ML15357A053

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GL Registration from Virginia Electric and Power Company (Dominion) North Anna Power Station Units 1 and 2
ML15357A053
Person / Time
Site: North Anna  
Issue date: 12/18/2015
From: Bischof G T
Virginia Electric & Power Co (VEPCO)
To:
Office of Nuclear Material Safety and Safeguards
References
15-581, GL-700115-20
Download: ML15357A053 (8)
v • d • e


Text

VIRGINIA AND POWER COMPANYRICHMOND, VIRGINIA 23261December 18, 2015Director, Office of Nuclear Material Safety Serial No. 15-581and Safeguards NAPS/JHLATT-IN: GLTS Docket Nos. 50-338/339U. S. Nuclear Regulatory Commission License Nos. NPF-4/7Washington, DC 20555-0001Gentlemen:VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)NORTH ANNA POWER STATION UNITS I AND 2ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICESIn accordance with 10 CFR 31.5, enclosed is NRC Form 664, General LicenseeRegistration, for registration of generally licensed devices maintained at North AnnaPower Station.If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.Sincerely,Gerald T. BischofSite Vice PresidentEnclosureCommitments made by this letter: Nonecc: U.S. Nuclear Regulatory CommissionAttention: Document Control DeskWashington, D. C. 20555-0001U.S. Nuclear Regulatory CommissionRegion IIMarquis One Tower245 Peachtree Center Ave., NE Suite 1200Atlanta, Georgia 30303-1 257NRC Senior Resident InspectorNorth Anna Power Station N~ill IIII II IIII U I.I li1ii 11iii II I~ NDI~ WII 11 111 1 i llI~i I!GL-7001 15-2010/30/2015NRC FORM 66407 -201510OCFR 31.5APPROVED BY 0MB: NO. 3150-0198SECTION 1PAGE 1 of 2U.S. NUCLEAR REGULATORY COMMISSIONGENERAL LICENSEE REGISTRATIONEXPIRES: 04/3012016Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices toensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. NuclearRegulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and RegulatoryAffairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide thechanges in the applicable boxes. USE CAPITAL LETTERS.General LicenseRegistration NumberGL-700115-20SECTION 1 -GENERAL LICENSEE INFORMATIONEnter the company name and the street address/physical location of use for your device(s). Forportable devices, specify the primary storage location. Do not use a P.O. Box address.Company Name: DOMINION VIRGIN.IA POWERDepartment: NORTH ANNA POWER STATIOIAddress Line 1: 1022 HALEY DRIVEAddress Line 2: END OF ROUTE 700City: MINERALState: VAZip Code: 23117 -0402wz~ -:For NRC use Only-: C, ategory:"(Do :not write here) : ,. .:... .-.'. .. :'. :".::: .-.:. ,"Packet Receipt Date (MMDDYYY ):: i : ? i I I I' I I L ..1 I~ I I .1J I.. .." -..::. Accession Number:.AA Ii IIIIIIII II 111i-111 IIII III! IIII Iin III IIIII nII 111111111GL-7001 15-2010/30/2015111111111 IIII IIIII IIII III III II111IlSECTION 1PAGE 2 of 2SECTION 1 -GENERAL LICENSEE INFORMATION (Continued)Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).Last Name: EVANSFirst Name: ROBERT Middle Initial:BTelephone: (540) 894-2107 Extension:Title: CURRENT SAFETY OFFICEREnter the mailing address where correspondence regarding your device(s) should be sent.This address should be specific to the use or storage location of your device(s).Department: NORTH ANNA POWER STATIONAddress Line 1: 1022 HALEY DRIVEAddress Line 2: END OF ROUTE 700City: MINERALState: VA D ___ Zip Code: 23117 -0402 [ -zAA I IIIHIIII11 II IIIIINVI l iii lii III 1111 11ilIIIIi11 1111111I II I! 111111 i II!1 III IIl IIIGL-700115-2010/30/2015 SECTION 2 -DEVICES SUBJECT TO REGISTRATION SECTION 2Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 1NRC Device Key 595514 (Internal Control Number)Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICALDistributor License Number: 29-30342-02GManufacturer Name: METOREX, INCDevice Model (Not Source Model)i DOPSDevice Serial Number: 128018Transfer.Date (Receipt Date): 08/12/1999rvn Not in possession of device (Also_J __J L D complete Section 4.)MM DD YYYYIsotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)1 AM241 30.000000000 mCi234*56E.E D IDII'.A.A IIII]111 Iv iIII n !1 Inn I iii1111 UIIII inII III 1111111 III Iin 111 1IIIII 1 IIII In I In I IIi!1SGL-700115-2010/30/2015 SECTION 3SECTION 3 -ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.Manufacturer NameInitial Transferor NameInitial Transferor License Number (if known)Device Model Number (Not Source Model)Device Serial Numbero Manufacturer/Initial Transferor listed aboveHow acquired and date (e.g.,from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F _7 F _77 other licensee, other source)?L..LJL.LJU Other Source(Received)MMDDYYYYIsotope (e.g. AM241 )1.3.4.6 .7.8.~D9.10. DI IActivity (e.g. 100)IIIILImUnit (e.g. mCi)LW~DIDIDID1WIDIDIDIDJI I I I I I I II IAA I II11 IIIII il11111 IIII11 l11 IIII II II II~II i11 liIIIIII II~II ii IIII[II IIIII 11L-0/0/215-2 SEcTiON 4 -NOT IN POSSESSION OF DEVICE SECTION 4Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of 1Part I Transfer Date:NRC Device Key: ______________________(from Section 2 or 6)MM DD YYYYLocation of the Device:o Whereabouts Unknown (complete Part 1 only) O Transferred to another general licensee (complete Parts 2 and 3)o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer)o Returned to Manufacturer (complete Part 1 only) (complete Part 2)Part 2 License Number of Recipient (if transferred to~a specific licensee):Company Name:-Department:Adrs ine 1:l l l ~l IIAddress Line 2:City:*Part 3 Enter the name of the individual responsible for. this device:Last Name:First Name: Middle Initial:Title:A A GL-7001 15-20 SECTION 5 -CERTIFICATION SECTION 510/30/2015 PAGE 1 of 1Ihereby certify that:A. All information' contained in this registration is true and complete to the best of my knowledge and belief.B. A physical inventory of the devices subject to registration has been completed, and the device information onthis form has been checked against the device labeling.C. l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.(Copies of applicable regulations may be viewed at the NRC website at:http://www, nrc.gov/reading-rm/doc-collections/cfr)SIGNATURE -RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATEWARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRCREGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALLMATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLYWRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITEDSTATES AS TO ANY MATTER IN ITS JURISDICTION.AA GL-700115-2010/30/2015 .. ...... .....IflL 5~ F C~r I (~ t'J R~t.. I -UtVIU~ rJU ~UI~JIL. I iLl ~ ~AI HUNPAGE lofINRC Device Key: 825331 Manufacturer License No: 12-04933-04GManufacturer Name: PERKINELMER LIFE SCIENCESModel Number: B310000 Serial #: DG08129527Isotope: BA133 Activity: 0.020000000 Unit: uCiTransfer Date: 07/20/2012NRC Device Key: 689428 ManufactureManufacturer Name: GE ION TRACKModel Number: ITEMISER III Serial #: 09'-8424Isotope: N163 Activity: 10.000000000;r License No: 20-15525-04GTransfer Date: 06/30/2003Unit: mCiNRC Device Key: 707159 "Manufacturer Name: METOREX, INC.Model Number: 880Isotope: CD109 Activity: 10.0Manufadturer License No: 455-01GSerial #: 128018Transfer Date: 02/27/200200000000Unit: mCiNRC Device Key: 547351Manufacturer Name: CONCO SERVICES CORP.Model Number: 101 SeriaIsotope: N163 Activity: 5.000000000Manufacturer License No: MD-3 1-076-01l#: N596Transfer Date: 02/15/1994Unit: mCi VIRGINIA AND POWER COMPANYRICHMOND, VIRGINIA 23261December 18, 2015Director, Office of Nuclear Material Safety Serial No. 15-581and Safeguards NAPS/JHLATT-IN: GLTS Docket Nos. 50-338/339U. S. Nuclear Regulatory Commission License Nos. NPF-4/7Washington, DC 20555-0001Gentlemen:VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)NORTH ANNA POWER STATION UNITS I AND 2ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICESIn accordance with 10 CFR 31.5, enclosed is NRC Form 664, General LicenseeRegistration, for registration of generally licensed devices maintained at North AnnaPower Station.If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.Sincerely,Gerald T. BischofSite Vice PresidentEnclosureCommitments made by this letter: Nonecc: U.S. Nuclear Regulatory CommissionAttention: Document Control DeskWashington, D. C. 20555-0001U.S. Nuclear Regulatory CommissionRegion IIMarquis One Tower245 Peachtree Center Ave., NE Suite 1200Atlanta, Georgia 30303-1 257NRC Senior Resident InspectorNorth Anna Power Station N~ill IIII II IIII U I.I li1ii 11iii II I~ NDI~ WII 11 111 1 i llI~i I!GL-7001 15-2010/30/2015NRC FORM 66407 -201510OCFR 31.5APPROVED BY 0MB: NO. 3150-0198SECTION 1PAGE 1 of 2U.S. NUCLEAR REGULATORY COMMISSIONGENERAL LICENSEE REGISTRATIONEXPIRES: 04/3012016Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices toensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. NuclearRegulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and RegulatoryAffairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide thechanges in the applicable boxes. USE CAPITAL LETTERS.General LicenseRegistration NumberGL-700115-20SECTION 1 -GENERAL LICENSEE INFORMATIONEnter the company name and the street address/physical location of use for your device(s). Forportable devices, specify the primary storage location. Do not use a P.O. Box address.Company Name: DOMINION VIRGIN.IA POWERDepartment: NORTH ANNA POWER STATIOIAddress Line 1: 1022 HALEY DRIVEAddress Line 2: END OF ROUTE 700City: MINERALState: VAZip Code: 23117 -0402wz~ -:For NRC use Only-: C, ategory:"(Do :not write here) : ,. .:... .-.'. .. :'. :".::: .-.:. ,"Packet Receipt Date (MMDDYYY ):: i : ? i I I I' I I L ..1 I~ I I .1J I.. .." -..::. Accession Number:.AA Ii IIIIIIII II 111i-111 IIII III! IIII Iin III IIIII nII 111111111GL-7001 15-2010/30/2015111111111 IIII IIIII IIII III III II111IlSECTION 1PAGE 2 of 2SECTION 1 -GENERAL LICENSEE INFORMATION (Continued)Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).Last Name: EVANSFirst Name: ROBERT Middle Initial:BTelephone: (540) 894-2107 Extension:Title: CURRENT SAFETY OFFICEREnter the mailing address where correspondence regarding your device(s) should be sent.This address should be specific to the use or storage location of your device(s).Department: NORTH ANNA POWER STATIONAddress Line 1: 1022 HALEY DRIVEAddress Line 2: END OF ROUTE 700City: MINERALState: VA D ___ Zip Code: 23117 -0402 [ -zAA I IIIHIIII11 II IIIIINVI l iii lii III 1111 11ilIIIIi11 1111111I II I! 111111 i II!1 III IIl IIIGL-700115-2010/30/2015 SECTION 2 -DEVICES SUBJECT TO REGISTRATION SECTION 2Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 1NRC Device Key 595514 (Internal Control Number)Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICALDistributor License Number: 29-30342-02GManufacturer Name: METOREX, INCDevice Model (Not Source Model)i DOPSDevice Serial Number: 128018Transfer.Date (Receipt Date): 08/12/1999rvn Not in possession of device (Also_J __J L D complete Section 4.)MM DD YYYYIsotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)1 AM241 30.000000000 mCi234*56E.E D IDII'.A.A IIII]111 Iv iIII n !1 Inn I iii1111 UIIII inII III 1111111 III Iin 111 1IIIII 1 IIII In I In I IIi!1SGL-700115-2010/30/2015 SECTION 3SECTION 3 -ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.Manufacturer NameInitial Transferor NameInitial Transferor License Number (if known)Device Model Number (Not Source Model)Device Serial Numbero Manufacturer/Initial Transferor listed aboveHow acquired and date (e.g.,from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F _7 F _77 other licensee, other source)?L..LJL.LJU Other Source(Received)MMDDYYYYIsotope (e.g. AM241 )1.3.4.6 .7.8.~D9.10. DI IActivity (e.g. 100)IIIILImUnit (e.g. mCi)LW~DIDIDID1WIDIDIDIDJI I I I I I I II IAA I II11 IIIII il11111 IIII11 l11 IIII II II II~II i11 liIIIIII II~II ii IIII[II IIIII 11L-0/0/215-2 SEcTiON 4 -NOT IN POSSESSION OF DEVICE SECTION 4Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of 1Part I Transfer Date:NRC Device Key: ______________________(from Section 2 or 6)MM DD YYYYLocation of the Device:o Whereabouts Unknown (complete Part 1 only) O Transferred to another general licensee (complete Parts 2 and 3)o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer)o Returned to Manufacturer (complete Part 1 only) (complete Part 2)Part 2 License Number of Recipient (if transferred to~a specific licensee):Company Name:-Department:Adrs ine 1:l l l ~l IIAddress Line 2:City:*Part 3 Enter the name of the individual responsible for. this device:Last Name:First Name: Middle Initial:Title:A A GL-7001 15-20 SECTION 5 -CERTIFICATION SECTION 510/30/2015 PAGE 1 of 1Ihereby certify that:A. All information' contained in this registration is true and complete to the best of my knowledge and belief.B. A physical inventory of the devices subject to registration has been completed, and the device information onthis form has been checked against the device labeling.C. l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.(Copies of applicable regulations may be viewed at the NRC website at:http://www, nrc.gov/reading-rm/doc-collections/cfr)SIGNATURE -RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATEWARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRCREGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALLMATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLYWRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITEDSTATES AS TO ANY MATTER IN ITS JURISDICTION.AA GL-700115-2010/30/2015 .. ...... .....IflL 5~ F C~r I (~ t'J R~t.. I -UtVIU~ rJU ~UI~JIL. I iLl ~ ~AI HUNPAGE lofINRC Device Key: 825331 Manufacturer License No: 12-04933-04GManufacturer Name: PERKINELMER LIFE SCIENCESModel Number: B310000 Serial #: DG08129527Isotope: BA133 Activity: 0.020000000 Unit: uCiTransfer Date: 07/20/2012NRC Device Key: 689428 ManufactureManufacturer Name: GE ION TRACKModel Number: ITEMISER III Serial #: 09'-8424Isotope: N163 Activity: 10.000000000;r License No: 20-15525-04GTransfer Date: 06/30/2003Unit: mCiNRC Device Key: 707159 "Manufacturer Name: METOREX, INC.Model Number: 880Isotope: CD109 Activity: 10.0Manufadturer License No: 455-01GSerial #: 128018Transfer Date: 02/27/200200000000Unit: mCiNRC Device Key: 547351Manufacturer Name: CONCO SERVICES CORP.Model Number: 101 SeriaIsotope: N163 Activity: 5.000000000Manufacturer License No: MD-3 1-076-01l#: N596Transfer Date: 02/15/1994Unit: mCi

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