title: iound4 u city date i 700152 ]apko roofing … · 2012. 12. 5. · i 700152 ]apko roofing...

Title: IOUND4

Descrfption:I;TARTING MAY 8,2006

Rec. Code Reclpient Name IHeld Proces.Pint•ed, City St.I Anniv. I Letter Date _1 Fee Catego CdI Fee | D§ate, Recwd CI 700152 ]APKO ROOFING PRODUCTSINC I U UIOP -l oQ pL.

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ITAIMKO IROOFING PRODUCTS

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May 26P, 2006

US Nuclear Regulatory CommissionAttn: Accounts Receivable Team, OCFOMail Stop T-9 E1OWashbaotion0C 2G0-566 4M ~ .lM3 ZIZ

RE: 2006 Annual General Ucense RegistrationGeneral Ucense Number GL-700152-7TAMKO Roofing Products, Inc.

To Whom It May Concern:Attached are theannual registration forms for the nuclear devices located at our facility

at.()7)F Please note that TAMKO Roofing Products, Inc willa t~i~b.>! .!F . ....... ..................................................... .. ...... .. ...... .... . . l a e n t h t T M O R o i g P o u t , ] c w lofficially change Its name to TAMKO Building Products, Inc, effective June 16, 2006. Thischange has been noted on the form as well.

If you have any questions or concerns, please contact me at (417) 624-6644 extension3500 or Ron Kelley, extension 3467.

Sincerely

C. Robert Findley

General Plant Manager

Enclosures:

Copy: R. Kelley, S. Szczepanik, B. Hockman

601 N. HIGH STREET P.O. BOX 1404 JOPLIN, MO 64802-1404SALES 417-624-6644 MANUFACTURING 417-624-2114 FAX 417-624-2114

I JlilnlilI ! 1111111f11111 1111i 111i1 11111 ~ii i 1111 !!1 i ll iiiH 111111!111 iHiiiiil Ilil IIIII lII I!1 IliSECTION 1

PAGE 1 of 2U.S. NUCLEAR REGULATORY COMMISSION

05/15/2006

NRC FORM 66402- 200410 CFR 31.5

JUIA 14 UiS

GENERAL UCENSEE REGISTRATIONAPPROVED BY OMB: NO. 3150-0198 EXPIRES: 02=12'=007Estmlted bden per rwspom.ea muryAtith Wet mudxy •dlain reuIt: 2D mlla NRu w. N en •s waioGntIo bt rac d genra inwo fhr d*.m. Isrmwe 0hIhwIleel d dwkm accutnthlly. Swd cnwmWs dng buwd. nsm.lo Wolhe Rscb mdFOlUVPdvwy Surim Branh (T-5 F54, U.S Nued ReogUly Carrriaa, Wallirglo.DOC 2=6.001. o by IW l ern,,, i Wh•'[email protected] io ihee O fit 0erw. Office d Inb anm and Rwulnay Ntre. NtOO.-1020 (315XD0)1=. of lo.@ Mwm unt andIBud~i, WuI•rgtw,, OC 205[•. mmn Lmed to h enh nlm~Mn cdllecindo dam nodislay a wmry valid OKb ontrd muwbm. ft WC ay mtcand w • s ar. md aern bil rol reaulrgd brwemmtha lhekdarmallae oadhom

Complete all six sections of this registration form. If any of the preprinted Information Is Incorrect, provide thechanges In the applicable boxes. USE CAPITAL LETTERS.

General LicenseRegistration NumberGL-700152-7

SECTION 1 - GENERAL LICENSEE INFORMATION

Enter the company name and the street address/physical location of use for your device(s). Forportable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: TAMKO ROOFING PRODUCTS INCITI AI MIK10ol I Bl IU I LI l, I 1 Ile I I lROl lD-I l-I, : .Department:

Address U ne 1: . ....................

Address Une 2:

City:.... .. .... ...... ...

1 1111 111 11 1111 111 1111111

State: MO iI Zip Code: (b)(7)(F) ... LLE. -EI IIýForNRC -"se Onlye& F]'(Do not write here) a- Y,

" Packet Receipt ate (M.MD.DY0:0

- ..AccessionN, Nber:

tli a

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,t 111111111111111111111111 lii Il lii I!1 I11111 l l 111111111 ll M I 1111 I11I11111 IIIi I I!i i!1GL-7O0152-7 SECTION 1o05r~o PAGE 2 of 2

SECTION I - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, telelphone number and title of the person who Is the responsible Individual for the devlce(s).

Last Name: KELLEY

IFK.TI IblLIe•I 1 I I I I I I 1 1 1 1 1 1 1 1 1First Name: RON Middle Initial:ICI jRjolBI•I,-jrjT I I I I I 1Telephone: (417) 624-6644 Extension: 3467

ZELJ LWILTitle: GENERAL MFG MANAGER

Enter the mailing address where correspondence regarding your device(s) should be sentThis address should be specific to the use or storage location of your device(s).

Department:

(b)(7)(F)

Address Une 1: _. .. . ... .

Address Une 2:

State: MO I ] Zip Code:: II [IIII III•'-,°.~~~ ~~ ... ...... z. .........Ll U i I I

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Ill lIIIIIIIIIIIIIII IIiHII11111II111111I1111I I1111I1111 IIIII 11111 liii I ii1IMI111 ll 11I1I I1II 1111 li'GL-700152-7

005/120oM SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2Our records Indicate that you have these devices. Please update the Information as necessary. PAGE I of 6

NRC Device Key 714195 (Internal Control Number)

Distributor/Distributed By. NDC INFRARED ENGINEERING INC

Distributor License Number 1933-19GL

I -- I , 1 1 1 1 1 1 1 1 1 1 IManufacturer Name: NDC INFRARED ENGINEERING INC

I I I I I J I II I I I I I I I I I JII I I IDevice Model (Not Source Model): 301

Device Serial Number(b)(7(F)

(b(•>7)(F . .... .... ....)

Transfer Date (Receipt Date): 12/28/1999

MM DD YYYY

Not In possession of device0 (Also complete Section 4.)

Isotope (e.g. AM241)

-b)(7)() -

'LIED2

3

4

5

6

WI lLI

Activity (e.g. 100)

'(b)(7)(F) ............. i.... J

I I I I I I II II I I I ]

L I'1-T I I I I~ i I I J1 ! I I

..I I t I 1 -1 1 1 1 1 1 1

Unit (e.g. mCi)i(b)(7)(F)

EIIIIJ

A A

11111111 111111 1i11111111111111111!1111 m I 111111I I11 11111111 III111 I11 1I4GL-700152-7o0/1s2o SECTION 2 - DEVICES SUBJECT TO REGISTRATION SE4

Our records Indicate that you have these devices. Please update the Information as necessary. PA(


Distributor/Distributed By:. OHMARTNEGA CORPORATION

Distrbutor Ucense Number 34-00639-03G

Manufacturer Name: OHMARTNEGA CORPORATION

Device Model (Not Source Model): SH-F1

Device Serial Number,(67)(?•)F-

Transfer Date (Receipt Date): 02/15/1995Not In poessulon of device

S0 (Also complete Section 4.)

MM DD YYYY

II111111111CTION 2

E 2 of 6


2

3

4

6

EIW1 J11

Activity (e.g. 100);(b)(7)(F)

Unit (e.g. mCI).(b)(7)(F)

I IIII

IL!1]ILIIIILiLJ1Ji lILJELLEI

I II 1 I1 1 I I II III 111 I I I I II

I 1 11 ! 1 I I Im

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I 1111111 1111111 1111 1!1111 11111 11111 11111 11li i 111 1 iii I llUIIIIii I 11111111 I~ii IIIII lIii lIII II!1•GL-7'00152-7

051¶5/2o6 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2Our records Indicate that you have these devices. Please update the Information as necessary. PAGE 3 of 6


Distributor/Distributed By. OHMARTNEGA CORPORATION

Distributor License Number. 34-00639-03G


Device Model (Not Source Model): SH-F1

Device Serial Number i~b)(7)(F)

Transfer Date (Receipt Date):01115/1995Not In pouesslon of device

0_(AJso Complete Section 4.)

MM DOD YYYY

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)(b)(7)(F) . (b)(7)(F) .(b)(7)(F)1 ........ .... .... ..... .. . ................... .................. .... .............................................. ........... ... ..... . , ,. ..

2

3

L I' 1,1 11 171' I4

5

1 1~l T LLIIIJIJ. 1 16

DIILL IIZEIII DIE

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InaliilMI il1111 1 111111111!111111111111II I11 III 1111111111! Ulii IIMn Iii m IIi 11 In! 111111•GL-700152-7

o0nar0ooe SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2Our records Indicate that you have these devices. Please update the Information as necessary. PAGE 4 of 6


Distributor/Distributed By: OHMARTNEGA CORPORATION

Distributor License Number: 34-00639-03G


Device Model (Not Source Model): SH-F1T -1 ll li iIi l I I I 1 1 1l 1 11 1Device Serial Number:.(b)(

7)(F)

Li~ ~ ~~" .............. -L II IIIII IIIII IIII I

Transfer Date (Receipt Date): 07/1511993Not In possession of device

T] ' (Also complete SecIon 4.)

MM DD YYYY

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)

2 DJLLJl3 ZEIZEDI4

5

6 WILDll

I.I7)(F........

.................... .......... .......

I T I -I I_1 1. 1 1 1 1 ILI T I I I I I -II I I I I I

:(b)(7)•

LIIn

LEEI

EIli1L~~~ I I-T I I I I I I I I

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I .l~ill !11111 1111111111111111111111i1111!111 ili111 (llIil ~lIl I I III I1 111 Jl1!1 NiI•GL-7001W2-7

o.ns/2ooe SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2

Our records Indicate that you have these devices. Please update the Information as necessary. PAGE 5 of 6


Distributor/Distributed By:. FIFE Corporation

* Distributor Ucense Number: 35-15511-03G

Manufacturer Name: FIFE CORPORATIONI I I I I I I I I III I IlIlI IlIlI I I I I IDevice Model (Not Source Model): 8600

Device Serial Number:..b)( .....

Transfer Dale (Receipt Date): 01/15/1983Not In possession of device(Also complete Section 4.)

MM DD YYYY

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCD)1 b( __ t___ ...... , .(b)(7)(F) (b)(7)(F)

2

3 • ~~I TTI I -I I I. I I I U

4

5 I L I TT I I I1 11 1 1=I I

6

IIL J I TIW I I I I I=

A A

I illlIi11111 1111 1111111 111lI!11 11111 11111111 !1111 Uli 11111lII~i IIII I 11i1111 II! 11 i ii liIii•GL-700152-7

05/152r06 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2Our records Indicate that you have these devices. Please update the Information as necessary. PAGE 6 of 6


DistributorlDistrdbuted By: BARBER-COLMAN COMPANY

Distributor License Number: 3G-044-02L I I I I I I I I I I I IIManufacturer Name: BARBER-COLMAN COMPANY

LI- II I I I I I I II I III III I~l I 1I I IIDevice Model (Not Source Model): 015202

Device Serial Number.(b)(7)(F)

Transfer Date (Receipt Date): 05/15/1985Not In possession of deviceq 5• tl 1 1 (Alo complete SecUon 4.)

MM DD YYYY

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)T _b_)(7)(F) l(b)(7)(F)

21 i L I T I Ii I I I I iI F J

3

SI I l I I I I I I1 I I4 i~I- I i I l' lI I I I I I 1 I 1Ii5

II I JI I D 1 1 1I D 16

I TI I I I I I I I 1

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"'I Ilill!!iif iiii 1111 111111 11111 11111 1111 i ii 11H1 liii lliii I I~1111111 1 iii ! 1111GL-700152-7

o01riooe SECTION 3SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1

Provide Information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name

Initial Transferor Name

Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number

0 Manufacturerfinitial Transferor listed aboveHow acquired and date (e.g.,from a distributor/manufacturer, 0 Other General Licensee Date Transferred: F FT1 F___T1other licensee, other source)? I I ..

U Other Source (Received) MM DD

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.


ILIIIIIBLLLE_

ILIILII

LIEIIII

Activity (e.g. 100)LILLBIIIBIIIE

BEIII[ILLIBELL:ri-IZ

. . . . I ! a

m I I I . . . .

B I E B B I E I

YYYYUnit (e.g. mCi)

Bill

LIlli11111WIJI

. . . . | , m - =

• " " = " I I I

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111111!i 111111 11111111 11111 11111 11111 11111U llnl 1I1I11111111 111111111 iii 11111 III1 11111111GL-700152-7 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 405/15/2008

Provide Information about devices listed In Section 2 or 6, but no longer In your possession. PAGE 1 of 1

Part I Transfer Date:

NRC Device Key.I[]I II I I I(from Section 2 or 6)

MM DD YYYYLocation of the Device:

O Whereabouts Unknown (complete Part I only) 0 Transferred to another general licensee (complete Parts 2 and 3)

o Never Possessed the Device (complete Part I only) 0 Transferred to a Specific Licensee (Not the manufacturer)

O Returned to Manufacturer (complete Part 1 only) (complete Part 2)

Part 2 License Number of Recipient (if transferred to a specific licensee):L[ I II I I II I ICompany Name:

Deparm I etI I:1I I II I I I Ilt I IDepartment:

I111111I111 1 1111 111 IIIII I I[I II

Address Line 1:

Address Line 2:1 1. 1 1 1 1 1 1 1 1 1 1 1 1 1 " 1 1 1 1 1 1 1 1 1 I F -City.

State: [_LJ Zip Code: [ILi_] - LI__LJPart 3 Enter the name of the Individual responsible for this device:

Last Name:

E L I I I I I I I I I I I1 1 1I I I I I I I ! IFirst Name: Middle Initial:

I o I In I I I II_ I I I I I 1 1 • " : 1 -_JI 2_Telephone Number~ III III 1111 Extension:E III]Title:1111111I IIII IIIII 1.111111111111 II

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1011 11111111111111 11111ll 11I1I 11111 I 1111 11111 Illiii111 IIllIi Iliii I 11l1111l (IlIIll ll li 1ll11GL-700152-7 SECTION 5 - CERTIFICATION SECTION 5o51/•5oo PAGE 1 of 1

I hereby certify that:

A. All information contained in this registration Is true and complete to the best of my knowledge and belief.

B. A physical inventory of the devices subject to registration has been completed, and the device Information on

this form has been checked against the device labeling.

C. I am aware of the requirements of the general license, provided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http:/Awww.nrc.gov/reading-rdoc-collections/cfr)

SIGNATURE - RESPONSIBLE INDIVIDUAL In Section 1) DATE

WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC

REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL

MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A W ILLFULLY

WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED

STATES AS TO ANY MATTER IN ITS JURISDICTION.

A A

I 11111111 Ilil 1111 lIIII IIFI liio5•f•2Moo SECTION 6 - DEVICES NOT SUBJECT TO REGISTRATION SECTION 6

PAGE 1 of 1

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title: iound4 u city date i 700152 ]apko roofing … · 2012. 12. 5. · i 700152 ]apko roofing...

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