t[,~,t·~ SIMS ~~ METAL

MANAGEMENT

November 1, 2018

234 Universal Drive North Haven, CT 06473

Director, Office of Nuclear Material Safety and Safeguards ATTN:GLTS U.S. Nuclear Regulatory Commission Washington D.C., 20555-0001 Attn: Katie Wagner

Dear Ms: Wagner,

Telephone 203-782-4250 Facsimile: 203-782-4272 scott.jacobs@simsmm,com

Enclosed is General Licensee Registration Form for my company. We have transferred the two Am242 sources for which we were covered under this general registration to Thermo Scientific for ultimate disposal. At this time we will no longer need to be covered under the license.

Included are two emails from Thermo Scientific acknowledging receipt of the devices and accepting ownership.

If there are any questions or additional items that my company needs to address do not hesitate to contac me directly.

Scott Jacobs ~ Regional SHEC Director

Sims Metal Management

GL • I 1 I ii ii 41 3171 . [ili] Date 11/1/18

NRC FORM 664 (01-2018) 10 CFR 31.5

SECTION 1 PAGE 1 of2

U.S. NUCLEAR REGULATORY COMMISSION

GENERAL LICENSEE REGISTRATION

APPROVED BY 0MB: NO. 3150-0198 0MB EXPIRATION DATE: 02/28/2019

Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability. Send comments regarding burden estimate to the Information Services Branch (T-2 F43), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to lnfocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs,

NEOB-10202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

Complete all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION

Registration Number

GL ·I 1 I 1 I 1 141 3171 · Cil:il Enter the company name and street address for the physical location of use for the device(s). For portable devices, specify the primary storage location. Do not use P. 0. Boxes.

Company Name:

Department:

I -I Address Line 1:

Address Line 2:

I I I I

City:

INlolRITIHI IHIAlvlEINI I I I I I I I I I I State: rn Zip Code: 10 I 6 4 I 7 I 3 I - I I I I I

,,,- ~

For NRC Use Only .. (Do no,t write here)'.·'

Cat~go!'Y: : CG] · , I

Packet Re~eipt .i::iate. (MMDDYYYY)'

, . · A'ccession Ntim§er

Date 11/1/2018 SECTION 1 PAGE2of2

SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, telephone number, and title of the person who is the responsible individual for the device(s).

Last Name:

I I I I I I First Name: Middle Initial:

D Business Telephone Number: Extension:

I I I I Title:

I I Enter the mailing address where correspondence regarding your device(s) should be sent. This address should be

specific to the physical location where the devices are used and/or stored.

Department:

I I I I I I I I I I I I I I I I I I I I Address Line 1:

I Address Line 2:

I I I I I I I I I I I I I I I I I I I I I I I I I I I I City:

INlolRITlttl lttlA!vlE!NI I I I I I I I I I I I I I State: [ili] Zip Code: I o I 6 ! 4 ! 7 I 3 I - I I I I I

SECTION 2 Date 11/1/2018

SECTION 2 -DEVICES SUBJECT TO REGISTRATION PAGE 1 OF

Our records indicate that you have these devices. Please update the information as necessary.

NRC Device Key 730682 (Internal Control Number)

Distributor/Distributed By: .

Distributor License Number:

lsl31-lol3lslsl I I I I I 11 Manufacturer Name:

Device Model (Not Source Model): .

I X I L I p I 8 I l I 8 I Q I I I I I I I I I I I I I I I I I I I I -I I I I Device Serial Number:

I 1 I 2 I 3 1 3 1 I· I I I I I I I I I I I I I I I I I I I I I I I I I

Isotope (e.g., AM241) Activity (e.g., 100)

1.

2.

3.

4. I 5.

6.

[Z] Not in possession of device (Also complete Section 4)

Unit (e.g., mCi)

Im IC I i I

I I

SECTION 2 Date 11/1/2018

SECTION 2- DEVICES SUBJECT TO REGISTRATION PAGE 1 OF

Our records indicate that you have these devices. Please update the information as necessary.

NRC Device Key 730682 (Internal Control Number)

Distributor/Distributed By:

Distributor License Number:

lsl31-lol31slsl I I I I I I 11 Manufacturer Name:

Device Model (Not Source Model):

I X I L I p I 8 I l I 8 I Q I I I I I I I I I I I . I I ·I I I I I I I I I I I Device Serial Number:

I 1 I 2 I 2 I s I I I I I I I I I I I I I I I I I I I I I I I I I I I [Z] Not in possession of device (Also complete Section 4)

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

1.

2.

3. I 4.

5.

6.

GL. I I I I I I I . [I] Date

SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION

SECTION 3

PAGE 1 OF

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

Manufacturer Name

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor Name

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor License Number (if known)

I I I I I I I I I I I I I I I I Device Model Number (Not Source Model)

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I .I Device Serial Number

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I How acquired and date (e.g., from a distributor/ manufacturer, other licensee, other source)?

0 Manufacturer/Initial Transferor listed above

0 Other General License Date Transferred: rn rn I I I I I 0 Other Source ·

MM DD YYYY

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

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

I I I I I I I I

I I I I I

GL • I 1 I 1 I ii 41 3 I 1 I - Cill] Date 11/1/2018 SECTION 4 - NOT IN POSSESSION OF DEVICE

Provide information 'about devices listed in Section 2 or 6, but no longer in your possession.

Part 1 Transfer Date

NRC Device Key (from Section 2 or 6)

Location of the Device:

730682

0 Whereabouts Unknown (complete Part 1 only) 0

Transferred to another general licensee (complete Parts 2 and 3)

SECTION 4

PAGE 1 OF

0 Never Possessed the Device (complete Part 1 only)

Q Transferred to a Specific Licensee (not the manufacturer) (complete Part 2)

@ Returned to Manufacturer (complete Part 1 only)

Part 2

License Number of Recipient (if transferred to a specific licensee)

lslsl:lol213181 I I I I I I I I Company Name:

jTjHjEjRjMjoj !s!c!r!EINITlrlFlrlcl Department:.

I I I I I I I I I I I I I I I I Address Line 1 :

Address Line 2:

I I I I I

I I

I

I I I I I I I I I I I I I I I I I I I I I I I I I I I I City:

!T!EjwjKjsjB!u!RIY! I I I I I I I I I I I I I I I State: [;Q Zip Code: ! O I 1 ! 8 ! 7 ! 6 I - ! I ! I !

Part 3 Enter the name of the individual responsible for this device.

Last Name:

I , I I I First Name: Middle Initial:

,.---1 ..--, r .....--, M"""T"'""I --.-, --r-1 --.-,-,,............,., -.--I ""'T"""I --.-, --r-, --.-1-, ............ , D Business Telephone Number: Extension

!8lo!'ol- !8l1!s!· !1ls!1!8! I I I I Title

I I I I I I I I I I

GL. '711 I ii 4 '311 I " [ili] Date 11/1/2018

I hereby certify that:

SECTION 5 - CERTIFICATION

SECTION 5 PAGE 1 of 1

A.

B.

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

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 generai license, provided in 10 CFR 31.5. \~Copies of applicable reg~lations may be viewed at the NRC Web site at www.nrc.gov/reading-rm/doc-collections/cfr/)

11/1/2018

SIGNAT E - RESPONSIBLE INDIVIDUAL (Listed 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

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

UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

SECTION 6 GL- I I I I I I I -DJ PAGE 1 OF

SECTION 6 - DEVICES NOT SUBJECT TO REGISTRATION Date

NRC Device Key: I Manufacturer License No.:

Manufacturer Name:

Model Number: I Serial No.: Transfer Date: I Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

NRC Device Key: l Manufacturer License No.:

Manufacturer Name:

Model Number: I Serial No.: Transfer Date: I Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

NRC Device Key: I l Manufacturer License No.:

Manufacturer Name:

Model Number: l Serial No.: Transfer Date: I Isotope: Activity: I I Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: Activity: Unit:

Isotope: _J Activity: Unit:

',

GL. I I I I I I I . [D Date PAGE

SECTION 6

OF SECTION 6 - DEVICES NOT SUBJECT TO REGISTRATION

NRC Device Key: ! ! Manufacturer License No.: L---;::====-------================: Manufacturer Name:

Model Number: .... I ______ __, Serial No.: ,__ _______ __, Transfer Date: !,__ ____ _. Isotope: Activity: Unit: ---------- ._ _______ ...., Isotope: A~tivity: ,__ _________ __.Unit: .__ _______ ....,

Isotope: .__ ________ _ Activity: Unit: ---------- .__ _______ ...., Isotope: Activity: Unit: ,....._ _______ _.

Isotope: .__ ________ _

NRC Device Key: ! ! Manufacturer License No.: '----;::::============:!...._ ______ ..:::::::================:

Manufacturer Name: · .__ _________________________ ___,

Model Number: .... I ______ __, Serial No.: '---------~ Transfer Date: ..... I ----~I Isotope: ==================== Activity: ..._ ________ __. Unit: ... I _______ _.....! Isotope: Activity: Unit: _________ __. ,....._ _______ _.

Activity: Unit: .__ ________ __, ,....._ _______ _.

Activity: Unit: .__ _______ ...., Isotope: .__ ________ _ Activity: Unit: ,__ _______ _.

NRC Device Key: I I Manufacturer License No.: ~======---------===================::::; Manufacturer Name:

Model Number: ,....._ ______ _. Serial No.: ,__ _______ __, Transfer Date: !...__ ____ _. -----------, Isotope: Activity: Unit:

Isotope: Activity: Unit: .__ ________ __,

Isotope: Activity: Unit: ,....._ ________ __. ,....._ _______ _.

Isotope: .__ ________ __, Activity: Unit: ...__________ ,....._ _______ ...., Isotope: _________ __. Activity: Unit: ,__ _______ _.

Scott Jacobs

From: Shawn Read Sent: To:

Wednesday, October 31, 2018 1:34 PM Scott Jacobs

· Subject: FW: Instrument 7233 Recieved for Trade-in

From: Niton Analyzer Service & Support <ustew-techsupengrs@thermofisher.com>

Sent: Wednesday, October 31, 2018 1:19 PM To: Shawn Read <Shawn.Read@simsmm.com> Subject: Instrument 7233 Recieved for Trade-in

Dear Shawn Read,

This letter is to inform you that on we received from you the following Trade in Unit:

Model: Niton Xlp 818 Alloy Analyzer

SerialNumbe~ 7233

RMA#: SE-1810244045

The unit is now under the ownership of Thermo Scientific Portable Analytical Instruments Inc.

for final disposal. Thermo Scientific Portable Analytical Instruments Inc. is licensed by the State of Massachusetts (Lie. No. 55-0238) to accept portable XRF devices containing sealed sources or an X-ray tube for disposal. The radioactive sealed sources are removed, stored, and disposed of in accordance with all applicable regulations.

1

If you have any questions regarding this matter, please feel free to call Jim Blute at

(978) 215-1310

Thank you,

Jim Blute

jim.blute@thermofisher.com

www.thermoscientific.com/pai

1hemio sde1rtitit. . . Portable, ,,'\~alytic:al ln:strumcnl.s

2.Raddirr Ro'.fld: . . Td':•rksbur:y. 'Mfrss.ac:hLleetts, D:187$

2

·; ,soa ~ts~ l 57 a. · t tsinf670-'.zJso

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Scott Jacobs

From: Gamalier Estrada Sent: To:

Tuesday,.December 12, 20171:31 PM Scott Jacobs

Subject: FW: Instrument 7228 Recieved for Trade-in

From: Niton Analyzer Service & Support [mailto:ustew-techsupengrs@thermo.com] Sent: Tuesday, December 12, 2017 1:21 PM To: Gamalier Estrada <Gamalier.Estrada@simsmm.com> Subject: Instrument 7228 Recieved for Trade-in

Dear Gamalier Estrada,

This letter is to inform you that on we received from you the following Trade in Unit:

Model: Niton Xlp 818 Alloy Analyzer

Serial Number: 7228

RMA#: SE-1709219876

The unit is now under the ownership of Thermo Scientific Portable Analytical Instruments Inc.

for final disposal. Thermo Scientific Portable Analytical Instruments Inc. is licensed by the State of Massachusetts (Lie. No. 55-0238) to accept portable XRF devices containing sealed sources or an X-ray tube for disposal. The radioactive sealed sources are removed, stored, and disposed of in accordance with all applicable regulations.

1

If you have any questions regarding this matter, please feel free to call Jim Blute at

(978) 215-1310

Thank you,

Jim Blute

jim.blute@thermofisher.com

www.thermoscientific.com/pai

Thermo Scientific 2 Radcliff Road Portable Analyucal Instruments Tewksbury, Massachusetts 01876

2

1800875-1578 +1 978 670-746D

info.pai@thermofisher.com WNW. thermoscientific. comlpai