secon southeast alaska - license amendment. · bachelors degree major - parks and recreation. minor...

34
SOUTHEAST ALASKA 500 108 th Ave. N.E. Ste 1740 P.O. Box 32159 P.O. Box 7038 Bellevue, WA 98004 Juneau, AK 99801 Ketchikan, AK 99901 (425) 827-3193 (907) 780-5145 (907) 225-6491 (425) 576-5113 FAX (907) 780-5896 FAX (907) 225-6492 FAX " DecemberX 2007 Nuclear Materials Licensing Branch U.S. Nuclear Regulatory Commission, Region IV RECEIVED 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-4005 DEC 1 9 2007 ON I\IIE; Dear Sirs Secon Inc. is submitting this application to amend our materials license #50-29231-01 in regards to the Radiation Safety Officer designation. Rick Millward, our current designated RSO, will be terminating his employment with this company and we have named Jason Bartschi to fulfill those duties. Please find attached Mr. Bartschis' resume and certifications. Thank you for your attention to this matter. John Logsdon Operations Manager

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Page 1: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

SOUTHEAST ALASKA

500 108th Ave. N.E. Ste 1740 P.O. Box 32159 P.O. Box 7038 Bellevue, WA 98004 Juneau, AK 99801 Ketchikan, AK 99901 (425) 827-3193 (907) 780-5145 (907) 225-6491 (425) 576-5113 FAX (907) 780-5896 FAX (907) 225-6492 FAX

" 4~£. DecemberX2007

Nuclear Materials Licensing Branch U.S. Nuclear Regulatory Commission, Region IV RECEIVED 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-4005 DEC 1 9 2007

ON I\IIE;Dear Sirs

Secon Inc. is submitting this application to amend our materials license #50-29231-01 in regards to the Radiation Safety Officer designation. Rick Millward, our current designated RSO, will be terminating his employment with this company and we have named Jason Bartschi to fulfill those duties.

Please find attached Mr. Bartschis' resume and certifications.

Thank you for your attention to this matter.

John Logsdon Operations Manager

Page 2: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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Certificate P.:..ge 1 of 1 I

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~!I ··,<lCertificate ofqcompLetion -~t~~ .~~ I .~ ••- .~ Ilf .~ .~ .,;t " II" _:.a il:;'c~~~~:

~~.l This is to certify that :~I'r~(:~~:·.~::.~:~~1I./!J f • ' ':.'>->.:"<'<.''1/ I Jason Bartschl i ,;.".,:"':''>'J­w ( I' r ~ J'., • " I '

I has completed a course ofstudy in i~'''~:;,){,

Yearly Refresher Course - Portable Nuclear Gauge ..~.·~{:~-=1'f:""

~" dated ,',-~.- -'- .... ~, 11 December 1, 2007 ·.!·\::~~:~~~::.::S~ 1/11 I db'" '" "". '" ',',p{,lU-....W<:. i Ojjere y :[-,-1', ",'J.

~"....\! American Technical Institute +:<:::., ,~ I :f'{;~:~~~_

~.~:' I irrr~~~.-=.:.~.:~Training satisfies US DOT training requirements of 49 CFR 172 including:V/.-0"" I ' '>:>'~""' ...' .... j '-.or"/// f ! :,',.,.-.\>.>;;l.f /,/ ; I • Emergency Procedures L.,' "'., \;'

I r-<: i-· _. • • Methods and procedures for avoiding accidents '~, '/?-: [~1 • Hazardous ~alerials identification and recognition :f:::>:~';~~';:.

......--::-~ I '. Self-protection measures ' ~<:-::::'-~_< ~~.:. ! • Regulations applicable to job functIOn .·Vf::-:::_'.'-':':~: ./~. i ,r,;,>~-:<>.,';·~ I Certification eXpiratIOn:,-' '1/11 I',',":' .... ,,Y(/ .' ,'f ~ Yearly Refresher Training .. 1 year from date listed I ','., " ;N :lOOT - 3 years from date listed above I ,qJL .r \ \ ; ~~~ American TechnicallnsiiiuIB J'~::./.~~ ".

\ 1 .. - • 5130 S. Ft. Apache Rd, #215-245 ' -" __ ---~,~i .~ .__~as vega~:_N~:~~~.~1.~8_.:h~~.::~~::~:.:::,CompaQ' "SO S;goolu,e •<;...::: . - - .... ...___........... _._....... . ... ."_ . ....... _... . .. ..__._. ...... ........ ~.. . '., ...,..1., .

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Page 3: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

Certificate Page 1 of 1

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httD://www.ati.coursehost.com/Certificate/A26F9F06 E9A3 473B 8DE8 1FD676CB 148F 12/1/2007

Page 4: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

JASON BARTSCHI

EXPERIENCE

2004 -2007 MAPPA Test Lab North Pole, AK

LAb/Field Technician

• Experienced in ASTM testing procedures for gradations, proctors, sampling and field testing.

• Certified by American Concrete Institute in field concrete testing, as well as compressive strength testing in Laboratory with hydraulic break equipment.

• Extensive background in asphalt testing including Marshall tests, theoretical maximum compaction (RICE tests), oil content (with nuclear oven),specific gravity, and basic mix design.

• Certified in nuclear testing of soils by Troxler Labs. Inc.

2005 CMT Geotechnical and Engineering Logan, UT

Field Technician/ LAb Technician

• Field tested soil density of footings, building pads, roadways, etc., with Troxler nuclear gauges.

• Concrete Testing

• Asphalt sampling

2004 Applied Geotechnical Engineering Consultants St. George, UT

Field Technician

• Testing soil density of footings, building pads, roadways, etc., with Troxler nuclear gauges.

• Concrete Testing

• Asphalt sampling

2000-2002 Red Rock Ranch Academy St. George, Utah

Wilderness Director • Assistant Director/Field support for one year

• Hired new staff and handled Training.

• Worked directly with staff and students tp solve problems

• Ordered supplies and organized warehouse.

2002-2003 Capital Regiment Drum & Bugle Corps Columbus, Ohio

Visual Instructor

• Assisted in teaching precision marching techniques

• Responsible for ten students' marching performance

Page 5: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

EDUCATION

1994 Graduated Mountain Crest High School Hyrum, Utah

2003 Graduated Dixie State College St. George, Utah

Associate degree

Major - Psychology

2007 Graduated Utah State University Logan, Utah

Bachelors Degree

Major - Parks and Recreation. Tvfinor in Psychology

CERTIFIATIONS -----_.~.-...._._._----~-~~-~._._-~ .~----------

2001 CPR/FA Certified Instructor American Red Cross

2002 Wilderness First Responder Wilderness Medicine of Utah Re-certified in 2007

2004 A.c.I. Certified American Concrete Institute

2004 Nuclear gauge Certification Troxler Labs Inc

REFERENCES

Brendan Mack Lab Manager - I\1APPA Test Labs (Anchorage & Delta Lab) 907-244-8007

Kit Winchester Field Supervisor - AGEC Engineering and Testing 907-590-4344

Bart Hunter Economic Geologist/Technician 520-668-2783

2

Page 6: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

SOUTHEAST ALASKA

500 108th Ave. N.E, Ste 1740 P.O. Box 32159 P.O. Box 7038 Bellevue, WA 98004 Juneau, AK 99801 Ketchikan, AK 99901 (425) 827-3193 (907) 780-5145 (907) 225-6491 (425) 576-5113 FAX (907) 780-5896 FAX (907) 225-6492 FAX

" !/£LDecember;i' 2007

Nuclear Materials Licensing Branch U.S. Nuclear Regulatory Commission, Region IV RECEIVED 611 Ryan Plaza Drive, Suite 400

DEC 1 9 2007Arlington, TX 76011-4005

DNlViSDear Sirs

Secon Inc. is submitting this application to amend our materials license #50-29231-01 in regards to the Radiation Safety Officer designation. Rick Millward, our current designated RSO, will be terminating his employment with this company and we have named Jason Bartschi to fulfill those duties.

Please find attached Mr. Bartschis' resume and certifications.

Thank you for your attention to this matter.

John Logsdon Operations Manager

Page 7: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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·1Certificate h.ge 1 c,f 1 !

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~I ,QCertificate of (!Completion. :~~l~~ . ~ .~ A.A "w. "_ill. ,r,"/'/'----' c~ '-. ',k_ >,-',---,-:~"~ '~.----- ,

~~ This is to certify thatF~:~::::::~::~:~·. vm/'I Jason Bartschi 'I\.:.<->:'.~·<-(/ { II , .::"-"r'''': .... " ..,....-1 r~ I has completed a course ofstudy zn +<~{

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~ I December 1 J 2007fg::~~::~~::::'> '--{ / l,l, I oFrered bl)~-' ':"","-.'.}.....(t t , .-' " ,I, ''JJ< ,)

r~~! American Technicallnstitutet:::?j~. ,-~ I ~i:;~~~~~ ~-:., ~:~:'I Training satisfies US DOT training requirements of49 CFR 172 including: ;~i:~,(:~:-:::::~ { ,-//,"" I ,...."'......'., '.j(///y , I '\\>,',;'

l.,u;' ,,/- • L' ~ ,J":f 1 ! Emergency Procedures I r 1­

i-' . !I • Methods and procedures for avoiding accidents t".,,_:::),;". [~:::::" ' I • Hazardous malenals Identification and recogniIJon :r: .>:::::-:-':_-~_ ,....-::-~ f '. Self-protection measures ,::_>::.: ----·c. ~~ ! • Regulations applicable to job function t.,~'f;~,:::.~::.:~:

~/~ I .1\\-,:-«,,' ",l '1/11 I CertlficationexPirallon:!',"'.: -.,'.j"U.' I I :lYearly Refresher Training, 1 year from dale listed I" ':··Vti) ; DOT - 3 yean> from dal~bove . ',' l ,.lr L.

::-\ \ \; _----~./?~ Amencan Technical. Insmu(e i:.->-'. (~ \ I -~ . 5130 S. Ft. Apache Rd. #215-245 :f:<,-- -----.

~~-=:.:~l Company RSO Signature Las Vegas, Nevada 89148 f:~-=- .. -~-'·

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Page 8: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

Certificate Page 1 of 1

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htto://\Vww.ati.coursehost.com/Ce11ificate/A26F9F06 E9A3 473B 8DE8 1FD676CB 148F J2/1/2007

Page 9: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

JASON BARTSCHI

EXPERIENCE

2004 -2007 MAPPA Test Lab North Pole, AK

Lab/Field Technician

• Experienced in AS1M testing procedures for gradations, proctors, sampling and field testing.

• Certified by American Concrete Institute in field concrete testing, as well as compressive strength testing in Laboratory with hydraulic break equipment.

• Extensive background in asphalt testing including Marshall tests, theoretical maximum compaction (RICE tests), oil content (with nuclear oven),specific gravity, and basic mix design.

• Certified in nuclear testing of soils by Troxler Labs. Inc.

2005 CMf Geotechnical and Engineering Logan, UT

Field Technician/ Lab Technician

• Field tested soil density of footings, building pads, roadways, etc., with Troxler nuclear gauges.

• Concrete Testing

• Asphalt sampling

2004 Applied Geotechnical Engineering Consultants St. George, UT

rzeld Technician

• Testing soil density of footings, building pads, roadways, etc., with Troxler nuclear gauges.

• Concrete Testing

• Asphalt sampling

2000-2002 Red Rock Ranch Academy St. George, Utah

Wilderness Director • Assistant Director/Field support for one year

• Hired new staff and handled Training.

• \Vorked directly with staff and students t.o solve problems

• Ordered supplies and organized warehouse.

2002-2003 Capital Regiment Drum & Bugle Corps Columbus, Ohio

Visual Instmctol'

• Assisted in teaching precision marching techniques

• Responsible for ten students' marching performance

Page 10: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

EDUCATION

1994 Graduated Mountain Crest High School Hyrum, Utah

2003 Graduated Dixie State College St. George, Utah

Associate degree

Major - Psychology

2007 Graduated Utah State University Logan, Utah

Bachelors Degree

Major - Parks and Recreation. Minor in Psychology

CERTIFL-\ TIONS

2001 CPR/FA Certified Instructor .-\merican Red Cross

2002 Wilderness First Responder Wilderness Medicine of Utah Re-certified in 2007

2004 A.c.I. Certified American Concrete Institute

2004 Nuclear gauge Certification Troxler Labs Inc

REFERENCES

Brendan Mack Lab Manager -lvL-\PPA Test Labs (.-\nchorage & Delta Lab) 907-244-8007

Kit Winchester Field Supervisor - ,-\GEC Engineering and Testing 907-590-4344

Bart Hunter Economic Geologist/Technician 520-668-2783

2

Page 11: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

'100eno J I orres - L;nange In H~U I-"age,

t' ' ,J

From: "John Logsdon" <[email protected]> To: <rjt@ nrc.gov> Date: 12/17/20079:06:30 PM Subject: Change in RSO

Mr. Torres,

Here are the documents we discussed on the phone today. Please let me know if there is anything else you require.

Thank you.

John Logsdon

John Logsdon

Operations Manager

SECON

5322 Shaune Dr.

Juneau, Alaska 99801

907-780-5145 Juneau

907-225-6491 Ketchikan

907-321-1131 Cellular

~' I - 1 P 0 3

Page 12: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

, .

• SOUTHEAST ALASKA

500 108lh Ave. N.E. Ste 1740 P.O. Box 32159 P.O. Box 7038 Bellevue, WA 98004 Juneau, AK 99801 Ketchikan, AK 99901 (425) 827-3193 (907) 780-5145 (907) 225-6491 (425) 576-5113 FAX (907) 780-5896 FAX (907) 225-6492 FAX

December 17, 2007

Nuclear Materials Licensing Branch U.S. Nuclear Regulatory Commission, Region IV 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-4005

Dear Roberto Torres,

Secon Inc. is submitting this application to amend our materials license #50-29231-01 in regards to the Radiation Safety Officer designation. Rick Millward, our current designated RSO, has had his employment with this company terminated and we have named Jason Bartschi to fulfill those duties. Please find attached Mr. Bartsohis' certifications.

In the interim, the nuclear testing gauges are locked per specification in their approved secure storage. We have received a stop work order from Mr. Millward which we will obey until Mr. Bartschi can be approved and our work is shut down until at least the middle of January due to weather.

We have trained and certified personnel. including Mr. Bartschis, that can operate these gauges when work resumes.

Thank you for your attention to this matter.

#C~ John Logsdon Operations Manager

Page 13: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

, NRC FORM 313 U.S. NUCLEAR REGULATORY COMMISSION (1Q..200S) 10 CFR 3D, 32,33, 34, 35, 36, 39, and 40

APPLICATION FOR MATERIALS LICENSE

DA NEWUCENSE

l""::Zt" ~B. AMENDMENT TO LICENSE NUMBER :50- 'Z.q'''~:r /-01

D C. RENEWAL OF LICENSE NUMBER

- -

ANY DEPARTMENT OR AGENCY OF THE UNITED STATES. AS TO ANY MATTERWITHIN ITS JURISDICnO"'...... '. '. .

CERTIFYING OFFICER - TYPEDIPRINTEDNM.1EANDlm.£: . ... . .' .•.... ..SIGNATUR~J(J) HlJ LoGSDOlv (}IBViTlew5 rf1NJ¥ZtE'f- •... . ... .C. .~ IDATE ..

./?-·/7·0 7

FOR NRC USE ONLY TYPE OF FEE IFEE LOG IFEE CA~EGORY ':"'~UNT RECEIVED . CHECK NUMBER COMMENTS

-~

APPROVED BY DATE

NRC FORM 313 (1Q..2005) PRINTED ON RECYCLED PAPER

APPROVED BY OMS: NO. 3150-0120 EXPIRES: 19131/2008Esllmaf8d burden 1l.8r'. response to comply wllt! this mandatory collection request: 4.4 hou($. Submittal of thE! ;rePlication Is nec~ry to datermlne that the applicant Is ~uallfled and that ad~U 8 procedures elast to protect the public health and safety.

endConimems ~ai' Ins bUr'den estlmateto the Records.and FOIA/Privacy SerVices Branch (T-5F53). .S. Nuclear RegulatoryCommisl!lOl'l, Washington. DC 20555-0001, or bylntemel e-:msllto Infocollectill>nrC;gov, sod to the DeskOffIcer;Offlceol InfOnnallon.and ~u1atory Affliirs. N' 8·10202, (3150-0120), OIIice 01 Manag~ent and BUdgBl, Washington,. DC 20503., If .ameans used toimpoS8 an Information coll$Ctlory d~ not. display a CUrrently vahdOMB control number; the NRC may not condu~or sponsor, and a person Is not reqUired to respond to, the .information coIledlonf '; ..... . .

INSTRUcTIONS: SEe THE APPROPRIATE LICENse APP'L1CATION GUlpe FQRDETAILEb INSTRUCTIONS FOR COMPLETING APPLICATION. SEND.TWO COPIES OF THE ENTIRE COMPLETED APPI,JCATION TO THE NRC OFFICE SPECIFIED BELOW.

APPUCATrON FOR DI$TRJBUnON OF EXEMPT PRODUCTS FILE APPlICA110NS WIlW:'

DIVISUJN OF INDUSTRIAL AND MEDICAL NUCLEAR SAFETY OFFICE OF NUCLEAR MATERIALS SAFETY AND SAFEGUARDS U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20S5&.0001

ALL OTHER PERSONS FILE APPUCAnONS AS FOLLOWS:

. IFVOU ARE LOCATED IN:

ALABAMA, 'CONNECllCUT, DELAWARE, DISTRICT OF COWMBIA, FLORIDA. GEORGIA, KEN1lJCKY, MAINE. MARYlAND, MASSACHUSETTS, NEW HAMPSHIRE, NEW JERSEY, NEW YORK, NORlll CAROUNA, PENNSYLVANIA, PUERTO RICo. RHODE ISLAND, soum CAROUNA, 'lENNESSEE, VERMoNT, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA, SEND APPUCATIONS TO:

LICENSING ASSISTANCE TEAM DIVISION OF NUCLEAR MATERIALS SAFETY. U.S. NUCLEAR REGULATORY COMMISSION,REGION I 475 ALLENDALE ROAD KING OF PRUSSIA,PA 19406-1415

1.' THIS IS AN APPLICATION FOR (Check appropriate '18m)

3. ADDRESS WHERE LICENSED MATERIAL IMLL BE USED OR POSSESSED

t;4/~ N~.l~~ -r;::. '""~ ~l. • ..>. f" A...rC,

j(" <:,_ 17<::: ""'. t{~"".,...... / Afe.,,,-sicA...; 11101

S. RADIOACTIVE MATERIAL e. Element end me55 number, b. chemical and/or physlcallonn:and c. maiximilm .unount .

whlcll will be poaaesS8il at anyone lime. .' -7. INDIVIDUAL(Sl RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEIR

TRAINING EXPERIENCE.

9. FACIUTIES AND EQUIPMENT. .'

11. WASTE MANAGEMENT.

IFVOU AJUi: LOCATED IN:

ILUNOIS,INDIAHA; IOWA, MICliIGAN, MINNESOTA, MISSOURI, OHIO, OR WiscoNSIN, BElli APPLICATIONS TO:

MATERIALSLICENSING BRANCH U.S: NUCLEAR REGULATORY COMMISSION, REGION III 2443 WARRENviLLE ROAD, SUITE 210 USLE,'IL 60S32~352

ALASKA; ARJZ()NA, ARKANSAS, CALIFoRNIA,CoLoRAoO. HAWAII, IDAHO, KANSAS, LOUiSIANA,' MISSISSiPPi, MONTANA, NEBRASKA, NEVADA, NEW MEXICO. NORlll DAKOTA; OKLAHOMA, OREGON. PAC1F1C TRUST TERRITORIES, SOUTH DAKOTA, TEXAS, UTAH; WASHINcm:iN, OR WYOMlNG; SEND APPUCAnoNS TO:

. NUCLEAR MATERIALs LICENSING BRANCH . U,S.NliCLEARREGliLATORY COMMISSION, REGION IV

.... 611 RYAN plAzA DRIVE; SUITE 400 ARlINGTON;TX 76011-4005

PERSONS LOCATED IN AGREEMENT STAres SEND APPuCAnONSTO lllE U,S.NUCLEAR·REGuLATORY COMMISSION ONLv IF THEY WISH TO POSSESS AND USE UCENSED MATERIAL IN STATES SUBJECT TO U.S.NUCLEAR REGULATORY COMMISSION JURISDIcTIONS; .

. . ..... 2. NAME AND MAILING ADDRESS OF APPLICANT {Include ZIP code}

. /. . h c~ ·.."S _""- I

A..b .... ~~. ~O~ ->QV'. -Ii..., '<'wi1l A!.,_{ k?-.. P"o; 'crc. X '3 "t.1 S'"1

-q'"'....._ ~ .......V\. , A I ~. t' (... ~ q~l ff'O f 4. NAME OF PERSON TO BE CONTACTED ABOUT THIS APPLICATION

~,A R-\"$'c:: fI:£'"(j:A50N

TELEPHONE NUMBER

(qo7) :-;:'~_S"- <""::' ('f 9 I " . ;

SUBMIT ITEMS 5 THROUGH 1; ON 8-1/2 X 11" PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PRoviDED IS DESCRIBED IN THE LICENSE APPLICATiON GUIDE. ; ..

6. PURPOSE(Sj FORWHICH LICENSED MATERIAL W,LL BE USED.

B. TRAINING FOR INDIVlDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS,

10. RADIATiON SAFETY PROGRAM.. C'f/1t 1J6£ . 8--S0 12. LICENSE FEES (See 10CFR 170 and SecQon170.31)

IAMOUNT . .FEE CATEGORY ENClOSED $

13. CERTIFICATION. (Must be completed by applicant) .THE APPLICANT. UNDERStANDS THAT ALL STATEMENTS AND REPRESENTATIONSMADE IN THis APPLiCATION ARE BINDING UPON THE APPLICANT,. . " .' . .:.... ..... .

THE APPLICANT AND ANY OFFICIAL EXECUTING.THIS CERTIFICATION ON BEHAlF OFTHEAPPLlCANT,NAMEDINITEM 2, CERTIFY THAT THIS APPLICATION IS PREPARED IN CONFORMITY WITH TITLE 10, CODE OF FEDERAL REGULATIONS, PARTS 30,32, 3a: 34, 3S: 36, 39i'AND 40, AND THAT ALL INFORMATlONCONTANED HEREIN IS TRUE AND CORRECTTO THE BEST OF THEIR KNOWlEDGE AND BEUEE . . .... '. ....•. ; . .; •. .

WARNING: 18 U.S.C. SECTION 1001 ACT OF JUNE 25, 194862 STAT. 749 MAKESi'r A CRIMINAL OFFENSE TO MAKE A W1LLFUu..YFALSE STATEMENT OR REPRESENTATlOfHO

Page 14: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red
Page 15: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

of2PAGE

~ Docke~ Q;- R~ferarrct- r";f.ftlit'la:"

iC~30~37·206·

! ___.. -­ .1 _

U.S. NUCLEAR REGULATORY COMMISSiON 1 1Uc~nsr. Numbei

i 50-29231-0-:

Fo;- us~: in CF-"i\~ )nternat1Dna~ hJi~j5; h~C;· ·~;e::es PQrtapr:)b'~

:TIS2.Suring p~lysica: properties of mateda!s.

i'/fp.TERJALS UGENSE SUPPLEftnEIHAR'( S:-fEET

!nter~:lazs .spe:::}fied fr:~ tr~s certtftc'8ffi' .o~ registraU~)n i~.s.Lted, by the l~_S.;.

Commission unde.: 1C CFR. 32.2') C or by an Agreement State.

.Ssa"!E=;j S:':I~rL:es ne!~c nQ!~ t,i.;; ·Ie.s"l.. tesi.e2 ~';: ih:::j:' 0.;'.,;:: i:'1 s;.or.ag€. anc~ .ar~; riO!. Ueing used. ~:')\Jt'e:·,,;ei,

\·vhen they e·j·e· r~3rn·,':vf.:{cj f,vrn s.:tcn·cQP fc!!' ·~YS::· c:~ t:·:;~:·,-!~:~f:::~~Te~.r t.c E:rr~>t"'-le·~ r':~E:·s.:,I~-:: 2nc.~ L1~~·.,rE' :fct tt8'::'!";

S~}~)~~:;::·: ~;~'i{-ll': hi::

cDntafTl~na!jan.

Lit:.:;enS.8G material may tis used 0\- stored at ths llcensee-'~ facility located at 5737 BlaGi:?i H.gh~N2Y,

Juneau, Alaska, and may also beuse.d at temporary job sItes of theiice.r:::.ee ,anywhere in thE: United States ,,..,,here the U.S. Ntrdear Regulatory Commissianrnaintaiils jurisdi:::tion fo:"" regtllating the use of licensed material, including areas of ,exciush/6 Federa! jUfisdictionwithin Agreement States.

reguiatoryagency.

It the jurisdidion status of 2 federalfi:rcilitywitJ1in an Agree.,'Tlent State is unknown, thelicerrsee should :::ontad: the federa~ .agency ::.-onrrol!ing t~e job s¥i:s in questicM1 to detemlin=e whether the proposed job 'site: IS an .are2 of Bx.::;!usive Federal jurisdictiQrL .Authorization for use of raDioadiv$ mater~ais at ~ob sites in .p~greeme!1t States nat undei- exctl1SfVe Fe'd'eTa~: jttri'Soi.ction shaH b05 .obtatn-ed .from the apr1fcp:iats st~te

L:ensed materi3l shaH only b.s used by, orums!' th6 supervision and in tle prl)'sical presBilGe of, !n·dhAdu.a~5 -wh'c have ra,=.s1ve::l l thiC -tr.aining desj;;tilied. ·tn a.p;p~icatio:-I l.1at&d 'f\Jiay 5.: 20.05.

E1,

[) .

42, ThE: Radiation Safety Officer (RSO) for this HC6I1SE: i~

il i ;

Page 16: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

NRC FORilf, 374.1". U.S. NUCLEA.R REGULfo.TORY COfillf'JIlSSlot.: of .; PP.GES

license I~umbcl

5D~2923';-01

MJt:.,TERi.t..LS UC:Er~SE

SUPPLEMEKi."h,R,Y SKt:ET

D"c:r,et or Reft'f.em::;, 1'Jl.J:l\;::e:

{J3D-2~720:3

--------_.------­

immedi3lelV from senliC5 ,me decontaminated, re.p2il'ed, 0, disposed of in acc.orda:-!::o:: v,lith Cammissioi·: regulations. The- report shall be rjjed witrlin 5 da.ys o~ th6 dale tne leak tes'. resLilt is lmDvJP v/ltr: tIlE' U.2. Nu:-:\ea~ R.e':ILli3tor\' Cornm~s5br:, Re:Jion 1\'. 6-;"; Rvar, P1C:::2 D~\vc, Suite 40el ,..." _. .

,p,rHngto". Texa:;· 76[,"; '\, ,f"'. TTl":: Direc'iOi Di,lisioli of I'JiJclsar hftate,ials Safety, Ths re:;,or,shc;l( spscif~' t~e. source involvec, the \es~ rE:~dts. and corrective. actio!'! taLe:i.

Tes:.£ fai' leai:f:!ge and/or contaminati,'xl shah bE perfDrmeti by persons spe-cifi:;aliy lj:ensed by tne U.S. r'~uciea; Reguiatory Commission or an Agreement StatE to perform such services, In a::lditiol"l, ttlE k;snsee j~ authorized tD collect 'Ieaf; te5.: sampies but not perfor;r: the anaj~:sis; analysis of lea~:.

test sample:: must be performed by persons specifically Ilcens€:d by tl'l::: Commjsslon 0, an .Agreement Stats to perforlT, such ser\'ices.

F. Records ::>f leak test results sha!i be kept in units of miciCicliries ami ·sha\.! be maintained for 3 years.

14. Sealed sou.rces or SOufC€'Toas containin~' iicensed materiai shall not be opaned or SOUfces removed or detached from source rods or gaug.e.s .by th\':: licensee, excepias spedficaHy authorized.

1.5. TIle licensee SI"la1! conduct '3 .physi~·invemory fPiSr:f 6 months'J or.at atller .int9f\.'a!s approved by the U.S. Nuclear Regulatory Commission, to.f:!,ccount'fnr a~ sealed source:s.andior devic:es re:;e~ved and possessed j..lnder il'1e license.

16. Eacr, por-..abls nu::;!-sar gauge strafi.t'..a.ve.aJock or outer locked container designed to prevent unauthorized or aceid-sntai rsmotl31·of'lMe sealed source trorli its s'hietda.s position. Tn& gauge or its container must b':', 10CK~d wheilln tr.a.mpoo, ,st0ra-~e, ·or vmen no.t unoe:r the, direct SUfVetHance of an ,aLlthorize.cl L!s~r.

17. Except fo/maintaining labeling a.s required by 10CFR Part 20 or 7'1, thE liCEnsee shaHobtalrl authorizatIon from the U.S Nu.dear R:e.gulatory Commission before ij·'a1.dngany Cf(ang,es in th€: sea-Jed snufC5; devic-E' I {)t s~ulce-dev.ice cGfnbi·natf·::;n that. would a1ter the descriptic,n 'or speGITicc~t~Gns aE, irrdicEi-e·d tfJ tnc resps·cliv6 Reg~strali"~n CerUt"lr-..ates issuec~ either by tniS C:ornm·~ssjorl pursuant 10 10 eFR 32.210 or by.an Agreemeni State.

J; b. /-\ny cleaning, rna'l;-rte~leri:e. Jr rt::r;·a~j bf the. Q.a-~1ges that reQui~·e~, d'E::t~!':hin;, th'2 SClL;rc~, O~ sGUl"·:;e rod rro;'T; tr·'E:: ·;!2.UtiE: s.r'ia!! be p.:.::r·forrn~::::J cr"'ily ~y t~'1t:= nlarv.Jf2.:~ur·e~' (>!' ofhE;!':' pers·r.<1~" 5pe.:;iri:.aHy· !i·~~~nse:? by the tJ.·S. h~uct~a~' Regul2tory Comn1!ssion or· o.n }.l\greernent ~~tate to pert"'orn, such serv'~es.

)-:' ~:":E· i±~>:::·'.s:~~·(, L1:~,:"'\::' U·"(~S~·:i.:~~.::"",~!,~ ~~·C.. 8!f~.':; ~;.:::,,:-~~.::.'2".: 12~~1s<'I:.\'S:: rn,~:r~'; t;-tE\:~ ::'. i's·:::. bel::~v~· t~~:o;:~ s ..~~-fa:::"':;~ :.r:c~

!i~~:7::;:·'~~_;~:.'~· ~~.t.:;:)~1 l..,~·~:f, ~:U:-f:.l':::;;" ,'::::~~;n~~ ~~'~2~ -E:;'~!?:·'::'.:is fr0!r, t-h.-::: t·:~\l;.l~':~;':;~· .j.F;;J·~·~·: t.:; ~i ~'l .i·I'T~~iC~;: :?,!:."~~~VE:. tt·l!:.~ ;svrfE."::·~I:'·

r?'~i'~"~; ~1~n6··- -3;)P:··C~p~"f,?d"r.:- ;,·,!,:),:.:e~'ii...l;·::':;·E' t.:i '-f.·:-i(i:::.f.' t!·~i~:·: p-rc:rb;;:Ii"ii:y :l :r~f:: s:~u·:·[:£. O~· r/!C)~):~ ~~·'E-":.~''Jinin2 }~").j~}:..:;::.:;

:)=.i::'~\N th~::. S:J:-;·E;::.:~ L !~, :~ ~l·:.i~ f~~:."~~.;i~.. !::- I::' ::.,~:":(~-;~}-( ~ ..~"f2 ·:~2·~':L'·';:· 1~2 jr'L::,t-·,~::. "Cf~::~)\'-:;' .~:i.~,,{,":, EU~·~~·?:~::::. t~'!i;:

::::;;:=~:·l~;~·f:: ~,:t·r:ll· ~~·r~;.)·~-:-:r· ..·~-=.,,·:i, r.~·-':~<:~·::j' ..l:"':::'~~ ~.:-.\ ·='.~-Vl:'U·:·~ :!..-:·iE'i', ~.~'I-::" G;:;~~~:<:: L'J'.i1:::, !~~ rr~f· (:{ c·,b:,~~'-·"_;~·.h:.~;·' b:::·f::·,:>~'~

Page 17: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

NRC FORM 3?4A U.S. NUCLEAR REGULATORY COMMISSION! PAGE of .(. PAGES" i License NUOll>er

i50-29231 ~01

be::-:omes appar·ant thai.. efbn::=.:· k re::;o\le~ tne seaied SOLliC€:, or pro~e: may t10~ be su:cessf'u\, th,:: lic6nsee shaH notify the U.S, !'\judea: Regulatory-Commission and submi: thE repor, required by -i~; C~R. 3.0.5D(b){2) an·j ':c.). Tile 'licensee srJali not abandon the. scalael s:Jurce Dr P"Cl~)E" witnou: obt;~nin9 th5 Con-lmi"ss',onls 1=Jij.:n" written co.nsent.

'r,~ r""o,.",_. ~- -D-'~:f'-aJ'I'" ",-,,·,'d~-' -';-- :_- n 01-. 1'_. "'--'1'-- t''''- lJ"-·---- S"~)! ~-,...,,~,' _i :.- --~a-~··- '/­':::'1 . .c.Av_:J"C:::;;'-:::::'-,hh..• rtJ\ ....I\,I·::::UULI~7VJi~t::JI'L:l::: f .....'::;'::..r=. 'I~ :...:!:::'.I~:'~'::. iie:.. •. """'dl'ui..L."I:.·.::.~I,"'I;".,ld;\~ Si

8ccordan::;E witr; thE- statements:. representations, and oro:::edures containsc i:-: th~ dO:;!l:-ne:lts b:;!~Gin3 • • • I I .;..'

any e;-:clt;2.~res, ilsiea helow. The U.S ~~udear Regulatory Cornrn:ssbn's reg~..I\ations ShEd! govern urdess m.e. statemen:~., r8pfe'Set1tat\on~~ and .p;.-osedufes In the- iicenseels appiication and 1~~'Jrresponde~se .are morE re.st;i·:;ti\I'e trlarr :the re,~u:a!icfns ..

A. Appiication datBO h/iay 5,2085

. '_. '.

Page 18: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

I

Certificate Plige 1 of 1 -/

.j

QCertifitate of QCompletion • ..,.. 6 w.. ..... .... ik.Ji .... ..•• .. • .. .. • .& ...

This is to certify that Jason Bartschi

has completed a course ofstudy in Yearly Refresher Course - Portable Nuclear Gauge

dated December 1, 2007

offered by American Technical Institute

Training satisfies US DOT training requirements of49 CFR 172 including:

• Emergency Procedures

• Methods and procedures for avoiding accidents

• Hazardous materials identifICation and recognition

• Self-protection measures • RegUlations applicable to job function

Certification expiration: Yearly Refresher Training - 1 year from date listed DOT - 3 years from date listed above

- ~/~ American Technicallnstiiu[e -=--~~::-:-----,-"",,~~:..=::"-=...o~=oo<-",-' 5130 S. Ft. Apache Rd. #215-245__-=-=,.-::- _

1..++-.1I•• ~.~ .. ~"': n~,,_n.,l,~n' n~_,I""~"';+~nn+~/A"In"JDI1()D D'"lt:U 11(\t:t: A O<::T") 1 ot:-I') A <::O'7'"lD A ., ""\ II J........ .'7

Page 19: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

\...,Cllllll;C:1lC ragc 1 Ul 1

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httD://www.ati.coursehost.com/Certificate/A26F9F06 E9A3 473B 8DE8 1FD676CB 148F 12/1/2007

Page 20: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

~:\temp\liW }UUUU1. I MI-' I-'age 1 I ,

Mail Envelope Properties (476738EO.AB3: 6 : 55987)

Subject: Creation Date From:

Change in RSO 12/17120079:04:16 PM "John Logsdon" <[email protected]>

Created By: [email protected]

Recipients nrc. gOY

ARL_PO.ARL_DO RJT (Roberto J Torres)

Post Office ARL_PO.ARL_DO

Route nrc. gOY

Files MESSAGE TEXT.htm imageOO1.jpg SECON Letter.pdf SECON License Change.pdf Jason Bartschi .pdf Mime.822

Size 329 5952 1793 47568 800052 195839 1440123

Date & Time 12/17120079:04:16 PM

Options Expiration Date: Priority: ReplyRequested: Return Notification:

None Standard No None

Concealed Subject: Security:

No Standard

Junk Mail Handling Evaluation Results Message is eligible for Junk Mail handling This message was not classified as Junk Mail

Junk Mail settings when this message was delivered Junk Mail handling disabled by User Junk List is not enabled Junk Mail using personal address books is not enabled Block List is not enabled

Page 21: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

"iOberto J I orres - L;hange In K~U I-"age·

From: "John Logsdon" <[email protected]> To: <[email protected]> Date: 12/17/2007 9:06:30 PM SUbject: Change in RSO

Mr. Torres,

Here are the documents we discussed on the phone today. Please let me know if there is anything else you require.

Thank you.

John Logsdon

John Logsdon

Operations Manager

SECON

5322 Shaune Dr.

Juneau, Alaska 99801

907-780-5145 Juneau

907-225-6491 Ketchikan

907-321-1131 Cellular

/--1('03,-; .' \.N:.

Page 22: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

SOUTHEAST ALASKA

500 1oalh Ave. N.E. Ste 1740 P.O. Box 32159 P.O. Box 7038 Bellevue, WA 98004 Juneau, AK 99801 Ketchikan, AK 99901 (425) 827-3193 (907) 780-5145 (907) 225-6491 (425) 576-5113 FAX (907) 780-5896 FAX (907) 225-6492 FAX

December 17,2007

Nuclear Materials licensing Branch U.S. Nuclear Regulatory Commission, Region IV 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-4005

Dear Roberto Torres,

Secon Inc. is submitting this application to amend our materials license #50-29231-01 in regards to the Radiation Safety Officer designation. Rick Millward, our current designated RSO, has had his employment with this company terminated and we have named Jason Bartschi to fulfill those duties. Please find attached Mr. Bartschis' certifications.

In the interim, the nuclear testing gauges are locked per specification in their approved secure storage. We have received a stop work order from Mr. Millward which we will obey until Mr. Bartschi can be approved and our work is shut down until at least the middle of January due to weather.

We have trained and certified personnel, including Mr. Bartschis, that can operate these gauges when work resumes.

Thank you for your attention to this matter.

//)/7:/CK-C ~ John Logsdon Operations Manager

Page 23: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

EXPIRES: 1013112008APPROVED BY OMB: NO. 3160-0120NRC FORM 313 U.S. NUCLEAR REGULATORY COMMISSION EstImated burden per response to comply wllh this mandatory coiled/on request: 4.4 (1G-2005) hours. Submittal of the :rePlication Is necessary to datermlne that the applicant Is 1DCFR 30. 32,33, ~uallfled Bnd that ad~U II procedures exist to protect the public hea!lh and sa~ty. 34,35.36. 39. and 40 endciOmmeirts ~ar Ing burden esIImsteto the Recoidsand FOIAlPnvacy S&lVlces

Branch (T-5 F53), .S. Nuclear RegUlatory Commission. Washington, DC 20555-0001, or bY'lntemet e-mail to InfocoUllcts~rc.gov,and to the Desk' Officer; Office of Intormltlon,and R~u1atory Affairs,N 6-10202, (3150-0120), OfIiceof Management

APPLICATION FOR MATERIALS LICENSE and Budget, Washmgton, DC 20503. If II means used to Impose an Information collection does not display a currently valid OMB control number, the NRC may nol conduct or sponsor, and a person is not reqUired to respond 10, Ihe information coIledion,

INSTRUCTIONS: SEE THE APPROPRIATE LICENSE APPLICATION GUIDE FORDETAILEDINSTRUCTIONS FOR COMPLETING APPLICATION· SEND TWO COPIES OF THE ENTIRE COMPLETED APPLICATION TO THE NRC OFFICE SPECIFIED BELOW.

APPUCATION FOR DISTRIBUTION OF EXEMPT PRODUCTS FILE APPUCAnoNS wrrn:, IF YOU ARE LOCAlED IN:

!LUI/CIS, INDIANA; IOWA, MICHIGAN, MINNESOTA, MISSOURI. OHIO. OR WISCONSIN, SEIIl OFFICI', OF NUCLEAR MATERIALS SAFETY AND SAFEGUARDS DMSION OF INDUSTRIAL AND MEDICAl NUCLEAR SAFETY

APPLICATIONS TO: U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555-0001 MATERIALS LICENSING BRANCH

U.S. NUCLEAR REGULATORY COMMISSION, REGION III 2443 WAR,RENVILLE ROAD, SUITE 210

ALL OTHER PERSONS FILE APPLICATIONS AS FOLLOWS: LISLE, IL 60532-4352

IF YOU ARE LOCATED IN:

ALABAMA. 'CONNECTICUT, DELAWARE. DISTRICT OF COLUMBIA, FLORIDA, GEORGIA, KENTUCKY, MAINE, MARYLAND. MASSACHUSETTS, NEW HAMPSHIRE, NEW JERSEY. NEW VORl<. NORlH CAROUNA, PENNSY1.VANIA, PUERTO RICO, RHODE ISLAND, SOUllf CAROUHA, Tl!NNESSEE, VERMONT, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA, SEND APPUCATIONS TO:

LICENSING ASSISTANCE TEAM DMBION OF NUCLEAR MATERIALS SAFETY U.S. NUCLEAR REGULATORY COMMISSION, REGION I 475 ALl.E:NDALE ROAD KING OF PRUSSIA, PA 19406-1415

ALASKA. ARIZONA, ARKANSAS, CAUFORNIA,COl.ORADO, HAWAII, IDAHO. KANSAS, LOUISIANA, MISSISSIPPI. MONTANA, NEBRASKA, NEVADA, NEW MEXICO, NORlli DAKOTA; OKLAHOMA, OREGON. PACIFIC TRUST TERRITORIES, SCUll! DAKOTA, TEXAS, UTAH, WASHINGTON, OR WYOMING, SEND APPUCATIONS TO:

NUCLEAR MATERIALS LICENSING BRANCH U.S. NUClEAR REGULATORY COMMiSSION. REGION IV 611 RYAN PLAZA DRIVE, SUITE 400 ARLINGTON.lX 76011-4005

PERSONS LOCATED IN AGREEMENT STAreS SEND APPLICATIONS TO ll!E 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.

I. THIS IS AN APPLICATION FOR (Check appropriste itsm) o A NEW LICENSE

~ ~. -e.""?""7/ J ~ B. AMENDMENT TO LICENSE NUMBER ..:;, 0 - (. I L ~ - 0 I

o C. RENEWAL OF LICENSE NUMBER

3. ADDRESS WHERE LICENSED MATERIAL WILL BE USED OR POSSESSED

q4/q ;Jt":',,~;t\ --r;:. J,...o"j I.~•• .>. 5' A.",r-c •

I(-~_ -{7Co: k. .If!. ........ '...... " Af<!)__ s4:.A../ 111 0 1

2. NAME AND MAIUNG ADDRESS OF APPUCANT (Includs ZlP cods)

Cal..-S4" ~~l"" _~. .::::O~ - l.. -,:, ,<,-:r

)

A!,,~{h..~..5o::.';)v.....c. -:Jl P_O. 'Gox '3 "t.1S'"7

~';;"""""'~~""'\A. , AI.... i"t...::, q "1 [f'O f 4. NAME OF PERSON TO BE CONTACTED ABOUT THIS APPLICATION

G,A R-r5'c:: H:f,­(j":A50N

TELEPHONE NUMBER

('Qo7J .... "Z 5-'- ~.~ ('f cr I '-. -:J

' ­-

SUBMIT ITEMS 5 THROUGH '11 ON B-112X 11" PAPER. THE TYPE AND SCOPE OF INFORMATION TO BE PROVIDED IS DESCRIBED IN THE LICENSE APPLICATION GUlDE. I5. RADIOACTIVE MATERIAL

s. Eisment end mess number; b. chemical and/or physlcallonn; and c. malximum amount 16. PURPOSE(S) FOR WHICH LICENSED MATERIAL WILL BE USED.

- whlcll will be pos8essed at anyone lime.

7. INDIVIDUALlS) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEIR TRAINING EXPERIENCE.

5. TRAININC FOR INDIVIDUALS WORKING IN OR FnECUENTING RESTRICTCD ARCAS.

9. FACIUTIES AND EQUIPMENT. 10. RADIATiON SAFETY PROGRAM. CHANGE [<..SO 12. LICENSE FEES (See 10 CFR 170 snd Seclion 170.31)

11. WASTE MANAGEMENT. FE G IAMOUNTE CATE DRY ENCLOSED $

13. CERTIFICATION. (Mus! be compIsted by upplicanl) THE APPLICANT UNDERSTANDS THAT ALL STATEMENTS AND REPRESENTATIONS MADE IN THIS APPLICATION ARE BINDING UPON THE APPLICANT.

THE APPLICANT AND ANY OFACIAL EXEClJTlNG THIS CERTIFICATION ON BEHALF OFTHE'APPUCANT, NAMED IN ITEM 2, CERTIFY THAT THIS APPLICATION ISPREPARED IN CONFORMITY WITH TITLE 10, CODE OF FEDERAL REGULATIONS. PARTS 30,32,33,34, 35,36,39, AND 40, AND THATAU. INFORMATION CONTANED HEREIN IS TRUE AND CORRECT'TO THE BEST OF THEIR KNOWLEDGE AND BELIEF.

WARNING: 18 U.S.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 AtN DEPARTMENT OR AGENCY OF THE UNITED STATES,AS TO ANY MATIERWITHIN ITS JURISDICTION. _

CERTIFYING OFFICER - TYPEDIPRINTED NAME ANDm~, " SIGNATU~ IDATE

.J6 H1J LOGSDOl'v cJlElfAT/ew51"t)JJM6't 'C -~ 1/'2:. .1' 7·0 7

FOR NRC USE ONLY TYPE OF FEE CHECKN=JCOMMENTSIFEE LOG IFEE CATEGORY ] :M~UNT RECEIVED

APPROVED BY DATE I i

NRC FORM 313 (10-2005) PRINTED ON RECYCLED PAPER

Page 24: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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:':.::::.::":::.::::::::'::.::::.~::'.::::':"::.:'.:::'.':':':::::''1:

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Page 25: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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Page 26: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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Page 27: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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Page 28: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

Certificate Pf.ge 1 of I

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, ~~;" . This is to certify th~t J1:~;~~~~~-::.~::::: «/(/. Jason Bartschl , :~ ..~j\ ..:..:')/ ~

1: Z: has completed a course ofstudy In +.~~)l (~ Yearly Refresher Course - Portable Nuclear Gauge ir:<;~:=.--::. C'-~ dated if=:-.:;·-=----.-=:;'

~ i December 1, 2007 ir;;~~> '-(l/f, : offered by :f-~·~,.·\ ..:j}.J~:S\ ; American Tech nical Institute :L :::?::. ,J~~ I !~£~~~~=-< ~-~:. t Training satisfies US DOT training requirements of 49 CFR 172 including: 'r'~~:::.:_:.-:-.::-::,./// I ' ";::>'~';--""> ~~// /;~I t : .,....,...~......>,>"O:-~

t,.. ,' ..i Lf i • Emergency Procedures I..' .i '..,. ", ')'I • Methods and procedures for avoiding accidents [//)-: ­

I • Hazardous materials identification and recognition :l:·.>··:::~~~~ :" ( ..::::-~ ! • Self-protection measures (::>:::.__,__:..

~.'--;': j • RegUlations applicable to jobfunction.,. ~ ~:€::.-<.-i /'/~ r<:,'::~<~>-.>//(;'1 Certificalion expiration: 'II .;,:::,~~.>:/ (/ i , r Yearly Refresher Training - 1 year from date listed " \, '., j l"'-t~j . DOT - 3 years from date listed~ove I _:.)J:..

r~,.\ i ~~ AmericanTechnicallnsiiiiJle 'l··// __ ..

~ /7 \, ,',.,\ i . t;~ '. 5130 S. Ft. Apache Rd. #215-245 :--:';::". __ ~:.

~ ~"-.::. i Company RSO Signature Las Vegas, Nevada 89148 t::-=_ -'-.. ('---::_ i .'''>.>~~ ~~-::j~'l:.1jl'1\'\:~r'~~~j[I'f~~-=~~~~~--~I;~~~;:=·~;'li{~~=:~1?jl;~\\.-~~fl~i'/~~~Z-:~:;~~~?~:~~~?(/::.·:·,<:::~·::::,:::'l,--::'m'~/ I I, \ \~.-.~:;/?;/, 1\ \ \ \ Y-.:> //~! ' '/,//: I, \ \\,'y.-;:::-:<-</I \ \ t<-::;7// .. i ',\' \\, \;V.../, ...../ ;' r '; .... ..... ". ,~ ..,/ J 1\\ \t...-.--'//?' '1\ \'-C./'/Ii J I all:' 0.J""lr' / 1/ I I' 0/ JI I 'r-l"'-lt:/// I (/. /f I U ',-i" ( ,/ " ..... ,''' j.'f"

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Page 29: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

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httn://\vvv'W.ati.coursehost.com/CeI1ificate/A2(lF9FOr, F9;\1 4718 RDFR 1FDf176CB148F 12/1/2007

Page 30: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

=:\temp\t;.iW JUUUU1. I Mt-' t-'age 1

Mail Envelope Properties (476738EO.AB3 : 6 : 55987)

Subject: Creation Date From:

Change in RSO 12117120079:04:16 PM "John Logsdon" <[email protected]>

Created By: [email protected]

Recipients nrc.gov

ARL_PO.ARL_DO RJT (Roberto J Torres)

Post Office ARL_PO.ARL_DO

Route nrc.gov

Files MESSAGE TEXT.htm

Size 329 5952

Date & Time 12/17120079:04: 16 PM

imageOO1.jpg SECON Letter.pdf SECON License Change.pdf Jason Bartschi .pdf Mime.822

1793 47568 800052 195839 1440123

Options Expiration Date: Priority: ReplyRequested: Return Notification:

None Standard No None

Concealed Subject: Security:

No Standard

Junk Mail Handling Evaluation Results Message is eligible for Junk. Mail handling This message was not classified as Junk. Mail

Junk Mail settings when this message was delivered Junk. Mail handling disabled by User Junk. List is not enabled Junk. Mail using personal address books is not enabled Block List is not enabled

Page 31: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

ACCEPTANCE REVIEW MEMO (ARM) Licensee: Colaska dba Secon License No.: 50-29231-01

Docket No.: 030-37206 Mail Control No.: 471603

Type of Action: Amendment Date of Requested Action: December 11, 2007

Reviewer R. Torres ARM reviewer(s): J. CookiR. Torres Assigned:

Response Deficiencies Noted During Acceptance Review

[ ] Open ended possession limits. Submit inventory. Limit possession. [ ] Submit copies of latest leak test results. [ ] Add IC L.C., split cover letter from license, add SUNSI markings to license. [ ] Confirm with licensee if they have NARM material.

Amendment request needs to be signed by management. Verify training certificate.

Reviewer's Initials: Date:

DYes DNo Request for unrestricted release Group 2 or >. Consult with Bravo Branch.

DYes DNo Termination request < 90 days from date of expiration

DYes DNo Expedite (medical emergency, no RSO, location of use/storage not on license, RAM in possession not on license, other)

DYes DNo TAR needed to complete action.

Branch Chief's and/or HP's Initials: Date:

/ SUNSI Screening according to RIS 2005-31

DYes ~o Sensitive and Non-Publicly Available if any item below is checked General guidance:

__RAM = or> than Category 3 (Table 1, RIS 2005-31), use Unity Rule __Exact location of RAM (whether = or > than Category 3 or not) __Design of structure and/or equipment (site specific) __Information on nearby facilities __Detailed design drawings and/or performance information __Emergency planning and/or fire protection systems

Specific guidance for medical, industrial and academic (above Category 3): __RAM quantities and inventory __Manufacturer's name and model number of sealed sources & devices __Site drawings with exact location of RAM, description of facility __RAM security program information (locks, alarms, etc.) __Emergency Plan specifics (routes to/from RAM, response to security events) __Vulnerability/security assessment/accident-safety analysis/risk assess

Mailing lists related to secur~esponse h Branch Chiefs and/or HP's Initials: r1 tZ-- Date: (7/~ o--:f'

Page 32: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

Checklist to Ensure That Radioactive Material Will Be Used as Intended

.__ ........_...._..._...ADDI" Inf' C . --- IN.. --- .71603

Name: Colaska dba Secon

Location: AK

Type of Request: Amendment Program Code(s): 03121

License No.: 50-29231-01 Docket No.: 030-37206

STEP 1, ITEM A - INITIAL SCREENING

-t5The applicant is a known entity or a licensee transferring control to a known entity. This determination has been made using the screening criteria in Worksheet A below.

A.

InlStructions for Step 1: Complete Step 1for all applications. If Step 1. Items Aand S, are 'YES" then do not complete Step 2. Sign I YE$or snd'date the completed form and add it to ADAMS as Non-Sensitive and Non-Publicly Available. If a'NO" re$lXlt!se Is indlc$tedfor Item NO

ns, add the completed form to ADAMS as Sensitive and Non-Publicly Available, and complete Step 2 (Additional screening). If of use is subject to aSecurity Order, complete Step 3, Item A, without delay. If the additional reqUirements for increased controls

Willb19 apptfed or voided, complete Step 3, Item B, without delay.

Worksheet A In$truetlons for Worksheet A: Answer each of the 6 questions below by placing a"Yes", "No", or "NA" response in the column on the YES, right. Best practices for areviewer are provided after each of the questions. If the answer to any of the 6 questions IS 'Yes" then indicate NO, or "Ye$' in Step 1, Item A, above. If the answers to all of the 6 questions is "No" then indicate "No" in Step 1. Item A, above. NOTE - If the NA reviewer has personal knowledge of the applicant's veracity, this can be taken into account in responding to any questions. For example. if,the applicant's management and/or RSO have been associated with acurrent or previous NRC or Agreement state license, then the ilpplicant.may be considered as aknown entity.

1. Does the applicant have a current Agreement State or NRC license? The reviewer should 1) confirm that a valid license/registration/authorization exists for the applicant; and 2) compare 'IRS the current license to the application to verify that the application represents a reasonable expansion of the licensee's operation (i.e., medical facility adding a gamma knife or an Agreement State licensee obtaining an NRC license in order to work in NRC jurisdiction without filing reciprocity).

2. Does the applicant have a current Agreement State or NRC license at another location and the new application represents the addition of a new facility within the scope of the licensee's core business? The reviewer should contact the appropriate licensing authority to .-- ­confirm that a valid license/registration/authorization exists for the applicant and the corporate office of the licensee to verify that it has knowledge of and approves of the new application.

3. Does the applicant have a current State or Federal government license, registration, authorization, etc., for other operations within the scope of its proposed license activities? (e.g., a company authorized by a State for mining that is now requesting authorization to use fixed gauges). The reviewer should contact the appropriate government -office to confirm that the license, registration. authorization, etc., is valid; and the applicant's corporate office to confirm that it has knowledge of and approves of the new application to possess radioactive materials.

4. Is the applicant a local, State or Federal government agency? The reviewer should contact the local, State or Federal government office to confirm that the applicant is a government entity. ,/""

5. Does the application only involve the relocation of an existing licensee, or its mailing address, to another State? This includes new licenses created from existing licenses listing locations in multiple States, in preparation for transfer of licenses to States that will shortly sign ­an Agreement with the NRC.

6. Is the application only the result of a licensee failing to submit a renewal application in a timely manner? -­

Page 33: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

STEP 1, ITEM B - INITIAL SCREENING CONTINUED

B. The applicant is requesting certain radionuclides and quantities that are less than the Risk Significant Quantity (TBq) values in Worksheet B, below, as ·highllgt1tt"!d~ by the reviewer, or is currently SUbject to a security order or additional requirements for increased controls. If "Yes", there is no need to proceed further.

tJjA-1

Worksheet B - Risk Significant Quantities (Ca ._~_. J - ---........ --, •• ,_, " -_ ....... ,. -_._- , .......... - - •• _, --"""';01-' •__ ... _ ........ , .... _ .................. - -_.........._-, ' , ..... ,.. ......... -_.........

Radionudide Risk Significant Quantity (TBq1)

Risk Significant

Quantity (Ci 1)

Radionuclide Risk Significant Quantity (TBq1)

Risk Significant

Quanti~ (Ci1)

Am-241 0.6 16 Pm-147 400 11,000

Am-241/Be 0.6 16 Pu-238 0.6 16

Cf-252 0.2 5.4 Pu-239/Be 0.6 16

Cm-244 0.5 14 Ra-2262 0.4 11

Co-60 0.3 8.1 Se-75 2 54

Cs-137 1 27 Sr-90 (Y-90) 10 270

Gd-153 10 270 Tm-170 200 5,400

Ir-192 0.8 22 Yb-169 3 81

The primary values are TBq. The curie (Ci) values are for informational purposes only. The Atomic Energy Act, as amended by the Energy Policy Act of 2005, authorizes NRC to regulate Ra-226 and NRC is in the process of amending its regulations for discrete sources of Ra-226.

Calculations of the Total Activity or the Unity Rule were completed. N0TE-lf an amendment of an existing license is being requested, the calculations wUl include the previously authorized quantities for the radionuclide(s).

Yes. NCI, Clr Not Applicable

(NA)

(' -

--­Total Activity-multiple activities are requested for a single radionuclide and the sum of the activities is less than the Risk Significant Quantity (TBq) for the radionuclide.

Unity Rule-multiple radionuclides are requested and the sum of the ratios is less than 1.0, e.g.,[(total activity for radionuclide A) + (risk significant quantity for radionuclide A)] + [(total activity for radionuclide B) + (risk significant quantity for radionuclide B)] < 1.0.

,d2;7L- rz/-zglrSignature and Date for Step 1: License Reviewer and Date

Page 34: SECON Southeast Alaska - License Amendment. · Bachelors Degree Major - Parks and Recreation. Minor in Psychology . CERTIFL-\ TIONS 2001 CPR/FA Certified Instructor .-\merican Red

(FOR LFMS USE)INFORMATION FROM LTS

BETWEEN:

license Fee Management Branch, ARM Program Code: 03121 and Status Code: 0

Regional Licensing Sections Fee Category: 3P Exp. Date: 20160630 Fee Comments: Decom Fin Assur Reqd: N ................................................................................ ................................................................................................ ..

lICENSE FEE TRANSMITTAL

A. REGION

1. APPLICATION ATTACHED Applicant/licensee: COlASKA DBA SECON SOUTHWEST ALASKA Received bate: 20071219 Docket No: 3037206 Control No. 471603 license No. 50-29231-01 Action Type Amendment

2. FEE ATTACHED ~ Amount: Check No.:

3. COMMENTS

Signe~ (2-3(-01­Date

B. lICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered / __/)

1. Fee Category and Amount:

2: Correct Fee Paid. Application may be processed for: Amendment Renewal license

3. OTHER

SignedDate