ML15357A053

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GL Registration from Virginia Electric and Power Company (Dominion) North Anna Power Station Units 1 and 2
ML15357A053
Person / Time
Site: North Anna  Dominion icon.png
Issue date: 12/18/2015
From: Gerald Bichof
Virginia Electric & Power Co (VEPCO)
To:
Office of Nuclear Material Safety and Safeguards
References
15-581, GL-700115-20
Download: ML15357A053 (8)
v • d • e


Text

VIRGINIA E*LECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/JHL ATT-IN: GLTS Docket Nos.

50-338/339 U. S. Nuclear Regulatory Commission License Nos.

NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS I AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Form 664, General Licensee Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.

Sincerely, Gerald T. Bischof Site Vice President Enclosure Commitments made by this letter: None cc:

U.S. Nuclear Regulatory Commission Attention: Document Control Desk Washington, D. C. 20555-0001 U.S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta, Georgia 30303-1 257 NRC Senior Resident Inspector North Anna Power Station

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GL-7001 15-20 10/30/2015 NRC FORM 664 07 - 2015 10OCFR 31.5 APPROVED BY 0MB: NO. 3150-0198 SECTION 1 PAGE 1 of 2 U.S. NUCLEAR REGULATORY COMMISSION GENERAL LICENSEE REGISTRATION EXPIRES: 04/3012016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a 1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.

Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License Registration Number GL-700115-20 SECTION 1 - GENERAL LICENSEE INFORMATION Enter the company name and the street address/physical location of use for your device(s).

For portable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: DOMINION VIRGIN.IA POWER Department:

NORTH ANNA POWER STATIO I

Address Line 1:

1022 HALEY DRIVE Address Line 2:

END OF ROUTE 700 City:

MINERAL State:

VA Zip Code: 23117 - 0402 wz~

For NRC use Only-:

C, ategory:"

(Do :not write here) :

-. :.,"Packet Receipt Date (MMDDYYY ):

i : ?

i I I I' I I

L

.1 I~

I I

.1J I

Accession Number:.

A A

Ii IIIIIIII II 111i-111 IIII III!

IIII Iin III IIIII nII 111111111 GL-7001 15-20 10/30/2015 111111111 IIII IIIII IIII III III II111 SECTION 1 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).

Last Name:

EVANS First Name:

ROBERT Middle Initial:B Telephone:

(540) 894-2107 Extension:

Title:

CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your device(s) should be sent.

This address should be specific to the use or storage location of your device(s).

Department:

NORTH ANNA POWER STATION Address Line 1:

1022 HALEY DRIVE Address Line 2:

END OF ROUTE 700 City:

MINERAL State:

VA D ___ Zip Code: 23117 -0402

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A A

I IIIHIIII11 II IIIIINVI l iii lii III 1111 11ilIIIIi11 1111111I II I! 111111 i II!1 III IIl III GL-700115-20 10/30/2015 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary.

PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number)

Distributor/Distributed By:

OXFORD INSTRUMENTS ANALYTICAL Distributor License Number:

29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model)i DOPS Device Serial Number: 128018 Transfer.Date (Receipt Date): 08/12/1999 rvn Not in possession of device (Also

  • _J
  • __J L

D complete Section 4.)

MM DD YYYY Isotope (e.g. AM241)

Activity (e.g. 100)

Unit (e.g. mCi) 1 AM241 30.000000000 mCi 2

3 4*

5 6

E.E D IDII

'.A

.A

IIII]111 Iv iIII n !1 Inn I iii1111 UIIII inII III 1111111 III Iin 111 1IIIII 1 IIII In I In I IIi!1 SGL-700115-20 10/30/2015 SECTION 3 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number o Manufacturer/Initial Transferor listed above How acquired and date (e.g.,

from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F

_7 F

_77

  • other licensee, other source)?L..LJL.LJ U Other Source (Received)

MM DD YYYY Isotope (e.g. AM241 )

1.

3.

4.

6 7.

8.~D 9.

10.

DI I

Activity (e.g. 100)

II II LI m

Unit (e.g. mCi)

LW~

DIDI DID1 WI DIDI DIDJ I

I I

I I

I I

I I

I A

A

I II11 IIIII il11111 IIII11 l11 IIII II II II~II i11 liIIIIII II~II ii IIII[II IIIII 1 1L-0/0/215-2 SEcTiON 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession.

PAGE 1of 1 Part I Transfer Date:

NRC Device Key:

(from Section 2 or 6)

MM DD YYYY Location of the Device:

o Whereabouts Unknown (complete Part 1 only)

O Transferred to another general licensee (complete Parts 2 and 3) o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) o Returned to Manufacturer (complete Part 1 only)

(complete Part 2)

Part 2 License Number of Recipient (if transferred to~a specific licensee):

Company Name:

-Department:

Adrs ine 1:l l l

~l II Address Line 2:

City:

  • Part 3 Enter the name of the individual responsible for. this device:

Last Name:

First Name:

Middle Initial:

Title:

A A

GL-7001 15-20 SECTION 5 - CERTIFICATION SECTION 5 10/30/2015 PAGE 1 of 1 Ihereby certify that:

A.

All information' contained in this registration is true and complete to the best of my knowledge and belief.

B.

A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C.

l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http://www, nrc.gov/reading-rm/doc-collections/cfr)

SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1)

DATE WARNING:

FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

GL-700115-20 10/30/2015 IflL 5~ F C~r I (~ t'J R

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I

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~AI HUN PAGE lofI NRC Device Key: 825331 Manufacturer License No:

12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B310000 Serial #: DG08129527 Isotope: BA133 Activity: 0.020000000 Unit:

uCi Transfer Date: 07/20/2012 NRC Device Key: 689428 Manufacture Manufacturer Name: GE ION TRACK Model Number: ITEMISER III Serial #: 09'-8424 Isotope: N163 Activity: 10.000000000

r License No

20-15525-04G Transfer Date: 06/30/2003 Unit:

mCi NRC Device Key: 707159 Manufacturer Name: METOREX, INC.

Model Number: 880 Isotope: CD109 Activity: 10.0 Manufadturer License No:

455-01G Serial #: 128018 Transfer Date: 02/27/2002 00000000 Unit:

mCi NRC Device Key: 547351 Manufacturer Name: CONCO SERVICES CORP.

Model Number: 101 Seria Isotope: N163 Activity: 5.000000000 Manufacturer License No:

MD-3 1-076-01 l#: N596 Transfer Date: 02/15/1994 Unit:

mCi

VIRGINIA E*LECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 December 18, 2015 Director, Office of Nuclear Material Safety Serial No.15-581 and Safeguards NAPS/JHL ATT-IN: GLTS Docket Nos.

50-338/339 U. S. Nuclear Regulatory Commission License Nos.

NPF-4/7 Washington, DC 20555-0001 Gentlemen:

VIRGINIA ELECTRIC AND POWER COMPANY (DOMINION)

NORTH ANNA POWER STATION UNITS I AND 2 ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES In accordance with 10 CFR 31.5, enclosed is NRC Form 664, General Licensee Registration, for registration of generally licensed devices maintained at North Anna Power Station.

If you have any questions, please contact Mr. R.. B. Evans at (540) 894-2107.

Sincerely, Gerald T. Bischof Site Vice President Enclosure Commitments made by this letter: None cc:

U.S. Nuclear Regulatory Commission Attention: Document Control Desk Washington, D. C. 20555-0001 U.S. Nuclear Regulatory Commission Region II Marquis One Tower 245 Peachtree Center Ave., NE Suite 1200 Atlanta, Georgia 30303-1 257 NRC Senior Resident Inspector North Anna Power Station

N~ill IIII II IIII U I.I li1ii 11iii II I~

NDI~ WII 11 111 1

i llI~i I!

GL-7001 15-20 10/30/2015 NRC FORM 664 07 - 2015 10OCFR 31.5 APPROVED BY 0MB: NO. 3150-0198 SECTION 1 PAGE 1 of 2 U.S. NUCLEAR REGULATORY COMMISSION GENERAL LICENSEE REGISTRATION EXPIRES: 04/3012016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device aocountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (7-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail[ to Infocollects.Resource~nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1 0202, (3150-01 9B), Office of[ Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a 1currently valid 0MB control number, the.NRC may not conduct or sponsor, end a. person is not required to respond to, the information collection.

Complete -all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License Registration Number GL-700115-20 SECTION 1 - GENERAL LICENSEE INFORMATION Enter the company name and the street address/physical location of use for your device(s).

For portable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: DOMINION VIRGIN.IA POWER Department:

NORTH ANNA POWER STATIO I

Address Line 1:

1022 HALEY DRIVE Address Line 2:

END OF ROUTE 700 City:

MINERAL State:

VA Zip Code: 23117 - 0402 wz~

For NRC use Only-:

C, ategory:"

(Do :not write here) :

-. :.,"Packet Receipt Date (MMDDYYY ):

i : ?

i I I I' I I

L

.1 I~

I I

.1J I

Accession Number:.

A A

Ii IIIIIIII II 111i-111 IIII III!

IIII Iin III IIIII nII 111111111 GL-7001 15-20 10/30/2015 111111111 IIII IIIII IIII III III II111 SECTION 1 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, teleiphone number and title of the person who is the responsible individual for the device(s).

Last Name:

EVANS First Name:

ROBERT Middle Initial:B Telephone:

(540) 894-2107 Extension:

Title:

CURRENT SAFETY OFFICER Enter the mailing address where correspondence regarding your device(s) should be sent.

This address should be specific to the use or storage location of your device(s).

Department:

NORTH ANNA POWER STATION Address Line 1:

1022 HALEY DRIVE Address Line 2:

END OF ROUTE 700 City:

MINERAL State:

VA D ___ Zip Code: 23117 -0402

[

z*z z

A A

I IIIHIIII11 II IIIIINVI l iii lii III 1111 11ilIIIIi11 1111111I II I! 111111 i II!1 III IIl III GL-700115-20 10/30/2015 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary.

PAGE 1 of 1 NRC Device Key 595514 (Internal Control Number)

Distributor/Distributed By:

OXFORD INSTRUMENTS ANALYTICAL Distributor License Number:

29-30342-02G Manufacturer Name: METOREX, INC Device Model (Not Source Model)i DOPS Device Serial Number: 128018 Transfer.Date (Receipt Date): 08/12/1999 rvn Not in possession of device (Also

  • _J
  • __J L

D complete Section 4.)

MM DD YYYY Isotope (e.g. AM241)

Activity (e.g. 100)

Unit (e.g. mCi) 1 AM241 30.000000000 mCi 2

3 4*

5 6

E.E D IDII

'.A

.A

IIII]111 Iv iIII n !1 Inn I iii1111 UIIII inII III 1111111 III Iin 111 1IIIII 1 IIII In I In I IIi!1 SGL-700115-20 10/30/2015 SECTION 3 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number o Manufacturer/Initial Transferor listed above How acquired and date (e.g.,

from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F

_7 F

_77

  • other licensee, other source)?L..LJL.LJ U Other Source (Received)

MM DD YYYY Isotope (e.g. AM241 )

1.

3.

4.

6 7.

8.~D 9.

10.

DI I

Activity (e.g. 100)

II II LI m

Unit (e.g. mCi)

LW~

DIDI DID1 WI DIDI DIDJ I

I I

I I

I I

I I

I A

A

I II11 IIIII il11111 IIII11 l11 IIII II II II~II i11 liIIIIII II~II ii IIII[II IIIII 1 1L-0/0/215-2 SEcTiON 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession.

PAGE 1of 1 Part I Transfer Date:

NRC Device Key:

(from Section 2 or 6)

MM DD YYYY Location of the Device:

o Whereabouts Unknown (complete Part 1 only)

O Transferred to another general licensee (complete Parts 2 and 3) o Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) o Returned to Manufacturer (complete Part 1 only)

(complete Part 2)

Part 2 License Number of Recipient (if transferred to~a specific licensee):

Company Name:

-Department:

Adrs ine 1:l l l

~l II Address Line 2:

City:

  • Part 3 Enter the name of the individual responsible for. this device:

Last Name:

First Name:

Middle Initial:

Title:

A A

GL-7001 15-20 SECTION 5 - CERTIFICATION SECTION 5 10/30/2015 PAGE 1 of 1 Ihereby certify that:

A.

All information' contained in this registration is true and complete to the best of my knowledge and belief.

B.

A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C.

l am aware of the requirements of the general license, p~rovided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http://www, nrc.gov/reading-rm/doc-collections/cfr)

SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1)

DATE WARNING:

FALSE STATEMENTS MAY BE SUBJECT TO CIVILAND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

GL-700115-20 10/30/2015 IflL 5~ F C~r I (~ t'J R

~t..

I

- UtVIU~ rJU

~UI~JIL. I iLl ~

~AI HUN PAGE lofI NRC Device Key: 825331 Manufacturer License No:

12-04933-04G Manufacturer Name: PERKINELMER LIFE SCIENCES Model Number: B310000 Serial #: DG08129527 Isotope: BA133 Activity: 0.020000000 Unit:

uCi Transfer Date: 07/20/2012 NRC Device Key: 689428 Manufacture Manufacturer Name: GE ION TRACK Model Number: ITEMISER III Serial #: 09'-8424 Isotope: N163 Activity: 10.000000000

r License No

20-15525-04G Transfer Date: 06/30/2003 Unit:

mCi NRC Device Key: 707159 Manufacturer Name: METOREX, INC.

Model Number: 880 Isotope: CD109 Activity: 10.0 Manufadturer License No:

455-01G Serial #: 128018 Transfer Date: 02/27/2002 00000000 Unit:

mCi NRC Device Key: 547351 Manufacturer Name: CONCO SERVICES CORP.

Model Number: 101 Seria Isotope: N163 Activity: 5.000000000 Manufacturer License No:

MD-3 1-076-01 l#: N596 Transfer Date: 02/15/1994 Unit:

mCi

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