ML20032D828

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Certificate of Disposition of Matls:No Matls Have Been Procured by Licensee Under License SNM-1691
ML20032D828
Person / Time
Site: 07002426
Issue date: 10/23/1981
From: Loucks J
CROZER-CHESTER MEDICAL CENTER, CHESTER, PA
To:
Shared Package
ML20032D826 List:
References
19853, NUDOCS 8111180014
Download: ML20032D828 (1)


Text

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APPROVED B UA5

" M1 NRO-314 U.S.HUCLEAR REGULATORY COMMISSION C.180225 (R0377 o

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Expir:s 5/31/32 CERTIFICATE OF DISPOSITION OF MATERIALS (All Blocks MUST BE Coreptered)

LICENSE NUMBER L CENSEE NAME AND ADDRESS CROZER-CHESTER MEDICAL CENTER SNM-1691 15th STREET & UPLAND AVENUE UPLAND, CHESTER, PENNSYLVANIA 19013 L CENSE EXPIRATION DATE 11/30/81

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e licensee or any individua! executing this certifica:e on behalf of the licensee certify : hat: (Check enc /cr complete appropriate itemisf below.)

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1. No mewri.11s have been procured by licensee.

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2. All materials procured and/or possessed by licensee under licensa number shown above, have been transferrec to:

L which has NRC license number:

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3. All materials procured and/or possessed by licensee under license nurr:ber shown above have been transferred to:

which has license rumber:

issued by an Agreement Sta:e pursuant to Section 274 of the Atomic Energy Act of 1554,as amended,and the Energy Reorganization Ai:t of 1974.

2 a.?aterials have been disposed of in the fct:owing rnanner. (Describe specific disoosalprocedures - if additionalsauce is needed, use reverse side.)

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ME RTIFYIMG Of>1CI At,

LEASE RETURN TO:

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U.S. Nuclear Regulatory Commission OS H. kwh, Ma D*

CHice of Nuclear Matenal Safety and Saf eguards President

~, insss 8111180014 811020 '

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^IE PDR ADOCK 07002426 October 23, 1981 C

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  • .:, FOR?.1314 (7 79) SUPERSEDES PREVIOUS EDITIONS WHICH ARE 03SOLETE.

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