ML16019A014

GL Registration from Virginia Electric & Power Co

ML16019A014
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
Download: ML16019A014 (8)

Text

VIRGINIA ELECTRIC AND POWER COMPANY RICHMIOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/J HL ATTN: GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS 1 AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC 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. R. B. Evans at (540) 894-2107.Sincerely, Site Vice President Enclosure Commitments made by this letter: None cc: U.S. Nuclear Regulatory Commission Attention:

Document Control Desk Washington, D. C. 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

' I IIIIIII M II IIIIII IIIii IIIII Ilill IIIII IIIII IIII M IIIII IIII IIII SECTION 1 PAGE 1 of 2 U.S. NUCLEAR REGULATORY COMMISSION GL-7001 15-20 10/30/2015 NRC FORM 664 07 -2015 10 CFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 31 50-01 98 EXPIRES: 04/30/2016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability.

Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (T-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid 0MB control number, the NRC may not conduct or sponsor, and 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 the changes in the applicable boxes. USE CAPITAL LETTERS.General License Registration Number GL-700115-20 SECTION 1 -GENERAL LICENSEE INFORMATION Enter the company name and the street address/physical location of use for your device(s).

For portable devices, specify the primary storage location.

Do not use a P.O. Box address.Company Name: DOMINION VIRGINIA POWER Department:

NORTH ANNA POWER STATIC Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA Zip Code: 23117 -0402 For NRC Use Only; (Do not write here) i A A t III IIII III 1111111111111 1111 ll III111n III III l IIII 1111 11III1 GL-700115-20 10/30/2015 I IIIIIIII 1III IIII 1111 11M11 III IIIIII SECTION 1 PAGE 2 of 2 SECTION 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: EVANS First Name: ROBERT Middle Initial: B Telephone:

(540) 894-2107 Extension:

WEZZIIEWE WI Title: CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your devicels) should be sent.This address should be specific to the use or storage location of your device(s).

Department:

NORTH ANNA POWER STATION Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL Stte V Z p Coe 31 00 -EII II A A GL-7001 15-20 10/30/2015 SECTION 2 -DEVICES SUBJECT TO REGISTRATION SEC Our records indicate that you have these devices. Please update the information as necessary.

PAG NRC Device Key 595514 (Internal Control Number)Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICAL Distributor License N umber: 29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model): DOPS Device Serial Number: 128018 Transfer Date (Receipt Date): 08/12/1 999 I I II~ _Jl in possession of device (Also D] complete Section 4.)MM DD YYYY IuIIIIIII2 El1 of 1 Isotope (e.g. AM241 )1 AM241 2 3 4 5 6 Activity (e.g. 100)30.000000000 Unit (e.g. mCi)mCi EW EW EW WE WE WE A A 111111II II~III II HiII 11111 IIII Ii11 111IIIII 1 1III 11II IIIIII II1111 II II IIIIIII111 I1IIII IIIII IIII GL-7001 15-20 10/30/2015 SECTION 3 SECTION 3 -ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 Provide information about other devices you have that are subject to registration.

Do not report specifically licensed devices.Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)Device Model Number (Not Source Model)Device Serial Number I I I 0 Manufacturer/initial Transferor listed above How acquired and date (e.g.,I' l from a distributor/manufacturer, 0 Other General Licensee Date Transferred: I jj I jj J other licensee, other source)? -UJ Other Source (Received)

MM DD Y YY Y 1.2.3.4.5.6.7.8.9.10.Isotope (eg. AM241)II III III hb Ir fl II II LL r l Activity (eg. 100)il II II II II II II II I[II Unit (e.g. mCi)WE WE WE WE LW WE WE WE WE I I I I I 4 I I I I I t I f W I I I I I I i I I A A

/ I l III1I11 I1I1 11IIIII11 HIIIill 111111 HIill11111 111111il1l11II1 Il111I11 I 11111111 IIII iii IIII I11III Il GL-0/0/1201 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: NRC Device Key: _ L -J (from Section 2 or 6)MM DD YYYY Location of the Device: o Whereabouts Unknown (complete Part 1 only) 0 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:

Address Line 1: Address Line 2: City: Part 3 Enter the name of the individual responsible for this device: Last Name: First Name: Middle Initial: Title: 1 K K A A I 111IIII11111I11I11IIIII11ii 1I1ii1I1111 III II IIMI 011I1111 lIII IIII IMII111 IIII IIII IIIIIIIIIII GL-7001 15-20 10/30/2015 SECTION 5 -CERTIFICATION SECTION 5 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.B. 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. Ilam 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:llww.nrc.

gov/reading-rm/doc-collections/cfr)

SIGNATURE

-RESPONSIBLE INDIVIDUAL (Listed in Section 1)DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES.

NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIALASPECTS.

18 U.S.C. SECTION 1001 MAKES ITACRIMINAL OFFENSE TO MAKEAWILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

/ l~III II~III III 11111 III111 II~ I I lIIII IlI 1111!1 IIII lIiiIIIl l GL-700115-20 10/30/2015..

..= .... .....I IIIIIIII IIII IIIII IIII IIII IIII................... .q N kl R PAGE 1 of 1 NRC Device Key: 825331 Manufacturer License No: 12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B31 0000 Serial #: DG08129527 Isotope: BA133 Activity:

0.020000000 Unit: uCi Transfer Date: 07/20/2012 NRC Device Key: 689428 Manufacture Manufacturer Name: GE ION TRACK Model Number: ITEMISER Ill Serial #: 09-8424 Isotope: NI63 Activity:

10.000000000 r License No: 20-15525-04G Transfer Date: 06/30/2003 Unit: mCi NRC Device Key: 707159 Manufacturer Name: METOREX, INC.Model Number: 880 Isotope: CD109 Activity:

10.0 Manufacturer License No: 455-01G Serial #: 128018 Transfer Date: 02/27/2002

'00000000 Unit: mCi NRC Device Key: 547351 Manufactt Manufacturer Name: CONCO SERVICES CORP.Model Number: 101 Serial #: N596 Isotope: NI63 Activity:

5.0 00000000

urer License No: MD-31-076-01 Transfer Date: 02/1 5/1 994 Unit: mCi VIRGINIA ELECTRIC AND POWER COMPANY RICHMIOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/J HL ATTN: GLTS Docket Nos. 50-338/339 U. S. Nuclear Regulatory Commission License Nos. NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS 1 AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC 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. R. B. Evans at (540) 894-2107.Sincerely, Site Vice President Enclosure Commitments made by this letter: None cc: U.S. Nuclear Regulatory Commission Attention:

Document Control Desk Washington, D. C. 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

' I IIIIIII M II IIIIII IIIii IIIII Ilill IIIII IIIII IIII M IIIII IIII IIII SECTION 1 PAGE 1 of 2 U.S. NUCLEAR REGULATORY COMMISSION GL-7001 15-20 10/30/2015 NRC FORM 664 07 -2015 10 CFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY 0MB: NO. 31 50-01 98 EXPIRES: 04/30/2016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability.

Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (T-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid 0MB control number, the NRC may not conduct or sponsor, and 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 the changes in the applicable boxes. USE CAPITAL LETTERS.General License Registration Number GL-700115-20 SECTION 1 -GENERAL LICENSEE INFORMATION Enter the company name and the street address/physical location of use for your device(s).

For portable devices, specify the primary storage location.

Do not use a P.O. Box address.Company Name: DOMINION VIRGINIA POWER Department:

NORTH ANNA POWER STATIC Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL State: VA Zip Code: 23117 -0402 For NRC Use Only; (Do not write here) i A A t III IIII III 1111111111111 1111 ll III111n III III l IIII 1111 11III1 GL-700115-20 10/30/2015 I IIIIIIII 1III IIII 1111 11M11 III IIIIII SECTION 1 PAGE 2 of 2 SECTION 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: EVANS First Name: ROBERT Middle Initial: B Telephone:

(540) 894-2107 Extension:

WEZZIIEWE WI Title: CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your devicels) should be sent.This address should be specific to the use or storage location of your device(s).

Department:

NORTH ANNA POWER STATION Address Line 1: 1022 HALEY DRIVE Address Line 2: END OF ROUTE 700 City: MINERAL Stte V Z p Coe 31 00 -EII II A A GL-7001 15-20 10/30/2015 SECTION 2 -DEVICES SUBJECT TO REGISTRATION SEC Our records indicate that you have these devices. Please update the information as necessary.

PAG NRC Device Key 595514 (Internal Control Number)Distributor/Distributed By: OXFORD INSTRUMENTS ANALYTICAL Distributor License N umber: 29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model): DOPS Device Serial Number: 128018 Transfer Date (Receipt Date): 08/12/1 999 I I II~ _Jl in possession of device (Also D] complete Section 4.)MM DD YYYY IuIIIIIII2 El1 of 1 Isotope (e.g. AM241 )1 AM241 2 3 4 5 6 Activity (e.g. 100)30.000000000 Unit (e.g. mCi)mCi EW EW EW WE WE WE A A 111111II II~III II HiII 11111 IIII Ii11 111IIIII 1 1III 11II IIIIII II1111 II II IIIIIII111 I1IIII IIIII IIII GL-7001 15-20 10/30/2015 SECTION 3 SECTION 3 -ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 Provide information about other devices you have that are subject to registration.

Do not report specifically licensed devices.Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)Device Model Number (Not Source Model)Device Serial Number I I I 0 Manufacturer/initial Transferor listed above How acquired and date (e.g.,I' l from a distributor/manufacturer, 0 Other General Licensee Date Transferred: I jj I jj J other licensee, other source)? -UJ Other Source (Received)

MM DD Y YY Y 1.2.3.4.5.6.7.8.9.10.Isotope (eg. AM241)II III III hb Ir fl II II LL r l Activity (eg. 100)il II II II II II II II I[II Unit (e.g. mCi)WE WE WE WE LW WE WE WE WE I I I I I 4 I I I I I t I f W I I I I I I i I I A A

/ I l III1I11 I1I1 11IIIII11 HIIIill 111111 HIill11111 111111il1l11II1 Il111I11 I 11111111 IIII iii IIII I11III Il GL-0/0/1201 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: NRC Device Key: _ L -J (from Section 2 or 6)MM DD YYYY Location of the Device: o Whereabouts Unknown (complete Part 1 only) 0 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:

Address Line 1: Address Line 2: City: Part 3 Enter the name of the individual responsible for this device: Last Name: First Name: Middle Initial: Title: 1 K K A A I 111IIII11111I11I11IIIII11ii 1I1ii1I1111 III II IIMI 011I1111 lIII IIII IMII111 IIII IIII IIIIIIIIIII GL-7001 15-20 10/30/2015 SECTION 5 -CERTIFICATION SECTION 5 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.B. 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. Ilam 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:llww.nrc.

gov/reading-rm/doc-collections/cfr)

SIGNATURE

-RESPONSIBLE INDIVIDUAL (Listed in Section 1)DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES.

NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIALASPECTS.

18 U.S.C. SECTION 1001 MAKES ITACRIMINAL OFFENSE TO MAKEAWILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

/ l~III II~III III 11111 III111 II~ I I lIIII IlI 1111!1 IIII lIiiIIIl l GL-700115-20 10/30/2015..

..= .... .....I IIIIIIII IIII IIIII IIII IIII IIII................... .q N kl R PAGE 1 of 1 NRC Device Key: 825331 Manufacturer License No: 12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B31 0000 Serial #: DG08129527 Isotope: BA133 Activity:

0.020000000 Unit: uCi Transfer Date: 07/20/2012 NRC Device Key: 689428 Manufacture Manufacturer Name: GE ION TRACK Model Number: ITEMISER Ill Serial #: 09-8424 Isotope: NI63 Activity:

10.000000000 r License No: 20-15525-04G Transfer Date: 06/30/2003 Unit: mCi NRC Device Key: 707159 Manufacturer Name: METOREX, INC.Model Number: 880 Isotope: CD109 Activity:

10.0 Manufacturer License No: 455-01G Serial #: 128018 Transfer Date: 02/27/2002

'00000000 Unit: mCi NRC Device Key: 547351 Manufactt Manufacturer Name: CONCO SERVICES CORP.Model Number: 101 Serial #: N596 Isotope: NI63 Activity:

5.0 00000000

urer License No: MD-31-076-01 Transfer Date: 02/1 5/1 994 Unit: mCi