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{{Adams | {{Adams | ||
| number = | | number = ML20195F354 | ||
| issue date = | | issue date = 05/28/1999 | ||
| title = | | title = Matls Licensing Package for License 50-27622-01 for Buzdor Engineering.Control:467128 | ||
| author name = | | author name = Hernandez M | ||
| author affiliation = NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV) | | author affiliation = NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV) | ||
| addressee name = | | addressee name = | ||
| addressee affiliation = | | addressee affiliation = | ||
| docket = 03034945 | | docket = 03034945 | ||
| license number = | | license number = 50-27622-01, 50-27622-1 | ||
| contact person = | | contact person = | ||
| document report number = | | document report number = 467128, 50-27622-01, 50-27622-1, NUDOCS 9906140309 | ||
| document type = DKT 30 MTL BYPRODUCT, LICENSE,MTL/BYPRODUCT & AMEND TO LICENSE (DKT 30), TEXT-LICENSE APPLICATIONS & PERMITS | |||
| document type = | | page count = 20 | ||
| page count = | |||
}} | }} | ||
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=Text= | =Text= | ||
{{#Wiki_filter: | {{#Wiki_filter:[ | ||
< , U.s. NuCLEA*1 REGULATORY C MISSION | |||
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MATERIALS LICENSE Purzuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code i of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,36,39,40, and 70, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, i | |||
source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license thill be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all cpplicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified belo L;censee 1. Buzdor Engineering 3. Lcense number 50-27622-01 1 ;,- , | |||
2. 3705 Arctic Boulevard, #1593 , | |||
4. Expiration date April 30,2009 Anchorage, Alaska 99503 5. Docket No. 030-34945 | |||
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Reference N e d 6. Byproduct, source, and/or special,' 7. Chemical and/or physical form 8.. Maximum amount that licensee may nuclear material # possess at any one time under this | |||
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- - license N- s M. SehledEuTces g ' u reg stered | |||
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A, Cesium-137 . A..[No single source to exceed P dither witti NRC ufide~r 10 -the maximum activity k CK32.22:,r.with an! , Especified in the certificate of h T t Agrhement. State and" ' | |||
, ,nregistration issued by NRC , | |||
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for an Agreement State | |||
%cgorated ir) ac '. compatible gau.ging de]vice | |||
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s A,ashecjfjed_in'ltbnv9M is license? 7'' | |||
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B. Americium-241 B. Sealedwurces registerede ' B No single source to exceed either with NRC under the maximum activity 3 specified in the certificate of 10 CFR 32.210.or @ith an Agreeme'nt State and registration issued by NRC incorporated in a or an Agreement State ! | |||
compatible gauging device as specified in item 9 of this license 9, Authorized use A. and B. To be used, for measuring physical properties of materials, in compatible portable Boart Longyear Company (formerly Campbell Pacific Nuclear Company) and/or Troxler Electronic Laboratories, Inc., gauging devices that have been registered either with NRC under 10 CFR | |||
! 32.210 or with an Agreement State and have been distributed in accordance with an NRC or l Agreement State specif;c license authorizing distribution to persons specifically authorized b an NRC or Agreement State license to receive, possess, and use the device O l | |||
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9906140309 990528 PDR ADOCK 03034945 C PDR | |||
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OfflCIAL RECORD C0n ML40 ; | |||
NRC, FORM 3{4A - u.S. NUCLEAR RE2uLAToRY Commission PAGE 2 cd 4 PAGEs | |||
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Ucense Number | |||
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50-27622-01 MATERIALS LICENSE oxket or Reference Number SUPPLEMENTARY SHEET 030-34945 CONDITIONS 10. Radioactive material shall be used only at the following: West 58th Avenue, Suite B., Anchorage, Alask Temporary job sites anywhere in the United S_tates where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating licensed material,-including areas of exclusive Federal | |||
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jurisdiction within Agreement State /s $ | |||
if the jurisdiction status of a Federal facility within an Agreement Sta 1s unknown, the licensee should contact the federal agency controlling the job site in question to deter}i$ne whether the proposed job site is an area of exclusive Federaljurisdiction. Authorization for use,pLradioactive materials atjob sites in Agreement States not under excl,usive Federaljurisdiction shalfbp obtained from the appropriate state regulatory agenc , | |||
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11. Licensed material _s' hall only be used'by, or'u' n der the'supdrvision and'in'the physical presence of, individuals who have received (e tr' i'niggIdeiinibed'iii application dated February 1,199 a 12. . | |||
g The Radiation Safety OffigBSO)'for.this . | |||
license isJohritV;rn!W Buzdor.* | |||
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, ..d N f Vs Before assuming thhduties esponsibilijies_asHSO this licens'e, future RSOs shall have successfully completb'd one oT ' 4raI3In~gfcoldseWescribed in Orite'ria in Section 8.8 of NUREG-1556, Volume 1, dated Mafi997,3(ile ' '1 13 ~ | |||
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Sealed sources shall be tested for leakage and/or contamination at intervals not to exceed the intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an Agreement Stat In the absence of a certificate from a transferor indicating that a leak test has been made within the intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an Agreement State prior to the transfer, a sealed source or detector cell received from another person shall not be put into use until teste Sealed sources need not be leak tested if they are in storage and are not being used. However, when they are removed from storage for use or transferred to another person, and have not been tested within the required leak test interval, they shall be tested before use or transfer. No sealed source shall be stored for a period of more than 10 years without being tested for leakage and/or contaminatio I J | |||
,e * * a NRC FORM 374A u.S. NUCLEAR REluLAToRY CoMMISSloN PAcC 3 of 4 PAGEs i '. Ucense Nurmer | |||
, 50-27622-01 MATERIALS LICENSE Dock or Reference Number SUPPL.EMENTARY SHEET 030-34945 The leak test shall be capable of detecting the presence of 0.005 microcurie of radioactive material on the test sample. If the test reveals the presence of 0.005 microcurie or more of removable contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(b)(2), and the source shall be removed immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations. The report shall be filed within 5 days of the date the leak test result is known with the U.S. Nuclear Regulatory Commission, Region IV,611 Ryan Plaza;Drivg guite s400, Arlington, Texas 76011, ATTN: Director, | |||
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Division of Nuclear Materials Safety. The report shalbspecify the source involved, the test results, and corrective action taken.'. s b" | |||
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s j Tests for leakage and/or cbntamination shall be performed by hersons specifically licensed by the Commission or an Agreement State to perform such services. In'sddition, the licensee'is authorized to collect leak test sarnples_but not perform the analysis; analysis ofTeak test samples must be performed by persons speciQcally licensed by the Com 'iiion or an'A'greement State to perform | |||
\- QG such service C | |||
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14. Sealed sources or source rods cont'aini ' .. [d | |||
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ate (n lihall not be opened or sources remove detached from source rods or gaugej.by@e EM" t_a's specificalf[ authorize ' | |||
15. The licensee shall conduct a p ekh l | |||
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, jnwegtoryevery, | |||
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thy, prat otherjnterval approved.by NRC, to account for all sources a~nd/or received and p essed%mder the licens ( | |||
16. Each portable gauge shall have a k$ outeri | |||
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ed cordainer design {ed to prevent unauth | |||
~ l accidental removal of the s'eaied source fromM,$edYsition..The gauge or its container must be i locked when in transport, storage, or when notMer the direct surveillance of an authorized use . Except for maintaining labeling as re i ed by 10 0 or 71, the licensee shall obtain authorization from NRC before es making in the sealedany charig$FRka source, device, or source-device l combination that would alter the description or specifications as indicated in the respective Certificates of Registration issued either by the Commission pursuant to 10 CFR 32.210 or by an Agreement Stat . Any cleaning, maintenance, or repair of the gauges that requires detaching the source or source rod from the gauge shall be performed only by the manufacturer or other persons specifically licensed by the Commission or an Agreement State to perform such service I 19. The licensee is authorized to transport licensed material only in accordance with the provisions of 10 CFR Part 71, " Packaging and Transportation of Radioactive Materia . If the licensee uses unshielded sealed sources extended more than 3 feet below the surface, the licensee shall use surface casing that extends from the lowest depth to 12 inches above the surface | |||
' and other appropriate procedures to reduce the probability of the source or probe becoming lodged below the surface. If it is not feasible to extend the casing 12 inches above the surface, the licensee shallimplement procedures to ensure that the cased hole is free of obstruction before making measurement .J | |||
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NR,C FORM 374A u.S. NUCLEAR REIutAToRY CoMMISSloN' PAGE 4 of 4 PAGEs | |||
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50-27622-01 L D ekd a RWmce Nt'nter MATERIALS LICENSE SUPPLEMENTARY SHEET 030-34945 l | |||
l If a sealed source or a probe containing sealed sources becomes lodged below the surface and it becomes apparent that efforts to recover the sealed source or probe may not be successful, the l licensee shall notify the U. S. Nuclear Regulatory Commission and submit the report required by 10 l CFR 30.50(b)(2) and (c). The licensee shall not abandon the sealed source or probe without obtaining the Commission's prior written consen . In addition to the possession limits in item 8, the licen_see shall further restrict the possession of licensed material to quantities below the minimu'm limit specified in 1,0 CFR 30.35(d) for establishing decommissioning financial assurance. ' | |||
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'i j 22. Except as specifically provided]~otherwise in this license, the licensee shall con accordance with the stateme'nts, | |||
~ representations, and procedures corithined in the documents, including any enclosures, listed be[ low. ,The Nuclear Regulatory Commissipn's regillations shall govern unless the statements, representations, an(p~r ocedures in the licenseejs1pplication and correspondence are more restrictWe than the regulations. { % / ff,j g q ,. y 5 t . - - - | |||
Application datedfebruary 1, b99 h V M( ;(: ~2 | |||
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l l FOR THE U.S. NUCLEAR REGULATORY COMMISSION MAY 2 81999 M // | |||
D:te By /'I. A1t-Christi Hernandez 6 Nuclear Materials Licensing Branch Region IV Arlington, Texas 76011 | |||
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UNITED STATES | |||
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/ t NUCLEAR REGULATORY COMMISSION O | |||
7,, t REGloN IV | |||
, 611 RYAN PLAZA DRIVE, sulTE 400 y g ARLINGTON, TEXAS 76011-8064 l | |||
May 28,1999 J | |||
Buzdor Engineering ATTN: John A. Buzdor, Radiation Safety Officer 3705 Arctic Blvd. #1593 Anchorage, Alaska 99503 | |||
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SUBJECT: NEW LICENSE Please find enclosed License No. 50-27622-01. You should review this license carefully and be sure that you understand all condition NRC expects licensees to conduct their programs with meticulous attention to detail and a high standard of compliance. Because of the serious consequences to employees and the public which can result from failure to comply with NRC requirements, you must conduct your program involving radioactive materials in accordance with the conditions of your NRC license, representations made in your license application, and NRC regulations. In particular, note that you must: Operate in accordance with NRC regulations 10 CFR Part 19, " Notices, instructions and Reports to Workers: Inspection and Investigations," 10 CFR Part 20, " Standards for Protection Against Radiation," and other applicable regulation . Possesc *adioactive material only in the quantity and form indicated in your licens . Use radioactive material only for the purpose (s) indicated in your licens . Notify NRC in writing of any change in mailing address (no fee required if the location of radioactive material remains the same). Request and obtain written NRC consent before transferring your license or any right thereunder, either voluntarily or involuntarily, directly or indirectly, through transfer of control of your license to any person or entity. A transfer of control of your license includes not only a total change of ownership, but also a change in the controlling interest in your company whether it is a corporation, partnership, or other entity. In addition, appropriate license amendments must be requested and obtained for any other planned changes in your facility or program that are contrary to your license or contrary to representations made in your license application, as well as supplemental correspondence thereto, which are incorporated into your license. A license fee may be charged for the amendments if you are not in a fee-exempt categor , Maintain in a single document decommissioning records that have been certified for completeness and accuracy listing all the following items applicable to the license: | |||
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Onsite areas designated or formerly designated as restricted areas as defined in 10 CFR 20.3(a)(14) or 20.100 s | |||
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Buzdor Engineering -2- | |||
* Onsite areas, other than restricted areas, where radioactive materials in quantities greater than amounts listed in Appendix C to 10 CFR 20.100120.2401 have been used, possessed, or store * | |||
Onsite areas, other than restricted areas, where spills or other unusual occurrences involving the spread of contamination in and around the facility, equipment, or site have occurred that required reporting pursuant to 10 CFR 30.50(b)(1) or (b)(4), including areas where subsequent cleanup procedures have removed the contaminatio * | |||
Specific locations and radionuclide contents of previous and current burial areas within the site, excluding radioactive material with half-lives of 10 days or less, depleted uranium used only for shielding or as penetrators in unused munitions, or sealed sources authorized for use at temporary job site * | |||
Location and description of all contaminated equipment involved in licensed operations that is to remain onsite after license terminatio . Submit a complete renewal application, or termination request at least 30 days before the expiration date on your license. You will receive a reminder notice approximately 90 days before the expiration date. Possession of radioactive material after your license expires is a violation of NRC regulation . Request termination of your license if you plan to permanently discontinue activities involving radioactive materia You will be periodically inspected by NRC. Failure to conduct your program in accordance with NRC regulations, license conditions, and representations made in your license application and supplemental correspondence with NRC will result in enforcement action against you. This could include issuance of a Notice of Violation; imposition of a Civil Penalty; or an Order suspending, modifying, or revoking your license as specified in the " General Statement of Policy and Procedure for NRC Enforcement Actions" (Enforcement Policy), NUREG 1600, Re You are hereby also on notice that the NRC Office of Investigations Region IV Field Office is continuing its investigation of activities conducted by Buzdor Engineering. Based on the results of that investigation, the NRC may decide that enforcement action, including any of the actions identified above, is warrante l | |||
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Should you have any questions concerning this letter, you may contact me at (817) 860-810 Ouestions specific to your license should be directed to Ms. Christi Hernandez at (817) 860-821 | |||
Sincerely, n / | |||
} YL .J2 C gDwight D. Chamberlain, Director j Division of Nuclear Materials Safety Docket: 030-34945 c License: 50-27622-01 Control: 467128 | |||
== | ===Enclosures:=== | ||
As stated | |||
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Buzdor Engineering -4- | |||
i DOCUMENT NAME: S:\DNMS\50-27622.mic j To receive copy of document, Indicate in box: "C" = Copy without enclosures *E" = Copy with enclosures "N" = No copy RIV:NMLB C:NMLB C:NMlB AI Edh DD:DNMSI y { | |||
MC Hernandez C L Cain i , | |||
EE Collin hy_ GkSaborn DDChar rah | |||
$1/99[ I 8/2I/99 h 05/7f/99 IN/99 d/ZO/99 ; | |||
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.{ f0FFICIAL RECORD COPY J | |||
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Buzdor Engineering -3-DOCUMENT NAME: P:\50-27622.MLC To receive copy of document, Indicate in box: 'C" = Copy without enclosures "E" = Copy with enclosures "N" = No copy RIV:NMLB - // C:NMLB C:NMIB TA:DNMS D:DNMS MCHernandez Af/S CLCain EECollins LLHowell DCChamberlain | |||
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04//5799 04/ /99 04/ /99 04/ /99 04/ /99 OFFICIAL RECORD COPY | |||
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NRC FORM 313 * | |||
U. S. NUCLEAR REGULATORY COSIINS$lON APPROv50 sY OMS: to. 3m4u EAPtRESwm IIM . Esemated tNrden per response to Comply with hp e)formatert Collecison to CFR 30. 32. 33 request T hours Sutirrwmel of the sopiceton as easeeery to essermme thel 34 35 30. 39 and 40 the appicart e qweised and tnei ===*e procedres eoet to protect the I putAc hoseh one se9ety Forward commente regenen0 tiureen eetmeio to tie tiformehon end Recorde Mmegemord Grancti (T4 F33). U S Nutdoor APPLICATION FOR MATERIAL LICENSE "Recuction | |||
* * " ' Prolert | |||
' " 4315H120),'"'Oece | |||
"aa c2 * * * """*'a=' * | |||
of hamrmesmer and Euages, Weehneion, DC 20503 NRC may twl Conduct or nimmor, and a person e not reaped to respond to, en awarmeson comechen wresse R esploys e curently vand Ones controlnumber fNSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPUCATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING APPLICATION SENDTWOCOP:ES OF ThE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELO APPLICATION POR DISTUBSUTION OF EAeMPT PRODUCTS FILE APPUCATIONS MTH: er YOU ARE LOCATSD W: | |||
, | DM4CN OF INDUSTRIAL AND MEDICAL NUCLEAR 5AFE TV ILUNOIS. NeDIANA, IOWA, MICH4AN, Mle6NE90TA, MISSOURA, OteO, OR wtSCONSIN, OFFICE OF NUCLEAR MATERMLS SAFETY AND SAFEQUARDS SEND APPUCATIONS TO: | ||
0 $ NUCLEAR REOULATCRY COMMIS$0N WASHWGTON, DC 20S$64001 MATERIALS UCENSING SECTCN | |||
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ALL OTHER P81480808 FILE APPUCAT10888 AS FOLLOW 9: | |||
801 WARRENVILLE RD 17 YOU ARE LOCATSO IN; USLE, IL 80632-4361 CONNECTICUT, OSLAWARE. 05TUUCT OF COLutBSIA, tLANet MARYLAND, ALASKA. AINZONA, ARKANSAS, CAUFORNLA, COLORADO, HAWAll, IDAHO, KANSAS, taASGACNUSETTS, NSW NA40PSNeRE, NEW JSRSEY, DeEW YORE (, Pesete0YLVANIA, LOUISaANA abONTANA, NEERASRA, NEVADA, NEW t#EXCO, NO88TH DAKOTA, RNOCE WLAND, OR VSRe00NT, GEND APPUCATIONS 7 OKLANOslA ORSOON, PAcrec TitWST TERRITOfutt, SOUTH DAKOTA, TEXAS, UTAH, j WASHINGTON, Oft WYOeseNG, SSND APPUCATIOD80 TO: | |||
LICENSMO AS$1STANT SECTON NUCLEAR MATERIALS SAFETY ORANCH NUCLENt MATERALS UCENSWO SECTON U S NUCLEAR NEQUtATORY COMM4880N. REOsON t U S NUCLEAR REGULATORY COMMIS$ON REGON IV 4TS ALLENCALE ROAD 011 RYAN PLAZA DRIVE. SUITE 400 IUNG OF PRUS$1A, PA 194001415 ARLpeOTON TX 78011 4084 ALABAtlA, PLORICA, OSORG6A, RENTUCKY, GNSS1004 ppt. NORTH CAROUNA, PUERTO RICO, SOUTH P ABN shda TSeINSSSEE, VIRCMIA, VIRGIN ISLANDS, OR WEST VNtelestA, GEND APPUCATIONS TO: | |||
ATLANTA FEDERAL CENTER U S NUCLEAR REGULATORY COMMISSON REGOle is 4 St FORSYTH STREET & W, SurTE 23786 l | |||
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ATLANTA, OEOROM 3030H418 PSRSONS LOCATSO IN AORSSaIENT STATSS SEseD APPuCATIONS TO THE U.S. NUCLEAR RBOULATORY CORBtNSO40N ONLY IF THEY WISH TO POSSESS AND USE UCENSED IRATERIAL IN STA700 SUSJSCT TO U.S teUCLEAR RSOULATORY COtstMSSON JURISCeCTIONS, THet :S AN APPLCATION FOR (Check empeggmese tem) 2 NAME AND MAILWO ADO 8tESS OF APPUCANT (Mciune bp cace) | |||
B New ucsN5E AMENDMENT TO LICENSE NUheSER dCM | |||
$ % 85 h([ W,MQ,,, eleR_.M ,\/b. 4 55 % | |||
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_C RENEWAL OF UCENSE NUMBER M t'.A(o g A W p cM m 3 | |||
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3 ADDRES$(ES)WHtRE LCENSED MATER AL WILL DE USED OR POSSESSED d NAME OF PERSON TO SE CONT ACTED ABOUT THIS kb %dbjMNbp ' | |||
700 td.EPbM AWr, G u dE. 'B wa A . Bu-ad o TELEPHONE DAA69ER | |||
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%'h"lhh l6h3 SUSMIT 61 EMS S THftOUON 11 ON S.1/2 X it" PAPER TNE TYPE AND SCOPE OF INFORMATION TO SE PNOVIDED IS DESCRISED W THE LICENSE APPLCATIOss OUIDE 8 RADeOACTNE MATERIA PURPOSE (S) FOR WH4CH LTENSED hMTERAL WILL DE USED a Elem.eril.ed mese nweer, en s N. Posseemed tp emmrel M e,, one ilme enslior preysses norm. and c mewumum amotril 7 WDMOVAL(1) RESPONSSLE FOR RADATON SAFETY PROGRAM AND THEIR 11tAhtpeQ EXPEReENCE S TRAL #$NO FOR WDfviDUAL$ WORiGNO M OR FREOUENTING RE81PC'LD AftEAS e FACUTIES AND EQUIPMEoff 10. RADmitON SAFETY PROGRAM 12 UCENSEE FEES (See f0 CFR f 70and Secean s 70 79 p | |||
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FEE CA1EGORY h l CL SED 5 13 CERTIFICATON 84A,ef Se composeday emiecent) TME APPUCANT UNDERSTANDS THAT ALL STATEheENTS AND REPRESENTATONS MADE IN TH16 APFL'CATON ARE SMDING UPON THE APPLICANT THE APPUCANT AND ANY OFFICML EXECUTwsG THIS CERTIFICATION ON SEMALF OF THE APPUCANT, NAMED IN ITEM 2 CERTIFY THAT THIS APPLICATION IS PREPARED IN CoopORMtTY wtTM TITLE 10. CODE OF FEDERAL REGULATIONS. PARTS 30,32. 33. 34,36,36,30 AND 40. AND THAT ALL INFORMATON CONTAINED HEREIN 'S TRUE AND CORRECT TO THE DEST OF TNElR KNOWLEDGE ApeO BEUEF WMtNWG 10 U S C SECTION 1001 ACT OFJUNE 28. itse 82 STAT 749 MADES (T A CRIMINAL OFFENSE TO MAKE A WILLFULLY F ALSE STATEMENT OR 8tE*RESENTATION TO ANY DEPARTMENT Oft AOENCY OF THE UNffED STATES As TO ANY MATTER WITHiN (TS JURsDeCTION , j CE 'TIFriNO OFFICER - WPEDvPRiseTe D Pe4ME AND TITLE DATE dohn A %2Moe SCRE& i % | |||
FOR NRC USE OHL,Y/ / / / | |||
TYPE OF FEE FEE loo FEE CATEoOstY AmeOvNT RECElveD CHECK NuueER' Cy | |||
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APPaovEoev DATE PRWTED ON RECYCLED PAPER edtC FORM S16161987) | |||
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Attachment to NRC Form 313 - Appendix B | |||
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5. Radioactive Material | |||
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Element and mass numbers are Cesium-137 and Americium-241 i Cesium-137, chemcal and/or physical form are sealed sources in compatible gauges as specified in Sealed Source and Devloe Registration Sheet. Quantity is not to exceed maximurn | |||
- activity per source as specified in Sealed Source and Device Registration Shee Aneridum-241, chemicaland/or physical form are sealed neutron sources in compatible gauges as specified in Sealed Source and Device Registration sheet. Quantity is not to exceed maximum activity per source as specrhed in Sealed Source and Device Registration Shee . Purposefs) For Which Licensed Material Will Be Used I | |||
Licensed Material Cesium-137 and Ameridum-241 would be used to measure physical l properties of materials,i.e., the moisture and density of soil ; | |||
l | 7. IndivMada) P N a=8hia For P="=!'=. Safety Pissi T . And Ths:r T4. Experience John A. Buzdor, PE, is the proposed Radiation Safety Officer (RSO). Mr. Buzdor's training course certificate from Troxler Eledronic Laboratories is attache Before being named as the RSO, future RSO's will have su | ||
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REGION 1 U S NUCLEAR REGULATORY COMMISSION. REGION IV 475 ALLENDALE ROAD 611 HYAN PLAZA DRIVE, SUITE 400 KWG OF PRUSSIA, PA 19408 1415 ARUNGTON. TX 76011 4064 ALABAMA, FLO14DA, GEORGIA, KENTUCKY, M4SSISSIPPI, NORTH CAROUNA, PUERTO RICO, SOUTH CAROUNA, TENNESSEE, VlftGINLA, VIRGIN ISLANDS, OR WEST VIRQiN6A, SENO APPUCATIONS TO: | |||
ATLANTA FEDERAL CENTER U S NUCLEAR REGULATORY COMMISSON, REGION 13 81 FORSYTH STREET S W, SUITE 23T85 ATLANTA, GEORGIA 30303 3415 PERSONS LOCATED IN AGRESMENT STATES SEND APPUCATIONS TO THE U.S. NUCLEAR REQULATORY COMMISSION ONLY BF THEY WISH TO POSSESS AND USE UCENSED MATEftlAL IN STATES SUSJECT TO U.S. NUCLEAR REGULATOftY COMMISSION JURISDicflON THIS IS AN APPUCATON FOR (ChecA apprepnefe dem) 2 NAME AND MAR ING ADDRESS OF APPLICANT pncfucle Zep cocle) | |||
T NEW UCENSE QQ , Qg { | |||
_ | |||
B AMENDMENT TO UCENSE NUMBER SW85 AtZm 3M ,-# \5% | |||
_C RENEWAL OF LICENSE NUMDER h@MQ [Qr,* %g 3 ADDRESS (ES) WHERE UCENSED MATERIAL WILL BE USED OR POSSESSED 4 NAME OF PERSON TO BE CONTACTED ABOUT THIS | |||
* | |||
BiliEDOC FN&vNEERML [w""'*" A . Buq3 o l 700 W. Ebm Aygr, m vc, 3 , | |||
ANCHoCA66~ Mc. CMM q''d'"**'"k"'{ gg { | |||
SUBMIT ITEMS 6 THROUGH 11 ON S 112 X 11* PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE UCENSE APPUCATON GUID RADIOACTIVE MATERIA e Elemani and mese rusnber; b chemical endtar phrecal form, and c. maimmum amount PURPOSE (S) FOR WHICH UCENSED MATERIAL WILL BE USED which wie be possessed at any one tune INDIVIDUAL (S) RESPONSIBLE FOR RADIATON SAFETY PROGRAM AND THEIR l TRANING EXPERIENCE 8 TRAINING FOR NDIVIDUALS VORKING IN OR FREOUENTING RESTRICTED AREAS S FACILITIES AND EOUIPMENT 10 RADIATION SAFETY PROGRAM 12 LICENSEE FEES (See 10 CFR f 70 end Seccan 170 31) | |||
FEE CATEGOelY 3P l 13 LERTIFICATION (Mumf be compfefedby especent) THE APPLICANT UNDLASTANDS THAT ALL STATEMLNTS AND REPRESENTATIONS MADE IN THIS APPUCATON ARE BINDING FO 8730 1 ' | |||
UPONTHE APPUCAN THE /PPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPUCANT, NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY WITH TITLE 10. CODE OF FEDERAL REGULATIONS, PARTS 30,32,33. 34,35, M 39 AND 40, AND THAT ALL INFORMATON CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIE WARNING 18 U S C. SECTON 1001 ACT OFJUNE 25,1948 82 STAT. 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATON TO ANY DEPARTMENT OR AOENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION , , | |||
CERTIFYMG OFFICER - TYPED /PR110ED NAME AND TITLE DATE dohn A hiot SCRECl i m i FOR NRC USE# ONLY/ / / / | |||
TYPE OF FEE FEE LOG FEE CATEGORY AMOUNT RECEIVED CHECK NUMBER C | |||
$ | |||
APPROVED BY DATE l | |||
i NRC FORM 313 (51997) PRINTED ON RECYCLED PAPER b a87128 ; | |||
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I l | , Attamment to NRC Form 313 - Appendix B | ||
. | |||
- | 5. Radioactive Matadal | ||
. | |||
Element and mass numbers ere Cesium-137 and Amerldum-241 Cesium-137, semical and/or physical form are sealed sources in compatible gauges as spoolfied in Sealed Source and Device Registration Sheet. Quantity is not to exceed maximum activity per source as specified in Sealed Source and Device Registration Shee i Anericium 241, Momical and/or physical form are sealed neutron sources in compaNne gauges as specified in Sealed Source and Device Registration sheet Quantity is not to exceed maximum activity per source as spedfied in Sealed Source and Device Registration Shee I S. Purpaamfa) For Widch Licanand Material Will Ba used Licensed Material Cesium-137'and Amerldum-241 would be used to measure physical properties of materials,i.e., the moisture and density of soil . Individualfa) Rampanaltda For Radiation Safety Program And their Training Experience John A. Buzdor, PE, is the proposed Radiation Safety Offloor (RSO). Mr. Buzdor's training course certificate from Troxier Electronic Laboratories is attache Before being named as the RSO, future RSO's will have successfully completed one of the training courses described in Criteria in the section entitled " Individual (s) responsible for radiation safety program and their training and experience - Radiation Safety Officer in NUREG 1556, Volume 1, dated May 199 ! | |||
8. Training For individualia) Worldng in or Frequenting Restricted Armaa | |||
, | |||
Before using licensed materials, authorize users will have successfully completed one of the ) | |||
training courses described in Criteria in the section entitled " Individual (s) responsible for : | |||
radiation safety program and their training and ' experience - Radiation Safety Officer in NUREG-1556, Volume 1, dated May 199 B. Facialties and Equipment | |||
, | |||
No response require I | |||
- BUZDOR ENGINEERING CONSTRUCTION TESTING AND SPECIAL INSPECTION | |||
F . | |||
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. Attadwnent to NRC Form 313 - Appendix'B 10. fladiation Safety Program | |||
' | |||
l Buzdor Enginsedng wit alther possess and use or have access to and use, a radiation survey ' | |||
*- | |||
meter that meets the Criteria in the secton entitled " Radiation Safety Program - Instruments" in NUREG-1556, Volume 1, dated May 1997, in the event of an inciden Physical inventories win be conducted at intervals not to exoped six months, to account for aN sealed sources and devices received and possessed under this Noens Buzdor Engineenng win maintain, for inspedion by NRC, documentaton demonstrating that unmanitored individuals are not likely to recorve a radiabon dose in excess of 10% of the allowable limitsin 10 CFR Part 20 or we wiu provide dosimetry processed and evaluated by a | |||
~ NVLAP-approved processor that is exchanged at a frequency recommended by the processo Buzdor Engineering wlN implement and maintain the operating and emergency procedures in Appendix H of NURAG 1556, Volume 1, dated May 1997, and provide copies of these procedures to aN gauge users and at eam job site. Allemately, operating and emergency procedures win be developed, implemented an maintained an win meet the cribens in the section entitled " Radiation Safety Program - Operating and Emergency Procedures" in NUREG-1556, Volume 1 dated May 199 Leak tests will be pedormed at intervals approved by the NRC or an Agreement State and specified in the Sealed Source and Device Registration Sheet. Leak tests wlN be preformed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organizaton authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit supplier's instruccon Buzdor Engineering wiH implement and maintain procedures for routine maintenance of our gauges according to each manufadurer's recommenda6ons and instruchon Buzdor Engineering wlN send the gauge to the manufacturer or other person authorized by NRC or an Agreement State to perform non-routine maintenance or repair operations that require the removal of the source or source rod from the gaug . Waste bannagement No response require Su2 DOR ENGINEERING CONSTRUCTION TESTING AND SPECIAL INSPECTION | |||
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EUZDOR ENGINEERING | |||
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January 30,1999 Nuclear Materials Ucensing Section FEB g5 9 ! | |||
U.S. Nuclear Regulatory Commission, Region IV - | |||
611 Ryan Plaza Drive, Suite 400 | |||
- | |||
A.2ngton, TX 76011 8064 | |||
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l Burdor Engineering Application For Material License Greetings: | |||
Attached is Buzdor Engineenng's application for material license (NRC Form 313). Also attached is our deck #1007 for $730.00, per fee category 3 Buzdor Engineering is a construction testing laboratory and has plans to purchase moisture / density gauges. The undersigned has 15 years experience operating, maintaining and transporting moistureMensity gauges for PSI /Pittsburgh Testing Laboratory and EBA Engineering, j | |||
, | , | ||
* 1 | Please expedite this application, as time is critical to our success. If there are questions or additional information is required, please contact u | ||
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Sincerely, Buzdor Engineering Johri z or, PE Senior Pr ' Engineer | |||
. | |||
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I ANCHORAGE 3705 Arcbc Blvd., #1593 99503 HCO2 Box 7710 99645 PALMER TEL: (907)746-1593 INTERNET: buzdor @ alaska. net FAX: (907)745-5545 l | |||
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Revision as of 12:43, 9 December 2021
ML20195F354 | |
Person / Time | |
---|---|
Site: | 05000276, 03034945 |
Issue date: | 05/28/1999 |
From: | Hernandez M NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV) |
To: | |
References | |
467128, 50-27622-01, 50-27622-1, NUDOCS 9906140309 | |
Download: ML20195F354 (20) | |
Text
[
< , U.s. NuCLEA*1 REGULATORY C MISSION
'
MATERIALS LICENSE Purzuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code i of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,36,39,40, and 70, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, i
source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license thill be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all cpplicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified belo L;censee 1. Buzdor Engineering 3. Lcense number 50-27622-01 1 ;,- ,
2. 3705 Arctic Boulevard, #1593 ,
4. Expiration date April 30,2009 Anchorage, Alaska 99503 5. Docket No. 030-34945
-
Reference N e d 6. Byproduct, source, and/or special,' 7. Chemical and/or physical form 8.. Maximum amount that licensee may nuclear material # possess at any one time under this
,
.
s j
/i
- - license N- s M. SehledEuTces g ' u reg stered
. . ,
'
A, Cesium-137 . A..[No single source to exceed P dither witti NRC ufide~r 10 -the maximum activity k CK32.22:,r.with an! , Especified in the certificate of h T t Agrhement. State and" '
, ,nregistration issued by NRC ,
- -
for an Agreement State
%cgorated ir) ac '. compatible gau.ging de]vice
-
s A,ashecjfjed_in'ltbnv9M is license? 7
u ypw~- M -
B. Americium-241 B. Sealedwurces registerede ' B No single source to exceed either with NRC under the maximum activity 3 specified in the certificate of 10 CFR 32.210.or @ith an Agreeme'nt State and registration issued by NRC incorporated in a or an Agreement State !
compatible gauging device as specified in item 9 of this license 9, Authorized use A. and B. To be used, for measuring physical properties of materials, in compatible portable Boart Longyear Company (formerly Campbell Pacific Nuclear Company) and/or Troxler Electronic Laboratories, Inc., gauging devices that have been registered either with NRC under 10 CFR
! 32.210 or with an Agreement State and have been distributed in accordance with an NRC or l Agreement State specif;c license authorizing distribution to persons specifically authorized b an NRC or Agreement State license to receive, possess, and use the device O l
/'
9906140309 990528 PDR ADOCK 03034945 C PDR
'
OfflCIAL RECORD C0n ML40 ;
NRC, FORM 3{4A - u.S. NUCLEAR RE2uLAToRY Commission PAGE 2 cd 4 PAGEs
Ucense Number
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50-27622-01 MATERIALS LICENSE oxket or Reference Number SUPPLEMENTARY SHEET 030-34945 CONDITIONS 10. Radioactive material shall be used only at the following: West 58th Avenue, Suite B., Anchorage, Alask Temporary job sites anywhere in the United S_tates where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating licensed material,-including areas of exclusive Federal
"
jurisdiction within Agreement State /s $
if the jurisdiction status of a Federal facility within an Agreement Sta 1s unknown, the licensee should contact the federal agency controlling the job site in question to deter}i$ne whether the proposed job site is an area of exclusive Federaljurisdiction. Authorization for use,pLradioactive materials atjob sites in Agreement States not under excl,usive Federaljurisdiction shalfbp obtained from the appropriate state regulatory agenc ,
s (.g.,% N
, I t -4 j g m
11. Licensed material _s' hall only be used'by, or'u' n der the'supdrvision and'in'the physical presence of, individuals who have received (e tr' i'niggIdeiinibed'iii application dated February 1,199 a 12. .
g The Radiation Safety OffigBSO)'for.this .
license isJohritV;rn!W Buzdor.*
3 j<f
,. w >
.i ~
, ..d N f Vs Before assuming thhduties esponsibilijies_asHSO this licens'e, future RSOs shall have successfully completb'd one oT ' 4raI3In~gfcoldseWescribed in Orite'ria in Section 8.8 of NUREG-1556, Volume 1, dated Mafi997,3(ile ' '1 13 ~
+0'
Sealed sources shall be tested for leakage and/or contamination at intervals not to exceed the intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an Agreement Stat In the absence of a certificate from a transferor indicating that a leak test has been made within the intervals specified in the certificate of registration issued by NRC under 10 CFR 32.210 or by an Agreement State prior to the transfer, a sealed source or detector cell received from another person shall not be put into use until teste Sealed sources need not be leak tested if they are in storage and are not being used. However, when they are removed from storage for use or transferred to another person, and have not been tested within the required leak test interval, they shall be tested before use or transfer. No sealed source shall be stored for a period of more than 10 years without being tested for leakage and/or contaminatio I J
,e * * a NRC FORM 374A u.S. NUCLEAR REluLAToRY CoMMISSloN PAcC 3 of 4 PAGEs i '. Ucense Nurmer
, 50-27622-01 MATERIALS LICENSE Dock or Reference Number SUPPL.EMENTARY SHEET 030-34945 The leak test shall be capable of detecting the presence of 0.005 microcurie of radioactive material on the test sample. If the test reveals the presence of 0.005 microcurie or more of removable contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(b)(2), and the source shall be removed immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations. The report shall be filed within 5 days of the date the leak test result is known with the U.S. Nuclear Regulatory Commission, Region IV,611 Ryan Plaza;Drivg guite s400, Arlington, Texas 76011, ATTN: Director,
~
Division of Nuclear Materials Safety. The report shalbspecify the source involved, the test results, and corrective action taken.'. s b"
- {,
s j Tests for leakage and/or cbntamination shall be performed by hersons specifically licensed by the Commission or an Agreement State to perform such services. In'sddition, the licensee'is authorized to collect leak test sarnples_but not perform the analysis; analysis ofTeak test samples must be performed by persons speciQcally licensed by the Com 'iiion or an'A'greement State to perform
\- QG such service C
~
k I+ /PM ()
14. Sealed sources or source rods cont'aini ' .. [d
. license r.,
ate (n lihall not be opened or sources remove detached from source rods or gaugej.by@e EM" t_a's specificalf[ authorize '
15. The licensee shall conduct a p ekh l
"
, jnwegtoryevery,
.
d.'m i::
thy, prat otherjnterval approved.by NRC, to account for all sources a~nd/or received and p essed%mder the licens (
16. Each portable gauge shall have a k$ outeri
'l
[
ed cordainer design {ed to prevent unauth
~ l accidental removal of the s'eaied source fromM,$edYsition..The gauge or its container must be i locked when in transport, storage, or when notMer the direct surveillance of an authorized use . Except for maintaining labeling as re i ed by 10 0 or 71, the licensee shall obtain authorization from NRC before es making in the sealedany charig$FRka source, device, or source-device l combination that would alter the description or specifications as indicated in the respective Certificates of Registration issued either by the Commission pursuant to 10 CFR 32.210 or by an Agreement Stat . Any cleaning, maintenance, or repair of the gauges that requires detaching the source or source rod from the gauge shall be performed only by the manufacturer or other persons specifically licensed by the Commission or an Agreement State to perform such service I 19. The licensee is authorized to transport licensed material only in accordance with the provisions of 10 CFR Part 71, " Packaging and Transportation of Radioactive Materia . If the licensee uses unshielded sealed sources extended more than 3 feet below the surface, the licensee shall use surface casing that extends from the lowest depth to 12 inches above the surface
' and other appropriate procedures to reduce the probability of the source or probe becoming lodged below the surface. If it is not feasible to extend the casing 12 inches above the surface, the licensee shallimplement procedures to ensure that the cased hole is free of obstruction before making measurement .J
_
,
.
NR,C FORM 374A u.S. NUCLEAR REIutAToRY CoMMISSloN' PAGE 4 of 4 PAGEs
License Number
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50-27622-01 L D ekd a RWmce Nt'nter MATERIALS LICENSE SUPPLEMENTARY SHEET 030-34945 l
l If a sealed source or a probe containing sealed sources becomes lodged below the surface and it becomes apparent that efforts to recover the sealed source or probe may not be successful, the l licensee shall notify the U. S. Nuclear Regulatory Commission and submit the report required by 10 l CFR 30.50(b)(2) and (c). The licensee shall not abandon the sealed source or probe without obtaining the Commission's prior written consen . In addition to the possession limits in item 8, the licen_see shall further restrict the possession of licensed material to quantities below the minimu'm limit specified in 1,0 CFR 30.35(d) for establishing decommissioning financial assurance. '
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'i j 22. Except as specifically provided]~otherwise in this license, the licensee shall con accordance with the stateme'nts,
~ representations, and procedures corithined in the documents, including any enclosures, listed be[ low. ,The Nuclear Regulatory Commissipn's regillations shall govern unless the statements, representations, an(p~r ocedures in the licenseejs1pplication and correspondence are more restrictWe than the regulations. { % / ff,j g q ,. y 5 t . - - -
Application datedfebruary 1, b99 h V M( ;(: ~2
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l l FOR THE U.S. NUCLEAR REGULATORY COMMISSION MAY 2 81999 M //
D:te By /'I. A1t-Christi Hernandez 6 Nuclear Materials Licensing Branch Region IV Arlington, Texas 76011
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UNITED STATES
/ t NUCLEAR REGULATORY COMMISSION O
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, 611 RYAN PLAZA DRIVE, sulTE 400 y g ARLINGTON, TEXAS 76011-8064 l
May 28,1999 J
Buzdor Engineering ATTN: John A. Buzdor, Radiation Safety Officer 3705 Arctic Blvd. #1593 Anchorage, Alaska 99503
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SUBJECT: NEW LICENSE Please find enclosed License No. 50-27622-01. You should review this license carefully and be sure that you understand all condition NRC expects licensees to conduct their programs with meticulous attention to detail and a high standard of compliance. Because of the serious consequences to employees and the public which can result from failure to comply with NRC requirements, you must conduct your program involving radioactive materials in accordance with the conditions of your NRC license, representations made in your license application, and NRC regulations. In particular, note that you must: Operate in accordance with NRC regulations 10 CFR Part 19, " Notices, instructions and Reports to Workers: Inspection and Investigations," 10 CFR Part 20, " Standards for Protection Against Radiation," and other applicable regulation . Possesc *adioactive material only in the quantity and form indicated in your licens . Use radioactive material only for the purpose (s) indicated in your licens . Notify NRC in writing of any change in mailing address (no fee required if the location of radioactive material remains the same). Request and obtain written NRC consent before transferring your license or any right thereunder, either voluntarily or involuntarily, directly or indirectly, through transfer of control of your license to any person or entity. A transfer of control of your license includes not only a total change of ownership, but also a change in the controlling interest in your company whether it is a corporation, partnership, or other entity. In addition, appropriate license amendments must be requested and obtained for any other planned changes in your facility or program that are contrary to your license or contrary to representations made in your license application, as well as supplemental correspondence thereto, which are incorporated into your license. A license fee may be charged for the amendments if you are not in a fee-exempt categor , Maintain in a single document decommissioning records that have been certified for completeness and accuracy listing all the following items applicable to the license:
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Onsite areas designated or formerly designated as restricted areas as defined in 10 CFR 20.3(a)(14) or 20.100 s
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- Onsite areas, other than restricted areas, where radioactive materials in quantities greater than amounts listed in Appendix C to 10 CFR 20.100120.2401 have been used, possessed, or store *
Onsite areas, other than restricted areas, where spills or other unusual occurrences involving the spread of contamination in and around the facility, equipment, or site have occurred that required reporting pursuant to 10 CFR 30.50(b)(1) or (b)(4), including areas where subsequent cleanup procedures have removed the contaminatio *
Specific locations and radionuclide contents of previous and current burial areas within the site, excluding radioactive material with half-lives of 10 days or less, depleted uranium used only for shielding or as penetrators in unused munitions, or sealed sources authorized for use at temporary job site *
Location and description of all contaminated equipment involved in licensed operations that is to remain onsite after license terminatio . Submit a complete renewal application, or termination request at least 30 days before the expiration date on your license. You will receive a reminder notice approximately 90 days before the expiration date. Possession of radioactive material after your license expires is a violation of NRC regulation . Request termination of your license if you plan to permanently discontinue activities involving radioactive materia You will be periodically inspected by NRC. Failure to conduct your program in accordance with NRC regulations, license conditions, and representations made in your license application and supplemental correspondence with NRC will result in enforcement action against you. This could include issuance of a Notice of Violation; imposition of a Civil Penalty; or an Order suspending, modifying, or revoking your license as specified in the " General Statement of Policy and Procedure for NRC Enforcement Actions" (Enforcement Policy), NUREG 1600, Re You are hereby also on notice that the NRC Office of Investigations Region IV Field Office is continuing its investigation of activities conducted by Buzdor Engineering. Based on the results of that investigation, the NRC may decide that enforcement action, including any of the actions identified above, is warrante l
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Should you have any questions concerning this letter, you may contact me at (817) 860-810 Ouestions specific to your license should be directed to Ms. Christi Hernandez at (817) 860-821
Sincerely, n /
} YL .J2 C gDwight D. Chamberlain, Director j Division of Nuclear Materials Safety Docket: 030-34945 c License: 50-27622-01 Control: 467128
Enclosures:
As stated
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i DOCUMENT NAME: S:\DNMS\50-27622.mic j To receive copy of document, Indicate in box: "C" = Copy without enclosures *E" = Copy with enclosures "N" = No copy RIV:NMLB C:NMLB C:NMlB AI Edh DD:DNMSI y {
MC Hernandez C L Cain i ,
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Buzdor Engineering -3-DOCUMENT NAME: P:\50-27622.MLC To receive copy of document, Indicate in box: 'C" = Copy without enclosures "E" = Copy with enclosures "N" = No copy RIV:NMLB - // C:NMLB C:NMIB TA:DNMS D:DNMS MCHernandez Af/S CLCain EECollins LLHowell DCChamberlain
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U. S. NUCLEAR REGULATORY COSIINS$lON APPROv50 sY OMS: to. 3m4u EAPtRESwm IIM . Esemated tNrden per response to Comply with hp e)formatert Collecison to CFR 30. 32. 33 request T hours Sutirrwmel of the sopiceton as easeeery to essermme thel 34 35 30. 39 and 40 the appicart e qweised and tnei ===*e procedres eoet to protect the I putAc hoseh one se9ety Forward commente regenen0 tiureen eetmeio to tie tiformehon end Recorde Mmegemord Grancti (T4 F33). U S Nutdoor APPLICATION FOR MATERIAL LICENSE "Recuction
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of hamrmesmer and Euages, Weehneion, DC 20503 NRC may twl Conduct or nimmor, and a person e not reaped to respond to, en awarmeson comechen wresse R esploys e curently vand Ones controlnumber fNSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPUCATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING APPLICATION SENDTWOCOP:ES OF ThE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELO APPLICATION POR DISTUBSUTION OF EAeMPT PRODUCTS FILE APPUCATIONS MTH: er YOU ARE LOCATSD W:
DM4CN OF INDUSTRIAL AND MEDICAL NUCLEAR 5AFE TV ILUNOIS. NeDIANA, IOWA, MICH4AN, Mle6NE90TA, MISSOURA, OteO, OR wtSCONSIN, OFFICE OF NUCLEAR MATERMLS SAFETY AND SAFEQUARDS SEND APPUCATIONS TO:
0 $ NUCLEAR REOULATCRY COMMIS$0N WASHWGTON, DC 20S$64001 MATERIALS UCENSING SECTCN
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ALL OTHER P81480808 FILE APPUCAT10888 AS FOLLOW 9:
801 WARRENVILLE RD 17 YOU ARE LOCATSO IN; USLE, IL 80632-4361 CONNECTICUT, OSLAWARE. 05TUUCT OF COLutBSIA, tLANet MARYLAND, ALASKA. AINZONA, ARKANSAS, CAUFORNLA, COLORADO, HAWAll, IDAHO, KANSAS, taASGACNUSETTS, NSW NA40PSNeRE, NEW JSRSEY, DeEW YORE (, Pesete0YLVANIA, LOUISaANA abONTANA, NEERASRA, NEVADA, NEW t#EXCO, NO88TH DAKOTA, RNOCE WLAND, OR VSRe00NT, GEND APPUCATIONS 7 OKLANOslA ORSOON, PAcrec TitWST TERRITOfutt, SOUTH DAKOTA, TEXAS, UTAH, j WASHINGTON, Oft WYOeseNG, SSND APPUCATIOD80 TO:
LICENSMO AS$1STANT SECTON NUCLEAR MATERIALS SAFETY ORANCH NUCLENt MATERALS UCENSWO SECTON U S NUCLEAR NEQUtATORY COMM4880N. REOsON t U S NUCLEAR REGULATORY COMMIS$ON REGON IV 4TS ALLENCALE ROAD 011 RYAN PLAZA DRIVE. SUITE 400 IUNG OF PRUS$1A, PA 194001415 ARLpeOTON TX 78011 4084 ALABAtlA, PLORICA, OSORG6A, RENTUCKY, GNSS1004 ppt. NORTH CAROUNA, PUERTO RICO, SOUTH P ABN shda TSeINSSSEE, VIRCMIA, VIRGIN ISLANDS, OR WEST VNtelestA, GEND APPUCATIONS TO:
ATLANTA FEDERAL CENTER U S NUCLEAR REGULATORY COMMISSON REGOle is 4 St FORSYTH STREET & W, SurTE 23786 l
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ATLANTA, OEOROM 3030H418 PSRSONS LOCATSO IN AORSSaIENT STATSS SEseD APPuCATIONS TO THE U.S. NUCLEAR RBOULATORY CORBtNSO40N ONLY IF THEY WISH TO POSSESS AND USE UCENSED IRATERIAL IN STA700 SUSJSCT TO U.S teUCLEAR RSOULATORY COtstMSSON JURISCeCTIONS, THet :S AN APPLCATION FOR (Check empeggmese tem) 2 NAME AND MAILWO ADO 8tESS OF APPUCANT (Mciune bp cace)
B New ucsN5E AMENDMENT TO LICENSE NUheSER dCM
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%'h"lhh l6h3 SUSMIT 61 EMS S THftOUON 11 ON S.1/2 X it" PAPER TNE TYPE AND SCOPE OF INFORMATION TO SE PNOVIDED IS DESCRISED W THE LICENSE APPLCATIOss OUIDE 8 RADeOACTNE MATERIA PURPOSE (S) FOR WH4CH LTENSED hMTERAL WILL DE USED a Elem.eril.ed mese nweer, en s N. Posseemed tp emmrel M e,, one ilme enslior preysses norm. and c mewumum amotril 7 WDMOVAL(1) RESPONSSLE FOR RADATON SAFETY PROGRAM AND THEIR 11tAhtpeQ EXPEReENCE S TRAL #$NO FOR WDfviDUAL$ WORiGNO M OR FREOUENTING RE81PC'LD AftEAS e FACUTIES AND EQUIPMEoff 10. RADmitON SAFETY PROGRAM 12 UCENSEE FEES (See f0 CFR f 70and Secean s 70 79 p
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FEE CA1EGORY h l CL SED 5 13 CERTIFICATON 84A,ef Se composeday emiecent) TME APPUCANT UNDERSTANDS THAT ALL STATEheENTS AND REPRESENTATONS MADE IN TH16 APFL'CATON ARE SMDING UPON THE APPLICANT THE APPUCANT AND ANY OFFICML EXECUTwsG THIS CERTIFICATION ON SEMALF OF THE APPUCANT, NAMED IN ITEM 2 CERTIFY THAT THIS APPLICATION IS PREPARED IN CoopORMtTY wtTM TITLE 10. CODE OF FEDERAL REGULATIONS. PARTS 30,32. 33. 34,36,36,30 AND 40. AND THAT ALL INFORMATON CONTAINED HEREIN 'S TRUE AND CORRECT TO THE DEST OF TNElR KNOWLEDGE ApeO BEUEF WMtNWG 10 U S C SECTION 1001 ACT OFJUNE 28. itse 82 STAT 749 MADES (T A CRIMINAL OFFENSE TO MAKE A WILLFULLY F ALSE STATEMENT OR 8tE*RESENTATION TO ANY DEPARTMENT Oft AOENCY OF THE UNffED STATES As TO ANY MATTER WITHiN (TS JURsDeCTION , j CE 'TIFriNO OFFICER - WPEDvPRiseTe D Pe4ME AND TITLE DATE dohn A %2Moe SCRE& i %
FOR NRC USE OHL,Y/ / / /
TYPE OF FEE FEE loo FEE CATEoOstY AmeOvNT RECElveD CHECK NuueER' Cy
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APPaovEoev DATE PRWTED ON RECYCLED PAPER edtC FORM S16161987)
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Attachment to NRC Form 313 - Appendix B
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5. Radioactive Material
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Element and mass numbers are Cesium-137 and Americium-241 i Cesium-137, chemcal and/or physical form are sealed sources in compatible gauges as specified in Sealed Source and Devloe Registration Sheet. Quantity is not to exceed maximurn
- activity per source as specified in Sealed Source and Device Registration Shee Aneridum-241, chemicaland/or physical form are sealed neutron sources in compatible gauges as specified in Sealed Source and Device Registration sheet. Quantity is not to exceed maximum activity per source as specrhed in Sealed Source and Device Registration Shee . Purposefs) For Which Licensed Material Will Be Used I
Licensed Material Cesium-137 and Ameridum-241 would be used to measure physical l properties of materials,i.e., the moisture and density of soil ;
7. IndivMada) P N a=8hia For P="=!'=. Safety Pissi T . And Ths:r T4. Experience John A. Buzdor, PE, is the proposed Radiation Safety Officer (RSO). Mr. Buzdor's training course certificate from Troxler Eledronic Laboratories is attache Before being named as the RSO, future RSO's will have su
REGION 1 U S NUCLEAR REGULATORY COMMISSION. REGION IV 475 ALLENDALE ROAD 611 HYAN PLAZA DRIVE, SUITE 400 KWG OF PRUSSIA, PA 19408 1415 ARUNGTON. TX 76011 4064 ALABAMA, FLO14DA, GEORGIA, KENTUCKY, M4SSISSIPPI, NORTH CAROUNA, PUERTO RICO, SOUTH CAROUNA, TENNESSEE, VlftGINLA, VIRGIN ISLANDS, OR WEST VIRQiN6A, SENO APPUCATIONS TO:
ATLANTA FEDERAL CENTER U S NUCLEAR REGULATORY COMMISSON, REGION 13 81 FORSYTH STREET S W, SUITE 23T85 ATLANTA, GEORGIA 30303 3415 PERSONS LOCATED IN AGRESMENT STATES SEND APPUCATIONS TO THE U.S. NUCLEAR REQULATORY COMMISSION ONLY BF THEY WISH TO POSSESS AND USE UCENSED MATEftlAL IN STATES SUSJECT TO U.S. NUCLEAR REGULATOftY COMMISSION JURISDicflON THIS IS AN APPUCATON FOR (ChecA apprepnefe dem) 2 NAME AND MAR ING ADDRESS OF APPLICANT pncfucle Zep cocle)
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BiliEDOC FN&vNEERML [w""'*" A . Buq3 o l 700 W. Ebm Aygr, m vc, 3 ,
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SUBMIT ITEMS 6 THROUGH 11 ON S 112 X 11* PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE UCENSE APPUCATON GUID RADIOACTIVE MATERIA e Elemani and mese rusnber; b chemical endtar phrecal form, and c. maimmum amount PURPOSE (S) FOR WHICH UCENSED MATERIAL WILL BE USED which wie be possessed at any one tune INDIVIDUAL (S) RESPONSIBLE FOR RADIATON SAFETY PROGRAM AND THEIR l TRANING EXPERIENCE 8 TRAINING FOR NDIVIDUALS VORKING IN OR FREOUENTING RESTRICTED AREAS S FACILITIES AND EOUIPMENT 10 RADIATION SAFETY PROGRAM 12 LICENSEE FEES (See 10 CFR f 70 end Seccan 170 31)
FEE CATEGOelY 3P l 13 LERTIFICATION (Mumf be compfefedby especent) THE APPLICANT UNDLASTANDS THAT ALL STATEMLNTS AND REPRESENTATIONS MADE IN THIS APPUCATON ARE BINDING FO 8730 1 '
UPONTHE APPUCAN THE /PPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPUCANT, NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY WITH TITLE 10. CODE OF FEDERAL REGULATIONS, PARTS 30,32,33. 34,35, M 39 AND 40, AND THAT ALL INFORMATON CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIE WARNING 18 U S C. SECTON 1001 ACT OFJUNE 25,1948 82 STAT. 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATON TO ANY DEPARTMENT OR AOENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION , ,
CERTIFYMG OFFICER - TYPED /PR110ED NAME AND TITLE DATE dohn A hiot SCRECl i m i FOR NRC USE# ONLY/ / / /
TYPE OF FEE FEE LOG FEE CATEGORY AMOUNT RECEIVED CHECK NUMBER C
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APPROVED BY DATE l
i NRC FORM 313 (51997) PRINTED ON RECYCLED PAPER b a87128 ;
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, Attamment to NRC Form 313 - Appendix B
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5. Radioactive Matadal
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Element and mass numbers ere Cesium-137 and Amerldum-241 Cesium-137, semical and/or physical form are sealed sources in compatible gauges as spoolfied in Sealed Source and Device Registration Sheet. Quantity is not to exceed maximum activity per source as specified in Sealed Source and Device Registration Shee i Anericium 241, Momical and/or physical form are sealed neutron sources in compaNne gauges as specified in Sealed Source and Device Registration sheet Quantity is not to exceed maximum activity per source as spedfied in Sealed Source and Device Registration Shee I S. Purpaamfa) For Widch Licanand Material Will Ba used Licensed Material Cesium-137'and Amerldum-241 would be used to measure physical properties of materials,i.e., the moisture and density of soil . Individualfa) Rampanaltda For Radiation Safety Program And their Training Experience John A. Buzdor, PE, is the proposed Radiation Safety Offloor (RSO). Mr. Buzdor's training course certificate from Troxier Electronic Laboratories is attache Before being named as the RSO, future RSO's will have successfully completed one of the training courses described in Criteria in the section entitled " Individual (s) responsible for radiation safety program and their training and experience - Radiation Safety Officer in NUREG 1556, Volume 1, dated May 199 !
8. Training For individualia) Worldng in or Frequenting Restricted Armaa
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Before using licensed materials, authorize users will have successfully completed one of the )
training courses described in Criteria in the section entitled " Individual (s) responsible for :
radiation safety program and their training and ' experience - Radiation Safety Officer in NUREG-1556, Volume 1, dated May 199 B. Facialties and Equipment
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No response require I
- BUZDOR ENGINEERING CONSTRUCTION TESTING AND SPECIAL INSPECTION
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l Buzdor Enginsedng wit alther possess and use or have access to and use, a radiation survey '
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meter that meets the Criteria in the secton entitled " Radiation Safety Program - Instruments" in NUREG-1556, Volume 1, dated May 1997, in the event of an inciden Physical inventories win be conducted at intervals not to exoped six months, to account for aN sealed sources and devices received and possessed under this Noens Buzdor Engineenng win maintain, for inspedion by NRC, documentaton demonstrating that unmanitored individuals are not likely to recorve a radiabon dose in excess of 10% of the allowable limitsin 10 CFR Part 20 or we wiu provide dosimetry processed and evaluated by a
~ NVLAP-approved processor that is exchanged at a frequency recommended by the processo Buzdor Engineering wlN implement and maintain the operating and emergency procedures in Appendix H of NURAG 1556, Volume 1, dated May 1997, and provide copies of these procedures to aN gauge users and at eam job site. Allemately, operating and emergency procedures win be developed, implemented an maintained an win meet the cribens in the section entitled " Radiation Safety Program - Operating and Emergency Procedures" in NUREG-1556, Volume 1 dated May 199 Leak tests will be pedormed at intervals approved by the NRC or an Agreement State and specified in the Sealed Source and Device Registration Sheet. Leak tests wlN be preformed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organizaton authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit supplier's instruccon Buzdor Engineering wiH implement and maintain procedures for routine maintenance of our gauges according to each manufadurer's recommenda6ons and instruchon Buzdor Engineering wlN send the gauge to the manufacturer or other person authorized by NRC or an Agreement State to perform non-routine maintenance or repair operations that require the removal of the source or source rod from the gaug . Waste bannagement No response require Su2 DOR ENGINEERING CONSTRUCTION TESTING AND SPECIAL INSPECTION
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EUZDOR ENGINEERING
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January 30,1999 Nuclear Materials Ucensing Section FEB g5 9 !
U.S. Nuclear Regulatory Commission, Region IV -
611 Ryan Plaza Drive, Suite 400
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l Burdor Engineering Application For Material License Greetings:
Attached is Buzdor Engineenng's application for material license (NRC Form 313). Also attached is our deck #1007 for $730.00, per fee category 3 Buzdor Engineering is a construction testing laboratory and has plans to purchase moisture / density gauges. The undersigned has 15 years experience operating, maintaining and transporting moistureMensity gauges for PSI /Pittsburgh Testing Laboratory and EBA Engineering, j
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Please expedite this application, as time is critical to our success. If there are questions or additional information is required, please contact u
Sincerely, Buzdor Engineering Johri z or, PE Senior Pr ' Engineer
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I ANCHORAGE 3705 Arcbc Blvd., #1593 99503 HCO2 Box 7710 99645 PALMER TEL: (907)746-1593 INTERNET: buzdor @ alaska. net FAX: (907)745-5545 l
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