ML15357A053

GL Registration from Virginia Electric and Power Company (Dominion) North Anna Power Station Units 1 and 2

ML15357A053
Person / Time
Site:	North Anna
Issue date:	12/18/2015
From:	Gerald Bichof Virginia Electric & Power Co (VEPCO)
To:	Office of Nuclear Material Safety and Safeguards
References
15-581, GL-700115-20
Download: ML15357A053 (8)

Text

VIRGINIA E*LECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/JHL ATT-IN: GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS I AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Form 664, General Licensee Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.

Sincerely, Gerald T. Bischof Site Vice President Enclosure Commitments made by this letter: None cc: U.S. Nuclear Regulatory Commission Attention: Document Control Desk Washington, D. C. 20555-0001 U.S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta, Georgia 30303-1 257 NRC Senior Resident Inspector North Anna Power Station

N~ill IIIIIIIIIIUI.li1ii GL-7001 15-20 I 11iii III~ NDI~ WII 11111 i llI~i1I! SECTION 1 10/30/2015 PAGE 1 of 2 NRC FORM 664 U.S. NUCLEAR REGULATORY COMMISSION 07 - 2015 10OCFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 EXPIRES: 04/3012016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a 1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.

Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-700115-20 Enter the company name and the street address/physical location of use for your device(s). For portable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: DOMINION VIRGIN.IA POWER Department: NORTH ANNA POWER STATIO I

Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA Zip Code: 23117 - 0402

For NRC use Only-:

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IIIIIIII II111i-111 Ii IIII III!IIII IinIIIIIIIInII111111111 111111111 IIIIIIIII IIIIIIIIII II111 GL-7001 15-20 SECTION 1 10/30/2015 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).

Last Name: EVANS First Name: ROBERT Middle Initial:B Telephone: (540) 894-2107 Extension:

Title:

CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your device(s) should be sent.

This address should be specific to the use or storage location of your device(s).

Department: NORTH ANNA POWER STATION Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA D ___ Zip Code: 23117 -0402 [ - z*z z A A

IIIIHIIII11 GL-700115-20 IIIIIIINVI l IIIiii li 1111 11ilIIIIi11 II 1111111I I!111111 i II!1 III IIl III 10/30/2015 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number)

Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICAL Distributor License Number: 29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model)i DOPS Device Serial Number: 128018 Transfer.Date (Receipt Date): 08/12/1999 rvn Not in possession of device (Also

• _J L

• __J*

• D complete Section 4.)

MM DD YYYY Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi) 1 AM241 30.000000000 mCi 2

3 4*

5 6

E.E DIDII

.A '.A

IIII]111 IviIIIn!1 SGL-700115-20 10/30/2015 Inn Iiii1111 UIIIIinII III 1111111 IIIIin 111 1IIIII 1IIIIInIIn SECTION 3 IIIi!1 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number o Manufacturer/Initial Transferor listed above How acquired and date (e.g.,

from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F _7 F _77 *

• other licensee, other source)?L..LJL.LJ U Other Source (Received) MM DD YYYY Isotope (e.g. AM241 ) Activity (e.g. 100) Unit (e.g. mCi) 1.

IIm LW~

3.

4.

II DIDI 6 .

DID1 7.

I I I I I I I I LI WI 8.~D DIDI

9. DIDJ

10. DI I I I A A

III11 IIIII 1L-0/0/215-2 il11111IIII11 l11 IIII IIIIII~II SEcTiON 4 i11 liIIIIII

- NOT IN POSSESSION OF DEVICE II~II ii IIII[II IIIII 1 SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of 1 Part I Transfer Date:

NRC Section (from Device Key:

2 or 6) ______________________ MM DD YYYY Location of the Device:

o Whereabouts Unknown (complete Part 1 only) O Transferred to another general licensee (complete Parts 2 and 3) o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) o Returned to Manufacturer (complete Part 1 only) (complete Part 2)

Part 2 License Number of Recipient (if transferred to~a specific licensee):

Company Name:

-Department:

Adrsine 1:l l l ~l II Address Line 2:

City:

• Part 3 Enter the name of the individual responsible for. this device:

Last Name:

First Name: Middle Initial:

Title:

A A

GL-7001 15-20 SECTION 5 - CERTIFICATION SECTION 5 10/30/2015 PAGE 1 of 1 Ihereby certify that:

A. All information' contained in this registration is true and complete to the best of my knowledge and belief.

B. A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C. l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http://www, nrc.gov/reading-rm/doc-collections/cfr)

SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

GL-700115-20 10/30/2015 .. . . . . .. . . . . .

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~AI HUN 5~ F C~r I(~ t'J R PAGE lofI NRC Device Key: 825331 Manufacturer License No: 12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B310000 Serial #: DG08129527 Transfer Date: 07/20/2012 Isotope: BA133 Activity: 0.020000000 Unit: uCi NRC Device Key: 689428 Manufacture ;r License No: 20-15525-04G Manufacturer Name: GE ION TRACK Model Number: ITEMISER III Serial #: 09'-8424 Transfer Date: 06/30/2003 Isotope: N163 Activity: 10.000000000 Unit: mCi NRC Device Key: 707159 " Manufadturer License No: 455-01G Manufacturer Name: METOREX, INC.

Model Number: 880 Serial #: 128018 Transfer Date: 02/27/2002 Isotope: CD109 Activity: 10.0 00000000 Unit: mCi NRC Device Key: 547351 Manufacturer License No: MD-3 1-076-01 Manufacturer Name: CONCO SERVICES CORP.

Model Number: 101 Seria l#: N596 Transfer Date: 02/15/1994 Isotope: N163 Activity: 5.000000000 Unit: mCi

VIRGINIA E*LECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/JHL ATT-IN: GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS I AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Form 664, General Licensee Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.

Sincerely, Gerald T. Bischof Site Vice President Enclosure Commitments made by this letter: None cc: U.S. Nuclear Regulatory Commission Attention: Document Control Desk Washington, D. C. 20555-0001 U.S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta, Georgia 30303-1 257 NRC Senior Resident Inspector North Anna Power Station

N~ill IIIIIIIIIIUI.li1ii GL-7001 15-20 I 11iii III~ NDI~ WII 11111 i llI~i1I! SECTION 1 10/30/2015 PAGE 1 of 2 NRC FORM 664 U.S. NUCLEAR REGULATORY COMMISSION 07 - 2015 10OCFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 EXPIRES: 04/3012016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a 1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.

Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-700115-20 Enter the company name and the street address/physical location of use for your device(s). For portable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: DOMINION VIRGIN.IA POWER Department: NORTH ANNA POWER STATIO I

Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA Zip Code: 23117 - 0402

For NRC use Only-:

wz~

• C,ategory:"

-

(Do :not write here) : ,. .  :... . -. '. .. :

'. * . :".:::

-. :. ,"Packet Receipt Date (MMDDYYY ):

i*-: ? i I I I' I I *

.1 .. " .. -..

I~ ::. I Accession I .1J INumber:.

.L*

A A

IIIIIIII II111i-111 Ii IIII III!IIII IinIIIIIIIInII111111111 111111111 IIIIIIIII IIIIIIIIII II111 GL-7001 15-20 SECTION 1 10/30/2015 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).

Last Name: EVANS First Name: ROBERT Middle Initial:B Telephone: (540) 894-2107 Extension:

Title:

CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your device(s) should be sent.

This address should be specific to the use or storage location of your device(s).

Department: NORTH ANNA POWER STATION Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA D ___ Zip Code: 23117 -0402 [ - z*z z A A

IIIIHIIII11 GL-700115-20 IIIIIIINVI l IIIiii li 1111 11ilIIIIi11 II 1111111I I!111111 i II!1 III IIl III 10/30/2015 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number)

Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICAL Distributor License Number: 29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model)i DOPS Device Serial Number: 128018 Transfer.Date (Receipt Date): 08/12/1999 rvn Not in possession of device (Also

• _J L

• __J*

• D complete Section 4.)

MM DD YYYY Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi) 1 AM241 30.000000000 mCi 2

3 4*

5 6

E.E DIDII

.A '.A

IIII]111 IviIIIn!1 SGL-700115-20 10/30/2015 Inn Iiii1111 UIIIIinII III 1111111 IIIIin 111 1IIIII 1IIIIInIIn SECTION 3 IIIi!1 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number o Manufacturer/Initial Transferor listed above How acquired and date (e.g.,

from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F _7 F _77 *

• other licensee, other source)?L..LJL.LJ U Other Source (Received) MM DD YYYY Isotope (e.g. AM241 ) Activity (e.g. 100) Unit (e.g. mCi) 1.

IIm LW~

3.

4.

II DIDI 6 .

DID1 7.

I I I I I I I I LI WI 8.~D DIDI

9. DIDJ

10. DI I I I A A

III11 IIIII 1L-0/0/215-2 il11111IIII11 l11 IIII IIIIII~II SEcTiON 4 i11 liIIIIII

- NOT IN POSSESSION OF DEVICE II~II ii IIII[II IIIII 1 SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of 1 Part I Transfer Date:

NRC Section (from Device Key:

2 or 6) ______________________ MM DD YYYY Location of the Device:

o Whereabouts Unknown (complete Part 1 only) O Transferred to another general licensee (complete Parts 2 and 3) o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) o Returned to Manufacturer (complete Part 1 only) (complete Part 2)

Part 2 License Number of Recipient (if transferred to~a specific licensee):

Company Name:

-Department:

Adrsine 1:l l l ~l II Address Line 2:

City:

• Part 3 Enter the name of the individual responsible for. this device:

Last Name:

First Name: Middle Initial:

Title:

A A

GL-7001 15-20 SECTION 5 - CERTIFICATION SECTION 5 10/30/2015 PAGE 1 of 1 Ihereby certify that:

A. All information' contained in this registration is true and complete to the best of my knowledge and belief.

B. A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C. l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http://www, nrc.gov/reading-rm/doc-collections/cfr)

SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

GL-700115-20 10/30/2015 .. . . . . .. . . . . .

~t.. I - UtVIU~ rJU ~UI~JIL. I iLl ~

IflL

~AI HUN 5~ F C~r I(~ t'J R PAGE lofI NRC Device Key: 825331 Manufacturer License No: 12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B310000 Serial #: DG08129527 Transfer Date: 07/20/2012 Isotope: BA133 Activity: 0.020000000 Unit: uCi NRC Device Key: 689428 Manufacture ;r License No: 20-15525-04G Manufacturer Name: GE ION TRACK Model Number: ITEMISER III Serial #: 09'-8424 Transfer Date: 06/30/2003 Isotope: N163 Activity: 10.000000000 Unit: mCi NRC Device Key: 707159 " Manufadturer License No: 455-01G Manufacturer Name: METOREX, INC.

Model Number: 880 Serial #: 128018 Transfer Date: 02/27/2002 Isotope: CD109 Activity: 10.0 00000000 Unit: mCi NRC Device Key: 547351 Manufacturer License No: MD-3 1-076-01 Manufacturer Name: CONCO SERVICES CORP.

Model Number: 101 Seria l#: N596 Transfer Date: 02/15/1994 Isotope: N163 Activity: 5.000000000 Unit: mCi