ML061710023

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

ML061710023
Person / Time
Site:	Braidwood
Issue date:	12/07/2005
From:	Gene Bonano Division of Nuclear Materials Safety III
To:
References
FOIA/PA-2006-0115, FOIA/PA-2010-0209
Download: ML061710023 (7)

Text

• Ip PAGE / OF NR'C FORM 303 U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY (4-2004)

CONTROL NUMBER REQUEST FOR ANALYSIS AND CHAIN OF CUSTODY LABORATORY - ORISE SAMPLE LOCAT N (LICEKSEE) J l ,f' LICENSE NO. DOCKET NO.

SAMPLE SUBMITTED ( ) 44rF." .

,fF-"*+ # TOTAL TYPE VOLUME DATE SAMPLES SUBMITTED PRIORITY fla. c*'O M / N "A/I I', IA [Ii ROUTINE

.5"00,i "SAMPLE COLLECTION INTERVAL

________Y MONTH DAY .YEAR ITIME 1~

INSPECTOR RESPONSIBLE &

1 9lO $Ai'f'- /~LI. ___

TELEPHONE NUMBER START STOP I*

1/1 0 O DESIRED SLIST ANALYSIS TO BE PERFORMED LLD (Optional) LLD OTHER TYPE OF ANALYSIS (Specify) LIST DESIRED Optinal)LLD (Optional)

GROSS ALPHA (GA) "I

- GROSS BETA (GB) , 'El" GAMMA SPEC (GS) II.

TRITIUM (H3) I D r CARBON-14 (C14) E-

" ' IODINE-125 (1125)

RELINQUISHED BY

• RECEIVED BY DATE TIME REASON FOR CHANGE OF CUSTODY

___ __ ,6Z 1ý N -e5 6 w '

FEE RECOVERABLE jNO E YES IF YES, TAC NUMBER / 5- * /0 REMARKS 5,ee,- FbAA 303A Information inthis record was deleted inaccordance with the Freedom of tnformatioff Act, exemptionsFl FOIA _CA ,6- ,,'.r NOTE: SAMPLES WILL BE DISCARDED AFTER ANALYSIS UNLESS REASONS ARE NOTED IN REMARKS ABOVE.

NRC ORM303(4.204)PRITEDON RCYCED APE NRC FORM 303 (4-2004) PRINTED ON RECYCLED PAPER

PAGE 2 OF 3 U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY NRC FORM 303A CONTROL NUMBER (4.2004)

SAMPLE RECORD - Continued Braidwood LABORATORY - ORISE SAMPLE NAME COLLECTION REMARKS, PRESERVATIVE SAMPLE ANALYSIS REQUESTED, ETC.

AND DESCRIPTION DATEITIME NUMBER 11/30/2005 ,z N]RC-24-R3 *;

..... 4-R -l-l#

"?*an Vell iap.

BDWW-6692) (#5 on 500 ml bottle 11/30/2005 500 ml bottle N'RC-25-113 l ell.JBDWW-6690) (#3 on cap) 11/30/2005 500 ml bottle ".

N1RC-26-R3 *Wel (BDWW-6691) (#4 on cap)

NRC127-R3 e "1210 250 mil bottle NR 27 Ri ............

11/30/.2005 113 full, 500 ml bottle NRC-28-R3 Lake #1 (BDWW-6688) (#1 on cap)

NRC-29-R3 Lake #2 (BDWW-6689) (#2 on cap) ..... 1.3.....0./2005....... 1/3 full, 500 ml bottle NRC-30-R3 GW-120605-JL.G-1 " 500 ml bottle NRC-31-R3 GW-1206054L-G-2 ............................. 500 ml bottle .. r NRC-32i-R3 GW-120605-JL-G-3 ......................--...... 500 ml bottle NRC-33-R3 GW-120505-JI,-P-9 ........................ 250 ml bottle NRC-34-R3 GW-120505.JL-P-10 ............................. 250 ml bottle NRC-35-R3 GW-120505-JL-P-11 ............................. 250 ml bottle NRC-36-R3 GW-120505-JI.;-P-12 ............................. 250 ml bottle NRC-37-R3 GW-120505-JL-S-1 250 ml bottle NRC-38-R3 GW-120505-JL-S-2 250 ml bottle NRC-39-R3 GW-120505-JL-S-3 ............................ 250 ml bottle NRC-40-R3 GW-120505-JL-S-4 ".............................. 250 ml bottle NRC-41-R3 GW-120505-JL-S-5 250 ml bottle NRC-42-R3 GW-120505-JL-S-6 .............................. 250 mil bottle NRC-43-R3 GW-120605-JRB-D-1 12/06/2005 500 ml bottle 10:25am

,. ,*12/05/2005 NRC-44-R3 GW-120505-JRB-D-2 ........1.2052005........ 250 ml bottle NRC-45-R3 GW-120605-JB-P-4 ..... 12/0.6/2005 ..... 250 ml bottle I.__*_8:25am NRC-46-R3 GW-120605-JRB-P-8 ..... 9.0..0...am.............

9:00am/, 250 ml bottle NRC-47-R3 GW-120505-JRB-VB2-6 ........ ....... 0.5.2P...5..... 250 ml bottle NRC-48-R3 GW-120505-JRB-VB3-4 ..... 1.0...5.2.00.5......

2:25pn 250 ml bottle 7._

NRC-49-R3 GW-120505-JRB-MW-113 ...... 2./-0.5/.2-0-05 ..... 250 ml bottle

____________ BD-VB34____(Special ___Well) ___........__ 3:57Pm NRC-50-R3 BD-VB3-4 (Special Well) 11130/2005 1Qt/IL (cubitalner)

__ __ __ __ _ __ __ _ __ __ _.....__ __ __ _ 3:00pmo .___ _ _ _ _ _ _ _ _ _ _ _ _ _

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

I PAGE 3 OF 3 NRC FORM 303A U.S. NUCLEAR REGULATORY COMMISSION LABORATORY USE ONLY (4-2004) CONTROL NUMBER SAMPLE RECORD - Continued Braidwood LABORATORY - ORISE SAMPLE SAMPLE NAME COLLECTION REMARKS, PRESERVATIVE NUMBER AND DESCRIPTION DATE1TIME ANALYSIS REQUESTED, ETC.

GW-120205-MK-D-5 ............ ...... 500 ml bottle, missing from 2nd batch of 1.............021................../2005 2.......

NRC-51-R13 samples sent 1216105

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

TRANSMISSION VERIFICATION REPORT TIME : 12/87/2885 16:55 NAME : US NRC RIIl DNMS FAX  : 6305151259 TEL DATE,TIME 12/87 16:54 FAX NO. /IA4E 18652413248 DURATION 00:01:12 PAGE(S) 04 RESULT OK MODE STANDARD ECM

UNITED STATES NUCLEAR REGULATORY COMMISSION REGION III 2443 Warrenvillc Road, Suite 210 Usle, Illinois 60532-4352 TELEFAX TRANSMITTAL NUMBER OF PAGES:

DATE: 12' a6 (includingthis page)

SEND TO: e-AW LOCATION: LA*

FAX NUMBER: 655-. * - dV

.39 n VERIFY BY CALLING SENDER FROM:

(SENDER) (SC/Jl:- 7at c~A 'JD TELEPHONE NUMBER: 630 -* - *d 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

( .s A)

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.

PRINTED ON RECYCLED PAPER WRC I=1*FORM 388 (Rill FORIJ US*, (4.2004)

(Rut) (4-2004) PRINTED ON RECYCLED P

TRANSMISSION VERIFICATION REPORT TIME : 12/07/2805 16:57 NAME : US NRC RIII DNMS FAX  : 6385151259 TEL DATE,TIME 12/87 16:56 FAX NO./NAVE 13814155397 DURATION 00:81:13 PAGE(S) 04 RESULT OK MODE STANDARD ECM

NRC FORM 386 (Rill) UNITED STATES (4-200_4)

NUCLEAR REGULATORY COMMISSION REGION III 2443 Warrenvtlb Road, Suite 210 Usle, Illinois 605324352 TELEFAX TRANSMITTAL NUMBER OF PAGES:

DATE: _______ (includingthis page),

SEND TO: lo~4 1-I LOCATION:

FAX NUMBER: 3/- /-537- [-] VERIFY BY CALLING SENDER FROM:

(SENDER)

TELEPHONE NUMBER: 630 - * .'.& 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 reJe>~ k 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 hiereby 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. Mall. Thank you.

F RIR III I I.C01PR N W

• R C CL DPIE L MWCFORM 3H OUR) (4-M*) pRp= ON RECYCLED PAPER