   REGION IO
                                                                                                                      U.S. NUCLEAR REGULATORY COMMISSION, REGION IV
        631 PARK AVENUE
        KING OF PRUSSIA. PA 19406                                                                                     MATERIAL RADIATION PROTECTION SECTION
                                                                                                                      611 RYAN PLAZA DRIVE, SUITE 1000
   ALABAMA. FLORIDA, GEORGIA. KENTUCKY. MISSI.SIPPI, NORTH CAROLINA,                                                  ARLINGTON.TX 76011 PUERTO RICO, SOUTH CAROLINA. TENNESSEE, VIRGINIA, VIRGIN ISLANDS,
                                                                                                 OR               ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA. OREGON, WASHINGTON.

WEST VIRGINIA. SEND APPLICATIONS TO 

                                                                                                                  AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND APPLICATIONS
        'J S NUCLEAR REGULATORY COMMISSION. REGION II                                                             TO:
       MATERIAL RADIATION PROTECTION                      SECTION
        ',71 MARIETTA STREET. SUITE 2900                                                                              U.S. NUCLEAR REGULATORY COMMISSION REGION V
                                                                                                                      MATERIAL RADIATION PROTECTION SECTION
       ATLANTA GA 30323
                                                                                                                      1450MARIA LANE, SUITE 210
                                                                                                                      WALNUT CREEK. CA 94596 PERSONS LOCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE
                                                                                              U.& NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS
                                                                                                                                                                                 AND USE LICENSED MATERIAL
  IN STATES SUBJECT TO U.S. NUCLEAR REGULATORY COMMISSION JURISOICTION.

THIS IS AN APPLICATION FOR lChoek aWmpriste it") 

                                                                                                               2. NAME AND MAILING ADDRESS OF APPLICANT (OncludeeZ Code)
             A NEWLICENSE
             8     AMENDMENT          TO LICENSE NUMBER_
             C RENEWAL OF LICENSE NUMBER
     A--A)DRESSIES! WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED

4 NAME OF PERSON TO B

E. CONTACT

ED ABOUT THIS APPLICATION 

                                                                                                                                                                   J TELEPHONE NUMBER

SUBMIT ITEMS S THROUGH 1 I ON E'i 11 - PAPER THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED 

                                                                                                                                                    IN THE LICENSE APPLICATION GUIDE

5 RADIOACTIVE MATERIAL 

     a E emeni and mass 'iunibet" b cýhen,cal end/or physlcls for,. end c.

n*,binusn 60.mn 6 PURPOSEIS) FOR WHICH LICENSED MATERIAL WILL BE USED 

      ýt,'       -C 11b5, Qosssed at anv one ti-e NIDIVNIUAL(S, RESPONSIBLE
                                                  FOR RADIATION SAFETY PROGRAM
     TRA,.,ING AND EXPERIENCE                                                          AND THEIR
                                                                                                                8    TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS
        SACITIES AND EQUIPMENT
                                                                                                               10    RADIATION SAFETY PROGRAM
"     W
      WASTE MANAGEMENT
                         N12.

LICENSEE FEES (See I0CFR 170andSection 170.31/ 

                                                                                                                                                                   iAMOUNT
                                                                                                               FEE CATEGORY                                        jENCLOSED      $
        ""ErTIF'CATION              (Must beomo/eredby*Phl/cAntJ THE        APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS
                                                                                                                                                                MADE IN THIS APPLICATION ARE
       8,,'E NGNUPON T.IE APPLICANT
          "iE    APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION
      PRFPAIIED ;N CONFORMITY WITH TITLE 10, CODE OF FEDERAL
                                                                                               ON BEHALF OF THE APPLICANT NAMED IN ITEM

2. CERTIFY THAT

                                                                                                                                                                        THIS APPLICATION IS
                                                                                     REGULATIONS, PARTS 30.32 33. 34 35. AND 40 AND THAT ALL
      ýS TOIJE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND                                                                                               INFORMATION CONTAINED HEREIN
                                                                                        BELIEF
         .ARNINC. IS, U SC SECTION 1001 ACT OF JUNE 25. 1948, 62 STAT
                                                                                         749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE
      Tr A%' ULEPARTMENT OR AGENCY OF THE UNITED STATES AS                                                                                                           STATEMENT OR REPRESENTATIO.N
                                                                                     TO ANY MATTER WITHIN ITS JURISDICTION
              .i" i      E.(*T'     'NTI OFFICER                     I TYPED/PRINTED NAME                                       ITITLE                                                    DATE
                                            P                                              14 V       UNTAAY ECONOMIC DATA
                                    N'..
                                     R      Pb                 NUMBER OF EMPLOYEES        (Tote/i'1o,         d WOULD YOU BE WILLING TO FURNISH COST INFORMATION
                                         SIM    I SM           ...      fre                                                                                                         r(JOI8e,.doCImffh., ,
                                                                                             .                    ON THE ECONOMIC IMPACT OF CURRENT NRC REGULATIONS                                        5 OR ANY FUTURE
          25271K                         S35kEV7M                                                                 PROPOSED NRC REGULATIONS THAT MAY AFFECT YOU' (NRC mru1/tionsjDenrmt It to Dfrorect coifdent"e1 Commn'itl or finncil-Drorietli/--,iiOrmet~on furniShod to S5OOK          /501K                 M   1DM             NUMBER OF BEDS                                              c
      5j 'ýOK IV                         -ISIOM
                                                                                                                        E
                                                                                                   FOR NRC USE ONLY
  ' p             I(F             (FE LOG                    FEE CATEGORY            COMMENTS                                                                                   APPROVED     BY

AV. ".-FCEiTE TO CHECK =NUMBER 

                A'ý    S     TMENT Ory THE REVERSE

PRIVACY ACT STATEMENT 

                                                                            Privacy Act of 1974 (Public Law 93-579), the follow Pursuant to 5 U.S.C. 552a(e)(3). enacted into law by section 3 of the to the Nuclear Regulatory Commission on NRC Form

,g statement is furnished to individuals who supply information as NRC 3 and described at 40 Federal Register 45334 313. This information is maintained in a system of records designated (October 1, 1975). 

                                                                      Act of 1954, as amended (42 U.S.C. 2111 and 2201(b)).

1, AUTHORITY: Sections 81 and 161(b) of the Atomic Energy CFR 

                                                                  by the NRC staff pursuant to the criteria set forth in 10

2. PRINCIPA

L. PURPOSE

(S): The information is evaluated of the Atomic Energy Act of the application meets the requirements Parts 30, 32, 33, 34, 35 and 40 to determine whether material license or amendment for the issuance of a radioactive 

   1954, as amended, and the Commission's regulations, thereof, information and use;
                                                    (a) provided to State health departments for their

3. ROUTINE USES: The information may be of incident or exposure, and other persons in the event and (b) provided to Federal, State, and local health officials The iformation may also be dis of the public health and safety.

for their information, investigation, and protection irdicates a violation or potential in the event that the information closed to appropriate Federal, State, and local agencies this information may be trans or judicial proceeding. in addition, violation of law and in the course of an administrative necessary for an NRC decision or to to the extent relevant and ferred to an appropriate Federal, State, or local agency about you.

and necessary for that agency's decision an appropriate Federal agency to the extent relevant NOT PROVID 

                                                          VOLUNTARY AND EFFECT ON INDIVIDUAL OF

4. WHETHER DISCLOSURE IS MANDATORY OR the requested information is not furn information is voluntary. If ING INFORMATION: Disclosure of the requested will not be processed. A request material license, or amendment thereof, ished, however, the application for radioactive the provisions of 10 CFR 2,790. Withhold must be in accordance with that information be held from public inspection and directly concerned need to inspect if any, of persons properly ing from public inspection shall not affect the right, the document.

U.S. Nuclear Regulatory Commission 

 5. SYSTEM MANAGER(S) AND ADDRESS:
                                                   Director, Division of Fuel Cycle and Material Safety Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555 NRC FORM 313

NRBC *'*RM 313 US NUCLEAR REGULATORY COMMISSION 

       '84C-I 3C 32 33 34 APPROVED BY Om B
                                 ...    0APPLICATION                                              I        FOROR MATERIAL
                                                                                                                      M31M0-0120            LICENSE                                                  E ....   5-31-87 NSTRUCTIONS SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS
                                                                                                                                                       FOR COMPLETING APPLICATION               SEND TWO COPIES
    )I THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.

FEDERAL AGENCIES FILE APPLICATIONS WITH 

                                                                                                                       IF YOU ARE LOCATED IN
                 NS  U'CLEAR REGULATORY COMMISSION                                                                    ILLINOIS. INDIANA. IOWA, MICHIGAN, MINNESOTA. MISSOURI. OHIO, OR
         'JIVISION OF FUEL CYCLE AND MATERIAL SAFETY. NMSS
                                                                                                                      WISCONSIN, SEND APPLICATIONS TO
        WASHINGTC!q. DC 20555 ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS. IF YOU ARE                                                               U S. NUCLEAR REGULATORY COMMISSION. REGION III
                                                                                                                            MATERIALS LICENSING SECTION
  LOCATED IN
                                                                                                                           799 ROOSEVELT ROAD
                                                                                                                           GLEN ELLYN, IL 60137 CONNECTICUT. DELAWARE, DISTRICT OF COLUMBIA, MAINE. MARYLAND,
 MASSACHUSETTS. NEW JERSEY,                       NEW YORK, PENNSYLVANIA. RHODE ISLAND,                              ARKANSAS. COLORADO, IDAHO. KANSAS, LOUISIANA, MONTANA, NEBRASKA.

OR VERMONT. SEND APPLICATIONS TO. NEW MEXICO, NORTH DAKOTA. OKLAHOMA. SOUTH DAKOTA, TEXAS, UTAH.

.S NUCLEAR REGULATORY COMMISSION, REGION I OR WYOMING, SEND APPLICATIONS TO: 

        NUCLEAR MATERIAL SECTION B
                                                                                                                           U.S. NUCLEAR REGULATORY COMMISSION. REGION IV
        631 PARK AVENUE
                                                                                                                           MATERIAL RADIATION PROTECTION SECTION
        KING OF PRUSSIA. PA               19406                                                                            611 RYAN PLAZA DRIVE. SUITE 1000
                                                                                                                           ARLINGTON, TX 76011 ALABAMA FLORIDA GEORGIA. KENTUCKY, MISSISSIPPI, NORTH CAROLINA.

PUERTO RICO, SOUTH CAROLINA. TENNESSEE, VIRGINIA, VIRGIN ISLANDS, OR 

 WEST VIRGINIA. SEND APPLICATIONS TO                                                                                 ALASKA, ARIZONA, CALIFORNIA, HAWAII, NEVADA. OREGON, WASHINGTON,
                                                                                                                     AND U.S. TERRITORIES AND POSSESSIONS IN THE PACIFIC, SEND APPLICATIONS
        'J S NUCLEAR REGULATORY COMMISSION, REGION It                                                                TO:
        MATERIAL RADIATION PROTECTION SECTION
        101 MARIETTA STREET. SUITE 2900                                                                                    U.S. NUCLEAR REGULATORY COMMISSION, REGION V
                                                                                                                           MATERIAL RADIATION PROTECTION SECTION
       AILANTA. GA 30323
                                                                                                                           1450 MARIA LANE. SUITE 210
                                                                                                                          WALNUT CREEK. CA 94596 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 JURISOICTION.

1 THIS IS AN APPLICATION FOR (Chock a'Copioreewt*t* , 2. NAME.AND MAILING ADDRESS OF APPLICANT (Includ.Zip Code) 

             A      NEW LICENSE
             B    AMENDMENT TO LICENSE NUMBE_
             C    RENEWAL OF LICENSE NUMBER
    ADORESSIESI WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED

4 NAME OF PERSON TO B

E. CONTACT

ED ABOUT THIS APPLICATION 

                                                                                                                                                                          jTELEPHONE    NUMBER

SUBMIT iTEMS S TIROUGH 11 ON 8' , 11 'PAPER THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN 

                                                                                                                                                               THE LICENSE APPLICATION GUIDE.

S R-ýDIOACTIVE MATERIAL 

                 aEcment ecll mass numbe.     b checal eImnd/orDfhys,Col 1orm.Iad    c  mTlS-.n,    anooIt          6.    PURPOSEBS) FOR WHICH LICENSED MATEPIAL WILL BE USED
         h    .ch
                -Ii,    o oos$ese4 at a"ny one tlme INDIVIDUALIS, RESPONSIBLE FOP
                                                     RADIATION SAFETY PROGRAM AND
     TRA 'IG             AND EXPERIENCE                                                          THEIR
                                                                                                                    8, TRAINING FOR INDIVIDUALS WORKING IN OR FREQUEN'ING RESTRICTED AREAS
        AC:IITIES AND EQUIPMENT
                                                                                                                  10.     RADIATION SAFETY PROGRAM
                                                     WASTE~~~     MNGMT
                                                                                                                    "12 LICENSEE FEES (See ?0CFRt 1tTOrsdlSteor, 170.31)
                                                                                                                  FEE CATEGORY                                             AMOUNT
                                                                                                                                                                         lENCLOSED   $
 j     '7EPTIFICATION               fMus'beomplvridbVyliclnrJ THE APPLICANT UNDERSTANDS THAT Al L
                                                                                                                           TATEMENT              R*          ....       .        .           -
        BIN' -. 3 -PTEN                APPLICANT                                                                                        . AND       tP1EUNTI          MADE IN THIS APPLICATION ARE
        -'E APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF
                                                                                                              OF THE APPLICANT. NAMED IN ITEM 2. CERTIFY THAT THIS APPLICATION IS
            AEPARED :% CONFORMITY WITH TITLE 1

0. CODE OF FEDERAL

                                                                                         REGULATIONS, PARTS 30.32.33, 34, 35. AND 40 AND THAT ALL INFORMATION
       ,F'IJ           AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF                                                                                                      CONTAINED HEREIN
      VARNINC                16 u S C SECTION 1301 ACT OF JUNE 25. 1948, 62 STAT 749 MAKES IT A CRIMINAL
       "TC,   ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER
                                                                                                                             OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION
                                                                                                            WITHIN ITS JURISDICTION
   SNn.*                'E*T .         C
                                       GOFliCS                       'TYPEDIPRINTED NAME                                              TITLE                                                         DATE
                                                                                                  14VLUNTARY ECONOMIC DATA
                         A. A   ,*:- R CE'PTS          I      NUMBER OF EMPLOYEES (Tor               for al          d    WOULD YOU BE WILLING TO FURNISH COST INFORMATION                                  o rtIOII. -noo      stfhow,,,
                 1
                "'SI'K                       vM 5v            emt,     fci,ty  -excluoingOrsdi   conftrlcrors         ON THE ECONOMIC IMPACT OF CURRENT NRC REGULATIONS OR ANY FUTURE
       S251K          NOOK                                                                                            PROPOSED NRC REGULATIONS THAT MAY AFFECT YOU' (NRCmoIlerio$s S 5MS    ?M                                                                  Irt ro votcr                                                                          pe-.r confidenrti& commerns*I Or frinolal-oroorrr. --*t,,tofrnltton f-rnlthld to
       $5500K - 750K                     S7M -0M           c NUMBER OF BEDS                                                   py   ,nConfidrce)
       S 50K          'V                    S
                                            '0M                                                                 F          YES                                                           NO
                                                                                                     FOR NRC USE ONLY
     "PE-         F6.             FEEFOG                   PEECATEGORY                  COMMENTS                                                                                     APPROVED By
      .      . T... CE "'E.D                    CHECK NUMBER
    .4    .     A'T STATEMFNT ON THE REVERSE

PRIVACY ACT STATEMENT 

                                                                                                                 93-579), the follow Pursuant to 5 U.S.C. 552a(e)(3), enacted into law by section 3 of the Privacy Act of 1974 (Public Law Commission     on NRC Forrr inq staxement is furnished to individuals who supply information to the Nuclear Regulatory described at  40  Federal Register 45334

313. This information is maintained in a system of records designated as NRC-3 and (October 1 1975). 

                                                                                                 (42 U.S.C. 2111 and 2201(b)).

1. AUTHORITY: Sections 81 and 161(b) of the Atomic Energy Act of 1954, as amended staff pursuant to the criteria set forth in 10 CFR

2. PRINCIPA

L. PURPOSE

(S): The information is evaluated by the NRC 

                                                                                    the requirements of the Atomic Energy Act of Parts 30, 32, 33, 34, 35 and 40 to determine whether the application meets of a radioactive material license or amendment
   1954, as amended, and the Commission's regulations, for the issuance thereof.

health departments for their information and use; 3. ROUTINE USES: The information may be (a) provided to State other persons in the event of incident or exposure, and (b) provided to Federal, State, and local health officials and and safety. The information may also be dis for their information, investigation, and protection of the public health that the information indicates a violation or potential closed to appropriate Federal, State, and local agencies in the event In addition, tt'fs information may be trans violation of law and in the course of an administrative or judicial proceeding.

relevant and necessary for an NRC decision or to ferred to an appropriate Federal, State, or local agency to the extent that agency's decision about you.

an appropriate Federal agency to the extent relevant and necessary for AND EFFECT ON INDIVIDUAL OF NOT PROVID 4, WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY 

                                                                          is voluntary. If the requested information is not furn ING INFORMATION: Disclosure of the requested information amendment thereof, will not be processed. A request ished, however, the application for radioactive material license, or with the provisions of 10 CFR 2.790. Withhold that information be held from public inspection must be in accordance persons properly and directly concerned need to inspect ing from public inspection shall not affect the right, if any, of the document.

5. SYSTEM MANAGER(S) AND ADDRESS: U.S. Nuclear Regulatory Commission Director, Division of Fuel Cycle and Material Safety Office of Nuclear Material Safety and Safeguards Washington, D.C. 20555}}


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