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NRC FORM 7 U. S. NUCLEAR REGULATORY COMMISSION APPROVED BY 0MB: NO. 3150-0027 EXPIRES: 02/28/2022

;~1c2i~9

i 10 i,r»'"~ ll(G(,i~>o Estimated burden per response to comply with this mandatory collection request 2.4 hours. This submittal

( ~ '.') APPLICATION FOR NRC EXPORT OR IMPORT is reviewed to ensure that the applicable statutory, regulatory, and policy con~derations are satisfied. Send comments regarding burden estimate to the Information Services Branch [T-6 A10M), U.S. Nuclear

\, / LICENSE, AMENDMENT, RENEWAL, Regulatory Comrn~on, Washington, DC 20555-0001 , or by e-mail to lnfocollects.Resource@nrc.gov, and ..... OR CONSENT REQUEST(S)

to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0027), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does

(See Instructions on Pages 4 and 5) not display a currently valid 0MB control number, the NRG may not conduct or sponsor, and a person is not required to respond to, the information collection.

D D Date Received

PART A. FOR NRC USE ONLY Public OR Non-Public

License Number Docket Number Adams Accession Number

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

1. Name and Address of Applicant/Licensee 1 a. Name of Applicant's Contact 1 b. Applicant's Reference Number Matheson Tri-Gas, Inc.

Samarattra Wilmore LNOX001/002 909 Lake Carolyn Parkway ste 1300 1c. Office Telephone Number 1d. Office Facsimile Telephone Number Irving, TX 75039 9725604172 9725019549

1 e. Applicant's E-mail Address

swilmore@mathesongas.com

2. Type of Action Requested D Export (Parts B, C, E) [ZJ Amendment/Renewal Current License Number: XMAT432 (Check one) D Import (Parts B, D, E) D Consent Request (Parts B, C) Current License Number:

3. Contract Number(s) , 4. First Shipment Date 5. Last Shipment Date , 6 . Proposed Expiration Date

08/01 /2019 08/03/2022 3 years

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

7. Name(s)/Address(es) of U. S. Suppliers and/or B. Name(s)/Address(es) of Intermediate 9. Name(s)/Address(es) of Ultimate Foreign other U. S. Parties to the Export Foreign Consignee(s) Consignee(s)

Matheson Tri-Gas, Inc. Leeden National Oxygen LTD. Global Foundaries Singapore Pte.,LTD 1650 Enterprise Parkway 21 Tanjong Kling Road 60 Woodlands Industrial Park D Twinburg, OH 44087 USA Singapore 628047 Singapore Street 2

Singapore 738406 Matheson Tri-Gas, Inc. LBSF Energy Solution SON BHD Singapore 1700 Scepter Road Gudang Berlesen Awan , PTO 41365 Waverly, TN 37185 USA Jalan ldaman 3/2

Senai Industrial Pk, Taman Desa Matheson Tri-Gas, Inc. ldaman 6775 Central Avenue 81400 Senai, Johar, Malaysia (on Newark, CA 94560 USA behalf of Leeden National Oxygen.LTD

7a. Function(s) Performed/Service(s) Provided Ba. Intermediate Use(s) 9a. Ultimate End Use(s) Shipping Locations Storage until resold Semiconductor Devices

10. Description of Radioactive Materials, Sealed Sources, Nuclear Facilities, 10a. Maximum Total Volume/ 1 Ob. Max Enrichment 1 Oc. Max Isotope Equipment, or Components; for Nuclear Equipment include Total Dollar Value Element WGT (KG), or or WGT% WGT(KG) of Equipment for Export Total Activity (TBq)

Cylinder content to vary(i.e. 5000L thru ?DOOL) 782 Kg 99.8% 99.8% of the 20

Deuterium (Heavy Hydrogen):

11 . Foreign origin (or obligations by country and, if known, by percentage of maximum total volume)

For Non-Nuclear end use in semiconductor devices. Singapore: 391 kg, Malaysia: 391 kg

NRC FORM 7 (07-2019)

XMAT432/01 11006165

August 6, 2019, szf

NRC FORM 7 (07-2019) 10 CFR 110

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U.S. NUCLEAR REGULATORY COMMISSION

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

License Number I Docket Number Adams Accession Number ~ D Public OR D Non-Public

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

12. Name(s)/Address(es) of Foreign Suppliers and/or other Foreign Parties to Import

13. Name(s)/Address(es) of Foreign or U. S. 14. Name(s)/Address(es) of Ultimate U. S. Consignee(s) Intermediate Consignee(s)

12a. NRG Export License Number(s) (if appl icable) 13a. License Number(s) / Expiration Date(s) 14a. License Number(s) / Expiration Date(s)

13b. Intermediate Use(s)

15. Description of Radioactive Materials, Sealed Sources, Nuclear Facilities

16. Foreign obligations (By country and by Percentage of Maximum Total Volume)

14b. Ultimate End Use(s)

15a. Maximum Total Volume/ 15b. Max Enrichment Element WGT (KG), or or WGT% Total Activity (TBq)

1 Sc. Max Isotope WGT(KG)

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

17. Additional Information provided on pages 3, 4, and/or separate sheets? 17a. Copies of Recipient's Authorizations Provided?

[Z] Yes D No [Z] Yes D No

18. Certification:

I, the applicant's authorized official, hereby certify that this application is prepared in conformity with Title10, Code of Federal Regulations, and that all information provided is correct to the best of my knowledge.

18c. Date

NRC FORM 7 (07-2019)

XMAT432/01 11006165

Received 08/06/19, szf

Page 3 of 3

NRC FORM 7 (07-2019) 10 CFR 110

U.S. NUCLEAR REGULATORY COMMISSION

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

License Number rocket Number 'Adams Accession Number IO Public OR O Non-Public

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

ADDITIONAL INFORMATION: (RENEWAL/INFORMATION CHANGE REQUEST FOR)

Block 1 a. Requesting change of Applicant contact from Scott Duff to Samarattra Wilmore

Block 1 c. Requesting change of Office Telephone Number from 9725605643 to 9725604172

Block 1 e. Requesting change of Applicant's Email Address to only swilmore@mathesongas.com

Block 2. Request for Renewal of current license# XMAT 432 Docket# 11006165

Block 6. Requesting expiration date to be extended the expiration date from August 1, 2019 to August 3, 2022.

Block 7. Requesting adding additional Supplier addresses Matheson Tri-Gas, Inc. 1650 Enterprise Parkway Twinburg, OH 44087 USA

Matheson Tri-Gas, Inc. 6775 Scepter Road Waverly, TN 37185 USA

Block 8. Adding : LEEDEN NATIONAL OXYGEN's Malaysia bonded warehouse location for storage before sold: LBSF Energy Solution SON BHD Gudang Berlesen Awan , PTO 41365 Jalan ldaman 3/2 Senai Industrial Pk, Taman Desa ldaman 81400 Senai , Johar, Malaysia (on behalf of Leeden National Oxygen, LTD.)

NRC FORM 7 (07-2019)

XMAT432/01 11006165

Received 08/06/19, szf

FORM 8XA•7f1 U.S. DEPARTMENT OF COMMERCE DATE RECEIVED FOAM APPJ\01/1:01 OMS NO. oe9,1.00Bs Bureau of Export Administration (Leave Blank)

/nfOJMallon f111nJ»mt(f ~4·,vlltl ls n.tbJeot to lfl't P,-uiA.ltonJ of S't<:Uon

!~~~11l\:,~=:::~1=r.~~ ~~,0~:r:,.-;::i::t11v ~s.o.

STATEMENT BY ULTIMATE CONSIGNEE AND PURCHASER 1. ULTIMATE CONSIGNEE CITY LBSF ENERGY SOLUTION SDN BHD SENAI, JOHOR

ADDRESS UNE I COUNTRY GUDANG BERLESEN AWAM, PTO 41365, JALAN IDAMAN MALAYSIA

AOORE$S LINE 2 POS!A~-.vu,; 'TELEPHONE OR FAX SENAI INDUSTRIAL PARK, TAMAN DESA !DAMAN, 81400 +60-7-5987687

2. DISPOSITION OR USE OF ITEMS BY ULTIMATE CONSIGNEE NAMED IN BI.OCK l We certify tl1at the Items:

A. D WIit be uaed by u& (as capltsl equipment) In lhe lorm In whloh received In a manulaoturlng process In Iha oounlry netned Tri Block t end wtll nol be reexported or lnoorporated Into en end product,

8. D WIii be proceseed or lncorporat9d by us lnlo lhe followlng product(s)

lo ba 1nanufac1ured In Iha counuy named In Block 1 tor distribution In

C. ~ WIil bo resold by ua In lhe form in which received In the oounlry named fn Block 11or use or consumption therein.

Tho speolllo ond-use by my customer will bo for manutacturinsi of lC Chif~

.o.D WIU be reexported by us In lhe ronn In which recolved to

D 011\er (deecrlbe lully) NOTE: 11 BOX (D) lo chodc~d, ooooptance of thb 101111 by the Bureau of Export AdmlntetreUon •• a supporllng documenl for license eppllcaUona ahall not bo eonatrued 11 nn oulhortzal/on lo rooxporl Iha llom.s to which lho form ap11lles unless spe.clflc approval has been obtained from lhe Sureau of Exporl Adtnlnlslrallon rar euch reexport.

3. NATURE OF BUSINESS OF ULTIMATE CONSJC'INEE NAMED IN BLOCI< 1

A. The nature of our usual business Is .manutacture ' ~i.\11:l:i Q' !ngu~trial gases • seecialty gi;ise3

B. Our business releUonahlp wilh the U.S. exporter Is af.fi 1 °' .;:it i on

and we have had lhls buelneso relallonshlp lor ...li_ yoar(a), 4, ADDITIONAL INFORMATION

6, ASSISTANCE IN PREPARING STATEMENT

STATEMENT OF ULTIMATE CONSIGNEE AND PURCflASER Wo CO(tlfy thal111l ol lho lt\Clo oont•ln•d (n lhlB etotomot~ aro l,vo and oortool lo tho boot of out knowlodgo and wo do oot.know of •1.•d<lllionol !Acta "'11ch aro lnoonulitant With tha llbow tllltO.monl. W0'8hQII ptomplly sond a 1upptomantal·slalem1nl 10 Iha U.S.. Elql<lrtilr, ~IOSlrtO anx Cllango ol laelt or Inion n1 .. t forlh In O,Ja a111omanl which OOOUfll. nflor rho.erotonwu h4" b<>•n l)lapafod nnd torwardod: l:lCC<lpl at 1poo111eo11y nuthoritod :lfu tho U.S. Export dmtnl•tmlon ftogUlaHon, (1S CFR Pilrta 7S0·774l, or by prior w~II0/1

• !'Pf:oval of .tho Duteau al Export Admlnlotrauon, wa wlh no! roru:porl, resell, or 01norwtso d C""' ol any Uoms approved on • ·UC<>nao allppOf!G<I by this statomc,n~ ~I) to .any oounlry OJ>Pl'OV<ld lorexportna broughl·lo our allonllon by mean• al a.blU al ladtng. common:lol nvoloo, 01 a.ny other mearu; or (2.) to nny ptl!IOn II wo knowlluil II wl reault dl,...,uy 01 ~ .. uy, In dlspo,IUon·of tho Item, c:onllllry to the ,opru,ontollont mo.da In thl11tatomon1 or conlru,y to Expo,1 Admlnls~allon FtopulaUO(ls •

. 'd. SIGNATURE OF OFFICIAL OF ULTIMATE CONSIGNEE ~~ ~ 7. NAME DF PURCHASER

'· 4EEDEN NATIONAL OXYGEN LTD,

NAME OF OFFICIAL

~ l SIGNATURE OF OfFJCIJ\i. OF PURCHASER --=.J ROGBR 'i'l\N - ,_,

TITLE OF OFFICIAL r; 'fi, NAME OF OFFIC.IAL

/;~~ I VICE PRESIDENT, SALES ROGER TAN

OATE ~ ~ B TITLE OF OFFICIAL (at )~J 25 OCT 2018 , VICE PRESIDENT, SALES

CERTIFICATION FOR VSE OF U.S. EXPORTER - DATE ~-~ Wo cerUt \hat no 001toclJ011&U addllla~ or ono,aUoM wore made on lhls lorm by us 25 OCT 2018

... ,.--e\. nllor lho ,m waa sl9no.d by l1o (l/111 o.con111l)noe)o,urcha••1J,

O. NAME OF EXPORTER SIGNATURE Of PERSON AUTHOAIZ!;D TO CERTIFY FOR EXPORTER

NAME OF PERSON SIGNINO TlilS DOCUMENT TITLE OF PERSON SIGNINO THIS DOCUMENT IDATE

We acknowledge that the making of any-lnlH atalamenla or oonoealrnenl of eny materlal feet In conneollon wllh this 111alemenl may result In lrnprl&onment or tln11, or both and denial, In whole or In parl, ol ll"•lfolpallon In U.S. OJCporls and reexports.

Mio 1tporllop~ur6fn 1<11 IJ\11 colloellon ol lnlormitl,al b 11tlm111d 1o1w•11t 1$ nrlt\1b1 ,., rupa1>11 pW$ ::1::',;;.\lf~':;!~Zfic=~\Yr=:'~\~(lf to the omcooJ Mo~,,... ... , .. ,..,,ut, for r«or;J;o ... ..~!:~~1m~=nr.::~~~~:i:~ tlotwkh)l:Andlng any Olluir provldan of ll\'1, no pmon 11 requlrld lQ m,oM kl n.o, Wh I peraoo be 1Uijtot .,11matoori•v•11t11u=bls"' ,c10,oflr,fon,~Jon.locludlnf ta I ptfLl!tV for tanu,e to wmptJ wllh a calls~llon or lnlormailon subJ«t to dtt 11qulrem11'1t1 ol UM P&pafWOA; ,u~1U..S1orr1 bo,dtn;tol~ ko<lor.oJ · ·,uo11,Roomm,.s01 .. vofb!>Ofl f\e1h1cUon Ac! unl&.!ls !hat col!ecllon of fnliumaUan dlapl&y& a wrrenl!y nld 0MB Conlrot Numbu.

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