Delaware City Refining Company

Transcription

1 Delaware City Refining Company Delaware City Refining Company LLC 4550 Wrangle Hill Road Delaware City, DE December 2014 CMRRR Director, Office of Nuclear Material Safety and Safeguards TTN: GLTS U.S. Nuclear Regulatory Commission Washington, DC RE: nnual General License Registration Package for To Whom It May Concern: Enclosed please find a reviewed and signed copy of NRC FORM 664 for the above-referenced general license. Sincerely, Todd Bretz, CSP, CPE Refinery Safety Supervisor (302) Enclosure(1): N NRC FORM 664 cc: Richard Pyle James Lee Electronic file location -- V:\SF\RIMS\SH Radiation\SH Sources-Devices

2 IIIII11 IIIII liii III II11I IIII I 1Il I IIII N II INIIIIII IIII 10/28/2014 NRC FORM CFR 31.5 GENERL LICENSEE REGISTRTION SECTION 1 PGE 1 of 2 U.S. NUCLER REGULTORY COMMISSION PPROVED BY OMB: NO EXPIRES: 03/31/2010 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC wit use this information to track general licensees and their devces to ensure a higher level of device accountability. Send comments regarding burden estimate to the Records and FOL/Privacy Serices Branch (T-5 F52), U. S. Nuclear Regulatory Commission, Washington, DC , or by internet to infocollects@nrc.gov to the Desk Officer, Office of Information and Regulatory ffairs, NEOB-10202, ( ). Office of Management and Budget, Washington, DC If a means used to impose an information collection does not display a currenty valid OMB control number, the NRC may not conduct or sponsor, and a person is not recuired to resoond 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 CPITL LETTERS. General License Registration Number SECTION 1 - GENERL LICENSEE INFORMTION Enter the company name and the street addresslphysical 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: DELWRE CITY REFINING I I I I ~I I... I I I I I I I I I I I I I I I Department: HELTH SFETY SECURITY FT-T I ddress Line 1: 4550 WRNGLE HILL ROD II I I II I I II I I ddress Line 2: City: S1 DELWRE CITY -i I State: DE F-fl Zip Code: F 1a-egQfjy: II7

3 10/28/2014 I11111II 1II IIII IIIIII VI IIIN SECTION 1 PGE 2 of 2 SECTION 1 - GENERL LICENSEE INFORMTION (Continued) Enter the name, telelphone number and title of the person who is the responsible individual for the device(s). Last Name: PYLE First Name: RICHRD Middle Initial: Telephone: (302) Extension: 6444 Title: CURRENT SFETY 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: HELTH SFETY SECURITY ddress Line 1: 4550 WRNGLE HILL ROD ddress Line 2: P.O. BOX 7000 City: DELWRE CITY State: DE Zip Code: I - I I III 11 III ID1

4 IIIIIIIIIIIIIIIIIIIIIW 1I111I IIIII1I IIII11111 I II IH 1IIIIIIIII 10/28/2014 SECTION 2 - DEVICES SUBJECT TO REGISTRTION SEC'TION 2 Our records indicate that you have these devices. Please update the information as necessary. PC;E 1 of 2 NRC Device Key (internal Control Number) Distributor/Distributed By: THERMO SCIENTIFIC PORTBLE NLYTICL INSTR Distributor License Number: Manufacturer Name: NITON CORPORTION Device Model (Not Source Model): XLI-SERIES Device Serial Number: 5339 Transfer Date (Receipt Date): 12/30/2002 Not in possession of device (lso complete Section 4.) MM DD YYYY Isotope (e.g. M241) 1 M ctivity (e.g. 100) Unit (e.g. mci) mci Kiln KECII KKKI KllJ Kill

5 IIIII 11111I11111Iliii IIIIIIIIII II~~ I IIIIIIIIII 11I IIIIHI 10/28/2014 SECTION 2 - DEVICES SUBJECT TO REGISTRTION SEC3TION 2 Our records indicate that you have these devices. Please update the information as necessary. PCjE 2 of 2 NRC Device Key (Internal Control Number) Distributor/Distributed By: THERMO SCIENTIFIC PORTBLE NLYTICL INSTR Distributor License Number: Manufacturer Name: NITON CORPORTION Device Model (Not Source Model): XLI-SERIES Device Serial Number: 5340 Transfer Date (Receipt Date): 12/30/2002 MM DD YYYY Not in possession of device (lso El complete Section 4.) I Isotope (e.g. M241) 1 M ctivity (e.g. 100) Unit (e.g. mci) mci BEZU LIEIJZZ KID Kiln Kiln

6 10/28/2014 SECTION 3 SECTION 3 - DDITIONL DEVICES SUBJECT TO REGISTRTION PGE 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 How acquired and date (e.g., 0 Manufacturer/Initial Transferor listed above from a distributor/manufacturer, 0 Other General Licensee Date Transferred: LjT [jj [ J j other licensee, other source)? U Other Source (Received) MM DD YYYY Isotope (e.g. M241 ) EDI i i LILIICi EliCuiD BELIEU LIZCuIZ BClLIE BIZIZE ctivity (e.g. 100) Unit (e.g. mci) DIE BCul LICu BClE Liii BClE DIE BClE BClE LIE --

7 IIIIII IIffl IIIII III IIII IIII~ WII III liiiii SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 10/28/2014 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PGE 1 of 1 Part I Transfer Date: I'.RC Device Key: I I I -j Il I I llll I (from Section 2 or 6) MM DD YYYY Location of the Device: O Whereabouts Unknown (complete Part 1 only) Q 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): ICompanI I IN Company Name: Department: ddress Line 1: ddress Line 2: City: State: I Zip Code: [ LIII J Part 3 Last Name: Enter the name of the individual responsible for this device: First Name: Middle Initial: Telephone Number: LIK E Z IZ Extension: [ Title:

8 I IIIIIIIIIIIIIIIIIIIIIIIIIII I II1I III II11111 SECTION 5 - CERTIFICTION SECTION 5 10/28/2014 PGE 1 of 1 I hereby certify that:. ll information contained in this registration is true and complete to the best of my knowledge and belief. B. 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. I am aware of the requirements of the general license, provided in 10 CFR (Copies of applicable regulations may be viewed at the NRC website at: e g-rm/dgpc-collections/cfr) SIGNTURE - RESPONSIBLE INDIVIDUL (Listed in Section 1) DTE WRNING: FLSE STTEMENTS MY BE SUBJECT TO CIVIL ND/OR CRIMINL PENLTIES. NRC REGULTIONS REQUIRE THT SUBMISSIONS TO THE NRC BE COMPLETE ND CCURTE IN LL MTERIL SPECTS. 18 U.S.C. SECTION 1001 MKES IT CRIMINL OFFENSE TO MKEWILLFULLY WRONG STTEMENT OR REPRESENTTION TO NY DEPRTMENT OR GENCY OF THE UNITED STTES S TO NY MTTER IN ITS JURISDICTION.

9 HIIII IIIII III IIII IIm 1IIII IIlI IIII I iiii 1101 II 10/28/2014 SECTION 6 - DEVICES NOT SUBJECT TO REGISTRTION SECTION 6 NRC Device Key: Manufacturer Name: Manufacturer License No: PGE 1 of 1 Model Number: Serial #: Transfer Date: