IR 05000232/2004001
| ML18278A217 | |
| Person / Time | |
|---|---|
| Site: | 05000232, 03020360 |
| Issue date: | 10/02/2018 |
| From: | Presler W A Shannon & Wilson |
| To: | Carol Hill NRC Region 4 |
| References | |
| 610125 | |
| Download: ML18278A217 (5) | |
Text
Hill, Carol From: Sent: To: Wendy Presler <WAP@shanwil.com>
Tuesday, October 02, 2018 7:11 PM Hill, Carol Cc: Subject:
Attachments:
Christopher Darrah; Steve Adamczak; Torres, RobertoJ [External_Sender]
License No. 50-23204-01 nrc313_signed.pdf; Presler RSO Training.pdf Hello. Please be advised that our currently registered RSO is no longer employed by Shannon & Wilson, effective 10/1/201 We wish to change our RSO to: Wendy A. Presler, P.E. Education:
M.S. Civil Engineering; B.S. Civil Engineering Current position:
Senior Geotechnical Engineer RSO Training:
Appended I have operated nuclear moisture-density gauges and x-ray fluorescence analyzers since 2004. NRC Form 313 and documentation of RSO training are appended, for your records. Please let me know if additional information is needed to complete the requested change of RSO. Best regards, J'~NONlf\lVIL$0N,INC . . Wendy A. Presler, P.E. J Senior Geotechnical Engineer 2355 Hill Road Fairbanks, Alaska 99709 www.shannonwilson.com Phone: (907} 479-0600 Fax: (907} 479-5691 Direct: (907} 458-3126 E-mail: wa p@shanwil.com fmt:111 Excellenc Innovatio Service. Value. We Help Our Clients Achieve Their Goals. 1 PUBLIC !~ediate Release ),,J--fi onnar Release NON-PUBLIC a A.3 Sensitive-Security Related a A.7 Sensitive lntemal a Other: --;-----Rev I ewer: MJ J D )' r II t; --Date: , .> /J 5 NRC FORM 313 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY 0MB: NO. 3160-0120 EXPIRES: 06/30/2019 (10-2017)
10 CFR 30, 32, 33, 34, 35, 36, 37, 39, and 40 APPLICATION FOR MATERIALS LICENSE Estimated burden per response to comply with this mandatory collection request 4.3 hours3.472222e-5 days <br />8.333333e-4 hours <br />4.960317e-6 weeks <br />1.1415e-6 months <br />. Submittal of the application Is necessary to detennine that the applicant is qualified and that adequate procedures exist to protect the public health and safety. Send comments regarding burden estimate to the lnfonnation Services Branch (T-2 F43), U.S. Nuclear Regulatory Commission , Washington , DC 2055S-0001, or by &-mail to lnfocollects
.Resource@rvc.gov, and to the Desk Officer , Office of lnfonnation and Regulatory Affairs, NEOB-10202 , (3150-0120), Office of Management and Budge~ Washington, DC 20503. If a me an s used to i mpose an information collection does not display a cunenlly valid 0MB control numbe r , the NRC may not conduct or sponsor , and a person is not required to respond to , th e infonnation collection. INSTRUCTIONS:
SEE THE CURRENT VOLUMES OF THE NUREG-1556 TECHNICAL REPORT SERIES ("CONSOLIDATED GUIDANCE ABOUT MATERIALS LICENSES")
FOR DETAILED INSTRUCTIONS FOR COMPLETING THIS FORM: IUtP:/Jwww.m: c.o o v/re adin q-rmldo c-collectlo n s/nure g s/s ta ff/sr 1 5561. SEND lWO COPIES OF THE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW. APPLICATION FOR DISTRIBUTION OF EXEMPT PRODUCTS FILE APPLICATIONS WITH: IF YOU ARE LOCATED IN: MATERIALS SAFETY LICENSING BRANCH DIVISION OF MATERIAL SAFETY, STATE , TRIBAL AND RULEMAKING PROGRAMS OFFICE OF NUCLEAR MATERIALS SAFETY AND SAFEGUARDS ILUNOIS, INDIANA, IOWA, MICHIGAN, MINNESOTA, MISSOURI, OHIO, OR WISCONSIN, SEND APPLICATIONS TO: U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555-0001 ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS: IF YOU ARE LOCATED IN: MATERIALS LICENSING BRANCH U.S. NUCLEAR REGULATORY COMMISSION, REGION Ill 2443 WARRENVILLE ROAD, SUITE 210 LISLE, IL 60532-4352 IF YOU ARE LOCATED IN: ' ALABAMA, CONNECTICUT, DELAWARE, DISTRICT OF COLUMBIA, FLORIDA, GEORGIA, KENTUCKY, MAINE, MARYLAND, MASSACHUSETIS, NEW HAMPSHIRE, NEW JERS!:Y, NEW YORK, NORTH CAROLINA, PENNSYLVANIA, PUERTO RICO, RHODE ISLAND, SOUTH CAROLINA, TENNESSEE, VERMONT, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA, ALASKA, ARIZONA, ARKANSAS , CALIFORNIA, COLORADO, HAWAII, IDAHO, KANSAS, LOUISIANA, MISSISSIPPI, MONTANA, NEBRASKA, NEVADA, NEW MEXICO, NORTH DAKOTA, OKLAHOMA, OREGON, PACIFIC TRUST TERRITORIES, SOUTH DAKOTA, TEXAS, UTAH, WASHINGTON, OR WYOMING, SEND APPLICATIONS TO: LICENSING ASSISTANCE TEAM DIVISION OF NUCLEAR MATERIALS SAFETY U.S. NUCLEAR REGULATORY COMMISSION , REGION I 2100 RENAISSANCE BOULEVARD, SUITE 100 KING OF PRUSSIA, PA 19406-2713 SEND APPLICATIONS TO: NUCLEAR MATERIALS LICENSING BRANCH U.S. NUCLEAR REGULATORY COMMISSION, REGION IV 1600 E. LAMAR BOULEVARD ARLINGTON, T X 76011-4511 PERSONS L OCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE U.S. NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS AND USE LICENSED MATERIAL I N ST A TES S U BJECT TO U.S. NUCLEAR REGULATORY COMMISSION JURISDICTIONS. 1. THIS IS AN APPLICATION FOR (Check appropriate item) D A. NEW LICENSE 0 B. AMENDMENT TO LICENSE NUMBER 50-23204-01 D c. RENEWAL OF LICENSE NUMBER 3. ADDRESS V'vHERE LICENSED MATERIALS V\/1LL BE USED OR POSSESSED 2. NAME AND MAILING ADDRESS OF APPLICANT (In c lude zip code) Shannon & Wilson, Inc. 2355 Hill Road Fairbanks, Alaska 99709 4. NAME OF PERSON TO BE CONTACTED ABOUT THIS APPLICATION Wendy A. Presler 2355 Hill Road Fairbanks , Alaska 99709 BUSINESS TELEPHONE NUMBER 907-458-3126 I BUSINESS CELLULAR TELEPHONE NUMBER BUSINESS E-MAIL ADDRESS wap@shanwil.com SUBMIT ITEMS 5 THROUGH 11 ON 8-112 X 11" PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE LICENSE APPLICATION GUIDE. 5. RADIOACTIVE MATERIAL 6. PURPOSE($)
FOR WHICH LICENSED MATERIAL WILL BE USED. a. Element and mass number, b. chemical and/or physical form; and c. maximum amount 7. INDIVIDUAL($)
RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEIR TRAINING AND which will be possessed at any one t i me. EXPERIENC . TRAINING FOR I ND I VIDUALS WOR K ING I N OR FREQUENTING RESTR I CTED AREAS. 9. FAC I LI T IES AND EQUIPMENT. 10. RADIATION SAFETY PROGRAM. 11. WASTE MANAGEMENT. 12. LICENSE FEES (Fees required only for new applica ti ons , wilh few e x ceptions*)
FEE I (See 10 CFR 170 and Section 170.31) CATEGORY 'Amendments/Renewals that Increase the scope of 1he existing license to a new or higher fee category will require a fee. n/a I AMOUNT $1 ENCLOSED 0.00 PER THE DEBT COLLECTION IMPROVEMENT ACT OF 1996 (PUBLIC LAW 104-134), YOU ARE REQUIRED TO PROVIDE YOUR TAXPAYER IDENTIFICATION NUMBER. PROVIDE THIS INFORMATION BY COMPLETING NRC FORM 531: https*J/www nrc govlread!ng-nnldoc-coUectjons/formslnrc531 jnfo h1ml. 13. CERTIFICATION. (Must be completed by applicant)
THE APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS MADE IN THIS APPLICATION ARE BINDING UPON THE APPLICAN THE APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPLICANT , NAMED IN ITEM 2 , CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY
\/,/ITH TITLE 10, CODE OF FEDERAL REGULATIONS, PARTS 30, 32, 33, 34 , 35, 36, 37, 39, AND 40, AND THAT ALL INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF. WARNING: 18 U.S.C. SECTION 1001 ACT OF JUNE 25, 1948 62 STAT. 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION. * dli A Digitally si ___ ..., .... CERTIFY I NG OFFICER -TYPED/PR I NTED NAME AND TITLE S I GNA Z;~l * . ._, -1 Chnstophe Darrah Christopher Darrah, Vice President, Office Manager Date: 2018 10.02 14:53:4 1 I .I\P PR OVED B Y NRG FORM 313 (10-2017)
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- ,. ~.~***. 4~.' Instro Tek, Inc. Radiation Safety Officer Training Wendy Presler --~~.~ ,t.~i.~*-:
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<3M'* ,:*~* .; .. \~.,* )~; Has successfully completed a certified course on the responsibilities of Radiation Safety Officer for portable nuclear gauges "....!"" .'-.,**~*
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4o:: ~* ' en 0 "' 01 using special form nuclear materia Subjects included were: Responsibilities of Radiation Safety Officer Commercial shipping of portable nuclear gauges Applicable 10 CFR Regulations Portable nuclear gauge security " Records for tracking and logging portable gauges Unit Conversions Applying for nuclear materials license lruitroTek,.
Inc. IrtsttoTek, Inc. 5908 Triangle Dr. Raleigh, NC 27617 (919) 875-8371 Radiation Safety Program Applicable 49 CFR Regulations NUREG 1556 VoL 1 Rev. 1 Records for Dosimetry Dose calculations and calculators Decay calculations and calculators Amending nuclear materials license ~-, .,,,. &--.......
Instructor:
Date of Training:
Location:
Dr. Larry James 04 Jan 2011 Raleigh, NC NRC FORM 532 U.S. NUCLEAR REGULATORY COMMISSION (0 5-20 1 6) '¥~ * 0 ACKNOWLEDGEMENT
-RECEIPT OF CORRESPONDENCE
- ; '"~ .., ...... Name and Address of Applicant and/or Licensee Date I 10/04/2018 I Alan M. Vetter License Number(s} Radiation Safety Officer I 50-23204-01 I Shannon & Wilson, Inc. Mail Control Number (s} 2355 Hill Road I 610125 I Fairbanks, AK 99709 Licensin g and/or Technical Reviewer or Branch C. Hill This is to acknowledge receipt of your
- D Letter and/or [Z] Application Dated: 10/02/218 The initial processing, which included an administrative review, has been performe Amendment D Termination D New License D Renewal D There were no administrative omissions identified during our initial review. D This is to acknowledge receipt of your application for renewal of the material(s)
license identified above. Your application is deemed timely filed, and accordingly, the license will not expire until final action has been taken by this office. D Your application for a new NRC license did not include your taxpayer identification number. Please complete and submit NRC Form 531, Request for Taxpayer Identification Number, located at the following link: htt o://www.nrc.
a ov/readin a-rm/doc-collections/forms/nrc531.
p df Follow the instructions on the form for submissio D The following administrative omissions have been identified:
Your application has been assigned the above listed MAIL CONTROL NUMBER. When calling to inquire about this action, please refer to this control number. Your application has been forwarded to a technical reviewe Please note that the technical review, which is normally completed within 180 days for a renewal application (90 days for all other requests), may identify additional omissions or require additional informatio If you have any questions concerning the processing of your application, our contact information is listed below: Region IV U. S. Nuclear Regulatory Commission DNMS/NMSB
-B 1600 E. Lamar Boulevard Arlington, TX 76011-4511 (817) 200-1103 or (817) 200-1140 NRG FORM 532 (05-2016)
BETWEEN: Accounts Receivable/Payable and Regional Licensing Branches [ FOR ARPB USE ] INFORMATION FROM WBL Program Code: 03121 Status Code: Pending Amendment Fee Category:3P Exp. Date: 02/29/2024 Fee Comments:
Decom Fin Assur Reqd: N License Fee Worksheet
-License Fee Transmittal A. REGION 1. APPLICATION ATIACHED Applicant/Licensee:
Shannon & Wilson, Inc. Received Date: 10/02/2018 Docket Number: 3020360 Mail Control Number: 610125 License Number: 50-23204-01 Action Type: Notifications 2.FEEATTAC 7 HED Amount: Check No.: . 3. COMMENTS Signed: Date: B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered / 1. Fee Category and Amount: ------------------
2. Correct Fee Paid. Application may be processed for: Amendment:
Renewal: License: Signed: Date: