•'

Dominion Resources Services, Inc. 707 E. Main Srreet, Richmond, VA 23219

Mailing Address: P.O. Box 27007 Richmond, VA 23261-7007

Web Address: www.dom.com

June 27 , 2016

Scott W. Moore, Acting Director Office of Nuclear Material Safety & Safeguards Attn : GLTS U.S. Nuclear Regulatory Commission Washington , DC 20555-0001

Subject: Transfer of Tritium Exit Signs

Mr. Moore:

~ , Dominion®

Pursuant to Federal Regulation 10 CFR 31 .5(c), Dominion Transmission, Inc. provides notice that on March 17, 2016, 23 self-luminous exit signs listed on Attachment 1 were transferred from Dominion's Loup Creek Station located at Route 85, Kopperston, West Virginia 24854 to SRB Technologies, Inc., which took possession of the devices at their licensed facility located at 320 Boundary Road , Suite 140, Pembroke, ON, Canada. For each sign, the manufacturer name, model number, serial number, manufacture date and original curie content are indicated on the attachment.

Attachment 2 is the confirmation letter from SRB Technologies confirming receipt of the 23

signs.

Please contact me at (804) 771-3480, if you have any questions regarding this letter.

Sincerely,

Scott J. Beckett Director, Facilities Management

Email: scott.j .beckett@dom.com

cc (with attachments) : Lillian M. Cuoco, Sr. Counsel , Dominion Resources Services Inc.

~I

•• ·isolite

Serlal Number Spreadsheet

fl Please completelyf111 out the above fields

Line Manufacturer Manufacturer Model Serial Original Activity Name Date Number Number (ClorTbci'

1 JJe'R. "Jullfl/1/ocJU :&,., #1111 cfl 11~ l"A49 SI a "-' - %0 2 ,,

" ,; I I Co49J'11 II

3 II " ,,

" Go4.9T00 ,, 4 /I /I /I ,,

t!. tJ 4"i It 7 " 5 I I

,, ,, " ~c4'i' l1"L II

'6 ,, ,, , , ',, t!04cttcz . ' 7 ' 'f.4i.1 No ,... lot' A It . - i'tt SJ,."'., C.t'oc..JrG"° ~ r #'1} 8 r-1 fl 'lldl-1llflu '1. HIUI DI.- J<i("

. C()4.Jil,;. A$" e1-zo

9 II ,, ~, ,, (!....,AOJ-8Z. ,,

10 " ,, ,, ,,

"-b4t!f1'i9 ,,

11 ,, ,, I I " C048"J ;1

12 ,. ,, ,, ,,

CD4~rfol ,,

13 ,, ,, ,, ,,

'tl48t,8~ fl ,, "' ' '

" ,, 40f.B'-1.1' " 14

15 " ,, 1/ ,, C04f lse,

,. 16

,, ,, ,, ,, "-04 'tJ "''3 "

17 II ,, ,, If I ~f)4B"171 ,,

18 II ,, ,~ ,, l'.n4.ll(,,fl'i II

19 II ,, If " c.o '19J'-7 /I

lO ,, ,, ,, .,

{!{>4 'I :1 ~' ,,

21 " ., ,, H l'..t. CLAf-0., I I

22 ,, " ,, IC ~ou,1, ,. ,,

23 ,, ,, II II IAAAt:JiJ,,Z, ,, 24 (I

,, " ,, t.Me•fo "

25 ,, ff ,, " to4S'-P.4. ••

*The above Information shoufd be on the sl811s labels. If any Information on the sign Is missing please fill In the fields with "missing" or "llleglble", etc. Please print clearly. A double srp Is counted as "TWO'' .rgns, not "ONE" Plea11 make note of this. The company & address Information, should belong to the End-User (location the signs have physlcally been removed from).

lsollte Corporation• 31 Waterloo Avenue• Berwyn, PA 19312 •800-888-5483 • 610-296-8952 l'-7~·0-S9 ReY2 )O!tpt15

05lflil f/d '"-1,J o., ul+' ;1.n I<;. o,,.J (!)St--11-t-'µ d sa;J osu+~ fJ '.. / r,,c,...J

C/>t.Jtl- tvJ.'>dN

6St1rr-' ;Vr. /<.O;-J Ir O'"'-P CR.q?,J( c<­Loc .... ,, CMd<.... -Lour C1t.. f ~- /._ __..

Cf~t,1ttv' fl) <;./<;.DJJ

Lw-1' C" €<- k -l()(.,c-(J CAI J'- -i~u. /I CMd<- .­Lou.fl Ciltc.I<- -/-/(.( F~ c ,t.H ll. I ~'o (ltfr f'.J s.1°'~rJ I Lo tLf' Cf.ee;:.- -­/.6u11 CL H (L -

JluffCW /; l '/qff ~AHi'-4/PP Cttft/'-. _,

l i<..11<> c/f.ft/L ~

' t. Ctt u .k ­"(.L/.J

6' .. ~ Cllfcl<---l(}''-'9 Ctt. f' lft-..-

4 f.1 .,,, ~ ... to ,,

•• ·1solite Com an Name Address1

"Please completely fill out the above fields

Line Manufacturer Manufacturer Name Date

~ Sl.1J iicJluo/-,u TlL.. rlt4ll" l"'

,, ., ,, .].- ,, ,,

'' ~

,, ,, " .Y ,, "

,, ,ff ,, e. , Ir

:r I! ,, If ,a. ··· II /I ,, g. ,, ,, ,,

Contact Name Contact Phone Contact Fax Contact Email

Model Serial Orlglnal Activity Number Number (ClorTbq) (3 y. Cn4.6r-SJ ~1-zo

" t! ()4. s 7170 It ,, C.04~[,ff' " ,, co4e,fr, ,,

" ,.,.,.aa "'ea II ,, (!(J 4-8(, 7 f . ,,, ,, ~o4'1SZO " It

f.() "'' 11 s-,,

,, ~"'"''"

,, . ..

J\.

J> llf. , .. ,,_ ,., "'~

,, "

,, It . :co4f~z. ,,

is 'S' 'fO "( 4Z. 41 4'9 ~

)4-

u.. '0" 14-' 15' J6"'

""' ~ j.g·

it>-.;M'

I• "' ,, . ,, ,, ,, ,, C( ,, ,,

,, ,, ,, . " ,,: H

"· It

" " ,, "

,, ,, • l'l"ll1' ~ zr ,,

,, ,, t" 1'4'(·., I. '3 If

ti ,, l'l).A. f J ~'

,, ,, (.f l'r\ (.t $ Z-4 '' ., ,, t.04.'il 10 " ,, ,, I t".l.>4.A '°Bt f( ,, ,,

~n4.9ZtL ,. ,, II eoq1~os- ,, ,, . ' . t-0.AO' ~() "- , . ,_I "' C04.8"'B4- .. ,, ,, , l!o4fa'e~ " _,..(ff.

/ 4-1 Yw· (_; . ,,

" ,, ,, l'114Bhff H

. 23

24 ~5

"The above Tnformatlon should be on the signs labels. If any information on the sign Is missing please ff/I tn the fields with "missing" or "Illegible'', etc. Please print clearly. A double sign fs counted as "TWO'' sfgns, not "ONE" Please make note of this. The company & 11ddress Information, shourd belong to the End-User (location the signs have physlcally been removed from). \

lsoltte Corporation • 31 Waterloo Avenue• Berwyn, PA 19312 •800-888-548~ • 610-296-8952 "'1·2.3•1>-$9 Rev1 30Sep11s

'

.Gw

l')S C:..IML tJ i/ sf/N . o>w µ£/r.:.or-i . ()'>t.?-fl. µcl i; ();../

C>SU4-I'- ;V"i.kPI'-' (!)<;c,n-r- fJ'd<:."'r-1 ~ J...)t.A.or-' CJ SC/H'- µ d c CJiV

t.c ,u1 ft. 'i.£k. -t.?;') (,Jt~ fl/ t ft;t>,...J

Oictw /v'£/r;o"'1 a?S"c.Htt- ,uc /<.1,..J

l,,.c.;.Lj1. Ctt. f c/1... ,,.... t ~W'/ UL 'if /L. ,.... {.DL..1Jf} CA H /l

,.

·-,

•• • 1· ISO 1te CERTIFICATE OF TRANSFER

This certificate serves as confirmation that the General Licensee identified below has fulfilled the requirements of the Code of Federal Regulations, Title 10, Volume 1, Part 31 .S(c) 8 (i) for transfer or disposal of the self-luminous signs identified in this certificate.

GENERAL LICENSEE: Dominion Transmission, 289 Gas Plant Rd. Brenton, WV 24818, USA

DEVICE TRANSFERRED: Tritium Exit Signs

RETURN MATERIAL AUTHORIZATION:# 11989PA-RMA

QUANTITY TRANSFERRED: 47

DATE SIGNS RECEIVED: May 17, 2016

LICENSED RECEIVER: SRB Technologies (Canada) Incorporated 320-140 Boundary Rd. Pembroke, Ontario K8A 6W5 CA

Operating under License of the Canadian Nuclear Safety Commission-License #NSPFOL-13.00/2022

06/03/16 Christen Martin, Sales Services Date

31 Waterloo Avenue· Berwyn, PA 19312 · 800-888-5483 · 610-647-8200 · Fax 610-296-8952

~ ,_

'·