IR 07200202/2010001

Princeton Community Hospital, NRC Form 591M Part 1, Inspection Report 03010772/2021001

ML21118A067
Person / Time
Site:	03010772, 07200202
Issue date:	03/04/2021
From:	Robert Elliott NRC Region 1
To:	Princeton Community Hosp
References
IR 2021001
Download: ML21118A067 (1)

Text

NRC FORM 591M PART 1 U.S. NUCLEAR REGULATORY COMMISSION (07-2012)

10 CFR 2.201 SAFETY INSPECTION REPORT AND COMPLIANCE INSPECTION 1. LICENSEE/LOCATION INSPECTED 2. NRC/REGIONAL OFFICE Princeton Community Hospital Region 1 12th Street Extension 2100 Renaissance Blvd Princeton, WV 24740 Suite 100 King of Prussia, PA 19406-2713 REPORT NUMBER(s) 2021001 3. DOCKET NUMBER(S) 4. LICENSE NUMBER(S) 5. DATE(S) OF INSPECTION 030-10772 47-16307-01 03/04/2021 though 4/6/21 LICENSEE:

The inspection was an examination of the activities conducted under your license as they relate to radiation safety and to compliance with the Nuclear Regulatory Commission (NRC ) rules and regulations and the conditions of your license. The inspection consisted of selective examinations of procedures and representative records, interviews with personnel, and observations by the inspector. The inspection findings are as follows:

1. Based on the inspection findings, no violations were identifie o 2. Previous violation(s) close o 3.The violations(s), specifically described to you by the inspector as non-cited violations, are not being cited because they were self-identified, non-repetitive, and corrective action was or is being taken, and the remaining criteria in the NRC Enforcement Policy, to exercise discretion, were satisfie Non-cited violation(s) were discussed involving the following requirement(s):

o 4. During this inspection, certain of your activities, as described below and/or attached, were in violation of NRC requirements and are being cited in accordance with the NRC Enforcement Policy. This form is a NOTICE OF VIOLATION, which may be subject to posting in accordance with 10 CFR 19.11. (Violations and Corrective Actions)

Statement of Corrective Actions I hereby state that, within 30 days, the actions described by me to the Inspector will be taken to correct the violations identified. This statement of corrective actions is made in accordance with the requirements of 10 CFR 2.201 (corrective steps already taken, corrective steps which will be taken, date when full compliance will be achieved). I understand that no further written response to NRC will be required, unless specifically requeste TITLE PRINTED NAME SIGNATURE DATE LICENSEE'S Sherri Snead, Director of Imaging REPRESENTATIVE NRC INSPECTOR Robin Elliott 4/7/21 Donna Janda Digitally signed by Donna BRANCH CHIEF Donna M. Janda Janda Date: 2021.04.27 16:06:42 -04'00'

NRC FORM 591M PART 1 (07/2012) Page 1 of 1