ML20151H766
| ML20151H766 | |
| Person / Time | |
|---|---|
| Issue date: | 05/02/1988 |
| From: | NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I) |
| To: | |
| Shared Package | |
| ML20151H535 | List: |
| References | |
| REF-QA-99990001-880719 99990001-88-84, NUDOCS 8808020043 | |
| Download: ML20151H766 (6) | |
Text
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Name and Address of General, Licensee t7/M/ f fM # Qye, S1$dbtdl }c2
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Date of Inspection:
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Signature of Inspector (s):_ 7_)6
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Principal Business of Licenspe:
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Purpose for which device (s) are used :
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Device Specifics:
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Model Number:
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Activity of Po-210 source
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Date Received:
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Date lease expires:
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Did licensee receive 3M notification:
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Has survey been performed by 3M Yes _
No ty Consultant: Yes _
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If Yes list consultant's name and location:
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Survey Perfonned by Inspector:
Serial Number of Device:
Direct Survey of Device:
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Smear Survey of Device:
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Survey Instrwent tised:
Model:
Serial No.:
Date of Calibration:
(If more than one unit use additional sheets)
If direct survey shows contar.ination, saroles of product Nst be obtained.
Type of product:
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Serial Number of Device: _
Direct survey Of Device alpha dpm/
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Snear Survey of Device:
alpha dpm/ _ cm8 Smear Survey of Work Area:
Survey Instrument Used:
Model:
5erial No.:
Date of Calibration:
5erial Number of Device:
Direct survey Of Device:
alpha dpm/_ _ ca' Direct Survey Of Work Area:
Smear Survey of Device:
alpha dpm/ _ car Smear Survey of Work Area:
Survey Instrurent Used:
Model:
Serial No.:
Date of C41thration:
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