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{{#Wiki_filter:NRC FORM 374 U.S. NUCLEAR REGULATORY  
{{#Wiki_filter:NRC FORM 374  
COMM ISSION MA TER IALS LIC E NS E PAGE 1 OF 6 PAGES Amendment  
U.S. NUCLEAR REGULATORY COMMISSION
No. 12 Pursuant to t h e Atomic Energy Act o f 1954 , as amended, t he Energy Reorganization  
MATERIALS LICENSE
Act of 1 974 (Pub lic Law 93-438), a n d T i t le 10 , Code of Federal Regulations , C h apte r I, Parts 30 , 31, 32 , 33 , 34 , 35, 36 , 37, 39 , 40 , 70 and 71, a n d in reliance on statements  
PAGE  
and represe n tations heretofore  
1 OF 6 PAGES  
made by the l i censee , a li cense is hereby iss ue d authoriz i ng the lic ensee to receive, acq uir e, possess, and t r a n sfer byprod u ct, source, a n d spec i al nuc l ear material des i g n a t ed below; t o use such material for t h e purpose (s) and at the place(s) designated  
Amendment No. 12  
below; to de li ver o r transfer such material to persons aut h orized to receive it in accordance  
Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code of Federal Regulations, Chapter I,  
with the regula ti ons of the app li cab l e Part(s). T his l ic ense shall be deemed to contain t he cond i t i ons spec i fied in Sect i on 183 of the Atomic Energy Ac t of 1954 , as a men ded, and i s subject to all applicable  
Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued
r u l es , regulations, and orde r s of the Nuclear Regu l atory Commiss i on now or hereafter  
authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s)  
in effect and to any conditions  
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
specified  
license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations,  
below. Licensee 1. Arctic Pipe Inspection, Inc. 2. P.O. Box 1296 Kenai, AK 99611 In accordance  
and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below.  
with letter dated June 07, 2018. u, t----------------1  
Licensee  
3. License number: 50-17314-0
1. Arctic Pipe Inspection, Inc.  
ns amended in its entirety to rea k'aS' follows: 4. Expirat i on Date: May 31, 2023 5. Docket No.: 030-12538  
2. P.O. Box 1296  
Reference  
Kenai, AK 99611  
No.: 6. Byproduct, source , and/or special nuclear materia l 7. Chemical a ria/or physical form 8. Maxim u m am ount tha t licensee may po ssess at any one t i me un der this lice n se 9. Aut h o riz ed use A. Cesium-1 37 A. Sealed S ource s (3M Company, Model 4F6H) . 4 1.5 curies per source an a 1.5 curies total : & CONDITIONS  
In accordance with letter dated  
A. For use i n NOT Systems, I nc., Mode l 13640 and Model 136408 tube wall calipe r s and Ludlum Measurements, Inc., Model 3110 wall caliper with Model 3001 source holder for measurement  
June 07, 2018.  
of wall thickness  
u,  
of pipes. 10. A. Licensed material may be used or stored only at the licensee's  
t----------------1  
facilities  
3. License number: 50-17314-0ns
located at: Prudhoe Bay, Intersection  
amended in its entirety to reak 'aS'  
of East Lake Colleen Drive and Spine Road, approximately  
follows:  
2 miles north of the airport, North Slope, Alaska, 99721 B. Temporary  
4. Expiration Date: May 31, 2023  
job sites of the licensee anywhere in the United States where the U.S. Nuclear Regulatory  
5. Docket No.: 030-12538  
Commission  
Reference No.:  
maintains  
6.  
jurisdiction  
Byproduct, source,  
for regulating  
and/or special nuclear  
the use of licensed material, including  
material
areas of exclusive  
7.  
Federal jurisdiction  
Chemical aria/or physical form  
within Agreement  
8.  
States.
Maximum amount that licensee  
NRC FORM 374A MATERIALS  
may possess at any one time
LIC E NS E SUPPL E M E NTARY SH EE T U.S. NUCLEAR R E GULATORY COMMISSION  
under this license
Li ce n se Number 50-17314-01  
9.  
Amendment  
Authorized use  
No. 12 Docket or Reference  
A.  
N u mbe r 030-12538  
Cesium-1 37  
PAGE 2 OF 6 PAGES If the jurisdiction  
A.  
status of a Federal facility within an Agreement  
Sealed Sources (3M Company,  
State is unknown, the licensee should contact the Federal agency controlling  
Model 4F6H)  
the job site in question to determine  
. 4  
whether the proposed job site is an area of exclusive  
1.5 curies per source ana
Federal jurisdiction.  
1.5 curies total :  
Authorization  
&  
for use of radioact i ve materials  
~
at job sites in Agreement-states not'under exclusive  
CONDITIONS  
Federal jurisdiction  
A.  
shall be obtained from the appropriate  
For use in NOT Systems, Inc., Model
state regulatory  
13640 and Model 136408 tube wall  
agency. 11. Licensed material shall only be used by, or u ria er the supervision  
calipers and Ludlum Measurements,  
of , individuals  
Inc., Model 3110 wall caliper with Model  
who have received the training described  
3001 source holder for measurement of
in the application  
wall thickness of pipes.  
dated November 29, 2012, and have been designated  
10. A. Licensed material may be used or stored only at the licensee's facilities located at: Prudhoe Bay, Intersection of East Lake Colleen Drive  
in writing by the Radiation  
and Spine Road, approximately 2 miles north of the airport, North Slope, Alaska, 99721  
Safety Officer. The licensee shall maintain records of individuals  
B. Temporary job sites of the licensee anywhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction  
designated  
for regulating the use of licensed material, including areas of exclusive Federal jurisdiction within Agreement States.  
as users for 3 years following  
 
the last use of licensed material by the individual.  
NRC FORM 374A  
12. The Radiation  
MATERIALS LICENSE
Safety Officer (RSO) for this license is George Notter. 0 13. A. Sealed sources shall be tested for leakage and/or contami nat i o n at intervals  
SUPPLEMENTARY SHEET
not to exce e d the intervals  
U.S. NUCLEAR REGULATORY COMMISSION  
specified  
License Number  
in the certificate  
50-17314-01  
of registration  
Amendment No. 12  
issued by the U.S. Nucl e ar Regulatory  
Docket or Reference Number
Commission  
030-12538  
under 10 CFR 32.210 or by an Agreement  
PAGE  
State. In the absence of a registration  
2 OF 6 PAGES  
certificate, sealed sources shall be tested for leakage and/or contamination  
If the jurisdiction status of a Federal facility within an Agreement State is unknown, the licensee should contact the Federal agency  
at intervals  
controlling the job site in question to determine whether the proposed job site is an area of exclusive Federal jurisdiction. Authorization  
not to exceed 6 months, or at such other intervals  
for use of radioactive materials at job sites in Agreement-states not'under exclusive Federal jurisdiction shall be obtained from the  
as specified.  
appropriate state regulatory agency.  
B. Notwithstanding  
11 . Licensed material shall only be used by, or uriaer the supervision of, individuals who have received the training described in the application  
Paragraph  
dated November 29, 2012, and have been designated in writing by the Radiation Safety Officer. The licensee shall maintain records of  
A of this Condition, sealed sour c es designed to prima rl ly emit alpha particles  
individuals designated as users for 3 years following the last use of licensed material by the individual.  
shall be tested for leakage and/or contamination  
12. The Radiation Safety Officer (RSO) for this license is George Notter.  
at intervals  
0  
not to exceed-3 months. C. In the absence of a certificate  
13. A. Sealed sources shall be tested for leakage and/or contamination at intervals not to exceed the intervals specified in the certificate of
from a transferor  
registration issued by the U.S. Nucle ar Regulatory Commission under 10 CFR 32.210 or by an Agreement State. In the absence of a  
indicating  
registration certificate, sealed sources shall be tested for leakage and/or contamination at intervals not to exceed 6 months, or at such  
that a leak test has been made within the intervals  
other intervals as specified.  
specified  
B. Notwithstanding Paragraph A of this Condition, sealed sources designed to primarlly emit alpha particles shall be tested for leakage  
in the certificate  
and/or contamination at intervals not to exceed-3 months.  
of registration  
C. 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
issued by the U.S. Nuclear Regulatory  
registration issued by the U.S. Nuclear Regulatory Commission under 10 CFR 32.210 or by an Agreement State, prior to the transfer, a  
Commission  
sealed source received from another person shall not be put into use until tested and the test results received.  
under 10 CFR 32.210 or by an Agreement  
D. Sealed sources need not be tested if they contain only hydrogen-3; or they contain only a radioactive gas; or the half-life of the isotope is  
State, prior to the transfer, a sealed source received from another person shall not be put into use until tested and the test results received.  
30 days or less; or they contain not more than 100 microcuries of beta- and/or gamma-emitting material or not more than 10  
D. Sealed sources need not be tested if they contain only hydrogen-3;  
microcuries of alpha-emitting material.  
or they contain only a radioactive  
 
gas; or the half-life  
NRC FORM 374A  
of the isotope is 30 days or less; or they contain not more than 100 microcuries  
MATERIALS LICENSE
of beta-and/or gamma-emitting material or not more than 10 microcuries  
SUPPLEMENTARY SHEET
of alpha-emitting material.
U.S. NUCLEAR REGULATORY COMMISSION  
NRC FORM 374A MATERIALS  
License Number  
LICENS E SUPPLEMENTARY  
50-17314-01  
SHEET U.S. NUCLEAR REGULATORY  
Amendment No. 12  
COMMISSION  
Docket or Reference Number
License Number 50-17314-01  
030-12538  
Amendment  
PAGE  
No. 12 Docket or Reference  
3 OF 6 PAGES  
Number 030-12538  
E. Sealed sources need not be tested if they are in storage and are not being used. However, when they are removed from storage for use  
PAGE 3 OF 6 PAGES E. Sealed sources need not be tested if they are in storage and are not being used. However, when they are removed from storage for use or transferred  
or transferred to another person, and have not been tested within the required leak test interval, they shall be tested before use or  
to another person, and have not been tested within the required l eak test interva l , they shall be tested before use or transfer.  
transfer. No sealed source shall be stored for a period ofmore than 10 years without being tested for leakage and/or contamination.  
No sealed source shall be stored for a period ofmore than 10 years without being tested for leakage and/or contamination.  
F. The leak test shall be capable of detecting the presence of 185 becquerels (0.005 microcuries) of radioactive material on the test  
F. The leak test shall be capable of detecting  
sample. If the test reveals the presence of 185 becquerels (0.005 microcuries) or mere of removable contamination, a report shall be  
the presence of 185 becquerels  
,..  
(0.005 microcuries)  
filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(c)(2), and the source shall be removed  
of radioactive  
immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations.  
material on the test sample. If the test reveals the presence of 185 becquerels  
G. Analysis of leak test samples and/orcontamination shall be -performed by persons specifically licensed by the U.S. Nuclear Regulatory  
(0.005 microcuries)  
Commission or an Agreement Stateto perform such services. The licensee is authorized to collect leak test samples but not perform  
or mere of removable  
the analysis.  
contamination, a report shall be ,.. filed with the U.S. Nuclear Regulatory  
H. Records of leak test results shall be kept in units of becquerels (microcuries) and shall be maintained for 3 years.  
Commission  
14. Sealed sources containing licensed material shall not be opened or $ources removed from source holders by the licensee, except as  
in accordance  
specifically authorized.  
with 10 CFR 30.50 (c)(2), and the source shall be removed immediately  
15. The licensee shall conduct a physical inventory every 6 months, or at other intervals approved by the U.S. Nuclear Regulatory Commission,
from service and decontaminated, repaired, or disposed of in accordance  
to account for all sealed sources and/or devices received and possessed under the license. Records of inventories shall be maintained for 3  
with Commission  
years from the date of each inventory, and shall include the radionuclides, quantities, manufacturer's name and model numbers, and the  
regulations.  
date of the inventory.  
G. Analysis of leak test samples and/or co ntamination
16. A. Each gauge shall be tested for the proper operation of the on-0ff mechanism (shutter) and indicator, if any, at intervals not to exceed 6  
shall be-performed  
months or at such longer intervals as specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission  
by persons specifically  
pursuant to 10 CFR 32.210 or the equivalent regulations of an Agreement State.  
licensed by the U.S. Nuclear Regulatory  
 
Commission  
NRC FORM 374A  
or an Agreement  
MATERIALS LICENSE
Stat eto perform such services.  
SUPPLEMENTARY SHEET  
The licensee is authorized  
U.S. NUCLEAR REGULATORY COMMISSION  
to collect leak test samples but not perform the analysis. H. Records of leak test results shall be kept in units of becquerels (microcuries)  
License Number  
and shall be maintained  
50-17314-01  
for 3 years. 14. Sealed sources containing  
Amendment No. 12  
licensed material shall not be opened or $ources removed fr o m source holders by the licensee, except as specifically  
Docket or Reference Number
authorized. 15. The licensee shall conduct a physical inventory  
030-12538  
every 6 months , or at other intervals  
PAGE  
approved by the U.S. Nuclear Regulatory  
4 OF 6 PAGES  
Commiss i on, to account for all sealed sources and/or devices received and possessed  
B. Notwithstanding the periodic on-off mechanism (shutter) and indicator test, the requirement does not apply to gauges that are stored,  
under the license. Records of inventories  
not being used, and have the shutter lock mechanism in a locked position. The gauges exempted from this periodic test shall be tested  
shall be maintained  
before use. Records of test results shall be maintained f6r3 years from ,the date of each test.  
for 3 years from the date of each inventory, and shall include the radionuclides, quantities, manufacturer's  
17. The following services shall not be performed by the licensee: installation, initial radialion surveys, relocation, removal from service,  
name and model numbers, and the date of the inventory.  
dismantling, alignment, replacement, disposal of the sealed source, and non-routine maintenance or repair of components related to the  
16. A. Each gauge shall be tested for the proper operation  
radiological safety of the gauge (i.e. , the sealed source, the source holder, source drive mechanism, on-off mechanism (shutter), shutter  
of the on-0ff mechanism (shutter)  
control, shielding). These services shall be performed only by persons specifically licensed by the U.S. Nuclear Regulatory Commission or
and indicator, if any, at intervals  
an Agreement State to perform such services.  
not to exceed 6 months or at such longer intervals  
18. The licensee may initially mount a gauge, if permitted by the certificate of registration issued by the U.S. Nuclear Regulatory Commission or
as specified  
an Agreement State, and under the following conditions:  
in the certificate  
A. The gauge must be mounted in accordance with written instructions provided by the manufacturer.  
of registration  
B. The gauge must be mounted in a location compatible with the Conditions of Normal Use and Limitations and/or Other Considerations of
issued by the U.S. Nuclear Regulatory  
...  
Commission  
Use in the certificate of registration issued by the U.S. Nuclear Regulatory Commission or an Agreement State.  
pursuant to 10 CFR 32.210 or the equivalent  
-
regulations  
C. The on-off mechanism (shutter) must be locked in the off position, if applicable, or the source must be otherwise fully shielded.  
of an Agreement  
D. The gauge must be received in good conditions (e.g., the package was not damaged).  
State.
E. The gauge must not require any modification to fit in the proposed location.  
NRC FORM 374A MATERIALS  
Mounting does not include electrical connection, activation, or operation of the gauge. The source must remain fully shielded, and the  
LIC E NS E SUPPLEM E NTARY SHEET U.S. NUCLEAR REGULATORY  
gauge may not be used until it is installed and made operational by a person specifically licensed by the U.S. Nuclear Regulatory  
COMMISSION  
Commission or an Agreement State to perform such operations  
License Number 50-17314-01  
 
Amendment  
NRC FORM 374A  
No. 12 Docket or Reference  
MATERIALS LICENSE
Number 030-12538  
SUPPLEMENTARY SHEET  
PAGE 4 OF 6 PAGES B. Notwithstanding  
U.S. NUCLEAR REGULATORY COMMISSION  
the periodic on-off mechanism (shutter)  
License Number  
and indicator  
50-17314-01  
test, the requirement  
Amendment No. 12  
does not apply to gauges that are stored , not being used, and have the shutter lock mechanism  
Docket or Reference Number
in a locked position.  
030-12538  
The gauges exempted from this periodic test shall be tested before use. Records of test results shall be maintained  
PAGE  
f 6r 3 ye a r s from , the date of each test. 17. The following  
5 OF 6 PAGES  
services shall not be performed  
19. A. The licensee may maintain, repair, or replace device components that are not related to the radiological safety of the device containing  
by the licensee:  
licensed material and that do not result in the potential for any portion of the body to come into contact with the primary beam or result in  
installation, initial radialion  
increased radiation levels in accessible areas.  
surveys , relocation, removal from service, dismantling, alignment , replacement, disposal of the sealed source, and non-routine  
B. The licensee may not maintain, repair, or replace any of the following device components: the sealed source, the source holder, source  
m aintenance
drive mechanism, on-off mechanism (shutter), shutter control, shielding, or any other component related to the radiological safety of the
or repair of components  
device, except as provided otherwise by specific condition of this license.  
related to the radiological  
20. Prior to initial use and after installation, relocation, dismantling, alignment, or any other activity involving the source or removal of the  
safety of the gauge (i.e., the s ea led source, the source holder, source drive me chanism, on-off mechanism (shutter), shutter control, shielding).  
shielding, the licensee shall assure that a radiological survey is performed to determine radiation levels in accessible areas around, above,  
These services shall be performed  
and below the gauge with the shutter open. This survey shall be performed only by persons authorized to perform such services by the U.S.  
only by persons specifically  
Nuclear Regulatory Commission or an Agreement State.  
licensed by the U.S. Nuclear Regulatory  
21. The licensee shall operate each device containing licensed material within the manufacturer's specified temperature and environmental  
Commission  
limits such that the shielding and shutter mechanism of the source holder are not compromised.  
or an Agreement  
22. The licensee shall assure that the shutter mechanism of each device containing licensed material is locked in the closed position during  
State to perform such services. 18. The licensee may initially  
periods when a portion of an individual's body may be subject to the direct radiation beam. The licensee shall review and modify, as  
mount a gauge, if permitted  
appropriate, its "lock-out" procedures whenever a new device is obtained to incorporate the device manufacturer's recommendations.  
by the certificate  
23. Except for maintaining labeling as required by 10 CFR Part 20, or Part 71, the licensee shall obtain authorization from the U.S. Nuclear  
of registration  
Regulatory Commission before making any changes in the sealed source, device, or source-device combination that would alter the  
issued by the U.S. Nuclear Regulatory  
description or specifications as indicated in the respective certificate of registration issued either by the U.S. Nuclear Regulatory  
Commission  
Commission pursuant to 10 CFR 32.210 or by an Agreement State.  
or an Agreement  
 
State, and under the following  
NRC FORM 374A  
conditions:  
U.S. NUCLEAR REGULATORY COMMISSION  
A. The gauge must be mounted in accordance  
PAGE
with wr i tten instructions  
6 OF 6 PAGES
provided by the manufacturer. B. The gauge must be mounted in a location compatible  
MATERIALS LICENSE
with the Conditions  
SUPPLEMENTARY SHEET
of Normal Use and Limitations  
License Number  
and/or Other Considerations  
50-17314-01  
of ... Use in the certificate  
Amendment No. 12  
of registration  
Docket or Reference Number  
issued by the U.S. Nuclear Regulatory  
030-12538  
Commission  
24. Except as specifically provided otherwise in this license, the licensee shall conduct its program in accordance with the statements,  
or an Agreement  
representations, and procedures contained in the documents, including any enclosures, listed below. This license condition applies only to  
State. -C. The on-off mechanism (shutter)  
those procedures that are required to be submitted in acc0rdance with the regulations. The U.S. Nuclear Regulatory Commission's  
must be locked in the off position, if applic a ble, or the source must be otherwise  
regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more  
fully shielded.  
restrictive than the regulations.  
D. The gauge must be received in good conditions (e.g., the package was not damaged). E. The gauge must not require any modification  
A. Application dated November 29, 2012 (Ml;;12345A196).  
to fit in the proposed location. Mounting does not include electrical  
B. E-mail received February 12, 2013 (ML 13141A577)  
connection, activation, or operation  
Date: August 28, 2018  
of the gauge. The source must remain fully shielded, and the gauge may not be used until it is installed  
<:(  
and made operational  
r-'  
by a person specifically  
en  
licensed by the U.S. Nuclear Regulatory  
~
Commission  
~
or an Agreement  
~
State to perform such operations
01)  
NRC FORM 374A MATERIALS  
J-
LICENSE SUPPL E MENTARY SHEET U.S. NUCLEAR REGULATORY  
(")  
COMMISSION  
0 s  
License Number 50-17314-01  
~
Amendment  
~
No. 12 Docket or Reference  
~
Number 030-12538  
~o  
PAGE 5 OF 6 PAGES 19. A. The licensee may maintain, repair, or replace device components  
FOR THE U.S. NUCLEAR REGULATORY COMMISSION  
that are not related to the radiological  
By: -~~~-----
safety of the device containing  
R/A  
licensed material and that do not result in the potential  
Michelle M. Hammond  
for any portion of the body to come into contact with the primary beam or result in increased  
Region IV
radiation  
levels in accessible  
areas. B. The licensee may not maintain, repair, or replace any of the following  
device components:  
the sealed source, the source holder, source drive mechanism, on-off mechanism (shutter), shutter control, shielding, or any other component  
related to the radiological  
safety of t he device, except as provided otherwise  
by specific condition  
of this license. 20. Prior to initial use and after insta llation, relocation, dismantling, alignment, or any other activity involving  
the source or removal of the shielding, the licensee shall assure that a radiological  
survey is performed  
to determ in e radiation  
levels in accessible  
areas around, above, and below the gauge with the shutter open. Th is survey shall b e p e rformed only by persons author i zed to perform such services by the U.S. Nuclear Regulatory  
Commission  
or an Agreement  
State. 21. The licensee shall operate each device containing  
licensed material within the manufacturer's  
specified  
temperature  
and environmental  
limits such that the shielding  
and shutter mechanism  
of the source holder are not compromised.  
22. The licensee shall assure that the shutter mechanism  
of each device containing  
li ce nsed material is locked in the closed position during periods when a portion of an individual's  
body may be subject to the direct radiation  
beam. The licensee shall review and modify, as appropriate, its "lock-out" procedures  
whenever a new device is obtained to incorporate  
the device manufacturer's  
recommendations.  
23. Except for maintaining  
labeling as required by 10 CFR Part 20, or Part 71, the licensee shall obtain authorization  
from the U.S. Nuclear Regulatory  
Commission  
before making any changes in the sealed source, device, or source-device  
combination  
that would alter the description  
or specificat
ions as indicat ed in the respective  
certificate  
of registration  
issued either by the U.S. Nuclear Regulatory  
Commission  
pursuant to 10 CFR 32.210 or by an Agreement  
State.
NRC FORM 374A U.S. NUCLEAR REGULATORY  
COMMISSION  
P AGE 6 OF 6 PAG ES MATERIALS  
LICENSE SUPPLEMENTARY  
SH EET L i cense Number 50-17314-01  
Amendment  
No. 12 Docket or Refe rence Number 030-12538  
24. Except as specifically  
provided otherwise  
in this license, the licensee shall conduct its program in accordance  
with t he statements, representations, and procedures  
contained  
in the documents, including  
any enclosures, listed below. This license condition  
applies only to those procedures  
that are required to be submitted  
in acc0rdance  
with the regulations.  
The U.S. Nuclear Regulatory  
Comm i ssion's regulations  
shall govern unless the statements, repres e ntations, and procedures  
in the licensee's  
application  
and correspondence  
are more restrictive  
than the regulations.  
A. Application  
dated November 29, 2012 (M l;;12345A196). B. E-mail received February 12, 2013 (ML 13141A577)  
Date: August 28, 2018 <:( r-' en 01) (") 0 s ~o FOR THE U.S. NUCL EAR REGULA T ORY COMMISSION  
By:-~~~-----R/A Michelle M. Hammond Region IV
}}
}}

Latest revision as of 13:05, 5 January 2025

Artic Pipe Inspection, Inc.; Amendment 12; License 50-17314-01; Docket 030-12538; Control 609070
ML18256A390
Person / Time
Site: 03012538
Issue date: 08/28/2018
From: Michelle Hammond
NRC Region 4
To:
Arctic Pipe Inspection
References
609070
Download: ML18256A390 (6)
v • d • e


See also: IR 05000173/2014001

Text

NRC FORM 374

U.S. NUCLEAR REGULATORY COMMISSION

MATERIALS LICENSE

PAGE

1 OF 6 PAGES

Amendment No. 12

Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code of Federal Regulations, Chapter I,

Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, 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, 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 shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations,

and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below.

Licensee

1. Arctic Pipe Inspection, Inc.

2. P.O. Box 1296

Kenai, AK 99611

In accordance with letter dated

June 07, 2018.

u,

t----------------1

3. License number: 50-17314-0ns

amended in its entirety to reak 'aS'

follows:

4. Expiration Date: May 31, 2023

5. Docket No.: 030-12538

Reference No.:

6.

Byproduct, source,

and/or special nuclear

material

7.

Chemical aria/or physical form

8.

Maximum amount that licensee

may possess at any one time

under this license

9.

Authorized use

A.

Cesium-1 37

A.

Sealed Sources (3M Company,

Model 4F6H)

. 4

1.5 curies per source ana

1.5 curies total :

&

~

CONDITIONS

A.

For use in NOT Systems, Inc., Model

13640 and Model 136408 tube wall

calipers and Ludlum Measurements,

Inc., Model 3110 wall caliper with Model

3001 source holder for measurement of

wall thickness of pipes.

10. A. Licensed material may be used or stored only at the licensee's facilities located at: Prudhoe Bay, Intersection of East Lake Colleen Drive

and Spine Road, approximately 2 miles north of the airport, North Slope, Alaska, 99721

B. Temporary job sites of the licensee anywhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction

for regulating the use of licensed material, including areas of exclusive Federal jurisdiction within Agreement States.

NRC FORM 374A

MATERIALS LICENSE

SUPPLEMENTARY SHEET

U.S. NUCLEAR REGULATORY COMMISSION

License Number

50-17314-01

Amendment No. 12

Docket or Reference Number

030-12538

PAGE

2 OF 6 PAGES

If the jurisdiction status of a Federal facility within an Agreement State is unknown, the licensee should contact the Federal agency

controlling the job site in question to determine whether the proposed job site is an area of exclusive Federal jurisdiction. Authorization

for use of radioactive materials at job sites in Agreement-states not'under exclusive Federal jurisdiction shall be obtained from the

appropriate state regulatory agency.

11 . Licensed material shall only be used by, or uriaer the supervision of, individuals who have received the training described in the application

dated November 29, 2012, and have been designated in writing by the Radiation Safety Officer. The licensee shall maintain records of

individuals designated as users for 3 years following the last use of licensed material by the individual.

12. The Radiation Safety Officer (RSO) for this license is George Notter.

0

13. A. 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 the U.S. Nucle ar Regulatory Commission under 10 CFR 32.210 or by an Agreement State. In the absence of a

registration certificate, sealed sources shall be tested for leakage and/or contamination at intervals not to exceed 6 months, or at such

other intervals as specified.

B. Notwithstanding Paragraph A of this Condition, sealed sources designed to primarlly emit alpha particles shall be tested for leakage

and/or contamination at intervals not to exceed-3 months.

C. 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 the U.S. Nuclear Regulatory Commission under 10 CFR 32.210 or by an Agreement State, prior to the transfer, a

sealed source received from another person shall not be put into use until tested and the test results received.

D. Sealed sources need not be tested if they contain only hydrogen-3; or they contain only a radioactive gas; or the half-life of the isotope is

30 days or less; or they contain not more than 100 microcuries of beta- and/or gamma-emitting material or not more than 10

microcuries of alpha-emitting material.

NRC FORM 374A

MATERIALS LICENSE

SUPPLEMENTARY SHEET

U.S. NUCLEAR REGULATORY COMMISSION

License Number

50-17314-01

Amendment No. 12

Docket or Reference Number

030-12538

PAGE

3 OF 6 PAGES

E. Sealed sources need not be 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 ofmore than 10 years without being tested for leakage and/or contamination.

F. The leak test shall be capable of detecting the presence of 185 becquerels (0.005 microcuries) of radioactive material on the test

sample. If the test reveals the presence of 185 becquerels (0.005 microcuries) or mere of removable contamination, a report shall be

,..

filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(c)(2), and the source shall be removed

immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations.

G. Analysis of leak test samples and/orcontamination shall be -performed by persons specifically licensed by the U.S. Nuclear Regulatory

Commission or an Agreement Stateto perform such services. The licensee is authorized to collect leak test samples but not perform

the analysis.

H. Records of leak test results shall be kept in units of becquerels (microcuries) and shall be maintained for 3 years.

14. Sealed sources containing licensed material shall not be opened or $ources removed from source holders by the licensee, except as

specifically authorized.

15. The licensee shall conduct a physical inventory every 6 months, or at other intervals approved by the U.S. Nuclear Regulatory Commission,

to account for all sealed sources and/or devices received and possessed under the license. Records of inventories shall be maintained for 3

years from the date of each inventory, and shall include the radionuclides, quantities, manufacturer's name and model numbers, and the

date of the inventory.

16. A. Each gauge shall be tested for the proper operation of the on-0ff mechanism (shutter) and indicator, if any, at intervals not to exceed 6

months or at such longer intervals as specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission

pursuant to 10 CFR 32.210 or the equivalent regulations of an Agreement State.

NRC FORM 374A

MATERIALS LICENSE

SUPPLEMENTARY SHEET

U.S. NUCLEAR REGULATORY COMMISSION

License Number

50-17314-01

Amendment No. 12

Docket or Reference Number

030-12538

PAGE

4 OF 6 PAGES

B. Notwithstanding the periodic on-off mechanism (shutter) and indicator test, the requirement does not apply to gauges that are stored,

not being used, and have the shutter lock mechanism in a locked position. The gauges exempted from this periodic test shall be tested

before use. Records of test results shall be maintained f6r3 years from ,the date of each test.

17. The following services shall not be performed by the licensee: installation, initial radialion surveys, relocation, removal from service,

dismantling, alignment, replacement, disposal of the sealed source, and non-routine maintenance or repair of components related to the

radiological safety of the gauge (i.e. , the sealed source, the source holder, source drive mechanism, on-off mechanism (shutter), shutter

control, shielding). These services shall be performed only by persons specifically licensed by the U.S. Nuclear Regulatory Commission or

an Agreement State to perform such services.

18. The licensee may initially mount a gauge, if permitted by the certificate of registration issued by the U.S. Nuclear Regulatory Commission or

an Agreement State, and under the following conditions:

A. The gauge must be mounted in accordance with written instructions provided by the manufacturer.

B. The gauge must be mounted in a location compatible with the Conditions of Normal Use and Limitations and/or Other Considerations of

...

Use in the certificate of registration issued by the U.S. Nuclear Regulatory Commission or an Agreement State.

-

C. The on-off mechanism (shutter) must be locked in the off position, if applicable, or the source must be otherwise fully shielded.

D. The gauge must be received in good conditions (e.g., the package was not damaged).

E. The gauge must not require any modification to fit in the proposed location.

Mounting does not include electrical connection, activation, or operation of the gauge. The source must remain fully shielded, and the

gauge may not be used until it is installed and made operational by a person specifically licensed by the U.S. Nuclear Regulatory

Commission or an Agreement State to perform such operations

NRC FORM 374A

MATERIALS LICENSE

SUPPLEMENTARY SHEET

U.S. NUCLEAR REGULATORY COMMISSION

License Number

50-17314-01

Amendment No. 12

Docket or Reference Number

030-12538

PAGE

5 OF 6 PAGES

19. A. The licensee may maintain, repair, or replace device components that are not related to the radiological safety of the device containing

licensed material and that do not result in the potential for any portion of the body to come into contact with the primary beam or result in

increased radiation levels in accessible areas.

B. The licensee may not maintain, repair, or replace any of the following device components: the sealed source, the source holder, source

drive mechanism, on-off mechanism (shutter), shutter control, shielding, or any other component related to the radiological safety of the

device, except as provided otherwise by specific condition of this license.

20. Prior to initial use and after installation, relocation, dismantling, alignment, or any other activity involving the source or removal of the

shielding, the licensee shall assure that a radiological survey is performed to determine radiation levels in accessible areas around, above,

and below the gauge with the shutter open. This survey shall be performed only by persons authorized to perform such services by the U.S.

Nuclear Regulatory Commission or an Agreement State.

21. The licensee shall operate each device containing licensed material within the manufacturer's specified temperature and environmental

limits such that the shielding and shutter mechanism of the source holder are not compromised.

22. The licensee shall assure that the shutter mechanism of each device containing licensed material is locked in the closed position during

periods when a portion of an individual's body may be subject to the direct radiation beam. The licensee shall review and modify, as

appropriate, its "lock-out" procedures whenever a new device is obtained to incorporate the device manufacturer's recommendations.

23. Except for maintaining labeling as required by 10 CFR Part 20, or Part 71, the licensee shall obtain authorization from the U.S. Nuclear

Regulatory Commission before making any changes in the sealed source, device, or source-device combination that would alter the

description or specifications as indicated in the respective certificate of registration issued either by the U.S. Nuclear Regulatory

Commission pursuant to 10 CFR 32.210 or by an Agreement State.

NRC FORM 374A

U.S. NUCLEAR REGULATORY COMMISSION

PAGE

6 OF 6 PAGES

MATERIALS LICENSE

SUPPLEMENTARY SHEET

License Number

50-17314-01

Amendment No. 12

Docket or Reference Number

030-12538

24. Except as specifically provided otherwise in this license, the licensee shall conduct its program in accordance with the statements,

representations, and procedures contained in the documents, including any enclosures, listed below. This license condition applies only to

those procedures that are required to be submitted in acc0rdance with the regulations. The U.S. Nuclear Regulatory Commission's

regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more

restrictive than the regulations.

A. Application dated November 29, 2012 (Ml;;12345A196).

B. E-mail received February 12, 2013 (ML 13141A577)

Date: August 28, 2018

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FOR THE U.S. NUCLEAR REGULATORY COMMISSION

By: -~~~-----

R/A

Michelle M. Hammond

Region IV

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