ML16364A187

GL Registration from Dominion Virginia Power

ML16364A187
Person / Time
Site:	North Anna
Issue date:	12/15/2016
From:	Gerald Bichof, Robert Evans Dominion Virginia Power, Virginia Electric & Power Co (VEPCO)
To:	Office of Nuclear Material Safety and Safeguards
References
16-467, GL-700115-21
Download: ML16364A187 (8)

Text

VIRGINIA ELECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 December 15, 2016 Director, Office of Nuclear Material Safety Serial No.16-467 and Safeguards NAPS/DPM ATTN: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 1AND2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Form 664, General License 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, G~d.iLbA-6 T. Bischof Site Vice President Enclosure Commitments made in this letter: None.

cc: U. S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, DC 20555-0001 U. S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta Georgia 30303-1257 NRC Senior Resident Inspector North Anna Power Station

Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 Illllllll 1111111111111111111111111111111 GL-700115-21 SECTION 1 11/07/2016 PAGE 1of2 NRC FORM 664 U.S. NUCLEAR REGULATORY COMMISSION 07 - 2015 10 CFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY OMB: NO. 3150-0198 EXPIRES: 04/30/2016 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 accountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (T-5 F53), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to lnfocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and 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-700115-21 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 VIRGINIA POWER I .I I I I I I I I I I I I I I I I I I Department: NORTH ANNA POWER STATIO I I I I I I I I I I I I I I I I I I I Address Line 1: 1022 HALEY DRIVE I I I I I I I I I I I I I I I I I I I I I Address Line 2: END OF ROUTE 700 I I I I I I I I I I I I I I I I I I I City: MINERAL I I I I I I I I I I I I I I I I I I I I I I State: VA rn Zip Code: 23117 - 0402 I I I I I I - l._____..l_____._I_,______,

For NRC Use Only (Do not write here)

Category:

Packet Receipf Date (MMDDYYYY):

rn I I I I I Accession .Number:

I I I I I I I*

Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll Illllllll llll lllll llll lllllll Ill llll llll GL-700115-21 SECTION 1 11/07/2016 PAGE 2of2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

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

Last Name: EVANS I I I I I I I I I I I I I I I I I I I I I I I First Name: ROBERT Middle Initial: B 11111111111111 D Telephone: (540) 894-2107 Extension:

I I I 11 I I 11 I I I I I I I I I I

Title:

CURRENT SAFETY OFFICER I I I I I I I I I I I I I I I I I I I I I I I 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 I I I I I I I I I I I I I I I I I I I I I Address Line 1: 1022 HALEY DRIVE I I I I I I I I I I I I I I I I I I I I I I I Address Line 2: END OF ROUTE 700 I I I I I I I I I I I I I I I I I I I I I I I City: MINERAL I I I I I I I I I I I I I I I I I I I I I I I State: . VA rn Zip Code: 23117 - 0402 ~,,~,~,~, - I I I I I

Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 GL-700115-21 Illllllll llll lllll llll llll llll 1110112016 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 I I I I I I I I I I I I I I I I I I I I I I I I Distributor License Number: 29-30342-02G I I I I I I I I I I I I I I Manufacturer Name: METOREX, INC I I I I I I I I I I I I I I I I I I I I I I I I Device Model (Not Source Model): DOPS I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number: 128018 I I I I I I I I I I I I I I I I I I I I I I I I I Transfer Date (Receipt Date): 08/12/1999 Not in possession of device (Also

• ITJITJI 111 D complete Section 4.)

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

I I I I I I I I I I I I I I I I I I I I I I 3

I I I I I I I I I I I I I I ! I I I I I I 4

I I I I I I I I I I I I I I I I I I I 5

I I I I I I I I I I I 1* I I I I I I 6

I I I I I I I I I I I I I I I I I I

Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll GL-700115-21 111111111111111111111111111111 11/07/2016 SECTION 3 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 I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor License Number (if known)

I I I I I I I I I I I I I Device Model Number (Not Source Model)

I I I I I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number I I I I I I I I I I I I I I I I I I I I I I I I I I 0

rn rn I Manufacturer/Initial Transferor listed above How acquired and date (e.g.,

from a distributor/manufacturer, other licensee, other source)?

0 Other General Licensee Date Transferred:

I. I. I. I.

0 Other Source (Received) MM DD YYYY sotope (e.g. AM241) Activ"ty (e.g. 100) Unit (e.g mCi) 1.

I I I 2.

I I I

3. I . I 4.

5.

6.

7.

8.

9.

10.

Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll Illllllll llll lllll l l llll llll

• GL-700115-21 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 11/07/2016 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of1 Part 1 Transfer Date:

(~=~~::~~:~e!~ 6 ) I I I I I I I I OJ OJ I I I I MM DD YYYY Location of the Device:

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

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

I I I I I I I I I I I I I I Company Name:

I I I I I I I I I I I I I I I I I I I I I I I I I I I Department: ,

I I I I I I I I I I I I I I I I I I I I I I I I I I I Address Line 1:

I I I I I I I I I I I I I I I I I I I I I I I I I I Address Line 2:

I I I I I I I I I I I I I I I I I I I I I I I I I City:

I I I I I I I I I I I I I I I I I I I I I I I I I I I I State: OJ Zip Code: I I I I I I -I I I I I Part 3 Enter the name of the individual responsible for this device:

Last Name:

I I I I I I I I I I I I I I I I I I I I I I I I I I I First Name: Middle Initial:

11111111111111 D Telephone Number: I I I I I I I I I I I I I Extension: ,----,I1-1-1-1-1

Title:

I I I I I I I I I I I I I I I I I I I I I I I I I I I

Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 111111111111111111111111111111 GL-700115-21 SECTION 5 - CERTIFICATION SECTION 5 11/07/2016 PAGE 1of1 I hereby 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. I am aware of the requirements of the general license, provided in 10 CFR 31.5.

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

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l/~/::<?:~ctions/cfr)

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SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC

. REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIALASPECTS. 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.

Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll GL-700115-21 111111111111111111111111111111 11/07/2016 SECTION 6 - DEVICES NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 1of1 NRC Device Key: 825331 Manufacturer License No: 12-04933-048 Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: 8310000 Serial#: DG08129527 Transfer Date: 07/20/2012 Isotope: BA133 Activity: 0.020000000 Unit: uCi NRC Device Key: 689428 Manufacturer License No: 20-15525-048 Manufacturer Name: GE ION TRACK Model Number: ITEMISER Ill Serial#: 09-8424 Transfer Date: 06/30/2003 Isotope: Nl63 Activity: 10.000000000 Unit: mCi NRC Device Key: 707159 Manufacturer License No: 455-01 G Manufacturer Name: METOREX, INC.

Model Number: 880 Serial#: 128018 Transfer Date: 02/27/2002 Isotope: CD109 Activity: 10.000000000 Unit: mCi NRC Device Key: 547351 Manufacturer License No: MD-31-076-01 Manufacturer Name: CONGO SERVICES CORP.

Model Number: 101 Serial#: N596 Transfer Date: 02/15/1994 Isotope: Nl63 Activity: 5.000000000 Unit: mCi