ML20248G918

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Matls Licensing Package for License 50-29121-01 for Terra Firma,Inc.Control:572666
ML20248G918
Person / Time
Site: 03034741
Issue date: 05/18/1998
From: Prange B
NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV)
To:
References
50-29121-01, 50-29121-1, 572666, NUDOCS 9806050392
Download: ML20248G918 (22)


See also: IR 05000291/2021001

Text

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i NRC FORM 374 .

PAGE 1 OF 5 fAGEs

U.s. NUCLEAR REGULATORY CoMMisslord

MATERIALS LICENSE

Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10

Cod 3 of Federal Regulation., Chapter 1. Parts 30,31,32,33,34,35,36,39,40, and 70, and in reliance on statements and

orpr:sentations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and

transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s)

d:signated below; to deliver or trLisfer such material to persons authorized to receive it in accordance with the regulations of the

applicable Part(s). This license shall be deemed to contain the conditions specif,ad in Section 183 of the Atomic Energy Act of 1954,

as amended, and is subject to all applicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in

siirct and to any conditions specified below.

Licensee l

1. Terra Firma Inc. 3. License number 50 29121-01

.

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2. 8801 Rendon Drive -

4. Expiration date May 31,2008

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Anchorage, Alaska 99507 p, 5. Docket No. 030-34741

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Reference No.

6. Byproduct, source, and/or special ,~ 8f Maximum amount that licensee may

nuclear material (7. Chemical and/or physical form possess at any one time under this

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y _ license

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A. Americium-241 A. Cealed neutron sCurces A. Not to exceed 100 millicuries

Amersham Corporation: J per source

,  ;; Model AMNV.340 -

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B. Americium-241 .

B. ' Sealed neutron sources , ~ B Not to exceed 300 millicur

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C- Amersham Corporation;.- ' , per source

E ' Model AMNV 339afi r"

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C. Not to exceed 10 millicuries

C. Cesium-137 '/ C. Sealed sources * W

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Amersham CorporaIon

Model CDCW556 or

f* per source

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isotope Products

Laboratories Model

HEG-0057

! D. Americium-241 D. Scaled neutron sources D. Not to exceed 50 millicuries

9 Amersham Corporation per source

I Model AMNV.997 or

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isotope Products

Laboratories Mode!

HEG-0058

5. Cesium-137 E. Sealed sources E. Not to exceed 10 millicuries

j Amersham Corporation per source

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- Model CDCW556 or

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isotope Products Model

HEG-137-8M C)

9806050392 980518

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i NRC FORM 374A U.s. NUCLEAR RE*1ULAToRY Commission PAGE 2 of 5 PAGEs

Ucense Number

, 50-29121-01

Docket or Reference Number

! MATERIALS LICENSE

SUPPLEMENTARY SHEET 030-34741

!

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,

9. Authorized use

l

l A. To be used in portable Troxler Electronic Laboratories, Inc. Model 3241-G, asphalt content gauging

l devices to measure properties of construction materials.

, 2 A. or B. To be e *od in portable Troxler Electronic Laboratories, Inc. Model 3241-C, asphalt content

'

i gauging devices to measure properties of construction mshists.

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C. and D. For use in portable Troxter Electronics Laboratories, Inc. Model 3400 Series gauging

devices for measuririg properties of construction materials.

E. For use in portable Troxier Electronic Laboratories, Inc. Model 4 448 thin layer density gauges to

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measure properties oi con,struction materials. 7-

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10. Licensed material may be used or stored at the licensee's facilities located at 8801 Rendon Drive,

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l Anchorage, Alash and may be'used at temporary job ' sites of the licensee lanywhere in the United States

l where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating the use of licensed

material, including areas of exclusive federal jurisdiction within' Agreement States.

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If the jurisdiction status of a federal agency within an Agreem.ent State is unknown, the licansee should

contact the federal agency c~ontrolling the job site.in question to determine whether the proposed job site

is an area of exclusive federaljurisdiction. Auth6rization for use of' radioactive' materials at job sites in

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Agreement States not under exclusive federal jurisdiction shall be obtained from the appropriate state

'

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regulatory agency. <

11. A. Licensed material shall only be used by, or under the supervision and in the physical presence of,

Ron J. P. Caron, Tamara Selmer, or individuals who have received the training described in

application dated May 5,1998.

B. The Radiation Safety Officer for this license is Ron J.P. Caron.

12. A. Sealed sources shall be tested for leakage and/or contamination at intervals not to axceed 6 months

or at se u other intervals as specified by the certificate of registration referred to in 10 CFR 32.210 or

by an Agreement State.

B. In the absence of a certificate from a transferor indicating that a leak test has been made within the

intervals specified in the certificate of registration issued by the NRC under 10 CFR 32.210 or by an

Agreement State prior to the transfer, a sealed source or detector cell received from another person

shall not be put into use until tested.

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1

. NRC FORM 374A u.s. NUCLEAR REGULATORY Commission PAGE 3 of 5 PAGES

Licenso Number

50-29121-01

Docket or Reference Number

MATERIALS LICENSE

SUPPLEMLWTARY SHEET

030-34741

!

12. (Continued)

C. Sealed sources need not be tested if they are in storage, and are not being used. However, when

they are removed from storage for use of transferred to another person, and have not been tested

within the required leak test interval, they shall be tested before use or transfer. No sealed source

shall be stored for a period of more than 10 years without being tested for leakage and/or

contamination. ,.

' - i

D. The leak test shall be capable of detecting the presence'of 0.005 microcurie of radioactive material

on the test sample. If the test reveals the presence of 0.005 microcurie or more of removable

contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance

with 10 CFR 30.50(b)(2), and the source shall be removed immediately from service and

decontaminated, repaired, or disposed of in accordance with Commission regulations. The report

.

shall be filed within 5 days of the date the leak test result is known with the U.S. Nuclear Regulatory

Commission, Region IV,611 Ryan Plaza Dri<e, Suite 400, Arlington, Texas 76011, ATTN: Director,

Division of Nuclear Materials Safety. The report shall specify the source involved, the test results,

'

and corrective action taken. y -

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E. Tests for leakage and/or contamination shall be performed by persons specifically licensed b'y the

Commission or an Agreement State to perform such services, in addition, the licensee is authorized

to collect leak test samples but not perform the analysis; analysis of leak test samples must be

performed by persons specifically licensed by the Commission or an Agreement State to perform

'

such services.

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13. Sealed sources or sourco rods containing licensed" material shall not be opene'd or sources removed or

detached from source rods or gauges by the licensee, except as specifically authorized.

.

14. The licensee shall conduct a physical inventory every 6 months, or at other interval spproved by NRC, to

account for all sources and/or devices received and possessed under the license.

15. Each portable gauge shall have a lock or outer locked container designed to prevent unauthorized or

accidental removal of the sealed source from its shielded position. The gauge or its container must be

locked when in transport, storage, or when not under the direct surveillance of an authorized user.

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NRC FORM 374A U.s. NUCLEAR REGULATORY CoMMtssioN PAGE 4 of 5 PAGEs

l

Licenn Number

50-29121-01

Docket or Reference Number

MATERIALS LICENSE

SUPPLEMENTARY SHEET 030-34741

.

16. Except for maintaining labeling as required by 10 CFR Part 20 or 71, the licensee shall obtain

authorization from NRC before making any changes in the sealed source, device, or source-device

combination that would alter the description or specifications as indicated in the respective Certificates of

Registration issued either by the Commission pursuant to 10 CFR 32.210 or by an Agreement State.

17. Any cleaNng, maintenance, or repair of the gauges that requires detaching the source or source rod from

the gauge shall be performed only by the manufacturer or by other persons specifically licensed by the

~

Commission or an Agreement State to perform such services. s

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18. The licensee is authorized td trdnsport licensed material only in accordance with the provisions of 10 CFR

Part 71," Packaging and Transportation of Radioactive Material." 1J

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19. A. If the licensee uses unshieiUed sealed sources extended more than 3 feet below the surface, the i

licensee shall use surface casing that extends.from the lowest depth to 12 inches above the surface l

l

and other appropriate procedures to reduce the probability of the source or probe becoming lodged

below the surface. .lf it is not feasible to extend the casing 12 inches above the surface, the licensee

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shallimplement procedures to ensure that the' cased hole is free of obstruction before making

measurements. ' r 4.1 3 c, X- T . d,~

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B. If a sealed source or a probe containing sealed so'urces becomes lodged below the surface and it

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becomes apparen, that effor's' t to recover the sealed source or probe may not be successful, the

licensee shall notify the U. S. Nuclear Regulatory _Comm,ission and submit the report required by

10 CFR 30.50(b)(2) and (c). The licensee shall not abandon the sealed source or probe without

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obtaining the Commission's prior written codie'nt. C .

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20. In addition to the possession limits in item 8, the licerisee shall further restrict the possession of licensed

material to quantities below the minimum limit specified in 10 CFR 30.35(d) for establishing

decommissioning financial assurance.

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. _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ __

, NRC FORM 374A U.s. NUCLEAR RESULAToRY Commission PAGE 5 of 5 PAGES

License Number

l 50-29121 01

MATERIALS LICENSE Docket or Reference Number

SUPPLEMENTARY SHEET 030-34741

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21. Except as specifically provided otherwise in this license, the licensee shall conduct its program in

accordance with the statements, representations, and procedures contained in the documents, including

any enclosures, listed below. The Nuclear Regulatory Commission's regulations shall govern unless the

statements, representations, and procedures in the licensee's application and correspondence are more

restrictive than the regulations.

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A. Application dated May 5,1998 . -

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B. Telefacsimile dated May 15,1998 ,

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FOR THE U.S. NUCLEAR REGULATORY COMMISSION

MAY 18 35

NMIC7 NT&cdE.

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D:te By

Beth A. Prange

Materials Branch

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Region IV, WCFO

Walnut Creek, California 94596

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, INFORMATION FROM LTS

BETWEEN: .

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License Fee Management Branch. ARM Proytam Code:

and Status Code: 3 >

Regional Licensing Sections .

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LICENSE FEE TRt.NSMITTA'.

A. REGION LO C F 0

1. APPLICATION ATTACHED

Applicant / Licensee: TERRA FIRMA INC.

Received Date: 980512

Docket No: 3034741

Control No. 572666

License No.

Action Type: New Licensee

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Check No.,

3. COMMENTS

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B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered / /)

Fee Category and Amount: 3 7ID

1rrect Fee Paid. Application may be processed for:

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UNITED STATES

NUCLEAR REIULATORY COMMISSION

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je REGION IV

k Walnut Creek Field Office

1450 Maria Lane, Suite 3oo

9 ,,,,,

Walnut Creek. California 94596-5368

May 18,1998

Terra Firma Inc.

ATTN: Tamara Selmer

Vice President

8801 Rendon Drive

Anchorage, Alaska 99507

SUBJECT: NEW LICENSE

Please find enclosed License No. 50-29121-01. You sheuld review this license carefully and be

sure that you unden>tand all conditions. If you have any questions, you may contact the

reviewer who signed your license at (925) 975-0250.

The NRC is required to have your Taxpayer identification Number in order to make payments

(refunds). The self-addressed, stamped NRC Form 531, " Request for Taxpayer Identification

.

Number"is enclosed. ,

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NRC expects lic9nsees to conduct their programs with meticulous attention to deteil and a high

standard of compliance. Because of the serious consequences to employees and the public

.which can result from failure to comply with NRC requirements, you must conduct your program

involving radioactive materials in accordance with the conditions of your NRC license,

representations made in your license application, and NRC regulations. In particular, note that

,

you must:

1. Operata in accordance with NRC regulations 10 CFR Part 19, " Notices, Instructions and

Reports to Workers: Inspection and Investigations," 10 CFR Part 20, " Standards for

Protection Agains' Radiation," and other applicable regulations.

2. Possess radioactive material only in i>J quantity and form indicated in your license.

3. Use radioactive material only for the purpose (s) indicated in your license. ,

i

4. Notify NRC in writing of any change in mailing address (no fee required if the location of j

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l radioactive material remains the same).

5. Request and obtain written NRC consent before transferring your licanse or any right

thereunder, either voluntarily or involuntary!y, directly or indirectly, through transfer of

control of your license to any person ci entity. A transfer of control of your license

includes not only a total change of ownership, but also a change in the control'ing

interest in your company whether it is a corporation, partnership, or other entity. In

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Terra Firma Inc. -2-

addition, appro;date license amendmerts must be requested and obtained for any other

planned changes in your facility or program that are contrary to your license or contrary

to representations made in your license application, as well as supplemental

correspondence thereto, which are incorporated into your license A license fee may be

charged for the amendments if you are not in a fee-exempt category.

6. Maintain in a single document decommissioning records that have been certified for

completeness and accuracy listing all the following items applicable to the license:

- Onsite areas designated or formerly designated as restricted areas as defined in

10 CFR 20.3(a)(14) or 20.1003.

- Onsite areas, other than restricted areas, where radioactive materials in

quantities greater than amounts listed in Appendix C to 10 CFR 20.1001-20.2401

have been used, possessed, or stored.

- Onsite areas, other than restricted areas, where spills or other unusual

occurrences involving the spread of contamination in and around the facility,

equipment, or site have occurred that required reporting pursuant to 10 CFR

30.50(b)(1) or (b)(4), including areas where subsequent cleanup procedures

,

have removed the contamination.

- Specific locations and radionuclides contents of previous and current burial areas

within the site, excluding radioactive material with half-lives of 10 days or less,

depleted uranium used only for shielding or as penetrators in unused munitions,

or sealed sources authorized for use at temporary job sites.

- Location and description of all contaminated equipment involyed in licensed

operations that is to remain onsite after license termination. '

7. Submit a complete renewal application with proper fee, or termination request at least

30 days before the expiration date on your license. You will receive a reminder notice

approximately 90 days before the expiration date. Possession of radioactive material

after your license expires is a violation of NRC regulations. J

8. Request termination of yourlicense if you plan to permanently discontinue activities

involving radioactive material.

You will be periodica4y inspected by NRC. Failure to conduct your program in accordance with

NRC regulations, license conditions, and representations made in your license application and

-

suppiemantal correspondence with NRC will result in enforcement action against you. This

could include issuance of a notice of violation; impositicn of a civil penSty; or an order

suspending, modifying, or revoking your license as specified in the "Goeral Statement of

Policy and Procedure for NRC Enforcernent Actions"(Enforcement Policy), NUREG 1600.

1

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Terra FPrna Inc. -3-

Also enclosed, please find the NRC letter dated July 12,1995, to all materials licensees which

transmits the NRC Policy on Communications Between the NRC and Licensees. It is the intent

of this policy to foster greater openness and candid communications and to improve

interactions with our licensees. We encourage you and your staff to become familiar with these

principles so that we can maintain a high level of professional communication at all levels in our

organizations.

Thank you for your cooperation.

Sincerely,

0

&aca.7m

'

Beth A. Prange

Sr. Health Physicist (Licensing)

Materials Branch

Docket: 030-34741 i

License: 50-29121-01

Control: 572666

Enclosures: As stated

cc: State of AK

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_ _ _ - - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - _ _ _ _

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Terra Firma Inc. -4-

bec:

LFARB, T-9, E-10

WCFO Inspection File

Docket File

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DOCUMENT NAME: G:\Beth\572666

To receive copy of document, indicate in box:"C" = Copy without enclosures "E" = Copy with enclosures "N" = No copy

RIV:MB M

BPrange bQf

6 ATl98

OFFICIAL RECORD COPY

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_ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _

NAY-15-90 00:47 n ti p. , g g

Terra Fi a Inc

8801 Ren e on Drive {

Ak 99507

Anchoraq'

Ph (907) 3 45934 ~

,

Fax (907) 3445934

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. . . . ._ . ._ ____ _ .

To Ms. Beth Prango From Ron J.P. Caron

Pam (925)97M)381 Pagee: 1 1

Phone: (925)975-02$0 note: 05/16/98 l

Ite: NRC Uca>nse Applicabon CC:

X Urgent X ror Review O Please Comment O please neply O Please stocycle

Esth

Sorry streut the confbalen, we will not be vaing Trexler Modelo SMM and 3430-M with the

Cf 292 eewrees. Our application submittal was latended to use geppes with Am and Ce

soureen only.

I greatly appreciate your personal attention in et pediting our application.

K further Irdermetten le regelred, please de not hooltate k contact me.

JO L ---

Men J.F. Caron

Freeldent

. _ _ _ _ _ - _ - _ _ _ _ - - _ _ _ _ - _ _ _ _ _ _ _ _ _

DATE

U.S. NUCLEAR REGULATORY COMMISSION -

[ NRC FORM 386

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78ME

- TELECOPIER TRANSMITTAL

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WARNING:

lAost taesimile machines produce copies on thermal paper. The image produced is highly

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j#nen%& UNITED STATES

[b

g NUCLEAR RESULATORY COMMISSION

g j REGION IV

  • Walnut Creek Field Office

b ,,,,, 1450 Maria Lene, Suite 3oo

Walnut Creek, California 94596-5368

MAY 12 3

Terra Firma Inc.

ATTN: Tamara Selmer '

Vice President

8801 Renden Drive ,

Anchorage, Alaska 99507 )

SUBJECT: ACKNOWLEDGMENT OF REQUEST FOR LICENSING ACTION

REFERENCE: Application dated May 5,1998

We have completed the administrative review and initial processing of your application

for a new license. ,

Please note that the technical review may identify additional omissions in the submitted

information or technical issues that require additional infomiation.

Applications for new licerises are normally processed within 90 days, unless the technical review

identifies:

. Major technical deficiencies

. P.olicy issues that require input and coordination with other NRC Regional offices,

Agreement State offices, or NRC's Office of Nuclear Materials and Safeguards

A copy of your correspondence has been forwarded to our License Fee an'd Accounts Receivable

Branch, Office of the Controller, who will contact you separately if the appryriate license fee has f

not been submitted for your request, or for billing if your request is subject to full cost recovery. I

Any correspondence about this application should reference the Control number listed below.

Sincerely,

~hiAfRJ '

Beth A. Prange

Sr. Health Physicist (Licensing)

Materials Branch

Control No. 572666

I

I

- _ - - _ - _ _ _ - _ _ _ - _ _ - _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ - _ _ - - - - _ _ _ _ _ _ _ - _ - _ _ - _ _ _ _ _ _ _ - _ - _ _ _ _ _ _ _ _ _ - - _ _ _ _ _ _ _ - _ _ _ _ _ ..

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Terra Firma Inc. -2-

]

bec:

Docket File 4

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G:\ 572669.aki

To receive a copy of this document, indicate in the box "C"- Copy without attachment / enclosure

"E"- Copy with attachment / enclosure "N"- No Copy

OFFICE RIV:WCFQ'.MB b

NAME J. Garci B. Prange 8[

lDATE- ,

h2/98 O 6//2/98

.- - -- -- -- -- -_- . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ _ - - _ _ - - - - - _ - __-

,

, - - - - -- - ___

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TERRA FIRMA INC.

- _ _ . _ _ _ _ _ _ _ _ . _ _ _ _

LaForatory Testing & Constmction Monitoring Services

May 5,1998

Nuclear Materials Licensing Section

U.S. Nuclear Regulatory Commission, Region IV

811 Ryan Plaza Drive, Suite 400

Arlington, Texas 76011-8064 4

I

Attention: Ms. Beth Prange

l

Subject: New License Apphcation

!

,

Dear Ms. Prange:

Terra Finna Inc. is submitting two copies of the Application For Material License for your

immediate review. We are a soils laboratory and construction monitoring company operating in

the State of Alaska. As part ofour construction monitoring services we anticipate purchasing five 4

(five) Troxler nuclear densometers used in measuring physical properties of materials, I

specifically, soils and asphalt. The manufacturer models may be any one of the following:

Model 3241

Model Series 3400 (inclusive of all model numbers)

Model 4640B l

!

The attached Conns are from the NUREG-1556, Vol. I booklet and we trust the information

enclosed is in the proper order. Al.;o enclosed is a check for $750.00 for the license fee. Please

do not hesitate to contact either Ron Caron or the undersigned at (907) 344-5934 if you have any

questions or require further information.  !

Sincerely, '1 I

TERRA FIRMA INC. 7

4

.

7

%% W '

Tamara Selmer ., i

Vice President ]

_

Encl.

I

t

!

l 5 22 @

880l Rendon Drive * Anchorage, Alaska 99507 * Phone: 907-344-5934 * Fax: 907-344-5934 * terrafirWalaska. net

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

r ,

l ,

~ t . -

NRC FORM 313 . Appandix A

(748) U. 5. NUCLEAR REGULATORY COMMisseON APPROVED Y 0118: NO. 818NH30

EAPIRES: Te13e

10 CFR 30. 32,23

34, M 30, 3t ang 40 Esemmed bureen per reasones to sempy weh se ardermanen sessene n

mouest T hows. Submfeel el to esoteesen a neesseery le eedomwietWe

pie oosheens e emeses and eiet esseuses psomosume meet le pream e si

-

pubhc homen ene esseny Forward sammente ugereisig bureen asemmle h

the informonen and Romern

,

I

APPLICATION FOR MATERIAL LICENSE "*"a c-a*== * e Monocement fbaneh (T4 F33), U S. Nuelse r

a'aaa oc - '"w = **=--*

Resueten Piesent Ot940120). Olhes of Management see Budgel

Weenagem. DC 20001. NRC may not sensuet er egenser, and a poseen se

not noeuwed to mesend to. e esenaten er : __ untene a employe e

ousney vehe OMS sensel number

INSTRUCTIONS:

SEND TWO COPIES OF EEE THETHE ENTIRE APPROPRIATE

COMPLETED APPLICATION LICENSE APPUCATION TO THE NRC OFFICE GUIDE F

SPECI

APPUCAflood POR DISTsuSUTION OF EXEeIPT PRODUCTS FLE APPUCATIONS WITH:

IP YOU ARE LOCATEJ IIt:

DIVISION OF INDUSTRIAL AND MEDICAL NUCLEAP W

OPPICE OF NUCLEAR MATERIALS SAFETY AND & COUARDS ILLasOIS, ledOaANA IOWA SAICHIGAN. BNetNESOTA M$80URI, OHIO, Ost W'erm

U $ NUCLEAR REOULATOftY PfWam88'Nd SENO APPUCATIOest 70-

WASHINGTON. OC 20506 4001

MAMRIALS UCENSNQ SECTION

ALL OTHER PERSOest FILE APPUCATIONS A8 POLLOWS

U S. NUCLEAR REGULATORY COMMISSION. REGION B

F YOU ARE LOCATED m: 801 WARRENVLLE RD.

URLE,L 806324361

OOessetCTICUT, DELAWARE, DISTItiCT OF COLualSA IIAME, eAARYLANO,

htASSACMUSETTS, esEW MAmoreHNts, esEW JERSEY, ffEW YORK, PEstNSYLVANLA, ALASMA **"* ARRAe8SAS, CAUPOftedlA, COLORADO, MAWAN, CANO. KANSA

RMOOE ISLANO, oft 44880887, SEsfD APPUCAfsDNS TO: LOUmlAMA, teOesTANA NEARASMA edEVADA,9 DEW RIEJUCO. NORTM DAKOTA,

UCENSING ASSISTANTSECTION

OKLAHOGAA, OREGON, PACIPic TRUST TERft!TO8tES, SOUTH DAs OTA, TEKAS

WASHINGTOed, Oft WTOeflNG, SENO APPLICATIOees TO:

NUCLEAft MATERIALS SAFETY BRANCH

U S NUCLEAR REOULATORYema***r'W REGION 1 .

N'JCLEAR MATERIALS LCENSING SECTION

47$ ALLENDALE ROAD

U S NUCLEAR REQULATORY COMM6 MON. REGION IV

10NG OF P0tVSSIA. PA 1940E 1415 011 RYAN PLAZA DRIVE. SurrE 400

ARLNGTON. TX 780114064

m masa FLORIDA,0E08104A, KENTUCMY, MatteSSIPP1,80014TH CAROUNA PUERTO

RIOO. SOUTH CAROLMA, TENNESSEE, VIROINLA, vist08N ISLANOS 04 WEST VWt04NIA,

GENO APPUCAfsDe88 70;

NUCLEAR MATERIALS LICENSING SECTION

U & NUCLEAR REGULATOftY r.mmman". REGION N

101 MARIETTA STREET. NW. SulTE 200

ATLANTA, GA 30323 4100

PgsteOest LOCATED IN 'a**'*88*87 STATES SENO APPUCATIONS TO THE U.S. NUCLEAR REGULATORY OOeMstSSION O

SAATERIAL M STATES SUBJECT TO U.S. NUCLEAR REOULATOftY haa***" JustiSDICTIONS SS AND USE UCEssSED

1.

Tvet b8 AN APPUCATION FOft (CAose n ~ seem) 2

TA

~

NEW uCENSE NAME AND MALNG ADORESW ANAM W&M

B AMENDMENT TO UCENSE NUMeER Terra Firma Inc.

]C RENEWAL OF LCENSE NUMPER 8801 Rendon Drive

Anchorage, Alaska 99507

ADOREsS(ES) WHERE UCENSED MATEmAL WLL BE USED OR primesmem

4

NAME OF PEPVIN TO BE CONTACTED ABOUT THIS

Motste-Density Por1able gauges wdl be stonsd at 8801 Rendon Dnve, APPUCATION

Anchorage, Alaska,99507. Gauges mil be dispatched from 8801 Rendon Ron J.P. Caron

Dnve and used only at ternparary Job snes for itmited penods of time for the

purpose of mensunng physical properties of rnatenals (sods and/or asphal" TELem NuMaER

M01) 394-5934

SUBMff

8 RAD'OACTTVE ffEMS

MAfr hAL. S THROUGH 11 ON &1/2 X 11" PAPER THE TYPE AND SCOPE OF INFORMATION _

.

e Element one mese number D. Chomscal enerer physsel almn, and s mammum amount

ween .m mees.amessienyoneame S

PURPOSE (S) FOR WMCH UCENSED MATERIAL WILL BE USED.

T.

INOMDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND ThaR

TltAINHO EXPEftfENCE.

p

e FACLfDES AND EQUIPMENT l

10. RADIATION SAFETY PROGRAM

ti. WASTE MANAGEMENT in UCENSEE FEES (see 90CFR f10mc h-,- 11031)

FEE CATEoORY P

13. CERTIFICATION. (eduef to - @O1 $750.00

UPON THE APPUCANT TeF . - , THE APPUCAP(IUNDERSTANDSTHAT ALL STATEMENTS AND REPRES6NTATIONS MADE N THa8 APPUC

THE APPUCANT AND ANY OFFICIAL EXECUTNG THtt CERTIFICATION ON BEHALF OF THE APPUCANT, NAMED W

CossFORMrrY WTTH TTTLE 10. CODE OF FEDERAL REGULATIONS. PARTS PC. 32. 73. 34 alk 3

CoststECT TO THE BEST OF THElft KNOWLEDGE AND DEUEF.

WARpeNQ 18 U S C. SECTION 1001 ACT OFJUNE 261844 02 STAT T40 MAMES ff A CftlMN/.c DFFENSE N

ANY DEPARTMErff OR AGENCYOF THE UNrTED STATES AS TO ANY MATTER WfTHW FTS JUR 8DICTICIfg,

TOO MAKE A WILL

! _ _ _

CaRTIFYING OFFCER - TYPE 7PRWTED NAME AND TTrL

)

! hcpOsu,tE7i l -

EI- DATE

WS/D

TYPE aF ,EE PEE loo

FOR NRC U6E ONLY

FEECaTEoORY l ~~ wT p ECErvED CHECuNuMSER COMueN'S

}s

APPROVEosv

oATE

NftC fores 313 (T40)

Page A-1 PRIMTED ON RECYCLEO PAPER

NUREG - 1556. Vol.1

~ -_.

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APPENDIX B

i

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ITEMS 5 & 6: MATERIALS TO BE POSSESSED AND PROPOSED

'

USES

YES j NO RADIOISOTOPE MANUFACTURER / QUANTITY MOST SPECIFY

MODEL NO. COMMON USE OTIIER USES

i NOT LISTED

ON SSD

CERTIFICATE

Cesium-137 Scaled sources in Not to exceed Measure Physical [ ] Not apphcable

'y compatible gauges as maximum activity Properties of

specified in Scaled per source as Materials t ] Uses are:

Source and Device specified in Scaled

Registration Sheet Source and Device

Registration Sheet

Americium-241 Scaled neutron sources Not to exceed Measure Physical [ ] Not applicable

in compatible gauges as maximum activity Properties of

X specified in Scaled per source as Materials [ ] Uses are:

'

Source and Device specifie.1 in Scaled

Registration Sheet Source and Device

Registration Sheet

Califormum-252 Scaled neutron sources Not to exceed Measure Physical [ ] Not apphcable

in compatible gauges as maximum activity Properties of

i specified in Scaled per source as Materials

y Source and Device specified in Scaled

[] Uses are:

Registration Sheet Source and Device

Registration Sheet

Other (specity)

FINANCIAL ASSURANCE REQUIRED AND EVIDENCE OF FINANCIAL ASSURANCE PROVIDED

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Page B-1 NUREG - 15 56, Vol. I

_ _ _ _ _ - _ _ _ - _ - _ _ - _

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APPENDIX B ,

ITEMS 7 THROUGH 11: TRAINING AND EXPERIENCE, FACILITIES

AND EQUIPMENT, RADIATION SAFETY PROGRAM,

AND WASTE DISPOSAL

ITEM NO. AND TITLE SUGGESTED RESPONSE YES ALTERNATIVE ,

'

PROCEDURES

ATTACHED i

7. INDIVIDUAL (S)

RESPONSIBLE FOR

Before obtainmg licensed materials, the proposed RSO will have [] {j

successfully completed one of the training courses described in

RADIATION SAFETY Criteria in the section entitled " Individual (s) Responsible for

PROGRAM AND x

Radiation Safety Program and Their Training and Experience -

THEIR TRAINING Radiation Safety Officer" in NUREG-1556, Vol.1, dated May l

AND EXPERIENCE. 1997.

RADIATION SAFETY AND

OFFICER Before being named as the RSO, future RSOs will have

successfully completed one of the training courses described in

Name: Criteria in the section entitled " Individual (s) Responsible for

Ron J.P. Caron Radiation Safety Program and Their Trainmg and Experience -

Radiation Safety Officer"in NUREG-1556. Vol.1. May 1997.

8. TRAINING FOR Before usmg hcensed matenals, authonzed users will have

INDIVIDUALS

[] []

successfully completed one of the training courses described in X

WORKING IN OR Criteria in the section entitled " Training for Individuals Working

FREQUENTING In or Frequenting Restricted Areas"in NUREG-1556, Vol. I,

RESTRICTED AREAS dated May 1997.

9. FACILITIES AND No information needs to be submitted m response to this item; Separate item 9 Response

EQUIPMENT key issues are addressed under " Radiation Safety Program - Need Not Be Submitted

Public Dose" and " Radiation Safety Prograin - Operating and With Application

Emergency Procedures",

j

10. RADIATION SAFETY The apphcant is ngl required to, and should not, submit its audit Need Not Be Submitted

PROGRAM - AUDIT program to the NRC for review during the licensing phase. With Application

PROGRAM

10. RADIATION SAFETY The apphcant is nDI required to submit a response to the Need Not Be Submitted

PROGRAM - termination of activities section during the initial application. With Application

TERMINATION OF However, when the license expires or at the time the licensee

ACTIVITIES teases operations. FRC Form 3R must be submitted.

10. RADIATION SAFETY We will either possess and use, or have access to and use, a

PROGRAM - SURVEY radiation survey meter that meets the Criteria in the section [{

-

[]

INSTRUMENTS entitled Radiation Safety Program - Instruments" in NUREG-

1556. Vol.1. dated May 1997. in the event of an incident.

10. RADIATION SAFETY Physical inventories will be conducted at intervals not to exceed

PROGRAM -

[] [}

6 months, to account for all sealed sources and devices received

MATERIAL RECEIPT and possessed ur der the license. X

AND

ACCOUNTABILITY

10. RADIATION SAFETY Either we will maintam, for mspection by NRC, documentation

PROGRAM -

[] []

demonstrating that unmonitored individuals are not likely to

OCCUPATIONAL receive a radiation dose in excess of 10% of the allowable limits X

DOSIMETRY in 10 CFR Part 20 or we will provide dosimetry processed and

evaluated by a NVIAP-approved processor that is exchanged at

a frequency recommended by the processor.

10. RADIATION SAFETY The applicant is nol required to submit a response to the public Need Not Be Submitted

PROGRAM - PUBLIC dose section during the licensing phase. This matter will be With Application

DOSE examined during an inspection.

NUREG - 1556, Vol.1 Page B-2

_ _ _ _ _ 1

_ ____-__

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APPENDIX B

l

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ITEM NO. AND IIILE SUGGESTED RESPONSE YES ALTERNATIVE

l PROCEDURES

A'ITACHED

10. RAulATION SAFETY We will implement and maintain the operating and [] []

I PROGRAM - emergency procedures in Appendir H of NUREG-1556, X

'

OPERATING & Vol.1, dated May 1997, and provide copies of these

'

G

g procedures to all gauge users and at each job site.

OR gj

Operating and emergency procedures will be developed.

implemented, and maintained and will meet the criteria in l

the section entitled " Radiation Safety Program - Operating

and Emergency Procedures" in NUREG-1556, Vol. I,

dated May 1997.

i 10. RADIATION SAFETY Leak tests will be performed at inte Yals approved by the [] []

[ PROGRAM - LEAK NRC or an Agreement State and specified in the Sealed The information in

X

l TEST Source and Device Registration Sheet. Leak tests will be #Pendix J

' supporting a

performed by an organization authorized bv NRC or an

Agreement State to provide leak testing seEvices for other Ped

licensees or using a leak test kit supplied by an

Qu _d

,,,p , ,,,g y ,g, g,

g

organization authorized by NRC or an Agreement State to attached.

provide leak test kits to other licensees and according to

the kit supplier's instructions.

10. RADIATION SAFETY ROUTINE C1 EANING & LUBRICATION

PROGRAM -

MAINTENANCE We will implement and maintain procedures for routine U II

maintenance of our gauges according to each

manufacturer's recommendations and inst:uctions.

NON-ROUTINE MAINTENANCE . [q

'

[]

The information

We will send the gauge to the manufacturer or other listed in #pendix

person authorized by NRC or an Agreement State to G supporting a

perform non-routine maintenance or repair operations that mruest to pedom

require the removal of the source or source rod from the ""f',"" g

gauge.

house is attached.

10. RADIATION SAFETY Re applicant is act required to submit its response to Need Not Be Submitted

PROGRAM - transportation during the licensing process. However, this With Application

TRANSPORTATION issue will be reviewed during inspection.

11. WASTE he applicant is not required to submit a response to waste Need Not Be Submitted

MANAGEMENT - management during the licensing process. However, the With Application

GAUGE DISPOSAL & licensee should develop, implement, and maintain gauge

TRANSFER

transfer and disposal procedures in its radiation protection

program.

Page B-3 NUREG - 1556, Vol. I

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.

.

TERRA FIRMA INC.

Laoratory Testing & Construction Monitoring Services

s Facility Location

and Storage Area

8801 Rendon Drive

Anchorage, Alaska 99507

(907)344-5934

Pa. king Area

.. - -

f

j

Overhead Bay Door Locked

Storage

, y,;,,,,_g g,3,,

tu,rneters stored

-

Area in k=LiJ urut on

nonh side of

_.

(6'xb')

Secured

l laixratory. Gagxs

f may consist orany

Door --*- of the following

Access M'xlel3241

Mixiel Series 34(X)

LABORATORY (*ll i"cl""I)

.g and Matel 4640)

E (550 sq/ ft. )

F

'is

$

$

m Work Bench

u

l'

Secured Door

Access (Entry

into 2nd floor

Office Area)

+- Main Entrance

OFFICE AREA

(Located on 2nd Floor)

880l Rendon Drive * Anchorage, Alaska 99M7 * Phone: 907-344 5934 * Fax: 907-344-5934 *

terrafir@ alaska. net

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