ML20009D009

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Certificate of Disposition of Matls:Six Cases Performed by F Enriquez.License SNM-1646 Will Not Be Renewed
ML20009D009
Person / Time
Site: 07002232
Issue date: 05/28/1981
From: Centrone J
WEST JERSEY HOSP., CAMDEN, NJ
To:
References
19205, NUDOCS 8107220372
Download: ML20009D009 (1)


Text

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90'~223z APPROVED BY GAO

EM NRC 314

. U S. NUCLE A R RE GU',ATO R Y L '.' '%51Cf6 B 1CO225 MO37 0

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Expires 5/31/32 CERTIFICATE OF DISPOSITION OF MATERIALS fg (All B:ocks MUST BE Corr'p:eted)

.LMLW REF # 70-2 qq..y L CUGE NAM: AND ADDRcOS

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PM \\ 22 UCENS5 NUMBER West Jersey Hospital Systems SIN-16h6 Mt. Ephraim & Atlantic Avenues LICENL. E:<PIR ATION DATE Camden,Ilev Jersey 0810h Jciica 6/30/81 c Lcensae or 3ay in datua' execut.ng this certif cate nq LAhalf of :Pe licenM= certify that: (Cn cA and/or corno'ere appropria e itern/Il t;efosar. )

1. No ma:vrrais nwe tan procured by !icen;ee.

mate im proc.uted and/or poss.esseo by iicmsc-e uncer licer).wrncer shoe.n scove, hue ben tra.,Jer.ed to;

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2. ~

been performed by Francisco Enriquez, M.D., at the above address.

veh:ch has NRC license number:

SIN-16h6 2

3. All materials orocured and/or poswssed by license under !icense number shown accve 5we been transfe red to:

which has ficense numbar:

isaued by -

39 Agreement State pursuant to Section 274 of the AtoTic Enargy Act cf 1954,as ame ded, and the Energy Reortpwation Act of 1974.

4. Ma:ena\\s haue been disposed of in tre f ollowmq rnarr;er. (Descnbe specific discoulprocertures -if addihonalspace is needed.
ise revv e side.)

We do not wish to renew this license at this time.

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JOSEPH F. CiNTPfNE, M.D.

CWI FY ING O F FICI At.

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LEASE METURN TO:

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SIGNATURE U.S. Nuctear Regulatory Cornmission l

Cf fice of Nuct+4r Meterni Saf ety and Saf eguards Wash:ngton. D.C. 20555

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8107220372 81052e oE PDR ADOCK 07002232 14 rww C

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