IR 015000020/2022001

QSA Global, Inc., NRC Form 591M, Inspection Report 15000020/2022001

ML22133A017
Person / Time
Site:	15000020, 015000020
Issue date:	04/06/2022
From:	Jason Draper NRC/RGN-III
To:	Ewing T QSA Global
References
IR 2022001
Download: ML22133A017 (2)

Text

NRC FORM 591M U.S. NUCLEAR REGULATORY COMMISSION (04-2022)

Materials Inspection Report Licensee/Location Inspected: NRC/Regional Office

QSA Global, In Region III 40 North Avenue U. S. Nuclear Regulatory Commission Burlington, Massachusetts 01803 2443 Warrenville Road, Suite 210 (Location Inspected: Job Site in Attica, IN) Lisle, IL 60532-4352

Report Number(s) 2022001 Docket Number(s) License Number(s) Date(s) of Inspection 150-00020 MA-12-8361 April 6, 2022

LICENSEE:

The inspection was an examination of the activities conducted under your license as they relate to radiation safety and to compliance with the Nuclear Regulatory Commission (NRC) rules and regulations and the conditions of your license. The inspection consisted of selective examinations of procedures and representative records, interviews with personnel, and observations by the inspector. The inspection findings are as follows: Based on the inspection findings, no violations were identifie. Previous violation(s) close. During this inspection, certain of your activities, as described below and/or attached, were in violation of NRC requirements, and were assessed at Severity Level IV, in accordance with the NRC Enforcement Polic The violation(s), specifically described to you by the inspector as non-cited violations, are not being cited because they were self-identified, non-repetitive, corrective action was or is being taken, and the remaining criteria in the NRC Enforcement Policy were satisfie (Non-cited violation(s) was/were discussed involving the following requirement(s) The following violation(s) is/are being cited in accordance with NRC Enforcement Policy. This form is a NOTICE OF VIOLATION, which may be subject to posting in accordance with 10 CFR 19.1 (Violations and Corrective Actions)

Statement of Corrective Actions I hereby state that, within 30 days, the actions described by me to the Inspector will be taken to correct the violations identifie This statement of corrective actions is made in accordance with the requirements of 10 CFR 2.201 (corrective steps already taken, corrective steps which will be taken, date when full compliance will be achieved). I understand that no further written response to NRC will be required, unless specifically requeste TITLE PRINTED NAME SIGNATURE AND DATE

LICENSEE'S REPRESENTATIVE

NRC INSPECTOR Jason Draper, Health Physicist Jason D. Draper Digitally signed by Jason D. Draper Date: 2022.04.13 14:05:46 -05'00'

BRANCH CHIEF Michael A. Kunowski Digitally signed by Michael A. Kunowski Date: 2022.04.15 07:07:05 -05'00'

Add Continuation Page Page 1 of 1 NRC FORM 592M U.S. NUCLEAR REGULATORY COMMISSION (10-2020)

Materials Inspection Record Licensee Name: Docket Number(s): License Number(s)

QSA Global, In MA-12-8361 Report Number(s): Date(s) of Inspection:

2022001 April 6, 2022 Inspector(s): Program Code(s): Priority: Inspection Guidance Used:

Jason Draper 03211 2 IP 87125

1 Licensee Contact Name(s): 1 Licensee E-mail Address: 1 Licensee Telephone Number(s):

Theo Ewing, Senior Sales and theo.ewing@qsa-global.com (225) 751-5893 Service Engineer

1 Inspection Type: Initial 1 Locations Inspected: 1 Next Inspection Date (MM/DD/YYYY):

Routine Announced Main Office Field Office N/A Normal Extended

Non-Routine Unannounced Temporary Job Site Remote Reduced No change

1 Scope and Observations:

This was an announced temporary job site inspection of a sealed source manufacturing company authorized by the Commonwealth of Massachusetts to use radioactive material for numerous applications, including but not limited to source and device fabrication, distribution, servicing, and emergency retrieval, as well as instrument calibration and student instructio The company used this license to perform periodic maintenance and inspection on radiographic exposure devices in NRC jurisdiction under the terms of a reciprocity request approved on March 23, 202 The scope of this inspection was limited to observations of the maintenance and inspection activities by the service engineer at the client's facility at 900 South Mound Street, Attica, Indian The inspector observed the reciprocity licensee's senior service engineer perform the annual maintenance and inspection activities on two QSA Global Sentry 330 radiographic exposure devices (REDs) while the cobalt-60 sealed sources remained shielded inside the device The periodic maintenance and inspection included cleaning accessible portions of the REDs, cleaning and lubrication of the locking mechanisms and outlet ports, and replacement of consumable part The inspector verified that the reciprocity licensee was using appropriate dosimetry and instrumentation including personnel dosimeter, direct reading dosimeter, alarming dose rate meter, and survey mete The inspector also verified that the licensee had controls in place to prevent the source from coming unshielded while the safety mechanisms of the REDs were disabled for the maintenanc The inspector also observed the client perform post-maintenance functional testing to ensure the REDs and its safety mechanisms functioned appropriatel While on-site, the inspector reviewed the reciprocity licensee's NRC Form 241 dated March 23, 2022, and verified that this form and its enclosure accurately described the activities observed during the inspectio No violations of NRC requirements were identified as a result of this inspectio NRC Form 592M (10-2020) Page 1 of 1