ML20010J437
| ML20010J437 | |
| Person / Time | |
|---|---|
| Site: | 07002185 |
| Issue date: | 09/14/1981 |
| From: | Suellentrop B HILLCREST MEDICAL CENTER, TULSA, OK |
| To: | |
| References | |
| 19678, NUDOCS 8110050067 | |
| Download: ML20010J437 (1) | |
Text
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APPROVED BY UAd
- FM NRO.314 US. RUCLEAR REGULATORY CO.*.", ISSION
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B-180225 (R0374
- ~~'3, Expiros S/31/33 CERTIFICATE OF DISPOSITION OF MATERIALS (A!! Ellocks f.fUST BE Como:ere21 M
L:CENSEE NAME AND ADDRESS 7'
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LICENSE NUMBER e
Hillcrest Medical CenteF ' #
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.7 9 -4 55 1120 South Utica uCENsE EXPIRATION DATE Tulsa, Oklahoma 74104 9-30-81
~-e licenses or any ind;viduai enscut ng this ccitificate on behalf of the licensee certify that: (Check and/or compiere appropria:e item (s i
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- 1. Nc matsrists have been procured by licenwe.
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- 2. A!! materials procursd and/or possessed by licensee Under licenst nuraber snown above, have teen transferred tc.
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which has NRC licensa number:
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- 3. All materials precured and/or possessed oy licensee under ficensa number shown above have been transferred to:
issued by e,hich has licensa number:
an Acreemsat State pursusnt to Section 274 of the Atornic En2rgy Act of 1954,as arne:tded,and the Energy Reorganization Act of 1974
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- 2. Materials have been disposed of in the foliosing manner. (Describe specific disoosalprocedures -if additionaLsicaceis needed.
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f Subscribed so and sworn before me this day of
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'j l FLEASE RETURN TO:
SIGNATURE.- 270 ~
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l US. Nuclear Regulatory Commission
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- Cffice of Nuctear MatarialSafety and Safec;uards Bob Suellentron. Atene. Administrator g
wasnington.o.c. 205ss UAT3 8110050067 810914 September 14, 1981 PDR ADOCK 07002185 E
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. PDR ES PREVIOUS EDITIONS WHICH ARE 093OLET.
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