ML20210B432

Ack Receipt of NRC Form 241 & Filing Fee in Listed Amount

ML20210B432
Person / Time
Issue date:	07/16/1999
From:	Kinneman J NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I)
To:	Brower C AFFILIATION NOT ASSIGNED
Shared Package
ML20210B413	List: ML20210B432
References
NUDOCS 9907230147
Download: ML20210B432 (8)

Text

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UNITED STATES p . NUCLEAR REGULATORY COMMISSION

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.e f 475 ALLENDALE ROAD

%, f- KING oF PRUSSIA. PENNSYLVANIA 19406-1415 July 16,1999 Mr. Christopher M. Brower Radiation Safety Officer 22 Sarah Wells Trail ICampbell Hall, NY 10916

SUBJECT:

APPROVAL OF PROPOSED ACTIVITIES IN NON-AGREEMENT

. STATES (NRC FORM 241) FOR CALENDAR YEAR 1999 i

Dear Mr. Brower:

This acknowledges receipt of NF' ' Form 241 dated July 14,- and the $1,100 filing fee, which you submitted to report proposed activities in Non-Agreement States under the authority of the general license pursuant to 10 CFR 150.20.

In the future, please use the NRC Form 241 and mark the appropriate box for submitting revisions and clarifications. Please fax your revision or clarification and a copy of the appropriate fee to (610) 337-5393.

The NRC Form 241 must include specific changes, such as locations, dates of work and

. personnel. Work locations are subject to NRC inspection in accordance with requirements for a general license, The total days of usage / storage through this reciprocity request is 119 days. If you have any questions, please call Cheryl Buracker on (610) 337-5093 or Rebecca Brown on (610) 337-5260. Your cooperation is appreciated.

Sincerely, h 0.. W

/ John D. Kinneman, Chief g Nuclear Materials Safety Branch No. 2 _l P Division of Nuclear Materials Safety l l

License No ' NY-2434-3468 i Control Nos. 001003 to 001021

Enclosure:

NRC Form 241 cc: States of New' Jersey and New York 4

I 9907230147 990714 PDR STPRO ESONY PD'n j

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7/14/99 Attachment to NRC Form 24 I Item 9: Client Name, Address, City / County, State, Zip Code I

(A) Port Authority ofNew York and New Jersey (II) O & G Industries I 241 Erie Street, Room 234 112 Wall Street  !

Jersey City, NJ 07310 Torrington,CT 06790 (B) Avalon Properties, Inc. (1) Geo Con a Woodward Clyde Co.

100 Canal Pointe Boulevard, Ste.110 900 Route 168 North Ste. E-l Princeton, NJ 08540-7063 Blackwood, NJ 08012 (C) Della Pello Cont, Co. Inc. (J) Glomar Construction P.O. Box 1657 1 Ardmore Street Milltown Road New Windsor, NY 12553 Union, NJ 07083 (K) McGoey, llauser and Edsall (D) Mount ilope Rock Products 45 Quassaick Avenue 625 Mount 11 ope Road New Windsor, NY 12553 Whanon, NJ 07885 (L) Millington Afiliated Quarries (E) A. Servidone Co., Inc. Stonehouse Road 1364 Route 9 Millington,NJ 07946 Castkton,NY 12033 (M) Tilcon New York, Inc.

(F) Braen Stone Industries 162 Old Mill Road P.O. Box 8310 West Nyack, NY 10994 11aledon,NJ 07538 (G) Dell Contractors j One liill Street Patersen,NJ 07538 '

Item 10: Work Locations

-(A) Port Authority Properities - ilo911and Tunnel, Lincoln Tunnel, George Washington Bridge, Newark Airport, Port of Elizabeth, Jersey City, Port of Newark (B) Avalon Crest Apartments, Fort Lee Executive Park, i Executive Drive, Fort Lee, NJ 07024 (C) Various Routes in New Jersey (To be determined)

(D) Various Routes and projects in New Jersey (To be determined)

(E) Various Routes and projects in New Jersey (To be determined)

(F) Various Routes in New Jersey (To be determined)

(G) Various Routes in New Jersey (To be detennined) f i e _

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. i item 10 Continued:

(11) Various Routes in Connecticut; Route 8 and Route 25, Trumbell, CT (1) Warren County Landfill,500 Mount Pisgah Avenue, Oxford, NJ 07893 (J) Various projects in Pennsylvania (To be determined) 1 (K) Various projects in Pennsylvania and New Jersey (To be determined)

(L) Various Routes in New Jersey (To be determined) 1 (M) Various Routes in New Jersey (To be determined) I i

I l Item iI Client Telephone Number:

(A) 201-216-2986 (II) 201-363-1731 (C) 908-687-6070 (D) 973-366-7741 (E) 518-732-7773 (F) 201-595-6250 l (G) 973-595-0404 (11) 860-485-6612 (1) 609-232 7662 I (J) 717-686-9103 (K) 717-296-2765 (L) 908-580-3910 (M) 914-358-4500 Item 12 - Technicians to perform work:

Brian Austin Rachael Kaschak Brian Sciuto l Frank Barrett Matthew Kennedy Joseph Sikora Shaun Bowman Rebecca La Chausse John Smith Russ Bracco Scott Levasseur Lizette Strait Anthony Brower Jeff Lewis James Terotta Christopher Brower Mitchell Manzo Tom Tremper Chris Cavalari Mike Meyer Daniel Vellone Mark Clark Art Minor Matthew Weinstein l Christopher Closi Ryan Morrison Michael Colby Daryl O' Dell j Michael Creeden Timothy Parker Don DeVaul Kevin Patton Scott Dochola Robert Patton Christopher Ferranti Randy Pray l Mark Foster Mark Riordan l Paul Gurciullo Chad Roes Richard Hamilton Jullia Santogatta 1

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Item 13 - Work Location Telephone Number (A) Not Available (B) 609-452-0025 (C) Not Available (D) Not Available (E) Not Available (F)~ Not Available (G) Not Available (H) Not Available (1) 908-475-3571 (J) Not Available (K) Not Available (L) Not Available (M) Not Available item 14 - Dates Scheduled 7/I4-16/99,7/19-23/99,7/26-30/99,8/2-6/99,8/9-13/99,8/16-20/99,8/23-27/99, 8/30-3I/99,9/I-3/99,9/6-10/99,9/13-I7/99,9/20-24/99,9/27-30/99,10!l/99, 10/4-8/99,10!!l-15/99,10!!8-22/99,10'25-29/99,i1/1-5/99,i1/8 12/99,i1/15-19/99, 11/22-24/99, i1/26/99,i1/29-30/99,12/1-3/99, 12/6-10/99,12/13-17/99,12/20-24/99, 12/27-3I/99 i

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STATE OF NEW YORK - DEPARTMENT OF LABOR DIVISION OF SAFETY AND HEALTH RADIOACTIVE MATERIALS LICENSE w

DL 99-020 Page 1 of 4 Page(s)

PURSUANT TO THE LABOR LAW AND INDUSTRIAL CODE RULE 38. AND IN RELIANCE ON STATEMENTS AND REPRESENTATIONS HERETOFORE MADE BY THE LICENSEE DESIGNATED BELOW. A LICENSE 15 HEREBY ISSUED AUTHORIZING SUCH LICENSEE TO RECEIVE. POSSESS. USE AND TRANSFER RADIOACTIVE MATERIAL (5) DESIGNATED BELOW; AND TO USE SUCH RADIOACTIVE MATERIAL (5) FOR THE PURPOSE (5) AND AT THE PLACE (5) DESIGNATED BELOW. TH15 LICENSE IS SUBJECT TO ALL APPUCABLE RULES. REGULATIONS. AND ORDERS NOW OR HEREAFTER IN EFFECT OF ALL APPROPRIATE REGULATORY AGENCIES AND TO ANY CONDITIONS SPECIFIED BELOW j

1. NAME OF LICENSEE . 3 LICENSE NUMBER j FEIN:14-1672799 2434-3468 j Advanced Testing Company, Inc.

l'IlONE:t914)496-1600

4. EXPIRATION DATE

3. ADDRESS OF LICENSEE RD 1, Box 400 Sa. REFERENCE No b AMENDMENT No.

Sarah Wells Trail Campbell Hall, New York 10916 6 2 l G. RADIOACTIVE MATERIALS 7. CHEMICAL AND/OR PHYSICAL FORM B MAXIMUM QUANTITY LICENSEE MAY POSSESS (112msnt m mass number) AT ANY ONE TIME A. Cesium 137 A. Scaled Sources A. See Condition 9.

B. Americium 241: Beryllium B. Scaled Sources B. See Condition 9.

C. Cobalt 57 C. Sealed Sources C. See Condition 9.

D. Cadmium 109 D. Scaled Sources D. See Condition 9.

9. . Authorized use:

Conditions 6. A. through 6.D.

1. The licensee is authorized to use any sealed source, associated portable moisture / density gauge, or associated portable x-ray fluorescence device which has been manufactured and distributed in accordance with a specific license issued by an Agreement State or the United States Nucler.r Regulatory Commission. Combinations of sources and devices must be compatible for use as stated in a Scaled Source and Device Registration Certificate (i.e. stated in the registration certificate for the source or device).

2. No single source may exceed the maximum activity specified for that nuclide in the Scaled Source and Device Registration Certificate for any device in which the source is to be used.

10. A. Licensed material shall be stored at the location indicated in Condition No. 2, and may be used at temporary job sites of the licensee anywhere within the State of New York, where the Department of Labor exercisesjurisdiction.

t g DOSH.241 W (4 91) a

p . .

. STATE of NEW YORK - DEPC.RTMENT of LA8oR

, DIVISION OF SAFETY AND HEALTH RADIOACTIVE MATERIALS UCENSE Page 2 of 4 Pages

3. License Number 2434-3468 Sa. Ref. No. 6 b. Amend. No. _2_

(Condition No.10 continued)

B. Overnight storage at other locations shall be in accordance with statements referenced in Condition 22 herein, providing that such storage may not be in a residence, or in an attached garage except within a vehicle. Any vehicle used for storage shall be driven only for purposes associated with use l or transport of the contained radioactive material, by a person qualified to use the material, and no passengers shall be carried unless they are also involved in work under this license. Vehicular storage shall only be allowed if no other storage is possible and shall not exceed five (5) consecutive nights unless authorization to exceed this limit is obtained from the Department l

v. Under no circumstances shall radioactive material authorized by this license be transferred to the custody of any person or firm other than the licensee, or be used or stored by another person or firm or its employees; unless that person or firm possesses a valid license to possess and use such radioactive material. i

11. Licensed material shall be used by, or under the supervision of, Christopher M. Brower (Radiation Safety Oflicer), by licensee personne! trained and certified by the device manufacturer. The licensee shall maintain a complete and accurate record of the qualifications of each person pennitted to use radiation sources under this license.

12. Sealed Sources containing radioactive materials shall not be opened or removed from the licensed gauge by the licensee.

13. A. The licensee is not authorized to dismantic, repair or effect any changes in the source holders / gauges.

Any maintenance involving exposure of the source or removal of shielding is prohibited. All other maintenance shall be performed in accordance with the manufacturer's recommendations.

B. The licensee shall not alter labels attached to gauges, and shall maintain labels in legible condition at all times.

14. The licensee shallinstmct persons who engage in work under the license,in accordance with section 38.27(c) of Code Rule 38. Such instruction shallinclude the licensee's operating and emergency procedures, and other information contained in documents incorporated in Condition 22.

15. The licensee shall conduct a physical inventory every six (6) months to account for all Gauges received and possessed under the License. The records of the inventcries shall be maintained for three (3) years from the date of the inventory for inspection by the Department, and shall include the quantities and kinds oflicensed matedal, Manufacturer's Name and Model No.', location of the gauges, the date of the inventory and the name of the person who performed it.

DOsH 243 W (4-91)

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, STATE OF NrW YORK DEPARTMENT OF LABOR q

DM510N OF SAFETY AND HEALTH i

hi i

RADIOACTIVE MATERIALS LICENSE Page 3 of 4 Pages

3. License Number 2434-3468 Sa. Ref. No. _6_ b Amend. No. 2.

16. A. The licensee shall maintain a utilization log containing the identification of sources used, dates removed and returned to storage, the location of use, the identity of user, and the daily check of sliding blocks required by Condition 21.

B. The log shall be kept at the location of storage and shall contain suflicient detail to enable the licensee to inform the Depanment at any time, of the exact location of each source.

17. Current copies of the following documents shall be maintained at temporary job sites for Department inspection:

A. The manufacturer's instmction manual and the licensee's operating and emergency procedures.

B. A copy of the results of the latest test for leakage and/or contamination performed on the scaled sources.

18. A. In the event of a serious incident involving licensed material, including but not limited to, the theft or loss of a gauge, or damage to a gauge, the Department shall be notified immediately by telephone.

Subsequent information about the incident acquired by the licensee shall be reponed as it is received.

All gauge users must carry the NYSDOL's current telephone number in their emergency procedures.

B. In the event that a gauge is damaged, the gauge and surrounding area shall be surveyed with an appropriate survey meter, and the results of the survey shall be reported to and approved by the Depanment before the gauge is removed from the site.

19. The licensee shall ensure that all persons authorized to use ponable gauges comply with safe use and maintenance procedures and that they do not leave a gauge unattended or unsecured at any time, even for a few minutes.

20. In addition to the possession limits in item 8, the licensee shall further restrict the possession oflicensed material to quantities below the minimum limit specified in Section 38.7 of 12 NYCRR 38 for establishing decommissioning fmancial assurance.

21. Each gauge shall be inspected on each day of use before use, and upon its return to storage, to ensure proper operation of all safety features including the following:

A. Tum the gauge over and visually verify that the tungsten sliding block is completely closed, keeping as much distance as possible between you and the base of the gauge. If any portion of the opening is uncovered, the sliding block must be cleaned and returned to the fully closed position before transporting, using, or storing the gauge. The manufacturer's instn etions for cleaning the sliding block must be followed.

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~ . . , ' STATE OF NEW YORK - DEPARTMENT OF t.A80R

( DIVISION OF SAFETY AND HEAT.TH

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i RADIOACTIVE MATERIALS LICENSE t.

Page 4 of 4 Pages

3. License Number 2434-3468 Sa. Ref. No. 6 b. Amend. No 2 (Condition No. 21 continued)

B. If a radiation survey meter is available, and in good working order, radiation levels at the gauge surface shall also be checked. The exposure rate should be approximately 10-20 mrem per hour.

C. If a sliding block is found to be partially or fully open, the Department of Labor must be notified by telephone within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />.

22. Except as specifically provided otherwise in this License, the licentee shall conduct its program in accordance with the statements, representation and procedures contained in the documents, including any enclosures, listed below. The Depanment's Regulations shall govern, unless the statements, representation and procedures in the licensee's application and correspondence are more restrictive than the Regulations.

A. License renewal request dated Decemhn 27,1995, signed by James P. Smith, Jr., with attachments.

B. Complete license renewal application dated Febmary 23,1996, signed by James P. Smith, Jr., with attachments.

C. Lettei received June 16,1996, signed by Christopher M. Brower.

D. License renewal request dated January 28,1999, signed by James P. Smitit, Jr., with attachments.

James J. McGowan COMMSSIONER OF LABOR a

00 DATE: y' n Cr by: Clayton J Bjadt CJBavp Associate Radiophysicist DOsH-243 W (4 91) 1

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