DATED: JULY 8, 1997 SIGNED BY: HUGH L. THOMPSON, JR.

Mr. Thomas W. Ortciger, Director

Illinois Department of Nuclear Safety

1035 Outer Park Drive

Springfield, IL 62704

Dear Mr. Ortciger:

On July 2, 1997, the Management Review Board (MRB) met to consider the

proposed final Integrated Materials Performance Evaluation Program (IMPEP)

report on the Illinois Agreement State Program. The MRB found the Illinois

program adequate to protect public health and safety and compatible with NRC's

program. 

Section 5, page 22, of the enclosed final report presents the IMPEP team's

suggestions and recommendations. We request your evaluation and response to

those suggestions and recommendations within 30 days from receipt of this

letter.

Based on the results of the current IMPEP review, the next review will be

scheduled in four years, unless program concerns develop that require an

earlier evaluation.

I appreciate the courtesy and cooperation extended to the IMPEP team during

the review and your support of the Radiation Control Program. I look forward

to our agencies continuing to work cooperatively in the future.

Sincerely,/RA/

Hugh L. Thompson, Jr.

Deputy Executive Director

 for Regulatory Programs

Enclosure:

As stated

cc: Gordon Appel, Deputy Director, IDNS

Paul Eastvold, Manager, Office of Radiation Safety, IDNS
Mr. Thomas W. Ortciger, Director

Illinois Department of Nuclear Safety

1035 Outer Park Drive

Springfield, IL 62704

Dear Mr. Ortciger:

On July 2, 1997, the Management Review Board (MRB) met to consider the

proposed final Integrated Materials Performance Evaluation Program (IMPEP)

report on the Illinois Agreement State Program. The MRB found the Illinois

program adequate to protect public health and safety and compatible with NRC's

program. 

Section 5, page 22, of the enclosed final report presents the IMPEP team's

suggestions and recommendations. We request your evaluation and response to

those suggestions and recommendations within 30 days from receipt of this

letter.

Based on the results of the current IMPEP review, the next review will be

scheduled in four years, unless program concerns develop that require an

earlier evaluation.

I appreciate the courtesy and cooperation extended to the IMPEP team during

the review and your support of the Radiation Control Program. I look forward

to our agencies continuing to work cooperatively in the future.

Sincerely,

Hugh L. Thompson, Jr.

Deputy Executive Director

 for Regulatory Programs

Enclosure:

As stated

cc: Gordon Appel, Deputy Director, IDNS

Paul Eastvold, Manager, Office of Radiation Safety, IDNS

bcc: Chairman Jackson

Commissioner Dicus

Commissioner Diaz

Commissioner McGaffigan

Distribution:

DIR RF DCD (SP01)

SDroggitis, OSP LRakovan, OSP PDR (YES_T NO_)

KSchneider, OSP JLynch, RIII

SMoore, NMSS JJohnson, KS RQuillin, CO

MBurgess, NMSS RWoodruff, RII CPaperiello, NMSS

GDeegan, NMSS DSollenberger, OSP RBarrett, AEOD

FCameron, OGC KCyr, OGC FCongel, AEOD

HNewsome, OGC WOmstead, OGC TCombs, OCA

DOCUMENT NAME: G:\KXS\97FINLTR.IL G:\KXS\ILIMP97.FIN G:\LJR\ILL2.LTR *See previous

concurrence. To receive a copy of this document, indicate in the box: "C" = Copy without attachment/enclosure "E" = Copy with attachment/enclosure "N" =

No copy

OFFICE Region II E OSP:DD OSP:D DEDR

NAME RWoodruff:nb:kk PHLohaus RLBangart HLThompson 

DATE 07/07/97* 07/07/97* 07/07/97* 07/ /97

OSP FILE CODE: SP-AG-8
INTEGRATED MATERIALS PERFORMANCE EVALUATION PROGRAM

REVIEW OF ILLINOIS AGREEMENT STATE PROGRAM

MARCH 24-28, 1997

FINAL REPORT

U.S. Nuclear Regulatory Commission
Illinois Final Report Page 2

1.0 INTRODUCTION

This report presents the results of the review of the Illinois radiation

control program. The review was conducted during the period March 24-28,

1997, by a review team comprised of technical staff members from the Nuclear

Regulatory Commission (NRC) and the Agreement State of Kansas. Team members

are identified in Appendix A. The review was conducted in accordance with the

"Interim Implementation of the Integrated Materials Performance Evaluation

Program Pending Final Commission Approval of the Statement of Principles and

Policy for the Agreement State Program and the Policy Statement on Adequacy

and Compatibility of Agreement State Programs," published in the Federal

Register on October 25, 1995, and the September 12, 1995, NRC Management

Directive 5.6, "Integrated Materials Performance Evaluation Program (IMPEP)." 

Preliminary results of the review, which covered the period July 23, 1994 to

March 28, 1997, were discussed with Illinois management on March 28, 1997. 

A draft of this report was issued to Illinois for factual comment on April 15,

1997. The State of Illinois responded in a letter dated June 2, 1997

(Attachment 1). The State's factual comments were considered by the team and

accommodated in the report as described in the June 25, 1995 memorandum to the

Management Review Board (MRB) transmitting the proposed final report

(Attachment 2). The MRB met on July 2, 1997, to consider the proposed final

report. Based on the existing NRC compatibility policy and the IMPEP

evaluation criteria, the review team recommended that Illinois' performance

with respect to the indicator, Legislation and Regulations, be found

unsatisfactory. Illinois has not yet adopted the Decommissioning

Recordkeeping regulation, or equivalent legally binding requirements, within

the specified period of time. At the MRB, Illinois noted that this regulation

is in process and projected for final adoption in late 1997 or early 1998. 

Because of the progress to date in the promulgation of this rule, the expected

adoption date in early 1998, and the lack of disruption to the collective

regulatory efforts of NRC and the Agreement States, the MRB determined that a

sufficient basis did not exist to support a finding of unsatisfactory for this

indicator. The MRB noted that if significant delays in rule adoption occur or

if Illinois adopts a rule that is not compatible with the NRC equivalent

regulations, the MRB could always reconsider the program compatibility finding

at a future date. The MRB final recommendation for Legislation and

Regulations is satisfactory. The MRB found the Illinois radiation control

program was adequate to protect public health and safety and compatible with

NRC's program

The Illinois Department of Nuclear Safety (IDNS) is a cabinet level agency

within Illinois State Government. The Director is appointed by and reports

directly to the Governor. The Office of Radiation Safety (ORS), which

includes the Division of Radioactive Materials (DRM), and the Office of

Environmental Safety (OES), report directly to the Department Director. The

IDNS organization charts are included as Appendix B. The DRM program

regulates approximately 857 materials licenses, has an 11e(2) uranium

(thorium) recovery program for the decommissioning of the Kerr-McGee West

Chicago site, and is the host State for the Central Midwest Low-Level

Radioactive Waste Compact. In addition to the radioactive materials program,

the IDNS administers programs for inspections at nuclear power plants and

emergency response under the Office of Nuclear Facility Safety, and an

environmental monitoring program and laboratory under the Office of

Environmental Safety. The review focused on the materials program as it is

carried out under the Section 274b. (of the Atomic Energy Act of 1954, as

amended) Agreement between the NRC and the State of Illinois. 
Illinois Final Report Page 3

In preparation for the review, a questionnaire addressing the common and noncommon indicators was sent to ORS on January 10, 1997. Illinois provided its

response to the questionnaire on February 24, 1997. A copy of that response,

as updated during the review, is included as Appendix C to this report. 

The review team's general approach for conduct of this review consisted of:

(1) examination of Illinois' response to the questionnaire, (2) review of

applicable Illinois statutes and regulations, (3) analysis of quantitative

information from the DRM licensing and inspection data base, (4) technical

review of selected files, (5) field accompaniments of three Illinois materials

inspectors, (6) the on-site visit at the Kerr-McGee West Chicago site that is

undergoing decommissioning, and (7) interviews with staff and management to

answer questions or clarify issues. The team evaluated the information that

it gathered against the IMPEP performance criteria for each common and noncommon indicator and made a preliminary assessment of the radiation control

programs's performance. 

Section 2 below discusses the State's actions in response to recommendations

made following the previous review. Results of the current review for the

IMPEP common performance indicators are presented in Section 3. Section 4

discusses results of the applicable non-common indicators, and Section 5

summarizes the review team's findings and recommendations.

2.0 STATUS OF ITEMS IDENTIFIED IN PREVIOUS REVIEWS

The previous routine review concluded on July 22, 1994. It should be noted

that Illinois participated in the IMPEP pilot program concurrent with the 1994

review. The final results of the review were transmitted to the Director,

IDNS, on December 28, 1994. 

The July 1994 review findings resulted in recommendations in eight program

indicators:

(1) Status and Compatibility of Regulations; (2) Legal Assistance; (3)

Administrative Procedures; (4) Status of the Inspection Program; (5)

Enforcement Procedures;(6) Inspection Procedures; (7) Inspection Reports; and

(8) Confirmatory Measurements. The State responded by letter dated February

24, 1995. On March 9, 1995, the Office of State Programs (OSP) met with State

staff to discuss unresolved issues concerning the Status and Compatibility of

Regulations. Following this meeting, OSP documented NRC's positions regarding

the compatibility issues in a letter dated September 7, 1995, and closed out

the other recommendations (2) through (8) based upon the meeting discussions,

and the State's letter of February 24, 1995. The State's corrective actions

were also evaluated during a review visit by the Region III State Agreements

Officer (RSAO) during the period of July 26 - August 2, 1995, and the results

of this visit were provided to the State on September 14, 1995. 

The recommendations regarding the Status and Compatibility of Regulations

indicator remain open, and are discussed in detail under Section 4.1. 

3.0 COMMON PERFORMANCE INDICATORS

IMPEP identifies five common performance indicators to be used in reviewing

both NRC Regional and Agreement State programs. These indicators include: 

(1) Status of Materials Inspection Program; (2) Technical Staffing and

Training, (3) Technical Quality of Licensing Actions, (4) Technical Quality of

Inspections, and (5) Response to Incidents and Allegations.
Illinois Final Report Page 4

3.1 Status of Materials Inspection Program

The team focused on four factors in reviewing this indicator: inspection

frequency, overdue inspections, initial inspection of new licenses, and timely

dispatch of inspection findings to licensees. The team evaluation is based on

the Illinois' questionnaire response relative to this indicator, data gathered

independently from the State's licensing and inspection data tracking system,

the examination of licensing and inspection casework files, and interviews

with managers and staff.

The team's review of the State's inspection priorities verified that the

State's inspection frequencies for various types or groups of licenses are at

least as frequent as similar license types or groups listed in the frequency

schedule in the NRC Inspection Manual Chapter (IMC) 2800. The State requires

more frequent inspections in some license categories as follows: wireline

services were verified to be inspected on a two year frequency as compared to

the NRC three year frequency; all type A broad scope licenses are inspected on

a one year frequency compared with the NRC two year frequency for type A broad

industrial and academic, and a one year frequency of type A broad medical;

type B and C broad scope licenses are inspected on a two and three year

frequency, respectively, compared to the NRC frequencies of three and five

years; and general license (GL) distribution type licenses are on a four year

frequency compared to NRC's five year frequency.

The inspection frequencies of licenses selected for inspection file review

were compared with the frequencies listed in the State's data system and

verified to be consistent with the State's system and as frequent as similar

license types under the IMC 2800 system.

In their response to the questionnaire, Illinois indicated that there were no

inspections overdue by more than 25 percent of the NRC frequency. This

information was verified during the inspection casework reviews, and the

review of the monthly generated "inspections due" listing provided to the

team. 

With respect to initial inspections of new licensees, the team reviewed the

inspection tracking data system and verified that the initial inspections had

been entered into the tracking system. Discussions with staff members were

conducted to determine how initial inspections are assigned and how data are

entered into the system. The inspection data system is updated as inspection

reports are developed, and the "inspections due" listing is updated on a

monthly basis, and provided to the inspectors. The initial inspections are

assigned a three month inspection due date with a 25 percent window, which

allows the inspections to be conducted well within the six month interval

after issuance.

The timeliness of the issuance of inspection findings was also evaluated

during the inspection file review. Out of 19 inspection files examined, eight

of the inspection findings sent to the licensees exceeded the 30 day guidance

in IMC 2800 for notification to the licensee following completion of the

inspection. Of these late notifications, two were clear inspections, and the

other six required from 50 to 84 days for the findings to be dispatched to the

licensee. The DRM policy requires the findings to be dispatched within 30

days following the inspection, same as NRC policy. The team suggests that the

State examine their procedures for preparing inspection reports and

correspondence, and make modifications needed to assure timely issuance of

inspection findings. 
Illinois Final Report Page 5

The State reported in their response to the questionnaire that 77 licensees

had submitted 1,276 requests for reciprocity during the review period, of

which 42 were from licensees with inspection intervals of three years or less. 

The State reported that seven reciprocity licenses were inspected, which

represents about 17 percent of the reciprocity licenses available for

inspection. Four of the inspections were industrial radiography, two were

source exchanges, and one was a well logger. In addition, the State conducted

seven additional non-reciprocity inspections of industrial radiography field

sites. The team considered that the State had expended considerable resources

since the last review to overcome the previous inspection backlog, and that in

this instance, the numbers of reciprocity type inspections were adequate. 

Representatives from the State of Illinois stated that it was not necessary to

inspect 50 percent of the reciprocity licensees to ensure safe licensee

operations, and the State reiterated this opinion in the June 2, 1997 response

to the draft report. However, now that the inspection backlog has been

overcome, the team suggests that the State should reconsider the IMC 1220

guidance for conducting reciprocity inspections, and increase the reciprocity

inspections to meet the guidance. 

Based on the IMPEP evaluation criteria, the review team recommends that the

Illinois' performance with respect to the indicator, Status of Materials

Inspection Program, be found satisfactory.

3.2 Technical Staffing and Training

In reviewing this indicator, the review team considered the radioactive

materials program staffing level, technical qualifications of the staff,

training, and staff turnover. To evaluate these issues, the review team

examined the State's questionnaire responses relative to this indicator,

interviewed IDNS management and staff, reviewed training records, and

considered any possible workload backlogs.

The IDNS organization chart shows that the Department consists of the Office

of Legal Counsel, the Office of Nuclear Facility Safety, the OES, the Office

of Administrative Services, and the ORS. 

ORS is made up of the Division of Electronics, and DRM. DRM has two Sections,

Licensing, and Inspection and Enforcement. The Licensing Section has four

positions for materials licensing, and five persons for low-level radioactive

waste and uranium/thorium mill licensing. The Inspection and Enforcement

Section has one inspector located in Springfield and five inspectors in the

Glen Ellyn Regional Office. The West Chicago office provides support for the

Mill Program which will be discussed under the appropriate non-common

indicator (Section 4.4). The Section managers and the DRM Chief are technical

managers. 

IDNS has established qualifications for all of the technical positions. 

Applicants for health physicist and engineer positions are required to have a

baccalaureate degree and are assigned duties in the program based upon their

experience and training. The experience and training of each person is

evaluated and additional training is given based upon the specific needs of

the position. Several of the personnel have advanced degrees in Health

Physics, two persons are certified health physicists, and two low-level

radioactive waste persons have degrees in Engineering, both are professional

engineers, and one with an advanced degree in Geology.

 

All license reviewers have had the basic health physics courses and the

Licensing course. All inspectors have had the basic health physics training

and the Inspection Procedures course. Other specialized training is given
Illinois Final Report Page 6

depending upon the needs of the position. Staff are assigned increasingly

complex licensing duties under the direction of senior staff, and accompany

experienced inspectors during increasingly complex compliance inspections. 

Staff are required to demonstrate competence as determined during

accompaniments by their supervisors. This information was verified through

discussions with managers and staff, review of the questionnaire response, and

review of the position descriptions. The team determined that all staff

utilized for the agreement materials program were technically qualified by

evidence of their training and experience. 

DRM reported that the program had experienced only two turnovers since the

previous review. One person left for additional schooling and the other

person accepted a position with a licensee. The vacancies were filled within

a matter of months and the program manager related that DRM had not

experienced any problems in replacing personnel in vacated positions. 

Although DRM has not participated in NRC training courses this fiscal year, a

review of the training records, and statements made by managers, confirmed

that DRM is committed to continued staff training as needed to allow the staff

to carry out the duties and functions of the radiation control program. The

DRM manager related that special training could be provided as needed through

contracts. 

Based on the IMPEP evaluation criteria, the review team recommends that the

Illinois' performance with respect to the indicator, Technical Staffing and

Training, be found satisfactory.

3.3 Technical Quality of Licensing Actions

The review team examined casework and interviewed the reviewers for 19

specific licenses. Licensing actions were reviewed for completeness,

consistency, proper radionuclides and quantities used, qualifications of

authorized users, adequate facilities and equipment, and operating and

emergency procedures sufficient to establish the basis for licensing actions. 

Casework was reviewed for timeliness, adherence to good health physics

practices, reference to appropriate regulations, documentation of safety

evaluation reports, product certifications or other supporting documents,

consideration of enforcement history on renewals, pre-licensing visits, peer

or supervisory review as indicated, and proper signature authorities. 

Licenses were reviewed for accuracy, appropriateness of the license and of its

conditions and tie-down conditions, and overall technical quality. The files

were checked for retention of necessary documents and supporting data.

The cases were selected to provide a representative sample of licensing

actions which had been completed in the review period and to include work by

all reviewers. The cross-section sampling included the following types of

licenses: large irradiator, medical, academic, nuclear pharmacy, research and

development, veterinary nuclear medicine, service, industrial radiography,

portable gauges and devices, wireline services and in-vitro general license. 

Licensing actions included one new license, five renewals, nine amendments,

and four terminations. A list of these licenses with case-specific comments

may be found in Appendix D.

The review team found that the licensing actions were generally thorough,

complete, consistent, and of acceptable quality with health and safety issues

properly addressed. License tie-down conditions were almost always stated

clearly, backed by information contained in the file, and inspectable. The

licensee's compliance history was taken into account when reviewing renewal

applications. Good communication was identified between licensing and
Illinois Final Report Page 7

inspection staff via “green sheets” placed in license files. Reviewers

appropriately used the State's licensing guides, license templates, standard

conditions and checklists. The licensing supervisor reviews and signs all

licensing actions. No potentially significant health and safety issues were

identified. 

One file review of a nuclear gauge distribution and installation license

identified a contradiction between a leak test license condition and the

sealed source and device (SS&D) registry sheet for a gauge. After the review,

IDNS contacted the State of California and determined that the SS&D registry

sheet inappropriately required leak testing of gauges at installation. 

California will correct the sheet at the next amendment. The review team

suggests that license reviewers check SS&D registry sheets prior to

authorizing license modifications which result in a change in the handling of

a sealed source or device. During the MRB, Illinois noted that IDNS staff's

normal practice is to check SS&D registry sheets in licensing actions.

IDNS maintains an aggressive program in the decommissioning area. In

addition, since 1993, NRC Region III has sent copies of 54 terminated NRC

license files, authorizing use of radioactive material at facilities in

Illinois, to IDNS for review and close-out. These license files were

identified during a contractor review of terminated license files which had

insufficient documentation to assure that radioactive material had been

properly disposed of and/or remediated when the licenses were terminated. 

IDNS performed historical research and performed surveys at the formerlylicensed sites. All but one of the sites, which is in remediation, have been

closed out. An NRC health physicist assisted the State on one of the facility

surveys. Records of the close-out measures were provided to NRC for inclusion

in the terminated license files. This effort was an excellent independent and

cooperative effort by IDNS.

Based on the IMPEP evaluation criteria, the review team recommends that

Illinois' performance with respect to the indicator, Technical Quality of

Licensing Actions, be found satisfactory.

3.4 Technical Quality of Inspections

The team reviewed the inspection reports, enforcement documentation, and

inspection field notes for 24 materials inspections conducted during the

review period. The casework included all six of the State's materials

inspectors and covered a sampling of different license types as follows: 

industrial radiography, wireline services, broad scope university, broad scope

research and development, broad scope medical, veterinary medicine,

teletherapy, brachytherapy, manufacturing and distribution, nuclear laundry,

nuclear medicine, large hospital, nuclear pharmacy, laboratory use, waste

packaging, large irradiator, portable gauge, and fixed gauge licensees. 

Appendix E lists the inspection cases reviewed in depth with case-specific

comments.

The team reviewed the inspection reports and found them to be comparable with

the types of information and data collected under NRC Inspection Procedure

(IP) 87100. The inspection procedures and techniques utilized by the State

were reviewed and determined to be consistent with the inspection guidance

provided in NRC IMC 2800. 

In addition, several spot checks were performed on the files to verify that

enforcement correspondence was being maintained in a consistent manner and to

verify the implementation of the proper inspection frequency. In all cases,

license files selected from the data base for the spot checks were determined
Illinois Final Report Page 8

to have the proper inspection frequency and current inspection findings and

correspondence. Some of the inspection files were also reviewed during the

license file review, thus providing further insight on how the State considers

inspection findings when completing a licensing action.

The review team noted that routine inspections adequately cover the licensee's

radiation program and include a written summary of the scope of the licensed

activities and a root cause if a noncompliance was identified. The review

team also noted that the inspectors observed licensed operations whenever

possible. The observation of licensed activities provides the inspectors with

an indication of the effectiveness of the licensee's radiation protection

program. Inspection accompaniments were conducted by the ORS Manager, the DRM

Chief, the Inspection and Enforcement Head, as well as the Glen Ellyn office

supervisor. Accompaniments give the IDNS program management a better

understanding of both the inspectors' abilities and competence to perform

license inspections and provide a better insight into licensee programs.

The inspection field notes provided documentation of inspection findings in a

consistent manner. The State uses separate inspection field notes for various

classes of licensees, such as industrial radiography, wireline services, broad

scope university, broad scope research and development, broad scope medical,

teletherapy, manufacturing and distribution, nuclear medicine, pool

irradiators, portable gauge, and fixed gauge licensees. The inspection field

notes provide documentation of the scope of the licensee's program including: 

unusual occurrences; postings; storage and use of radioactive material;

receipt, transfer, and disposal of radioactive material; inventory; leak

tests; radiation protection program; personnel monitoring; training;

independent measurements; and inspection compliance and noncompliance

findings. The review team also noted that the DRM had specific field notes

for radiography field sites and follow-up forms for documenting follow-up

inspections to ensure previously cited violations have been corrected.

The inspection reports and field notes demonstrated that DRM inspectors were

examining appropriate radiation health and safety issues at licensees'

facilities. From the review of case work, the review team found a number of

minor issues (i.e., timeliness of letters to licensee, announced inspections,

supervisory oversight) that were discussed directly with the Head, Inspection

and Enforcement Section. However, none of the issues indicated a systemic

problem in the technical quality of inspections. The review team found that

the inspection reports contained only minor discrepancies, when compared to

DRM internal guidance or standard practices.

All of the inspection results and reports, correspondence and enforcement

letters were verified as having been reviewed and signed off by the Head,

Inspection and Enforcement Section, before issuing the results to licensees. 

The review team concluded that this supervisory review enhanced the quality of

the inspection and enforcement documents.

The appropriateness of announcing routine materials inspections was discussed

with DRM managers during this review. As iterated during the previous review,

IDNS' philosophy with regard to the announcing of inspections considers less

than 24-hour notification to a licensee to be an "unannounced" inspection. 

DRM staff members stated that if a licensee, upon notification of an

inspection the next day, indicated that the Radiation Safety Officer (RSO)

would not be available for the inspection, the inspection would likely be

deferred. Although this scheduling practice is not consistent with NRC

guidance, it is a reasonable approach. The review team suggests that the

State evaluate whether the practice of deferring inspections due to licensee

scheduling conflicts is being abused.
Illinois Final Report Page 9

Three inspector accompaniments were performed by a review team member during

the period of March 11-14, 1997. One inspector was accompanied during the

inspection of a nuclear medicine program, and the other two inspectors were

accompanied on portable gauge inspections. These accompaniments are

identified in Appendix E. The three other DRM inspectors have been

accompanied during previous reviews. On the accompaniments, the DRM

inspectors demonstrated appropriate inspection techniques and knowledge of the

regulations. The inspectors were well prepared and thorough in their reviews

of the licensees' radiation safety programs. Overall, the technical

performance of the inspectors was satisfactory, and their inspections were

adequate to assess radiological health and safety at the licensed facilities.

The State calibrates their own survey instruments at their CRCPD-certified

Regional Calibration Facility. The review team interviewed the individual

responsible for the calibration of the State's radiological survey

instrumentation. The calibration facility has National Institute of Science

and Technology traceable sealed sources to determine the efficiency of

beta/gamma instrumentation.

It was noted that the State has a variety of portable instruments for routine

confirmatory surveys and use during incidents and emergency conditions. The

instruments were a good mix of low range GM tubes and pancake probes, micro R

meters, high range instruments, instrumentation with calibration standards for

alpha detection, a neutron rem ball, a portable multichannel analyzer, and the

Environmental Laboratory maintains a mobile laboratory van for use in

emergencies and emergency exercises. Air monitoring equipment is also

available. The portable instruments used during the inspector accompaniments

were observed to be operational and calibrated. The portable instruments

maintained in the DRM office were also observed to be calibrated.

Based on the IMPEP evaluation criteria, the review team recommends that

Illinois' performance with respect to the indicator, Technical Quality of

Inspections, be found satisfactory.

3.5 Response to Incidents and Allegations

In evaluating the effectiveness of the State's actions in responding to

incidents and allegations, the review team examined the State's response to

the questionnaire regarding this indicator, reviewed the incidents reported

for Illinois' "Nuclear Material Events Database" (NMED) against those

contained in the Illinois' files, reviewed in general all 1996 and 1997

incident files, and reviewed in detail the casework of 17 incident files and

five allegation files. In addition, the review team interviewed the DRM

Chief, the Head, Inspection and Enforcement Section, and the Freedom of

Information Act (FOIA) Officer.

Responsibility for initial response and follow-up actions to materials

incidents and allegations rests with the Inspection and Enforcement Section. 

IDNS procedures require the prompt response to each significant incident or

allegation. Each incoming notification is discussed with management and staff

as appropriate and the response is coordinated with the appropriate field

staff including an on-site inspection as appropriate. The managers related

that all incidents, complaints, and allegations are evaluated by management,

followed up with an inspection when necessary, and recorded and tracked in the

computerized tracking system. The State does not utilize the NMED system for

reporting significant events, but the event information is provided on printed

copy to the Office of State Programs (OSP) for entry into the NMED system. 

Initial notification is made through the RSAO, Region III.
Illinois Final Report Page 10

The review team suggests that the procedures for notifying NRC of incidents be

revised to reflect the current guidance to Agreement States to notify the NRC

Headquarters Operations Center of events requiring immediate or 24-hour

reporting by the licensee.

The review team examined in detail the State's response and documentation of

the 17 events listed in Appendix F and verbally discussed several other events

with the Head, Inspection and Enforcement Section. This effort included the

State's incident and allegation process, tracking system, file documentation,

open records laws and policies, and notification of events to other Federal

and State agencies. 

The review team found that the State's responses generally were well within

the performance criteria. Responses were prompt and well-coordinated, and the

level of effort was commensurate with health and safety significance. 

Inspectors were dispatched to the site when appropriate. In general, the

State took suitable corrective and enforcement actions, notified the NRC,

other States, and other agencies as appropriate, and followed the progress of

the investigation through until close out.

As noted above, Illinois does not participate in the NMED program offered by

NRC. The State has their own tracking system and data/report entry system,

and all events and allegations are tracked chronologically by date. 

Significant events are reported to the RSAO, Region III, and printed copies of

the event reports are submitted to OSP for entry into the NMED system. The

team discussed the merits of participating in the NMED system, including

quality control, and queries available for generating various reports that

would be of value to license reviewers and inspectors, and program managers. 

The DRM Chief related that the State's system was easier to use than the NRC

system; however, the State is considering converting their software to

Microsoft Access. The review team suggests that the State reconsider the

benefits of participating in the NMED system. 

All five allegation files reviewed were referred to the State from Region III,

and all were closed out with Region III. Region III reported that there were

no outstanding allegations that had been referred to the State of Illinois. 

Allegations were responded to promptly with appropriate investigations and

follow-up actions. The identity of a Concerned Individual (CI) can be

protected under the State's open record law. IDNS management related that all

confidential information is approved and processed by the FOIA Officer. The

CI’s identity can be protected as needed, and the managers related that

notification to the CI concerning the results of investigations are provided

as needed. This close out action was confirmed by the reviewer. All

allegations received by the State are handled in accordance with the same

procedures as those used for allegations referred to the State of Illinois by

NRC. In general, the State's response was determined by the review team to

meet the indicator guidance. 

The review team also found good correlation of the State's response to the

questionnaire, the incident information in the files, and the event

information reported on the NMED system printout for Illinois. 

Based on the IMPEP evaluation criteria, the review team recommends that

Illinois' performance with respect to the indicator, Response to Incidents and

Allegations, be found satisfactory. 
Illinois Final Report Page 11

4.0 NON-COMMON PERFORMANCE INDICATORS

IMPEP identifies four non-common performance indicators to be used in

reviewing Agreement State programs: (1) Legislation and Regulations, (2)

Sealed Source and Device Evaluation Program, (3) Low-Level Radioactive Waste

Disposal Program, and (4) Uranium Recovery Program. Illinois is the host

State for the Central Midwest Low-Level Radioactive Waste Compact, and

received an amended Agreement in 1990 to include authority for 11e(2)

byproduct material; therefore, all of the four non-common performance

indicators were applicable to this review.

4.1 Legislation and Regulations

4.1.1 Legislative and Legal Authority

The State provided, in their response to the questionnaire, a listing of

legislation that affects the radiation control program. IDNS is designated as

the State radiation protection agency under the provisions of the Radiation

Protection Act of 1990, as amended [420 ILCS 40/1-40/45]. The Act grants IDNS

the authority to promulgate rules and regulations to be followed in the

administration of the radiation protection program. 

Other statutes, the Radioactive Waste Storage Act [420 ILCS 35/0.01-35/6], the

Illinois Low-Level Radioactive Waste Management Act [420 ILCS 20/1-20/24] and

the Uranium and Thorium Mill Tailings Control Act [420 ILCS 42], provide

authority for the low-level radioactive waste disposal and uranium recovery

programs.

The Radiation Protection Act has a sunset date of December 31, 2000. The

legislature will have to pass another Act to reauthorize the State’s program. 

The other aforementioned statutes do not have sunset provisions.

4.1.2 Status and Compatibility of Regulations

In a December 19, 1994, letter from NRC to IDNS, a number of unresolved

compatibility issues from the 1992 program review and from the State’s 1994

implementation of 10 CFR Part 20-equivalent regulations were identified. A

series of discussions and meetings resolved some of the compatibility issues

as reflected in the September 7, 1995, letter to the State. That letter

discussed the implementation deferral for the “Policy Statement on Adequacy

and Compatibility of Agreement State Programs.” The Staff Requirements

Memorandum approving this policy was issued June 30, 1997. The implementing

procedures for the new policy indicate that any Agreement State rule that is

not compatible with NRC'S rule should be changed to conform with the new

policy within 3 years after the policy's effective date.

The unresolved compatibility issues remaining are as follows:

C Financial assurance for decommissioning, 330.250 "General Requirements

for the Issuance of Specific Licenses" 

The State's "decommissioning" rule exempts all educational institutions,

nuclear pharmacies and medical institutions. This regulation does not

meet Division 2 compatibility standards.

Discussions with staff during the review indicated that modifications

were planned for this rule in the new Part 326, currently in process,

which would align it more closely with 10 CFR 30.35.
Illinois Final Report Page 12

C "Quality Management Program and Misadministrations," 10 CFR Part 35

The State adopted misadministration requirements on May 2, 1994 in Part

335.1080 "Notifications, Reports and Records of Reportable Events." The

State requires licensees to notify the patient of the reportable event

within 15 days after the licensee ascertains and confirms that a

reportable event has occurred instead of within 24 hours as required by

NRC regulations. This regulation does not meet Division 2 compatibility

standards.

IDNS has not adopted the Quality Management Program, pending the outcome

of the NRC's rebaselining initiative and the NRC/Agreement State Working

Group's recommendations on medical rules. As stated in the September 7,

1995, letter to IDNS, the NRC is evaluating methods by which Agreement

States can be provided increased flexibility in the adoption of

compatible Quality Management rules. NRC is continuing to defer

compatibility findings for Agreement States that have not yet adopted a

compatible Quality Management rule, until NRC issues a revised Part 35

rule, compatibility designations for the new rule are established, and

an effective date for Agreement State implementation has been set.

C 10 CFR Part 20-equivalent rules in Ill. Adm. Code 310.20 "Definitions"

Declared pregnant woman - This definition deletes the requirement for a

woman to provide the estimated date of conception along with her

declaration of pregnancy. This issue relates to Section 340.280 "Dose

to an Embryo/Fetus" (also Division 1 compatibility). Section 340.280

adds a clause for a situation in which a declared pregnant woman does

not wish to disclose the estimated date of conception. If an estimated

date of conception is not disclosed, the dose is limited to 50 millirem

(0.5 mSv) per month. This definition does not meet Division 1

compatibility standards. 

The State believes that this definition protects a woman’s right to

privacy with respect to the date of conception. During the MRB, IDNS

offered additional insight into effectiveness of their definition and

the differences between NRC and the Illinois definitions. The MRB

recommends that NRC staff reevaluate the compatibility classification

for the definition of "Declared pregnant woman" under the new Adequacy

and Compatibility Policy Statement.

Two additional regulations required for compatibility have not been adopted

but the State imposed the requirements by legally binding requirements,

license conditions. The State has met compatibility requirements through this

action.

C “Emergency Planning Rule,” 10 CFR Parts 30, 40 and 70 (54 FR 14051)

which was due April 7, 1993.

Radiological contingency plans are required by license condition for all

affected licensees. The State has verified by inspection that the three

licensees requiring contingency plans have them implemented. This

regulation is planned to be adopted with the revision of Part 330,

currently in process.

C "Licensing and Radiation Safety Requirements for Irradiators," 10 CFR

Part 36 amendments (58 FR 7715) which was due July 1, 1996.
Illinois Final Report Page 13

The State reported that all irradiator licenses issued implement the

rule through license conditions. This regulation is planned to be

adopted with the issuance of Part 336, projected for late 1997.

Since the last review, the State adopted regulations to satisfy compatibility

for the following:

C “Notification of Incidents,” 10 CFR Parts 20, 30, 31, 34, 39, 40 and 70

(56 FR 64980) which was due on 10/15/94 and adopted on 6/12/95.

C "Licensing Requirements for Land Disposal of Radioactive Waste," 10 CFR

Part 61 amendment (58 FR 33886) that was due on July 22, 1996, and was

adopted on May 1, 1996.

Current NRC policy on compatibility requires that Agreement States adopt

certain equivalent regulations or legally binding requirements no later than

three years after they are effective. As of the date of the review, two

regulations are overdue for adoption.

C "Decommissioning Recordkeeping, and License Termination: Documentation

Additions," 10 CFR Parts 30, 40, 70, and 72 amendments (58 FR 39628)

which was due on October 25, 1996. IDNS drafted regulations for

compatibility with this regulation in their proposed restructuring of

Part 330. The availability of this section for public comment is

projected for Summer/Fall 1997. Adoption is projected for late 1997 or

early 1998. The review team recommends that IDNS expedite promulgation

of Part 330 at the first opportunity.

C "Self-Guarantee as an Additional Financial Mechanism," 10 CFR Parts 30,

40, and 70 amendments (58 FR 68726) which was due on January 28, 1997. 

Note, this rule is designated as a Division 2 matter of compatibility. 

Division 2 compatibility allows the Agreement States flexibility to be

more stringent (i.e., the State could choose not to adopt self-guarantee

as a method of financial assurance). If a State chooses not to adopt

this regulation, the State's regulation, however, must contain

provisions for financial assurance that include at least a subset of

those provided in NRC's regulations, e.g., prepayment, surety method

(letter of credit or line of credit), insurance or other guarantee

method (e.g., a parent company guarantee). Self-Guarantee regulations

are included in the new Part 326, currently in draft. Adoption is

projected by late 1997 or early 1998.

In addition, we would like to bring to the State's attention other regulations

that will be needed, in the future, for compatibility. These rules are:

C “Uranium Mill Tailings Regulations: Conforming NRC Requirements to EPA

Standards,” 10 CFR Part 40 (59 FR 28220) due by July 1, 1997. The State

is evaluating the need to promulgate this regulation since there is only

one license to which it applies.

C “Timeliness in Decommissioning of Materials Facilities,” 10 CFR Parts

30, 40, and 70 amendments (59 FR 36026) due by August 15, 1997.

C “Preparation, Transfer for Commercial Distribution and Use of Byproduct

Material for Medical Use,” 10 CFR Parts 30, 32 and 35 amendments (59 FR

61767, 59 FR 65243, 60 FR 322) due by January 1, 1998.

C "Frequency of Medical Examinations for Use of Respiratory Protection

Equipment," 10 CFR Part 20 amendments (60 FR 7900) due by March 13,
Illinois Final Report Page 14

1998. Note, this rule is designated as a Division 2 matter of

compatibility. Division 2 compatibility allows the Agreement States

flexibility to be more stringent (i.e., the State could choose to

continue to require annual medical examinations).

C "Low-Level Waste Shipment Manifest Information and Reporting," 10 CFR

Parts 20 and 61 amendments (60 FR 15649, 60 FR 25983) that will become

effective March 1, 1998. Illinois and other Agreement States are

expected to have that equivalent rule effective on the same date.

C “Performance Requirements for Radiography Equipment,” 10 CFR Part 34

amendments (60 FR 28323) due by June 30, 1998.

C "Radiation Protection Requirements: Amended Definitions and Criteria,"

10 CFR Parts 19 and 20 amendments (60 FR 36038) due by August 14, 1998.

C “Medical Administration of Radiation and Radioactive Materials,” 10 CFR

Parts 20 and 35 (60 FR 48623) due by October 20, 1998.

C "Clarification of Decommissioning Funding Requirements," 10 CFR Parts

30, 40, and 70 amendments (60 FR 38235) due by November 24, 1998.

C "Compatibility with the International Atomic Energy Agency," 10 CFR Part

71 amendment (60 FR 50248, 61 FR 28724) due by April 1, 1999.

C “Termination or Transfer of Licensed Activities: Recordkeeping

Requirements,” 10 CFR Parts 20, 30, 40, 61 and 70 (61 FR 24669) due by

May 16, 1999.

C “Resolution of Dual Regulation of Airborne Effluents of Radioactive

Materials: Clean Air Act,” 10 CFR Part 20 (61 FR 65119) due by January

9, 2000.

C “Recognition of Agreement State Licenses in Areas Under Exclusive

Federal Jurisdiction Within an Agreement State,” 10 CFR Part 150 (62 FR

1662) due by January 13, 2000.

C “Criteria for the Release of Individuals Administered Radioactive

Material,” 10 CFR Parts 20 and 35 (62 FR 4120) due by January 29, 2000.

The review team examined the procedures used in the State's regulation

promulgation process and found that proposed regulations are published in the

Illinois Register with a 45 day minimum comment period and may include a

public hearing. According to DRM management, NRC is provided with draft

proposed regulations for comment early in the promulgation process and again

prior to final adoption.

The team notes that NRC staff is currently reviewing all Agreement State

equivalent regulations to Part 20, Standards for Protection Against Radiation. 

These reviews are being conducted outside the IMPEP process and the States

will be notified of the results.

Based on the existing NRC compatibility policy and the IMPEP evaluation

criteria, the review team recommended in the proposed final report that

Illinois' performance with respect to the indicator, Legislation and

Regulations, be found unsatisfactory. Illinois has not yet adopted the

Decommissioning Recordkeeping regulation, or equivalent legally binding

requirements, within the specified period of time. At the MRB, Illinois noted

that this regulation is in process and projected for final adoption in late
Illinois Final Report Page 15

1997 or early 1998. Because of the progress to date in the promulgation of

this rule, the expected adoption date in early 1998, and the lack of

disruption to the collective regulatory efforts of NRC and the Agreement

States, the MRB determined that a sufficient basis did not exist to support a

finding of unsatisfactory for this indicator. The MRB noted that if

significant delays in rule adoption occur or if Illinois adopts a rule that is

not compatible with the NRC equivalent regulations, the MRB could always

reconsider the program compatibility finding at a future date. The MRB final

recommendation for Legislation and Regulations is satisfactory.

4.2 Sealed Source and Device Evaluation Program

In evaluating the State's Sealed Source & Device (SS&D) evaluation program,

the review team examined the information provided by the State relative to

this indicator in their response to the questionnaire, reviewed a sample of

the actions completed since the last review, reviewed new procedures and

guidance, and interviewed the DRM staff and manager responsible for SS&D

evaluations.

Since the last review, the State has issued or established a number of

guidance documents to assist in the review of SS&Ds and help to ensure that

all pertinent issues are addressed. These include review and Quality

Assurance (QA) checklists, a “Blue Sheet” to track correspondence and staff

work regarding SS&D actions, electronic templates of blank registry sheets,

and Instructional Sets, which provide licensing guidance in specific areas

including “Instructions for Preparation and Review of Quality Assurance

Manuals for Licenses Authorizing Manufacture and Distribution of SS&Ds.” In

addition, the State has established “S” and “D” evaluation manuals, for sealed

sources and devices respectively, which are a collection of any applicable

document or training guidance pertaining to SS&D reviews, and include a wide

variety of information such as both State and NRC issued policy letters,

regulatory guides, national and international standards, and SS&D Workshop

materials.

4.2.1 Technical Quality of the Product Evaluation Program

The review team reviewed 11 registry sheets out of the 36 registry sheets

reported for the period since the last review. The SS&D registry sheets

issued by the State and evaluated by the review team are listed with casespecific comments in Appendix G. Overall, the quality of the evaluations was

good, but the review team identified and discussed with the staff several

deficiencies in the files involving issues that may result in safety issues if

not adequately addressed during all safety reviews. The review team

identified weaknesses in documenting major issues on 6 of the 11 cases

reviewed. Although there were no immediate safety implications identified in

the particular files reviewed, it was not possible to determine from the

limited number of files reviewed and the staff interviews whether these

deficiencies were isolated occurrences. The review team suggests that the

State evaluate the review information supporting the registry sheets issued

during this period to ensure there is no weakness in the review process. 

During the exit meetings with staff and DRM managers, the review team noted

that the deficiencies were discussed with the State's technical staff. The

review team suggests that the documentation issues identified in Appendix G be

addressed as appropriate. The review team suggests in future evaluations that

the State ensure all major issues are documented by either correspondence from

the manufacturer or a note to the file by the reviewer.
Illinois Final Report Page 16

4.2.2 Technical Staffing and Training

The State reported that a five-person team with combined staff efforts

equaling approximately one full time equivalent is dedicated to performing

safety evaluations. The balance of staff time is spent in licensing actions. 

The State reported that 48 actions, involving 36 registry sheets, were

completed during the review period. The actions reported by the State also

included actions associated with Naturally Occurring or Accelerator-Produced

Radioactive Materials (NARM), and staff efforts expended on several cases

before the applications were withdrawn by the applicant. 

The State utilizes a team approach in performing evaluations of sources and

devices, and if needed, can obtain engineering assistance from the two

registered professional engineers that work in the Low-Level Radioactive Waste

and the Uranium Mill Tailings programs. The head reviewer performs

approximately one-half of the reviews and performs a concurrence-type review

of most of the actions assigned to the other three reviewers. All SS&D

deficiency letters, and draft and completed registration certificates

generated by the staff are reviewed by the head reviewer, to ensure that all

engineering-related safety issues are addressed. The concurrence review for

all SS&D deficiency letters, and draft and completed registration certificates

are also reviewed by the Licensing Section Head. This team approach provides

the technical expertise and experience needed for this size of program. 

The head reviewer has a B.S. degree, and demonstrated to the review team an

ability to understand and interpret the information submitted by applicants as

described in the performance criteria, including engineering-related issues. 

The three remaining reviewers have a B.S. in bioengineering (providing some

background in mechanics and materials), a B.S. in Health Physics, and a B.S.

in Health Care/A.A.S. in Radiological Physics. The Licensing Section Head,

who supervises the reviewers, has a B.A. in Microbiology and an M.S. in Health

Care Management. All members are trained in health physics principles and

have attended at least one SS&D workshop. There have been no additional staff

involved in the SS&D Evaluation Program since the last program review.

4.2.3 Evaluation of Defects and Incidents Regarding SS&Ds

The State evaluated three incidents associated with SS&D product failures or

problems. The State adequately addressed the issues involved. The review

team identified no outstanding issues related to the three incidents.

Based on the IMPEP evaluation criteria, the review team recommends that

Illinois' performance with respect to the indicator, Sealed Source and Device

Evaluation Program, be found satisfactory.

4.3 Low-Level Radioactive Waste (LLRW) Disposal Program

In the process of evaluating this performance indicator, the review team

evaluated the State's response to the questionnaire; reviewed information

provided by the State regarding the status of the LLRW program, regulations

and procedures; the qualifications of the technical staff; and interviewed

staff and managers. 

The current status of the LLRW program is that the State is beginning the site

selection process over and a disposal site application is not anticipated for

several years. Therefore, the staff are working on other projects (see

uranium recovery program discussion in Section 4.4) until a site has been

selected. Previously, a LLRW disposal facility site was selected at
Illinois Final Report Page 17

Martinsville, Illinois but was later rejected by a Governor-appointed

committee.

4.3.1 Status of Low-Level Radioactive Waste Disposal Inspection

The State does not have a site at this time; therefore, no inspections have

been conducted.

4.3.2 Technical Staffing and Training

IDNS has designated certain staff for the LLRW program. The technical staff

reports to the materials licensing supervisor. The LLRW staff works on the

LLRW activities, uranium recovery activities, and special projects such as

complex decommissioning cases. The technical qualifications of the LLRW staff

are described in the uranium recovery program discussion (Section 4.4.2). 

IDNS has the appropriate number of staff and technical expertise mix needed to

evaluate a LLRW disposal site application and has several contracts in place

to provide assistance in the review of a LLRW disposal site application. 

4.3.3 Technical Quality of Licensing

The State did not conduct LLRW disposal site licensing activity during the

review period. The LLRW staff developed several guidance documents which

address the following: 

(1) describe the licensing process, (2) provide guidance to the applicant, and

(3) describe the acceptance criteria for meeting the regulatory requirements. 

This latter document is considered by the review team to be a significant

accomplishment by IDNS and has been shared with several States that are

developing LLRW disposal sites and regulatory programs. 

4.3.4 Technical Quality of Inspections

Since there is no site selected to date, there were no inspections conducted. 

4.3.5 Response to Incidents and Allegations

There were no incidents or allegations pertaining to the State's LLRW program

activities during the review period. The State explained to the review team

that incidents and allegations relating to LLRW disposal would be handled in

the same manner as those pertaining to any materials licensee. 

Based on the IMPEP evaluation criteria for the above five performance areas,

the review team recommends that Illinois' performance with respect to the

indicator, Low-Level Radioactive Waste Disposal Program, be found

satisfactory. 

4.4 Uranium Recovery Regulatory Program

In the process of evaluating this performance indicator, the review team

evaluated the State's responses to the questionnaire; reviewed information

provided by the State regarding the license status, inspection history, site

status, financial assurances, and regulations status; reviewed selected

licensing and inspection files; evaluated the qualifications of the technical

staff; and interviewed staff and managers working in the uranium recovery

regulatory area. 

In 1990, the Illinois Agreement was amended to include the authority for

11e(2) byproduct material and the facilities that generate such material. The

IDNS uranium recovery program is administered as part of the materials
Illinois Final Report Page 18

licensing program. The State has only one licensee, Kerr-McGee Chemical

Corp., West Chicago site. This facility is in decommissioning and the

material is being shipped out of State. The off-site contamination is being

permitted back on-site for a limited time prior to shipment out of State. The

State has worked closely with the local community and the licensee to develop

a decommissioning plan acceptable to all stakeholders. 

4.4.1 Status of Uranium Recovery Program Inspection

IDNS inspection frequency for the West Chicago site is annually. This is

consistent with the criteria in IMC 2800 and 2801. This frequency has been

applied since the licensee began decommissioning operations in 1994. The last

three inspections were conducted in September 1994, January 1996, and February

1997. Prior to the beginning of the decommissioning, inspections were

conducted every two years. 

IDNS has a resident health physics inspector at the site who conducts daily,

weekly, and monthly operational checks and observes the site operations daily. 

In addition, there is a State contractor engineering resident that supports

the health physics resident and checks the engineering quality control on the

site. 

IDNS also reviews the annual environmental monitoring report submitted by the

licensee and determines compliance for the environmental program. This is

conducted on a separate schedule from the annual license compliance

inspection. A separate quality assurance inspection is conducted annually at

the licensed sites.

The review team found that there were no overdue or backlogged inspections in

the uranium recovery program. The last annual inspection notification letter

was issued in 30 days. The previous inspection notification letter was issued

in 80 days; however, the inspector became seriously ill shortly after the

inspection which delayed the issuance of the letter. All inspection reports

are reviewed and signed by the Head, Inspection and Enforcement Section, even

when the inspections are conducted by the uranium recovery program staff. 

4.4.2 Technical Staffing and Training

The Licensing Section Head supervises the staff working in the uranium

recovery program with the LLRW supervisor managing the resident inspector and

the other staff engineer. These supervisors have many years of experience in

managing this type of facility. The technical staff consists of two health

physicists, two engineers (both professional engineers), and a geologist, with

a support contractor supplying additional expertise in these areas. The

review team examined the training, education, and experience of the staff

members and found that the qualifications of the technical staff are

commensurate with the expertise identified as necessary to regulate uranium

recovery and 11e(2) byproduct material. 

Additional support is provided by the staff in the environmental surveillance

division for environmental monitoring, verification surveys, and sample

analyses on an as needed basis. The laboratory was visited by the review team

and found to be a state-of-the-art facility which participates in three

different laboratory inter-comparison programs. 

4.4.3 Technical Quality of Licensing Actions

The review team evaluated the latest version (amendment 43) of the Kerr-McGee

Chemical Corp. license. In examining the license and selected documentation
Illinois Final Report Page 19

in the file, the review team found that the license included appropriate

license conditions for the decommissioning operations at the facility. The

license authorizes the licensee to decommission the site in phases with a

separate evaluation of each phase going through a complete license evaluation

process (separate safety evaluation report and other supporting

documentation). Detailed procedures have been referenced by license

conditions. The license files were well organized and referenced documents

examined by the review team were quickly located. 

Most license reviews are conducted using the expertise of all staff in the

uranium recovery program. The review team noted that the team approach is

effective in achieving peer review and applying the necessary expertise to the

specific review. 

4.4.4 Technical Quality of Inspections

Inspection and enforcement is handled in the same manner as any Illinois

licensee. 

The review team examined the compliance file for Kerr-McGee and reviewed the

last three routine inspection reports. The file also had documentation for

the 1996 environmental monitoring data review and the 1996 quality assurance

audit. The documentation for these activities show that past inspections and

audits adequately covered the scope, completeness, and technical accuracy

necessary to determine compliance with regulations, license conditions, and

available guidance. Appropriate enforcement actions were taken given the

scope of the violations noted. 

Given the location of the licensed site, there is an extensive environmental

monitoring program with the licensee, IDNS, and the Illinois Environmental

Protection Agency, all conducting independent monitoring programs. The State

reviews the licensee's annual environmental monitoring report and any

violations as noted are addressed as notice of violations (NOVs), such as the

NOV issued based on the 1996 review. 

In addition to the annual compliance inspection, a Quality Assurance

inspection was conducted to evaluate the licensee's checks on the construction

and clean-up activities at the site. The inspection was thorough and the

violation identified was quickly addressed by the licensee.

4.4.5 Response to Incidents and Allegations

There was one incident but no allegations pertaining to the uranium recovery

activities licensed by IDNS. The incident was addressed in a timely manner

and the documentation was complete and timely. The documentation was located

in both the license file and the Department's incident file.

Based on the IMPEP evaluation criteria for the above five performance areas,

the review team recommends that Illinois' performance with respect to the

indicator, Uranium Recovery Program, be found satisfactory. 

5.0 SUMMARY

As noted in Sections 3 and 4 above, the review team found the State's

performance with respect to each of the common and non-common performance

indicators to be satisfactory. Accordingly, after consideration of the

satisfactory finding for the non-common indicator "Legislation and

Regulation," the team recommended, and the MRB concurred, in finding the
Illinois Final Report Page 20

Illinois program to be adequate to protect public health and safety and

compatible with NRC's program. 

Below is a summary list of recommendations and suggestions, as mentioned in

earlier sections of the report, for consideration by the State. 

1. The team suggests that the State examine their procedures for preparing

inspection reports and correspondence, and make modifications needed to

assure timely issuance of inspection findings (Section 3.1).

2. Now that the inspection backlog has been overcome, the team suggests

that the State should reconsider the IMC 1220 guidance for conducting

reciprocity inspections, and increase the reciprocity inspections to

meet the guidance

(Section 3.1).

3. The review team suggests that license reviewers check SS&D registry

sheets prior to authorizing license modifications which result in a

change in the handling of a SS&D (Section 3.3).

4. The review team suggests that the State evaluate whether the practice of

deferring inspections due to licensee scheduling conflicts is being

abused (Section 3.4).

5. The review team suggests that the procedures for notifying NRC of

incidents be revised to reflect the current guidance to Agreement States

to notify the NRC Headquarters Operations Center of events requiring

immediate or 24-hour reporting by the licensee (Section 3.5).

6. The review team suggests that the State reconsider the benefits of

participating in the NMED system (Section 3.5).

7. The review team recommends that IDNS expedite promulgation of Part 330

at the first opportunity (Section 4.1).

8. The review team suggests that the State evaluate the review information

supporting the registry sheet issued during this period to ensure there

is no weakness in the review process (Section 4.2.1).

9. The review team suggests that the documentation issues identified in

Appendix G be addressed as appropriate (Section 4.2.1). 

10. The review team suggests in future evaluations that the State ensure all

major issues are documented by either correspondence from the

manufacturer or a note to the file by the reviewer (Section 4.2.1).

For NRC, the MRB recommends that the NRC staff reevaluate the compatibility

classification for the definition of "Declared pregnant woman" under the new

Adequacy and Compatibility Policy Statement.
LIST OF APPENDICES 

Appendix A IMPEP Review Team Members

Appendix B Illinois Organization Charts

Appendix C Illinois' Questionnaire Response

Appendix D License File Reviews

Appendix E Inspection File Reviews

Appendix F Incident File Reviews

Appendix G Sealed Source and Device Evaluation Reviews

Attachment 1 Illinois' Response to Review Findings

Attachment 2 Responses to IDNS comments on the Draft

IMPEP Review Report
APPENDIX A

IMPEP REVIEW TEAM MEMBERS 

Name Area of Responsibility

Richard L. Woodruff Team Leader

RSAO, RII Status of Materials Inspection Program

Technical Staffing and Training

Response to Incidents and Allegations

James L. Lynch Technical Quality of Licensing Actions

RSAO, RIII Legislation and Regulations

James Johnson, Kansas Technical Quality of Inspections

Michelle L. Burgess Sealed Source & Device Evaluation Program

NMSS/IMNS/SSDB

Dennis Sollenberger Low-Level Radioactive Waste Disposal Program

OSP Uranium Recovery Program 
APPENDIX B

ILLINOIS DEPARTMENT OF NUCLEAR SAFETY

ORGANIZATION CHARTS