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NRC FORM 7 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0027 EXPIRES: 0613012009 (6-2006) Estimated burdei per response to comply with this mandatory collection request 2.4 hours. This 10CFRIIO submittal is reviewed to ensure that the applicable statutory, regulatory, and policy considerations are satisfied. Send comments regarding burden estimate to the Records and FOIA/Privacy Services Branch (17-5F52), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, APPLICATION FOR NRC EXPORT/IMPORT or by Internet e-mail to [email protected], and to the Desk Officer. Office of Information and Regulatory Affairs, NEOB-10202, (3150-0027), Office of Management and Budget, Washington, LICENSE, AMENDMENT, OR RENEWAL DC 20503. Ifa means used to impose an Information colection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to (See Instructions on Page 5) respond to, the Information collection.
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ýYt -0 . - ' 1ý 'ý 'ý- 50 Z" PART B. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, OR RENEWALS (Ifmore space Is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.) 1. NAME AND ADDRESS OF APPLICANTILICENSEE 1la. NAME OF APPLICANT'S CONTACT lb. APPLICANT'S REFERENCE NUMBER Halliburton Energy Services Cindy Dorris HES4035 2107 City West Blvd., Bldg 2 1c. PHONE NUMBER 1d. FAX NUMBER Houston, Texas 77242 (713) 839-4566 (713) 839-4564
le. E-MAIL ADDRESS [email protected] 2. TYPE OF NRC LICENSE REQUESTED (Check One) F] EXPORT F] IMPORT F COMBINED EXPORTIIMPORT AMENDMENT/RENEWAL (Parts B, C, E) (Parts B, D, E) (Parts B, C, D, E) Existing License Number: CBP0025b-1R
3. CONTRACT NUMBER(S) 4. FIRST SHIPMENT DATE 5LAST SHIPMENT DATE 16. PROPOSED EXPIRATION DATE
1 1 10/31/2015 PART C. TO BE COMPLETED FOR EXPORT ONLY OR COMBINED 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, If necessary.)
7. NAME(S)/ADDRESS(ES) OF SUPPLIERS 8. NAME(S) /ADDRESS(ES) OF INTERMEDIATE 9. NAME(S) /ADDRESS(ES) OF ULTIMATE AND/OR OTHER PARTIES TO THE EXPORT FOREIGN CONSIGNEE(S) FOREIGN CONSIGNEE(S)
Saudi Arabia and Qatar
SEE PAGE 3 OF THIS FORM
7a. LIST FUNCTIONS PERFORMEDISERVICE PROVIDED 8a. INTERMEDIATE USE(S) 9a. ULTIMATE END USE(S)
10. DESCRIPTION OF RADIOACTIVE MATERIALS, SEALED SOURCES, lOa. MAX TOTAL VOLUME I 10b. MAX ENRICHMENT 1c. MAX ISOTOPE NUCLEAR FACILITIES, EQUIPMENT, OR COMPONENTS ELEMENT WGT (KG), OR OR WGT % WGT (KG) TOTAL ACTIVITY (TBq)
11. FOREIGN OBLIGATIONS (BY COUNTRY AND BY PERCENTAGE OF MAXIMUM TOTAL VOLUME)
NRC FORM 7 (6-2006) PRINTEDO RECYCLED PAPER Page 2 of
NRC FORM7 U.S. NUCLEAR REGULATORY COMMISSION (6-2o•0) 10 CFR 110 APPLICATION FOR NRC EXPORTIIMPORT LICENSE, AMENDMENT, OR RENEWAL (Continued)
FRI~ ~ 7` Aa"C -. PART D. TO BE COMPLETED FOR IMPORT ONLY, OR COMBINED LICENSES, AMENDMENTS, OR RENEWALS (Ifmore space is needed to complete any of the items, use Pages 3-4 first, and then attach additional sheets, if necessary.)
12. NAME(S) I ADDRESS(ES) OF FOREIGN 13. NAME(S) I ADDRESS(ES) OF INTERMEDIATE 14. NAME(S) I ADDRESS(ES) OF ULTIMATE SUPPLIERS AND/OR OTHER PARTIES CONSIGNEE(S) CONSIGNEE(S) TO IMPORT
12a. NRC EXPORT LICENSE NUMBER(S) 13a. LICENSE NUMBER(S) I EXPIRATION DATE(S) 14a. LICENSE NUMBER(S) I EXPIRATION DATE(S) (if applicable)
13b. INTERMEDIATE USE(S) 14b. INTERMEDIATE USE(S)
15. DESCRIPTION OF RADIOACTIVE MATERIALS, SEALED SOURCES, 15a. MAX TOTAL VOLUME I 15b. MAX ENRICHMENT 15c. MAX ISOTOPE NUCLEAR FACILITIES ELEMENT WGT (KG), OR OR WGT % WGT (KG) TOTAL ACTIVITY (TBq) Category 2 quantities or Americium-241 and Americium-241/Be for shipments that are in excess of 0.6 Terebequerels threshold.
16. FOREIGN OBLIGATIONS (BY COUNTRY AND BY PERCENTAGE OF MAXIMUM TOTAL VOLUME)
PART E. TO BE COMPLETED FOR ALL LICENSES, AMENDMENTS, OR RENEWALS
17. ADDITIONAL INFORMATION 7a. COPIES OF RECIPIENTS' PROVIDED ON PAGES 3,4, E YES [ NO AUTHORIZATIONSF PROVIDED?NYES NO AND/OR ON SEPARATE SHEETS? I
I, the applicant's authorized official, hereby certify that this application is prepared in conformity with Title10, 18. CERTIFICATION: Code of Federal Regulations, and that all information provided is correct to the best of my knowledge.
18a. PRINT NAME AND TITLE OF AUTHORIZED OFFICIAL 18b. SIGNATURE- AUTHORIZED OFFICIAL 18c. DATE Cindy Dorris _,,' International Trade Compliance Export Administrator I LL• 09114/2007 Page 3 of 4
NRC FORM 7 U.S. NUCLEAR REGULATORY COMMISSION (6-20W6) 10 CFR 110 APPLICATION FOR NRC EXPORT/IMPORT LICENSE, AMENDMENT, OR RENEWAL (Continued)
ADDITIONAL INFORMATION (Reference applicable block numbers from page 1 and/orpage 2 for each entry)
THIS APPLICATION IS FOR EXTENDING THE EXPIRATION DATE FOR LICENSE CBP0025b-1 R AND TO ADD ADDITIONAL ULTIMATE CONSIGNEE (S) *copy of NRC License No. CBP0025b-1 R included with this Form*
Ultimate Foreign Consignee (s) Also see page 4:
SAUDI ARABIA:
Halliburton Energy Services Sperry-Sun Saudi Co., LTD ABU Hydriya Road Al Nabia End Saihat, 31952. Al Khobar Saudi Arabia Kingdom of Saudi Arabia
Halliburton Energy Services Saudi Halliburton P.O. Box 3474 AI-Khobar 31952 Saudi Arabia Kingdom of Saudi Arabia
Halliburton Energy Services Sperry-Sun Saudi Co. Saudi Halliburton Abqaiq Facility Abqaiq, Saudi Arabia Kingdom of Saudi Arabia
Halliburton Energy Services Logging LLC Near Dammam-Jubail Highway Opposite AI-Rashid Crushing Company Abu Hydria Exit Dammam, Saudi Arabia Kingdom of Saudi Arabia
Halliburton Energy Services Sperry Sun Saudi Co. P.O. Box 30142 AI-Khobar Saudi Arabia
Halliburton Energy Services Halliburton Logging LLC P. 0. Box 3474 Damman Airport Saudi Arabia Page 4 to be included with Form 7
QATAR
Sperry-Sun Drilling Services C/O Al Abed Trading P.O. Box 3266 Doha, Qatar State of Qatar
Halliburton Worldwide LTD C/O Jaidah Motors & Trading Co. P.O. Box 3036 Doha, Qatar State of Qatar
HES/Halliburton Worldwide Unit 5 & 6 Venture Nasser Enterprises WLL Doha, Qatar State of Qatar
Halliburton Energy Services, Worldwide Qatar, HWL Marine Salwa Industrial Area Street No.38, Gate No. 47 P.O. Box 3036 Doha, Qatar