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Home My WebLink AboutDRC-2025-000547 CLIVE SITE LETTER OF TRANSMITTAL DATE: 2/14/2025 ATTN: LLRW CC; Treesa Parker Karen Kirkwood RE: Transmittal 2025-009 Description of Documents Transmitted Qty See attached for update to Qualification Cards. Q1105 M and TE Calibrations Rev 3 1 Q1120 Quality Control Technician I Rev 3 1 Q1126 CWF Lift Approval Rev 3 1 Q1130 Quality Control Technician II Rev 3 1 Q1132 Quality Control Technician III Rev 6 1 Q2245 Quality Control Tech IV Rev 0 1 ------------------------------------------------------------------------------------------------------------ Please replace your current procedure revisions with the documents within 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 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: QUALIFICATION FOR PERFORMING M & TE CALIBRATIONS (NO EXPIRATION) PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS None (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS CL-QC-PR-011, M & TE Calibration (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Assist with a minimum of 3 calibrations Perform 1 independent calibration under observation of SME. (ADD ADDITIONAL LINES AS NECESSARY) M & TE CALIBRATIONS Q1105 Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ________________ Revision No.: __ 3 _2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:40:56 -07'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this documentLocation: Clive Date: 2025-02-14 08:02:06Foxit PhantomPDF Version: 9.7.5Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 PRACTICAL CRITERIA: Task (Description) Satisfactory (Check Mark) SME Date (Completed) Initials ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: QUALIFICATION FOR QUALITY CONTROL TECHNICIAN I (NO EXPIRATION). NO TIME REQUIREMENTS. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q1110, Quality Control Technician Assistant Q1122, Standard Proctor Q1123, Density Testing of Soils Q1105, M & TE Calibrations Q1113, Debris Inspection Q1114, Surveying Q1124, Daily Construction Report Q2244, CLSM-Macro Test (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS LLRW & 11e.(2) Construction Quality Assurance/Quality Control (CQA/QC) Manual State-issued Part B Permit, Attachment II-9, Construction Quality Assurance/Quality Control (CQA/QC) Manual CL-QC-PR-001, Quality Control Inspections and Testing CL-QC-PR-002, CQA QC Forms CL-QC-PR-011, M&TE Calibration CL-QC-PR-016, Construction Surveying CL-QC-PR-018, In-Cell Bulk Disposal CL-QC-PR-038, Lift Approval Using an 826 Compactor CL-QC-WI-002, CQA/QC Manual Compliance Inspections CL-QC-WI-003, Macro Vault QC Inspections (ADD ADDITIONAL LINES AS NECESSARY) Q1120 QUALITY CONTROL TECHNICIAN I Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __3_ 2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:43:22 -07'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this document Location: CliveDate: 2025-02-14 08:01:42 Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Written exam passed at 80% or higher Interview with Supervisor (ADD ADDITIONAL LINES AS NECESSARY) ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: QUALIFICATION FOR PREPARING, PERFORMING AND REVIEWING CWF LIFT APPROVALS PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Defensive Driver (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS LLRW & 11e.(2) Construction Quality Assurance/Quality Control (CQA/QC) Manual CL-QC-PR-001, Quality Control Inspections and Testing (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Observed lift approval preparation and testing Performed CWF inspections and testing required for approval Written exam passed at 80% or higher (ADD ADDITIONAL LINES AS NECESSARY) Q1126 CWF LIFT APPROVAL Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __3_ 2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:45:53 -07'00' Digitally signed by Thomas Brown DN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this document Location: CliveDate: 2025-02-14 08:03:02 Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: QUALIFICATION FOR QUALITY CONTROL TECHNICIAN II (NO EXPIRATION). PREFERRED MINIMUM OF 2 YEARS OF EXPERIENCE in surveying, embankment construction, and soils & aggregate testing. Required minimum of 1 YEAR AS A QUALITY CONTROL TECHNICIAN I. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q1120, Quality Control Technician I Q1131, Soil Classification Q1100, Rock Placement Q1101, Sealed Single Ring Infiltrometer Field Permeability Q1102, Clay Placement Lift Approval Q1121, CLSM Lift Approval Q1125, Waste Lift Approval (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS LLRW & 11e.(2) Construction Quality Assurance/Quality Control (CQA/QC) Manual State-issued Part B Permit, Attachment II-9, Construction Quality Assurance/Quality Control (CQA/QC) Manual CL-QC-PR-001, Quality Control Inspections and Testing CL-QC-PR-002, CQA QC Forms CL-QC-PR-016, Construction Surveying CL-QC-PR-018, In-Cell Bulk Disposal CL-QC-PR-038, Lift Approval Using an 826 Compactor CL-QC-PR-039, Clay Liner and Radon Barrier Construction CL-QC-WI-001, Sealed Single Ring Infiltrometer CL-QC-WI-002, CQA/QC Manual Compliance Inspections Q1130 QUALITY CONTROL TECHNICIAN II Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __3_ 2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:45:05 -07'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this document Location: CliveDate: 2025-02-14 08:03:25 Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Written exam passed at 80% or higher Interview with Supervisor (ADD ADDITIONAL LINES AS NECESSARY) ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 4 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: QUALIFICATION FOR QUALITY CONTROL TECHNICIAN III (NO EXPIRATION). PREFERRED MINIMUM OF 3 YEARS OF EXPERIENCE in surveying, embankment construction, and soils & aggregate testing. Required 2 YEARS AS A QUALITY CONTROL TECHNICIAN, AND A MINIMUM OF 1 YEAR AS A QUALITY CONTROL TECHNICIAN II. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q1103, Unmanned Aircraft Operations Q1126, CWF Lift Approval Q1130, Quality Control Technician II (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS LLRW & 11e.(2) Construction Quality Assurance/Quality Control (CQA/QC) Manual State-issued Part B Permit, Attachment II-9, Construction Quality Assurance/Quality Control (CQA/QC) Manual ASTM D75, Sampling Aggregates ASTM C117, Materials Finer than no. 200 Sieve in Mineral Aggregates by Washing ASTM C136, Sieve Analysis of Fine and Coarse Aggregates Q1132 QUALITY CONTROL TECHNICIAN III Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __6 _2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:48:35 -07'00' Digitally signed by Thomas Brown DN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this documentLocation: Clive Date: 2025-02-14 08:02:33 Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 4 ASTM D698, Laboratory Compaction Characteristics of Soil Using Standard Effort ASTM D2487, Classification of Soils for Engineering Purposes ASTM D6938, In-Place Density and Water Content of Soil and Soil-Aggregate by Nuclear Methods ASTM D1140, Determining the Amount of Material Finer than No. 200 Sieve in Soils by Washing CL-QC-PR-001, Quality Control Inspections and Testing CL-QC-PR-025, Standard Practice for Achieving Certified AASHTO Results CL-QC-PR-038, Lift Approval Using an 826 Compactor CL-QC-WI-002, CQA/QC Manual Compliance Inspections CL-QC-WI-003, Macro Vault QC Inspections CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 4 (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Written exam passed at 80% or higher Interview with Supervisor (ADD ADDITIONAL LINES AS NECESSARY) ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 4 of 4 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL QUALIFYING AS THE QUALITY CONTROL TECHNICIAN IV. THIS INDIVIDUAL IS RESPONSIBLE FOR OVERSEEING QC ACTIVITIES RELATED TO THE FOLLOWING: CONSTRUCTION OF EMBANKMENT LINER SYSTEMS; CONSTRUCTION AND INSPECTION OF TEMPORARY COVER; INSTALLATION AND INSPECTION OF THE PRE-FINAL COVER MONITORING NETWORK. CONSTRUCTION OF EMBANKMENT COVER SYSTEMS; INSTALLATION AND INSPECTION OF THE FINAL COVER MONITORING NETWORK; INSPECTION AND TESTING RELATED TO SITE FACILITY CONSTRUCTION. WASTE PLACEMENT/DISPOSAL ACTIVITIES IN THE LLRW EMBANKMENT(S); WASTE PLACEMENT/DISPOSAL ACTIVITIES IN THE MIXED WASTE LANDFILL CELL; SURVEYING AND TRACKING VOLUMES OF INCELL BULK DISPOSAL PLACEMENT; INSPECTION AND SURVEYING OF INTERIM RAD COVER; INSPECTION AND SURVEYING OF FINAL "TOP OF WASTE"; REGULATORY NOTIFICATIONS REQUIRED BY THE CONSTRUCTION QUALITY ASSURANCE/QUALITY CONTROL (CQA/QC) MANUAL. PREFERRED MINIMUM OF 6 YEARS OF EXPERIENCE in surveying, embankment construction, and soils & aggregate testing. Required 5 YEARS AS A QUALITY CONTROL TECHNICIAN, AND A MINIMUM OF 3 YEAR AS A QUALITY CONTROL TECHNICIAN III. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q1132, Quality Control Technician III (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS Radioactive Material License # UT 2300249 State-Issued Part B Permit, Module V Ground Water Quality Discharge Permit # UGW450005 LLRW & 11e.(2) Construction Quality Assurance/Quality Control (CQA/QC) Manual State-issued Part B Permit, Attachment 11-9, Construction Quality Assurance/Quality Control (CQA/QC) Manual CL-QC-PR-001, Quality Control Inspections and Testing CL-QC-PR-002, CQA QC Forms Q2245 QUALITY CONTROL TECHNICIAN IV Qual Manager ___________________________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation ___________________________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __0_ 2/14/2025 Garrett Q. Dutson, P.E.Digitally signed by Garrett Q. Dutson, P.E. Date: 2025.02.13 16:52:12 -07'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this document Location: CliveDate: 2025-02-14 08:03:48 Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 CL-QC-PR-011, M&TE Calibration CL-QC-PR-016, Construction Surveying CL-QC-PR-018, In-Cell Bulk Disposal CL-QC-PR-025, Standard Practice for Achieving Certified AASHTO Results CL-QC-PR-038, Lift Approval Using an 826 Compactor CL-QC-PR-039, Clay Liner and Radon Barrier Construction CL-QC-WI-001, Sealed Single Ring Infiltrometer CL-QC-WI-002, CQA/QC Manual Compliance Inspections CL-QC-WI-003, Macro Vault Inspections (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS Classroom Training with Written Exam Passed At 80% Or Higher Successful Interview by the QC Supervisor (ADD ADDITIONAL LINES AS NECESSARY) ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ 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*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3