ML24012A089

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GL Registration from Dominion Virginia Power
ML24012A089
Person / Time
Site: North Anna  Dominion icon.png
Issue date: 12/07/2023
From: Hilbert L, Simmons G
Dominion Energy Virginia, Virginia Electric & Power Co (VEPCO)
To:
Document Control Desk, Office of Nuclear Material Safety and Safeguards
References
23-341, GL-700115-29
Download: ML24012A089 (1)
v • d • e


Text

VIRGINIA ELEcrruc AND POWER CoMPANY

RICHMOND, VIRGINIA 23261

December 7, 2023

Director, Office of Nuclear Material Safety Serial No.23-341 and Safeguards NAPS/RAP ATTN: Document Control Desk/GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION ENERGY VIRGINIA)

NORTH ANNA POWER STATION UNITS 1 AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES

In accordance with 10 CFR 31.5, enclosed is NRG Form 664, General Licensee Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. G. R. Simmons at (540) 894-2107.

Sincerely,

~ad)-

Lisa Hilbert Site Vice President

Enclosure

Commitments made in this letter: None.

cc: U.S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, DC 20555-0001

U. S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta Georgia 30303-1257

NRC Senior Resident Inspector North Anna Power Station UNITED STATES NUCLEAR REGULATORY COMMISSION WASHINGTON, D.C. 2055~01

11/15/2023

TO: Users of Devices Subject to General License Registration

SUBJECT:

ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES

The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices. Information about the general license registration program is available at the following NRC website:

https://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html

Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:

Director, Office of Nuclear Material Safety and Safeguards ATTN: Document Control Desk/GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001

Registration Fee: Commission regulations (10 CFR 170.31, Category 30) require that you submit a registration fee with each registration on an annual basis. The registration fee is subject to change yearly, and you are required to submit the fee that is in effect as of the date of this letter. An invoice for the current amount due will be sent to you under separate cover. If you have any questions about the fee or the invoice, please contact the License Fee Billing Help Desk at (301) 415-7554 or e-mail at fees.resource@nrc.gov.

NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.

Attachment:

NRC Form 664 -- General Licensee Registration and Instructions

Sincerely,

/RA/

U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Materials Safety, Security, State, and Tribal Programs Materials Safety and Tribal Liaison Branch TO: Users of Devices Subject to General License Registration

SUBJECT:

ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES

The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices. Information about the general license registration program is available at the following NRC website:

https://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html

Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:

Director, Office of Nuclear Material Safety and Safeguards ATTN: Document Control Desk/GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001

Registration Fee: Commission regulations (10 CFR 170.31, Category 30) require that you submit a registration fee with each registration on an annual basis. The registration fee is subject to change yearly, and you are required to submit the fee that is in effect as of the date of this letter. An invoice for the current amount due will be sent to you under separate cover. If you have any questions about the fee or the invoice, please contact the License Fee Billing Help Desk at (301) 415-7554 or e-mail at fees.resource@nrc.gov.

NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.

Attachment:

NRC Form 664 - General Licensee Registration and Instructions

Sincerely,

/RA/

Joseph D. Rolland U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Materials Safety, Security, State, and Tribal Programs Materials Safety and Tribal Liaison Branch Dirstribution: MLXXXXXXXXX MSTR r/f Office NMSS Name J. Rolland Date 11/15/2023 OFFICIAL RECORD ONLY 11111111 11111111 11111111111 11111 111111111111111 IIII IIIIII IIIII IIII IIII I llllllll llll lllll llll 111111111111111111

GL-700115-29 SECTION 1 11/03/2023 PAGE 1 of 2 NRC FORM664 (11 - 2022) U.S. NUCLEAR REGULATORY COMMISSION

10CFR31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 3150-0198 0MB EXPIRATION DATE: 11/30/2025 EstJmated burden per response to comply wrth thl8 mandatory collectlon request 20 minutes N RC wiU use this information to track general hceneees and their devlcee to ensure a tug her level of device accountablDty Send comments regarding burden estimate to the FOIA, l.Jbrary, and I nformatJon Collect!ons Branch (T -6 A 1 OM), U S Nuclear Regularo!y ComrruSS1on, W3shlngton, DC 20665-0001, or by a-mall to lnfocollect! Reeource@nrc gov, and the 0MB reviewer at 0MB Office of lnformatron and Regulatory AffaJrs, (3150-0198), Attn Desk Officer for the Nuclear Regulatory Comm1Se1011, 725 17th Street NW, Wsehmgton, DC 20603; a-mall: 0[8 subrrqsJon@omb eoo goy. The N RC may not conduct or sponsor, and a person 1s not required to respond to, a collection of informatJon unless the document requesting or requmng the coUectlon dJsplays a currently valid OM B control number Complete all six sections of this registration fonn. If any of the preprinted Information Is Incorrect, provide the changes In the appllcable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-700115-29

Enter the company name and the street address for the physical location of use for your devlce(s). For portable devices, specify the primary storage locatlon. Do not use P.O. Boxes.

Company Name: DOMINION VIRGINIA POWER r I.I I. I f I I I Department l I: I I Address Line 1: 1022 HALEY DRIVE I I I [

Address Line 2: END OF ROUTE 700 I I* I. I' r I 1: 1* 1: I: l I [ I I I r t [ I: 1, I. l City: MINERAL -:

I 1: I I I. I r I I I: I: I l I: I: I 1. I. I. I l I I

State:VA rn Zip Code: 231174527 I I r r I* I - I: I I I,.

I 111111111111111 11111111111 11111 111111111111111 IIII IIIIII IIIII IIII IIII I llllllll llll lllll llll 111111111111111111 GL-700115-29 11/03/2023 SECTION 1 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, telephone number and title of the person who is the responsible individual for the devlce(s).

Last Name: SIMMONS I I I I I I I I I I I I I I I I r I I I I I I I

First Name: GEORGE Middle Initial: R 11111111111111 D Business Telephone Number: (540) 894-2107 Extension-

! I I 11 I I 11 r I I I I I I I I I Business E-mail Address* Bob Simmons@dominionenergy.com I I I I I I I' I I I I I I I I I I I I I I l I t I I I I I I I litle: RAD PROTECTION MANAGER I I I I I I I I I I I I I I I I I I I I I I I I

Enter the mailing address where correspondence regarding your devlce(s) should be sent.

Department NORTH ANNA POWER STATION I I I. I I I I I I I I I I I I I I I I I I I I I

Address Line 1: 1022 HALEY DRIVE I I I I I I I I I I I I I I I I I I I I I I 1* I Address Line 2* END OF ROUTE 700 I I I 1. I I I I I I I I I I I I I I I I I r I I City: MINERAL I I I I I I I I I I I I I I I I I I I I I I I I

State: VA rn Zip Code: 231174527 I I I I I I - I I I I I I IIIIIII IIIIII II IIIIII IIIII 11111 lllll lllll lllll llll 1111111111111111111

  • 11111111111111111I IIII IIII IIII

GL-700115-29 SECTION 2 11/03/2023 SECTION 2 - DEVICES SUBJECT TO REGISTRATION Our records Indicate that you have these devices. Please update the Information as necessary. PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number)

Distnbutor/Distributed By: Metorex Incorporated I I I I I I I' I I, I t I' I r I I I I I I I I I I Distributor License Number: 29-30342-02G I I I I I I I I I I i, I I I Manufacturer name: METOREX, INC I I I I I I I I I I I I I I I I I I I I I I I I Device Model (Not Source Model): OOPS I I I I I I I I I I I I I I I I I I I I I I I, I Device Serial Number: 128018 I I I I l I I I I I I I I I I I I I I I I I I I

Transfer Date: 08/12/1999

Not In possession of device (Also

[IJITJI I I I I complete Section 4.)

MM DD yyyy

Isotope (e.g. AM241) Activity (e.g. 1005), Unit (e.g. mC1) 1 AM241 30 mC1 I I I I I I I I I I I I I I I I I I I l~I ~I I 2 CD109 10 mC1

111111 1111111111111 ~11~11 3

r---T""I 1-----r--l ---.--I.,......--,I I I I I I I I I I I I I I I I I I I 4 1~1-1

~I ~I I I I I I I I I I I I I I I I I I I 5

~,,-,~,~,, 1111111111111 1111 6

I I I I I I I I I I I I I I I I I I I I I I I I o

111111111111111111111111111 111111111111111 11111 111111111111111 IIII IIII I 11111111111111111 111111111111

GL-700115-29 11/03/2023 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION SECTION 3 PAGE 1 of 1 Provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name I I Initial Transferor Name I I I I I I Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

I I I I I I I I I I I Device Serial Number I I I I I I I I I I I How acquired and date (e.g., 0 Manufacturer/Initial Transferor listed above from a_ distnbutor/manufacturer,

  • Other General Licensee Date Transferred: ~ u:J}] I ?-IO I l IO I other licensee, other source)? ~

O Other Sources MM DD YYYY

Isotope (e.g. AM241) Activity(eg.100) Unit (e g mC1)

1* N j 6., I \\0 Im le i

2. I I
3. I I
4. I I
5. I

6.

7

8.

9.

10.

I 111111111111111 11111111111 11111 111111111111111 IIII 111111111111111 IIII I llllllll llll 11111111111111111 GL-700115-29 11/03/2023 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide Information about devices listed In Section 2 or 6, but no longer in your possession. PAGE 1 of 1

Part 1 Transfer Date:

~~~ ~:~:n~~-r6) lg 1~ ls-I 3 1, I I I 1- @ill uJI] I~ IO Ii 13 I MM DD YYYY Location of the Device:

0 Whereabouts Unknown (Complete Part 1 only) 0 Transferred to another general licensee (Complete Parts 2 and 3) 0 Never Possessed the Device (Complete Part 1 only) 9 Transferred to a Specific 2 ) Licensee (Not the manufacturer) 0 Returned to Manufacturer (Complete Part 1 only) (Complete Part Part 2 License Number of Recipient (if transferred to a specific licensee):

IR Io 1~ I, Io lo I I I I I I I I Company Name:

I WI q Is It' I e I k;: I" I A I f I r Io I / I lf If I e le I i I ~ I I I j Is I+ IF I I I Department le Io I°' Ir I 0 I e-I+ I I w I q Is I t I e I I.o I ~ Is If I o l.s I Cf I, I I ~ I q I c. I. I Address Line 1:

I q I q I q la I I wl e I r I + I I 1+ I ; ~ I h I w l t{ I 7 I I, I 1 I t I I I I I I Address Line 2:

I I I I I I I I I I I I ! I I I l I I I I I I I I I City:

I.A:lo Ill CI: e lw 15 I I I I I I I I I I I I I I I l I I I 8ta te* JTI X I Zip Code: J 7 lq 17 I l J j I - I I I I I

Part 3 Enter the name of the individual responsibe for this device:

Last name*

I I I I I I I I I I I I I I I I I. I I I I I I I I I I I First name. Middle Initial:

11111111111111 D

~~~:~ Telephone I I I I* I I I I ~I ~I ~I ~I ~I Extension*.----I r-----,1 1.--------.1--,1---,1

liUe*

I I I I I I I. I I I I I I I I I I I I I I. I I I I I I I I IIIIIII IIIIII II IIIIII IIIII 11111 IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII I IIIIIIII IIII IIIII IIII IIII IIII GL-700115-29 11/03/2023 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide Information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1 of 1

Part 1 Transfer Date*

~:~~:~~nK;~:r6) 161Bl9IYl~l8 I I ~[ilz]l?-lo l?-IJ I MM DD YYYY Location of the Device:

0 1/v'hereabouts Unknown (Complete Part 1 only) O Transferred to another general licensee (Complete Parts 2 and 3) 0 Never Possessed the Device (Complete Part 1 only) S Transferred to a Specific Licensee (Not the manufacturer) 0 Returned to Manufacturer (Complete Part 1 only) (Complete Part 2)

Part 2 License Number of Recipient (if transferred to a specific licensee):

IDIQl~l-131~1 I I I I I I I Company Name:

l2 I u I r le I )' I I£ 1.. 1.., I e I I' I I J I+ I q I t I i IO I(\\ I I I I I I Department:

Is It I c I~ Ir I; I~ I y I I I I I I I I I I I I I I I I I Address Line 1:

Is I s--1 7 IO I I H-1 " 17 I tr: Is I, I g I" I J I I 11, Io I g I J I I I I I I Address Line 2:

I I I I I I I I I I I I I I I I I I I I l-I I I I I I City:

l.s I" Ir I(' I yl I I I I I I I I I I I I I I I I I I I I I 8ta te: ~ Zip Cod9' 12 I J I ~ I B I 1 I - I I I I I

Part 3 Enter the name of the individual responsibe for this device:

Last name:

I I I I I I I I I I I I I I I I I I I I I I I I I I I First name: Middle Initial.

11111111111111

~~~~~~s Telephone I I j 11 I I I ~I.....--I ~I --r-1 ---,I Extension: -1 ~I I~. l____,l___,I

Title:

I I I I I I I I I I I I I I I I I I I I I I I I I I 11111111 1111111111111111111 11111 111111111111111 IIII 111111111111111 IIII I llllllll llll 11111111111111111

GL-700115-29 SECTION 5 - CERTIFICATION SECTION 5 11/03/2023 PAGE 1 of 1

I hereby certify that:

A All information contained in this registration Is true and complete to the best of my knowledge and belief.

8. A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C. I am aware of the requirements of the general license, provided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http:/. * -rm/doc-collections/cfr)

SIGNATU - RESPONSIBLE INDMDUAL (Listed in Section 1) DATE

WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

'11111111111111111111111111111111111111111111111 IIII IIIIII IIIII IIII IIII I llllllll llll 11111111111111111 GL-700115-29 11/03/2023 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 1 of 2

NRC Device Key: 547351 Manufacturer License No: MD-31-076-01

Manufacturer Name* CONCO SERVICES CORP.

Model Number* 101 Serial #: N596 Transfer Date: 02/15/1994

Isotope: Nl63 Activity: 5 Unit: mCi

NRC Device Key: 689428 Manufacturer License No* 20-15525-04G

Manufacturer Name: GE ION TRACK

Model Number ITEMISER Ill Senal #: 09-8424 Transfer Date. 06/30/2003 Isotope: Nl63 Activity: 10 Unit. mCi

NRC Device Key: 707159 Manufacturer License No

Manufacturer Name: METOREX, INC.

Model Number. 880 Serial#: 128018 Transfer Date: 02/27/2002

Isotope: CD109 Activity: 10 Unit mC1

NRC Device Key: 825331 Manufacturer License No: 12-04933-04G

Manufacturer Name* PERKINELMER LIFE SCIENCES

Model Number: 8310000 Serial#'. DG08129527 Transfer Date. 07/20/2012

Isotope: BA133 Activity: 20 Unit: uCi

NRC Device Key: 859758 Manufacturer License No* MA-15-5254

Manufacturer Name* MORPHO DETECTION, INC.

Model Number. ENTRYSCAN Ill Serial#: 09-15947(ES4 -150009) Transfer Date: 12/02/2006

Isotope: Nl63 Activity: 10 Unit mCi

NRC Device Key: 859759 Manufacturer License No: MA-15-5254

Manufacturer Name: MORPHO DETECTION, INC.

Model Number. ENTRYSCAN Ill Serial #: 09-14086(ES4-150007) Transfer Date: 12/29/2005

Isotope. Nl63 Activity: 1 O Unit* mC1

NRC Device Key: 859760 Manufacturer License No. MA-15-5254

Manufacturer Name. MORPHO DETECTION, INC.

Model Number: ENTRYSCAN Ill Serial#* 09-14085(ES4-150004) Transfer Date: 08/20/2006

Isotope: Nl63 Activity: 10 Unit* mCi

  • 111111111111111111111111111 11111 1111111111 11111 1111 lll1111111111111111 111111111111111111 111111111111 GL-700115-29 11/03/2023 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 2 of2

NRC Device Key: 859761 Manufacturer License No: MA-15-5254

Manufacturer Name: MORPHO DETECTION, INC.

Model Number: ENTRYSCAN Ill Serial#: 09-14254(ES4-150002) Transfer Date: 02/08/2006 Isotope: Nl63 Activity: 10 Unit mCi

NRC Device Key: 859762 Manufacturer License No: MA-15-5254 Manufacturer Name: MORPHO DETECTION, INC Model Number. ITEMISER Ill Serial #: 09-15454 Transfer Date: 02/13/2020 Isotope: Nl63 Activity: 10 Unit mCi

NRC Device Key: 859763 Manufacturer License No: MA-15--5254

Manufacturer Name: MORPHO DETECTION, INC.

Model Number: ITEMISER Ill Serial#: 09-12990 Transfer Date: 02/13/2020 Isotope: Nl63 Activity: 1 O Unit mCi

NRC Device Key: 859764 Manufacturer License No: MA-15-5254

Manufacturer Name: MORPHO DETECTION, INC.

Model Number: ITEMISER Ill Serial #. 09-20943 Transfer Date: 01/20/2011 Isotope: Nl63 Activity: 10 Unit mCi

NRC Device Key: 859765 Manufacturer License No: MA-15-5254 Manufacturer Name: MORPHO DETECTION, INC.

Model Number: ITEMISER Ill Serial #". 09-23953 Transfer Date: 09/20/2013 Isotope: Nl63 Activity* 1 0 Unit: mC1

  • GE Ion Track e.

April 29, 2003

SURRY POWER STATIQN(SURRY,VA):

Congratulations on the purchase of your Itemiser~ detection system. We trust that it will give you many years of service.

The instrument, (device}, contains an ultra sehsltive Ion Trap Mobility Spectrometer, which utilizes a radioactive source to provide a means of Ionizing the sampled air.

The radioactive source is emitter: none of the radiation from this a Ni-63 beta radiation source. Nl-63 source can penetrate the internal is a low-energy beta assembly and expose the operator. However, in order to ensure that no Ni-63 leaks from the source holder, the device must be leak tested annually. You will be contacted approxlmately 30 days prior to the leak test due date with more Information on this leak test requirement. There are *no serviceable parts In the detector and no attempt to access the source or detector must be made.

Possession and use of the device Is governed by Code of Massachusetts Regulations 1 0SCMR 120.122(0) (Certain M8a.$uring, Gauging, or Controlling D~vlces) or by the U.S. Nuclear Regulatory Commission or Agreement State under requirements subst~ntl$11y the same as those In 105 CMR 120.122(0). Coples of the relevant sections are enclosed together with a list of agreement states and U.S. NRC regions.

We would ask you to examine these and acquaint yourself with the regulatorx responsibilities and check with your state or other radiation control agency to verify if further registration Is required. The device is registered with the Massachusetts Radiation Control Program under !Tl's Sealed Source Device Registration, Number MA-0399-D-104-G, and distributed under.license# 15-5254.

Please do not hesitate to call me If ani questions arise r~gardlng the enclosed regulations or wipe testing your Itemiser 3.

Serial number of Source/Instrument: Source #09-8432; Inst SIN 04034907411

Sincerely yours,

Technical Services Manager

Note: No clmnges m11y be made to Ibis document without the n:vicw 1111d conscrit of the !2dlallon mfcty officer.

ION Tock lasuumcnts Document Nambcr. MP022382. Rev, 3

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