ML061710024

NRC Form 303, Request for Analysis and Chain of Custody, Laboratory - Orise, for Braidwood Nuclear Generating Station, and Fax Cover Sheet

ML061710024
Person / Time
Site:	Braidwood
Issue date:	12/08/2005
From:	Gene Bonano Division of Nuclear Materials Safety III
To:
References
FOIA/PA-2006-0115, FOIA/PA-2010-0209
Download: ML061710024 (10)

Text

PAGE I OF 2 NRC FORM. 30a

,(4-*004};

U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY CONTROL NUMBER REQUEST FOR ANALYSIS AND CHAIN OF CUSTODY BRAIDWOOD LABORATORY - ORISE SAMPLE LOCATION (LICENSEE) LICENSE NO. DOCKET NO.

Rraidwnrd Nuclear Generating Station 50-456/50-457 SAMPLE SUBMITTED

1. TOTAL TYPE VOLUME WEIGHT DATE SAMPLES SUBMITTED PRIORITY

• 3 Water 500 ml .. 12/08/2005 E ROUTINE

___________~~JURGENT.

5 Water 250 ml . SAMPLE COLLECTION INTERVAL MONTH DAY YEAR TIME START 12 7 2005 INSPECTOR RESPONSIBLE TELEPHONE NUMBER STOP 12 8 2005 Gen, Unn nnn 630-29-QR2-26 LIST DESIRED LS EIE ANALYSIS TO BE PERFORMED LLD (OptIonaR IL Otoa OTHER TYPE OF ANALYSIS (Specify) LIST (Optional)

"LLD DESIRED D GROSS ALPHA (GA) -

El GROSS BETA (GB) . 1"-71 E GAMMA SPEC (GS) * .

-fTRITIUM (H3) 200 pCi/L. E.

CARBON-14 (C14) -. r--l

-- IODINE-125 (1125) mm mmm RELINQUISHED BY RECEIVED BY DATE TIME REASON FOR CHANGE OF CUSTODY FEE RECOVERABLE 9 NO E] YES IFYES, TAC NUMBER REMARKS Hold samples until notified by NRC Contact: Bill Snell (630-829-9871) or Gene Bonano (630-829-9826) with any questions or concerns.

All eight samples are from residencial wells, UTMOST PRIORITY.... 'SID NO GAMMA SPEC, ONLY TRITIUM ANALYSIS, COUNT DOWN TO ENVIRONMENTAL LLD NOTE: SAMt~f*tU Qn3MbthR jIltWIJSIS UNLESS REASONS ARE NOTED IN REMARKS ABOVE.

NRC FORM 303 ,(444orance With theFreedom of kiformattoh PRINTED ON RECYCLED PAPER Act, exemptions

.IN&'l6-11 ...... _..~

X.

PAGE 2 OF 2 U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY NRC FORMA 303A 1-20'4) CONTROL NUMBER SAMPLE RECORD - Continued LABORATORY - ORISE I3 IIDWO0D SAMPLE SAMPLE NAME COLLECTION REMARKS, PRESERVATIVE NUMBER AND DESCRIPTION

• DATEJTIME ANALYSIS REQUESTED, ETC.

1210712005 Sample from kitchen sink bypass water NRC-52-R13 * " ':". .'=Braidwood, IL) .... 11.........

.............................. softener.

12/08100 Sample from kitchen sink bypass water

.r21...d......................

I___RC-54-___ Braidwood,__

_ )_-__ . 8:30am

. ............................... . softener.

NRC-56-R3 _*e_ _ 12/08/2005 NRC-4-R32J~Y Braidwood, I... ... ....... Sample from kitchen sink bypass water

.............................

.............. softener.

NC-55-R3 il...12/0.7/2005.... fn-NRC5MW3 12/07/2005 NR" 1/0/205.

....... ..

NRC-58-R3 el . 12/07/2005 NRC-59-R3 12/07/2005

-RC..ORM .... PN ORYE E

..... *..°.....................

°.°......... .......... *........

I.............................

i.. i.. .... .. .. .. .. ..

PRINTED ON RECYCLED PAPER NRC FORM 303A {4-2004)

PAGE 1 OF 2 NRC FORM 303 U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY (4-2004)

REQUEST FOR ANALYSIS AND CONTROL NUMBER CHAIN OF CUSTODY LABORATORY - 0RISE SAMPLE LOCATION (LICENSEE) LICENSE NO. DOCKET NO.

Braidwood Nuclear Generating Station 50-456150-457 SAMPLE SUBMITTED

1. TOTAL TYPE VOLUME WEIGHT DATE SAMPLES SUBMITTED PRIORITY Water 500 M1 []ROUTINE

____ ___ URGENT SAMPLE COLLECTION INTERVAL MONTH DAY YEAR TIME START 12 7 2005 INSPECTOR RESPONSIBLE TELEPHONE NUMBER Willilm,,Rnpii Wilioi n~l __________13082-971

, 3fl.R20-9)71 STOP 12 7 2005 LIST DSIREDLIST DESIRED ANALYSIS TO BE PERFORMED LISTOTHER TYPE OF ANALYSIS (Specify)

LLD (Optional) LLD (Optional)

D GROSS ALPHA (GA) _---_

GROSS BETA (GB)

G

• i---I TRITIUM (H3) 200 pCEl D I CARBON-14 (C14) "

L IODINE-125 (1125) .-

RELINQUISHED BY RECEIVED BY DATE TIME REASON FOR CHANGE OF CUSTODY FEE RECOVERABLE NO YES IF YES, TAC NUMBER REMARKS Hold samples till notified by NRC Contact: Bill Snell (630-829-9871) or Gene Bonano (630-829-9826)

NOTE: SAMPLES WILL BE DISCARDED AFTER ANALYSIS UNLESS REASONS ARE NOTED IN REMARKS ABOVE.

NRC ORM203 4-204)I'RIi~UUN ECYCED APE NRC FORM 303 (4-20N) PRI ED ON RECYCLED P ER

PAGE 2-. OF 2.-...

NRC FORM 303A U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY (4"2004) CONTROL NUMBER SAMPLE RECORD -- Continued LABORATORY - ORISE SAMPLE SAMPLE NAME COLLECTION REMARKS, PRESERVATIVE NUMBER AND DESCRIPTION DATE/TIME ANALYSIS REQUESTED, ETC.

...........................

• , °....... *............ ."......... ..

".v.

N~iC FORM ~0.................................'A~

I"PRINTE;:N O RECYCLEID P E'IR NRC FORM 303A (4-2004)

PAGE OF NRC FORM 303 U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY (4-2004)

REQUEST FOR ANALYSIS AND CONTROL NUMBER CHAIN OF CUSTODY LABORATORY - ORISE SAMPLE LOCATION (LICENSEE) LICENSE NO. DOCKET NO.

SAMPLE SUBMITTED

1. TOTAL TYPE VOLUME WEIGHT DATE SAMPLES SUBMITTED PRIORITY ROUTINE

_ __ _ __ _ _ _ _ _ _ _ _ I EURGENT SAMPLE COLLECTION INTERVAL MONTH DAY YEAR TIME START INSPECTOR RESPONSIBLE TELEPHONE NUMBER STOP.

LIST DESIRED LIST DESIRED ANALYSIS TO BE PERFORMED LLD (Optional) OTHER TYPE OF ANALYSIS (Spec[iy) LLD (Optional)

- GROSS ALPHA (GA)_ D EL GROSS BETA. (GB) El E GAMMA SPEC (GS) -

D TRITIUM (H3) -

I- CARSON-14 (C14) I-]

U IODINE-125 (1125) .

,IDECE)DB

,DBY, " ATE ME/*

TI REASON FOR CHANGE OF CUSTODY FEE RECOVERABLE - NO YES IFYES, TAC NUMBER REMARKS NOTE: SAMPLES WILL BE DISCARDED AFTER ANALYSIS UNLESS REASONS ARE NOTED IN REMARKS ABOVE.

NRC FORM 303 (4-2004) PRINTED ON RECYCLED PAPER

PAGE OF U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY NRC FORM 303A I4.2o64) CONTROL NUMBER SAMPLE RECORD -- Continued LABORATORY - ORISE SAMPLE SAMPLE NAME COLLECTION REMARKS, PRESERVATIVE NUMBER AND DESCRIPTION DATE/TIME ANALYSIS REQUESTED, ETC.

• *.*.i......... ............. ...

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....

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.......

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........ W NRCY A E NRC~~~.. FOR PR[It ED ON RECYCLED PAPER NRC FORM 303A (4°2004)

TRANSMISSION VERIFICATION REPORT TIME : 12/88/2885 14:38 NAME : US NRC RIII DNMS FAX  : 6385151259 TEL DATETIME .12/88 14:36 FAX NO./NAME 18652413248 DURATION .88:81:87 PAGE(S) 83 RESULT ' OK MODE STANDARD ECM

NRC FORM 386 (Rill) UNITED STATES (4-2004) .

NUCLEAR REGULATORY COMMISSION REGION III 2443 Warrenville Road, Suite 210 Usleo Illinois 60532-4352 TELEFAX TRANSMI1TAL DATE: U.; "0 NUMBER OF PAGES:

(including this page) '5 SEND TO: ThA~ C) Irj ZA

LOCATION:

FAX NUMBER: ________.__ L- VERIFY BY CALLING SENDER FROM:

(SENDER) (9r gF7I) . ),a f+0,1 TELEPHONE NUMBER: 630 -inA)-.e 9c FAX NUMBER: 630 - 515- 1259 Ifyou do not receive the complete fax transmittal, please contact the sender as soon as possible at the telephone number provided above.

MESSAGE /

---ýrb 6'f-4 NOTICE This message Is Intended only for the use of the Individual or entity to which It is addressed and may contain Information that Is privileged, confidential, or exempt from disclosure under applicable law. If the reader of this message Is not the Intended recipient or the employee responsible for delivering the message to the Intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication Is strictly prohibited. If you have recelved this communication In error, please notify the sender Immediately by telephone and return the original to the above address, by U.S. Mail. Thank you.

(4-2004) PRItITED ON RECYCLED PAPER NI~ FORM 3W NRC @UU) 3M OM (4-M)0, .PRINTE On RECYCLED PAPER

TRANSMISSION VERIFICATION REPORT TIME : 12/88/2085 14:48 NAME : US NRC RIII DNMS FAX  : 6305151259 TEL DATE,TIME 12/08 14:39 FAX NO./NAME 13014155397 DURATION 88:01:81 PAGE(S) 83 RESULT OK MODE STANDARD ECM

NRC FORM 386 (Rill) UNITED STATES

.(4-2004)

F1& NUCLEAR REGULATORY COMMISSION 4;C p Iý J REGION III 2443 Warernville Road, Suite 210 Usle, Illinois 60532-4352 TELEFAX TRANSMITTAL DATE: !0 6 *NUMBEROF PAGES:

(includingthis page) '.3 SEND TO: I tj LOCATION: bLAiPI FAX NUMBER: 3 6_/ ./(5__5"3  %

n VERIFY BY CALLING SENDER FROM:

(SENDER) CeA e Z-t1 t TELEPHONE NUMBER: 630 - 07 ,FAX NUMBER: 630 - 515 - 1259 If you do not receive the complete fax transmittal, please contact the sender as soon as possible at the telephone number provided above.

MESSAGE NOTCE This message Is Intended only for the use of the Individual or entity to which It is addressed and may contain Information that Is privileged, confidential, or exempt from disclosure under applicable law. If the reader of this message Is not the Intended recipient or the employee responsible for delivering the message to the Intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication Is strictly prohibited. If you have recelved this communication In error, please notify the sender Immediately by telephone and return the original to the above address, by U.S. Mail. Thank you.

TR 203 RNTDONREYLE ........... AP1 I=C FORM 33a OM (4.2004) PRWNED ON RE*CYCLED PAPER