ML20024D128

NRC Form 742 (Blank), Material Balance Report

ML20024D128
Person / Time
Issue date:	01/24/2020
From:	Office of Nuclear Material Safety and Safeguards
To:
Liu T
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ML20023B572	List: ML20024D128 ML20024D131
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Download: ML20024D128 (2)

Text

5. MATERIAL TYPE (Submit separate report for each type)

U.S. DEPARTMENT OF ENERGY AND U.S. NUCLEAR REGULATORY COMMISSION

1. NAME AND ADDRESS MATERIAL ACCOUNTABILITY NRC FORM 742 (MM-YYYY)

4. REPORT PERIOD (MM/DD/YYYY)

APPROVED BY OMB: NO. 3150-0004 DOE/NRC FORM 742

2. LICENSE NUMBER(S)

3. REPORTING IDENTIFICATION SYMBOL (RIS)

FROM TO SECTION A

8. BEGINNING INVENTORY -- U.S. GOVT-OWNED

9. BEGINNING INVENTORY -- NOT U.S. GOVT-OWNED

11. PROCUREMENT FROM DOE RIS FROM:

13. PROCUREMENT -- FOR THE ACCOUNT OF DOE

14. DOD RETURNS -- USE A

15. DOD RETURNS -- USE B

16. DOD RETURNS -- OTHER USES

21. PRODUCTION

a. ICT

b. ICT

c. ICT

30. RECEIPTS REPORTED TO DOE/NRC ON DOE/NRC 741 (not listed elsewhere)

FROM:

34. RECEIPTS -- MISC

37. PROCUREMENT BY OTHERS

38. DONATED MATERIAL -- FROM U.S. GOVT TO OTHERS

39. DONATED MATERIAL -- FROM OTHERS TO U.S. GOVT

40. TOTAL (Lines 8-39)

41. EXPENDED IN SPACE PROGRAMS RIS TO:

RIS TO:

44. DOD -- USE A

45. DOD -- USE B

46. DOD -- OTHER USES

47. EXPENDED IN U.S. GOVT TESTS

48. ROUTINE TESTS

49. SHIPPER -- RECEIVER DIFFERENCE

51. SHIPMENTS REPORTED TO NRC/DOE ON NRC/DOE 741 (not listed elsewhere)

TO:

RIS EXPIRES: (MM/DD/YYYY)

RIS

22. FROM OTHER MATERIALS

42. SALES TO U.S. GOVT RIS TO:

43. SALES TO OTHERS FOR THE ACCOUNT OF U.S. GOVT (MM--YYYY) 10 CFR 30, 40, 50, 70, 72, 74, 75, 150, Public Laws83-703, 93-438, 95-91 PC SEQ MATERIAL BALANCE REPORT A. ELEMENT WEIGHT B. ISOTOPE WEIGHT RECEIPTS REMOVALS Estimated burden per response to comply with this mandatory collection request: 2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br /> for small licensees and 5 hours5.787037e-5 days <br />0.00139 hours <br />8.267196e-6 weeks <br />1.9025e-6 months <br /> for large licensees. Reported lessons learned are incorporated into the licensing process and fed back to industry. Send comments regarding burden estimate to the Information Services Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0004), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

Page 1 MANDATORY DATA COLLECTION AUTHORIZED BY

DATE SIGNATURE (See instructions for provisions on confidentially)

TITLE

54. SHIPMENTS -- MISC

65. ROUNDING ADJUSTMENT

58. DONATED MATERIAL -- TO U.S. GOVT BY OTHERS

59. DONATED MATERIAL -- TO OTHERS BY U.S. GOVT

a. ICT

b. ICT

72. DECAY

75. ACCIDENTAL LOSSES

73. FISSION AND TRANSMUTATION

74. NORMAL OPERATIONAL LOSSES/MEASURED DISCARDS

77. INVENTORY DIFFERENCE

82. TOTAL (Lines 41-81)

80. ENDING INVENTORY -- U.S. GOVT OWNED

81. ENDING INVENTORY -- NOT U.S. GOVT OWNED MATERIAL ACCOUNTABILITY SECTION A (Continued)

FOREIGN OBLIGATIONS SECTION B CERTIFICATION SECTION C To the best of my knowledge and belief, the information given above and in any attached schedules is true, complete, and correct.

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

83. BIAS ADJUSTMENT

71. DEGRADATION TO OTHER MATERIALS

76. APPROVED WRITE-OFFS PC SEQ PC SEQ A. ELEMENT WEIGHT B. ISOTOPE WEIGHT

2. ELEMENT WEIGHT

3. ISOTOPE WEIGHT

1. COUNTRY OF OBLIGATION

4. TOTAL WEIGHT U.S. DEPARTMENT OF ENERGY AND U.S. NUCLEAR REGULATORY COMMISSION DOE/NRC FORM 742 (MM-YYYY) 10 CFR 30, 40, 50, 70, 72, 74, 75, 150, Public Laws83-703, 93-438, 95-91 MATERIAL BALANCE REPORT (Continued)

Page 2 NRC FORM 742 (MM-YYYY)