4
Page 1 of - NRC FORM 7 (¥) u. S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0027 EXPIRES: (11/30/2015) (11-2012) Estimatedburdenper responseto complywiththismandatorycollectionrequest:2.4 hours. This 10 CFR 110 submittal is reviewed to ensure that the applicable statutory, regulatory, and policy ""., .,.,/ ....... considerationsare satisfied. Send comments regarding burden estimate to the Information APPLICATION FOR NRC EXPORT OR IMPORT ServicesBranch(T-5F53),U.S.NuclearRegulatoryCommission,Washington,DC 20555-0001, LICENSE, AMENDMENT, RENEWAL, or by internet e-mail to [email protected], and to Ihe Desk Officer, Office of Informalion and Regulalory Affairs, NEOB-10202,(3150-0027), Office of Managemenl and OR CONSENT REQUEST(S) Budget.Washinglon.DC 20503. If a meansused 10 imposean infomnalloncollecliondoes nol display a currentlyvalid OMB conlrol number, Ihe NRC may nol conducl or sponsor, and a (See Instructions on Pages 4 and 5) personis not requiredtorespondto, the infomnalioncollection. !J:1PUBLIC DATE RECEIVED PART A. FOR NRC USE ONLY OR rn NON-PUBLIC '2 -G, -1'-1 LLJ 1 LICENSE NUMBER DOCKET NUMBER ADAMS ACCESSION NUMBER Ry~ IK{ DO II ()o(Q I <{5 PART B. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, RENEWALS, OR CONSENT REQUESTS (If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.) 1. NAME AND ADDRESS OF APPLICANT/LICENSEE 1a. NAME OF APPLICANT'S CONTACT 1b. APPLICANT'S REFERENCE NUMBER Don Jordan IMS Systems, Inc. 1c. PHONE NUMBER 1d. FAX NUMBER 519 Myoma Road (920) 686-3889 (920) 686-3899 Mars, PA 16046 1e. E-MAIL ADDRESS [email protected] 2. TYPE OF ACTION REQUESTED (Check One) CONSENT REQUEST [{J EXPORT Ii IMPORT AMENDMENT/RENEWAL D (Parts B, C) (Parts B, C, E) L (Parts B, D, E) Current License Number: Current License Number: -- - _. - 3. CONTRACT NUMBER(S) 4. FIRST SHIPMENT DATE 5. LAST SHtPMENT DATE 6. PROPOSED EXPIRATION DATE 01 March 2014 30 January 2015 31 January 2015 PART C. TO BE COMPLETED FOR EXPORT LICENSES, AMENDMENTS, OR RENEWALS (If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.) 7. NAME(S) I ADDRESS(ES) OF SUPPLIERS 8. NAME(S) I ADDRESS(ES) OF INTERMEDIATE 9. NAME(S) I ADDRESS(ES) OF ULTIMATE AND/OR OTHER PARTIES TO THE EXPORT FOREIGN CONSIGNEE(S) FOREIGN CONSIGNEE(S) See Additional Information IMS Messsysteme GmbH, Eckert & Ziegler - nuclitec Dieselstral3e 55, Gieselweg I 42579 Heiligenhaus, Germany 38110 Braunschweig, Germany 7a. FUNCTION(S) PERFORMED/SERVICE(S) PROVIDED 8a. INTERMEDIATE USE(S) 9a. ULTIMATE END USE(S) See Additional Information Gauge manufacturer Source capsule exchange. 10. DESCRIPTION OF RADtOACTIVE MATERIALS, SEALED SOURCES, 10a. MAX TOTAL VOLUME I NUCLEAR FACILITIES, EQUIPMENT, OR COMPONENTS; FOR 10b. MAX ENRICHMENT 10c. MAX ISOTOPE NUCLEAR EQUIPMENT INCLUDE TOTAL DOLLAR VALUE OF ELEMENT WGT (KG), OR OR WGT % WGT(KG) EQUIPMENT FOR EXPORT TOTAL ACTIVITY (TBq) One IMS Messsysteme Model 5245 thickness gauge [SSDR 2.0 TBq Cs-137 [NOT NR-1120-D-IOI-S] with 2 TBq (nominal) ofCs-137 in a APPLICABLE] sealed source [SSDR IL-1082-S-197-S] Special Form Capsule [GB/197/S-96]. The value of the export is . 11. FOREIGN OBLIGATIONS (BY COUNTRY AND BY PERCENTAGE OF MAXIMUM TOTAL VOLUME) NRC FORM 7 (11-2012) ~~ 2.

PART A. FOR NRC USE ONLY OR !J:1PUBLIC -G, -1' …CustomsBroker&FreightForwarder 3.RAMServices,Inc. 510CountyHighwayV TwoRivers,WI54241 GaugePackaging&ShippingDocuments NRC FORM 7

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Page 1: PART A. FOR NRC USE ONLY OR !J:1PUBLIC -G, -1' …CustomsBroker&FreightForwarder 3.RAMServices,Inc. 510CountyHighwayV TwoRivers,WI54241 GaugePackaging&ShippingDocuments NRC FORM 7

Page 1 of -NRC FORM 7

(¥)u. S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0027 EXPIRES: (11/30/2015)

(11-2012) Estimatedburdenper responseto complywith thismandatorycollectionrequest:2.4 hours. This10 CFR 110 submittal is reviewed to ensure that the applicable statutory, regulatory, and policy""., .,.,/....... considerationsare satisfied. Send comments regarding burden estimate to the Information

APPLICATION FOR NRC EXPORT OR IMPORT ServicesBranch(T-5 F53),U.S.NuclearRegulatoryCommission,Washington,DC 20555-0001,

LICENSE, AMENDMENT, RENEWAL,or by internet e-mail to [email protected],and to Ihe Desk Officer, Office ofInformalion and Regulalory Affairs, NEOB-10202,(3150-0027),Office of Managemenland

OR CONSENT REQUEST(S) Budget.Washinglon.DC 20503.If a meansused 10 imposean infomnalloncollecliondoes noldisplay a currentlyvalid OMB conlrol number, Ihe NRC may nol conducl or sponsor,and a

(See Instructions on Pages 4 and 5) personis not requiredto respondto, the infomnalioncollection.

!J:1PUBLIC

DATE RECEIVED

PART A. FOR NRC USE ONLY OR rn NON-PUBLIC'2 -G, -1'-1LLJ

1

LICENSE NUMBER DOCKET NUMBER ADAMS ACCESSION NUMBER

Ry~ IK{ DO II ()o(Q I <{5PART B. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, RENEWALS, OR CONSENT REQUESTS

(If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)

1. NAME AND ADDRESS OF APPLICANT/LICENSEE 1a. NAME OF APPLICANT'S CONTACT 1b. APPLICANT'S REFERENCE NUMBER

Don Jordan

IMS Systems, Inc. 1c. PHONE NUMBER 1d. FAX NUMBER

519 Myoma Road (920) 686-3889 (920) 686-3899Mars, PA 16046 1e. E-MAIL ADDRESS

[email protected]

2. TYPE OF ACTION REQUESTED (Check One) CONSENT REQUEST

[{J EXPORT Ii IMPORT AMENDMENT/RENEWAL D (Parts B, C)

(Parts B, C, E)L

(Parts B, D, E) Current License Number: Current License Number:

-- - _. -3. CONTRACT NUMBER(S) 4. FIRST SHIPMENT DATE 5. LAST SHtPMENT DATE 6. PROPOSED EXPIRATION DATE

01 March 2014 30 January 2015 31 January 2015

PART C. TO BE COMPLETED FOR EXPORT LICENSES, AMENDMENTS, OR RENEWALS(If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)

7. NAME(S) I ADDRESS(ES) OF SUPPLIERS 8. NAME(S) I ADDRESS(ES) OF INTERMEDIATE 9. NAME(S) I ADDRESS(ES) OF ULTIMATEAND/OR OTHER PARTIES TO THE EXPORT FOREIGN CONSIGNEE(S) FOREIGN CONSIGNEE(S)

See Additional Information IMS Messsysteme GmbH, Eckert & Ziegler - nuclitecDieselstral3e 55, Gieselweg I42579 Heiligenhaus, Germany 38110 Braunschweig, Germany

7a. FUNCTION(S) PERFORMED/SERVICE(S) PROVIDED 8a. INTERMEDIATE USE(S) 9a. ULTIMATE END USE(S)

See Additional Information Gauge manufacturer Source capsule exchange.

10. DESCRIPTION OF RADtOACTIVE MATERIALS, SEALED SOURCES,10a. MAX TOTAL VOLUME I

NUCLEAR FACILITIES, EQUIPMENT, OR COMPONENTS; FOR 10b. MAX ENRICHMENT 10c. MAX ISOTOPENUCLEAR EQUIPMENT INCLUDE TOTAL DOLLAR VALUE OF

ELEMENT WGT (KG), OROR WGT % WGT(KG)

EQUIPMENT FOR EXPORTTOTAL ACTIVITY (TBq)

One IMS Messsysteme Model 5245 thickness gauge [SSDR 2.0 TBq Cs-137 [NOTNR-1120-D-IOI-S] with 2 TBq (nominal) ofCs-137 in a APPLICABLE]sealed source [SSDR IL-1082-S-197-S] Special FormCapsule [GB/197/S-96]. The value of the export is .

11. FOREIGN OBLIGATIONS (BY COUNTRY AND BY PERCENTAGE OF MAXIMUM TOTAL VOLUME)

NRC FORM 7 (11-2012) ~~ 2.

Page 2: PART A. FOR NRC USE ONLY OR !J:1PUBLIC -G, -1' …CustomsBroker&FreightForwarder 3.RAMServices,Inc. 510CountyHighwayV TwoRivers,WI54241 GaugePackaging&ShippingDocuments NRC FORM 7

NRC FORM 7 U. S. NUCLEAR REGULATORY COMMISSION(11-2012)10 CFR 110

APPLICATION FOR NRC EXPORT OR IMPORTLICENSE, AMENDMENT, RENEWAL, OR CONSENT REQUEST(S) (Continued)

LICENSE NUMBER DOCKET NUMBER ADAMS ACCESSION NUMBER

~BLlCI~ I OR []NON-PUBtiC

i f)(~ 13,-), oc llbO(r\l<4.~ IPART D. TO BE COMPLETED FOR IMPORT LICENSES, AMENDMENTS, OR RENEWALS

(If more space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)

12. NAME(S) / ADDRESS(ES) OF FOREIGN13. NAME(S) / ADDRESS(ES) OF INTERMEDIATE 14. NAME(S) / ADDRESS(ES) OF ULTIMATE U. S.SUPPLIERS AND/OR OTHER PARTIES

TO IMPORT CONSIGNEE(S) CONSIGNEE(S)

12a. NRC EXPORT LICENSE NUMBER(S) 13a. LICENSE NUMBER(S) / EXPIRATION DATE(S) 14a. LICENSE NUMBER(S) / EXPIRATION DATE(S)(if applicable)

13b.INTERMEDIATE USE(S) 14b. ULTIMATE END USE(S)

15. DESCRIPTION OF RADIOACTIVE MATERIALS, SEALED SOURCES, 15a. MAX TOTAL VOLUME /15b. MAX ENRICHMENT 15c. MAX ISOTOPEELEMENT WGT (KG), OR

NUCLEAR FACILITIESTOTAL ACTIVITY (TBq) ORWGT% WGT(KG)

16. FOREIGN OBLIGATIONS (BY COUNTRY AND BY PERCENTAGE OF MAXIMUM TOTAL VOLUME)

PART E. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, RENEWALS OR CONSENT REQUEST(S)17. ADDITIONAL INFORMATION [Z] YES DNO 17a. COPIES OF RECIPIENTS' [Z] YES DNOPROVIDED ON PAGES 3, 4,

AUTHORIZATIONS PROVIDED?ANDIOR ON SEPARATE SHEETS?

18. CERTIFICATION:I, the applicant's authorized official, hereby certify that this application is prepared in conformitywith Title10, Code of Federal Regulations, and that all information provided is correct to the bestof my knowledge.

18a. PRINT NAME AND TITLE OF AUTHORIZED OFFICIAL '" ?9J--i~'CIAL 18c. DATEDavid Artman

J/Z7/Z0J'/Safety Coordinator & Radiation Safety Officer - Alternate

Page 2 of

NRC FORM 7 (11-2012)

Page 3: PART A. FOR NRC USE ONLY OR !J:1PUBLIC -G, -1' …CustomsBroker&FreightForwarder 3.RAMServices,Inc. 510CountyHighwayV TwoRivers,WI54241 GaugePackaging&ShippingDocuments NRC FORM 7

Page of

NRC FORM 7(11-2012)10 CFR 110

U. S. NUCLEAR REGULATORY COMMISSION

APPLICATION FOR NRC EXPORT OR IMPORTLICENSE, AMENDMENT, RENEWAL, OR CONSENT REQUEST(S) (Continued)

LICENSE NUMBER DOCKET NUMBER

O)(r~1 R5 tOO lIon (()/<..1SADAMS ACCESSION NUMBER

i:J61UBLIC OR [J NON-PUBLIC

AobiTIONAL INFORMATION (Reference applicable block numbers from page 1 and/or page 2 for each entry)

BLOCKS 7 & 7A

1. NUCOR - Hertford Steel Plate Mill1505 River Road,Cofield, North Carolina 27922.

Owner of gauging system

2. En-Log Strategic Services333 North Sam Houston Parkway East,Houston, Texas 77060

Customs Broker & Freight Forwarder

3. RAM Services, Inc.510 County Highway VTwo Rivers, WI 54241

Gauge Packaging & Shipping Documents

NRC FORM 7 (11-2012)

Page 4: PART A. FOR NRC USE ONLY OR !J:1PUBLIC -G, -1' …CustomsBroker&FreightForwarder 3.RAMServices,Inc. 510CountyHighwayV TwoRivers,WI54241 GaugePackaging&ShippingDocuments NRC FORM 7

Deputy DirectorOffice of International ProgramsU.S. Nuclear Regulatory CommissionWashington, DC 20555-0001

In re: Application for a Specific license to Export IAEA Cregory 2 quantities of radioactive material.

IMS Systems of Mars, Pennsylvania, seeks a license to export a gauge manufactured by our parentcompany to Germany in order for the sealed source capsule manufacturer to exchange the sealedsource capsule. This exchange is needed to address actual or potential corrosion problems with thisgauge and/or source capsule. I

After the capsule exchange this gauge will be returned to the owner of the gauge, NUCOR, using theGeneral license for imports of byproduct material.

The radioactive materials licenses of the companies listed below are attached to the application.

1. IMS Systems,2. NUCOR,3. RAM Services,4. IMS Messsysteme GmbH.5. Eckert & Ziegler nuclitec [formerly known as QSA Global).

If additional materials or information is required you may contact Mr. Jordan, as noted on the Form 7 orme via email at [email protected] or by telephone at +1 724 772 9772. Thank you forassisting us in this matter.

Sincerely,

(j)~ 2a~David ArtmanService & Safety Coordinator/RSO - Alternate