virgin islands paving, inc.; deficiency response …thank you in advance for your cooperation....
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lIRGIN 15LANOS PAVING INC PO Box 4720 Klngshilf VI 008514720 TEL (340) 778-5220 FAX (340) 773-6233
February 141 2013
licensing Assistance Team
Division of Nuclear Materials Safety
US Nuclear ReguJatory Commission Region 1
2100 Renaissance Boulevard Suite 100
King of Prussia PA 19406-2713
Re Renewal of Material license
Control Number 579815
Dear Sir or Madam
Virgin Islands Paving Inc currently has a material license (55-25624-01) We are in need
of renewing this license for future projects Thank you in advance for your cooperation
Sincerely
Robert J Schierloh
President
579 gISshyRECID IN LATJ lS 13 NMSSRGN1 MIrERIALS-002
NRC FOAII ~13 us NUOLEAR REGUIATORY CousslON Pgt-201~ 111 ~ SO 3233 W 36 8$ WlIIICIlIO
APPLICATION FOR MATERIALS LICENSE
APPflaquoMD BY 0IIIIIl NO S1-o1~O EJIPIRIS (01I311111HS) EIIImIIIed IunIen 1 ~~1IIs~~__43111n SUIImIIa of Ie lI(IlIIIcdrIlB~dIIIerIIhUIalIlle appIlc8nIls quallllallIld_8deQIJIIa pocaIIJnI eIlSI III ~ lilt puDIIC ItlImIIII1II __ Il8IIII tcJIImIInIII ~ IMIIUIn ellllmalt to 119 InbItIatoIl Sellbls BlBncII (l-GF63) usNIdaBr~~WfsMIglDn DC~OIb $otIIIJ 10 I~ IIIJfJ 10 Ole ~ 0Ib 0IIIce oIlnfomaIIlIIlQI ~ rmJe10102 (31~al) 0Ib If ~ end lIuifrIat ~ DC ~ 11 aUamped Ib IIqI(lle ~CIlIIaQIon IIOIS IIOtdI6pIiJ a~WIld OllIe alIItJI fItlIIIle1I1e NRC may noIconduel orlIampOI aII paul J1IOt~ blllJlll)lll b II1e lr1IOrmIIIklIl COIIaCIkIn
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~OF IftlERAI a srATE MATERIAI$ ~ SNIIRONMENTAI MHlAGEMliNT PROGAAMS OIVISIOH 01 MA~ lIAFEIY AND STATeAGREIM~HTS us NIJClSAA REGUlATORY COMMISSION WASHINGTON OC 2IJ555-(lOO
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IF YOU MIG OCIlED IN
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~ IIBSISTANCE TEAM tlMBION OF NVCUAR MATERIAIS ~ I)e NIICLEAR RIGIAATQRY COMMl$$fON REGION I 2100 flEfoIAI$WICE BOUlEVARO ~ 100 KING OF PRUS$1A IA 194080271 I
IF YOU ME LlXA1ID l1li
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NAT111ALS UCENSINO DIVIHCH 1)$ fllJCIeAA REGULAlOfcY cotWlSSION ~III 2443 WARRENIIIUS ROAD SUm 210 1ISlpoundll~
AIASffA AAIZONA MJl(AN8M CALIRlRMA COlOIWIO IlAWAII 1DAHO1WIUs lOUISIANA 31 I IIONTAfA NfBUIIIlICI IIlYAIM w1lllllCO MOImt MICVTA eMl 0AIIIiCIIII PAClAClAIM 1tIiWJ0AIIII $OVTH 1MM01A ~ UTNf WA8KlNG1ON OR WYOJMQ
SINDNPUCA11OHlI11)
NUClEAR MATeRlAI$ LICENSING IRAI4Cl1 US ~R RltilULATOAV COIIIMISSION RlGIoNN 1800 1lt ~ iCULEVARD ARUNGTON1X 18011sU
PERSONS LOCATED IN AGREEMENT STATES SEND APPLlCAt1OIeS TO THE us NUCLEAR REGULATORY COa8lON ONLY IF tHEY WISH TO POSSESS AND USE UOENSED IlATEfUAL IN STATeS SUBJeCT TO UsNUOLEAR REGULATORY CDllMlSSION JURISDICTIONS t nilS IS AN AllUCATfON FOR (CM1ca~um)
0 A NEW UCeNSE
0 a AMEHIlMENT TO UcampNSE NUMBER
55-2562401c RENltWIL OF UCENSIi NUUIiIeR[J 3 ADDRESS WlEIU UcentENSEI1 MATeRIAl WILLIE useD OR ICIS$E$EiED
Virgin Islands Paving 1nc 13 OA Estate Bdhlehenl st Croix VI 00850
2 HAMil ANO MAlUNG ADDRess OFNIIICAHT (IrtrNde l1Flaquo1118
Virgin Islands Paving Inc PO Box 4720 Kingshlll VI 00851
4 WI OF EASON TO IE OONTACTeD ABOUT THlSAPPUCATION
Bryan Farley BUSIHE88 TELEFHONE HUMSER 19lJSlHEG$ OELLUIAA TElEPHOHe HUMIIIR
(340) 118-5220 (340) 277-5S61 IilVSINESS EMAILADDReI3$
bfarleyvipavingcom SUllMtT IaC $ THFIOUGH 11 ()HB-1Z)( 11 PAPeR ~TtPENiOSCClPeOl INRIRMATJOH TO as FIIOVIOEO IS oEOOAleO IN liE lICENSfAlllJCATJOHGlJIDE
5 RADIOACTIVE MATEAIAI I ElemIlllt_-IIII1IIMrb~_p~Iorm_c1II8IlOmum lImQunt
WIIkhwll ~ bull _tIIW T IIlaquoIM~)Rl8POltI81BLE FOR RADIAIIOII6AfETY IR()GAAM Nfl) THEIR
TRAINING exPERIGtlCe
II fACIUl1ES AHD aIJlfMENT
11 WASTEMAHAGEMEIfl
Ij IJIVOSE~ FOR WttICH UCENSEO MAT1ilRIAI WIll BE USED
8 1RAIfoIM FOR INDMDUAIS WIORtltIHGlN QR F1=IEQUIlIomHG ftESllUCTIi1) AREAS
10 RADlATIONSAF1I~
12 IJCSIISEFEIS (S8e10CFtH70ltIIIIISaeM11O31
AMOIIN FEI CATEGORYmiddot 3P s 000~Nel0GE0
13 CMTIIlCAIlON (MlIflle~IlYIIJIIfcIIIII) THEAPPUCNITrJNOEJI((JTANDSTHIITA(LSTATCNIElITUNOREPRESEIrATlONsMADEtNTUIS AFPUCATIONARE8INOING UPON1HE~IIT
THE APPLICANT IyenIDNIY omCIAI EXEOVTlNG THIS CERTIFICAIlO ON 8eHAlJ OF THE APPLlCANT NAMED IN rrEM2 ceRTIFY THAT TI1ISAlPllCITiON IS PREPARED IN COIIFQIIMITY~mu 10 CQDI5 QI~Rm3II1ATlONS PARTS 30 raquo _ 34 1538 III AND 4( AND NAT ALlINIORrMTlON CONTIIMED-stl 18 TRIIE Nfl) ~tO
NI BE$ OF THEIR IOIOWIJOGIG Nfl) BElJEJ WARNINO 111 USC S~ 1001 fICf OF JUNE 251148 62 STAT 11IWltE8 rr A C RIMI~QmNSE to MAKE II WlfUUIIY FALSe STATeMeNT OR REPRESENTATION TO AN( tlEPARTMEHTOR AGeNCY OF THE UNITEO$1ATESM TO ANY MAlTER WITHIN ITS JURIEIOICTION
CERTlJVIHG OFFICER - TfIIDIPIIIINTllD NAME ANO TlTUil DATE
Jj 1s-113iRobel1 J Sebier1obmiddot ~ut ~~ FOR NRC USE ONLY
lYPEOfFEE CllECI( NUMSEI COMMENtSIFeELOO IFeECATEGORV ~ReCeMD
APPROIEDiH DATE
I Me FORM lila (~12)
5a Element and 5b Chemical andor 5e Maximum amount that will mass number physical fonn be possessed at one time
A Cesium-137 Sealed source No single source to exceed Troxler Drawing 102112 9mCi
B Americium~241 Sealed source No single source to exceed Troxler Drawing 102451 44mCi
6 Purpose for Which Licensed Materials Will Be Used
To be used in Troxler 3400 series gauges and CPN AC2 series gauges for measurement ofphysical properties ofmaterials
11
Gauge Inventory
Man Troxler Model 9430
Gauge Senal 20404 SSampD Reg NCs46-C-13Q-S
License 55-2562401 Company Virgin Islands Paving Inc
Address 13 GA Estate 8ethlehem East Airport Road St CrolJ( VI 00850
Certification AssaV Leak Test Troxler Spec Form ANSI Radionudlde Activity Serial Data Date Dampte Orawlns Certificate Class AM-2418E 1480GBq 47-15882 21591 21591 122691 102451 USA0632S C66545
CS-137 O300GBq 75-1157 62091 62091 122691 102112 USA0614S C64444
2 Man Troxler Model 3440
Gauge Serial 24458 SSampD Reg NC-646-0-130-S
License 55-25624()1 COmpany Virgin Islands Paving Jnc
Addmss 13 GA Estate Bethlehem East Airport Road St Croix VI 00850
CertJfkatlon Assay leakTest Troxler Spec Form ANSI
Aadionuclide Activity Serial Date Date Date Drawing Certificate Class AM-2418E 1A8OGBq 47-20508 U1994 l2J394 514103 1024S1 USA0632S C66S45
CS-137 O300GSq 75-6508 11395 1113195 51403 102112 USA0614S C64444
3 Man (PN Model AC-2R
Serial A220801043
license 55-25624middot01 Company VIrgin Islands Paving Inc
Address 13 GA Estate Sethlenem East Airport Road St Croix VI 00850
Leak Test Spec Form RadlonucllCle Activity Date Certificate
Am-241Be lOOmCi 6212010 CZIOCJ9S-96
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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APPENDlXF SEALED SOURCE PHYSfCALJNVENTORY LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
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L
1 IIUJlIm(C AlW 1NSTR1CJIONS TO WORDRS
I Wen-alI wotbn who are likely to exceed 100 mtIIrlJIyr fllsuactecl per flO CFR1912] ~~~~lqCFltJPJ2rJ
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
NRC FOAII ~13 us NUOLEAR REGUIATORY CousslON Pgt-201~ 111 ~ SO 3233 W 36 8$ WlIIICIlIO
APPLICATION FOR MATERIALS LICENSE
APPflaquoMD BY 0IIIIIl NO S1-o1~O EJIPIRIS (01I311111HS) EIIImIIIed IunIen 1 ~~1IIs~~__43111n SUIImIIa of Ie lI(IlIIIcdrIlB~dIIIerIIhUIalIlle appIlc8nIls quallllallIld_8deQIJIIa pocaIIJnI eIlSI III ~ lilt puDIIC ItlImIIII1II __ Il8IIII tcJIImIInIII ~ IMIIUIn ellllmalt to 119 InbItIatoIl Sellbls BlBncII (l-GF63) usNIdaBr~~WfsMIglDn DC~OIb $otIIIJ 10 I~ IIIJfJ 10 Ole ~ 0Ib 0IIIce oIlnfomaIIlIIlQI ~ rmJe10102 (31~al) 0Ib If ~ end lIuifrIat ~ DC ~ 11 aUamped Ib IIqI(lle ~CIlIIaQIon IIOIS IIOtdI6pIiJ a~WIld OllIe alIItJI fItlIIIle1I1e NRC may noIconduel orlIampOI aII paul J1IOt~ blllJlll)lll b II1e lr1IOrmIIIklIl COIIaCIkIn
UQlTRUC110N8 seE THE APPRORlATE UCENSI APPUCA11ON GUIDE FOR DETAILED INSTRUeT10NS FORCOMPLE11NC APPUCAnON SEND TWO COPIES OF THE EtmRE COMPLeTED APPLICATION TO THE NRC OFFICE SPECtFlED BELOW
IPPUCAONPOR0IS1RI8IJ11OIIIOFelIEMPT~fllEAPfIIJCAI1OIIISWllM
~OF IftlERAI a srATE MATERIAI$ ~ SNIIRONMENTAI MHlAGEMliNT PROGAAMS OIVISIOH 01 MA~ lIAFEIY AND STATeAGREIM~HTS us NIJClSAA REGUlATORY COMMISSION WASHINGTON OC 2IJ555-(lOO
AU~PIIMIONI~~TIOHIIMfOUDIn
IF YOU MIG OCIlED IN
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~ IIBSISTANCE TEAM tlMBION OF NVCUAR MATERIAIS ~ I)e NIICLEAR RIGIAATQRY COMMl$$fON REGION I 2100 flEfoIAI$WICE BOUlEVARO ~ 100 KING OF PRUS$1A IA 194080271 I
IF YOU ME LlXA1ID l1li
1ILIMOI$IIiIDWOI ICJWA MICIIfGM M1NN11801A MIJOUIIII OHIO OR WIIICOIfI1N NO APPLICAIlONs TO
NAT111ALS UCENSINO DIVIHCH 1)$ fllJCIeAA REGULAlOfcY cotWlSSION ~III 2443 WARRENIIIUS ROAD SUm 210 1ISlpoundll~
AIASffA AAIZONA MJl(AN8M CALIRlRMA COlOIWIO IlAWAII 1DAHO1WIUs lOUISIANA 31 I IIONTAfA NfBUIIIlICI IIlYAIM w1lllllCO MOImt MICVTA eMl 0AIIIiCIIII PAClAClAIM 1tIiWJ0AIIII $OVTH 1MM01A ~ UTNf WA8KlNG1ON OR WYOJMQ
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NUClEAR MATeRlAI$ LICENSING IRAI4Cl1 US ~R RltilULATOAV COIIIMISSION RlGIoNN 1800 1lt ~ iCULEVARD ARUNGTON1X 18011sU
PERSONS LOCATED IN AGREEMENT STATES SEND APPLlCAt1OIeS TO THE us NUCLEAR REGULATORY COa8lON ONLY IF tHEY WISH TO POSSESS AND USE UOENSED IlATEfUAL IN STATeS SUBJeCT TO UsNUOLEAR REGULATORY CDllMlSSION JURISDICTIONS t nilS IS AN AllUCATfON FOR (CM1ca~um)
0 A NEW UCeNSE
0 a AMEHIlMENT TO UcampNSE NUMBER
55-2562401c RENltWIL OF UCENSIi NUUIiIeR[J 3 ADDRESS WlEIU UcentENSEI1 MATeRIAl WILLIE useD OR ICIS$E$EiED
Virgin Islands Paving 1nc 13 OA Estate Bdhlehenl st Croix VI 00850
2 HAMil ANO MAlUNG ADDRess OFNIIICAHT (IrtrNde l1Flaquo1118
Virgin Islands Paving Inc PO Box 4720 Kingshlll VI 00851
4 WI OF EASON TO IE OONTACTeD ABOUT THlSAPPUCATION
Bryan Farley BUSIHE88 TELEFHONE HUMSER 19lJSlHEG$ OELLUIAA TElEPHOHe HUMIIIR
(340) 118-5220 (340) 277-5S61 IilVSINESS EMAILADDReI3$
bfarleyvipavingcom SUllMtT IaC $ THFIOUGH 11 ()HB-1Z)( 11 PAPeR ~TtPENiOSCClPeOl INRIRMATJOH TO as FIIOVIOEO IS oEOOAleO IN liE lICENSfAlllJCATJOHGlJIDE
5 RADIOACTIVE MATEAIAI I ElemIlllt_-IIII1IIMrb~_p~Iorm_c1II8IlOmum lImQunt
WIIkhwll ~ bull _tIIW T IIlaquoIM~)Rl8POltI81BLE FOR RADIAIIOII6AfETY IR()GAAM Nfl) THEIR
TRAINING exPERIGtlCe
II fACIUl1ES AHD aIJlfMENT
11 WASTEMAHAGEMEIfl
Ij IJIVOSE~ FOR WttICH UCENSEO MAT1ilRIAI WIll BE USED
8 1RAIfoIM FOR INDMDUAIS WIORtltIHGlN QR F1=IEQUIlIomHG ftESllUCTIi1) AREAS
10 RADlATIONSAF1I~
12 IJCSIISEFEIS (S8e10CFtH70ltIIIIISaeM11O31
AMOIIN FEI CATEGORYmiddot 3P s 000~Nel0GE0
13 CMTIIlCAIlON (MlIflle~IlYIIJIIfcIIIII) THEAPPUCNITrJNOEJI((JTANDSTHIITA(LSTATCNIElITUNOREPRESEIrATlONsMADEtNTUIS AFPUCATIONARE8INOING UPON1HE~IIT
THE APPLICANT IyenIDNIY omCIAI EXEOVTlNG THIS CERTIFICAIlO ON 8eHAlJ OF THE APPLlCANT NAMED IN rrEM2 ceRTIFY THAT TI1ISAlPllCITiON IS PREPARED IN COIIFQIIMITY~mu 10 CQDI5 QI~Rm3II1ATlONS PARTS 30 raquo _ 34 1538 III AND 4( AND NAT ALlINIORrMTlON CONTIIMED-stl 18 TRIIE Nfl) ~tO
NI BE$ OF THEIR IOIOWIJOGIG Nfl) BElJEJ WARNINO 111 USC S~ 1001 fICf OF JUNE 251148 62 STAT 11IWltE8 rr A C RIMI~QmNSE to MAKE II WlfUUIIY FALSe STATeMeNT OR REPRESENTATION TO AN( tlEPARTMEHTOR AGeNCY OF THE UNITEO$1ATESM TO ANY MAlTER WITHIN ITS JURIEIOICTION
CERTlJVIHG OFFICER - TfIIDIPIIIINTllD NAME ANO TlTUil DATE
Jj 1s-113iRobel1 J Sebier1obmiddot ~ut ~~ FOR NRC USE ONLY
lYPEOfFEE CllECI( NUMSEI COMMENtSIFeELOO IFeECATEGORV ~ReCeMD
APPROIEDiH DATE
I Me FORM lila (~12)
5a Element and 5b Chemical andor 5e Maximum amount that will mass number physical fonn be possessed at one time
A Cesium-137 Sealed source No single source to exceed Troxler Drawing 102112 9mCi
B Americium~241 Sealed source No single source to exceed Troxler Drawing 102451 44mCi
6 Purpose for Which Licensed Materials Will Be Used
To be used in Troxler 3400 series gauges and CPN AC2 series gauges for measurement ofphysical properties ofmaterials
11
Gauge Inventory
Man Troxler Model 9430
Gauge Senal 20404 SSampD Reg NCs46-C-13Q-S
License 55-2562401 Company Virgin Islands Paving Inc
Address 13 GA Estate 8ethlehem East Airport Road St CrolJ( VI 00850
Certification AssaV Leak Test Troxler Spec Form ANSI Radionudlde Activity Serial Data Date Dampte Orawlns Certificate Class AM-2418E 1480GBq 47-15882 21591 21591 122691 102451 USA0632S C66545
CS-137 O300GBq 75-1157 62091 62091 122691 102112 USA0614S C64444
2 Man Troxler Model 3440
Gauge Serial 24458 SSampD Reg NC-646-0-130-S
License 55-25624()1 COmpany Virgin Islands Paving Jnc
Addmss 13 GA Estate Bethlehem East Airport Road St Croix VI 00850
CertJfkatlon Assay leakTest Troxler Spec Form ANSI
Aadionuclide Activity Serial Date Date Date Drawing Certificate Class AM-2418E 1A8OGBq 47-20508 U1994 l2J394 514103 1024S1 USA0632S C66S45
CS-137 O300GSq 75-6508 11395 1113195 51403 102112 USA0614S C64444
3 Man (PN Model AC-2R
Serial A220801043
license 55-25624middot01 Company VIrgin Islands Paving Inc
Address 13 GA Estate Sethlenem East Airport Road St Croix VI 00850
Leak Test Spec Form RadlonucllCle Activity Date Certificate
Am-241Be lOOmCi 6212010 CZIOCJ9S-96
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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_ appJopriatec~ft~JI1C1I~_wueetiwatiaIl is
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bull U~ Jicease ismaiatUcd 8IId ~aad~ teqaeStSiaharltj[iady ~
8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
5a Element and 5b Chemical andor 5e Maximum amount that will mass number physical fonn be possessed at one time
A Cesium-137 Sealed source No single source to exceed Troxler Drawing 102112 9mCi
B Americium~241 Sealed source No single source to exceed Troxler Drawing 102451 44mCi
6 Purpose for Which Licensed Materials Will Be Used
To be used in Troxler 3400 series gauges and CPN AC2 series gauges for measurement ofphysical properties ofmaterials
11
Gauge Inventory
Man Troxler Model 9430
Gauge Senal 20404 SSampD Reg NCs46-C-13Q-S
License 55-2562401 Company Virgin Islands Paving Inc
Address 13 GA Estate 8ethlehem East Airport Road St CrolJ( VI 00850
Certification AssaV Leak Test Troxler Spec Form ANSI Radionudlde Activity Serial Data Date Dampte Orawlns Certificate Class AM-2418E 1480GBq 47-15882 21591 21591 122691 102451 USA0632S C66545
CS-137 O300GBq 75-1157 62091 62091 122691 102112 USA0614S C64444
2 Man Troxler Model 3440
Gauge Serial 24458 SSampD Reg NC-646-0-130-S
License 55-25624()1 COmpany Virgin Islands Paving Jnc
Addmss 13 GA Estate Bethlehem East Airport Road St Croix VI 00850
CertJfkatlon Assay leakTest Troxler Spec Form ANSI
Aadionuclide Activity Serial Date Date Date Drawing Certificate Class AM-2418E 1A8OGBq 47-20508 U1994 l2J394 514103 1024S1 USA0632S C66S45
CS-137 O300GSq 75-6508 11395 1113195 51403 102112 USA0614S C64444
3 Man (PN Model AC-2R
Serial A220801043
license 55-25624middot01 Company VIrgin Islands Paving Inc
Address 13 GA Estate Sethlenem East Airport Road St Croix VI 00850
Leak Test Spec Form RadlonucllCle Activity Date Certificate
Am-241Be lOOmCi 6212010 CZIOCJ9S-96
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
6 Purpose for Which Licensed Materials Will Be Used
To be used in Troxler 3400 series gauges and CPN AC2 series gauges for measurement ofphysical properties ofmaterials
11
Gauge Inventory
Man Troxler Model 9430
Gauge Senal 20404 SSampD Reg NCs46-C-13Q-S
License 55-2562401 Company Virgin Islands Paving Inc
Address 13 GA Estate 8ethlehem East Airport Road St CrolJ( VI 00850
Certification AssaV Leak Test Troxler Spec Form ANSI Radionudlde Activity Serial Data Date Dampte Orawlns Certificate Class AM-2418E 1480GBq 47-15882 21591 21591 122691 102451 USA0632S C66545
CS-137 O300GBq 75-1157 62091 62091 122691 102112 USA0614S C64444
2 Man Troxler Model 3440
Gauge Serial 24458 SSampD Reg NC-646-0-130-S
License 55-25624()1 COmpany Virgin Islands Paving Jnc
Addmss 13 GA Estate Bethlehem East Airport Road St Croix VI 00850
CertJfkatlon Assay leakTest Troxler Spec Form ANSI
Aadionuclide Activity Serial Date Date Date Drawing Certificate Class AM-2418E 1A8OGBq 47-20508 U1994 l2J394 514103 1024S1 USA0632S C66S45
CS-137 O300GSq 75-6508 11395 1113195 51403 102112 USA0614S C64444
3 Man (PN Model AC-2R
Serial A220801043
license 55-25624middot01 Company VIrgin Islands Paving Inc
Address 13 GA Estate Sethlenem East Airport Road St Croix VI 00850
Leak Test Spec Form RadlonucllCle Activity Date Certificate
Am-241Be lOOmCi 6212010 CZIOCJ9S-96
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
11
Gauge Inventory
Man Troxler Model 9430
Gauge Senal 20404 SSampD Reg NCs46-C-13Q-S
License 55-2562401 Company Virgin Islands Paving Inc
Address 13 GA Estate 8ethlehem East Airport Road St CrolJ( VI 00850
Certification AssaV Leak Test Troxler Spec Form ANSI Radionudlde Activity Serial Data Date Dampte Orawlns Certificate Class AM-2418E 1480GBq 47-15882 21591 21591 122691 102451 USA0632S C66545
CS-137 O300GBq 75-1157 62091 62091 122691 102112 USA0614S C64444
2 Man Troxler Model 3440
Gauge Serial 24458 SSampD Reg NC-646-0-130-S
License 55-25624()1 COmpany Virgin Islands Paving Jnc
Addmss 13 GA Estate Bethlehem East Airport Road St Croix VI 00850
CertJfkatlon Assay leakTest Troxler Spec Form ANSI
Aadionuclide Activity Serial Date Date Date Drawing Certificate Class AM-2418E 1A8OGBq 47-20508 U1994 l2J394 514103 1024S1 USA0632S C66S45
CS-137 O300GSq 75-6508 11395 1113195 51403 102112 USA0614S C64444
3 Man (PN Model AC-2R
Serial A220801043
license 55-25624middot01 Company VIrgin Islands Paving Inc
Address 13 GA Estate Sethlenem East Airport Road St Croix VI 00850
Leak Test Spec Form RadlonucllCle Activity Date Certificate
Am-241Be lOOmCi 6212010 CZIOCJ9S-96
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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3 Nftltstrft amp4ioJimcbrl1lltfhs prgelaquoltWller rMiatii8OU1De
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
7 Bryan Farley will be the designated RSO for Virgin Islands Paving Inc He has completed Troxlers Nuclear Gauge Safety Training Class and has completed Troxlers Radiation Safety Officer Training Class
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPENDIXD RSO RESPONSl8lUnES
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8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
8 Before using licensed materials all gauge users will have successfully completed the Troxler Nuclear Gauge Safety Training Class
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
9 Nuclear gauges will be stored under lock and key in the Quality Control Lab at one ofthe following locations for Virgin Islands Paving Inc
Virgin Islands Paving Inc 13 GA Estate Bethlehem
St Croix VI 00850
Virgin Islands Paving Inc 149B Subbase St Thomas VI 00802
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
10 Radiation Safety Program
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
Virgin Islands Paving Inc
Radiation safety Program
A Personnel Monitoring
All personnel will wear a personnel monitoring device such as a TDL badge to measure radiation exposure when using or transporting gauges The badges shall be exchanged at intervals not to exceed 3 months Dosimetry badges shall be provided by a vendor accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) such as Troxler Electronic Laboratories Inc
Troxler Radiation Monitoring Services 3008 Cornwallis Road Research Triangle Park NC 27709
B Radiation Detection Instruments
We will maintain a survey meter for the use in the event ofan incident involving the gauge The survey meter will be cahbrated annually by the manufacturer or other vendor and checked for functionality before use
Survey meter in use will be
Manufacturer SE International Inc Model Radiation Alert 4 Type G~M survey meter Radiation detected Alpha Beta Gamma and X-ray Window thickness l5mgcm2
Sunrey meter will be calibrated by
Troxler Blectronic Laboratories Inc 30008 Cornwallis Road Research Triangle Park NC 27709
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
C Sealed Source Leak Testing
Leak testing will be performed at intervals not to exceed 6 months or other intervals specified in the license Leak test samples will be analyzed by an organization authorized by the NRC or Agreement State to provide leak test services such as Troxler Electronic Laboratories Inc (North Carolina license No 031-0182-1)
D Material Receipt and Accountability
Records ofreceipt transfer and disposal ofgauges will be maintained for at least 3 years
Physical inventories ofsealed sources will be conducted at intervals no to exceed 6 months
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPSHDIXE GAUGE UTIlizATION LOG
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E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPENDlXF SEALED SOURCE PHYSfCALJNVENTORY LOG
8fIiifd 8tGnlCIe ------~---+--------I NambIr Lwa1M ~ = ~
Peiformect1JJ____________
E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
E Public Dose
Gauges will be used transported and stored in such a way that no member ofthe public receives a dose ofmore than 100 mrem in one year
Dose in unrestricted areas will not exceed 2 mrem in anyone hour
Will control and maintain constant surveillance over gauges that are not in storage and secure gauges from unauthorized use or removal
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPENDIXG PUBLIC DOSE CALCUlATION WORKSHEET
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
1 Alwa)IswarIlSSlpedael~~ (q1IDb44p)w-_or Wil~thes-ge
3 Nftltstrft amp4ioJimcbrl1lltfhs prgelaquoltWller rMiatii8OU1De
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
9 DOSeIN~AREM1H0NE1IOUft
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F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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3 Nftltstrft amp4ioJimcbrl1lltfhs prgelaquoltWller rMiatii8OU1De
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
F Operating and Emergency Procedures
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPENDIXH OPERATING AND EMERGENCY PROCEDURES
OPeRATING PROCEDURES
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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L
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If W-ltakt~~in~NRCIDd~to the Iicen80Y
c Are ~oCltSalts RWned wiaappapdafcinfDrmfdbt JwhdwIl
d WemamytoarCdDmd JeaDasad ifJSNRC~
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1-4
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~ ~ ~~~ 1-l~~8~= =~~~7n=C_1~_____MI~t4wNw~~~~
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
NOm Alarefacltaleiltaotevwya_ -4InfJIc~
~~~------------------ ~~~----------AudttOt~________ DateofABdlt_~_ ~bull 0_ m bull
~)
L AlJDlTHlBJORY a Lat1ilditarfJdlloeatia1i~OIl(lJe)_______
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L
1 IIUJlIm(C AlW 1NSTR1CJIONS TO WORDRS
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b Di401dlp8popeadDraucad_~coaraeuslag~ Co Are trainm~ lbIiDttUJed b _ opcOltlaquol
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c Are ~oCltSalts RWned wiaappapdafcinfDrmfdbt JwhdwIl
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1-4
Me rte _____- l1li - __ atI ~_ I~ Uil
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b llSO JiasIlJflialellt IiDHI potbm IislIxr-ncBarioDllfiqi1dJiM7
c UoallflDJuta eofIidftrt staffto 8IJPOli thondittion ptAeCiaDpm8um
- ~
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
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L
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1-4
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tampJWAUIAlION OF011IDt JrACTOBS
a seatorUcelseo ~ ltappropriarety favolved radbdlOQ~ ~mtOtKidiatiOrtS8ftitYom_(Jl8(1J~
b llSO JiasIlJflialellt IiDHI potbm IislIxr-ncBarioDllfiqi1dJiM7
c UoallflDJuta eofIidftrt staffto 8IJPOli thondittion ptAeCiaDpm8um
- ~
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
Incident Procedures
An accident may be defined as an event were the gauge is lost stolen or physically damaged to the extent tlmt the soutee shielding is or could be compromised
If the gauge is lost or stolen follow these steps
L Notify the Radiation Safety Officer Bryan Farley at 340-277-5567 or 340-778-5220 as soon as possible He will then immediately notify the appropriate regulatory agency (USNRC Operations Center 301-816--5100) and the gauge manufacturer(Troxler 919shy549-9539
2 The regulatory agency will direct the ampSO as to additional agencies that must be notified
In the event of damage at the job site
1 Locate the source ifpossible 2 Rope off the accident site and keep bystanders out oithe area A minimum distance of 15
feet from the gauge or source should be maintained 3 If a vehicle is involved keep it all at the site until it can be verified that it has not been
contaminated 4 Stay with the gauge but notify the RSO (Bryan Farley) as soon as possible The RSO will
notify the appropriate regulatory agency (USNRC) ifneeessary S The RSO (Bryan Farley) or regulatory agency will determine ifthe gauge can be safely
transported If it is cleared notify Troxler obtain a RGA number and ship by nonnal means Ifit is not cleared Troxler or the regulatory agency can offer further advice or assistance in making arrangements for safe shipment and disposal
Notify the USNRC if
1 $2500000 in damage to personal property 2 Harm to a person due to radiation 3 Ifsource can not be found
Make a report ud take pidures regardiessU
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
NOm Alarefacltaleiltaotevwya_ -4InfJIc~
~~~------------------ ~~~----------AudttOt~________ DateofABdlt_~_ ~bull 0_ m bull
~)
L AlJDlTHlBJORY a Lat1ilditarfJdlloeatia1i~OIl(lJe)_______
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L
1 IIUJlIm(C AlW 1NSTR1CJIONS TO WORDRS
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a seatorUcelseo ~ ltappropriarety favolved radbdlOQ~ ~mtOtKidiatiOrtS8ftitYom_(Jl8(1J~
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- ~
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
G Maintenance
We will implement and maintain procedures for routine maintenance (cleaning and lubrication) ofour gauges according to the manufacturers
recommendations and instructions
We will send the gauges to the manufacturer to perfonn non-routine maintenance or repair operations that require removal ofthe source or source rod from the gauge
H Transportation
Gauges will be transported in compliance with DOT regulations and Troxler Transportation Guide
1 Audit Program
An audit of the radiation safety program content and implementation will be performed and documented annually Records of audits will be
maintained for at least 3 years Corrective action will be taken promptly to
prevent recurrence of deficiencies
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
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- ~
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
APPENDIX I PORTABLE GAUGE AUDIT CHECKUST
NOTE lIireaDatiollllltldspmfc1ed IJ)UANc ~
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- ~
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
L
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11 Waste Management
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
11 Waste Management
Licensed material will be disposed ofifneeded by Troxler Electronic Laboratories Inc
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