Feb 14 2012 116PM No 0966 D 116 I bull
NRt FORM 314 US NUCLEAR REGULATORY COMMISSION ~12Qt2) oCR 3O~~ M2~W)7038(1)(1) _ 64(k)(6 1(1)
CERTIFICATE OF DISPOSITION OF MATERIALS
LICENSEE NAME AND ADDRESS
Pinnacle Mining Co ~-PO Box 338 Pineville WV 24874
APPROVED flY OMS NO 311GoO021 EXPlRI9 103112013 E$Imaed Ilurden per le44lOlIlt 0 comPl1 lUi ibis mandalilly ~n reques~ 30 mllwtee This $lI1lPIIU Ii II$Ild by H~C as 11 01 IIe tI8$Is tor 1$ deleanilllon tl8I tile IIOIIt III telaasad 01 UMlSIlleIad IJM SMd 004MMnl RIOlIII1ing buJden asllmala to IhI InlOrmallOll $eMleI 9r8ildl (TmiddotS fS3) us NucIw Rogula~ ((lInmloalon Wsshlnjlon DC ~t or br Inlemel ItmiddotmaII Iti InCotollellls~rcenlGgoy and 10 IIWl Desk Officer 0ftQ of InrormallOll and RegIllamp1OIy AIIM NEOM020~ t315()C628) OMoe 01 tl8li1lemenl Id Budge~ Washln8lon DC 201503 II a mew used 10 Impose an Inlolrnallon aIIactM does nllIdie B Ilmn~ valid O~B ~ numllel IIWl NRC may 001 oorducl III _IQIIOI and 9
~ Is noIrequlred (j) respottd 10 1I1eIobmllOll~
LICENSE NUMBER DOCKET NUMBER
47r25412middot02 030-36508
LICENSE EXPIRATION OATE
September 302013
A LICENSE STATUS (Check the appropriate box)o This license has expired o This license has nol yelexpired please lerminale it
B DISPOSAL OF RADIOACTIVE MATERIAL (Check the gpproprlale boxes and complete as neceuery H ddltlona space Is needed provide attachments)
The licensee or any individual executing this certificale on behalf of the licensee certifies thaI
1 No radioactive malerials have ever been procured or poss6lsed b~ the licensee under this licenseD [] 2 All activities authorized b~ this license have ceased end aU radioactive materials procured andor possessed by the licensee
under this license number cited above have been disposed of In the following manner
[] 8 Transfer or radloecVve meterlals to the licensee listed below Kanawaha Scates and Systems Inc 26 Whitney Drive Milford Ohio 45150 (Ohio license 03214130000)
o b Disposal of radioactivemalerials o 1 Directly by the licensee
D 2 By licensed disposal site
o 3 By waste cOlltractor
o Co All radioactive materials have been removed such that an~ remainIng resIdual radioactivity Is within the limits or 10 CFR Pert 20 Subpart E and Is ALARA
C SURVEYS PERFORMED AND REPORTED
[] 1 A radiellon survey was conducted by lhe licensee The survey confirms
III Q 1he absence of licensed radioactive materials
o b Ihat Bny remaining residual radioaclivity is within the limile of 10 CFR 20 Subpart e and is ALARA
D 2 A copy of the radialian sUJVey results
o a is attached or 0 b is not aUached (Provide e)(pllJlla~on) or D c was forwarded to NRC on
[Z] 3 A radiation survey Is not requIred as only sealed sources were ever possessed under this license and Dele
D a The esults of the latest leak lest are allached andor [] b No Ieking sources have ever been idenlified
The person to be contacled regardIng the Informallon provided on this fonn NAME
RlSScll L Hodges lmEPI81lt Poreman I RSO
TELEPHONE (lftCludii Arampa Clc1eJ
(304) lS6-S814 I~AAIL AOOR5SS
nlssellhodgescliffsnrcom
IoWlaIINIIOiIIfCI~r~lh$bMel~
PO Box 338 Pineville WV 24874
C CERTIFYING OFFICIAL I CERTIFY UNDER PENALTV OF PERJURY THAT THE fOREGOING ISJRUE AND CORRECT
PRINTEO NAM E ANOttTlE
Russell L Hodges Plant ForemnlRSO Lpoundbull bull II~1JJ r~ rATE 2-10-12
WARNING fALSi STATiMENTS IN THIS CERTIFICATE MAY B~ SUBJECT TO CMl ANDIOR CRIMINAL PEifAlTIES NItC REGULATIONS REQUIRE THAT SUBMiSsIONS TO THE NRC BE COMPLETi AND ACCURATE IN ALL MATERIAL RESPECT 18 USC SICTlON 1001 MIIKES IT A CltlM1NAl OFFENSE TO MAKE 4 WIllFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DePARTMENT OR AGENCY Of THE UNITED STATES A8 TO ANV ttAlTER WITHIN ITS JURISDICTION NACIORIUI4 11-2012)
57
_
NMSSIRGNl ~RIALs002
eD14 2012 1 16PM__________~~_____No 0966_P 216_--- I bull
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Kanawha Soaes amp Systems
January 23 2012
Cliffs North American Coal n50 Warehouse off Rt16 on Pinnacle Creek Road Welch WV 24874
RE Disposal of radiation sources
AnN Russell Hodges
This letter Is to advise you that the Radiation MaterIel detailed below was removed from Cliffs North American Coal Pinnacle Creek Road Welch WV by Benny Browning KSS Field ServIce
nechnlclan on December 28 2011 and that Kanawha Scales amp Systems has taken possession amp title of safa material Thl5 work was performed under our State of Ohio License for RadIoactive
Material 1103214130000
Manufacture Gamma Metrics Model 2000 SerlalH 126
Sources Cs-131 Cfmiddot252 C(middot252 Cf-252 Cf-252 Cf-252 Cf-252
Activity 739 mel 144 ug 149 ug
150 ug 151 ug 961 ug
928 ug
Serial 1-477 CF-ZI038 CF-21039 CF-21456 CF-Z1457 CF-Z2B18 CF-Z2819
This letter Is an eSlerlljal record and should be maintained for Inspectlol) Jri the appropriate regulalorv agency If you are pot the Radiation Safety Officer or resectPonsble tor malntalnlng regulatory records for radloacjllje material please forward this letter to the aPl~roprlate person
Sincereiv
Larry Welch Analyzer COordinator I RadIation Safety Officer Kanawha Scales amp Systems Ic Office 888middot280middot7254 Fa)( 513middot576middot1884 Cell 513middot615middot5535 E-Mail rwelchkanawhascalescom Web site wwwkanawhascalescom
(
~eD 14 201t 1 16PM ________________~--No 0966 p 316_-----
SERVICE REPORT
elrmlngham Al Oa)lOnOH PILI Ibursh PA Customer H eLINOR~~[Vjcng Loca~ionMonlgome1f Al lanlonOH SI Maryl PII
Plke~lIeI(V DtllOUlII1 F~monlWY Cincinnati Job 39714 CincinnallOH AIIMI Pkldg wv (513) S76~0700
httplIwwwkanawhascales(om DateColumbu~aH M~mphllN ChlenOA wv
~~
Name Cliffs North American Coal POll Scheduled 9302011 --~~---
Address 50 Wcuehouse Off Rr 16 on Pinnacle Creek Rd Caller Russell Hodges Phone 304-256-5814
City Welch State WV Zip 24874 (ontact Russell Hodges Phone 301middot256~S814
Service Support cu~tomer denl5ty gauge removal and relocation Kay-Ray 7062 Requested
MANUFAaUR(~ MODEL SEAIAl NUIAB~R cUSTOMER 10
L I CAPAcnvPMStOtlAlNm TESTMpoundTHOD OEVlcE lClCAllOH
MANUFACruREft MOOEl SEftlAL NUMBER KSSIO I QJSTOMERID
2r-~~--------~-----------+------------~----~1--------------~ ClPACI1YOMSrONIVHITS TE$T MEntOD DEVICElOCAnON
Service Performed I Recommendations
i I i ) I l i ~ ~ I ~ ~ i
I i l I
~ j t i~ ~ ~ yen i - i I i j ~~middot I i~ I
I (J
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shy ) Ishy l ~I I
Description of Parts Used
IffniiTDAllYTIME SUMMARV RT or OT Mileage
TravllTo Job ) Men i Stan ExpensesI Imiddot ff Mlleago
Total j On SIte bull - r Truck - Job CompleteI MilNgamp t o_I -~
ZoneTravel From Job InspClot Mileage o Technlcliln Customer Printed Name Date Signature Signature
~ ~ I ----_____---L~~)
Feb 14 2012 1 16PM No 0966~P 416_----- - ~-~-----------------
6385151259 USHRC RE610N3 DHMS
UNlTlI) fTAttO NUCLEAR REGULATORY OOMMISSION
REGION III 2A4a WrranViVo IOQdSul(e 21ft
L1sla IIIlnola eftll3l0435a
TELEFAX TRANSMITTAL
NUMBER OFPAGESDATE Il lt~11 (Includlnglhl$ page)
SENOTO
LOCATION
FAXNUMB8R 53 II 87- IiS1 o VERIFY BY CALLING SENDER bull w
FROM (SfNDER)
TELEPHONe NUMBER li30middot ~2 712 FAX NUMBER 630 GIS 115
bull d
If you do not reoe(ve the oomplete fax transmUtal prease oontact the sender as soon as posslble at the telephone number provIded above
MESSAGE Af+c~J IS Y0k tIlPP(centUCJ ~~proti rlt~eamp+
eurotU)~IOAJ 40 te~ve ~2- so~rees
NOTICS
Tht mbullbullbullagamp ntended only for the US6 0 fhelndMdul1 Of entity to whloh t Is addressed an mly aonttlln information that Is prlllagacf conndan1illl or exompt (rom dIsclosure Under applicable law If the reader of thl meesage I not Ihe fnlendud recipient or the ampl9ya8 reaponalblfll tor deUverlng the mebullbullage (0 the Intended raQlplBntr you are h6re~y nollrlecilhat any dlssemlnatlon dIstrIbution or aopylng of thIs communloltlon Ie atrlnlly prohlblttd If you have raoelvad hl communroatlon In error plaaa nQtlfy the sender lmmedtately ~Y telephonamp ftnd return th orlgfhlJllo thi bov d~~r66S I by U$ Mall Thank you
__Nc0966___ P 56------- Feb 14 201L 116PMi_---------------~---
PAGE 0202-12911 20 20 6305151259 USNRC RE6IDH3 Iraquo1S Depound 19 2011 11 nVM Kuuha Snlos ampSyStems No 9692 P 214
RepORT OF PROPOSED ACTIVITIISS IN NONmiddotAGREEMENT STATES AReAS OF EXCIU81VE FEDERAL JURISDICTION OR OPtlONORI WATERS
(pIetila llItl nln_Cltfone bfofO oomplaffng thf tomtJ
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to E tftflj Welo bulla 11011 SftfCft omtllr (RSO)
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v ACTIVITIta TO Bli OONIraquoI01II) UIII)III lit GIINIlAIJOJltl8G G N11110 CF~1120o flllOOGINB 0 IfAKTEQYlNeANOIOIHlAU8AAl1QN8 01YP6OFSERVI(ie~___-__
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111fteJAllftCOMlIBf1it JiMIl 110 4IKJIII1I amplItvIrJu1lnd JIu QIIMIIIIl4n fallrlouUon lWIAII6I11II1D~91fm1lIdabon Ull~tlll lfRO rllIIIcIltZlllall 1II1~ll~ 1116 JlfG_lAlA6IIAnlII~hlflnG MIIl rIlIlIIallOIIAlUu
m~IUYMlW GAlll rorA~u 1)I~nO ~
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feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
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M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
eD14 2012 1 16PM__________~~_____No 0966_P 216_--- I bull
()
Kanawha Soaes amp Systems
January 23 2012
Cliffs North American Coal n50 Warehouse off Rt16 on Pinnacle Creek Road Welch WV 24874
RE Disposal of radiation sources
AnN Russell Hodges
This letter Is to advise you that the Radiation MaterIel detailed below was removed from Cliffs North American Coal Pinnacle Creek Road Welch WV by Benny Browning KSS Field ServIce
nechnlclan on December 28 2011 and that Kanawha Scales amp Systems has taken possession amp title of safa material Thl5 work was performed under our State of Ohio License for RadIoactive
Material 1103214130000
Manufacture Gamma Metrics Model 2000 SerlalH 126
Sources Cs-131 Cfmiddot252 C(middot252 Cf-252 Cf-252 Cf-252 Cf-252
Activity 739 mel 144 ug 149 ug
150 ug 151 ug 961 ug
928 ug
Serial 1-477 CF-ZI038 CF-21039 CF-21456 CF-Z1457 CF-Z2B18 CF-Z2819
This letter Is an eSlerlljal record and should be maintained for Inspectlol) Jri the appropriate regulalorv agency If you are pot the Radiation Safety Officer or resectPonsble tor malntalnlng regulatory records for radloacjllje material please forward this letter to the aPl~roprlate person
Sincereiv
Larry Welch Analyzer COordinator I RadIation Safety Officer Kanawha Scales amp Systems Ic Office 888middot280middot7254 Fa)( 513middot576middot1884 Cell 513middot615middot5535 E-Mail rwelchkanawhascalescom Web site wwwkanawhascalescom
(
~eD 14 201t 1 16PM ________________~--No 0966 p 316_-----
SERVICE REPORT
elrmlngham Al Oa)lOnOH PILI Ibursh PA Customer H eLINOR~~[Vjcng Loca~ionMonlgome1f Al lanlonOH SI Maryl PII
Plke~lIeI(V DtllOUlII1 F~monlWY Cincinnati Job 39714 CincinnallOH AIIMI Pkldg wv (513) S76~0700
httplIwwwkanawhascales(om DateColumbu~aH M~mphllN ChlenOA wv
~~
Name Cliffs North American Coal POll Scheduled 9302011 --~~---
Address 50 Wcuehouse Off Rr 16 on Pinnacle Creek Rd Caller Russell Hodges Phone 304-256-5814
City Welch State WV Zip 24874 (ontact Russell Hodges Phone 301middot256~S814
Service Support cu~tomer denl5ty gauge removal and relocation Kay-Ray 7062 Requested
MANUFAaUR(~ MODEL SEAIAl NUIAB~R cUSTOMER 10
L I CAPAcnvPMStOtlAlNm TESTMpoundTHOD OEVlcE lClCAllOH
MANUFACruREft MOOEl SEftlAL NUMBER KSSIO I QJSTOMERID
2r-~~--------~-----------+------------~----~1--------------~ ClPACI1YOMSrONIVHITS TE$T MEntOD DEVICElOCAnON
Service Performed I Recommendations
i I i ) I l i ~ ~ I ~ ~ i
I i l I
~ j t i~ ~ ~ yen i - i I i j ~~middot I i~ I
I (J
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shy ) Ishy l ~I I
Description of Parts Used
IffniiTDAllYTIME SUMMARV RT or OT Mileage
TravllTo Job ) Men i Stan ExpensesI Imiddot ff Mlleago
Total j On SIte bull - r Truck - Job CompleteI MilNgamp t o_I -~
ZoneTravel From Job InspClot Mileage o Technlcliln Customer Printed Name Date Signature Signature
~ ~ I ----_____---L~~)
Feb 14 2012 1 16PM No 0966~P 416_----- - ~-~-----------------
6385151259 USHRC RE610N3 DHMS
UNlTlI) fTAttO NUCLEAR REGULATORY OOMMISSION
REGION III 2A4a WrranViVo IOQdSul(e 21ft
L1sla IIIlnola eftll3l0435a
TELEFAX TRANSMITTAL
NUMBER OFPAGESDATE Il lt~11 (Includlnglhl$ page)
SENOTO
LOCATION
FAXNUMB8R 53 II 87- IiS1 o VERIFY BY CALLING SENDER bull w
FROM (SfNDER)
TELEPHONe NUMBER li30middot ~2 712 FAX NUMBER 630 GIS 115
bull d
If you do not reoe(ve the oomplete fax transmUtal prease oontact the sender as soon as posslble at the telephone number provIded above
MESSAGE Af+c~J IS Y0k tIlPP(centUCJ ~~proti rlt~eamp+
eurotU)~IOAJ 40 te~ve ~2- so~rees
NOTICS
Tht mbullbullbullagamp ntended only for the US6 0 fhelndMdul1 Of entity to whloh t Is addressed an mly aonttlln information that Is prlllagacf conndan1illl or exompt (rom dIsclosure Under applicable law If the reader of thl meesage I not Ihe fnlendud recipient or the ampl9ya8 reaponalblfll tor deUverlng the mebullbullage (0 the Intended raQlplBntr you are h6re~y nollrlecilhat any dlssemlnatlon dIstrIbution or aopylng of thIs communloltlon Ie atrlnlly prohlblttd If you have raoelvad hl communroatlon In error plaaa nQtlfy the sender lmmedtately ~Y telephonamp ftnd return th orlgfhlJllo thi bov d~~r66S I by U$ Mall Thank you
__Nc0966___ P 56------- Feb 14 201L 116PMi_---------------~---
PAGE 0202-12911 20 20 6305151259 USNRC RE6IDH3 Iraquo1S Depound 19 2011 11 nVM Kuuha Snlos ampSyStems No 9692 P 214
RepORT OF PROPOSED ACTIVITIISS IN NONmiddotAGREEMENT STATES AReAS OF EXCIU81VE FEDERAL JURISDICTION OR OPtlONORI WATERS
(pIetila llItl nln_Cltfone bfofO oomplaffng thf tomtJ
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to E tftflj Welo bulla 11011 SftfCft omtllr (RSO)
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111fteJAllftCOMlIBf1it JiMIl 110 4IKJIII1I amplItvIrJu1lnd JIu QIIMIIIIl4n fallrlouUon lWIAII6I11II1D~91fm1lIdabon Ull~tlll lfRO rllIIIcIltZlllall 1II1~ll~ 1116 JlfG_lAlA6IIAnlII~hlflnG MIIl rIlIlIIallOIIAlUu
m~IUYMlW GAlll rorA~u 1)I~nO ~
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feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
~eD 14 201t 1 16PM ________________~--No 0966 p 316_-----
SERVICE REPORT
elrmlngham Al Oa)lOnOH PILI Ibursh PA Customer H eLINOR~~[Vjcng Loca~ionMonlgome1f Al lanlonOH SI Maryl PII
Plke~lIeI(V DtllOUlII1 F~monlWY Cincinnati Job 39714 CincinnallOH AIIMI Pkldg wv (513) S76~0700
httplIwwwkanawhascales(om DateColumbu~aH M~mphllN ChlenOA wv
~~
Name Cliffs North American Coal POll Scheduled 9302011 --~~---
Address 50 Wcuehouse Off Rr 16 on Pinnacle Creek Rd Caller Russell Hodges Phone 304-256-5814
City Welch State WV Zip 24874 (ontact Russell Hodges Phone 301middot256~S814
Service Support cu~tomer denl5ty gauge removal and relocation Kay-Ray 7062 Requested
MANUFAaUR(~ MODEL SEAIAl NUIAB~R cUSTOMER 10
L I CAPAcnvPMStOtlAlNm TESTMpoundTHOD OEVlcE lClCAllOH
MANUFACruREft MOOEl SEftlAL NUMBER KSSIO I QJSTOMERID
2r-~~--------~-----------+------------~----~1--------------~ ClPACI1YOMSrONIVHITS TE$T MEntOD DEVICElOCAnON
Service Performed I Recommendations
i I i ) I l i ~ ~ I ~ ~ i
I i l I
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Description of Parts Used
IffniiTDAllYTIME SUMMARV RT or OT Mileage
TravllTo Job ) Men i Stan ExpensesI Imiddot ff Mlleago
Total j On SIte bull - r Truck - Job CompleteI MilNgamp t o_I -~
ZoneTravel From Job InspClot Mileage o Technlcliln Customer Printed Name Date Signature Signature
~ ~ I ----_____---L~~)
Feb 14 2012 1 16PM No 0966~P 416_----- - ~-~-----------------
6385151259 USHRC RE610N3 DHMS
UNlTlI) fTAttO NUCLEAR REGULATORY OOMMISSION
REGION III 2A4a WrranViVo IOQdSul(e 21ft
L1sla IIIlnola eftll3l0435a
TELEFAX TRANSMITTAL
NUMBER OFPAGESDATE Il lt~11 (Includlnglhl$ page)
SENOTO
LOCATION
FAXNUMB8R 53 II 87- IiS1 o VERIFY BY CALLING SENDER bull w
FROM (SfNDER)
TELEPHONe NUMBER li30middot ~2 712 FAX NUMBER 630 GIS 115
bull d
If you do not reoe(ve the oomplete fax transmUtal prease oontact the sender as soon as posslble at the telephone number provIded above
MESSAGE Af+c~J IS Y0k tIlPP(centUCJ ~~proti rlt~eamp+
eurotU)~IOAJ 40 te~ve ~2- so~rees
NOTICS
Tht mbullbullbullagamp ntended only for the US6 0 fhelndMdul1 Of entity to whloh t Is addressed an mly aonttlln information that Is prlllagacf conndan1illl or exompt (rom dIsclosure Under applicable law If the reader of thl meesage I not Ihe fnlendud recipient or the ampl9ya8 reaponalblfll tor deUverlng the mebullbullage (0 the Intended raQlplBntr you are h6re~y nollrlecilhat any dlssemlnatlon dIstrIbution or aopylng of thIs communloltlon Ie atrlnlly prohlblttd If you have raoelvad hl communroatlon In error plaaa nQtlfy the sender lmmedtately ~Y telephonamp ftnd return th orlgfhlJllo thi bov d~~r66S I by U$ Mall Thank you
__Nc0966___ P 56------- Feb 14 201L 116PMi_---------------~---
PAGE 0202-12911 20 20 6305151259 USNRC RE6IDH3 Iraquo1S Depound 19 2011 11 nVM Kuuha Snlos ampSyStems No 9692 P 214
RepORT OF PROPOSED ACTIVITIISS IN NONmiddotAGREEMENT STATES AReAS OF EXCIU81VE FEDERAL JURISDICTION OR OPtlONORI WATERS
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to E tftflj Welo bulla 11011 SftfCft omtllr (RSO)
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Mlltord Ohio 4mB (513) 1l1~HlS (S13) S1dmiddotI88~ USA
v ACTIVITIta TO Bli OONIraquoI01II) UIII)III lit GIINIlAIJOJltl8G G N11110 CF~1120o flllOOGINB 0 IfAKTEQYlNeANOIOIHlAU8AAl1QN8 01YP6OFSERVI(ie~___-__
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111fteJAllftCOMlIBf1it JiMIl 110 4IKJIII1I amplItvIrJu1lnd JIu QIIMIIIIl4n fallrlouUon lWIAII6I11II1D~91fm1lIdabon Ull~tlll lfRO rllIIIcIltZlllall 1II1~ll~ 1116 JlfG_lAlA6IIAnlII~hlflnG MIIl rIlIlIIallOIIAlUu
m~IUYMlW GAlll rorA~u 1)I~nO ~
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feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
Feb 14 2012 1 16PM No 0966~P 416_----- - ~-~-----------------
6385151259 USHRC RE610N3 DHMS
UNlTlI) fTAttO NUCLEAR REGULATORY OOMMISSION
REGION III 2A4a WrranViVo IOQdSul(e 21ft
L1sla IIIlnola eftll3l0435a
TELEFAX TRANSMITTAL
NUMBER OFPAGESDATE Il lt~11 (Includlnglhl$ page)
SENOTO
LOCATION
FAXNUMB8R 53 II 87- IiS1 o VERIFY BY CALLING SENDER bull w
FROM (SfNDER)
TELEPHONe NUMBER li30middot ~2 712 FAX NUMBER 630 GIS 115
bull d
If you do not reoe(ve the oomplete fax transmUtal prease oontact the sender as soon as posslble at the telephone number provIded above
MESSAGE Af+c~J IS Y0k tIlPP(centUCJ ~~proti rlt~eamp+
eurotU)~IOAJ 40 te~ve ~2- so~rees
NOTICS
Tht mbullbullbullagamp ntended only for the US6 0 fhelndMdul1 Of entity to whloh t Is addressed an mly aonttlln information that Is prlllagacf conndan1illl or exompt (rom dIsclosure Under applicable law If the reader of thl meesage I not Ihe fnlendud recipient or the ampl9ya8 reaponalblfll tor deUverlng the mebullbullage (0 the Intended raQlplBntr you are h6re~y nollrlecilhat any dlssemlnatlon dIstrIbution or aopylng of thIs communloltlon Ie atrlnlly prohlblttd If you have raoelvad hl communroatlon In error plaaa nQtlfy the sender lmmedtately ~Y telephonamp ftnd return th orlgfhlJllo thi bov d~~r66S I by U$ Mall Thank you
__Nc0966___ P 56------- Feb 14 201L 116PMi_---------------~---
PAGE 0202-12911 20 20 6305151259 USNRC RE6IDH3 Iraquo1S Depound 19 2011 11 nVM Kuuha Snlos ampSyStems No 9692 P 214
RepORT OF PROPOSED ACTIVITIISS IN NONmiddotAGREEMENT STATES AReAS OF EXCIU81VE FEDERAL JURISDICTION OR OPtlONORI WATERS
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to E tftflj Welo bulla 11011 SftfCft omtllr (RSO)
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Mlltord Ohio 4mB (513) 1l1~HlS (S13) S1dmiddotI88~ USA
v ACTIVITIta TO Bli OONIraquoI01II) UIII)III lit GIINIlAIJOJltl8G G N11110 CF~1120o flllOOGINB 0 IfAKTEQYlNeANOIOIHlAU8AAl1QN8 01YP6OFSERVI(ie~___-__
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111fteJAllftCOMlIBf1it JiMIl 110 4IKJIII1I amplItvIrJu1lnd JIu QIIMIIIIl4n fallrlouUon lWIAII6I11II1D~91fm1lIdabon Ull~tlll lfRO rllIIIcIltZlllall 1II1~ll~ 1116 JlfG_lAlA6IIAnlII~hlflnG MIIl rIlIlIIallOIIAlUu
m~IUYMlW GAlll rorA~u 1)I~nO ~
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feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
__Nc0966___ P 56------- Feb 14 201L 116PMi_---------------~---
PAGE 0202-12911 20 20 6305151259 USNRC RE6IDH3 Iraquo1S Depound 19 2011 11 nVM Kuuha Snlos ampSyStems No 9692 P 214
RepORT OF PROPOSED ACTIVITIISS IN NONmiddotAGREEMENT STATES AReAS OF EXCIU81VE FEDERAL JURISDICTION OR OPtlONORI WATERS
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feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
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M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
feb 14 2C12 117PM_______-------~~~o 0966_P 616_~ l bull I tj~
Mel RADIOACTIVE SOURCE MOVEMENT ADVICE EgEzM
This form MUST be filled out whenever a radioactive source is moved ALL details must be correclly and legibly entered Radloacllve shipments to destinations oUlside MCI premises must have prior approval of the Radiation safety Officer (RSO) All shipments must be corractly packed labeled and dooumented
~)UL~rlLV 1 2 3 4
BiJ CC)ft fJJtf Nuollde CF J5J c~ )5) CF L5vZ CF 51FifYl1te~
Activity lq4 1Ll Imiddot I 1 4~ I 5C)i~ j~1 Uj Serial Number CF-ZJof1 CF~ l1)-9 CF 2 -Sh CFZII5] Product Code
Ordered For
Moved From Moved To
O~ Iortk Af4e I(A-~ mlfit 7amp~k71 CtrP ftJ1 i3uruH DtvP~I~ R~f(UA+o~ PI~Nt-X-eltIC 010il Ve~tLe uJI -t$3i5
Date of Movement I I 200 HAS THE RADIATION STORE BEEN h LOCKEtD YIN [l]
Signad
o 1 for Shipments from KSS ~ Attach shipping documents Lo this form
Transport Co ~ Con NoteNoI--_~__n--l ~~E=------
Lebel Type Transport IndexD I Receiver Notified YiN 1------ NRC Notlfled YIN ITJ ------I
ShIpped YIN Test Cert D Plale 0 RIYets Dmiddot Signs D Signed I J Checked by RSO I
L_______ L--___~___jordelegatel
2 For Goods Reclaved a KSS bull Attach 91l1 certificates and documents to this (orm
St~teman gt Order No I Ma~ ~urfaC6 dose Rate uSvhr D 3 AADLOG-XLS updated I[ J I Logbook updated I _ I by peirson moving source _lh_lt_middot___- by RSD only L-Jn_it_~~~---
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
____r_e_b__r4_~LU~I~L___I_l~_~M_____________________________~__________ 0096 7 6_----
Mel - RADlOAS(llYt ~OUBCE MOVeMENTADYICE FORM
This form MUST be filled oui whenever a radloacllve source ~ moved ALL details musl be oorrectly and legibly entered Radioactive shipments to desllnations oulslde Mel premlampes must have prlot approval of the Radiation Safety Offlctlr (RSO) All shIpments mustbe correctly packed labeled end dOCllmented
Nuollde
Aotivlty
Serlal Number
Product Code
Ordered Fot
2 3 4
CF ~2StZ CF~25(
1 (0 Ike) ~ -)8 ut
(IF 2L8IB CFLHfc
Moved ToMoved FtrC lttffi f A~encNL ealtL rZ)t~elL1Ccfvot~~ Corp I
~IMlcle p~ P[AI+ utf 8~tfe--l+ U- IgtL
PLai~lk I wv XeJl~tt ~(D 4-5385
Date ofMovernent ~ I HAS THE ~DIATION STORE BEEN ~ SIgned LOCKED YIN18i5 I G[] DOfl$ thl form relalll to liI$hlpm to orttom KsS YIN l------l If YES please flll out sections 1or 2 and 3below ~
1 For Shipments from KSB bull Attach shipping documents to this form
Transport Co ~~==tt------~ Con NotaNo IL--~~__~ Label Type 0 Traneport ndexD
L--~-r NRC N~tmed YIN IT] Shipped YIN Test Cart Dplate [~ Rivets D S19m ---_-
Signed l-~-----1 ChElClked b~ RSO I I ---______---1 bull or delegate
6 FOr Goode Reolend at IpoundS - Attaah test cElrtlficaes and documpnt9 to this form
S~reman gt Order No I ] Max Surtaoe dose Rate uSlihr -------1
a RADLOGXLS updatad I--In_~---___J Logbook updated I by pauon moving 90uroa by RBD onlylnlt
---------
-----~ _
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
Feb14 2012 117PM__~~____________No 0966_P 816~--
()CeSIVJI t=eDbK
1iJ K55
Ctile1
I I + ( (f
M= - RADIPACnyenE SOURCE MOVEMENT ADVICE EQRM
ThIs form MUST be filled oui whenever a radioactive source Is moved ALL details must
be oorrectly and legibly entered Radioactive shIpments to delltlllatJ ons outsIde MCI premIse must have prior approval otthe Radiation Safety Oftloer (RSO) All shipments must middotbe correotly paoked labeled and documented
1 2 3 it
Nuclide C$ J37 ActIvity 7 )q MCt Serial Number Rmiddot477 Product Code
Ordered For
Moved From Moved To
I(tlltutJIlA- amp~l~ +- ~Ste~(1Hi ItdiAtIltiI~ 81foCfll~ iJefNltt(lJtO ~lD W~+4 DrIve
rv~l tod DrlO1ftevi lfe (l1V~ YS150
Pate of Movement I I 200 HAS THE RAt)IATION STORl IJEEIII LOCKEDYN W
0S~ned lB ~Jl Jf IJ Does thIs form reiMe 10 ashlpml~(tQ or from KSS YIN yIf YES please fill out secUollSl1 or 2 and 3 below 1 1 For Shipments from Kss bull Attach shipping doouments to this term I
Transport Co Imiddotteb JiS ~ Con NoteNo
MaXSUrfaceusvhr c==J LabeIT~peO TraoliportlodexD
RecelverNotifiedYlN7 W N~CN~HnedYM [TI Shipped YIN Test Cart Dplate D ANeta D Signs --_-
Signed 1 Checked by RSO________--1 T - or dele9~le ~---------
For GoDds Reolevfd at KSS -Attach 1ell cert1llcates and deoumenls to 1hls form
St~reman ~gt Order No I I Mllx Surface dose Rate uSVhr D MDLOGXLS updated I I by person movlOQ SOUfctt Inlt
______- __~___ bullbull _ _______ l _-_ bull bullbull bullbull _w _~
~~
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
Feb14 2012 1 7PM_____---------~-~O 0966_P 916_---
~
BILL OF LADING SHIPPER J
Cltffi J()flA AtteAl~A~t~L -50 DArekusc _efFlr-ll(o AlllUJfie Cteetlt ~ -
bJeck kll~ff7f
NATURE AND QUANTITY OF CONTENTS PACKAGE
PROPER SHIPPING NAME FORM ACTIVITY CATEGORY TRANSPORT TYpr INDEX
I-WHITE il
HAZARDOUS MATERIAlS DESCRIPTIONS CHMICAl FORM AND NUMBER OF OR FOR YELLOW TYPEA AND PROPER SHIPPING NAME (FORM ~9 PHYSICAL 8TATI (GAS BECQUERElS I-YEllOW LABEL OR
CFR 1~21 01 HAZARDOUS MATEIAALS TABLE) IQUUJSOLlDj OR AND CLiRIES OR CATEGORIES TYPES SPECIIILFORrt III-YELLOWLABEL ONLY
I Sql Ghl YrJIDW UI CJ7 Iyfe A otlMCl
550 Ip~
ftc-KED LiP ey fgt ~-CoN()Jfy FR~ampHT t~ fJ8-1 f
This Is to certIfy that theabovename~middotm~terlalsare properly ci~SS(fI~fiifribedl packaged marked and labeled and are In proper condition for tr~n$portqtlon according to the applicable regulations of 1he Department of Transportation -
RMA Company Name REMARKS Address
Contact Emergertcy Contact Information
llttlNlwM s~4s 4-- $~~S ~~ JO~ob() Dri~ r(U- I WV 25 i 59 B
P tj()f ( Gerg etl~ (ti-t~ ~ f3el roWN4 AUTHORImo SIGNATURe I DATE J ~Dq~71012(j
v o Revised 0812001 I
jJ~gt
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
_~F_eb__14_-=-2~O12_1__ N 0966 P 1016 __17_PM_~____~__________ o
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 1Pax 513-576-1884 Email Address kharnesskanawhascalescom Website Address wwwkanawhascalescom
LEAK TEST CERTIFICAIE
This cettficRte shllll not be Ieprodnced except In 11111 wltllout the written aPlProval of l(auawha Scales amp Systems) Inc
DEVICE INIlOIlMAlION
Device Serial Numbe 126 Soulce Scripl Number ~-i 77 Device Manufacturer Gammametlics Source Manufactofol Go+opound~ PCC~uds Device Model 2000 SourcemiddotModeJ
Device 1)pe Elemental AnalytOlmiddot Location Cliffs NR I Pinnacle Prep Plant
Redioisotope(s) Cs-137~ Aotlvity 10 xnCi 1 2S mlcrogrBms
LEAK TEST INFORMA1Qf
Leak Test Performed By Benny Browning Leak Test Pelormed On 92211
Leak Test Specimen Number 10095 Leek Test Analysis Date 102711
Loak Test Analysis Performed By KHarness ~
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
The analysis of this leak test sample was provided by Kanawha Scnles amp Systems Inc Ohio Bureau of Radiation Protection License Number 03214130000 In the event thIs specimen indicates leakage andor contamination in excess of 0005 mlc)oculi6s Kanawha SClles amp Systoms Inc will notify you promptly by telephone andor email at such time you will need to take the appropljate aCfions equlred by the govetning regulatory ogency responsible In )OUI 8lea
CLIENT INFOIlMATION MII nampShiI)) T0
Cliffs North American Coal Contact RusseH Hodges Pinnacle Creek Rd PhoIlle 304 256- 5814
Weloh~ WV 24814 BmaH
This certificate is an essential record and should be maintained for inspection by the
appropriate leguL~t9D ageuCI
NEXT LEAK TEST DUE 03222012
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
~eb 4 2012 117 PM No 0966 P 1116 --~--------~------------------------------------~---------- ---~
26 Whitnoy Dllve Milford OH 45150 I Phon~ 513-S76middot0700 Fax 513-576-1884 Bmall Addless khamessktll1llwhascalescom I Website Addles wwwkanWh8SCaloscoJ~
LEAK TEST CERTIFICATE
TIlls certificate shall not be l~plodllced except In Ill wIthout tbe WlUten Ilpplov~l of KAnAwhll Senles amp SystemsInc
DEVICE INFORMATION
DevJce Serlai Numbol 126 Source Seri~1 Numbfil Cf -457 Dovice Manufacturer Gammametlies Source Manufacturer r-rol-- eflt povice Model 2000 Soume Modo)
Device Type Elemental Analyzer Localion Cliffs NR I Pinnacle Prep Pltmt
Radioilotope(s) Cs-~7 1 Cf-252 Activity 10 mel 25 mlclograms
LEAK TESr INFORMATION
Lellk Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Speelmtm Number 10095 Leak Test Analysts Dilte 102111
Leak Test Analysis Performed By KHarness
Leak Tost Results hldicate an Activity of lt0005 uCi
NOTIFlCATlON
bullThe analysis oftnis leak test sample was provided by Kanawha Scates amp Systems Inc Ohio Bureau ofRadIation Protection Llc(lnse Number 03214130000 In the event this specimen Indicates loakage andlor contllmination in excess ofOOOS mleroeurlcs Kanawha Scales amp Systems Inc will notify you promptly by telephone andor email at sucb time you will need to take the appropllate actions required by the governing regUlatory agency responsible in your area
CLIENr INFORMATION Manamp ShtIp l0
cum NOJ1h Amorlcan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256- 5814 Welch WV 24874 Bmail
This celtlficate is an essential record and should be rnairltained for insp~tion by the appropriate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
Feb 14 2012 117 o 0966_P 1216_-----
26 Whitney Dllve Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address kharnesskanawhascalescom I Website Address wwwkanawhascalescom
LEAK TEST CERTIFICATE
Thi9 cCltlflcnt6 shAll not be middoteproduccd except tn tun without the lVtlttell ~pproval of KanHwbA SCRles amp Systems lllc
DEVICE INFORMATION
bevice Serial Number J26 Source Selial Number Cr- -Zllti 16 bevice Manufacturer Gammametlics Source Manufactuler Frru+e~ Devine Model 2000 SOUf(e Model
Device Type Elemental Analyzer Location Cliffs NR I Pilmacle Prep Plant
Radloisotope(s) Cs-J3t Cf~2S2 Activity 10 mCI I 25 micrograms
LEAK TEST INFORMATION
Leak Test Perfolmed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date lO27ft J
Leak Test Analysis Performed By KHarnes$
Leak Test Results Indicate an Activity of lt0005 uCI
NOTlFICATlqN
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadiation Protection License Numbel 03214130000 In the event this specimen indicates leakage andlor contamInation In excess of0005 mimocurios Kanawha Scales amp SYlitems Inc wlU notifY you promptly by telephone andor email at such time you will need to take the appropliate actions required by the governlnglegulatory agency responsible in youI area
CLIENT INFORMATION ManampShIIP T0
Cliffs NOlth American Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304256middot 5814 Welch WV 24874 Email
This certificate is an essential record and should b$ maintained for inspection by the
appropriate ~gulatorv agene
NEXT LEAR TEST DUE 0322l2012
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
_--Fe_b_l_4_2_0_12_~__18_PM_________________Nc 0966 P 1316_--
26 Whitney Drive Milford OH 45150 I Phone 513-576-0700 I Fax 513-576-1884 Email Address khl1rnesska(l8whascaleseorn I Website Addtess wwwkllnawhascalescom
LEAK TEST CERTIFICATE
This certificate sball not be Ieproduced except hl full without the written IIpPIoval of KanAwlu SeRles amp Systems Inc
DEVICE INFOIlMATION
Device Serial Number 126 SOUlce Serial Numbetmiddot C~ - Z1~1 cr Device Manufacturer Gammametrics Source Manufacturer rr-otJeR-Device Model 2000 Souroe Modol
Device Type Elomental Analyzel Locadon Cliffs NR I Pinnacle Prep Plant
Radiolsotopes) ~I Cfmiddot2S2 Activity 10 mCi I 25 micrograms
LEAKIJpsT INFORMATION
Leak Test Performed By Benny Browning Leak Test Performed On 922111
Leak Test Specimen Number 10095 Leak Test Analysis Dato 1012711 I
Leak Test Analysis Performed By KHflrness
Leak Test Results Indicate an Activity of lt 0005 uC
Tho analysis oftbis leak test sample was provided by Kanawha Scales amp S~stems) Inc Ohio Bureau ofRadiation Proteotlon License Nlmbel 03214130000 In the event this specimen indicates leakage andor contamination In excess of 0005 microcurles Kanawha Scales amp Systemslne will nottfy you promptly by telophone andlot email at such time you will Med to take the appropriate actions required by the govElming l-egulatory agency responsible in your area
CLIENT INFORMATION M iIampShi T0ft Ip
Cliffs North American Coal Contact Russoll Hodges Pinnacle Creek Rd Phone 304256middot5814 Wolch WV 24874 Blnail
This certificate is an essential record and sllould be maintained fo) inspection by the
middotaIPlopriate leguJatory agepey
NEXT LEAK TEST DUE 03222012
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
~~Fe_b_1_4~20_1_2~1_8_P_M~~~~~~~~~~~~~~~~~o0966~P 1416~~
r26 Whitney Drive Milford OH 45150 I Phone 51 J 576-0700 I Fax 513-576-1884 Bmail Address kharllesskanawhllscalescoID I Website Addless w~Wllawhlscalescom
LEAK TEST CERTIFICATE
This cert1ficate sllall not be reproduced except til full without the WIUteD ~pplovftl of 1(IIDftwlta Scales amp Systems lnc
DEViCE INFORMATION
Device Serial Number 126 Soml~c SClill1 Numbel~ CF - L Ili5(o bevice Manufacturer Oamrnal11l1tlics Source Manufactulet Frc)lAI~ Device Model 2000 Source Model
Device Type Elemental Analyzer Locetion CHffs NR I Pinnacle Prop Plant
Rildioisotope(s) ~Cfmiddot2S2 Aetlvlty 10 mCI I 25 micrograms
iRAtTEST INlJORMATION
Leak Test Performed By Benny Browning Leak Test Performed on 922111
Leak Test Specimen Number 10095 Leak Test Analysis Date 1027111
Leak Test Analysis Performed By KHftrness
Leak Test Results Indicate an Activity of lt0005 uCi
NOTIFICATION
Tha analysis ofthis leak test sample was plOvided by Kanawha SCltlles amp Systems Ine Ohio Bureau of Radiation Protection License Numbel 03214] 30000 In the event thls specimen Indicates leakage andoi contamination in excess of 0005 microDurlesJ Kanawha Scales amp Systems Inc will llOtity you promptly by telephone lindor email at suoh time you will need to take the appropriate actions Iequired by the governing regulatory agenoy responsible In yow area
CLIENT INFORMATIO~ MRilampShllP T0
Cliffs North Amerioan Coal Contact Russell Hodges Pinnacle Creek Rd Phone 304 256~ 5814
Welch WV 24874 Email
This certificate is an essential record and should be maintained for inspection by tbe pproprlate regulatory agency
NEXT LEAK TEST DUE 03222012
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
Feb 14 2012 118PM o 0966 P 1516_--
26 Whitney Drive Milford OM 45150 I Phone 513-576middot0700 I Fqx 513-576-1884 Email AddresskhalUess~nawbasclllescomWebsiteAddles~ Ytl~kanawhMltale$QQm
LEAK TEST CERTIFICAE
This celmiddottlficate sbn not be reproduced except In tull witllout the written RPIWOQI of (anliwha Scales amp Systems Inc
DEVICE INFORMATION
Device SerIal Number 126 Source Serial Numbel cr=- -Zlb3Cf Device Manufacturer Gllmmametrlcs Source Manufacturer h-rJvtheJt Device Model 2000 SOUlce Model
Device Type Elemental Analyzer Location Cliffs NR I raquolnnacle Prep Plent
Radioillotope(s)(J1S2 ~Cf~2S2 Activity 10 mCi I 25 micrograms
LEAK TnSf INliORMATION
Leak Test Performed By Benny Browning bak tost Performed On 922111
Leak Test Specimen Number 10095 Leak Tcst Analysis Date 1027Ill
Leak Test Analysis Pelformed Bymiddot KHarn6Ss
Leak Test Results Indicate an Activity of lt 0005 lCI
NOTIFICA1rION
The analysis ofthis leak test sample was provided by Kanawha Scales amp Systemslnc Ohio BUleall ofRadiation Protection License Number 032J41)0000 In the event this specimen indieattlB Icakage andor contamination in excess of0005 mlcrocuries KlUliwha Scal6S amp Systems Inc wUl notify you promptly by telephone andor email at such time you wJll need to take the applopriate actions required by the governing regulatory agency Icsponsibte in your alea
CLIENT INFORMATION MRnampShlIP T0
Cllm North AmerIcan Coal Contact Russell Hodges PInnacle Creek Rd Phonl~ 304256middot 5814 Welch WV 1A874 Email
This certificate is an essential record and should be maintained for inspection by the
appropriate regulatqaft26ncY
NEXT LEAl TEST DUE 03222012
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
_---Fe_b_1_4_2_0~12_1_1_8_PM_________~_______No 0966 1616__
26 Whitney Drive MUfOld OH 45150 1Phone 513-516-0700 I Fax 513-516-1884 Email Addess kharnesSkao8whascalescom I Website Address wwwkanawhasclllescom
LEAK TEST CERTIFICATE-This certificnte shnll not be leplncluced except in full without fhe written approval of KanawbA SCAJe$ amp SystemsllllC
DltVICE INFOlUllAT10N
Device Sorial Number 126 Source Sel1al Number CF -2ID~ce Device Manufacturer Gammametlics SOUICO Manufacturer HDt+iett Device Model 2000 Source Model
Device Type Elemental Analyzer Location Cliffs NR I Pinnacle Prep Plant
RadlolsotoPe(s)CF)5l Gs--i41 I Cf-2S2 Activity 10 mCi I 25 micrograms
JEAK TEST INFORMATION
Leak Test Perfmmed By Benny Browning Leak Test Performed On 9122111
Leak Test Specimen Number 10095 Leak Test Analysis Date 102711
Leak Test Analysis PerforJ11ed By IltHllrness Leak Test Results Indicate an Activity of lt0OO5uCi
NOTIFICAfION
The analysis ofthls leak test sample was provided by Kanawha Scales amp Systems Inc Ohio Bureau ofRadialion Protection License Number032t4lJOOOO In the event this specimen Indicates leakage andor contamination in excess 010005 mlcrocuries KanawhQ Scales amp Systems Inc will notify you promptly by telephone andor email at 8uob time you will need to take the appropriate actions required by the governing regulatory agone responsible in your area
CLIENT INFODMAnON M 1amp81 T0a liP
ClitIs Nollh American COBl Contllct Russell Hodges Pinnacle Cleek Rd Phone 304256- 5614 W6lcb WV 14874 Bmall
This certificate is an essential record and should be maintained rO)middot inspection by the approprIate regulatory agency
NEXT LEAK TEST DUE 03222012
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader
This is to acknowledge the receipt of your lette lapplication ated
11 7gt ()O Ic1 and to inform you that the initial processing which
inclu1~rai~~~Jr~v~w hZ ~7P~~5~() ~0))00 There were no administrative omissions Your application was assigned to a
technical reviewer Please note that the technical review may identify additional omissions or require additional information
D Please provide to this office within 30 days of your recEipt of this card
A copy of your action has been forwarded to our License Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved
Your action has been assigned Mail Control Number 571 i f() When calling to inquire about this action please refer to this control number You may call us on (610) 337-5398 or 33i-5260
NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader