SOIL TECHNOLOGY ASSOCIATES 250 Killingly Rd PO Box 106 Pomfret Center CT 06259 860-928-5020 Fax 860-928-1924

PERSOhlAL INFORMATION WAS REMOVED fW NRC NO COpy OF THIS INFORMATION

March 292013-rAINED BY THE NRC

Licensing Assistance Team Division ofNuclear Materials Safety US Nuclear Regulatory Commission Region I 2100 Renaissance Boulevard Suite 100 King ofPrussia P A 19406-1415

RE Soil Technology Associates Inc Application for Amendment to License No 06-30338-01 j JtJ-3 t() 3f

This letter is to provide the NRC with additional information regarding the application for an amendment to the above referenced license This license was most recently renewed on

October 24 2011 and copy of the renewal letter is enclosed for your convenience

The reason for the amendment to the existing license is to change the RSO from Terence P Chambers to Bruce D Woodis There are no other changes to the ownership of the company equipment the storage location or persons trained in the operations of the nuclear gauges

Alll-1V) AcSS()ClCltes was Jointly by Terence ownership interest passing to me upon his death

Subsequent to his untimely demise I have acquired the proper training for Nuclear Gauge Operation Hazmat and Certification for Radiation Safety Officer (copies of training certificates enclosed)

It is important to note that during the period of time between Terence Chambers death and this licensing amendment request the gauge has remained stored iIl its proper location in accordance with the terms ofour license and remains unused even though we have a certified gauge technician on staff

We are hoping that our application for license amendment can be processed in a timely fashion in light of the recent tragic circumstances regarding the need to replace the RSO designated on our current license I would be pleased to answer any questions or provide additional information as needed to supplement the amendme~t request

aUurs (j D~---

Bruce D Woodis LLS S 8 0 3 fBDWbig

NMSSIRGNI MATERIALS-002

middot ~~ egtF L ~Se1~~ UNITED STATES ~

NUCLEAR REGULATORY COMMISSION REGION I

475 ALLENDALE ROAD KING OF PRUSSIA PENNSYLVANIA 19406-1415

October 24 2011

Docket No 03034238 License No 06-30338-01 Control No 576149

Terence P Chambers President Soil Technology Associates Inc P O Box 106 Pomfret Center CT 06259-0106

SUBJECT SOIL TECHNOLOGY ASSOCIATES INC LICENSE RENEWAL CONTROL NO 576149

Dear Mr Chambers

This refers to your application dated September 30 2011 for renewal of your NRC license Enclosed with this letter is the renewed license The renewed license is written in accordance with current NRC policy and includes significant change in the conditions of the license Please review the document carefully and be sure that you understand all conditions If there are any errors or questions please notify the US Nuclear Regulatory Commission Region I Office Licensing Assistance Team (610) 3375239 so that we can provide appropriate corrections and answers

The NRC expects licensees to conduct their programs with meticulous attention to detail and high standards of safety and compliance Because of the serious consequences to employees and the public that can result from failure to comply with NRC requirements you must conduct your program according to NRC regulations the conditions of your NRC license and the representations made in your application In particular note that you must

1 Operate in accordance with NRC regulations 10 CFR Part 19 Notices Instructions and Reports to Workers Inspections 10 CFR Part 20 Standards for Protection Against Radiation and other applicable regulations

2 Notify the IRC in writing of any change in mailing address

3 In accordance with 10 CFR 3036(d) notify the NRC promptly in writing and request termination of the license

a) when you decide to terminate all activities involving materials authorized under the license or

b) if you decide not to acquire or possess and use authorized material

4 Request and obtain a license amendment before you

T Chambers 2

a) change Radiation Safety Officers

b) order byproduct material in excess of the amount or radionuclide or form different than authorized on the license

c) add or change the areas of use or addresses of use identified in the license application or on the license or

d) change the name or ownership of your organization

5 Submit a complete renewal application or termination request at least 30 days before the expiration date of your license You will receive a reminder notice approximately 90 days before the expiration date Possession of byproduct material after your license expires is a violation of NRC regulations

You will be periodically inspected by the NRC Failure to conduct your program safely and in accordance with NRC regulations license conditions and the representations made in your license application and supplemental correspondence with NRC will result in enforcement action against you This could include issuance of a notice of violation imposition of a civil penalty or an order suspending modifying or revoking your license

An environmental assessment for this action is not required since this action is categorically excluded under 10 CFR 5122( c)( 14)

Current NRC regulations and guidance are included on the NRCs website at wwwnrcgov select Nuclear Materials Med Ind amp Academic Uses then Licensee Toolkits see our toolkit index page You may also obtain these documents by contacting the Government Printing Office (GPO) toll-free at 1-866-512-1800 The GPO is open from 700 am to 630 pm EST Monday through Friday (except Federal holidays)

Thank you for your cooperation

Sincerely

-~- ~ ~~Z~~ Sattar Lodhi PhD Senior Health Physicist Materials Security and Industrial Branch Division of Nuclear Materials Safety

Enclosure Amendment No 03

middot ~~ egtF L ~Se1~~ UNITED STATES ~

NUCLEAR REGULATORY COMMISSION REGION I

475 ALLENDALE ROAD KING OF PRUSSIA PENNSYLVANIA 19406-1415

October 24 2011

Docket No 03034238 License No 06-30338-01 Control No 576149

Terence P Chambers President Soil Technology Associates Inc P O Box 106 Pomfret Center CT 06259-0106

SUBJECT SOIL TECHNOLOGY ASSOCIATES INC LICENSE RENEWAL CONTROL NO 576149

Dear Mr Chambers

This refers to your application dated September 30 2011 for renewal of your NRC license Enclosed with this letter is the renewed license The renewed license is written in accordance with current NRC policy and includes significant change in the conditions of the license Please review the document carefully and be sure that you understand all conditions If there are any errors or questions please notify the US Nuclear Regulatory Commission Region I Office Licensing Assistance Team (610) 3375239 so that we can provide appropriate corrections and answers

The NRC expects licensees to conduct their programs with meticulous attention to detail and high standards of safety and compliance Because of the serious consequences to employees and the public that can result from failure to comply with NRC requirements you must conduct your program according to NRC regulations the conditions of your NRC license and the representations made in your application In particular note that you must

1 Operate in accordance with NRC regulations 10 CFR Part 19 Notices Instructions and Reports to Workers Inspections 10 CFR Part 20 Standards for Protection Against Radiation and other applicable regulations

2 Notify the IRC in writing of any change in mailing address

3 In accordance with 10 CFR 3036(d) notify the NRC promptly in writing and request termination of the license

a) when you decide to terminate all activities involving materials authorized under the license or

b) if you decide not to acquire or possess and use authorized material

4 Request and obtain a license amendment before you

T Chambers 2

a) change Radiation Safety Officers

b) order byproduct material in excess of the amount or radionuclide or form different than authorized on the license

c) add or change the areas of use or addresses of use identified in the license application or on the license or

d) change the name or ownership of your organization

5 Submit a complete renewal application or termination request at least 30 days before the expiration date of your license You will receive a reminder notice approximately 90 days before the expiration date Possession of byproduct material after your license expires is a violation of NRC regulations

You will be periodically inspected by the NRC Failure to conduct your program safely and in accordance with NRC regulations license conditions and the representations made in your license application and supplemental correspondence with NRC will result in enforcement action against you This could include issuance of a notice of violation imposition of a civil penalty or an order suspending modifying or revoking your license

An environmental assessment for this action is not required since this action is categorically excluded under 10 CFR 5122( c)( 14)

Current NRC regulations and guidance are included on the NRCs website at wwwnrcgov select Nuclear Materials Med Ind amp Academic Uses then Licensee Toolkits see our toolkit index page You may also obtain these documents by contacting the Government Printing Office (GPO) toll-free at 1-866-512-1800 The GPO is open from 700 am to 630 pm EST Monday through Friday (except Federal holidays)

Thank you for your cooperation

Sincerely

-~- ~ ~~Z~~ Sattar Lodhi PhD Senior Health Physicist Materials Security and Industrial Branch Division of Nuclear Materials Safety

Enclosure Amendment No 03

T Chambers 2

a) change Radiation Safety Officers

b) order byproduct material in excess of the amount or radionuclide or form different than authorized on the license

c) add or change the areas of use or addresses of use identified in the license application or on the license or

d) change the name or ownership of your organization

5 Submit a complete renewal application or termination request at least 30 days before the expiration date of your license You will receive a reminder notice approximately 90 days before the expiration date Possession of byproduct material after your license expires is a violation of NRC regulations

You will be periodically inspected by the NRC Failure to conduct your program safely and in accordance with NRC regulations license conditions and the representations made in your license application and supplemental correspondence with NRC will result in enforcement action against you This could include issuance of a notice of violation imposition of a civil penalty or an order suspending modifying or revoking your license

An environmental assessment for this action is not required since this action is categorically excluded under 10 CFR 5122( c)( 14)

Current NRC regulations and guidance are included on the NRCs website at wwwnrcgov select Nuclear Materials Med Ind amp Academic Uses then Licensee Toolkits see our toolkit index page You may also obtain these documents by contacting the Government Printing Office (GPO) toll-free at 1-866-512-1800 The GPO is open from 700 am to 630 pm EST Monday through Friday (except Federal holidays)

Thank you for your cooperation

Sincerely

-~- ~ ~~Z~~ Sattar Lodhi PhD Senior Health Physicist Materials Security and Industrial Branch Division of Nuclear Materials Safety

Enclosure Amendment No 03

RM 313 US NUCLEAR REGULA TORY COMMISSION APPROVED BY OMB NO 3150-0120 EXPIRES Ufgt1nILU1

Estimated burden per response to comply with this mandatory collection request 43 houn Submittal of the3233 application is necessary to determine that the applicant is qualified and that adequate procedures exist to protect he public health and safety Send comments regarding burden estimate to the Information Services

34 35 36 39 and 40

p Branch (Tmiddot5 F53) US Nuclear Regulatory Commission Washington DC 205)5()()()1 or by internet amiddotmail to

(Wt~ APPLICATION FOR MATERIALS InfocoliectsResouroenrcgov and to the Desk Officer Office of Information and Regulatory Affairs NEOBmiddot10202 (3150-0120) Office of Management and Budget Washington DC 20503 If a means used to

~ LICENSE impose an information collection does not display a currently valid OMS control number the NRC may not bullbullbullbullbull oonduct Of sponsor and a person is not required to respond to the infOfmation 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 AMENDMENTSRENEWALS THAT INCREASE THE SCOPE OF THE EXISTING LICENSE TO A NEW OR HIGHER FEE CATEGORY WILL REQUIRE A FEE

APPUCATlON FOR DISTRIBUTION OF EXEMPT PRODUCTS FILE APPLICATIONS WITH IF YOU ARE LOCATED IN

OFFICE OF FEDERAL ampSTATE MATERIALS AND ILUNOIS INDIANA IOWA MICHIGAN MINNESOTA MISSOURI OHIO OR WISCONSIN ENVIRONMENTAL MANAGEMENT PROGRAMS SEND APPLICATIONS TO DIVISION OF MATERIALS SAFETY AND STATE AGREEMENTS

MATERIALS LICENSING BRANCH WASHINGTON DC 20555-0001 US NUCLEAR REGULATORY COMMISSION

US NUCLEAR REGULATORY COMMISSION REGION III 2443 WARRENVILLE ROAD SUITE 210

ALL OTHER PERSONS FILE APPUCATlONS AS FOLLOWS LISLE IL 60532-4352

IF YOU ARE LOCATIED IN

ALABAMA CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO HAWAII IDAHO KANSAS KENTUCKY MAINE MARYLAND MASSACHUSETTS NEW HAMPSHIRE NEW JERSEY LOUISIANA MISSISSIPPI MONTANA NEBRASKA NEVADA NEW MEXICO NORTH NEW YORK NORTH CAROLINA PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH DAKOTA OKLAHOMA OREGON PACIFIC TRUST TERRITORIES SOUTH DAKOTA TEXAS CAROLINA TENNESSEE VERMONT VIRGINIA VIRGIN ISLANDS OR WEST VIRGINIA UTAH WASHINGTON OR WYOMING

SEND APPLICATIONS TO SEND APPLICATIONS TO

LICENSING ASSISTANCE TEAM NUCLEAR MATERIALS LICENSING BRANCHDIVISION OF NUCLEAR MATERIALS SAFETY US NUCLEAR REGULATORY COMMISSION REGION IVUS NUCLEAR REGULATORY COMMISSION REGION I 1600 E LAMAR BOULEVARD2100 RENAISSANCE BOULEVARD SUITE 100 ARLINGTON TX 76011-4511 KING OF PRUSSIA PA 19406middot2713

PERSONS LOCATED IN AGREEMENT STATES SEND APPLICATIONS TO THE US NUCLEAR REGULATORY COMMISSION ONLY IF THEY WISH TO POSSESS AND USE LICENSED MATERIAL IN STATES SUBJECT TO US NUCLEAR REGULATORY COMMISSION JURISDICTIONS

1 THIS IS AN APPLIGATION FOR (Check appropriate item) NAME AND MAILING ADDRESS OF APPLICANT (Include ZiP code)

A NEW LICENSE Technology Associates Inc

06-30338-01[] B AMENDMENT TO LICENSE NUMBER PO Box 106 Center CT 06259 o C RENEWAL OF LICENSE NUMBER

3 ADDRESS WHERE LICENSED MATERIAL lMLL BE USED OR POSSESSED

BUSINESS TELEPHONE NUMBER BUSINESS CELLULAR TELEPHONE NUMBER250 Killingly Road

(860) 928-1921 (860) 234-6889 Pomfret Center CT 06259 BUSINESS EMAIL ADDRESS

bwoodiskwpinccom

12 LICENSE FEES (Fees required only for new applications with few exceptions) AMOUNTFEE CATEGORY(See 10 CFR 170 and Section 17031) ENCLOSED

13 CERTIFICATION (Must be completed by applicant) THE APPLICANT UNDERSTANDS THA T ALL STATEMENTS AND REPRESENTATlONS MADE IN THIS APPLICA TlON 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 lMTH TITLE 10 CODE OF FEDERAL REGULATIONS PARTS 30 32 33 34 353639 AND 40 AND THAT ALL INFORMATION CONTANED HEREIN IS TRUE AND CORRECT TO THE BEST OF THEIR KNOWLEDGE AND BELIEF WARNING 18 USC SECTION 1001 ACT OF JUNE 25194862 STAT 749 MAKES IT A CRIMINAL OFFENSE TO MAKE A lMlLFUllY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER lMTHIN ITS JURISDICTION

CERTIFYING OFFICER -- TYPEDIPRINTED NAME AND TITLE

D Woodis President

NRC FORM 313 (03-2013)

) APPENDIXB

ITEMS 5 AND 6 MATERIALS TO BE POSSESSED AND PROPOSED USES

Yes No Radioisotope Manufacturer or Quantity Use As Listed Specify Other Distributor Model No onSSD Uses Not

Certificate Listed on SSD

JII Certificate

I Cesium-l 37 Sealed source manufacturer Not to exceed Yestg rtmot or distributor and model either the applicable

Specificnumber maximum

description ofactivity per

the gauge use source or o Uses are

Device manufacturer or maximum distributor and model activity per FcR~number device as ~e~bmit safety

specified in O~~ alysis(() CFN ~L Sealed Source rodl3ll16 supporting safe

CPU- ~I and Device use) Registration Certificate(i)-rraJ)(~fZ t--aJEL

3450

) Americium- Sealed source manufacturer Not to exceed YesltJl ~ot 241 or distributor and model either the applicable

Specificnumber maximum

description ofactivity per

the gauge use source or o Uses are

Device manufacturer or maximum ]15 I ~b distributor and model activity per 6tlpoundUaianumber device as (Submit safety

specified in mlS~IAL2 analysis(i)CPM ~L Sealed Source supporting safe

Gt~-o and Device use) Registration6)T~ ~L CertificateMq)

) B-1 NUREG - 1556 Vol 1 Rev 1

~LmiddotT60-kO~Y ~

PM~ er-r _J c f C(p-o~-O I

APPENDIXB

Yes No Radioisotope

v Californiumshy252

V Other Isotope (Specify)

)

Manufacturer or Distributor Model No

Sealed source manufacturer or distributor and model number

Device manufacturer or distributor and model number

Sealed source manufacturer or distributor and model number

Device manufacturer or distributor and model number

Quantity

Not to exceed either the maximum activity per source or maximum activity per device ru

specified in Sealed Source and Device Registration Certificate

Not to exceed either the maximmn activity per source or maximmn activity per device as specified in Sealed Source and Device Registration Certificate

Use As Listed onSSD

Certificate

Yes 0

Specific description of the gauge use

Yes 0

Specific description of the gauge use

Specify Other Uses Not

Listed on SSD Certificate

o Not applicable

o Uses are

(Submit safety analysis supporting safe use)

o Not applicable

o Uses are

(Submit safety analysis supporting safe use)

Financial Assurance Required and Evidence ofFinancial Assurance Provided

) NLJREG - 1556 Vol 1 Rev 1 B-2

APPENDIXB

ITEMS 7 THROUGH 11 TRAINING AND EXPERIENCE FACILITIES AND EQUIPMENT RADIATION SAFETY PROGRAM AND WASTE DISPOSAL

Item No And Title

7 INDIVIDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEm TRAINING AND EXPERIENCE shyRADIATION SAFETY OFFICER

8 TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS

9 FACILITIESAND EQUIPMENT

10 RADIATION SAFETY PROGRAM - AUDIT PROGRAM

10 RADIATION SAFETY PROGRAM TERMINATION OF ACTIVITIES

10 RADIATION SAFETY PROGRAM - SURVEY INSTRUMENTS

Suggested Response

Before obtaining licensed materials the proposed RSO will have successfully completed one ofthe training courses described in Criteria in the section entitled Individual(s) Responsible for Radiation Safety Program and Their Training and Experience Radiation Safety Officer in NUREG-1556 Vol 1 Rev 1 dated November 2001

Before using licensed materials authorized users will have successfully completed one of the training course described in Criteria in the section entitled Training for Individuals Working In or Frequenting Restricted Areas in NUREG-1556 Vol J Rev 1 dated November 2001

No information needs to be submitted in response to this item key issues are addressed under Radiation Safety Program Public Dose and Radiation Safety Program shyOperating and Emergency Procedures

The applicant is not required to and should not submit its audit program to NRC for review during the licensing phase

The applicant is not required to submit a response to the termination of activities section during the initial application However when the license expires when the licensee ceases operation NRC Form 314 must be submitted

We will either possess and use or have access to and use a radiation survey meter that meets the Criteria in the section entitled Radiation Safety Program Instruments in NUREG-J556 Vol 1 Rev 1 dated November 200 I

Yes Alternative Procedures Attached

o

Separate Item 9 Response

Need Not Be Submitted With Application

Need Not Be Submitted With Application

Need Not Be Submitted With Application

o

B-3 NUREG - 1556 Vol 1 Rev 1

APPENDrxB

) Item No And Title

10 RADIATION SAFETY PROGRAM - MATERIAL RECEIPT AND ACCOUNTABILITY

10 RADIATION SAFETY PROGRAMshyOCCUPATIONAL DOSIMETRY

10 RADIATION SAFETY PROGRAM PUBLIC DOSE

10 RADIATION SAFETY

) PROGRAMshyOPERATING AND EMERGENCY PROCEDURES

10 RADIATION SAFETY PROGRAM LEAK TEST

Suggested Response

Physical inventories will be conducted at intervals not to exceed 6 months to account for all sealed sources and devices received and possessed under the license

Either we will maintain for inspection by NRC documentation demonstrating that unmonitared individuals are not likely to receive a radiation dose in excess of 10 percent of the allowable limits in 10 CFR Part 20 ar we will provide dosimetry processed and evaluated by an NVLAP-approved processor that is exchanged at a frequency recommended by the processor

The applicant is not required to submit a response to the public dose section during the licensing phase This matter will be examined during an inspection

We will implement and maintain the operating and emergency procedures in Appendix H of NUREG-1556 Vol 1 Rev 1 dated November 2001 and provide copies of these procedures to all gauge users and at each job site

OR

Operating and emergency procedures will be developed implemented and maintained and will meet the criteria in the section entitled Radiation Safety Program - Operating and Emergency Procedures in NUREG-1556 Vol 1 Rev 1 dated November 2001

Leak tests will be performed at intervals approved by NRC or an Agreement Sate and specified in the Sealed Source and Device Registration Sheet Leak tests will be performed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organization authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit suppliers instructions

~lL~lCGY kltcc f=CMFeG-r C L-1C-i~ Ctsr W3~-0 I

Yes Alternative Procedures

Attached

ri 0

(5( 0

Need Not Be Submitted With Application

r

0

0

GI 0

The information in AppendixJ supporting a requestto perform leak testing and sample analysis is attached

) NUREG -1556 Vol 1 Rev 1 B-4

~LmiddotT60-kO~Y ~

PM~ er-r _J c f C(p-o~-O I

APPENDIXB

Yes No Radioisotope

v Californiumshy252

V Other Isotope (Specify)

)

Manufacturer or Distributor Model No

Sealed source manufacturer or distributor and model number

Device manufacturer or distributor and model number

Sealed source manufacturer or distributor and model number

Device manufacturer or distributor and model number

Quantity

Not to exceed either the maximum activity per source or maximum activity per device ru

specified in Sealed Source and Device Registration Certificate

Not to exceed either the maximmn activity per source or maximmn activity per device as specified in Sealed Source and Device Registration Certificate

Use As Listed onSSD

Certificate

Yes 0

Specific description of the gauge use

Yes 0

Specific description of the gauge use

Specify Other Uses Not

Listed on SSD Certificate

o Not applicable

o Uses are

(Submit safety analysis supporting safe use)

o Not applicable

o Uses are

(Submit safety analysis supporting safe use)

Financial Assurance Required and Evidence ofFinancial Assurance Provided

) NLJREG - 1556 Vol 1 Rev 1 B-2

APPENDIXB

ITEMS 7 THROUGH 11 TRAINING AND EXPERIENCE FACILITIES AND EQUIPMENT RADIATION SAFETY PROGRAM AND WASTE DISPOSAL

Item No And Title

7 INDIVIDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEm TRAINING AND EXPERIENCE shyRADIATION SAFETY OFFICER

8 TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS

9 FACILITIESAND EQUIPMENT

10 RADIATION SAFETY PROGRAM - AUDIT PROGRAM

10 RADIATION SAFETY PROGRAM TERMINATION OF ACTIVITIES

10 RADIATION SAFETY PROGRAM - SURVEY INSTRUMENTS

Suggested Response

Before obtaining licensed materials the proposed RSO will have successfully completed one ofthe training courses described in Criteria in the section entitled Individual(s) Responsible for Radiation Safety Program and Their Training and Experience Radiation Safety Officer in NUREG-1556 Vol 1 Rev 1 dated November 2001

Before using licensed materials authorized users will have successfully completed one of the training course described in Criteria in the section entitled Training for Individuals Working In or Frequenting Restricted Areas in NUREG-1556 Vol J Rev 1 dated November 2001

No information needs to be submitted in response to this item key issues are addressed under Radiation Safety Program Public Dose and Radiation Safety Program shyOperating and Emergency Procedures

The applicant is not required to and should not submit its audit program to NRC for review during the licensing phase

The applicant is not required to submit a response to the termination of activities section during the initial application However when the license expires when the licensee ceases operation NRC Form 314 must be submitted

We will either possess and use or have access to and use a radiation survey meter that meets the Criteria in the section entitled Radiation Safety Program Instruments in NUREG-J556 Vol 1 Rev 1 dated November 200 I

Yes Alternative Procedures Attached

o

Separate Item 9 Response

Need Not Be Submitted With Application

Need Not Be Submitted With Application

Need Not Be Submitted With Application

o

B-3 NUREG - 1556 Vol 1 Rev 1

APPENDrxB

) Item No And Title

10 RADIATION SAFETY PROGRAM - MATERIAL RECEIPT AND ACCOUNTABILITY

10 RADIATION SAFETY PROGRAMshyOCCUPATIONAL DOSIMETRY

10 RADIATION SAFETY PROGRAM PUBLIC DOSE

10 RADIATION SAFETY

) PROGRAMshyOPERATING AND EMERGENCY PROCEDURES

10 RADIATION SAFETY PROGRAM LEAK TEST

Suggested Response

Physical inventories will be conducted at intervals not to exceed 6 months to account for all sealed sources and devices received and possessed under the license

Either we will maintain for inspection by NRC documentation demonstrating that unmonitared individuals are not likely to receive a radiation dose in excess of 10 percent of the allowable limits in 10 CFR Part 20 ar we will provide dosimetry processed and evaluated by an NVLAP-approved processor that is exchanged at a frequency recommended by the processor

The applicant is not required to submit a response to the public dose section during the licensing phase This matter will be examined during an inspection

We will implement and maintain the operating and emergency procedures in Appendix H of NUREG-1556 Vol 1 Rev 1 dated November 2001 and provide copies of these procedures to all gauge users and at each job site

OR

Operating and emergency procedures will be developed implemented and maintained and will meet the criteria in the section entitled Radiation Safety Program - Operating and Emergency Procedures in NUREG-1556 Vol 1 Rev 1 dated November 2001

Leak tests will be performed at intervals approved by NRC or an Agreement Sate and specified in the Sealed Source and Device Registration Sheet Leak tests will be performed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organization authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit suppliers instructions

~lL~lCGY kltcc f=CMFeG-r C L-1C-i~ Ctsr W3~-0 I

Yes Alternative Procedures

Attached

ri 0

(5( 0

Need Not Be Submitted With Application

r

0

0

GI 0

The information in AppendixJ supporting a requestto perform leak testing and sample analysis is attached

) NUREG -1556 Vol 1 Rev 1 B-4

APPENDIXB

ITEMS 7 THROUGH 11 TRAINING AND EXPERIENCE FACILITIES AND EQUIPMENT RADIATION SAFETY PROGRAM AND WASTE DISPOSAL

Item No And Title

7 INDIVIDUAL(S) RESPONSIBLE FOR RADIATION SAFETY PROGRAM AND THEm TRAINING AND EXPERIENCE shyRADIATION SAFETY OFFICER

8 TRAINING FOR INDIVIDUALS WORKING IN OR FREQUENTING RESTRICTED AREAS

9 FACILITIESAND EQUIPMENT

10 RADIATION SAFETY PROGRAM - AUDIT PROGRAM

10 RADIATION SAFETY PROGRAM TERMINATION OF ACTIVITIES

10 RADIATION SAFETY PROGRAM - SURVEY INSTRUMENTS

Suggested Response

Before obtaining licensed materials the proposed RSO will have successfully completed one ofthe training courses described in Criteria in the section entitled Individual(s) Responsible for Radiation Safety Program and Their Training and Experience Radiation Safety Officer in NUREG-1556 Vol 1 Rev 1 dated November 2001

Before using licensed materials authorized users will have successfully completed one of the training course described in Criteria in the section entitled Training for Individuals Working In or Frequenting Restricted Areas in NUREG-1556 Vol J Rev 1 dated November 2001

No information needs to be submitted in response to this item key issues are addressed under Radiation Safety Program Public Dose and Radiation Safety Program shyOperating and Emergency Procedures

The applicant is not required to and should not submit its audit program to NRC for review during the licensing phase

The applicant is not required to submit a response to the termination of activities section during the initial application However when the license expires when the licensee ceases operation NRC Form 314 must be submitted

We will either possess and use or have access to and use a radiation survey meter that meets the Criteria in the section entitled Radiation Safety Program Instruments in NUREG-J556 Vol 1 Rev 1 dated November 200 I

Yes Alternative Procedures Attached

o

Separate Item 9 Response

Need Not Be Submitted With Application

Need Not Be Submitted With Application

Need Not Be Submitted With Application

o

B-3 NUREG - 1556 Vol 1 Rev 1

APPENDrxB

) Item No And Title

10 RADIATION SAFETY PROGRAM - MATERIAL RECEIPT AND ACCOUNTABILITY

10 RADIATION SAFETY PROGRAMshyOCCUPATIONAL DOSIMETRY

10 RADIATION SAFETY PROGRAM PUBLIC DOSE

10 RADIATION SAFETY

) PROGRAMshyOPERATING AND EMERGENCY PROCEDURES

10 RADIATION SAFETY PROGRAM LEAK TEST

Suggested Response

Physical inventories will be conducted at intervals not to exceed 6 months to account for all sealed sources and devices received and possessed under the license

Either we will maintain for inspection by NRC documentation demonstrating that unmonitared individuals are not likely to receive a radiation dose in excess of 10 percent of the allowable limits in 10 CFR Part 20 ar we will provide dosimetry processed and evaluated by an NVLAP-approved processor that is exchanged at a frequency recommended by the processor

The applicant is not required to submit a response to the public dose section during the licensing phase This matter will be examined during an inspection

We will implement and maintain the operating and emergency procedures in Appendix H of NUREG-1556 Vol 1 Rev 1 dated November 2001 and provide copies of these procedures to all gauge users and at each job site

OR

Operating and emergency procedures will be developed implemented and maintained and will meet the criteria in the section entitled Radiation Safety Program - Operating and Emergency Procedures in NUREG-1556 Vol 1 Rev 1 dated November 2001

Leak tests will be performed at intervals approved by NRC or an Agreement Sate and specified in the Sealed Source and Device Registration Sheet Leak tests will be performed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organization authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit suppliers instructions

~lL~lCGY kltcc f=CMFeG-r C L-1C-i~ Ctsr W3~-0 I

Yes Alternative Procedures

Attached

ri 0

(5( 0

Need Not Be Submitted With Application

r

0

0

GI 0

The information in AppendixJ supporting a requestto perform leak testing and sample analysis is attached

) NUREG -1556 Vol 1 Rev 1 B-4

APPENDrxB

) Item No And Title

10 RADIATION SAFETY PROGRAM - MATERIAL RECEIPT AND ACCOUNTABILITY

10 RADIATION SAFETY PROGRAMshyOCCUPATIONAL DOSIMETRY

10 RADIATION SAFETY PROGRAM PUBLIC DOSE

10 RADIATION SAFETY

) PROGRAMshyOPERATING AND EMERGENCY PROCEDURES

10 RADIATION SAFETY PROGRAM LEAK TEST

Suggested Response

Physical inventories will be conducted at intervals not to exceed 6 months to account for all sealed sources and devices received and possessed under the license

Either we will maintain for inspection by NRC documentation demonstrating that unmonitared individuals are not likely to receive a radiation dose in excess of 10 percent of the allowable limits in 10 CFR Part 20 ar we will provide dosimetry processed and evaluated by an NVLAP-approved processor that is exchanged at a frequency recommended by the processor

The applicant is not required to submit a response to the public dose section during the licensing phase This matter will be examined during an inspection

We will implement and maintain the operating and emergency procedures in Appendix H of NUREG-1556 Vol 1 Rev 1 dated November 2001 and provide copies of these procedures to all gauge users and at each job site

OR

Operating and emergency procedures will be developed implemented and maintained and will meet the criteria in the section entitled Radiation Safety Program - Operating and Emergency Procedures in NUREG-1556 Vol 1 Rev 1 dated November 2001

Leak tests will be performed at intervals approved by NRC or an Agreement Sate and specified in the Sealed Source and Device Registration Sheet Leak tests will be performed by an organization authorized by NRC or an Agreement State to provide leak testing services for other licensees or using a leak test kit supplied by an organization authorized by NRC or an Agreement State to provide leak test kits to other licensees and according to the kit suppliers instructions

~lL~lCGY kltcc f=CMFeG-r C L-1C-i~ Ctsr W3~-0 I

Yes Alternative Procedures

Attached

ri 0

(5( 0

Need Not Be Submitted With Application

r

0

0

GI 0

The information in AppendixJ supporting a requestto perform leak testing and sample analysis is attached

) NUREG -1556 Vol 1 Rev 1 B-4

) Item No And Title

10 RADIATION SAFETY PROGRAMshyMAINTENANCE

) toRADIATION SAFETY PROGRAMshy

TRANSPORTATION

11 WASTE MANAGEMENTshyGAUGE DISPOSAL AND TRANSFER

S7LT~1 ASBJc POM((Zeuro- CT LIC- 1t Ct9 038-0

APPENDIXB

Suggested Response Yes Alternative Procedures Attached

Routine Cleaning and Lubrication

We will implement and maintain procedures for routine maintenance of our gauges

0

according to each manufacturers recommendations and instructions

Non-Routine Maintenance

We will send the gauge to the manufacturer or other person authorized by NRC or an Agreement State to perform non-routine maintenance or repair operations that require the removal of the source or source rod from the gauge

0

The information listed in AppendixG supporting a request to perform non-routine maintenance in-house is attached

The applicant is not required to submit its Need Not Be Submitted response to transportation during the licensing With Application process However this issue will be reviewed during inspection

The applicant is not required to submit a Need Not Be Submitted response to waste management during the With Application licensing process However the licensee should develop implement and maintain gauge transfer and disposal procedures in its radiation protection program

) B-5 NUREG - 1556 VoL 1 Rev 1

Certiftcate oj Comlletton This certifies that

Bruce D Woodis

has successfully completed the

RadiationSafetYOfficerCourse

conducted by the training department of

Troiler Electrolic Laboratories ifLC

Ken Brown March 192013 lVfllfillli F TroilerF Jr Instructor Date President

Troxler Elecronlc LaboratorleEl Incent PO Box 12057middot 3008 Comwallis Rdbull Research TrisnQle Park NC 27709 53775873Phcne (919 E4amp-8S61 bull Fax (919)649-0761 Web site wwillxlerlabsoorrmiddot

Nucfear gauge Safety Certification This certitlesthat

bruce d woodis

has successfully c0111pleted training on radiation safety and regulatolY requirenlents for the use of portable nuclear gauges on this date

March 17 2013

This certificate is not valicluntil signed by the licensee RSO I attest that the person named above and no othel~ lws ompleted the onlinE course and tests I certitY that the individual has completed practical skills training for setting up ami making measurements routine maintenance packaging and transport storage and emergency pl~(edur~s for portable nuclear gauges

Licellsee RSO -BRUCk~D (V(cXJ)IS 9~w (plintnalllE) SignatulE rhlte ~

Troxler Online Training meets the reqUirements in Chapter 646 Part XIII Florida Administrative Code

~ Troxler Electronic laboratories Inc _If__1-__ ~~~~~ PO B~x 12057 - 3008 E Co~nwallis Road - Research Triangle Park NC 27709 The Lender iq Construction Testing rIJfnlf Phone (919) 549-8661 - Fax 919) 549-0761 - wwwtroxlerlabscom

Course Tracking Code 57576B9ACH87758 37527 -_ ----~-----_ - -- ~yT-----=----~ --- r- - - - IJ~eurolt

i1OTrn-tILTllTnlJn q~~caour~lItrLllfTf1Tf l2S~IJl--~~---- - - OM bull_rr bull

Certiftcate oj Comlletton This certifies that

Bruce D Woodis

has successfully completed the

RadiationSafetYOfficerCourse

conducted by the training department of

Troiler Electrolic Laboratories ifLC

Ken Brown March 192013 lVfllfillli F TroilerF Jr Instructor Date President

Troxler Elecronlc LaboratorleEl Incent PO Box 12057middot 3008 Comwallis Rdbull Research TrisnQle Park NC 27709 53775873Phcne (919 E4amp-8S61 bull Fax (919)649-0761 Web site wwillxlerlabsoorrmiddot

Nucfear gauge Safety Certification This certitlesthat

bruce d woodis

has successfully c0111pleted training on radiation safety and regulatolY requirenlents for the use of portable nuclear gauges on this date

March 17 2013

This certificate is not valicluntil signed by the licensee RSO I attest that the person named above and no othel~ lws ompleted the onlinE course and tests I certitY that the individual has completed practical skills training for setting up ami making measurements routine maintenance packaging and transport storage and emergency pl~(edur~s for portable nuclear gauges

Licellsee RSO -BRUCk~D (V(cXJ)IS 9~w (plintnalllE) SignatulE rhlte ~

Troxler Online Training meets the reqUirements in Chapter 646 Part XIII Florida Administrative Code

~ Troxler Electronic laboratories Inc _If__1-__ ~~~~~ PO B~x 12057 - 3008 E Co~nwallis Road - Research Triangle Park NC 27709 The Lender iq Construction Testing rIJfnlf Phone (919) 549-8661 - Fax 919) 549-0761 - wwwtroxlerlabscom

Course Tracking Code 57576B9ACH87758 37527 -_ ----~-----_ - -- ~yT-----=----~ --- r- - - - IJ~eurolt

i1OTrn-tILTllTnlJn q~~caour~lItrLllfTf1Tf l2S~IJl--~~---- - - OM bull_rr bull

Nucfear gauge Safety Certification This certitlesthat

bruce d woodis

has successfully c0111pleted training on radiation safety and regulatolY requirenlents for the use of portable nuclear gauges on this date

March 17 2013

This certificate is not valicluntil signed by the licensee RSO I attest that the person named above and no othel~ lws ompleted the onlinE course and tests I certitY that the individual has completed practical skills training for setting up ami making measurements routine maintenance packaging and transport storage and emergency pl~(edur~s for portable nuclear gauges

Licellsee RSO -BRUCk~D (V(cXJ)IS 9~w (plintnalllE) SignatulE rhlte ~

Troxler Online Training meets the reqUirements in Chapter 646 Part XIII Florida Administrative Code

~ Troxler Electronic laboratories Inc _If__1-__ ~~~~~ PO B~x 12057 - 3008 E Co~nwallis Road - Research Triangle Park NC 27709 The Lender iq Construction Testing rIJfnlf Phone (919) 549-8661 - Fax 919) 549-0761 - wwwtroxlerlabscom

Course Tracking Code 57576B9ACH87758 37527 -_ ----~-----_ - -- ~yT-----=----~ --- r- - - - IJ~eurolt

i1OTrn-tILTllTnlJn q~~caour~lItrLllfTf1Tf l2S~IJl--~~---- - - OM bull_rr bull

HAZMAT Certification as required by US DOT and lATA

JIll) 1( (Ifilmiddot Ulli

Bruce D Woodis

110 bull 1IllI 11111111 lilHI ((Id III itlrdlllllt 111111 1I1IIi 1111111111111 III JrIIIIIII 11111 JIIIIlIII11i1 Ilr rllBltI( ItI(I111011 11middot111 Jilll(lrdllIi 1IIllilIil( r1uI 111-1 (I ( 111111 aIlIlIIt~fallll(IIrltl(ll tillI ((1 1((11 -il((I tllldi(I1(IIWlllfll) i) ltl III I 111 11 dllif I illi 1111l1)PItlIWTIllilllrul dlfI

d~tnll 1 (t Ifr I IUllillll1 t (lllll JIIIlillrl1 11 1Ilnttl- (r I III II ( rtc IH1I1( fll i(ilI() fll

I III nlllll Dl r XII1I1Ml jllllf hl)1111l (II

March 19 2013 3 Years From Date of Class Ken Brown

Troxler Electronic Laboratorios Inc PO Sox 12057 middot30GB Cor111ailis Road ResearCliTIangie iarkN 27709

Ti~ iJl_kmiddot 111 i middotmiddotII~fI T~tIHl EJ1H~-llf1 Phone 1(19) 549middot8661 fax 1919549middot0751 bullIIiwtro)ierlabscorn J TRQXIIER

Jfazmat Emyojlr Certification

ComyallY Soil Technology Associates

Compy ffa~~1Pe V tAtW= 7706 oJ

Enrollment ID

53775873

(L-lt+=-I-L---=-~_--_ and to inform you that the initial processing which includes a administrative review has b~ performed

rI7I Th d t t degY~-2J~tmiddot-CJI J dkLJ ere were no a miniS ra Ive omissions our app lca Ion was assl~e to a technical reviewer Please note that the technical review may identify additional omissions or require additional information

D 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 amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved

Your action has been assigned Mail Control Number 0fo371 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) Sincerely (696) Licensing Assistance Team Leader

(L-lt+=-I-L---=-~_--_ and to inform you that the initial processing which includes a administrative review has b~ performed

rI7I Th d t t degY~-2J~tmiddot-CJI J dkLJ ere were no a miniS ra Ive omissions our app lca Ion was assl~e to a technical reviewer Please note that the technical review may identify additional omissions or require additional information

D 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 amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved

Your action has been assigned Mail Control Number 0fo371 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) Sincerely (696) Licensing Assistance Team Leader