ML20023E216
| ML20023E216 | |
| Person / Time | |
|---|---|
| Site: | 07002669 |
| Issue date: | 04/18/1983 |
| From: | Morrison G ROBERT PACKER HOSP., SAYRE, PA |
| To: | |
| Shared Package | |
| ML20023E209 | List: |
| References | |
| NUDOCS 8306150169 | |
| Download: ML20023E216 (1) | |
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w FORM NRC-314 U S '.vLLE AR RE GU LATOR Y COMMISSION APPROVED BY GAO (9 76)
B.180225 R O374)
E wpires 5/31 79 CERTIFICATE OF DISPOSITION OF MATERIALS (All Blocks MUST BE Completed)
LICENSEE NAME AND ADDRESS LICENSE NUMBER l
um c c.v Robert Packer Hospital av
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LICENSE EXPIR ATION DATE J;rfre, Pennsylvania 15840
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August 31, 1982 The hcensee or any indiv rdum e x ecu ting this ce rt,ficate on beha:f of t he ! c en see ce r tif y that / Check and/or complete appropnare item (s) Delow /
3 1.
No ma terials have tjeen or ocu red by licensee
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2 All ma ter als pr ocurad and or possessed by i,censee un der hcen se numter shown atjove have tren transferred to which has NRC license number
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3 Ait mater.ats pr ocure d an d or possessed by ocrsee under hcense numoer shown above have been transf erred to which has Incense number
.. _ _ issued by an Agreement State pursuant to Section 274 of the Atomic Energy Act of 1954, as amended, and the E nergy Reorganization Act of 1974 C
4 Mate nais have neen disposed o+,n tne f onowing man ne r (Describe specofic disposalprocedures - of additional space is needed, use reverse side )
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8306150169 830608 PDR ADOCK 07002669 C
PDR CERTIFYtNG OFFICI AL PLE ASE RE TURN TO
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e SIGN ATUR E U.S. Nuclear R egulatory Commission Of fice of Nuclear Material Saf ety and Saf eguards Ga r y R. M Or rison Washington. D C. 20555 Vice-President. Adrninistration DATE
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i NRC FORM 314 19-76) SUPE RSEDES PREVIOUS EDITtONS WHICH ARE OBSOLETE.
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