DRC-2018-004078 - 0901a06880801d5c

CLIVE SITE
LETTER OF TRANSMITTAL
p R c - 2.o io-oo ti-o9 S
DATE: 04/27/2018
ATTN: Don Verbica — DWMRC
CC; Treesa Parker
Karen Kirkwood
RE: Transmittal 18016
Description of Documents Transmitted Qty
See attached for an update to Qualification Cards;
Q1011 Radiation Safety Technician 1, Rev 4 1
Q11012A Radiological Surveyor, Rev 3 1
Please replace your current procedure revisions with the documents with in this
Transmittal.
You are not required to sign any documents to verify receipt of this distribution.
However, you should make every effort to ensure that your copy of the License is
current.
FROM: EnergySolutions
Document Control
Clive Facility
(included) Yes/No Practical Evaluation Revision No.: 4
Dale Thorne
Dale Thome gla_ it..., Apr 27 2018 8:27 AM Date con.
PRINTED NAME
Thomas A. Brown
PRINTED NAME
SIGNATURF Thomas Brown eL Apr 27 2018,2:33 AM uate co
SIGNATURE
Yes
Qual Manager
Radiation
Safety Officer
Ttii.t.aw..tWit.fatitout....or=watz144
Effective Date: 4/27/2018
ENERGYSOLUTIONS CL-TN-PR-100-F7
Revision 1
QUALIFICATION CARD
EMPLOYEE NAME

QUALIFICATION #: Q1011 I QUALIFICATION TITLE:
QUALIFICATION APPROVAL:
[RADIATION SAFETY TECHNICIAN I

SCOPE:
' THIS DOCUMENT APPLIES TO PERSONNEL QUALIFYING AS RADIATION SAFETY TECHNICIAN I (RST I). 1
RST I DUTIES INCLUDE: ROUTINE SURVEYS AND JOB COVERAGE IN CONTAMINATION AREAS, HIGH CONTAMINATION
AREAS, RADIATION AREAS AND AIRBORNE RADIOACTIVITY AREAS. IT DOES NOT INCLUDE COVERAGE IN HIGH OR VERY
HIGH RADIATION AREAS, RELEASES OF TOOLS AND MATERIALS WITH INACCESSIBLE SURFACES OR POST-
DECONTAMINATION RELEASE OF PERSONNEL. ALL SURVEYS AND DOCUMENTATION GENERATED BY ANY RST I MUST
BE REVIEWED AND APPROVED BY AUTHORIZED PERSONNEL.
PERSONNEL QUALIFYING AS AN RST II MUST HAVE:
• A HIGH SCHOOL DIPLOMA OR EQUIVALENT
• A VALID DRIVER'S LICENSE
PERSONNEL QUALIFYING AS AN RST I MUST HAVE COMPLETED SELF-STUDY IN THE FOLLOWING AREAS:
• CONTAINER RETURN INSPECTION
• DOOR AND GATE CHALLENGE TRAINING
PERSONNEL QUALIFYING AS AN RST I MUST COMPLETE FUNDAMENTAL ACADEMIC TRAINING IN THE FOLLOWING
AREAS:
• 1.01 BASIC MATHEMATICS AND ALGEBRA
• 1.02 UNIT ANALYSIS AND CONVERSION
• 1.03 PHYSICAL SCIENCES
• 1.04 NUCLEAR PHYSICS
• 1.05 SOURCES OF RADIATION
• 1.06 RADIOACTIVITY AND RADIOACTIVE DECAY
• 1.07 INTERACTION OF RADIATION WITH MATTER
• 1.08 BIOLOGICAL EFFECTS OF RADIATION
• 1.09 RADIOLOGICAL PROTECTION STANDARDS
• 1.10 ALARA
•
•
1.11 EXTERNAL EXPOSURE CONTROL
1.12 INTERNAL EXPOSURE CONTROL
Page 1 of 3
ENERGYSOLUTIONS CL-TN-PR-100-0
Revision 1
QUALIFICATION CARD

• 1.13 RADIATION DETECTOR THEORY

L REQUALIFICATION REQUIRED EVERY 36 MONTHS

PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS

None NA NA

(ADD ADDITIONAL LINES AS NECESSARY)
PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS
CL-RS-PR-115, Radiological Surveys
CL-RS-PR-120, Access Control Points
CL-RS-PR-130, Radiological Control
CL-RS-PR-140, Radiation Work Permit
CL-RS-PR-150, Posting Requirements for Radiological Hazards
CL-RS-PR-200, Air Sampling
CL-RS-PR-701, HIS-20 Health Physics Information System
CL-IN-PR-450, Instrument Operation
(ADD ADDITIONAL LINES AS NECESSARY)
QUALIFICATION CRITERIA: Pa e No if a plicable SME SIGNATURE DATE COMPLETED INITIALS
Self Study Training Completed
Fundamental Academic Training Complete
All Prerequisite Reading Completed
Practical Evaluation
RST I Fundamentals Academic Written Exam
Completed with a Score of 80% or Better
RST I Procedures Written Exam Completed
with a Score of 80% or Better
RST I Comprehensive Written Exam
Completed with a Score of 80% or Better
Interview with Radiation Safety Officer (RSO) or
designee
(ADD ADDITIONAL LINES AS NECESSARY)
PRACTICAL CRITERIA:
Task
(1)o..1 iption )
Set Up, Retrieve, and Process at least 3 Lapel
and 3 Lo Vol. Air Samples.
Satisfactor
(( h(c I, \ lal IS) e — 1
I I .. _ J
SNIL Date
I( .inplo,(11 Initials
Demonstrate familiarity with Hi Vol. Air
Sampler r N 1 1 ,. _ 0
Demonstrate familiarity with VTD Effluent
sampling requirements. r - , i i ... - J
Perform and Document at least 2 Constancy
Checks on the following instruments:
• Ludlum Model 2360 w/ 43-93 probe
• Ludlum Model 3030
- r , 1 1
Page 2 of 3
EMPLOYEE
EMPLOYEE MANAGER
RSO
DATE
PRINTED NAME SIGNATURE
DATE
PRINTED NAME SIGNATURE
DATE
ENERGYSOLUTIONS CL-TN-PR-100-F7
Revision 1
QUALIFICATION CARD
• Micro Rem
• Ion Chamber
• Ludlum Model 78
1 ... 1 _ 0
Perform and Document at least 2 Daily Alarm I" ..- 1
Tests on Canberra Argos 4AB and Eberline 1 ... 1 _ . PCM2.
Perform and Document surveys using the
following instruments:
• Ludlum Model 2360 w/ 43-93 probe
• Ludlum Model 3030 r - N
• Micro Rem 1 I
• Ion Chamber
• Ludlum Model 78
Perform and Document at least 1 Routine ,- - , Survey Inside and 1 Outside the RA (at least one
of the surveys must include a tritium smear with
documentation including the COC).
1 ... 1 _ 0
Provide Job Coverage at each of the following
areas for the specified times:
• ICWF (24hrs.)
• Rotary (16 hrs.) e - ..
• Access Control (8hrs.) I I
• Receiving Dock(s) (8hrs.)
• CWF (8hrs.)
-and spend at least 4 hrs. in the Instrument
Room.
Demonsfrate familiarity with all release criteria r - % and Perform and Document at least 10 1 1
Container / Conveyance surveys. ... _ 0
c ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID:
PRINTED NAME SIGNATURE
Verification of Completed Documentation
QUAL MANAGER

DATE

PRINTED NAME SIGNATURE
***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL***
Page 3 of 3
DOCUMENT SUMMARY FORM
Please provide the following information for new/revised documents.
Forward the completed form, approved document, and electronic file, to Document Control.
Document No.: Q1011 Revision No.: 4
Title: RADIATION SAFETY TECHNICIAN I

Special Status (i.e. Restricted; SSI; etc.): NA
If special status is applicable, please note any special distribution/handling requirements:
Summary of changes (if this is a revision):.
Removed "Visibly Clean" self-study requirement.
E Yes X This document requires evaluation per the requirements of a license. If yes,
No attach evaluation results.
II Yes EI This document requires regulatory agency approval before implementation. If
No yes, contact Document Control.
Type of
revision: Contains technical changes X Contains only administrative changes
Distribution (or changes to distribution) for controlled copies of this document.
NA
Source: ES-AD-PR-001, Rev.5, Document Preparation [Attachment 5.4]
94.z- Dale Thorne Qual Manager
Dale Thorne Apr 27 2018 6 8a 4M vale cosisn
Yes
(included) Yes/No Practical Evaluation
Radiation
Safety Officer
PRINTED NAME
Thomas A. Brown PRINTED NAME
SIGNATURE
Apr 27 2018 9:32.1 Date owe,
SIGNATURE
Brown
WilliNNINNINNII*041111111111,400111111111111
Effective Date: 4/27/2018 Revision No.: 3
ENERGYSOLUTIONS CL-TN-PR-100-F7
Revision 1
QUALIFICATION CARD
EMPLOYEE NAME
QUALIFICATION #: Q1012A QUALIFICATION TITLE: E RADIOLOGICAL SURVEYOR _j
QUALIFICATION APPROVAL:
SCOPE:
THIS DOCUMENT APPLIES TO PERSONNEL WHO WILL BE QUALIFIED TO PERFORM LIMITED EXTERNAL RADIATION AND
DIRECT AND REMOVABLE CONTAMINATION MEASUREMENTS USING PROPER MATERIALS AND PORTABLE RADIATION
SURVEY INSTRUMENTS. RADIOLOGICAL SURVEYORS PERFORMING MEASUREMENTS IN SUPPORT OF DOCUMENTED
RELEASES SHALL BE SUPERVISED BY A QUALIFIED RADIATION SAFETY TECHNICIAN. RADIOLOGICAL SURVEYORS ARE
NOT AUTHORIZED TO RELEASE MATERIALS FROM THE RESTRICTED AREA. RADIOLOGICAL SURVEYORS CANNOT MAKE
MEASUREMENT IN SUPPORT OF PERSONNEL PROTECTIVE ACTIONS/EQUIPMENT UNLESS SPECIFICALLY AUTHORIZED
BY THE RADIATION WORK PERMIT ASSOCIATED WITH THE TASK. ALL DOCUMENTATION GENERATED BY RADIOLOGICAL
SURVEYORS SHALL BE COUNTERSIGNED AND APPROVED BY QUALIFIED RADIATION SAFETY TECHNICIAN.
PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS
None NA NA
(ADD ADDITIONAL LINES AS NECESSARY)
PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS
CL-RS-PR-115, Radiological Surveys
CL-RS-PR-120, Access Control Points
CL-RS-PR-150, Posting Requirements for Radiological Hazards
CL-IN-PR-450, Instrument Operation
CL-SH-PR-100, Clive Health and Safety Program — Section 4.3.
(ADD ADDITIONAL LINES AS NECESSARY)
Page 1 of 2
ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID:
EMPLOYEE
EMPLOYEE MANAGER
RSO
DATE
PRINTED NAME SIGNATURE
DATE
PRINTED NAME SIGNATURE
DATE
PRINTED NAME SIGNATURE
Verification of Completed Documentation
QUAL MANAGER
PRINTED NAME SIGNATURE
DATE
***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL***
ENERGYSOLUTIONS CL-TN-PR-100-E7
Revision 1
QUALIFICATION CARD
QUALIFICATION CRITERIA: Pa e No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS
Self Study Training Completed
All Prerequisite Reading Completed
Practical Evaluation Completed
Radiological Surveyor Written Exam Completed
with a Score of 80% or Better
Interview with Radiation Safety Officer (RSO) or
designee
(ADD ADDITIONAL LINES AS NECESSARY)
PRACTICAL CRITERIA:
HI ask
114 s( 1 iption)
Perform at least 1 complete scan of an
intermodal or C Van using the Ludlum 2360
with the 43-93 probe.
Satisfactor
(( liLd, \ lat l) SNIF, Date
(( oniphAt(1) Initials
e— 1
I I . _ 0
Perform at least 12 integrated counts using the
Ludlum 2360 with the 43-93 probe.
r—% 1 1 . _ ,
Take at least 10 Large Area Wipes (LAWs) and
then count them using the Ludlum 2360 with the
43-93 probe.
e - 1 1 1 . - ,
Take at least 25 Disk Smears and count them
using the Ludlum 3030.
e—N I I . - .
Perform at least 5 dose rate measurements using
a Microrem meter.
r— 1
I I . _ ,
Perform at least 5 dose rate measurements using
an Ion Chamber.
e - 1
I I
Complete at least 16 hours of work under the
supervision of a qualified Radiation Safety
Technician II.
e - 1
I I
Page 2 of 2
DOCUMENT SUMMARY FORM
Please provide the following information for new/revised documents.
Forward the completed form, approved document, and electronic file, to Document Control.
Document No.: Q1012A Revision No.: 3
Title: RADIOLOGICAL SURVEYOR
Special Status (i.e. Restricted; SSI; etc.): NA
If special status is applicable, please note any special distribution/handling requirements:
Summary of changes (if this is a revision):.
Removed "Visibly Clean" self-study training
Yes X This document requires evaluation per the requirements of a license. If yes, _ No attach evaluation results.
n Yes Isi This document requires regulatory agency approval before implementation. If
No yes, contact Document Control.
Type of
revision: Contains technical changes X Contains only administrative changes
Distribution (or changes to distribution) for controlled copies of this document.
NA
Source: ES-AD-PR-001, Rev.5, Document Preparation [Attachment 5.4]