2015 -09-30 13 :50 3rd Flr E x945 OPTIONA(. FOFIM 99 (7-!lO)

FAX TRANSMITTAL # o1 P391l• ... I o

Mr. Torres,

443-861-9965 >> 81 7200121 0 p 1 . /vi CtJ6t : 316-7!1 tttw-: °*1-c 7 Of{;;

30 Sep 15

Enclosed are amendment requests for NRC License Nos. 30-12350-01 and Sub-734. Both request a change in RSO. The requests are from the current license holder, Brigadier General Timothy Coffin.

Very respectfully,

,f]M!Uh u V'Al\o

GURVIS DAVIS U.S. Army Test and Evaluation

Command, Radiation Safety Staff Officer

~IE!l;IEOW/E~ SEP 3 0 2015 ~

DNMS PUBLIC

a Jmmedlate ~ Q/"Normal Releue

NON-PUBLIC 0 A.3 Sensltive-Seculty Rolated 0 A.7 Sensftivw fnllmal 0 Other:.~~---

Revfew: ~< Date:~~{/5

2015-09-30 13:53 3rd Flr E x945 443-861-9965 >>

DEPARTMENT OF THE ARMY . U.S. ARMY WHITE SANDS MISSILE RANGE

100 Headquarters Avenue WHITE SANDS MISSILE RANGE, NEW MEXICO 88002-5000

8172001210 p 11/19

TEDT-WST-SO . :'> "<., 2 April 2015 . lf c.,f<. . i1~ -OP

MEMORANDUM THRU Mr. Gurvi Davis, CSTE-~, U.S. Army Test and Evaluation Command, 2202 Aberdeen Soul vard--Third Floor, Aberdeen Proving Ground, MD 21005-5001

FOR Nuclear' Materials Licensing Branch, U.S. Nuclear Regulatory Commissio'n, Region IV1 1600 E. 'Lamar Boulevard, Arlington, TX 76011-4511

SUBJECT: Assignment of Radiation Safety Officer for Source Materials License 1 White Sands Missile Range, (WSMR) USNRC License SUB-734 (Request for Amendment · Thereto)

1. This letter notifies you that Mr. George R Cicotte has been appointed Radiation Safety Officer, upon the departure of Ms. Patricia Haworth, for USN RC License· SUB­

. 734, Docket 040-07086.

2. Mr. Cicotte's educatiori and experience are outlined in the enclosure.

3. Point of contact for this matter is Mr. George R. Cicotte, Radiation Safety Officer, Test Center Safety Office, White Sands Missile Range, NM (575) 678-4869 or (575) 678-5212. '

Encl. ~~k(.//L·

TIMOTHY . OFFIN '-T''­Brigadier eneral, USA · Commanding

PUBLIC Q fmmedlate Release rJ' Nonnal Release

NON-PUBLIC Q A.3 Sensitive-Security Relatld 0 A.7 Sensitive Internal ·a Other:~i-....----

(#}C - %W 6 Reviewer:

2015-09-30 13:53 3rd Flr E x945 443-861-9965 » 8172001210 p 12/19

u:s. NUCt.EAR REGULATORY COMMISSION APPRovgo BY OMB: Nd. 3180°0120 gX!>IRES: 05/0112016

APPLICATION FOR MATERIALS 'LICENSE

Estimated burd!ln per ~11¢1\:<I lo comply ~11h 11\1• ~elory collootlOn request 4.3 hours. ~Ullml lisl of Iha aPJlliO~llOn Ii neoes"ry lo deloimme lhat lhe •pfll/c3nl Is quaUned and 11\al adequele procMUtes exist lo protect lh• pubRo heillh and safely. Send commants regarding burden estlmelll lo Iha ~OIA, Prlvaoy, and lnlorrna!ion Collaciloll~ 611f!Ch {T-5 F53), U.S. Nuclear R&gulalllry CommiS!!on, WeshlMlon, DC 20555-0001, or by ln!emet a-mall lo lnfocollec!S.R•souioo@~.gov, eiid lo lhc 00$k O{!lcer, Oftlai of lnl011T1BtJon and Rsgula~IY Aff31~. Nt:OB-10202, ~160·0120), Oft1'1l or Mariagement and 9Ud9el. Washing Ion, DC 205-03. II a moan• U<ed lo lmpo;o an lnlormallon COllGcUon does no~ d~pl~Y a currenUy vsid OM~ control number, ll\Q NRC mey not oonducfor~p0n~or, end e p.mon Is not reqllirad to raspond to, lhe Information collcOllon.

INSTRUCTIONS: SEE THE: APPROPR!A1E LICENSE APPLICATION GUIDE FOR DETAILED INSTRUCTIONS FOR COMPLETING APPLICATION. S

0

ENO JWO COPIES OF' THE ENTIRE COMPL.ETED APPLICATfON TO THE NRC: OFFICE SPECIFIED BELOW. *AMENDMENTS/RENEWALS THAT INCREASE THE SCOPE Of' THE EXISTING LICENSE TO A NEW OR HIGliER FEE CATEGORY Will.. REQUIRE A !'EE.

A~~UCAT!ON FOR O!STRIBUTION Of i;XEMPT ?RODUCTe !'!LE APPllCA TION$ WftH:

or-r-IGE Or ~DERAL & STAlii MA'fERIALS AND E.NVIRONM~NTAL MANMoMENT PROGRAMS DIVISION OP MATi;RIALSSJ\l'ET'i AND STAiEAGREEMENre !J.$. NUCLEAR ReGULl\TORYOOMMISSION WASHINGTON, PC 2055S.0001

.ALL OTH~R P5R5QNS FIL~ APPLICATIONS AS POU.OW5:

IF you AR~ LOCATED IN:

At.AB.o;MA, CONNECT1CUi, Ol!LAWA)je, blSTF!lCT OF COLUM~IA, fl,O~IDA; GEORGIA, KENTUCKY, MAl!'lE, MARYl.Al'IO, MASSACHUSffiS, NE.W HAMPSHIRE, ~IEW JERS~V, NEW YORK, NORTfl CAROLINA, PS.NNSYLVANIA, PUERTO RICO, RllDDt !SLANP, SOUT~ CAROLINA, Tl'NNESSEe, VERMONT, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA,

Sf.NO APPLICATIONS TO;

LICENSING ASSISTANCE TEAM . DIVISION OF NUCLEAR MATERIAt.S $AFETY U.S. NUCLeJ\R REGUIATORY COMMISSION, RoGION I 2100 Ri;NAlSSAj\JQE llOUl.fVAAO. SUITE 100 KlNG 01' PRUSSIA, PA 194~713

IF YOU AR~ LOCA'l"EO IN:

ILLINOJS, lNDIANA, IOWA, MICH1~AN, MINNESOTA, MISaOUR!, OHIO, OR \lllSCONSIN, SENO APl'l.ICAflONS TD:

MATERIALS UCENSING BRANCl-l U.S .. NUCLEAR REGULAIOIW COMMISSIQN, ~GION ar 24-la WARRENVILLE ROAD, SUITE 210' LISLI<, IL 60532-4M~

ALASKA, ARIZONA, ARKMlSAS, CALll'ORNIA, COLORADO, HP.WAI!, !DAHO, KANSAS, LOUISIANA, MISSISSIPPI, MONTANA, N~~SKA, NI;VADA, NEW M5XIC0, NORTH , ' DAKOTA, Dj(LAHOMA, OREGON, PACIFIC TRUST1"RRl'l'ORIES, SOIJTH OAKOTA, TEXAS, UTAH, \llASHINGTON, OR WYOMING,

S2NO APPLICAilONS TO:

NUCl..fAR MATERIAi.$ LICENSING BRANCH U.S. NUCLEAR RoOUl.ATORY COMMISSION, REGION IV 1coo E. LAMAR BOUL~VAAD ARLINGTON, rx 7G011·4511

PERSONS LOCATl=:D IN AGR.l:EMENT STATES SEND APPLICATIONS TO THE U.S. NU CL.EAR REGUl.ATORY COMMISSION ONLY If' THEY WISH TO POSSE;SS AND USE J.JCENS!Ot:l MATE;RIAl IN SIATES SUJ:!JECTTO U.$.NUCLEAR REGULATORY COMMISSION.JURISDICTIONS.

1. THl_SISANAJ>PUl)ATION FOR (CMckopprw>liO/B/19m)

D A. N£W LICENSE

0 B. AMENDMl:NT TO LICENSE' NVMS~R

D c. RoN~WAL or- uo-oNse NVMBER .

SUB-734

3. ADDR"..SS WliERE uoeiseo MATERIAL IMLL a~ USED OR POSSOSSEO

At locations on White Sands Missile Range (WS11R.) designated by the WSMR Radiation Safety Committee,

i NAME ANO MAILJNG ADDROSS OFAPPLIOANT (lnclllfi• ZIP eo!!e)

Department of the Army Comn1ander, White Sands Iv.Gssile Range ATIN; CS!E-DTC-WS-ES-R White Sands Missile Rangc, New Me.i..."ico 88002-504&

4. NAM~ OF PERSON iO Ile CONTACTCD AeOUT THIS APPLICATION

George·R. Cieotte

SUSINl:SS TEt.~PHQNe NUMBi;R

(575) 678-4869

BUSINees EMAIL ADDRESS

george,r,ciootte.civ@mail.mil

BUSINE6$ CEUULAR TEU:PHoNe NUMBER

sUeMIT ITEMS 5THROIJGH 11 ON 5-1/Z xii" PAPER. THE TYPE; AND SCOPE OF JNFORMAflON TO BE PROVIDED IS DeSCRIBEO IN 1'HE LICENSE APPLICATION GUIDE.

6. RADIOACTIVE MATfl'l!AL :1. Elemonl Md m•°' mnnbsr.1>. ch<ml<iill 3!tllor pny;loil !brm; ortd c. msiXimum 8mounl

which wll1 ~o poos .. sed •I •l\Y ono lltM.

6. TRAINING F~ INDNIOUAI.$ WORl(JNG IN OR FRl:Q!J!;NTING RESTRICTED ARW.

10. RAO!A TION SAFETY PROGRAM.

1:1. l !CaNSE FEEB (!'ooo reqU!tl!d onJy ~rn111v app<leouoM, Wllh few •>«opUon:;') (See 100FR 170ond SO<lion 170.111)

6. PURP0$E{S) r-oR 'M-!ICfl LICENSED MAToRIAl. WILL BE usm 7. INDIViDUAL($) RE'SPONSIBL!: FOR RADIATION SAFe'TY PROGRAM AND THEIR

TRAINiN<> oXF'ERIENCE.

9. FACll.1Ttes AND EQUIPMENT.

11. WASTE MANAGEMENT.

NIA AMOUNT I ENCLOSED S o.oo

1a. Ci:RTIFICATION. (Melli/ b• comp/Bled by ~ppfltanl) THE APPLIOANT U{'JOERSTANDS THAT ALL BTATEMENrs AND Re>RESENTATfONS MADE< IN THIS APPUCATION ARE BINO/NIJ UPON TH: APPl.JCANt

THc APPLICANT ANO ANY OFFICIAL oXEOlJTIN13 THIS CERTIF!OATION ON al'HALF OF THE APl'UCANT, NAMED IN ITEM 2, CERTIFY THAT iHI$ AF'PLICATioN IS PRl;PAAEO IN CONl'ORMIT'f WITH Tino 10, CODE OF FEDERAL RE;GULATIONS, PARTS ao, ~ 33, 311, 3S '36, ~7. 39, AND 40, AND THAT ALL INFORMATION CONTANrn HEREIN IS TRUE /IND CORR~CI iO IHE BESTOFTHEIR KNO\'.\.EDGE AND BE\.IEF. WAllNING: 18 u.s.c. S1'CllON 1001 ACT OF JUNE ~5. l 945 62 STAT, r4!1 MA!<ES IT Ac RIMINA~ O~F2NSE TO MAKE A 'MLL!'ULLY FALSE ofATE™eNT OR REPRESENTATION TO ANY Dr;J>ARTMl:NT OR AGONCY OF THC UNITED STAT"..S AS TO ANY MATTeR WITHIN ITS JURISDICTION. '

Ci;RTll'YING OFFICER-"TYP£DIPRINTED NAME AflD TlnE DATe

Timothy R. Coffin, ~l'igadfor Gcnc!'al, USA, Conummding

NRC FORM 313 (03-2014)

&,589592.

2015-09-30 13:54 3rd Flr E x945 443-861-9965 » 8172001210 p 13/19

APPENDIX A

U.S. NUCLEAR REGULATORY COMMISSION

TRAINING AND EXPERIENCE RADIATION SAFETY OFFICER

1. NAME OF PROPOSED RADIATION SAFETY OFFICER 2. EDUCATION

George R. Cicotte Bachelor of Science in Physics

3. PROFESSIONAL/TECHNICAL CERTIFICATIONS

SPECIAL TY BOARD CATEGORY MONTH AND YEAR CERTIFIED

Haz.ardous Waste Operations 29 CFR 1910.120 02/1992

4. TRAINING RECEIVED JN BASIC RADIOISOTOPE HANDLING TECHNIQUES

CLOCK CLOCK HOURS OF

FIELD OF TRAINING LOCATIONS AND DATES OF TRAINING HOURS OF SUPERVISED ON LECTURE/ THE JOB

LABORATORY EXPERIENCE

A. RADIATION PHYSICS FOR MORE SPECIFIC DATES AND LOCATIONS, SEE TRAINING SUMMARY

AND 1) U.S. Navy Nuclear Power School, Mare Island, CA. (Feb-Oct 1975) l) 640 1) 2000

INSTRUMENTATION 2) U.S. Naval Nuclear Propulsion Training unit, SSG Prototype Reaaor, Nov 1975- 2) 200 2) 1700

Aue 1975 3) 100 3) 1000 3) u .s. Nuclear Reeulatory commission (see Training Summary, attilched) 4) 8 4) 200 4) Hellier Associates, New London, CT. Aug 1999

S) 6 5) 24 S) O•k Ridge Associated universities, oak Ridge, TN Sep 1988 6) schlumbereer, Houston, TX, Nov 1998 6) 8 6) 1000 7) MDS Norion, Inc., Montreal, QC, Canada Jun 2001 7) 8 7) N/A 8) Harvard School of Public Health, cambridee, MA Jun 1969 8) 8 8) N/A 9) U.S. Department of Energy, Hanford Site, Richland, WA, r.eb l992 9) 8 9) s 10) Ohio Department of Public Health, Columbus, OH. Mar 1998 10) 4 10) 8 11) u.s. Army Test & Eva lu~tion command, Aberdeen Proving Ground, MO Sei;> 11) 8 11) N/A

2014

B. RADIATION PROTECTION :I.), 2), 3), 4), 5), 6), 7), 8), 9), :10), 1t) Ibid. A. x 20% Ibid. A. x 20%

c. MATHEMATICS PERTAINING TO THE USE AND l), 2), 3), 4), 5), 6), 7), SJ, 9), 10), 11) Ibid. A. x 20% Ibid. A. x 20% MEASUREMENT OF RADIOACTIVITY

D. RADIATION BIOLOGY 1), Z), 3), 4), 5), 6), 7), 8), 9), 10), 11) Ibid. A. x 20% Ibid. A. x 20%

E. RADIATION DOSIMETRY 1), 2.), 3), 4), S), 5), 7), 8), 9), 10), ll) Ibid. A. x 20% Ibid. A. x 20%

(continued next page)

2015-09-30 13:54 3rd Flr E x945 443-861-9965 » 8172001210 p 14/19

APPENDIX A

RSO TRAINING AND EXPERIENCE, CONTINUED

s. EXPERIENCE WITH RADIOISOTOPES MAX.

CLOCK ISOTOPE QUANTITY LOCATION

HOURS TYPE OF USE

USED

14C, m1, ass, 22Na, S>Ni 15 mCi Lebanon Valley College so Laboratory

9osr, gov, 131 11 12911 210Bi, Portsmouth Naval Shipyard, USS Henry day 210Po, 50Co, ssco, mes, Naval nuclear propulsion

~'Cr, 4oK, 9H, 23su. 2l8u, SSBN 625, USS Dixon AS·37, USS Pigeon ASR-

reactor refueling, za9Pu, z~u, z1opb, ~c, >10 kCi 21, DSRV-1, DSRV-2, USS ARD-30 (floating >7,000

operations, maintenance, mixed fission and

drydock), USS Hunley AS-31, USS Proteus AS-and training

activation products 19, multiple

226Ra, z2sRa, 90Sr, 9oy1

241Am, 147Pm, 22Na, 69Ni, Commercial nuclear power stations: Commercial nuclear 109cd, l.9<ir, i33Ba, u°Th,

14C, 1251, 1311, 12~ 1 , 210Bi, Three Mile Island, Peach Bottom, Dresden, reactor operations and

21op0 , soco, ssco, n1cs, Quad Cities, LaSalle, Zion. maintenance, special

$'Cr, 4oK, 'H, usu, 13su, >10 kl.i DP.partrnl'lnt of En~rgy: >10,000 nuclear material SNM

z~Pu, 234LJ, 21opb, 99fc, Fernald, Hanford, Paducah, Portsmouth, Ames production facilities,

mixed fission and Laboratory, Sandia, Los Alamos, Pantex, environmental

activation products Battelle Columbus, others. remediation

226Ra, 22aRa, 3osr, gov, Commercial nuclear power stations: 241Am, 141Pm, 22Na, 6sNi, Seaver Valley, Hope Creek, Salem, Oyster Inspection and/or design lOSCd, 1921r, ll9Ba, B°fh, Creek, Davis-Besse, Cook, Fermi, Fort Calhoun, review of commercial and i~c, m 1, .,11, i<si, •10Bi, Grand Gulf, Palo Verde, Columbia, Duane research nuclear reactors,

21op0 , soco, ssco, mes, >10 kCi, Arnold, Limerick, Cooper, Peach Bottom, Perry, inspection and licensing sicr, 40K, 3H, mu, 23su, except Vogtle, North Anna, C;;illoway, Trojan, San of Agreement State 239Pu, 234u, 210Pb, 99Tc, soco >10s Ci Onofre, Diablo Canyon, Rancho Seco, Ft. St. >10,000 licensees (including 10

mixed fission products, 1921r 2 kCi Vrain, Saxton, River Bend. Research reactors: CFR 33 licensees),

reactor and Vallecitos, White Sands Missile Range, Hanford emergency preparedness

accelerator-produced B-, K·, and N·Reactors, EBR·2, DPR·l, evaluations, Sealed

activation products Humboldt Bay. Source and Device

Industrial and medical facilities throughout evaluations

Ohio 22SRa, 2~SRa, 90Sr, 90y, 241Am, 147Pm, zzNa, s~Ni, U.S. Air Force (USAF) bases (some since ioscd, m1r, msa, z30Th, deactivated}: 14c, 22s 11 131 11 12s11 210Bi, Scott AFB, McClellan AFB, Lackland AFB, ZlOPo, soco, seco, n~Cs,

>100 Ci Medina AFB, March AFB, Castle AFB, Randolph

>6,000 Environmental

s1cr, 4oK, 3H, 23su. z38u, AFB, Plattsburgh AFB, Hill AFB, Tinker AFB, remediation 2Mpu, BAU, 210Pb, 99Tc, Brooks AFB, McChord AFB, McGuire AFB, mixed fission and Robbins AFB, others. activation products

Uranium depleted in isotope 235U >999 kg All above except Leb;;inon Valley College. >20,000 All above

(continued next page)

2015-09-30 13:55 3rd Flr E x945 443-861-9965 » 8172001210 p 15/19

APPENDIX A

RSO TRAINING AND EXPERIENCE, CONTINUED

6. EXPERIENCE SUPERVISING USE OF RADIOISOTOPES MAX.

CLOCK ISOTOPE QUANTITY LOCATION

HOURS TYPE OF USE

USED

H6Ra, 22SRa, sosr, 90y,

mAm, 147Pm, ZZNa, 63Ni, 109cd, 192lr, 13>sa, 2s°Th, l4C, l~SI, m1, l291, l10Bi, Facilities of the U.S. Department of Energy, Z!OPo, 6oco, ssco, mes, U.S. Navy (USN), U.S. Air Force (USAF), U.S. As listed ins., above, plus Ster, 40K, aH, nsu, nsu, >10 kCi Army (USA), and other commercial, research, :04,000 training/mentoring of ~3~Pu, l34U, 210Pb, 9~Tc, medical, and industrial locations as listed in S., junior staff. mixed fission products, above. reactor and accelerator,produced ;;ictivation products

Uranium depleted in >999 kg All as listed in 5., above :04,000 As listed in 5., above

isotope mu

7. PRACTICAL EXPERIENCE ACTIVITY LOCATIONS EXPLANATION

Engineering L<iboratory Technician (ELT), Radiological Controls Shift Supervisor (RCSS), Health Physics Technician (HPT) commercial

PERFORMED SAFITT EVALUATIONS OF FACILITIES AND All as listed under 6., nuclear power, Radiation Safety Officer (Quadrex

EQUIPMENT OF PROPOSED USES above Health Physics Systems], Research Engineer [Battelle Pacific NW Laboratories], Consultant Engineer [Power Management Services], Reactor Technical Reviewer ([USNRC] Manual Chapter 1245), Health Physicist (HP) [various]

EVALUATED QUALIFICATIONS OF AUTHORIZED USERS NORM/NARM, byproduct, and accelerator-

AND INDIVIDUALS WORKING UNDER THE SUPERVISION Ohio Dept. of Health produced materi;;ils and reactor licensing and

OF AUTHORIZED USERS FOR PROPOSED USES (ODH), USNRC inspection; reactor design evaluations and

license reviews per 10 CFR 52.

CONDUCTED A LABORATORY AUDIT PROGRAM University of

+ RESEARCH AND DEVELOPMENT LABS Cincinnati, Procter & Licensing and inspection of Agreement State

• MEDICAL LABS- NUCLEAR MEDICINE, Gamble, lsomedix, licensees. ONCOLOGY, ETC. Syncor, others

MAINTAINED PERSONNEL MONITORING PROGRAM FOR DETERMINING EXTERNAL EXPOSURE

• SELECT APPROPRIATE DEVJCES All as listed in 6, ELT, RCSS, HPT, HP, Research Engineer,

• MONITORED EXPOSURE RECORDS above Consultant Engineer

• ESTABLISHED EXPOSURE INVESTIGATIVE LEVELS

MAINTAINED A BIOA$$AY PROGRAM FOR DETERMINING INTERNAL EXPOSURE

+ DETERMINED METHOD; Ibid IN-VIVO AND IN VITRO Ibid

• ESTABLISHED ACTION LEVELS Pl ~BLIC

• EMERGENCY FOLLOW-UP ACTIONS ~mmediatl' Relea:;e Normal Release

(continued next page) NON.PUBLIC Q A.3 Sensitive-Security ~

a A.7Se~ a Other:

-· ·--tti'I~~-·~· flftw' ----------------------~~~

2015-09-30 13:55 3rd Flr E x945 443-861-9965 >> 8172001210 p 16/19

APPENDIX A

RSO TRAINING AND EXPERIENCE, CONTINUED

7. PRACTICAL EXPERIENCE (continued) ACTIVllY LOCATIONS EXPLANATION

CALCULATED INHRNALAND EXTERNAL RADIATION All as listed in 6, ELT, RCSS, HPT, HP, Research Engineer, DOSES above Consultant Engineer

MONITORED AND MAINTAINED ABSOLUTE AND OTHER SPECIAL FILTER SYSTEM ASSOCIATED WITH THE USE, Ibid Ibid STORAGE, OR DISPOSAL OF RADIOACTIVE MATERIAL EVALUATED, SELECTED, DESIGNED, AND SUPERVISED MAINTENANCE OF PROCESS CONTROL AND

Ibid Ibid CONFINEMENT SYSTEMS, SUCH AS GLOVEBOXES AND HOODS,

PERFORMED SHIELDING EVALUATIONS, INCLUDING Ibid Ibid

DETERMINATION OF TYPE AND AMOUNT NEEDED

CALCULATED RADIOACTIVE DECAY, BUILDUP, AND Ibid Ibid

SECULAR AND TRANSIENT EQUILIBRIUM

EVALUATED, SELECTED, MAINTAINED, AND EFFECTIVELY USED RESPIRATORY PROTECTIVE Ibid Ibid EQUIPMENT

MAINTAINED A CONTAMINATION CONTROL PROGRAM

• AMBIENT RADIATION SURVEYS

• CONTAMINATION SURVEYS Ibid Ibid • AIR SAMPLING PROGRAM

• SEALED SOURCE LEAK TESTING

• SAMPLE ANALYSIS INVESTIGATIONS

• OVEREXPOSURES

• ACCIDENTS, SPILLS, LOSSES, THEFTS Ibid Ibid • UNAUTHORIZED RECEIPTS, USES, TRANSFERS,

DISPOSALS

• MiSADMINISTRATIONS CONDUCTED RADIATION PROTECTION TRAINING FOR FACILITY PERSONNEL

• AUTHORIZED USERS AND LAB WORKERS

• ANIMAL CARETAl<ERS

• NURSING STAFF Ibid Ibid

• INCINERATOR OPERATORS

• ANCILLARY STAFF

• SECURITY

• WASTE PROCESSORS/HANDLERS

DOE Hanford, OOH,

DEVELOPED RADIATION SAFETY MANUALS multiple commercial

Research Engineer, Consultant Engineer, RSO, HP nuclear power

facilities SELECTED INSTRUMENTATION ASSOCIATED WITH THE MEASUREMENT OF RADIATION

• SURVEY INSTRUMENTS (GM, ION CHAMBER, SCINTILLATION)

All as listed in 6, ELT, RCSS, HPT, HP, Research Engineer, above Consultant Engineer • COUNTING EQUIPMENT

• SPECIAL EQUIPMENT (DOSE CALIBRATOR, DIRECT READING DOSIMETER, AIR SAMP~ER)

(continued next page)

2015-09-30 13:55 3rd Flr E x945 443-861-9965 » 8172001210 p 17/19

APPENDIX A

RSO TRAINING AND EXPERIENCE, CONTINUW

7. PRACTICAL EXPERIENCE (continued) ACTIVITY LOCATIONS EXPLANATION

PERFORMED INSTRUMENT CALIBRATIONS All as listed in 6, ELT, RCSS, HPT, HP, Research Engineer,

above Consultant Engineer COORDINATED MATERIAL INVENTORY AND ACCOUNTABILITY PROGRAM

Ibid Ibid • MONITORED RECEIPT, USE, DECAY, TRANSFER, AND DISPOSAL

PERFORMED SHIELDING EVALUATIONS, INCLUDING Ibid Ibid

DETERMINATION OF TYPE AND AMOUNT NEEDED

CALCULATED RADIOACTIVE DECAY, BUILDUP, AND Ibid Ibid

SECULAR AND TRANSIENT EQUILIBRIUM

COORDINATED RADIOACTIVE WASTE DISPOSAL PROGRAM

• EFFLUENT MONITORING

• COLLECTION Ibid Ibid

+ TREATMENT

+ PACKAGING

• DISPOSAL PREPARED RADIOACTIVE PACKAGES FOR

Ibid Ibid TRANSPORTATION. DEVELOPED AND MAINTAINED A FACILITY EMERGENCY PLAN FOR RESPONDING TO RELEASE OF RADIOACTIVE Ibid Ibid MATERIAL

DETERMINED NEED FOR FINANCIAL ASSURANCE FOR All as listed in 61 Research Engineer, HP DECOMMISSIONING. abov~exceptUSN · DEVELOPED AND MAINTAINED DECOMMISSIONING

Ibid Research Engineer, HP FINANCIAL ASSURANCE FUNDING PLAN. PREPARED RADIOACTIVE PACKAGl:S FOR Al l as listed in 61 ELT, RCSS, HPT, HP, Research Engineer, TRANSPORTATION. above Consultant Engineer DEVELOPED AND MAINTAINED A FACILITY EMERGENCY PLAN FOR RESPONDING TO RELEASE OF RADIOACTIVE Ibid Ibid MATERIAL

8. PROFESSIONAL ORGANIZATIONS HEALTH PHYSICS SOCIETY, PLENARY MEMBER, 1986-present

9. AWARDS, SCIENTIFIC PRESENTATIONS AND PUBLICATIONS Awards:

Letter of Commendation, Radiochemistry Program, 1979, USS Hunley AS-31

Letter of Commendation, Dosimetry Program, 1979, USS Hunley AS-31

Letter of Commendation, Engineering "E," 1980, USS Hunley AS-31

Letter of Commendation, Navy Battle "E," 1980, USS Hunley AS-31

Meritorious Unit Commendation, 1980, USS Hunley AS-31

Civilian of the Quarter, 2005 Q4, U.S. Air Force Institute for Operational Health and Brooks City-Base

Performance Award, FY201S, U.S. Army Test & Evaluation Command, White Sands Missile Range

(continued next page)

"158 95 92

2015-09-30 13:56 3rd Flr E x945 443-861-9965 » 8172001210 p 18/19

APPENDIX A

RSO TRAINING ANO EXPrnlENCE, CONTINUED

9. AWARDS, SCIENTIFIC PRESENTATIONS AND PUBLICATIONS (continued)

Scientific Presentations:

Strom, Daniel J.; P.S. Stansbury; S.W. Porter Jr. 1995. Conflicting Paradigms In Radiation Protection: 20 Questions With Answers From The Regulator, The Health Physicist, The Scientist, And The Lawyers. PNL-SA-24763 . Presented at the Health Physics Training and Education Conference, January 29 - February 1, 1995, Charleston, South Carolina. Pacific Northwest Laboratory, Richland, Washington.

Strom, Daniel J.; R.L. Hill, J.S. Dukelow, and G.R. Cicotte. 1993. Probabilistic Descriptions of Human Interactions with Radiation Sources Based on Historical Accidents. PNL-SA-22651-A, presented at the Society for Risk

Analysis Annual Meeting, December 5, 1993. Society for Risk Analysis, Atlanta, Georgia.

Stoetzel, Gregory A., G.R. Cicotte, T.P. Lynch, and L.K. Aldrich . 1991. Evaluation of workplace air monitoring locations. Conference Proceedings, Hanford Symposium on Health and the Environment: Current Topics in Occupational Health, Richland, Washington, 29 Oct - 1 Nov 1991. PNL-SA-20058, Battelle Pacific Northwest Laboratory, Richland, Washington.

Cicotte, George R. and R.D. Mogle. 1995. Mitigation Factors Determination at Department of Energy Sites for Safeguards and Security Purposes. February 1995. Presented at the DOE Office of Safeguards and Security Issues Annual Meeting, February 7, 1995, Albuquerque, New Mexico.

Cicotte, George R. 2007. Benefits and Pitfalls of the Historical Site Assessment. Proceedings of the 40th Mid-Year Topical Meeting of the Health Physics Society - Decontamination, Decommissioning, and Environmental Cleanup. January 2007. Knoxville, Tennessee.

Publications:

Cicotte, George R.; and GA Stoetzel. 1993. Task 5: Clean-up Standards for Rocky Flats Plant D&D Projects. PNL-8788. August 1993. U.S. Department of Energy Rocky Flats Office (DOE-RF), Golden, Colorado.

Hickey, Eva E., G.A. Stoetzel, D.J. Strom, G.R. Cicotte, C.M. Wiblin, and S.A. McGuire. 1993. Air Sampling in the Workplace, NUREG-1400. September 1993. U.S. Nuclear Regulatory Commission, Washington, DC.

Munson, Leo H., G.R. Cicotte, E.E. Hickey, T.J. Froehlich, P.C. Olsen, and G.A. Stoetzel. 1991. Guidance for Contamination Control at DOE Sites. Pacific Northwest National Laboratory, Richland, Washington.

Rademacher, Steven E., [Lt. Col. USAF], J.L Hubbel [1st Lt. USAF], and G.R. Cicotte. 2007. Boeing Michigan Aeronautical Research Center (BOMARC) Missile Shelters and Bunkers Scoping Survey Workplan. August 2007. IOH-SD·BR·SR-2007-0001, Headquarters, Air Force Safety Center, Kirtland Air Force Base, Albuquerque, New Mexico.

Stoetzel, Gregory A., and G.R. Cicotte. 1994. Evaluation of Air Flow Patterns in K-East and K-West Fuel Storage Basins. Letter Report dated September 29, 1994, frorn G.A. Stoetzel and G.R. Cicotte [Pacific Northwest National Laboratory, Richland, Washington] to S.S. Lewis [Fluor Hanford, Inc., Richland, Washington] . Pacific Northwest National Laboratory, Richland, Washington.

Stoetzel, Gregory A., G.R. Cicotte, TP. Lynch, and L.K. Aldrich . 1996. A Method for Evaluating the Adequacy of Workplace Air Sampling and Monitoring Locations. Article in Applied Occupational and Environmental Hygiene, Vol. 11, No. 4, pp 398-403. April, 1996. American Conference of Governmental Industrial Hygienists, Cincinnati, Ohio.

(continued next page)

NRC FORM 532 (1 -2012)

U. S. NUCLEAR REGULATORY COMMISSION

DATE

1211612015

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

SUB-734 Department of the Army Commander MAIL CONTROL NUMBER

ATTN: CSTE-DTC-WS-ES-R 589592 White Sands Missile Range, New Mexico 88002-5048 LICENSING AND/OR TECHNICAL REVIEWER

D D

D

CH

This is to acknowledge the receipt of your:

[{] LETTER and/or [{]APPLICATION DATED: 04/02/2015

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

D AM ENDMENT D TERMINATION D 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 material(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 NRG license did not include your taxpayer identification number. Please fill out NRC Form 531, located at the following link:

http://www. n re.gov /read ing-rm/doc-collections/forms/n rc53.1,Qdf

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

A copy of your action has been emai led to our License Fee and Accounts Receivable Branch, in our Headquarters office in Rockville, MD. You wi ll 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 DNMS/NMSB - B 1600 E. Lamar Boulevard Arlington, TX 76011 -451 1 (817) 200-1103 or (817) 200-1140

BETWEEN:

Accounts Receivable/Payable and

Regional Licensing Branches

[ FOR ARPB USE] INFORMATION FROM WBL

Program Code: 11220 Status Code: Pending Amendment Fee Category:2F Exp. Date: 08/31/2013 Fee Comments: NOT SHIELDING Decom Fin Assur Reqd: N

License Fee Worksheet - License Fee Transmittal A. REGION

1. APPLICATION ATTACHED Appl icant/Licensee: ARMY, DEPARTMENT OF THE

Received Date: 09/30/2015 Docket Number: 4007086 Mail Control Number: 589592 License Number: SUB-734

Action Type: Amendment

2. FEE ATTACHED

Amount:

Check No.:

3. COMMENTS

Signed: LlJJ~L Date: J~/Jb.k

B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered

1. Fee Category and Amount: ~~~~~~~~~~~~~~~~~-

2. Correct Fee Paid. App lication may be processed for:

Amendment:

Renewal :

License:

Signed:

Date: