· rrm UNIVERSITY

Office of Research Compliance

November 12, 2012

RECEIVED

NOV 1 2 2012

DNMS 1910Uni\lersilyOri~e Bolse, ldaho 83725·11 39

Man Lundgren Assistant Djrector, I{esearch Compliance

Radiation Safety Officer phone 208·426-2345

matuundgren@boisestate.edu www.bolseslate.edulresearchlcompliance/

US Nuclear Regulatory Cornmission, Region IV 612 East Lamar Boulevard, Suite 400 Arlington, TX 76012-4125

RE: NRC License 11-27388-01 Amendment - Change RSO

Due to a change in my position and duties, Boise Stale University [s seeking to amend its radioactive materials license, 11-27-388-01 , to designate Suzy Arnette, Ph.D. as the Radiation Safety Officer. Dr. Arnette's Statement of Training and Experience is enclosed.

Sincerely,

/fr~ Mall Lundgren Radiation Safety Officer

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PUBUC a_teRm­~onnaJ ReleaM

NON.pUBUC o A.3 Senaltlve-Seeurtty Rea.t.d o 1..1 SensftJ.,. Intemal a 0thIr.~ ___ _

Dale, 11p"1Ua.

.. 57 9 4 5 8

Statement of Training & Experience in Radiation Work

I. Name _ _ _ -'S~l~"~"~n~ne:.::M~,~P~,~A~l~n~e~tt~c __ _ Mail Stop_ MS-1826 _ _ _

Tit le/Position_Laboratory Safety Officer__ Telephone_ 208-426-3906_.

Resenrch_ NIA _____ ________ ___ ___ _

Authorized person who wi ll supervise your work_N/A ___ _ _ _ _

2. Eductltion (List degrees, major subject, emphasis, date, and school) Ph.D. Chemishy, CombinAtorial, 2006, Un iversity of Virgin ill. B.S. Chemistry, 2001, Berry College:

3. Forma l tra ining in Radiation SAfely

Provide It statement ill the following areas, Inc lude Ilame of person or institutioJl providing the training. Provide duration and dAte.

a) Principles and Practices of Radiation Proleclion Dade Moeller Training Academy - Radiat ion SafclY Officer

Where _ _ LHS Veglls, NV _ ___ _

Duration _ _ 5 dayS~~~~~~;::;;;; When October 22-26, 2012 Boise State University - I{adialion Sarety Course

01lmtioll _ _ 2 h: .. o=n~lS~::::_::-:~-=--:-, Wllen _ _ 201 2_ University or Virginia - Radiation Snfety Training

Duratiotl _ _ 4 hOV'l:"~'== _ _ _ _ _ When __ 200B_

b) Characteristics orronizing Radiation Dade Moeller Training Academy - Radialion Safety Officer

Where _ _ Llts veg~~~";N~V~~C~== Dllrll tiol'l _ _ 5 days When _ _ Octobel' 22-26, 20 12

Boise Slate University - Radiation Sarety Course Duralion _ _ 2 hours' _ _ _ _ __ _

When _ _ 20l2,-;c== University of Virginia - Radintion Sl\fety Training

Duratioll _ _ 4 hOllrs' _____ _ _ When __ 200S, _ _ _

c) Radioactivity Detection instmmenlation llnd Monitoring Techniques. OOlde Moeller Training Academy - Radiftl ion SafetyOfficcr

Where _ _ Las Vegas, NV _ _ __ _ Dllratio" _ _ 5 days,~=,"",,=;-_ _ _ When __ Oclober 22-26, 2012="",=

Boise Stll te Univcrsity - Itlldiation Safety Course Ouratiol'l __ 2 hOUI"5, _ ___ __ _

When __ 20 12''';:::;;::0:: University of Virginia - t{ndiation Sarety Training

Duratio" _ _ 4 hours _ ___ _ _ _ When _ _ 2008 _ _ _

Revis«! 8mt [ t -Boise Stale University Environmcntall/ealth and Safety, 1910 University Orive- Boise, 10 83725-1826

3. Pormal tmining in Radiation Safety (colliinucd)

d) Units of Rndifltion Dose lind Quantities Dade Moeller Training Academy. Radiation Safety Officer

Wherc _ _ Lns VCg",~,,~N:V~;;;;===== Durtltion _ _ S tlays-;: Whc" _ _ Octobec 22-26, 2012="",=

Boise State University - Radiation Safely Course Duratioll _ _ 2 hou .. s, _ _ ____ _ When __ 20 I 2.",= =

University of Virginia - Radiation Safety TrAining DUflIlion __ 4 hour5, ______ _ WhCII __ 2008, _ _ _

Provide 1\ statement in the following nrcns. Include lIome of person or institution providing the Imining. Provide duration and dale.

e) Diological H:lZords of Exposure to Radia tion (oppropriate to the types lind forms of mdioactive material to be used) DRde Moeller Tmining Academy - RadiAtion Safety Officer

Where _ _ Las veg;.,,:,~N~V~;::;=== Duratioll _ _ 5 days--:: When _ _ Oclouer 22-26, 2012.0-= _ _

Doise Slate University - Radiation Sillety Course Dumlion _ _ 2 hours _ _____ _ When 2012

University of Virginia - Radiation Safety Trnining Dumtion __ 4 hours~ _____ _ When _ _ 2008 _ _ _

4. Radiation work (Descl'ibe bdefly yOl)f anticipated work alllilist the types and quantities of licensed material to be used at noise Slate Uni versity)

Take 011 Radiation SAfety Officer duties which will include: receiving lind surveying shipments, Inking inventory of University materials, performing radiation safety surveys. performing/assessing spill clean-up, and 11Ilndiing wasle materials.

5. Describe your HandS-Oil Use of RadioacHve Malerials

In 2008, I slarted collaborating with the Rfldintion Safety Group Ilt the University ofVirginifl regnrding labomtory surveys, tmining development. and mixed waste. I would occasionally accompany the I{ad Group on their material surveys and completed their tmining program. Since I joined Boise State Universi ty, I hnve been handling mdioaetive mllterint vials for inventory, conducting contamination surveys, and handling radioactive wClste. My experience involves small sca le laboratory qunntities with the following isotopes: 3-Hydrogen. 63·Nickel, and depleted uranium. Recently t coordinated the cal ibration of the survey instruments.

6. Statement

This information is correct to Ihe best ormy knowledge. I ngrec 10 comply with the Radionctive Materials Management Manual and Radiation Safety Policies of Boiso State University.

Signa'nrc '~r 1"11 f' {h;:tt. Print Name Sl124n ne t11 e Arl1"tte

Itevised YJJt 1 2

Doise Stille University Environmental Health and SlIfety, 1910 University Drive- Boise, ID 83725·1826

Hill, Carol

From: Sent: To: Cc: Subject:

Attachments:

Ms. Hill,

Matt Lundgren [mattlundgren@boisestate.edu) Monday, November 12, 2012 2:48 PM Hill, Carol Suzy Arnette Amendment Request for License 11-27388-01 -Boise State University Amendment Request - Boise State University -11-27388-01 2012.11.12.pdf; Statement OfTraining and Experience - Suzy Arnette.pdf

Attached you will find a cover letter outlining a request to amend Boise State University's license 11-27388-01 accompanied by associated documentation.

Have a great day and thank you for your time.

Matt

Mall Lundgren I Assistant Director I Radiation Safety Officer Boise Stale University I Office of Research Compliance 208.426.2345 I http://www.boisestatc.edu/rcsearch/compliance/ I MS-11 39

1

NRC FORM 532 U. S. NUCLEAR REGULATORY COMMISSION (1·2012)

DATE

111271201 2

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

Boise State Un iversi ty ATTN: Malthew R. Lundgren

Rad iation Safety Officer 1910 University Drive Boise, Idaho 83725-1826

This is to acknowledge the receipt of your:

IZl LETTER and/or 0 APPLICATION

11-27388-01

MAIL CONTROL NUMBER

579458

LICENSING ANDIOR TECHNICAL REVIEWER

ch

DATED: 11112/2012

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

IZl o

o

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 material( s) license identified above. Your application is deemed timely filed, and accordingly, the license wi ll 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 Form 531 , located at the following link:

http: .. www.n[C..gQv/reading-rmJd~lIectionslfQLmsJorc531....ruif

Send the completed NRC Form 531 , by facs imile, 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 Rockville, 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 DNMS/NMSB - B 1600 E. Lamar Boulevard Arlington , TX 76011-4511 (817) 200-1103 or (817) 200-1140

NRC FORM 532 {1.201 j' J\

.' II ?>-'

BETWEEN:

Accounts Receivable/Payable

,,'" Regional Licensing Branches

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[ FOR ARPB USE 1

INFORMATION FROM WBL

Program Code: 03620 Status Code: Pending Amendment

Fee Category: 3M 3P Exp. Date: 08/3112011

Fee Comments: Decom Fin Assur Reqd: Y

License Fee Worksheet - License Fee Transmittal

A. REGION

,. APPLICATION ATTACHED ApplicanVUcensee: BOISE STATE UNIVERSITY

Received Date: Docket Number: Mail ContrOl Number: Ucense Number:

AdiOn Type:

2. FEE ATTACHED

Amount:

Check No.:

3. COMMENTS

1111 212012 3032216 579458 11-27388-01

AmerM:Iment

Signed:

Date:

B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 031s entered I I

1. Fee Category andArnount:

2. Correct Fee Paid. Application may be processed lor:

AmerM:Iment:

Renewal:

Ucense:

3. OTHER _____________ _

Signed:

Date:

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