January 24, 2013

USNRC ATTN: Licensing As!>istant 6 12 East Lamar Boulcvard, Suite 400 Arlington, Texas 76011.4 125

SU BJEC 1': License 50-29210-02 Amendm ent

RECEIVED

JAN 2 5 2013

DNMS

Design Alaska, Inc. would like to add a second nuclear instrument to our license. The new instrument will be used in the same manner as our existing instrument, and will be handled and stored in the same manner. We will not be replacing the instrument we currently have; both instruments will be in use going forward.

Following is NRC Form 313 and items supportjng documentation. Please contact our office if additional information is necessary.

nest regards,

"Lilirv~~-Wendy A. Presler, RSO Civi l Engineering Department

Enclosures PUBLIC o Immtdllt. R., .... ~omlll R.l" ..

NON-PUBUC e A.3 SenoItiVOoStc:Urlly _ e A.7 Sonsm", I_ e Othet: _____ _

RevI-. 7brz-.: _, (-Z-,-z..u

Design Alaska Inc. Architects ' Engineers' SlIIvevors 601 College Road Fairuanks Alaska 99701 907 452 1241

Fax 907 456 6883 E M<)i l mllil@dusignalaska.GOm

I::~,~ORM 313 U.S, NUCLEAR REGULATORY COMMISSION OMS; , I' ..... ' ,

I ~·'" . ;;;;';;;'-.;0<;: ."'" ro . ... "" . " . """~:'~ APPLICATION FOR MATERIALS LICENSE I ~~~:::''' . ",, \~rc.::, .. ~':.~ : ::.; :. ~

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"SEE' ~'ENTiRE', LICENSE APPLICATION GUIDE fOR DETAILED INSTRUCTIONS fOR COMPLETING APPLICATION, I COMPLETEO APPLICATION TO THE NRC OffiCE SPECifiED BELOW,

Di STRIBUTION OF EXEMPT PRO DUCTS riLE APPlICATlOH$WlTN: IF YOU ARElOCAT~D IH:

orr lC',I; or FCDERAl .. STATE MArERIALS ... 1-10 ILUNOIS, INOI ... NA, IOWA, MlCi-lIGAN, WNNESOT ... , MISSOURI, 01110, OR WISCONSIN. ENVIRO«t.IEtWU, IU.NllGEMENT PROGRA.MS SEND "'PPUCATlOto'S TO: OIV1S1ON Of' M,.\TE-.s S*E ry AHO S1"'E ot.OtlU.MliNTS U,S. NUClEAA REGUlA10RY COMMISSION Wll ERlAI.$ LiCENSING IIRNCtI WASHNGTON.OC ~, U S NUClEAA "fEGLlAl OOY (lOI,tMISSION. REGION III

20M3 WARRENVILLE ROAD. SUITE 210 liSLE , Il 1I0632·~J:;2

IF YOU "'RE LOCATED IN:

AlABAIM., CONNEC TICUT, DElAWARE, OISTRICT OF COUJ~BIol, FlORIIlA, O€OROIA. , KENTUCKY, ..... IINE, MARI'lAHD, IAASSo\CHUsens, NEW HAMPSI«RE, NEW JERSEY, , NEW YOfU(. NORllI CAROliNA. PENNSYlV"NIo\, POCRTO RICO, HtIOO£ ISLAI/O. SOUlH , CAIlOllN", TENNESSEE, VEIlIIIONf. VIRGINIA, VlAGIH ISLANDS. 011 W"-SlIlIRGINL\. """.' SENO Idl'PlICATIONS TO: SEND IdI'PUCA1IONS TO:

lICENSI~ASSISTAi'lCE TEAM NUClE ... R M"'TER"'LS LICENSING IlRANCH DlI/ISlON Of' NllClENl Ml\T ER' ... I.S $.O.FElY u .s NUC Le ... R REGUL ... TORY COMMISSION, Rl:GION IV U.S. NUCl.EIIR REGUlATORY COMMISSION. k EGI()N I 11100 E, I. ... MAR BOOLEII ... RO ~' OO REtWSSANCF. OOl.l.EV.o.NO, SUITE w) AALlM::lTON. U 16011 -01.511 lUNG Of PRIJSSII,. PA '~7Il

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Design Alaska, Inc.

III 1\ "",F.-.;m TO UCf.ttSE _BER 50-292 10-02 601 College Road _._- ---- - -I J C. RENE __ 01' LiCENSE MJM\lER

Fairbanks, AK 99701 --- ----, 'M1.LIlf. •

Wendy A. Presler

~O.1 .College Road , ,AK 99701

(907) 452-1241

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,~"'~ • 1'tJHf'QSE(S1 FOR 'M«:tI lICENSEO 1M1l'lMl WU lIE USEe

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NRC FORM a l l ~20t

11/2012 Application for Materials license Design Alaska, Inc.

ITEMS SAND 6' MATERIALS TO BE POSSESSED AND PROPOSED USES Yes No Radioisotope Manufacturer or Distributor Quant ity Use As listed Specify Other Uses

Model No. onSSD Not listed on SSD

Certificate Certificate

, Cesium-137 Sealed source manufacturer 21 mel Measure the Not applicable

and model number: (10 mCi in density of thin

InstroTek Model 3500 the 3500 asphalt and

Xplo rer and Humboldt Xplorer concrete layers

M odel HS-5001SD and 11 mCi in the

Hs-500150)

, Americium-241 Sealed source manufacturer 40mCi Measure the Not applicab le

and model number: density of thin

InstroTek Model 3500 asphalt and

Xplorer concrete layers

, Americium-241Be Sealed source manufacturer 44mCi Measure the Not applicable

and model number: density of thin

Humboldt Model HS- asphalt and

500150 concrete layers

Item No. and Title Response Yes Alternative .

Procedures Attached

-7. INDIVIDUAL(s) Before obta ining licensed materials, the , n!a RESPONSIBLE FOR proposed RSO will have successfully

RADIATION SAFETY completed one of the training courses

PROGRAM AND THEIR described in Criteria in the sect ion

TRAINING AND EXPERIENCE entitled " Individual(s) Responsible for

- RADIATION SAFETY Radiation Safety Program and Their

OFFICER Training and Experience - Radiation

NAME: WENDY PRESLER Safety Officer" in NUREG-1556, Vol. " Rev. 1, dated November 2001.

8. TRAINING FOR Before using licensed materials, , n!, INDIVIDUALS WORKING IN authorized users will have successfully

OR FREQUENTING com pleted one of the training courses

RESTRICTED AREAS described in Criteria in the section

entit led "Training for Individuals

Working In or Frequenting Restricted Areas" in NUREG-1556, Vol. 1, Rev 1,

da ted November 2001.

11/2012 Application for Materials license Design Alaska, Inc.

Item No. and Title Response Yes Alternative

Procedures Attached

9. FACILITIES AND No additional information to submit n/. n/a EQUIPMENT with this item.

10. RADIATION SAFETY We wi ll possess and use a radiation , n/. PROGRAM - SURVEY survey meter meeting the Criteria in

INSTRUMENTS "Radiation Safety Program -

Instruments" in NUREG-1SS6, Vol. 1,

Rev. 1, dated November 2ool. 10. RADIATION SAFETY Physical inventories will be conducted , n/. PROGRAM - MATERIAL at interval not to exceed 6 months, to

RECEIPT AND account for all sealed sources and

ACCOUNTABILITY devices received and possessed under

this license.

10. RADIATION SAFETY Either we will maintain, for inspection , n/. PROGRAM - by NRC, documentation demonstrating

OCCUPATIONAL that unmonitored individuals are not

DOSIMETRY likely to receive a radiation dose in

excess of 10 percent of the allowable

limits in 10 CFR Part 20, or we will

provide dosimetry processed and

evaluated by an NVLAP-approved

processor that is exchanged at a

frequency recom mended by the

processor.

10. RADIATION SAFETY We will implement and maintain the , n/. PROGRAM - OPERATING operating and emergency procedures

AND EMERGENCY in Appendix H of NUREG-1556, Vol. 1,

PROCEDURES Rev. 1, dated November 2001, and

provide copies of these procedures to

aU gauge users and at each job site.

11/2012 Application for Materials license Design Alaska, Inc.

Item No. and Title Response Ye, Alternat ive

Procedures Attached ,

10. RADIATION SAFETY l eak tests will be performed at x nfa PROGRAM - LEAK TEST intervals approved by NRC and

specified in the Sealed Source and

Device Registrat ion Sheet. leak tests

will be performed by an organization

authorized by NRC to provide leak

testing services for other licensees or

using a leak test kit supplied by an

organization authorized by NRC to

provide leak test kits to other licensees

and according to the kit supplier's

instructions.

10. RADIATION SAFETY Routing Cleaning and Lubrication: We x nfa PROGRAM - MAINTENANCE will implement and maintain

procedures for routine maintenance for

our gauges according to each

manufacturer's recommendat ions and

instructions.

Non-Routine Maintenance: We will send the gauge to the manufacturer or

other person authorized by NRC to

perform non-routine maintenance or

repair operations that require the

removal of the source or source rod

from the gauge.

" 57 9 8 43

STATEMENT OF PROPOSED USE.

Design Alaska, Inc. is a professional corporation, licensed in the State of Alaska, and provides Architectura l, Engineering and Surveying services. Construction testing services are offered beginning Spring 2011 and continuing indefinitely.

Design Alaska, Inc. currently possesses an InstroTek, Inc. Model 3500 Xplorer nuclear density gauge for use in construction testing. The gauge is used to determine soil compaction and moisture content , and is common to the industry. The gauge is used at jobsite locations by one of our trained technicians. The gauge is stored in a secure location at Design Alaska. Inc.

Design Alaska, Inc. wishes to purchase a second gauge for use in construction testing. The gauge to be added to our license is the Humboldt Model HS-5001SD. The Humboldt gauge will be used to determine soil compaction and moisture content, and is common to the industry. The gauge will be used at jobsite locations by one of our trained technicians. The gauge will be stored in a secure location at Design Alaska, Inc.

Nuclear Density Gauge Operating Procedures

If personnel dosimetry is provided: • Always wear your assigned thermoluminescent dosimeter (TLD) or film

badge when using the gauge. • Never wear another person's TLD or film badge. • Never store your TLD or film badge near the gauge. • Before removing the gauge from its place of storage, ensure that gauge

source is in the fully shielded position and that in gauges with a movable rod containing a sealed source, the source rod is locked (e.g .. keyed lock, padlock, mechanical control) in the shielded position. Place the gauge in the transport case and lock the case.

• Sign out the gauge in the log book (that remains at Design Alaska) including the dale(s) of use, name(s) of the authorized users who will be responsible for the gauge, and the temporary job site(s) where the gauge will be used.

• Block and brace the gauge to prevent movement during transport and lock the gauge in or to the vehicle. Follow all applicable Department of Transportation (DOT) requirements when transporting the gauge.

• Use the gauge according to the manufacturer's instruct ions and recommendations.

• Do not touch the unshielded source rod with your fingers, hands, or any part of your body.

• Do not place hands, fingers, feet, or other body parts in the rad iation field from an unshielded source.

• Unless absolutely necessary, do not look under the gauge when the source rod is being lowered into the ground. Using the scraper plate that is provided with the gauge, follow the manufacturer's procedures to minimize radiation exposure.

• After completing each measurement in which the source is unshielded, immediately return the source to the shielded position.

• Always maintain constant surveillance and immediate control of the gauge when it is not in storage. At job sites, do not walk away from the gauge when it is left on the ground . Take action necessary to protect the gauge and yourself from danger of moving heavy equipment.

• A lways keep unauthorized persons away from the gauge. • Perform routine cleaning and maintenance according to the

manufacturer's instructions and recommendations. • When the gauge is not in use at a temporary job site, place the gauge in a

secured storage location (e.g., secured and locked in the truck or locked in the storage cabinet at Design Alaska) .

• Before transporting the gauge, ensure that , where applicable, each gauge source is in the fully shielded position. Ensure that in gauges with a movable source rod, the source rod is locked in the shielded position (e.g. , keyed lock, padlock, mechanical control) . Place the gauge in the transport case and lock the case. Block and brace the case to prevent movement

Design Alaska, Inc. January 2011 Page 1

11 57 9S 4 3

Nuclear Density Gauge Operating Procedures

during transportation. Lock the case in or to the vehicle, preferably in a closed compartment.

• Return the gauge to its proper locked storage location (cabinet at Design Alaska) at the end of the work shift.

• Log the gauge into the daily use log when it is returned to storage (at Design Alaska).

• After making changes affecting the gauge storage area (e.g. changing the location of gauge within the storage area, removing shielding, adding gauges, changing the occupancy of adjacent areas, moving the storage area to a new location), reevaluate compliance with public dose limits and ensure proper security of gauges.

Design Alaska, Inc. January 2011 Page 2

,Ii iI

HUMBOLDT

Humboldl" NEW HS-SOOISD Mois,uHI/t)Qnsl'ly G..uge prO'rlOdo. oasior and more effic;ent oper",ion, oa,,, colle(;\;on and processiny, .a/ely and rep<>i, than any o,hQlld""ge '" il! d~S$,

n,is now G;)uge U$C'S sI3Ie-o/-lhc-arl llldmology to bring you a hO&1 of new featuros 10 make your job e(\$ier, Fcaluringll 4.3" touch·sc,een, the SO Gauge provides inlulti'r"C! operation of all 9r"I'9c npe.ation •. Yoo alw have the option 10 u ... the gauge" loveh pad ,nstelld of the touch-scre"n, if desired.

n", SD's versatil ity ..Jlow, it 10 meas""~ densily th'oogh oired I' '' ''$mi,.;on .",d badlcalle. mode~, as willi lIS including thi n lift and t"mel, modes, as woll itS moistu,e dou;rrrninalions. Thc 9~u9o:. uses an advanced mic'Q,pWCes50r-bas.ed t\lchnology to providu highly-accurate mcasuremell\s 01 density and moisture thil ire aulomatlCallycomputod fOf direct readou ts 01 wet density, d,y dollsl'ty, moisture cont.ml, potccn! of moisture, percent 01 compaction (Proctor or Ma.shall), void mtlo alld air voids. The SO Gauge compli ll5 wi th ~II peni"e '" $I~ndards: ASl'M 06938, D2950, CIO<\O .. Ild AA5HTO T310.

"l"ho ga"ge is calibrated by the Five·blor:k calib,allOf, method.

Humboldt HS·5001SD Nuclear Density Gauge

.!. Touch·Screen or Touch P.d_ VOl' have you. choico with lho new Humboldt HS-SOO1SD Moisture/Dellsi ly Gauge. The gauge f(!~lu((!, a 4.3" loveh-$Ct'(>en, whkh

provides complete control Of yo;.. <;ilIl <>Iso usc Ih" menu-driven 101l(h pad.

E .. y to Pow.1"-Th(! SO Touch"''''erl G"ug!! i. powe,ed by ~ ",ch~'9(!nbl/! Li · ION battc')', which pmv;,:Ie.

up to 60 hIS. of ""'lime. In addi tion, 1he gauge C¥I "'~ be powcrod by si~ ~Mndard M alk.:llinc batteries.. Ca. wr9Cf available.

GO'S--

Li-ION

n.., SD Gauge i$ "G"ipped with GPS, G 5 which koops track of Iho aClUa llocatioll P of your .eadings to ensure 1oc.:rliOlU and valid,ty of 10$11.

Blu. tooth E~bl.d_

The new SO 9"uge can connect to you. PC lordownloading lest .... ull$ via ilslJ1uetoolh wirel", .. I(!c hllclogy. No mol(! c"bles and gi'U()(!1 on your dcsl<.. lJ1uelOOlh provid(!s a reliabl" and seaJfe cornrmctlorl up 10 30 fce\.

USB Port-Tho, SO gauge also has a USU Slol, which provides a con .... ni"",1 way to Clt p1Ure tesl dal~ and Iilk/! i, wilh you, a. we ll as p1'ovide an /!~sy way to UP9.~de the gilUgO'S Irrmware . Firmware upgrades will be availilbl(! """ Ihe IIltemet lrom our websrl/!.

Euy Self Rep.ir_

The SD GaUQe'. mod\J1M design enable. it to be ,(l,vited in thc foeld by you, ,I Ileccs~.y,

No ne!!d to send the g~\Jye in lor repair, wo'll send yo;.. the ,wcossa')' oompoJ>\!'llI . ..... <1 w,,1k yotJ thtoogh any repair procedu ....

Moi.ture/Oansity Gaug_ HS-5001SD121 Me".ures 10 12" (300mmJ depth in I" (2SmmJ increments.

Moisture/Density Gaug_ HS·SOO1 SD122 Measuro. 10 12" (3OOmm) d~h in 2" {5OmmJ If>(;'emcnlS.

Mo!.ture/Oensity G. "g_ HS·5001S0081 M(!Jsures to 8 " (2OOmm) deplh in I" (25mm) inc.e,,,,,,,I5.

Moi.tur./o.n.ity Gaug_ HS-5001SD082 MI!~suros to 6' (2OOmml depth in 2 " (5Omml increments.

11579843

Humboldt HS·5001SD Nuclear Density Gauge -R. dlo.di .... M~t.rI.ls o.!ta ~!.d '!.d fo!: llc.n.~w~pp~!~atlon

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M'mU!fll"lellt Dep!h: 4-8" (100 kl2OO'rm1

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HS-SOO1EZ: Tme. Stability, Pawcr Supply S!ab;~ty: Power SGur.:.-

1iS·500ISO:

H$-SOOlEZ: p~ eon .... mplion­

HS·SOO1SD: IiS-SOOIEZ:

1FT,cob LQ)wi\h IH<k-ligh~ 16:'1, 480 . 212 piuI 4 __ x 20 ;oIphanurr.er ic .... 1 bKkI~ liquid crystal display

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Gauge. Rcfcw.nco Stomdatd. Source .lnd CO", CertifICation, WIpe Test Kit, Rod C;u;cic/Scrapcr Plate, Drill Pin, Four Potmd Hammill, Drill P,n hu"ctiorl Tool , Zippmoo Accc~o;ory Case, Tran$it Casc, Radiation Safety MJOII.'lI and Opc'al0'" Man lJ;ll.

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141o lS8"F HOlD 7O"Q ambieflt, 3(1"F 11WQ Op«aung Tornpcralllre: M3telOl,1 Surl~u

SIOIIIge Temperalu~:

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Shielding:

Post ,I'd F,,'me:

lrod.x Rod:

Top Shell:

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98'l1o withoot ~, R.in·l!emlanl Construdoon

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Comput .... M;IC~ined 6(161· T6 Ai...mum, Hard·eo_too Jnd Teflon ImprcgMlw

Compote< Mid>in.ed 6061, T6 Al.,mru:n,

Ancdiled for AnIlcono5lOn

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InjOOion-Mo\ded NorytWlth Integral Color

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15.75" x 8.1.6" x 5.5" (400 . 220 x 14Omm) IS" Of 21 ,S" (4500< 55Onvn)

1OIbs(l3.6kgJ

25" ~ 7.S" ~ 3" (350 x 200 ~ 7~m)

l!!,.lbsf1.Skg)

3'" ~ 14- . 195" (187 x3S6~ 495mrnI 31 ib.(11.6I<g)

197" • 9.S" x 5" (500 x 2SO ~ I25nmI 16 It>. (1.3tgl 'lQ1b. (41kgj

U.SA Toll Free: 1.800537.1118] Voice : 1.919.832 .6509

Fax: 1.919.833.528]

_ em!!l: hsi@~mbo~mfg .c,?",

Hill, Carol

From: Sent: To: Subject: Attachments:

Murnahan, Colleen Monday, January 28,20137:52 AM Hill, Carol FW: Amendment to License 50-29210-02 USNRC - License 50-29210-02 Amendment.pdf

From: Presler, Wendy [mailto:Wendy@designalaska.com] Sent: Friday, January 25, 2013 2:57 PM To: Murnahan, Colleen Cc: Rowe, John R; Robjn Christie (robin@advancedcalibration.com) Subject: Amendment to license 50-29210-02

Ms. Murnahan,

Attached is a request to amend our license (#50-29210-02) to include a second nuclear gauging device. Please contact me if you need more information.

Best regards,

Wendy Presler Land Ptann ing & Development Design Alaska. Inc. 60 I College Road Fairbanks, AK 9970 I (907)452-1 24 1 ext. 705

111.5 7 9843

NRC FORM 532 u. S. NUCLEAR REGULATORY COMMISSION (1-2012)

DATE

0 112812013

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

Design Alaska, Inc . AlTN: Linda L. Taylor Radiation Safety Oflicer 60 I Col lege Road, Fairbanks, Alaska 9970 I

50-292 10-02

MAIL CONTROL NUMBER

579843

LICENSING ANOIOR TECHNICAL REVIE'NER

,h

[(]

o

o

This is to acknowledge the receipt of your:

IZl LETTER andlor 0 APPLICATION DATED: 0 1/241201 3

The initial processing, which included an administrative review, has been performed .

IZl AMENDMENT 0 TERMINATION 0 NEW LICENSE 0 RENEWAL

There were no administrative omissions identified during our initial review.

This is to acknowledge receipt of your application for renewal of the malerial(s) license identified above. Your application is deemed timely filed, and accordingly, the license will not expire until final action has been taken by this office.

Your application for a new NRC license did not include your taxpayer identification number. Please fill out NRC Fonn 531 , located at the following link:

hllR :f1ww~9ov@Ming-rm/doc-conectiQns/fQrms/nrc531 . pdf

Send the completed NRC Form 531, by facsimile , to the following number: (301) 415-5387

A copy of your action has been emailed to our License Fee and Accounts Receivable Branch, in our Headquarters office in Rockvi lle, MD. You will be contacted separately if there is a fee issue involved.

Your application has been assigned the above listed MAIL CONTROL NUMBER. When calling to inquire about this action, please refer to this control number. Your application has been forwarded to a technical reviewer. Please note that the technical review, which is normally completed within 180 days for a renewal application (90 days for all other requests) , may identify additional omissions or require additional information. If you have any questions concerning the processing of your application, our contact information is listed below:

Region IV U. S. Nuclear Regulatory Commission DNMSINMSB - B 1600 E. Lamar Boulevard Arlington , TX 76011 -4511 (817) 200-1103 or (617) 200-1140

NRC FORM 532

(1 · 2012) Vt!J<Z!13

BETVVEEN:

Accounts Receivable/Payable

"d Regional licensing Blanches

r FOR ARPB USE J INFORMATION FROM WBL

Program Code: 03121 Status Code: Pending Amendment

Fee Category: 3P Exp. Date: 04130/2021 Fee Comments: Decom Fin Assu( Reqd: N

License Fee Worksheet - License Fee Transmittal

A. REGION

1 APPLICATION ATTACHED

ApplicantlUcensee: DESIGN ALASKA. INC.

Received Dale: 0112512013 Docket Number: 30384 13 Mail Control Number: 579843 license Number: 50-29210-02

Action Type: Amendment

2. FEE ATTACHED

Amounl :

Check No.:

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