Page 1 of 3 NRC FORM 7 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0027 EXPIRES: 0613012009 (6-2006) Estimated burden per response to comply with this mandatory collection request 2.4 hours. This 10CFR 110 submittal is reviewed to ensure that the applicable statutory. regulatory, and policy considerations are satisfied. Send comments regard~ng burden estimate to the Records and FOIAlPfivacy Services Branch (1-5 F52). U.S. Nuclear Regulatory Commission, Washington. DC 20555-001, APPLICATION FOR NRC EXPORTIIMPORT or by intemet e-mail to infocollects@nr:.gov, and to tie Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3151-0027), Office of Management and Budget Washington, LICENSE, AMENDMENT, OR RENEWAL DC 20503. If a means used koimpose an intormation coltection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person Is not required to (See Instructionson Page 5) respond to, the information collection. 0 I I I I I I I I I I I LICENSE~t0M PC PART B. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, OR RENEWALS (If more space is needed to complete any of the Items, use Pages 3-4 first, and then attach additional sheets, Ifnecessary.) 1. NAME AND ADDRESS OF APPLICANT/LICENSEE la. NAME OF APPLICANT'S CONTACT lb. APPLICANTS REFERENCE NUMBER Halliburton Energy Services Cindy Dorris HES4037 2107 City West Blvd., Bldg 2 1c. PHONE NUMBER Id. FAX NUMBER Houston, Texas 77242 (713) 839-4566 (713) 839-4564 le. E-MAIL ADDRESS
[email protected] 2.