**NRC INSPECTION MANUAL** NMSS/IMNS

MANUAL CHAPTER 1220

PROCESSING OF NRC FORM 241, \"REPORT OF PROPOSED ACTIVITIES IN

NON-AGREEMENT STATES, AREAS OF EXCLUSIVE FEDERAL JURISDICTION,

AND OFFSHORE WATERS,\" AND INSPECTION OF AGREEMENT STATE

LICENSEES OPERATING UNDER 10 CFR 150.20

1220-01 PURPOSE

To establish procedures for processing Nuclear Regulatory Commission
Form 241 and changes to NRC Form 241; provide information to Agreement
State licensees for filing NRC Form 241; and institute the frequencies
and requirements for inspection of Agreement State licensees operating
under reciprocity in areas of NRC jurisdiction.

1220-02 OBJECTIVES

02.01 To ensure that licensed material is used in accordance with
regulatory requirements and that licensed operations are conducted in a
manner to ensure protection of the public health and safety.

02.02 To ensure compliance with 10 CFR 150.20, \"Recognition of
Agreement State licenses.\"

02.03 To provide information to appropriate State Radiation Control
Departments and to NRC\'s Office of State Programs regarding Agreement
State licensees operating in non‑Agreement States.

1220-03 DEFINITIONS

03.01 [Agreement State]{.underline}. Any State with which the Commission
(or the Atomic Energy Commission) has entered into an effective
agreement under SubSection 274b, \"Cooperation with States,\" of the
Atomic Energy Act of 1954, as amended.

03.02 [Non-Agreement State]{.underline}. Any State that is not an
Agreement State.

03.03 [Exclusive Federal Jurisdiction]{.underline}. An area over which
the Federal government exercises legal control without interference from
the jurisdiction and administration of State law.

03.04 [Reciprocity]{.underline}. Commission recognition of certain
Agreement State licenses for work performed in areas of NRC
jurisdiction.

03.05 [Reciprocity Activities]{.underline}. Activities conducted by
Agreement State licensees in non-Agreement States, areas of exclusive
Federal jurisdiction, and offshore waters, under the general license
provisions of 10 CFR 150.20.

03.06 [Filing]{.underline}. Filing will be deemed to be complete as of
the time of NRC receipt, either by mail or facsimile.

03.07 [Initial Filing]{.underline}. NRC receives NRC Form 241 filed by
Agreement State licensees requesting reciprocity for activities
conducted in non-Agreement States or in offshore waters. Filing by
facsimile is considered acceptable if the facsimile includes 4 copies of
the NRC Form 241 and evidence that the appropriate fee requirements will
be met within 3 days. This evidence can be a copy of the check or a copy
of NRC Form 629, if paying by credit card, that will be mailed to the
NRC. The licensee should receive confirmation (by telephone, e-mail, or
facsimile) that NRC has received the facsimile.

1220-04 RESPONSIBILITIES AND AUTHORITIES

04.01 [Division of Industrial and Medical Nuclear Safety, Nuclear
Material Safety and Safeguards]{.underline}. Maintain the computer-based
Reciprocity Tracking System (RTS) to track reciprocity activities, in
order to assist in the planning of inspections of those activities, and
to provide summaries of reciprocity activities and inspections on an
Agency-wide basis; and to establish the following procedures and
guidelines for use in processing NRC Form 241.

04.02 [Regional Offices]{.underline}

a.  Schedule, conduct, and track inspections to achieve the overall
    objectives of the inspection program, including the objectives of
    this chapter.

b.  Each year, before January 1, provide: a Procedures Letter
    (Appendix II) to reciprocity licensees from the previous year with
    the procedures and information required for filing NRC Form 241 for
    reciprocity and for withholding reciprocity information from public
    disclosure; the applicable regulations and Information Notices;
    copies of NRC Form 241; and other pertinent information.

c.  Review NRC Form 241 when received to ensure that the proposed
    activities of Agreement State licensees are in accordance with 10
    CFR 150.20 and are authorized under the Agreement State license in
    accordance with the procedures described in Appendix I. If not,
    contact the licensee regarding the lack of conformance with the NRC
    general license in 10 CFR 150.20.

d.  Enter the licensee information into the RTS, and distribute copies
    of the signed NRC Form 241 (include a copy of the licensee\'s
    Agreement State specific license with the initial forms) to
    appropriate authorities (as described in Appendix I), including the
    NRC regional office having jurisdiction in the area(s) in which the
    Agreement State licensee intends to operate. Signature authority for
    the reviewing official of the reciprocity activities, as requested
    by NRC Form 241, should be designated according to regional policy.

e.  Inspect Agreement State licensees operating in non‑Agreement States,
    areas of exclusive Federal jurisdiction within Agreement States, or
    in offshore waters under reciprocity using the same provisions used
    for equivalent NRC-licensed activities. Carry out enforcement
    actions against those licensees when violations are found during an
    NRC inspection. (See Appendix III for specific procedures and
    frequency.)

f.  Maintain records of reciprocity activities in the RTS.

g.  Maintain Form 241 requests for 20 years following the year for which
    the Form 241 was effective.

END

Appendices:

I. Procedures and Guidelines for Processing NRC Form 241\"

> (Appendix I provides the procedures to be followed, by the reviewers,
> in the processing reciprocity requests from the receipt of NRC Form
> 241 to the input of data into the RTS to the final distribution of
> completed actions.)

II\. \"Procedures Letter\"

> (Appendix II contains a sample Procedures Letter to be sent, by the
> regions, to Agreement State licensees each year, providing information
> concerning filing for reciprocity (including Forms 241 and procedures
> for filing, applicable guidelines, and regulations).)

III\. \"Inspection of Agreement State Licensees\"

> (Appendix III provides information for use by regional inspectors
> concerning inspection frequencies and the tracking of inspections
> through the RTS.)

APPENDIX I

PROCEDURES AND GUIDELINES FOR PROCESSING NRC FORM 241

A.  PURPOSE

To establish the procedures and guidelines for implementing the
requirements of this chapter.

B.  FILING OF INITIAL NUCLEAR REGULATORY COMMISSION FORM 241

The following points address requirements for filing the initial NRC
Form 241.

1.  Agreement State licensees requesting reciprocity for activities
    conducted in non-Agreement States, areas of exclusive Federal
    jurisdiction, or in offshore waters are subject to 10 CFR 150.20.
    The first time within a calendar year that an Agreement State
    licensee conducts activities in non-Agreement States or in offshore
    waters, it must file a copy of a completed NRC Form 241, four copies
    of its Agreement State license, and the appropriate fee as specified
    in fee category 16 of 10 CFR 170.31, unless the exemption in 10 CFR
    170.11(a)(4) is applicable. See 10 CFR 150.20(b)(1) for further
    details.

> Note: A licensee operating under reciprocity pursuant to 10 CFR 150.20
> does not have to obtain affirmative authorization from NRC before
> performing activities requested on NRC Form 241. Licensees that do not
> qualify for the general license will be informed of this
> determination, within 3 days of receipt of NRC Form 241 (See Item 4. ,
> \"Deficient NRC Forms 241), and that work is not to be performed in
> areas of exclusive Federal jurisdiction, non‑Agreement States or in
> offshore waters, until NRC receives the required information.
>
> Note: Verify that those licensees engaging in radiography activities
> are registered as a user for each approved package issued a
> Certificate of Compliance number(s), in accordance with the
> requirements of 10 CFR 71.12, Item 8.
>
> Note: If a company has more than one Agreement State license, a
> separate NRC Form 241 must be submitted for work conducted under each
> Agreement State license used during the calendar year.
>
> Note: All fee payments and questions concerning fees should be
> referred to the License Fee and Accounts Receivable Branch (LFARB).

2.  In completing NRC Form 241, the Agreement State licensee must
    provide sufficient information to enable NRC to conduct inspections.

> Note: The Agreement State licensee should only identify work to be
> conducted during a single calendar year.

3.  In general, the preferred method of filing is through the facsimile
    transmission of NRC Form 241, a copy of the Agreement State license,
    and evidence that the appropriate fee requirements will be met
    within 3 days. This evidence can be a copy of the check or a copy of
    NRC Form 629, if paying by credit card, that will be mailed to the
    NRC. The licensee should receive confirmation (by telephone, e-mail,
    or facsimile) that NRC has received the facsimile. Alternatively,
    the licensee may file the required information through the mail or
    other means as long as NRC receives the information at least 3 days
    before the licensee engages in the activity.

4.  If the facsimile or other acceptable method for filing all of the
    required information is not available to the licensee because of an
    emergency or for other reasons, the Regional Administrator can waive
    the time requirements specified in 10 CFR 150.20(b)(1) for the
    filing of NRC Form 241, provided the Agreement State licensee:

    a.  informs the region by telephone, facsimile, NRC Form 241, or
        letter of initial activities ; [and]{.underline}

    b.  receives oral or written authorization for the activity(ies)
        from the region; [and]{.underline}

    c.  files NRC Form 241, 4 copies of the Agreement State license,
        evidence (as described in paragraph B.3 above) that the
        appropriate fee requirements will be met within 3 days.

```{=html}
<!-- -->
```
C.  PROCESSING OF NRC FORM 241

Agreement State licensees are required to report their proposed
activities in non‑Agreement States to the NRC Regional Administrator of
the region in which the Agreement State is located. The regional office
shall take the following actions in processing NRC Form 241.

1.  RECEIPT

> Verify that the filing is timely. Stamp or otherwise note the date of
> receipt on all copies of NRC Form 241. The form must normally be
> received by NRC at least 3 calendar days before the licensee\'s
> beginning work.
>
> Note: The Regional Administrator may waive the 3-day time requirement,
> as discussed in B.4. above.

2.  INITIAL NRC FORM 241

    a.  Immediately upon receipt of NRC Form 241, verify that the
        required information has been provided and that the
        certification block has been signed and dated by the Radiation
        Safety Officer or management representative.

    b.  Verify that a fee for the appropriate fee and 4 complete copies
        of a valid, active Agreement State license are included with the
        initial NRC Form 241.

> Note: For NRC Forms 241 received without evidence of the fee payment,
> notify the licensee, by telephone, that the required fee must be
> provided before conducting activities under reciprocity.
>
> In cases where the Agreement State licensee seeks a waiver of the time
> requirements from the Regional Administrator, the reviewing personnel
> in the region may authorize reciprocity activities before receipt of
> the fee only after contacting LFARB for approval.

c.  Review the Agreement State license that was submitted with NRC Form
    241 to verify that the proposed activities are authorized by the
    license and that the license will be in effect during the time of
    the proposed activities.

> Note: The Agreement State licensee cannot qualify for a general
> license under 10 CFR 150.20, if the specific license issued by the
> Agreement State limits the activity authorized by the license to
> specified installations or locations; only if the license authorizes
> temporary job site locations will the general license of 10 CFR 150.20
> apply.

d.  For initial NRC Forms 241, enter the Agreement State licensee and
    fee information into the Reciprocity Tracking System (RTS).

e.  Enter work location information into the RTS.

> Note: The Location Reference Number (LRN) is generated by the RTS and
> is necessary for the tracking of NRC Form 241 and any changes to NRC
> Form 241 and is described in the RTS Users Manual. This number should
> be entered on NRC Form 241 for use by the licensee on subsequent
> changes.

f.  If NRC Form 241 is deficient (i.e., does not contain the required
    information, or the information provided indicates that the
    applicant does not qualify), see Item 4. , \"Deficient NRC Forms
    241.\" When it is determined that the required information has been
    submitted and the fee payment has been provided, sign and date NRC
    Form 241 as the reviewing official and forward a copy to the
    Agreement State licensee. This copy may be transmitted via
    facsimile.

> Note: For cases where NRC Form 241 is received and the filing
> indicates that the licensee does not qualify for a general license
> under 10 CFR 150.20, notify the licensee of this fact within 3 days of
> receipt of NRC Form 241 and forward the package to LFARB for fee and
> ADAMS processing.
>
> Note: Signature authority for the reviewing official of the
> reciprocity activities as requested by NRC Form 241 should be
> designated according to regional policy.

g.  Promptly notify, by e-mail, the reviewing official for reciprocity
    activities in the NRC regional office responsible for the area in
    which the activity will be conducted, of the completed action.

h.  In the lower right hand corner, mark the NRC\'s signed Form 241 (or
    letter in lieu of Form 241) with the assigned ADAMS code and write
    \"copy to Region \" indicating the appropriate region for
    distribution. Forward the completed Form 241 or letter, a copy of
    the Agreement State license, and evidence of the fee payment to
    LFARB for fee processing. After determining that the appropriate fee
    has been paid, LFARB will enter the fee payment information on NRC
    Form 241 and forward the completed package to the NRC Document
    Control Desk for ADAMS processing . After processing, the form will
    be returned to the regional office for the official files.

i.  Distribute a copy of NRC Form 241 to the State(s) where the work is
    to be performed.

```{=html}
<!-- -->
```
3.  CHANGES TO NRC FORM 241

    a.  Verify that NRC Form 241 indicates a request for a change for
        additional work locations, or changes to the radioactive
        material, or work activities different from the information
        previously identified by the licensee on the initial Form 241.
        The preceding may include updates to or deletions of specific
        locations or work sites, work site contacts, or dates of work
        previously identified by the licensee.

    b.  Confirm that the information on file in the RTS for the initial
        NRC Form 241 is current and correct before revising the
        licensee\'s reciprocity record in the RTS.

    c.  Obtain the number of total usage days to date from the RTS
        (number of days activities are conducted and/or licensed
        material is stored in non-Agreement States) and record on NRC
        Form 241.

    d.  For new locations of work, additional dates, or different
        activities, enter the information into the RTS. Assign an LRN
        for each new location of work listed on NRC Form 241.

    e.  If NRC Form 241 is deficient, see Item 4. , \"Deficient NRC
        Forms 241.\" When it is determined that the required information
        has been submitted, sign and date NRC Form 241 as the reviewing
        official or send a letter indicating that the revisions to the
        reciprocity activities submitted on the initial NRC Form 241
        have been reviewed and found sufficient, and forward a copy of
        the authorized NRC Form 241 to the Agreement State licensee.
        Signed NRC Forms 241 may be transmitted via facsimile.

> Note: For cases where changes to NRC Form 241 are received and the
> filing indicates modifications in activities that would no longer
> allow the licensee to qualify for a general license under 10 CFR
> 150.20, notify the licensee of this fact within 3 days of receipt of
> NRC Form 241.

f.  In the lower right hand corner, mark the NRC\'s signed copy of NRC
    Form 241 (or letter in lieu of Form 241) with the assigned ADAMS
    Distribution code for reciprocity documents, and write \"copy to
    Region \"indicating the appropriate region for distribution. After
    processing, the form will be returned to the regional office for the
    official files.

> Note: It is not necessary for the licensee to resubmit the Agreement
> State license unless the license has been amended since the filing of
> the initial NRC Form 241.

g.  Promptly notify, by e-mail, the NRC regional office(s) responsible
    for the area in which the activity will be conducted, of completed
    action.

h.  Distribute a copy of NRC Form 241 to the State(s) where the work is
    to be performed.

```{=html}
<!-- -->
```
4.  DEFICIENT NRC FORMS 241

    a.  If NRC Form 241 contains omissions or errors, try to first
        resolve them by telephone contact with the Agreement State
        licensee within 3 days of receipt of the NRC Form 241 request.
        If the discrepancies can be resolved by telephone contact, mark
        the form with the corrections and emphasize to the licensee the
        need to comply with the requirements of 10 CFR 150.20 and that
        the Agreement State licensee must confirm, in writing or by
        facsimile, the information provided by telephone.

    b.  If the deficiencies cannot be resolved by telephone, send a
        letter requesting the necessary additional information,
        identifying to the licensee the errors, omissions or
        deficiencies. Emphasize to the licensee the need to comply with
        the requirements of 10 CFR 150.20 before conducting activities
        under reciprocity and notify the licensee that further review
        will continue on receipt of the requested information.

    c.  If the discrepancies cannot be resolved with the Agreement State
        licensee, notify the licensee by telephone and send a follow-up
        letter, within 3 days of receipt of the NRC Form 241 request,
        explaining that the licensee has not submitted the required
        information and thus does not qualify for a general license
        under 10 CFR 150.20. Indicate to the licensee that work is not
        to be performed in areas of exclusive Federal jurisdiction,
        non-Agreement States, or in offshore waters until NRC receives
        the required information. Send the official record copy of the
        follow‑up letter, any additional required information from the
        licensee, and evidence of any required fee payment to LFARB for
        fee review and ADAMS processing.

> Note: It is the responsibility of the Agreement State licensee to file
> for reciprocity if work is to be performed in an area of exclusive
> Federal jurisdiction. However, in situations where the licensee
> requests assistance in making a determination about such an area, the
> regional office or reviewing official should refer the Agreement State
> licensee to the procedures for determining exclusive Federal
> jurisdiction, contained in Appendix II, \"Procedures Letter.\"
>
> Note: The Office of Enforcement is prepared to forgo enforcement
> action in cases where an Agreement State licensee has relied in good
> faith on an inaccurate determination made by the official of the
> Federal installation where the work is to be conducted.

d.  For Agreement State licensees whose proposed reciprocity activities
    are approaching or would exceed the 180-day limit, the licensee
    should be notified by telephone or mail that a specific NRC license
    must be applied for and obtained if activities in non-Agreement
    States in excess of 180 days are to be conducted within the calendar
    year.

```{=html}
<!-- -->
```
5.  APPARENT NON-COMPLIANCE WITH 10 CFR 150.20

> If NRC Form 241 describes activities that appear to be in
> noncompliance with the Agreement State specific license or other
> regulatory requirements, the following actions shall be taken:

a.  Where the Agreement State license limits use to a specific address
    or location, advise the licensee, by telephone or in writing (with a
    copy to the appropriate Agreement State) within 3 days of receipt of
    the NRC Form 241 request, to apply to the Agreement State licensing
    authority for a license amendment permitting temporary job site
    locations, or to the appropriate NRC regional office, for a specific
    NRC license. The reviewer should note the resolution or proposed
    action on NRC Form 241 and forward the evidence of any required fee
    payment with the signed original copy of NRC Form 241 to LFARB for
    fee review and ADAMS processing.

b.  Cases where activities were started before the initial NRC Form 241
    was submitted; where the Agreement State license is expired, limits
    locations, or otherwise is ineligible for reciprocity; or where the
    180-day limit is exceeded are violations of 10 CFR 150.20 and should
    be treated in accordance with the NRC Enforcement Policy,
    NUREG-1600.

c.  Cases where activities, because of their nature or necessity (e.g.,
    emergencies, weekends), were started before changes were phoned in
    or submitted (but the initial NRC Form 241 was submitted) should be
    reviewed on a case-by-case basis when determining compliance with
    10 CFR 150.20.

> Note: Staff should consider other instances of failure to change NRC
> Form 241 as noncompliance with the general license provisions of 10
> CFR 150.20.

6.  NRC FORMS 241 - EQUIVALENCE OR MISDIRECTION

    a.  [Equivalence]{.underline} - There may be cases where the
        Agreement State licensee submits a letter in lieu of NRC
        Form 241. This is acceptable, provided that the submittal
        contains all of the information required by NRC Form 241,
        including 4 complete copies of a valid Agreement State license,
        if applicable, and the required fee.

    b.  [Misdirection of NRC Form 241]{.underline} - If an Agreement
        State licensee inadvertently submits NRC Form 241 to the NRC
        Office of Nuclear Material Safety and Safeguards or to the wrong
        NRC regional office, the receiving office shall promptly notify
        the appropriate NRC regional office, by telephone and send the
        NRC Form 241 to the appropriate NRC regional office by
        facsimile. The original NRC Form 241 and the backup
        documentation may be sent by mail.

```{=html}
<!-- -->
```
D.  WITHHOLDING RECIPROCITY INFORMATION FROM PUBLIC DISCLOSURE

Agreement State licensees that seek to withhold information contained in
NRC Form 241 from public disclosure, must submit an application and
affidavit for withholding pursuant to 10 CFR 2.790, when the initial NRC
Form 241 is filed. The regional office shall take the following actions
in processing requests for withholding of information on NRC Form 241
from public disclosure.

1.  RECEIPT

    a.  Verify that the licensee has submitted an application for
        withholding information and an affidavit with the initial NRC
        Form 241 pursuant to 10 CFR 2.790. Confirm that two versions of
        the Form 241 have been submitted with brackets (\[ \]) placed
        around the information sought to be withheld. One version should
        have the information in brackets intact for NRC\'s use in
        processing the request for reciprocity. The other version should
        be \"sanitized\" for public disclosure with the information
        sought to be withheld deleted or erased. The \"sanitized\"
        version will be the version placed in the PDR if it is
        determined to be proprietary. Confirm that the additional
        information outlined in Attachment 1, Appendix I, has also been
        supplied in the application.

> Note: If the licensee has already submitted an NRC Form 241 for the
> year, it must submit an application and affidavit within a week of
> NRC\'s receipt of NRC Form 241.
>
> Note: The Office of the General Counsel has determined that only the
> information contained in Items 8 to 12 of NRC Form 241 can be
> requested for consideration for withholding from public disclosure as
> proprietary information.

b.  If the application or affidavit are deficient (i.e., do not contain
    the required information) or request that information other than
    that found in Items 8 to 12 be withheld, notify the licensee by
    telephone within 3 days of receipt of the request that additional
    information is needed and that the review will continue on receipt
    of the required information. Inform the licensee that for NRC to
    consider withholding the information contained in NRC Form 241 from
    public disclosure, it must review the information to ensure its
    status, with respect to being withheld, and that the review of its
    request for reciprocity will continue on receipt of this
    information.

c.  Review the application or affidavit to determine whether the
    information contained in the application and affidavit for
    withholding is complete and sufficient. Notify the licensee by
    letter, signed by Regional Branch Chief with Regional Counsel
    concurrence, acknowledging agreement or disagreement in whole or in
    part with its claim for proprietary treatment and the
    appropriateness of its 10 CFR 2.790 affidavit. Attachment 2 of this
    appendix contains samples of the letters to be sent to licensees
    when acknowledging agreement or disagreement with requests for
    withholding specific information contained in Form 241 from Public
    Disclosure.

> Note: Once the application and affidavit request for withholding
> information have been determined to be sufficient, the request will be
> maintained by the NRC regional office for as long as the Agreement
> State licensee continues to perform reciprocity activities and submit
> NRC Form 241s. If the licensee skips a year between filing reciprocity
> requests, the application and affidavit for withholding must be
> resubmitted for review.

d.  According to Management Directive 12.6, \"NRC Sensitive Unclassified
    Information Security Program,\" information originated by NRC
    licensees that has been determined to be proprietary must be marked
    to ensure proper handling and that the information is only released
    on a need-to-know basis. The words \"Proprietary Information\"
    should be placed at the top and bottom of the page on the front of
    each document containing proprietary information. Documents
    containing Proprietary Information must be covered by a Proprietary
    Information cover sheet, NRC Form 190. Documents containing
    Proprietary Information must be transmitted between NRC facilities
    and outside NRC facilities in a single opaque envelope or wrapper.
    The single opaque envelope or wrapper must not bear any markings or
    indications that the document contains Proprietary Information.

```{=html}
<!-- -->
```
E.  RETENTION AND DISPOSAL OF RECIPROCITY LICENSING DOCUMENTS

    1.  All reciprocity licensing documents, the initial NRC Form 241s,
        changes, and 10 CFR 2.790 requests must be retained and/or
        destroyed in accordance with the approved records disposition
        schedules contained in NUREG-0910, \"NRC Comprehensive Records
        Disposition Schedule.\" NRC Schedule 2-24.4.d, as rewritten,
        requires that NRC Form 241 license files be retained for 20
        years after license termination.

> Note: The records disposition schedules, rewritten November 20, 1995,
> are with the National Archives and Records Administration (NARA) for
> review and approval. NUREG-0910 is updated on NARA approval of new and
> revised schedules.

2.  In-active license records should be retired to off-site storage
    through the Records and Archives Services Section (RASS),
    Information and Records Management Branch, Office of Information
    Resources Management (IRM). They will remain in storage for the
    remainder of their 20-year retention period following the year for
    which the Form 241 was effective. Procedures for retiring records
    are contained in NRC Management Directive 3.53, \"NRC\'s Records
    Management Program.\"

3.  Retired records are available for recall from the RASS, IRM, through
    each respective region\'s Records Liaison Officer. Requested records
    (complete box or individual file folders) can be received by the
    requester via express mail or the internal mail system within 1 to 4
    days after RASS receives a request.

END

Attachments:

1\. Information Needed For Withholding Information From

Public Disclosure

2\. Sample Letter #1 - Acknowledging Agreement With Request

to Withhold Form 241 Information from Public Disclosure

3\. Sample Letter #2 - Acknowledging Disagreement With Request

> to Withhold Form 241 Information from Public Disclosure

4\. Sample Letter #3 - Acknowledging Partial Agreement With Request

> to Withhold Form 241 Information from Public Disclosure

ATTACHMENT 1

INFORMATION NEEDED FOR WITHHOLDING INFORMATION

FROM PUBLIC DISCLOSURE

Licensees wishing Nuclear Regulatory Commission (NRC) to withhold, as
proprietary or confidential, the information contained in Items 8 to 12
of NRC Form 241 from public disclosure should submit an application for
withholding accompanied by an affidavit. The application and affidavit
must be submitted in accordance with 10 CFR 2.790(b)(1). Note: Only the
information requested to be withheld as proprietary needs to be
accompanied by an affidavit. For the Commission to determine whether the
information should be withheld from public disclosure, the following
information should be provided in sufficient explanatory detail in
addition to the other requirements of 10 CFR 2.790:

1.  Clear identification of the document(s), or parts thereof, to be
    withheld as proprietary or confidential.

2.  Statement that this information is held in confidence by the owner
    of the information.

3.  A rational basis for requesting withholding of the information,
    clearly stating the reasons why the company believes the information
    contained therein is proprietary or confidential.

4.  Confirmation, with details provided, that the information
    transmitted to, and received by, NRC is held in confidence.

5.  Statement as to whether the information is currently available in
    public sources.

6.  Confirmation whether the company customarily treats this
    information, or this type of information, as confidential, with an
    explanation.

7.  Determination whether the public disclosure of the information would
    be likely to cause substantial harm to the competitive position of
    the company, with an explanation in detail as to why. Affidavit
    should also include the value of the information to the company, the
    amount of effort or money expended in developing the information,
    and the ease or difficulty for others to acquire the information.

8.  Clear identification of the position of the person executing the
    affidavit (an officer or upper-level management official delegated
    to review the information sought to be withheld and authorized to
    apply for withholding on behalf of the company.)

9.  Statement that the company submitting the affidavit is the owner of
    the information or is required, by agreement with the owner of the
    information, to treat the information as proprietary and that the
    affiant is an employee of the company.

ATTACHMENT 2

SAMPLE LETTER #1 - ACKNOWLEDGING AGREEMENT WITH REQUEST

TO WITHHOLD FORM 241 INFORMATION FROM PUBLIC DISCLOSURE

(Licensee\'s Name)

(ATTN: Contact Name)

City, State Zip Code

Dear :

SUBJECT: REQUEST FOR WITHHOLDING INFORMATION CONTAINED ON NRC FORM 241

By NRC Form 241, \"Report of Proposed Activities in non-Agreement
States,\" letter from (Licensee\'s Name) dated , and affidavit dated ,
you submitted proprietary material consisting of client information and
requested it be withheld from public disclosure pursuant to 10 CFR
2.790.

This is the response to that request.

You stated that the submitted information should be considered exempt
from public disclosure for the following reasons:

1\.

2\.

We have reviewed your application and the material in accordance with
the requirements of 10 CFR 2.790 and, on the basis of your statements,
have determined that the submitted information sought to be withheld
does contain proprietary information. Therefore, the client information
contained in Items 8 to 12 of NRC Form 241, marked as proprietary, will
be withheld from public disclosure pursuant to 10 CFR 2.790(b)(5) and
Section 103(b) of the Atomic Energy Act of 1954, as amended. Your
request for withholding will be maintained by Region  , indefinitely or
for as long as you continue to perform reciprocity activities and submit
NRC Form 241s. If you skip a year between filing reciprocity requests,
you must resubmit for review an application and affidavit for
withholding information contained in NRC Form 241 from public
disclosure.

Withholding from public inspection shall not affect the right, if any,
of persons properly and directly concerned to inspect the documents. If
the need arises, we may send copies of this information to our
consultants working in this area. We will, of course, ensure that the
consultants have signed the appropriate agreements for handling
proprietary information.

If the basis for withholding this information from public inspection
should change in the future such that the information could then be made
available for public inspection, you should promptly notify the U. S.
Nuclear Regulatory Commission. You should understand that NRC may have
cause to review this determination in the future (e.g., if the scope of
a Freedom of Information Act request includes your information). In all
review situations, if NRC makes a determination adverse to the above,
you will be notified in advance of any public disclosure.

If you have any questions concerning this action, please feel free to
contact me at (XXX) XXX-XXXX.

Sincerely,

(Regional Branch Chief)

ATTACHMENT 2 (Continued)

SAMPLE LETTER #2 - ACKNOWLEDGING DISAGREEMENT WITH REQUEST

TO WITHHOLD FORM 241 INFORMATION FROM PUBLIC DISCLOSURE

(Licensee\'s Name)

(ATTN: Contact Name)

City, State Zip Code

Dear :

SUBJECT: REQUEST FOR WITHHOLDING INFORMATION CONTAINED ON NRC FORM 241

By NRC Form 241, \"Report of Proposed Activities in non-Agreement
States,\" letter from (Licensee\'s Name) dated , and affidavit dated ,
you submitted proprietary material consisting of client information and
requested it be withheld from public disclosure pursuant to 10 CFR
2.790. This is the response to that request.

We have reviewed your application and the material in accordance with
the requirements of 10 CFR 2.790 and, for the following reasons, have
determined that the submitted information, in whole or in part, sought
to be withheld does not contain proprietary information:

1\.

2\.

Therefore, we have determined that the material, specifically Items 8 to
12, NRC Form 241, should be released and placed in the Public Document
Room (PDR). In accordance with 10 CFR 2.790(c), this information is
being forwarded to you as notice that the information will be placed in
the PDR thirty (30) days from the date of this letter. If within thirty
(30) days of this letter, you request withdrawal of these documents in
accordance with 10 CFR 2.790(c), or provide additional reasons for the
withholding of information, your request will be considered in light of
applicable statutes and regulations and a determination made as to
whether the documents should be withheld from public disclosure or
returned to you.

Withholding from public inspection shall not affect the right, if any,
of persons properly and directly concerned to inspect the documents. If
the need arises, we may send copies of this information to our
consultants working in this area. We will, of course, ensure that the
consultants have signed the appropriate agreements for handling
proprietary information.

If the basis for withholding this information from public disclosure
should change in the future such that the information could then be made
available for public inspection, you should promptly notify NRC. You
should understand that NRC may have cause to review this determination
in the future (e.g., if the scope of a Freedom of Information Act
request includes your withheld information). In all review situations,
if NRC makes a determination adverse to the above, you will be notified
in advance of any public disclosure.

If you have any questions concerning this action, please feel free to
contact me at (XXX) XXX-XXXX.

Sincerely,

(Regional Branch Chief)

ATTACHMENT 2 (Continued)

SAMPLE LETTER #3 - ACKNOWLEDGING PARTIAL AGREEMENT WITH REQUEST

TO WITHHOLD FORM 241 INFORMATION FROM PUBLIC DISCLOSURE

(Licensee\'s Name)

(ATTN: Contact Name)

City, State Zip Code

Dear :

SUBJECT: REQUEST FOR WITHHOLDING INFORMATION CONTAINED ON NRC FORM 241

By NRC Form 241, \"Report of Proposed Activities in non-Agreement
States,\" letter from (Licensee\'s Name) dated , and affidavit dated ,
you submitted proprietary material consisting of client information and
requested it be withheld from public disclosure pursuant to 10 CFR
2.790. This is the response to that request.

We have reviewed your application and the material in accordance with
the requirements of 10 CFR 2.790 and, on the basis of your statements,
have determined only certain information contained in Items 8 to 12 of
NRC Form 241 to be proprietary.

The client information contained in Item(s) of NRC Form 241, marked as
proprietary, does contain proprietary information and will; therefore,
be withheld from public disclosure pursuant to 10 CFR 2.790(b)(5) and
Section 103(b) of the Atomic Energy Act of 1954, as amended. Your
request for withholding will be maintained by Region  , indefinitely or
for as long as you continue to perform reciprocity activities and submit
NRC Form 241s. If you skip a year between filing reciprocity requests,
you must resubmit for review an application and affidavit for
withholding information contained in NRC Form 241 from public
disclosure.

We have also determined that, for the following reason(s), the
information contained in Item(s) of NRC Form 241 does not contain
proprietary information:

1\.

2\.

Therefore, the client information contained in Items of NRC Form 241,
should be released and placed in the Public Document Room (PDR). In
accordance with 10 CFR 2.790(c), this information is being forwarded to
you as notice that the information will be placed in the PDR thirty (30)
days from the date of this letter. If within thirty (30) days of this
letter, you request withdrawal of these documents in accordance with 10
CFR 2.790(c), or provide additional reasons for the withholding of
information, your request will be considered in light of applicable
statutes and regulations and a determination made as to whether the
documents should be withheld from public disclosure or returned to you.

ATTACHMENT 2 (Continued)

SAMPLE LETTER #3 - ACKNOWLEDGING PARTIAL AGREEMENT WITH REQUEST

TO WITHHOLD FORM 241 INFORMATION FROM PUBLIC DISCLOSURE

(Licensee Name) -2-

Withholding from public inspection shall not affect the right, if any,
of persons properly and directly concerned to inspect the documents. If
the need arises, we may send copies of this information to our
consultants working in this area. We will, of course, ensure that the
consultants have signed the appropriate agreements for handling
proprietary information.

If the basis for withholding this information from public disclosure
should change in the future such that the information could then be made
available for public inspection, you should promptly notify NRC. You
should understand that NRC may have cause to review this determination
in the future (e.g., if the scope of a Freedom of Information Act
request includes your withheld information). In all review situations,
if NRC makes a determination adverse to the above, you will be notified
in advance of any public disclosure.

If you have any questions concerning this action, please feel free to
contact me at (XXX) XXX-XXXX.

Sincerely,

(Regional Branch Chief)

APPENDIX II

PROCEDURES LETTER TO BE SENT TO LICENSEES

WITH PROCEDURES AND INFORMATION FOR FILING NRC FORM 241

A. PURPOSE

To provide Agreement State licensees with procedures and applicable
guidelines, regulations and information for filing Nuclear Regulatory
Commission Form 241.

B. SAMPLE PROCEDURES LETTER

(Licensee\'s Name)

ATTN:  (Contact Person)

(Title)

(Licensee\'s Address)

(City), (State) (Zip)

Dear (Contact Person):

Agreement State licensees (licensees) seeking to conduct activities
under reciprocity in areas of exclusive Federal jurisdiction,
non-Agreement States, or in offshore waters (reciprocity activities),
for the first time in a calendar year, must submit NRC Form 241,
\"Report of Proposed Activities in Areas of Exclusive Federal
Jurisdiction, Non-Agreement States, and Offshore Waters\"; 4 copies of
the Agreement State specific license; and the fee specified in fee
Category 16, 10 CFR 170.31. NRC must receive this filing at least 3 days
before the licensee engages in activities permitted under the General
License established by 10 CFR 150.20 (Enclosure 1). This general license
authorizes persons holding a specific license from an Agreement State to
conduct the same activity in areas of exclusive Federal jurisdiction,
non-Agreement States, or in offshore waters, if the specific license
issued by the Agreement State does not limit the authorized activity to
specified locations or facilities.

A licensee operating under reciprocity pursuant to 10 CFR 150.20 does
not have to obtain affirmative authorization from NRC before performing
activities requested on NRC Form 241. If, however, in processing NRC
Form 241, NRC determines that the NRC Form 241 contains omissions or
errors, the staff will contact the licensee in an attempt to obtain the
correct information. If the discrepancies cannot be resolved and the
Agreement State licensee does not qualify for the general license, staff
will inform the licensee of this determination and indicate that the
licensee has not complied with the requirements of 10 CFR 150.20, and
work is not to be performed in areas of exclusive Federal jurisdiction,
non‑Agreement States, or in offshore waters, until NRC receives the
required information.

Licensees cannot perform work in areas of exclusive Federal jurisdiction
without either (a) filing NRC Form 241 for reciprocity in accordance
with 10 CFR 150.20(b) or (b) applying for a specific NRC license. An
area of exclusive Federal jurisdiction is an area over which the Federal
government exercises legal control without interference from the
jurisdiction and administration of State law. For example: If the work
is to be performed on Federal property in an Agreement State, the
licensee must first determine the jurisdictional status of the area
where it plans to work. If the licensee is unsure about the
jurisdictional status of the work location on Federal land, it should
contact the Federal agency that controls the facility where the work is
to be performed. Enclosure 2, \"All Agreement States Letter SP-96-022,\"
contains procedures developed by NRC\'s Office of State Programs for
determining exclusive Federal jurisdiction. A written statement
concerning the jurisdictional status is not required, to file for
reciprocity. However, it is recommended that the

(Licensee Name) -2-

Agreement State licensee obtain such a statement for the file for future
reference and inspection purposes.

Under the general license, licensees conducting reciprocity activities,
including storage (usage), are limited to a total of 180 days in any
calendar year. Reciprocity activities conducted in offshore waters are
not subject to the 180-day limit. NRC tracks reciprocity usage on the
basis of approved usage days. NRC will not approve any activity, under
the general license, that causes the total usage days to exceed 180
days. NRC may note, and notify the licensee, that a filing proposes
reciprocity activities which approach or would exceed the 180-day limit.
It is important that licensees track the days of use and submit changes
to dates of work when applicable.

Licensees who perform activities using separate Agreement State licenses
must submit separate reciprocity requests. For example, if a licensee
has separate radiography and service licenses, and performs reciprocity
work under both, the licensee must submit a separate NRC Form 241 with
evidence of the appropriate fee for the initial filing for each license.
The activities under reciprocity for each license will be limited to 180
days.

Enclosure 3 contains guidelines to follow in filing NRC Form 241. It is
expected that licensees will review this information, as well as the
regulations cited in 10 CFR 150.20(b), to ensure that the radiation
safety program is in compliance with NRC regulations before conducting
activities under reciprocity.

NRC will perform inspections of activities performed in non-Agreement
States by Agreement State licensees operating under a general license
pursuant to 10 CFR 150.20. These inspections will occur at the listed
work site location(s) .

Agreement State licensees operating under reciprocity in areas of NRC
jurisdiction must conduct activities involving radioactive materials in
accordance with the conditions specified in the licensee\'s Agreement
State license, representations made in NRC Form 241, and other rules,
regulations, and orders of NRC, now or hereafter in effect. Failure to
comply with these regulations or to conduct your radiation safety
program in compliance with NRC regulations before operating under
reciprocity may result in NRC enforcement action(s) against the
licensee. Such actions could include the issuance of a notice of
violation, the proposed imposition of a civil penalty, or an order
suspending, modifying, or revoking the license as specified in the
\"General Statement of Policy and Procedures for NRC Enforcement
Actions\" enclosed in this package.

(Licensee Name) -3-

During the review of enforcement actions taken against Agreement State
licensees operating under reciprocity, it was noted that some Agreement
State licensees have not always made the effort to become aware of NRC
regulations. This is the licensee\'s obligation. The lack of awareness
of NRC requirements, and applicable provisions is not an acceptable
justification to preclude NRC enforcement actions.

For your information and use in filing for reciprocity, I have enclosed
applicable NRC bulletins (Enclosure 4), information notices (Enclosure
5), and regulatory guides (Enclosure 6); reference copies of NRC Form
241, \"Report of Proposed Activities in Non-Agreement States\"
(Enclosure 7), NRC Form 3, \"Notice to Employees\" (Enclosure 8), 10 CFR
Parts 19, 20, 71 (as applicable, 10 CFR Parts 30, 34, 35, 39, 40, 61,
and 70) (Enclosure 9); and NUREG-1600, \"General Statement of Policy and
Procedures for NRC Enforcement Actions\" (Enclosure 10).

If you have any questions about the regulations or the application
process, please feel free to contact me at (XXX) XXX-XXXX.

Sincerely,

(Reviewing Official)

Enclosures:

1.  10 CFR Part 150

2.  All Agreement States Letter SP-96-022

3.  Guidelines for Filing NRC Form 241

4.  Applicable NRC bulletins, (e.g. NRC Bulletin 95-01)

5.  Applicable Information Notices (e.g. NRC Information Notice 91-49,

6.  "Enforcement of Safety Requirements for Radiographers\" should be
    enclosed for radiography licensees)

7.  Applicable Regulatory Guides

8.  NRC Form 241, \"Report of Proposed Activities in Non-Agreement
    States\"

9.  NRC Form 3, \"Notice to Employees\"

10.10 CFR Parts 19, 20, 71 (as applicable, 10 CFR Parts 30, 34, 35, 39,
40, 61, and 70)

11\. NUREG-1600, \"General Statement of Policy and Procedures for NRC
Enforcement Actions.\"

END

Enclosure:

1\. Guidelines For Filing Nuclear Regulatory

Commission Form 241

(Same as Enclosure 3 in Sample Procedures Letter above)

ENCLOSURE 1

GUIDELINES FOR FILING NUCLEAR REGULATORY COMMISSION FORM 241

[Initial Filing]{.underline}

Agreement State licensees (licensees) seeking to conduct activities
under reciprocity in areas of exclusive Federal jurisdiction,
non-Agreement States, or in offshore waters (reciprocity activities),
for the first time in a calendar year, must submit: NRC Form 241,
\"Report of Proposed Activities in Areas of Exclusive Federal
Jurisdiction, Non-Agreement States, and Offshore Waters\"; 4 copies of
the Agreement State specific license; and evidence of the fee specified
in fee Category 16, 10 CFR 170.31, with the NRC Regional Administrator
for the region where the Agreement State specific license is issued. NRC
must receive this filing at least 3 days before the licensee engages in
activities permitted under the General License established by 10 CFR
150.20. Failure to file NRC Form 241 may result in civil or criminal
penalties.

To facilitate NRC\'s inspection of Agreement State licensees working
under reciprocity, it is important that the information submitted on NRC
Form 241 be specific regarding the location(s) and date(s) of use as
well as the activity requested. If it is not possible to provide
complete addresses for the locations of work, the licensee should
provide as much information as possible, concerning the work site(s) or
client(s) location such as the town, county, or area (e.g., the Bisco
pipeline in Somewhere County, Any State). Please note that reciprocity
activities will not be approved for locations such as \"temporary
jobsites in the United States\" or \"in the State of .\" The licensee is
responsible for providing new or additional information concerning
addresses or locations of work as soon as such information becomes
available. A Location Reference Number will be generated by NRC for use
in tracking reciprocity activities and is specific for each work
location. Location Reference Numbers will be provided to licensees on
the signed Form 241 copies and should be referenced for any changes to
work location information provided on the initial filing of NRC Form
241.

For the dates of work, it is acceptable to indicate that the licensee
will operate under reciprocity for 180 days from January 1 through
December 31, provided the licensee narrows down or deletes dates as they
become known. For example: the initial NRC Form 241 may list March 1 -
March 31 for the site at the Bisco pipeline; however, because of rain,
work was not performed on March 2 - March 10. The need to delete work
dates becomes important when a licensee approaches the 180-day limit;
therefore, the licensee should delete the dates when work was not
performed. (See Changes, below.)

In general, the preferred method of filing is through the facsimile
transmission of NRC Form 241, 4 copies of the Agreement State license,
and evidence that the appropriate fee requirements will be met within
3 days. This evidence can be a copy of the check or a copy of NRC Form
629, if paying by credit card, that will be mailed to the NRC. The
licensee should receive confirmation (by telephone, e-mail, or
facsimile) that NRC has received the facsimile. Alternatively, the
licensee may file the required information through the mail or other
means as long as NRC receives the information at least 3 days before the
licensee engages in the activity.

In addition, the licensee must also submit, by mail, 4 copies of NRC
Form 241, 4 copies of the Agreement State license, and the fee or
evidence that the fee has been paid, within 3 days of the facsimile
transmission. Alternatively, the required information may be transmitted
through the mail or other means as long as NRC receives the information
at least 3 days before the initiation of licensed activities.

[Changes]{.underline}

Additional work locations or clients, changes to the radioactive
material, or work activities that are different from the information
submitted on the initial NRC Form 241 must be filed with the NRC. When
submitting revision requests, file by NRC Form 241 or letter, so that
NRC receives the filing at least 3 days before the licensee engages in
such activity. It is not necessary to resubmit the Agreement State
license unless the license has been amended since the filing of the
initial Form 241. Filing by facsimile is acceptable provided: (1) the
licensee confirms that NRC has received the facsimile; and (2) NRC
receives, within 3 days, NRC Form 241 or letter in lieu of Form 241.

[Emergency Filing]{.underline}

If you are unable to file all the required information by facsimile or
other acceptable method for filing, because of an emergency or for other
reasons, the NRC Regional Administrator may waive the time requirements
specified in 10 CFR 150.20(b)(1) for the filing of NRC Form 241 if you:

a.  Inform the region by telephone, facsimile, an NRC Form 241, or a
    letter of initial activities or changes to the information submitted
    on the initial NRC Form 241; [and]{.underline}

b.  Receive oral or written authorization for the activity(ies) from the
    region; [and]{.underline}

c.  Submit a copy of NRC Form 241, and 4 copies of your Agreement State
    license (for initial filings).

[NRC Receipt]{.underline}

When it has been determined that the required information has been
submitted and the fee payment has been provided, NRC will sign and date
the NRC Form 241 and will forward a copy to the Agreement State
licensee. A licensee operating under reciprocity pursuant to 10 CFR
150.20 does not have to obtain affirmative authorization from NRC before
performing activities requested on NRC Form 241 provided the Form 241
was filed at least 3 days before the licensee engaged in reciprocity
activities. If, however, in processing NRC Form 241, NRC determines that
the NRC Form 241 contains omissions or errors, the NRC staff will
contact the licensee in an attempt to obtain the correct information. If
the discrepancies cannot be resolved and the Agreement State licensee
does not qualify for the general license, NRC staff will inform the
licensee of this determination and indicate that work is not to be
performed in areas of exclusive Federal jurisdiction, non‑Agreement
States, or in offshore waters until NRC receives the required
information.

[Fees]{.underline}

Under the current fee regulations in 10 CFR Parts 170 and 171, initial
filings of NRC Form 241 require payment of a fee.

According to 10 CFR 171.11(a), fees will not be assessed for a license
applied for, by, or issued to, a nonprofit educational institution for
the possession and use of byproduct material, source material, or
special nuclear material.

[Withholding Information]{.underline}

Licensees wishing NRC to withhold, as proprietary or confidential, the
information contained in Items 8 to 12 of NRC Form 241 from public
disclosure must submit an application for withholding accompanied by an
affidavit. The application and affidavit must be submitted in accordance
with 10 CFR 2.790(b)(1) and should be submitted with the initial
submittal of the Form 241 for the calendar year. This means that an
application and affidavit for withholding information must be submitted,
either the first time an Agreement State licensee submits NRC Form 241
for a calendar year, or if the licensee has already submitted an NRC
Form 241 for the year, it must submit an application and affidavit for
withholding information within a week of NRC\'s receipt of the Form 241.

NRC\'s Office of the General Counsel has determined that only the
information requested in Items 8 to 12 of NRC Form 241 can be considered
for withholding from public disclosure as proprietary information.
Therefore, if your company wishes NRC to withhold the information
contained in NRC Form 241, Items 8 to 12, from public disclosure, you or
the company, as owner of the information, must submit an application and
affidavit for withholding in accordance with 10 CFR 2.790(b)(1). Only
the information requested to be withheld as proprietary needs to be
accompanied by an affidavit. For the Commission to determine whether the
information should be withheld from public disclosure, you should
address the following items in sufficient explanatory detail in addition
to the other requirements of 10 CFR 2.790:

-   Clearly identify the document(s), or parts thereof, to be withheld
    as proprietary or confidential.

-   State whether this information is held in confidence by the owner of
    the information.

-   Provide a rational basis for requesting withholding of the
    information. Clearly state the reasons why your company believes the
    information contained therein is proprietary or confidential.

-   Confirm that the information transmitted to, and received by, NRC is
    held in confidence. Please give details.

-   To the best of your knowledge, state whether the information is
    currently available in public sources.

-   Confirm whether your company customarily treats this information, or
    this type of information, as confidential. Please explain why.

-   Determine whether the public disclosure of the information would be
    likely to cause substantial harm to the competitive position of your
    company. If so, explain why in detail. Your affidavit should also
    include the value of the information to your company, the amount of
    effort or money expended in developing the information, and the ease
    or difficulty for others to acquire the information.

-   Clearly identify the position of the person executing the affidavit
    (an officer or upper-level management official delegated to review
    the information sought to be withheld and authorized to apply for
    withholding on behalf of the company.)

-   State that the company submitting the affidavit is the owner of the
    information or is required, by agreement with the owner of the
    information, to treat the information as proprietary and that the
    affiant is an employee of the company.

Two versions of the Form 241 should be submitted with brackets (\[ \])
placed around the information sought to be withheld. One version should
keep the information in brackets intact for NRC\'s use in processing the
request for reciprocity. The other version should be \"sanitized\" for
public disclosure by deleting the information sought to be withheld. If
the information is determined to be proprietary, the \"sanitized\"
version will be the version placed in the PDR.

On reviewing your application and affidavit, the NRC regional office
will notify you by letter acknowledging agreement or disagreement with
your request for information to be maintained as proprietary
information. For deficient affidavits, you will be requested to provide
additional information.

Once approved, a request for withholding proprietary or confidential
information will be maintained by the NRC regional office indefinitely
or for as long as you, as the Agreement State licensee, perform
reciprocity activities and submit NRC Form 241s. If you should skip a
year between filing reciprocity requests, you must resubmit your request
and affidavit for withholding proprietary information.

[Additional Requirements]{.underline}

Additional pertinent regulations are cited in 10 CFR 150.20(b). In
particular, radiographers and radiographers\' assistants must, at all
times during radiographic operations, wear direct reading pocket
dosimeters, alarm ratemeters, AND either film badges or
thermoluminescent dosimeters (TLDs) as required by 10 CFR 34.33(a).
Secondly, radiographic exposure devices, sources, and associated
equipment must comply with the requirements described in 10 CFR 34.20.
Licensees need to be aware that when exposure devices are transported,
Department of Transportation regulations must be followed. These
regulations can be found in 49 CFR and are incorporated by reference in
10 CFR 71.5. Also, to transport certain devices, licensees must be
registered as users for all approved packages issued Certificate of
Compliance numbers. Package users also need to have a quality assurance
program as specified in 10 CFR 71.12(c) and outlined in NRC Bulletin
95-01, \"Quality Assurance Program for Transportation of Radioactive
Material.\" Industrial radiography licensees in the Agreement States
should be aware that 10 CFR 34.31(b)(2) requires each licensee to have
written procedures for inspection and maintenance of Type B packaging
used to transport radioactive materials. The inspection and maintenance
program must include procedures to assure that Type B packages are
shipped and maintained in accordance with the Certificate of Compliance
or other approvals.

APPENDIX III

INSPECTION OF AGREEMENT STATE LICENSEES

A.  PURPOSE

Policy and guidelines for performing inspections of Agreement State
licensees working under reciprocity.

B.  INSPECTION

The regional office(s) that have U.S. Nuclear Regulatory Commission
(NRC) jurisdiction in the area(s) in which the Agreement State licensees
will operate shall take the following action:

1.  Frequency

> Inspections of Agreement State licensees operating under general
> licenses under 10 CFR 150.20 should be conducted using the same
> provisions used for equivalent NRC-licensed activities, except as
> specifically defined in this chapter. These provisions include, but
> are not limited to, inspection processes and inspection records as
> defined in NRC Manual Chapter 2800 (MC 2800). However, the inspection
> frequencies for reciprocity licensees are not subject to the
> provisions in MC 2800 and are not to be extended for good licensee
> performance.
>
> To determine if a reciprocity licensee should be a candidate for
> inspection, the region processing the initial NRC Form 241 request
> should do the following:

a.  Determine if the reciprocity licensee has had NRC escalated
    enforcement in the past 2 years.

b.  Review the Nuclear Materials Event Database (NMED) to determine if
    the reciprocity licensee has had a significant NMED event (e.g.,
    source disconnects, lost sources, overexposures) in the past 2
    years.

> If NRC has inspected the reciprocity licensee (in the field), in the
> last calendar year, and the licensee has not had escalated enforcement
> or a significant NMED event in the past 2 years, then the reciprocity
> licensee is NOT to be considered a candidate for inspection. All other
> reciprocity licensees are to be considered candidates for inspection.
>
> The percentages of inspections of reciprocity licensees to be
> inspected each year are based on the number of candidates for
> inspection per region. The percentages of inspections by program code
> and priority should be as follows, with Priorities 1 through 3 as Core
> Inspections and the remaining priorities as non-Core Inspections:
>
> Priorities 1, 2, and 3 program codes - 20 percent of the candidate
> licensees from the candidate pool are to be inspected each year.
>
> All other program codes - Are to be inspected each year, as resource
> and inspection schedules permit.
>
> NOTE: If the work to be performed by the reciprocity licensee (who is
> a candidate for inspection) is within a Region other than the Region
> that received the Form 241, the Region receiving the Form 241 should
> promptly notify the Region where the work is to be done of the
> Accession Number of the Form 241 and supporting documentation.
>
> NOTE: In cases where a licensee performs reciprocity activities in
> several regions, the Region with the first opportunity to inspect the
> licensee at a work site should do so. The completed inspection should
> be recorded as a completion for the inspecting Region. The inspecting
> Region should notify the Regional Office responsible for the area in
> which the Agreement State licensee is located.

2.  Location

> Inspections of Agreement State licensees operating under reciprocity
> in areas of NRC jurisdiction pose many difficulties, such as short
> lead time and logistics. Nevertheless, reciprocity inspections are to
> be conducted during actual field work. Such inspections should be
> unannounced, but may be announced, when necessary, in the interest of
> effectiveness and efficiency.

C.  INSPECTION REPORTS AND ENFORCEMENT ACTION

Inspection records (unless escalated enforcement action is anticipated)
shall be prepared for all inspections of Agreement State licensee
activities. The inspecting Region should enter any pertinent information
\[as described in the Reciprocity Tracking System (RTS) Users Manual\]
about inspections and escalated enforcement actions into the RTS. The
inspection report number should be recorded in the comment field in the
RTS.

> Note: For assist inspections, follow the procedures in MC 2800.

\"General Policy and Procedure for NRC Enforcement Actions,\"
NUREG-1600, shall be used as the policy and criteria for taking
enforcement actions against the licensee. Copies of the enforcement
correspondence shall be sent to:

> The Agreement State authority issuing the license under which the
> Agreement State licensee is operating;
>
> The NRC regional office in which the Agreement State is located; and
>
> Other distribution, in accordance with existing procedures.

END