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Category:Administrative Form
MONTHYEARML24009A2292024-01-25025 January 2024 NRC Form 896 - Topical Report Verification on the Radiological Fuel Qualification Methodology for Dry Storage Systems ML22322A1312022-10-28028 October 2022 NRC Form 653 - Transfers of Industrial Devices Report (to General Licensees) ML22167A1642022-08-0303 August 2022 OMB Copy NRC Form 314 ML22193A1682022-07-11011 July 2022 2022 NRC 620 Certification for 10 CFR Part 60 ML22214B6492022-07-11011 July 2022 Cz USA, NRC 532 - Ssd 22 17 ML22074A2872022-05-26026 May 2022 NRC Form 244 ML22117A2142022-04-26026 April 2022 NRC Form 620 for OMB Clearance No. 3150-0120, NRC Form 313 ML22028A0152022-03-25025 March 2022 NRC Form 653, 653A, 653B (OMB Copy) - Transfer of Industrial Devices Report (to General Licensees) ML20252A1332020-09-0808 September 2020 Nuclear Materials Relief Request Online Form ML19289B9592019-10-24024 October 2019 Defense Threat Reduction Agency Approval Form ML19164A1182019-06-13013 June 2019 Environmental Resource Associates NRC 532, Mcn: 612433 ML19063B1642019-04-0101 April 2019 NRC 313A (Aud) - Authorized User Training, Experience and Preceptor Attestation ML19063B1672019-04-0101 April 2019 NRC Form 313A, Radiation Safety Officer of Associate Radiation Safety Officer Training, Experience and Preceptor Attestation ML19063B1682019-04-0101 April 2019 NRC Form 313A (Aus) - Authorized User Training, Experience and Preceptor Attestation ML19063B1692019-04-0101 April 2019 NRC Form 313A, Authorized User Training, Experience, and Preceptor Attestation ML19063B1722019-04-0101 April 2019 NRC Form 313A (AMP) - Authorized Medical Physicist or Ophthalmic Physicist, Training, Experience and Preceptor Attestation ML18135A2152018-08-14014 August 2018 NRC Form 244, Registration Certificate - Use of Depleted Uranium Under General License 2024-01-25
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MONTHYEARML24009A2292024-01-25025 January 2024 NRC Form 896 - Topical Report Verification on the Radiological Fuel Qualification Methodology for Dry Storage Systems ML22322A1312022-10-28028 October 2022 NRC Form 653 - Transfers of Industrial Devices Report (to General Licensees) ML22167A1642022-08-0303 August 2022 OMB Copy NRC Form 314 ML22193A1682022-07-11011 July 2022 2022 NRC 620 Certification for 10 CFR Part 60 ML22214B6492022-07-11011 July 2022 Cz USA, NRC 532 - Ssd 22 17 ML22074A2872022-05-26026 May 2022 NRC Form 244 ML22117A2142022-04-26026 April 2022 NRC Form 620 for OMB Clearance No. 3150-0120, NRC Form 313 ML22028A0152022-03-25025 March 2022 NRC Form 653, 653A, 653B (OMB Copy) - Transfer of Industrial Devices Report (to General Licensees) ML20252A1332020-09-0808 September 2020 Nuclear Materials Relief Request Online Form ML19289B9592019-10-24024 October 2019 Defense Threat Reduction Agency Approval Form ML19164A1182019-06-13013 June 2019 Environmental Resource Associates NRC 532, Mcn: 612433 ML19063B1642019-04-0101 April 2019 NRC 313A (Aud) - Authorized User Training, Experience and Preceptor Attestation ML19063B1672019-04-0101 April 2019 NRC Form 313A, Radiation Safety Officer of Associate Radiation Safety Officer Training, Experience and Preceptor Attestation ML19063B1682019-04-0101 April 2019 NRC Form 313A (Aus) - Authorized User Training, Experience and Preceptor Attestation ML19063B1692019-04-0101 April 2019 NRC Form 313A, Authorized User Training, Experience, and Preceptor Attestation ML19063B1722019-04-0101 April 2019 NRC Form 313A (AMP) - Authorized Medical Physicist or Ophthalmic Physicist, Training, Experience and Preceptor Attestation ML18135A2152018-08-14014 August 2018 NRC Form 244, Registration Certificate - Use of Depleted Uranium Under General License 2024-01-25
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NRC FORM 653 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY 0MB: NO. 3150-0001 EXPIRES: 11/30/2022 (12-2019) Estimated burden per response to comply with this mandatory collection request: 36 10 CFR 32 TRANSFERS OF INDUSTRIAL minutes. NRG requests quarterly reports to keep apprised of device movements. Send comments regarding the burden estimate to the lnfomnation Services Branch (T-6 A10M),
DEVICES REPORT U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to lnfocollects.Resource@nrc.gov, and to the Desk Officer, Office of lnfomnation and (TO GENERAL LICENSEES) Regulatory Affairs, NEOB-10202, (3150-0001), Office of Management and Budget, Washington, DC 20503. If a means used to impose an infomnation collection does not (Continue on NRG Form 653, 653A or 6538, as appropriate) display a currently valid 0MB control number, the NRG may not conduct or sponsor, and a person is not required to respond to, the infomnation collection.
For each "licensee" to whom a device(s) has been transferred during the reporting period, supply the following:
Name of Vendor Reporting Period Leidos, Inc.
From To License Number 07/01/2022 09/30/2022 Intermediate Person(s) (if any)
Name of Intermediate Persons(s) Name of Responsible Individual Tille of Responsible Individual Business Telephone Number Name of Intermediate Persons(s) Name of Responsible Individual Tille of Responsible Individual Business Telephone Number General Licensee Information Name of General Licensee Malling Address at the Location of Use (No P.O. Boxes, include zip code)
- No distributions to report ****
11-------------------....-----------l Name of Responsible lndlvldual IBusiness Telephone Number Submitted 28 October 2022 By: Daniel Madson (RSO) r)
Voice: 858.826.9~?~-~85~28.~
TIiie of Responsible Individual eMail: madsond@/o~ /p/
Information on Device(s) Transferred \ / -I'>> ,,
7 / /
Date of Transfer Type of Device Model Number Serial Number Activity and Units L/
Intermediate Person(s) (if any)
Name of Intermediate Persons(s) Name of Responsible Individual Tille of Responsible Individual Business Telephone Number Name of Intermediate Persons(s) Name of Responsible Individual Tille of Responsible Individual Business Telephone Number General Licensee Information Name of General Licensee Malling Address at the Location of Use (No P.O. Boxes, Include zip code)
Name of Responsible Individual IBusiness Telephone Number Title of Responsible Individual Information on Device(s) Transferred Date of Transfer Type of Device Model Number Serial Number Isotope Activity and Units NRG FORM 653 (12-2019) Page of