NRC FORM 313 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0120 EXPIRES: 05/31/2015 (03-2014) Estimated burden per response to comply with this mandatory collection request: 4.3 hours. Submittal of the 10 CFR 30, 32, 33, 34 35, 36, 37, 39, and 40 application is necessary to determine that the applicant is qualified and that adequate procedures exist to
.;)e;..:t"'"'':Urovz.,_.. protect the public health and safety. Send comments regarding burden estimate to the FOIA, Privacy, and
fo.,"(f"" ~>0~ APPLICATION FOR MATERIALS
Information Collections Branch (T-5 F53), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, /!: 0 or by internet e-mail to [email protected], and to the Desk Officer, Office of Information and < 0 1;. . Regulatory Affairs, NEOB-10202, (3150-0120), Office of Management and Budget, Washington, DC 20503. If a ~ l LICENSE means used to impose an information collection does not display a currently valid OMB control number, the ~ ... ') +0~ ......... ,.. NRC may not conduct or sponsor, and a person is not required to respond to, the information collection .
INSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING APPLICATION. SEND TWO COPIES OF THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW. *AMENDMENTS/RENEWALS THAT INCREASE THE SCOPE OF THE EXISTING LICENSE TO A NEW OR HIGHER FEE CATEGORY WILL REQUIRE A FEE.
APPLICATION FOR DISTRIBUTION OF EXEMPT PRODUCTS FILE APPLICATIONS WITH: IF YOU ARE LOCATED IN:
OFFICE OF FEDERAL & STATE MATERIALS AND ILLINOIS, INDIANA, IOWA, MICHIGAN, MINNESOTA, MISSOURI, OHIO, OR WISCONSIN, ENVIRONMENTAL MANAGEMENT PROGRAMS SEND APPLICATIONS TO: DIVISION OF MATERIALS SAFETY AND STATE AGREEMENTS
&-. )v US. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSING BRANCH
WASHINGTON, DC 20555-0001 U.S. NUCLEAR REGULATORY COMMISSION, REGION Ill 2443 WARRENVILLE ROAD, SUITE 210
ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS: LISLE, IL 60532-4352
IF YOU ARE LOCATED IN:
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SEND APPLICATIONS TO: SEND APPLICATIONS TO:
LICENSING ASSISTANCE TEAM NUCLEAR MATERIALS LICENSING BRANCH DIVISION OF NUCLEAR MATERIALS SAFETY U.S. NUCLEAR REGULATORY COMMISSION, REGION IV U.S. NUCLEAR REGULATORY COMMISSION, REGION I
030~\0'53 1600 E. LAMAR BOULEVARD
2100 RENAISSANCE BOULEVARD, SUITE 100 KING OF PRUSSIA, PA 19406-2713
ARLINGTON, TX 76011-4511
PERSONS LOCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE U.S. NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS AND USE LICENSED MATERIAL IN STATES SUBJECT TO U.S.NUCLEAR REGULATORY COMMISSION JURISDICTIONS.
1. THIS IS AN APPLICATION FOR (Check appropriate 1tem) 2 NAME AND MAILING ADDRESS OF APPLICANT (Include ZIP code)
D A. NEW LICENSE
Underwood Engineering, Inc.
0 B. AMENDMENT TO LICENSE NUMBER 29-23425-01 143 Harding A venue
D Bellmawr. NJ 08031
C. RENEWAL OF LICENSE NUMBER
3 ADDRESS WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED 4. NAME OF PERSON TO BE CONTACTED ABOUT THIS APPLICATION
Daniel Ruch, RSO
BUSINESS TELEPHONE NUMBER I BUSINESS CELLULAR TELEPHONE NUMBER
SEE ATTACHED (856) 933-1818 (215) 901-3481
BUSINESS EMAIL ADDRESS
SUBMIT ITEMS 5 THROUGH 11 ON 8-112 X 11" PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE LICENSE APPLICATION GUIDE
5. RADIOACTIVE MATERIAL 6. PURPOSE(S) FOR WHICH LICENSED MATERIAL WILL BE USED
a. Element and mass number; b. chemical and/or phys1cal form; and c. maix1mum amount 7 INDIVIDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEIR which Will be possessed at any one time
TRAINING EXPERIENCE
8 TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS. 9 FACILITIES AND EQUIPMENT
10 RADIATION SAFETY PROGRAM. 11. WASTE MANAGEMENT
12 LICENSE FEES (Fees requ1red only for new applications, with few exceptions*) FEE CATEGORY I I AMOUNT
$1 I (See 10 CFR 170 and Section 17031) ENCLOSED
13 CERTIFICATION. (Must be completed by applicant) THE APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS MADE IN THIS APPLICA T/ON ARE BINDING UPON THE APPLICANT.
THE APPLICANT AND ANY OFFICIAL EXECUTING THIS CERTIFICATION ON BEHALF OF THE APPLICANT. NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY WITH TITLE 10, CODE OF FEDERAL REGULATIONS, PARTS 30, 32, 33, 34, 35, 36, 37, 39, AND 40, AND THAT ALL INFORMATION CONTANED HEREIN IS TRUE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF WARNING: 18 US C. SECTION 1001 ACT OF JUNE 25, 1948 62 STAT. 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION
CERTIFYING OFFICER-- TYPED/PRINTED NAME AND TITLE "G"Wee /_ u DATE
William R. Underwood, PE/Owner ,,,,q /1L/ ,>,, ·:.C.' · ·' ··:"':'.: :·':' '""::::;::tufOffNRCUSE ONLY : >::::..:.: ': <:.:''!, ..... ..·,
TYPE :OF .. FEE r§E~OO' ,,:~;;,:CATEG~Y ;I:OUNTReeeiVED CHECK~OMMENTS , , , ·: ,,
' c::{';,,.. .;,,, ··• ·: .. .. •' ·.· . ·::,.. .
APPROVED.~¥ ,., ''·'":;.:- .. ·:··· ... ,: OA:Te· ... · . · ' : .: '
,.,: > .. '::' ' ....... . ..... ::· ·::·,;,;
NRC FORM 313 (03-2014)
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NMSSIRGN1 MATERIALS-::~'.!
UNDERWOOD
ENGINEERING
INC.
Add Contact Information for RSO:
Daniel Ruch 14 3 Harding A venue Bellmawr, NJ 08031 856-93 3-1818 office 215-901-3481 cell *See Attached Certificate
143 Harding Avenue, Bellmawr, NJ 08031
856-933-1818 • Fax 856-933-3121
William R. Underwood, P.E.- President
~CELEBRATING~
~ 1978- 1998 _Jil. 20 YEARS
GEOTECHNICAL • ENVIRONMENTAL • SEPTIC SYSTEMS SOILS • CONCRETE • ASPHALT • MASONRY • STRUCTURAL STEEL • ROOFING
APNGA Certificate of Achievement
This confirms that
I2aniel Ruch_ __ , _________ _
has successfully completed the APNGA Portable Nuclear Gauge
Radiation Safety Officer Class
on this day
Fridav. Janlk1rv 10,2014
ftmerican Portable Nuclear Gauge .Association (APNG.A:;r tJJW m .apnga .com
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APNGA Portable Nuclear Gauge Safety Certification Class
Certificate of Completion to:
Sean Axner
Hazmat refresher training is required within 3 years after today's date: Thursday, January 30. 2014
Course covers training criteria of NUREG 1556, The Agreement States, and 49 CFR 172, Subpart H ( nc udes ATA Requirements) The Company RSO comp(etes the training requirements by familiarizing the emp{oyee with:
State specific regulations including introduction to the stare regulatory website The company radiation safety program, specifically gauge safety operating and emergency procedures A tour of storage area with emphasis on security, documents and postings Loading, security, and transporting gauges in company vehicles The safety and operating features of the gauge(s) in use by the company Introduction to gauge safety content on gauge manufacturer website The RSO must also monitor the employee completing and passing a closed book test of this class material
The RSO signature certifies that the trainee has received the above training requirements.
tJoc/mwcn/~,~Lhc_ ~ C:ompail';u~ a me Si~nature ot RSO
.knerican Portable Nuclear Gauge Association (APNG~ w•.o.o u.o.apnga .c~·m
George E. lt.tlrshall APNGA Director
QIC RESOURCE ·' Training Course Certification
This is to certify that
Daniel M. Ruch has successfully completed the user's course as required by the U.S. Nuclear Regulatory Commission and the Agreement States, in the Fundamentals of · 1
' Safety a{Jd Gage operation, for the use of nuclear moisture/density equipment. I
The course covered:
Atomic Physics Transportation Operation
1 ;Radiation Safety Risk Field Applications I
f)ose/Shlelding Calculations A LARA Calibration
Accidents/Storage Measurement Theory Maintenance
Ma~ 28, 1998 ~c_J?~ · Date of Training 1990 Instructor· Philip C. Pa/11/a
, /
UNDERWOOD
ENGINEERING
INC.
Individuals that will be using NDG:
1. Sean Axner 2. James G. Bramley 3. Frank J. DeBellis 4. Michael Garofalo 5. Shane Johann 6. Fred Miller 7. Raymond Sandberg
*See Attached Certificates
143 Harding Avenue, Bellmawr, NJ 08031
856-933-1818 • Fax 856-933-3121
William R. Underwood, P.E.- President
~ ~ GEOTECHNICAL • ENVIRONMENTAL • SEPTIC SYSTEMS 20 YEARs SOILS • CONCRETE • ASPHALT • MASONRY • STRUCTURAL STEEL • ROOFING
Training Course Certification This is to certify that
Jam·es G. Bram.iey has successfully completed the ·RSO af!d Operator's course as required by the U.S~ Nuclear Regulatory Commission and the Agreement States, in the Fundamentals of
Safety and Gage operation, for the use of Nuclear Moisture I Density equipment. . . . . . . .
The course covered:
Atomic Physics
Radiation Safety
Dose/Shielding Calculations
Transportation
Risk
. ALARA
Operation
Field Applications
Calibration
Accidents/Storage Measurement Theory Maintenance
D . ~~i .;1o September 16, 2000 \ ... ae_~ c_ l-~ _
Date of Training 4810 Instructor· Philip C, Pa/ifla
Manufacturer's Rep. .
Training Course Certification.· This is to certify that
Frank J~ DeBe~~is has successfully completed the RSO and Operator's course as required by the U.S.
Nuclear Regulatory Commission and the Agreement States, in the Fundamentals of
Safety and Gage operation, for the use of Nuclear Moisture I Density equipment.
This course meets the requirements in NUREG 1556 Vol1, Appendix D. It covered:
Atomic Physics
Radiation Safety
Dose/Shielding Calculations
Accidents/Storage
June 7, 2003 ~
Date of Training
49 CFR Transportation
Risk
A LARA
Measurement Theory
Operation
Field Applications
Calibration
Maintenance
~ cC}?4Jk 6922 Instructor· Philip C. Pa/11/a
APNGA Portable Nuclear Gauge Safety & U.S. D.O. T. Hazmat Certification Class
Certificate of Completion to:
Mike Garofalo HAZMATrefresher training is required within 3 years after today's date:
September 1, 2014
This course covers training criteria ofNUREG 1556, The Agreement States, and 49 CFR 172, Subpart H.
The Company RSO completes the training requirements by familiarizing the employee with: • . State specific regulations including introduction to the state regulatory website • The company radiation safety program, specifically gauge safety operating and emergency procedures
. • A tour of storage areawith emphasis on security, documents and postings .• Loading, security and transporting gauges in company vehicles •• Hands-on training with the gauge and methods in use by the company • Introduction to gauge safety content on gauge manufacturer website ' Certificate covers both Gauge Safety and U SDOT HAZMAT requirements
.· The acknowledgement and signature of the RSO/Official makes the training and certific . ---.....
Urc!ur=d-~~~~lvtc_ ~ ·'· · ·.. Com~a~e ~g-.orno
American Portable Nuclear Gauge Association • p.O. Box 423, Emmitsburg, MD 21727 • www.apnga.com
APNGA Portable Nuclear Gauge Safety & U.S. D.O.T. Hazmat Certification Class
Certificate of Completion to:
Shane Johann HAZMATrefresher training is required within 3 years after today's date:
August 5, 2014
This course covers training criteria of N UREG 1556, The Agreement States, and 49 CFR I 72, Su bpmi H.
·The Company RSO completes the training requirements by familiarizing the employee with: . • State specific regulations including introduction to the state regulatory website
• The company radiation safety program, specifically gauge safety operating and emergency procedures • A tour of storage area with emphasis on security, documents and postings • Loading, security and transporting gauges in company vehicles • Hands-on training with thegauge and methods in use by the company • Introduction to gauge safety content on gauge manufacturer website • Certificate covers both Gauge Safety and USDOT HAZMAT requirements
The'acknowledgementand signature of the RSO/Official makes the training and certific
u~~~~iN~,.,.vv'\A s:: · Company Name ) · Signature of RSO PNGA
American Portable Nuclear Gauge Association P.O. Box 423, Emmitsburg, MD 217'27 • www.apnga.com
Comyaction and 1Jensity Testing
This certifies that
Fred Miller
has successfully completed training on compaction and density testing methods on the date below.
~ (li) Jr''· ~ox~~~ -- ~ The Leader in Construction Testing Equipment
July 09, 2013
Troxler Electronic Laboratories, Inc. PO Box 12057-3008 Cornwallis Road -Research Triangle Park, NC27709 Phone: (919) 549-8661 - Fax (919) 549-0761 - www.troxlerlabs.com
Course: Compaction & Density Testing Tracking Code8955M6K8F9M7H75_ 42040
Training Course Certification This is to certify that
Raymond a Sandberg has successfully completed the RSO and Op.erator's course as required by th'e U.S.
NuciJar Regulatory Commission and the Agreenyent States, in the Fundame~tals of
Safety and Gage operation, for the use of Nuclear Moisture I Density equipment •. This course meets the requirements in NUREG 1556 Vo/1, Appendix D. It cdvered:
• . A~omlc Physics '
Radiation Safety
Dose/Shielding Calculations
Accidents/Storage
= . : AprU 28, 200_! Date of Training
TransportaUon Operation ' .. ·'
Risk FJeld Applications I. •: I •• •
~
A LARA Calibration .. , Measurement Theory Maintenance
--==r:t.a~c.~~ 5266 Instructor· Philip C. Paflf/a ·
I '~ • I 1'.1·
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' ....
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UNDER\VOOD ENGINEERING TESTING CO.,INC. 143 Harding Ave.
Bellmawr, NJ 08031 William R. Underwood. PE -President
Locations that the NDG is being used and stored
NDG will be used at:
I. Jonah Kelly Center - US Army Reserve Center - Ft. Dix, NJ 2. Ft. Dix Dining Hall- US Army Reserve Center- Ft. Dix, NJ
NDG will be stored at:
1. Undervv-ood Engineering- 143 Hading Ave. Bellmawr, NJ 08031
Estimated Timeline ofUse
Phone (856) 933-1818 Fax (856) 931-7124
NDG will be used at the above referenced sites fi·om approximately May 2014 t]mi May 2016
SOILS.· FOUNDATIONS CONCRETE ASPHALT MASONRY STRUCTURAL STEEL ROOFING
UNDERWOOD
ENGINEERING
INC.
Model and Serial Numbers of the NDG:
1. Gauge Model- 3430, Gauge Serial Number- 32399 2. Gauge Model- 3430, Gauge Serial Number- 30494 3. Gauge Model- 3430, Gauge Serial Number- 31165 4. Gauge Model- 3430, Gauge Serial Number- 32414 5. Gauge Model- 3411, Gauge Serial Number- 5501
143 Harding Avenue, Bellmawr, NJ 08031
856-933-1818 • Fax 856-933-3121
William R. Underwood, P.E.- President
~ ~ GEOTECHNICAL • ENVIRONMENTAL • SEPTIC SYSTEMS 20YEARs SOILS • CONCRETE • ASPHALT • MASONRY • STRUCTURAL STEEL • ROOFING
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Instro'l'ek, Inc. 5908 Triangle Drive Raleigh, NC 2.7 617 (919)875-8371 Fax (919)875-8328
MELINDA JOHNSON '
10/14/2014 . Test Number: 23.
UNDERWOOD ENGINEERING TESTING CO.,INC. 143 HARDING AVE.
Phone~ (856)933-1818 Fax: (856) 931-7124
SUITE 10 BELLMAWR, NJ 08031
LEAK TEST CERTIFICATE
NC Materials License #092-1073-1
This c~rtifies that leak test analysis was conducted on the sample with the following information. The results shown below accurately represent the level of removable contamination.
Gauge Model: 343cr Gauge S/N: 32399
Source (Model/Serial#)
47-28609 750-7660
Test Date: 10/11/2014.
Reading in miGroCuries
0.00000 0.00027
Note: 0.005 microCuries (185 Bq) or greater is considered a leaking source. 0 The source(s) tested above may remain in use.
Reviewed by: Date:
Customer Signa~ ~Date:
oCPN gauges are 50 mCi Am24l:Be and 10 mCi Cs-137. Hmnboldt gauges are 40 mCi Am24l:Be and 10 mCi Cs-137. InstroTek Gauge is 40 mCi Am24l:Be and 10 mCi Cs-137. Troxler gauges all, except 4640, aFe 40 mCi Am24l:Be and 8 mCi Cs-137. Troxler 4640 is 8 mCi Cs-137.
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InstroTek, Inc. 5908 Triangle Drive Raleigh, NC 27617 (919)875-8371 Fax (919)875-8328
MELINDA JOHNSON
T-G 10/14/2014
Test Number: 20
UNDERWOOD ENGINEERING TESTING CO.,INC. 143 HARDING AVE.
Phone: (856) 933-1818 Fax: (856) 931-7124
SUITE 10 BELLMAWR, NJ 08031
LEAK TEST CERTIFICATE
NC Materials License #092-1073-1
This certifies tnat leak test analysis was conducted on the sample with the following information. The results ·shown below accurately repres~nt the level of removable contamination.
Gauge Model: 3430 Gauge S/N: 30494
Source (Model/Serial#)
47-27590 750-4998
Test Date: 10/11/2014
Reading in microCuries
0 ._00000 0.00024
Note: 0.005 microCuries (185 Bq) or greater .is considered a leaking source. 0 The source(s) tested above m~y remain in use.
Reviewed by: Date:
Customer Signat~ ~ Date:
•cPN gauges are 50 mCi Am241:Be and 10 mCi Cs-137. Humboldt gauges are 40 mCi Am241:Be and 10 mCi Cs-137. InstroTek Gauge is 40 mCi Am241:Be and 10 mCi Cs-137. Troxler gauges all, except 4640, are 40 mCi Am241:Be and 8 mCi C~-137. Troxler 4640 is 8 mCi Cs-;137.
InstroTek, Inc. 5908 Triangle Drive Raleigh, NC 27617 (919)875-8371 Fax (919)875-8328
10/14/20~4. Test Number: 21
MELINDA JOHNSON UNDERWOOD ENGINEERING TEE;TING CO.,INC. 143 HARDING AVE.
Phone: (856) 933-1818 · Fax: (856) 931-7124 ·
SUITE 10 BELLMAWR, NJ 080~1
LEAK TEST CERTIFICATE
NC Materials License #092-1073-1
This certifies that leak test analysis was conducted on the sample with the f-ollowing information. The results shown below accurately represent the level of removable contamination.
Gauge Model: 3430 Gauge S/N: 31165
Test Date: 10/11/2014
Source (Mo~el/Serial#) Reading in microCuries
47-2373 750-5811
Note: 0.005 microCuries (185 Bq) or greater l~aking source. 0 ~he source(s) tested above use.
1 Date:
0.00000 0.00026
is considered a may remain in
Reviewed by: ~ · I ++4-g --'------- ' I
Customer Signat~s ~Date:
•cPN gauges are 50 mCi Am241:Be and 10 mCi Cs-137. Humboldt gauges are 40 mCi Am241:Be and 10 mCi Cs-137. InstroTek Gauge is 40 mCi Am241:Be and 10 mCi Cs-137. Troxler gauges all, except 4640, are 40 mCi Am241:Be and 8 mCi Cs-137. Troxler 4640 is 8 mCi Cs-137.
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InstroTek, Inc. 5908 Triangle Drive Raleigh, NC 27617 (919)875-8371 Fax (919)875-8328
MELINDA JOHNSON
T-Il 10/14/2014
Test Number: 23
UNDERWOOD ENGINEERING TESTING CO.,INC. 143 HARDING AVE.
Phone: (856) 933-1818 Fax: (856) 931-7124
SUITE 10 BELLMAWR, NJ 0803.1
LEAK TEST CERTIFICATE
NC Materials License #092-1073-1
This certifies that leak test analysis was conducted on the sample with the following information. The results shown below accurately represent the level of removable contamination.
Gauge Model: 343cr Gauge S/N: 32414
Test Date: 10/11/2014
Source (Model/Serial#) Reading in microCuries
47-28624 750-'7720
0.00000 ·o. ooo25
Note: 0.005 microCuries (185 Bq) or greater is considered a ~=:~ing source.
0,Th;;rource(s) tested aboVe may remain in
I Reviewed by:
t ./ . Date: /fJ J /4 /z~ lq-
' ,
Customer ~..___Date:
°CPN gauges are 50 mCi Am241:Be and 10 mCi Cs-137. Humboldt gauges are 40 mCi Am24l:Be and 10 mCi Cs-137. InstroTek Gauge is 40 mCi Am241:Be and 10 mCi Cs-137. Troxler gauges all, except 4640, are 40 mCi Am241:Be and 8 mCi Cs-137. Troxler 4640 is 8 mCi Cs-137.
(
InstroTek, Inc. 5908 Triangle Drive Raleigh, NC 27617 (919)875-8371 Fax (919)875-8328
MELINDA JOHNSON
10/14/2014 Test Number: 20
Phone: (856) 933-1818. UNDERWOOD ENGINEERING TESTING CO.,INC. 143 HARDING AVE.
Fax: (856) 931-7124 ·
SUITE 10 BELLMAWR, NJ 08031
LEAK TEST CERTIFICATE
NC Materials License #092;-1073-1
This certifies that leak test analysis was conduct~d on the sample with the following information. The results shown below accurately represent the level of removable contamination.
Gauge Model: 3411 Gauge S/N: 5501
Test Date: 10/11/2014
Source (Model/Serial#) Reading in microCuries
47-1607 750-7923
0.00000 0.00026
Note: 0.005 microCuries (185 Bq) or greater i~ considered a leaking source. 0 ~he source(s) tested above may remain in use.
Reviewed by: Date:. I '
C4stomer Signat~~ Date:
°CPN gauges are 50 rnCi Am24l:Be and 10 rnCi Cs-137. Humboldt. gauges are 40 rnCi .. r' Am24l:Be and 10 rnCi Cs-137. InstroTek Gauge is 40 rnCi Am24l:Be and 10 rnCi Cs-137. \ '-- Troxler gauges all, except 4640, are 40 rnCi Am24l:Be and 8 rnCi Cs-137. Troxler 4640
is 8 rnCi Cs-137.
NRC FORM 374 U.S. NUCLEAR REGULATORY COMMISSION
PAGE 1 OF _4_ PAGES
Amendment No. 07
MATERIALS LICENSE Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code o' -1deral Regulations, Chapter I, Parts 30, 31, 32, 33, 34, 35, 36, 39, 40, and 70, and in reiiance on statements and representations t. Jfore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s) and at the place(s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below.
Licensee In accordance with the letter dated
May 5, 2008,
1. Underwood Engineering Company, Inc. 3. License number 29-23425-01 is amended in
its ~qtirety to read as follows:
2. 143 Harding Avenue
Bellmawr, New Jersey 08031
-6,- - filyproduct, sour-ee, . .and/or.-speGial· .. nuclear material
A. Cesium 137
B. Americium 241
9. Authorized use:
4. Expiration date ~pril 30, 2015
5. Docket No. 030;21 053 Reference No.
-·•:? ..... .Chemicsl-and/orphysic;:;L form=-.- -.-·· · - . ..&...,.,Maximum-amounHl:lat-lieensee-may ·. ppssess at any one time under this
license
' A. Sealed Sources {OSA Global
Model CDCW556; l~otope Products Laboratories Models ,HEG~J37-8M; HEG-137, HS.LP:Wg.220P064)' ...
B. Sealed Sources (.QSA Global Modei AMNV.997; Isotope Products Laboratories Models Am1.N02, 3021, 3027; HSI Dwg. 2200067)
A. 170 millicuries total and no single source to exceed the maximum activity specified in the device's certificate of registration issued by the U.S. Nuclear Regulatory Commission or an Agreement State
B. 710 millicuries total and no single source to exceed the maximum activity specified in the device's certificate of registration issued by the U.S. Nuclear Regulatory Commission or an Agreement State
A and B. In Troxler Electronic Laboratories Models 3216, 3411, 3430; 4640 and Humboldt Scientific Inc., Model 5001 C portable gauging devices for measuring physical properties of materials.
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION
MATERIALS LICENSE SUPPLEMENTARY SHEET
CONDITIONS
PAGE 2 ot 4 PAGES ~--------------------------------License Number
29-23425-01 Docket or Reference Number
030-21053
Amendment No. 07
10. Licensed material may be used or stored at the licensee's facilities located at 143 Harding Avenue, Bellmawr, New Jersey, and may be used at temporary job sites of the licensee anyvvhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating the use of licensed material, including areas of exclusive Federal jurisdiction within Agreement States.
If the jurisdiction status of a Federal facilitY within an Agr'~e111ent State is unknown, the licensee should contact the Federal agency controlj'fpg \he job site in question tQ d~~termine whether the proposed job site is an area of exclusive FederaJ Jyrisdiction. Authorization for use·of (Pdioactive materials at job sites in Agreement States not unde(exdusive Federal jurisdiction shall be obtaiped from the appropriate state regulatory agency. ·
·-· ,...
11. Licensed material shall be usedJ>y, or under the supervision andln the physical presence of, individuals wh_Qh"~.Y~ L~-c;:~lv€:1d J.tieJcgJning d~scrib~gin _th~gpp1J£;<.'!ti~J:J::tt~g.d""Mar£;h ~Q .. ~~OQ:S,~- ---~-----·-- " ___ _
12. The Radiation Safety Officer for thi~ lie§9se is P~tricfa M. Bem~sderfer.
~" A. Sealed sources shall be te~ted fo'r leakage and/or contamination at intervals not to exceed six months or at the intervals spe~ifiedin the certificate ofTegistration issued by the U.S. Nuclear Regulatory Commission under 10 CFR 32.210 or under equivalent regulations of an Agreement State. ··
B. In the absence of a certificate from a trarisreror indicating that a. leak test has been made within the intervals specified in the certificate of registration issued.by the ~.S. Nuclear Regulatory Commission under 10 CFR 32.210 or under equivalent regulations of an Agreement State, prior to the transfer, a sealed source received from another person shall not be put into use until tested and the test results received.
c_ Sealed sources need not be tested if they are in storage and are not being used; however, when they are removed frorn storage for use or transferred to another person and have not been tested within the required leak test interval, they shall be tested before use or transfer. No sealed source shall be stored for a period of more than 1 o years without being tested for leakage and/or contamination.
D. The leak test shall be capable of detecting the presence of 0.005 microcurie (185 becquerels) of radioactive material on the test sample. If the test reveals the presence of 0.005 microcurie (185 becquerels) or more of removable contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(c)(2), and the source shall be removed immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations.
NRC FORM 374.4. U.S. NUCLEAR REGULATORY COMMISSION
MATERIALS LICENSE SUPPLEMENTARY SHEET
PAGE 3 of 4 PAGES
License Number 29-23425-01 Docket or Reference Number 030-21053
Amendment No. 07
E. Tests for leakage and/or contamination, limited to leak test sample collection, shall be performed by the licensee or by other persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services. The licensee is not authorized to perform the analysis; analysis of leak test samples must be periormed by persons specifically licensed by U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
F. Records of leak test results shall be ~ept-in units of microcuries and shall be maintained for 5 years. '•,
·-..:.
14. Sealed sources or source rods containing licensed material sha]l ryqt be opened or sources removed or detached from source rods or gqtJges by the licensee, except as spe,eifically authorized.
15. The licensee shall conduct ~physical inventory every six months, or at'oth.er intervals approved by the U.S. Nuclear Regulatory Commission, to account for all sources a,nd/or devices received and possessed under the license. Records ofii:ryentories shall be maintained for"~ years from the date of each inventory
... ~mL~b9!Un9t\.ld~Jh~~r_ggiQn!)-9li.d~~Ju9.V.~o1i.tie$,.!IIanu~tu,r~t:$,.flja_ro~u~ndrnocie_lm.Jmbers_,_aodJhe date .of the inventory.
16. Each portable nuclear gauge Sh<;JII have a foe~ pr ou.ter lpcked qontainer designed to prevent unauthorized or accidental removal 'Of the sealed ,source from its shielded position. The gauge or its container must be locked when in transport or storage, or when not under the dired surveillance of an authorized user.
17. Any cleaning, maintenance, or repair bf theJ)auges tha~ie_quires detaching the source or source rod from the gauge shall be performed only by'tpe·m~nUJacturetor by other persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
18. A If the licensee uses unshielded sealed sources extended more than 3 feet below the surface, the licensee shall use surface casing that extends from the lowest depth to 12 inches above the surface and other appropriate procedures to reduce the probability of the source or probe becoming lodged below the surface. If it is not feasible to extend the casing 12 inches above the surface, the licensee shall implement procedures to ensure that the cased hole is free of obstruction before making measurements.
B. If a sealed source or a probe containing sealed sources becomes lodged below the surface and it becomes apparent that efforts to recover the sealed source or probe may not be successful, the licensee shall notify the U.S. Nuclear Regulatory Commission and submit the report required by 10 CFR 30.50(b)(2) and (c)~ The licensee shall not abandon the sealed source or probe without obtaining the Commission's prior written consent.
19. The licensee is authorized to transport licensed material in accordance with the provisions of 10 CFR Part 71, "Packaging and Transportation of Radioactive MateriaL"
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 4 of 4 PAGES
MATERIALS LICENSE SUPPLEMENTARY SHEET
~------------------------------License Number
29-23425-01 Docket or Reference Number
030-21053
Amendment No. 07
20. Except as specifically provided otherwise in this license, the licensee shall conduct its program in accordance with the statements, representations, and procedures contained in the documents, including any enclosures, listed below. The U.S. Nuclear Regulatory Commission's regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more restrictive than the regulations.
Date
A. Application dated March 30, 2005 (M.L0.5J 08,0357) B. Letter dated May 1, 2007 (ML071 ~20.243)' · C. Letter dated May 5, 2008 (rytL_O~l1440334)
· ... _.·
May 27 2008
For the U.S. Nuclear Regulatory Commission
By f2n_ h.- J,r;, ~-(;enny Jo~nse¢" / ~
Materials Secufi(y and Industrial Branch Division of Nuclear Materials Safety Region I King of Prussia, Pennsylvania 19406
Tuesday, May 27, 2008 12:09:25 PM
This is to acknowledge the receipt of your lette /application ated
11)1 q l1 ~ , and to inform you that the initial processing which includes an administrative review has been performed. )
l1t11eu1Me~.rr C~q -J.3~JJ)-O I IXJ Thef~ were no aarrumstrative om1ss1ons. Your fpplication was assigned to a technical reviewer. Please note that the technical review may identify additional omissions or require additional information.
O Please provide to this office within 30 days of your receipt of this card
A copy of your action has been forwarded to our License Fee & Accounts Receivable Branch, who will contact you separately if there is a fee issue involved.
Your action has been assigned Mail Control Number -sg~ L(t-f-[ . When calling to inquire about this action, please refer to this control number. You may call us on (610) 337-5398, or 337-5260.
NRC FORM 532 {RI)
{6-96)
Sincerely, Licensing Assistance Team Leader