Regulatory Guide 3.65

Standard Format and Content of Decommissioning Plans for Licensees Under 10CFR30,40 and 70

ML003739878
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Issue date:	08/31/1989
From:	Office of Nuclear Regulatory Research
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RG-3.65
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U.S. NUCLEAR REGULATORY COMMISSION

August 1989 REGULATORY GUIDE

OFFICE OF NUCLEAR REGULATORY RESEARCH

REGULATORY GUIDE 3.65 (Task CE 304-4)

STANDARD FORMAT AND CONTENT OF

DECOMMISSIONING PLANS FOR

LICENSEES UNDER

10 CFR PARTS 30, 40, AND 70

USNRC REGULATORY GUIDES

Regulatory Guides are issued to describe and make available to the pub lic methods acceptable to the NRC staff of implementing specific parts of the Commission's regulations, to delineate techniques used by the staff in evaluating specific problems or postulated accidents, or to pro vide guidance to applicants. Regulatory Guides are not substitutes for regulations, and compliance with them is not required. Methods and solutions different from those set out in the guides will be acceptable if they provide a basis for the findings requisite to the issuance or continu ance of a permit or license by the Commission.

This guide was issued after consideration of comments received from the public. Comments and suggestions for improvements in these guides are encouraged at all times, and guides will be revised, as ap propriate, to accommodate comments and to reflect new Information or experience.

Written comments may be submitted to the Regulatory Publications Branch, DFIPS, ARM, U.S. Nuclear Regulatory Commission, Washing ton, DC 20555.

The guides are issued in the following ten broad divisions:

6. Products

2. Research and Test Reactors

7. Transportation

3. Fuels and Materials Facilities

8. Occupational Health

4. Environmental and Siting

9. Antitrust and Financial Review

5. Materials and Plan) Protection

10. General Copies of issued guides may be purchased from the Government Printing Office at the current GPO price. Information on current GPO prices may be obtained by contacting the Superintendent of Documents, U.S.

Government Printing Office, Post Office Box 37082, Washington, DC

20013-7082, telephone (202)275-2060 or (202)275-2171.

Issued guides may also be purchased from the National Technical Infor mation Service on a standing order basis. Details on this service may be obtained by writing NTIS, 5285 Port Royal Road, Springfield, VA 22161.

TABLE OF CONTENTS

Page INTRODUCTION .......................................................

3.65-1

1.

General .......................................................

3.65-1

2.

Purpose and Applicability .....................................

3.65-2

3.

Format ........................................................

3.65-2

3.1 Graphical Presentations ..................................

3.65-2

3.2 Physical Specifications ..................................

3.65-3

3.3 Procedures for Updating or Revising Pages ................

3.65-3 CONTENT OF DECOMMISSIONING PLAN ....................................

3.65-4

1.

General Information ...........................................

3.65-4

2.

Description of Planned Decommissioning Activities .............

3.65-4

2.1 Decommissioning Objective, Activities, Tasks, and Schedules ................................................

3.65-4

2.2 Decommissioning Organization and Responsibilities ........

3.65-5

2.3 Training .................................................

3.65-5

2.4 Contractor Assistance ....................................

3.65-5

3.

Description of Methods Used for Protection of Occupational and Public Health and Safety ......................................

3.65-5

3.1 Facility Radiological History Information ...............

3.65-5

3.2 Ensuring that Occupational Radiation Exposures Are As Low As Is Reasonably Achievable (ALARA)

...............

3.65-6

3.3 Health Physics Program ....................................

3.65-6

3.4 Contractor Personnel .....................................

3.65-7

3.5 Radioactive Waste Management ............................

3.65-7

4.

Planned Final Radiation Survey ................................

3.65-8

5.

Funding .......................................................

3.65-8

6.

Physical Security Plan and Material Control and Accounting Plan Provisions in Place During Decommissioning ...............

3.65-9 IMPLEMENTATION .....................................................

3.65-9 REFERENCES .........................................................

3.65-10

APPENDIX 1, Form NRC-314 ...........................................

3.65-11 VALUE/IMPACT STATEMENT .............................................

3.65-13 iii

A.

INTRODUCTION

1.

GENERAL

Section 30.36, "Expiration and Termination of Licenses," of 10 CFR Part 30,

"Rules'of General Applicability to Domestic Licensing of Byproduct Material";

Section 40.42, "Expiration and Termination of Licenses," of 10 CFR Part 40,

"Domestic Licensing of Source Material"; and Section 70.38, "Expiration and Termination of Licenses," of 10 CFR Part 70, "Domestic Licensing of Special Nuclear Material," require, in part, all holders of specific licenses to submit a completed Form NRC-314 when they decide to terminate the license.'

(A copy of Form NRC-314 is provided in Appendix 1.)

On June 27, 1988, the Commission published amendments to its regulations in 10 CFR Parts 30, 40, and 70 (53 FR 24018), prescribing specific criteria for decommissioning nuclear facilities, effective July 27, 1988.

Amended §§ 30.36,

40.42, and 70.38 require certain licensees to submit, on or before the license expiration date, a plan for completing decommissioning when the licensee decides to terminate the license.

In particular, those sections require a licensee to submit a plan for completion of decommissioning if the procedures necessary to carry out decommissioning have not been previously approved by the NRC and could increase potential health and safety impacts to workers or to the public, such as in any of the following cases:

1.

Procedures would involve techniques not routinely applied during cleanup or maintenance operations;

2.

Workers would be entering areas not normally occupied where surface con tamination and radiation levels are significantly higher than routinely encountered during operation;

3.

Procedures could result in significantly greater airborne concentrations of radioactive materials than are present during operation; or

4.

Procedures could result in releases of radioactive material to the environ ment significantly greater than those associated with operation.

Large manufacturers under Part 30, uranium hexafluoride producers under Part 40, and processors and fuel fabricators under Part 70 would be included under this requirement.

Broad scope materials programs licensed pursuant to

10 CFR Part 30, panoramic indicators, and large-scale well-logging operations licensed under 10 CFR Part 30 may also require submittal of a decommissioning plan.

In some cases, licenses presently contain a specific condition that requires submittal of a decommissioning plan.

For clarification, it is noted that the term "decommissioning plan" refers to the plan submitted at the time the licensee decides to terminate the license.

Guidance on preparing this decommissioning plan is presented in this regulatory guide.

The term "decommissioning funding plan" refers to the plan submitted early in facility life that indicates the applicant's or licensee's financial

3.65-1

assurance provisions.

Guidance on the decommissioning funding plan, including cost estimates and acceptable funding methods, will be contained in separate regulatory guidance in preparation.

Any information collection activities mentioned in this regulatory guide are contained as requirements in 10 CFR Parts 20, 30, 40, and 70, which provide the regulatory basis for this guide.

The information collection requirements in

10 CFR Parts 20, 30, 40, and 70 have been cleared under OMB Clearance Nos. 3150

0014, 3150-0017, 3150-0020, and 3150-0009, respectively.

2.

PURPOSE AND APPLICABILITY

This regulatory guide, developed in conjunction with the amendments to the regulations concerning decommissioning, would be applicable to certain licensees (discussed above in Section 1) when they decide to permanently discontinue all licensed activities involving nuclear materials.

The purpose of the guide is to identify the information needed by the NRC staff for evaluations involving de commissioning.

The guide also provides a format for submitting this information.

Conformance with this guide is not required, but its use will facilitate prep aration of a decommissioning plan by licensees and timely, uniform review by the NRC staff.

A different format will be acceptable to the staff if it provides an adequate basis for approval of a decommissioning plan.

The guidance is ap propriate for use in license amendments to partially clean up a nuclear facility and release that part for unrestricted use at a time other than at the decommis sioning of the facility as a whole, e.g., cleanup of separate buildings.

The amended sections of the decommissioning rule (30.36(b), 40.42(b),

70.38(b)) require each licensee to notify the Commission promptly, in writing, and request termination of license when the licensee decides to terminate all activities involving material authorized under the license.

This notification and request for termination of the license must include a decommissioning plan if required as noted in Section 1 above.

Because the amendments on decommissioning require approval of a decommis sioning plan before starting decommissioning procedures and review and approval may take several weeks, it is recommended that the plan be prepared and submitted as soon as residual radioactive contamination has been assessed.

If the information requested in this guide in such sections as 2.1.3, 2.3,

3.2, 3.3, and 6 is the same as or similar to information currently required under the license, only changes need to be submitted.

Information contained in previous submittals, statements, or reports filed under the license may be incorporated by reference, provided the reference is clear and specific.

How ever, some cases may occur (e.g., Sections 2.1.3 and 3.5) in which a license amendment may be required to effect a change.

3.

FORMAT

3.1 Graphical Presentations Graphical presentations such as drawings, maps, diagrams, sketches, and tables should be employed if the information may be presented more adequately or conveniently by such means.

Due concern should be taken to ensure that all

3.65-2

information so presented is legible, that symbols are defined, and that scales are not reduced to the extent that visual aids are necessary to interpret per tinent items of information.

These graphical presentations should be located in the section where they are primarily discussed.

References used may appear either as footnotes to the page where discussed or at the end of each chapter.

3.2 Physical Specifications a.

Paper size

(1)

Text pages:

8-1/2 x 11 inches.

(2)

Drawings and graphics:

8-1/2 x 11 inches; however, a larger size is acceptable provided the finished copy when folded does not exceed 8-1/2 x 11 inches.

b.

Paper stock and ink.

Suitable quality in substance, paper color, and ink density for handling and reproduction by microfilming or image-copying equipment.

c.

Page margins.

A margin of no less than 1 inch should be maintained on the top, bottom, and binding side of all pages submitted.

d.

Printing

(1)

Composition:

text pages should be single spaced.

(2)

Typeface and style:

should be suitable for microfilming or image-copying equipment.

(3)

Reproduction:

may be mechanically or photographically reproduced.

All pages of text should be printed on both sides and the image printed head to head.

e.

Binding.

Pages should be punched for standard 3-hole loose-leaf binders.

f.

Page numbering.

Pages should be numbered with the digits correspond ing to the chapter f owed by a hyphen and a sequential number, e.g., the third page of Section 4 should be numbered 4-3.

Do not number the entire report sequentially.

g.

Table of contents.

A table of contents and an index of key items should be included.

3.3 Procedures for Updating or Revising Pages Data and text should be updated or revised by replacing pages.

The changed or revised portion on each page should be highlighted by a "change indicator"

mark consisting of a bold vertical line drawn in the margin opposite the binding margin.

The line should be of the same length as the portion actually changed.

All pages submitted to update, revise, or add pages to the report should show the date of change and change or amendment number.

A guide page listing the pages to be inserted and the pages to be removed should accompany the revised pages.

When major changes or additions are made, a revised-table of contents should be provided.

3.65-3

CONTENT OF DECOMMISSIONING PLAN

1.

GENERAL INFORMATION

The licensee's name and address and the appropriate numbers of the licenses to be terminated should be furnished.

2.

DESCRIPTION OF PLANNED DECOMMISSIONING ACTIVITIES

The amended sections of the rule on decommissioning require that a decom missioning plan, if submitted, contain a description of planned decommissioning activities.

This section describes the information that should be submitted to provide an adequate description of those activities.

2.1 Decommissioning Objective, Activities, Tasks, and Schedules

2.1.1 Decommissioning Objective, Activities, and Tasks In this section, the licensee should indicate the decommissioning objective and discuss how the proposed activities and tasks* will achieve this objective and the reasoning used to select particular methods to be used in the decommis sioning.

The licensee should list or tabulate the major activities and tasks related to processes, systems, and equipment and land to be decommissioned.

References 1, 2, and 3 contain information that may be helpful in developing a list of decommissioning activities and tasks.

References 1-3 contain lists of examples of tasks and activities involved in decommissioning materials facilities.

Further guidance is under development on these lists.

2.1.2 Description A description and an analysis of the proposed methods for accomplishing the activities and tasks listed in paragraph 2.1.1 should be presented.

The description should include a discussion of historical information on operational occurrences that could adversely affect decommissioning safety (see Section 3.1),

the current assessment of residual radioactive contamination, and potential accidents that could have a significant impact on decommissioning safety.

The analyses should show that decommissioning can be accomplished in a safe manner.

2.1.3 Procedures The licensee should state a commitment to conduct decommissioning activities and tasks in accordance with written procedures approved by licensee management.

The control system that ensures that written procedures are prepared, reviewed, revised, approved, and implemented should be described.

2.1.4 Schedules For major activities, the relationship between activities and tasks should be shown.

The schedules for accomplishing interrelated activities and tasks should be presented.

Schedules or diagrams should clearly indicate the esti mated time for completion of decommissioning.

• For the purposes of this guide, an activity is an organized unit of work for performing a function and may consist of several tasks.

A task is a specific work assignment or job.

3.65-4

2.2, Decommissioning Organization and Responsibilities The organization with respect to the overall project should be described.

Positions with responsibilities related to decommissioning safety should be identified and their functions described.

The minimum qualifications for these positions should be presented.

The discussion should address the project team, decommissioning staff, worker health and safety training, and the use, control, and management of subcontractors.

2.3 Training A description of the training program, including general and specific radiological safety training, for operators, contractor personnel, and other personnel should be presented.

This section should also contain a description of the system for maintaining records of training received by personnel.

2.4 Contractor Assistance The licensee may choose to accomplish some or all decommissioning activities and tasks by using contractors.

However, the responsibility for safety during decommissioning rests with the licensee.

For each contracting organization, the scope of work, the contractor qualifications to perform work with radio active material, and administrative controls to be used to ensure adequate health and safety protection should be described.

The licensee should indicate which activities will be performed under subcontractor licenses and indicate the name, address, and license number of the subcontractor.

3.

DESCRIPTION OF METHODS USED FOR PROTECTION OF OCCUPATIONAL AND PUBLIC

HEALTH AND SAFETY

The amended sections of the rule on decommissioning require that a decom missioning plan contain a description of the methods used to ensure protection of workers and the environment against radiation hazards during decommissioning.

This section describes the information that should be presented to provide an adequate description of these methods.

The licensee should include both admin istrative and technical issues in the descriptions.

3.1 Facility Radiological History Information If a decommissioning plan is required, the licensee should describe histor ical information that should be reviewed and dealt with in the decommissioning planning to ensure worker safety.

This information is of two types:

one is related to an indication of where in the facility work with radioactive materials has been performed; and the other is related to operational occurrences resulting in contamination that could have an affect on decommissioning safety.

With regard to the first type of information, the plan should include a list of all locations in the facility where any work with radioactive materials was ever performed, what material was involved, a description of the operations performed, and typical radiation and contamination levels during those operations.

Maps and drawings of the facility showing all modifications made to radiological work sites during the life of the facility should be included.

3.65-5

With regard to operational occurrences, such things as spills, releases, or other accidents that resulted in significant residual radioactive contamination should be included in the plan.

The licensee should also describe system and equipment design, including modification or revision, in high-radiation areas, normally inaccessible systems and equipment that may be contaminated, and any areas of the site that may be-excessively contaminated.

This type of infor mation can be obtained from plant records and personnel familiar with the plant operations.

This information is important to safety and should be considered when preparing plans for decommissioning (see Section 2.1.2).

The decommission ing rule amendments require that the location of this information be identified and that this type of information be kept in an identified location; see amended paragraphs 30.35(g), 40.36(f), and 70.25(g).

Radiation levels of contaminated systems, structures, and components should be established.

It is recognized that at the time the decommissioning plan is submitted, complete information may not be available.

However, sources of radi ation that are the basis for radiation protection should be described either by measurement or calculation.

Information in this section should be updated as additional radiation surveys are made, but need not be submitted to the NRC.

Radiation sources should be described by radioactivity level and location; major sources of radioactivity should be located on plant layout drawings.

For all sources, the basis for determining the radioactivity levels should be provided.

3.2 Ensuring that Occupational Radiation Exposures Are As Low As Is Reasonably Achievable (ALARA)

The licensee should state the policy for keeping individual and collective occupational radiation exposure ALARA during decommissioning.

Management posi tions responsible for radiation protection and maintaining occupational exposure ALARA during decommissioning should be described.

If a licensee can demonstrate that an existing ALARA plan or other radiation protection program includes the ALARA information for this section, a separate ALARA plan for decommissioning would not be needed.

Alternatively, the licensee may indicate modifications to the existing ALARA plan, radiation protection program, or ALARA plan for decom missioning to provide the information in this section.

This section should contain a description of methods for occupational radia tion protection.

It should provide information on equipment, special techniques, and practices that will be used by the licensee in meeting the standards for protection against radiation of 10 CFR Part 20, including ALARA.

This would include, for example, a work activity control program to minimize worker exposure (including the criteria for issuing and terminating radiation work permits), a program for controlling sources and minimizing spread of contamination (see Sec tion 3.3), a respiratory protection program to determine hazards and provide appropriate equipment (see Section 3.3), and a program to control the handling and storage of radioactive material.

3.3 Health Physics Program The organization's health physics program to be in effect during decommis sioning should be described.

The program should include quality assurance pro visions such as audits, inspections, or management reviews.

3.65-6

The criteria for selecting equipment and instrumentation for performing radiation and contamination surveys and personnel monitoring, including special instruments for detectind low levels of radiation, should be provided in this section; the types of instruments to be used should be described.

The use, storage, calibration, testing, and maintenance for these instruments should be described.

The purpose (e.g., personnel monitoring, radiation surveys), range, and sensitivity should be described for each type.

The policy, methods, frequency, and procedures for effluent monitoring, conducting radiation surveys, and personnel monitoring (including internal and external dosimetry systems) should also be described.

The anticipated use of respiratory protection should be explained.

Methods for contamination control should be described, including anticontamination clothing, control of access to restricted areas, and ventilation systems for containment of airborne radioac tive contamination (including anticipated use of special and temporary ventila tion systems).

The program for determining airborne radioactivity in work areas such as locations of air samples, types of equipment, and frequency of sampling and analyses should be described.

If appropriate, changes may be made to an existing program.

However, the decommissioning plan should clearly indicate the contents of the existing program and present the additional information described in this section.

In addition-to the information developed in Section 3.1 regarding radiation levels present as a result of facility operations, the health physics program should identify potential sources of radiation or contamination exposure to workers or to the public that are generated by the decommissioning activities themselves.

The licensee should specify how these potential sources will be controlled.

3.4 Contractor Personnel The licensee should describe radiation protection policies to ensure the safety of contractor personnel when they are working in restricted areas and the means of implementing these policies, in particular with regard to the policies described in Sections 3.2 and 3.3.

3.5 Radioactive Waste Management Processes and systems to be used for handling, storing, and disposing of radioactive waste should be described.

The plan should show how the require ments of 10 CFR Part 61, Part 71, § 20.311 of Part 20, and applicable disposal site license conditions for processing and disposal of low-level radioactive wastes will be met.

The plan should contain a projection of radioactive waste generation.

This projection should include a detailed characterization of the wastes to be generated with projected volumes, radionuclide concentrations, waste forms and classification, and information on any significant quantities of special wastes such as chelates and mixed waste (i.e., mixed radioactive and hazardous wastes).

If radioactive wastes are to be temporarily stored onsite, the quantities of waste, the expected length of storage, the location of storage areas, radiation levels at access points, and the manner in which positive con trol will be maintained should be described.

If wastes from restricted areas are to be disposed of by land fill or similar methods, the means for demonstrat ing that criteria for release for unrestricted use are met should be specified

3.65-7

(see § 20.302 of 10 CFR Part 20).

If mixed waste generation is anticipated, the effect on work procedures and the decommissioning schedule resulting from com pliance with EPA requirements should be indicated.

References 1-5 contain information that may be useful in developing the information requested in this Section.

4.

PLANNED FINAL RADIATION SURVEY

The amended sections of the rule on decommissioning require that the decom missioning plan, if submitted, contain a description of the planned final radia tion survey.

This section describes the information that should be submitted to provide an adequate description of the survey procedure.

In this chapter, the licensee should describe the plan for demonstrating that the plant and site will meet criteria for release for unrestricted use.

The final radiation survey plan should include (1) the proposed method for ensuring that all equipment, systems, structures, and the site are included in the survey (diagrams, plot plans, and layout drawings should be used to facili tate presentation) and that sufficient data is included for a meaningful sta tistical survey (additional guidance on survey methods is under development),

(2) a description of and data on background radiation, (3) the type, specifica tions, and operating conditions of instruments to be used, and (4) methods to be used for reviewing, analyzing, and auditing data.

The final radiation survey plan should demonstrate that a reasonable effort has been made to elimi nate residual radioactive contamination.

The licensee must explicitly describe the radiation and contamination levels expected upon release of the facility for unrestricted use and provide a justification if they are different from existing or accepted guidance.

Licensees should obtain site decontamination criteria from appropriate NRC licensing staff.

5.

FUNDING

As discussed in Section 1 of the Introduction, the amended §§ 30.36, 40.42, and 70.38 contain requirements for decommissioning plans.

Included in those sections is a requirement that the decommissioning plan contain the following:

"An updated detailed cost estimate for decommissioning, comparison of that esti mate with present funds set aside for decommissioning, and a plan for assuring the availability of adequate funds for completion of decommissioning."

Certain licensees, in accordance with §§ 30.35, 40.36, and 70.25 of the amended rule, have already presented a cost estimate for purposes of establishing financial assurance for decommissioning; other licensees have presented a certification that the amounts prescribed in the rule have been provided for; while still other licensees have not been required to present any formal information to the NRC with regard to funding.

(Explanation of funding provisions will be con tained in separate regulatory guidance under development.)

Licensees who have already submitted a cost estimate should present an updated cost estimate as part of the decommissioning plan, while licensees who had submitted either a certification or made no formal submittal must now submit a detailed cost esti rate as part of their decommissioning plan.

In all cases the estimates should be based on the detailed information submitted in Sections 2 through 4 of this plan.

References 1, 2, and 3 contain information on decommissioning costs that

3.65-8

can be adapted to the individual case.

More detailed guidance on preparing decommissioning cost estimates is being developed.

The licensee is to show how adequate funds for the completion of decommis sioning will be made available.

A comparison of the cost estimate made in this section with present funds is to be provided.

If there is a deficit in present funding, the licensee should include a description of how sufficient funds for decommissioning will be made available.

Guidance on acceptable funding methods is being developed.

6.

PHYSICAL SECURITY PLAN AND MATERIAL CONTROL AND ACCOUNTING PLAN PROVISIONS

IN PLACE DURING DECOMMISSIONING

If applicable, a description of and a schedule for any proposed changes to the NRC-approved physical security plan and special nuclear material control and accounting plan should be provided in this section.

If not appli cable, a notation to this effect should be entered in this section.

IMPLEMENTATION

The purpose of this section is to provide information to licensees regardingthe NRC staff's plans for using this regulatory guide.

Except in those cases in which a licensee proposes an acceptable alter native method for complying with specified portions of the Commission's regu lations, the guidance described in this guide will be used in the evaluation of decommissioning plans docketed after August 31, 1989, that are required by 10

CFR 30.36, 40.42, and 70.38.

3.65-9

REFERENCES

1.

H. K. Elder and D. E. Blahnik, "Technology, Safety and Costs of Decommis sioning a Reference Uranium Fuel Fabrication Plant," prepared for the Nuclear Regulatory Commission (NRC)

by Pacific NorthwestLaboratory (PNL),

NUREG/CR-1266* (PNL-3354),

October 1980.

2.

E. S. Murphy, "Technology, Safety and Costs of Decommissioning Reference Non-Fuel-Cycle Nuclear Facilities," prepared for the NRC by PNL,

NUREG/CR-1754,* February 1981, and Addendum 1,* to be published.

3.

H. K. Elder, "Technology, Safety and Costs of Decommissioning a Reference Uranium Hexafluoride Conversion Plant," prepared for the NRC by PNL,

NUREG/CR-1757,* October 1981.

4.

H. K. Elder, "Technology, Safety and Costs of Decommissioning Nuclear Fuel Cycle Facilities, Classification of Decommissioning Wastes," prepared for the NRC by PNL, NUREG/CR-4519* (PNL-5586),

May 1986.

5.

"Onsite Disposal of Radioactive Waste," U.S. Nuclear Regulatory Commission, NUREG-1101, November 1986.

• Copies may be obtained from the Superintendent of Documents, U.S. Government Printing Office, Post Office Box 37082, Washington, DC

20013-7082, or from the National Technical Information Service, Springfield, VA

22161.

"**Copies are

10370, for ment Room, available, under the decommissioning document file number 43 FR

inspection and copying for a fee at the Commission's Public Docu

2120 L Street NW.,

Washington, DC.

3.65-10

APPENDIX I

NRC FORM 314

_U.S. NUCLEAR REGUL.ATORY COMMISISON

APPROVED BY OMB: 3150.0028

1.8a9)

EXPIRES: 4/30192

10 CFR 30.31I011)

ESTIMATED BURDEN PER RESPONSE TO COMPLY WITH

10 CFR 40.421815I Iivl THIS INFORMATION

COLLECTION REQUEST: .5 HRS.

10 .CFR 70*.38W

V

CERTIFICATE OF DISPOSITION OF MATERIALS

FORWARD COMMENTS REGARDING BURDEN ESTIMATE

TO

THE

RECORDS

AND

REPORTS

MANAGEMENT

BRANCH IP-530). U.S. NUCLEAR REGULATORY COMMIS

SION. WASHINGTON. DC 20666. AND TO THE PAPERWORK

INSTRUCTIONS: SEND THE COMPLETED CERTIF ICATE TO THE

(All items MUSTbe completed- REDUCTION PROJECT (31B0-002.), OFFICE OF MANAGE.

NRC OFFICE SPECIFIED ON THE REVERSE.

print or type)

MENT AND BUDGET, WASHINGTON. DC 20603.

I-I

LICENSEE NAME AND ADDRESS

LICENSE NUMBER

LICENSE EXPIRATION DATE

THE LICENSEE OR ANY INDIVIDUAL EXECUTING THIS CERTIFICATE ON BEHALF OF THE LICENSEE CERTIFIES THAT:

(Check end/or coiplete the anPMoP.ae iretsJ beiow.J

A. MATERIALS DATA (Oseck one and complete as necessary)

1 NO MATERIALS HAVE EVER BEEN PROCURED OR POSSESSED BY THE LICENSEE UNDER THIS LICENSE.

__.

OR

"

2. ALL MATERIALS PROCURED AND/OR POSSESSED BY THE LICENSEE UNDER THE LICENSE NUMBER CITED ABOVE HAVE BEEN DISPOSED OF

IN THE FOLLOWING MANNER. (Ie sedirion,, stse is needed, use the ýreverre side orproi',det&atchments.)

Describe specific material transfer actions and. if there were radioactive wastes generated in terminating this license, the disposal actions, including the disposition of low-level radioactive waste, mixed waste, Greater.than.Class.C waste, and sealed sources, if applicable.

For transfers, specify the date of the transfer, the name of the licensed recipient, and the recipient's NRC license number or Agreement State name and license number.

If materials were disposed of directly by the licensee rather than transferred to another licensee, licensed disposal site or waste contractor, describe the specific disposal procedures (e.g., decay in storsgej.

B. OTHER DATA

J

1. OUR LICENSE HAS NOT YET EXPIRED. PLEASE TERMINATE IT.

2. WAS A RADIATION SURVEY CONDUCTED TO CONFIRM THE ABSENCE OF LICENSED RADIOACTIVE MATERIALS AND TO DETERMINE WHETHER

ANY CONTAMINATION REMAINSON THE PREMISES COVERED BY THE LICENSE? (Check.oie/

F NO (Atfach exfllensrionJ

YES, THE RESULTS (Check oe-)

ARE ATTACHED. or WERE FORWARDED TO NRC ON (Dare,

E. CONTACT

ED REGARDING THE INFORMATION PROVIDED ON THIS FORM

NAME

I TELEPHONE NUMBER

4. MAIL ALL FUTURE CORRESPONDENCE REGARDING THIS LICENSE TO

CERTIFYING OFFICIAL

I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOrNG IS TRUE AND CORRECT.

SIGNATURE

DATE

PRINTED NAME AND TITLE

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.

NRC FORM 314 16-89)

3.65-11

APPENDIX 1 (Continued)

FILE CERTIFICATES AS FOLLOWS

IF YOU ARE A DISTRIBUTOR OF EXEMPT PRODUCTS. SEND TO:

U.S. NUCLEAR REGULATORY COMMISSION

DIVISION OF INDUSTRIAL AND MEDICAL NUCLEAR SAFETY, NMSS

WASHINGTON, DC 20555 ALL OTHERS. IF YOU ARE LOCATED IN:

CONNECTICUT, DELAWARE, DISTRICT OF COLUMBIA, MAINE. MARYLAND.

MASSACHUSETTS. NEW HAMPSHIRE. NEWJERSEY. NEW YORK, PENNSYLVANIA.

RHODE ISLAND, OR VERMONT, SEND TO:

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NUCLEAR MATERIALS SAFETY SECTION 8

475 ALLENOALE ROAD

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WEST VIRGINIA, SEND TO:

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NUCLEAR MATERIALS SAFETY SECTION

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IF YOU ARE LOCATED IN:

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MATERIALS LICENSING SECTION

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3.65-12

VALUE/IMPACT STATEMENT

A draft value/impact statement was published with the draft of this guide when it was published for public comment (Task CE 304-4, December 1985).

No changes were necessary, so a separate value/impact statement for the final guide has not been prepared.

A copy of the draft value/impact statement is available for inspection or copying for a fee in the Commission's Public Document Room at

2120 L Street NW, Washington, DC, under Task CE 304-4.

3.65-13

UNITED STATES

NUCLEAR REGULATORY COMMISSION

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POSTAGE AND FEES PAID

USNRC

PERMIT NO.G-67 OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE, $300