ML20154F402
| ML20154F402 | |
| Person / Time | |
|---|---|
| Site: | 07000578 |
| Issue date: | 09/14/1998 |
| From: | Prange B NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION IV) |
| To: | |
| References | |
| 466889, NUDOCS 9810090211 | |
| Download: ML20154F402 (37) | |
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! NRc FORM 374A U.S. NUCLEAR REGULATORY Commission PAGE 1 of 1 PAGES
! Lic;nse Number SNM-536
! MATERIALS LICENSE eket r Reference Number SUPPLEMENTARY SHEET 070-00578 1
Amendment No. 9 i
University of Hawaii at Manoa 2040 East-West Road Honolulu, Hawaii 96822 c a~ R P> <+ny , . -
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. cry %g in accordance with NRC Form 314 dated August 12,1998, License No. ,SNM-536 is hereby terminated.
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FOR THE U.S. NUCLEAR REGULATORY COMMISSION Date By b O. r/m 1
Materials Branch Region IV; WCFO nb Walnut Creek, Califomia 945S6
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IVIL't U OfflCIAL RECORD COPY
UNITED STATES l
,4jfMeCq'o,, NUCLEAR REZULATORY COMMISSION e 7, REGION IV i e a 'NALNUT CREEK FIELD OFFICE I o I 1450 MARIA LANE WALNUT CREEK, CAUFORNIANbb
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SEP 141998 l University of Hawaii Environmental Health and Safety Ofiice ATTN: Irene Sakimoto Radiation Safety Officer 2040 East-West Road Honolulu, Hawaii 96822
SUBJECT:
LICENSE TERMINATION On August 12,1998, you contacted the U.S. Nuclear Regulatory Commission and indicated that you wished to terminate your NRC radioactive materials license. The NRC staff has reviewed your sealed source leak test results. Based on its review, the staff has concluded that: 1) all licensable radioactive material under this license has been removed from your facility and 2) residual radioactive material attributable to licensed activities does not exceed current NRC criteria.
Based on these conclusions, the facilities which were under this license are suitable for unrestricted use and NRC license number SNM-536 is hereby terminated.
Sincerely, 73 mea.7%
Beth A. Prange 7
Sr. Health Physicist (Licensing)
Materials Branch Docket No.: 070-00578 License No.: SNM-536 Control No.: 466889 cc: State of HI I
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Environmental licalth and Safety Office 2040 East-West Road Ilonolulu,llawai'i 96822 Telephone: (808) 956-8660 Facsimile: (808) 956,3205 September 1,1998 Ms. Beth Prange U. S. Nuclear Regulatory Commission Region IV, WCFO 1450 Maria Lane Walnut Creek, Californis 94596-5368 Docket No.: 070-0578 License No.: $NM-536
Dear Ms. Prange,
Enclosed is a copy of the DOE Relinquishment of Ownership papers for the 5 Ci PuBe sources transferred to Los Alamos National Laboratory.
Please let me know if you need any other information to terminate this license.
Thank you for your help in terminating this license.
Sincerely,
}%w IC. fabbnda Irene K. Sakimoto Radiation Safety Officer-Enc: LANL letter An Equal Opportunity / Affirmative Action Institution
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1 DOE AUTIIORIZATION TO SHIP /RELINOUISHMENT OF OWNERSIIIP l Sign Below and Return to the Following Address:
Sherry W. Jones Ims Alamos National Laboratory '
P. O. Box 1663, NMSM/SD, MS E524 Ims Alamos, New Mexico 87545 l
' You are authorized by the Department of Energy (DOE) to ship the 239PuBe source (s) on the reverse side of this form to the los Alamos National Laboratory.
NOTE: Name and signature must be of an official of the facility that has the authority to relinquish ownership of the 239 PuBe source (s). This form must be signed and retrrned before Los Alamos will authorize the shipment of your source (s).
l The UNIVERSITY OF IIAWAII hereby relinquishes all ownership of the 239PuBe neutron source (s) indicated on the reverse side of this form to the United States Department of Energy (DOE) upon acceipt/ acceptance of the source (s) by the Los Alamos National Laboratory.
Eugene S. Imai Sr VP for Administration OFFICIAL NAME/FITLE:
NAME (Please Print /rype) TITLE (Please Print /fype) l
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SIGNATURE: 'AA ~
DATE: 5/28/98 0 -
/AAMh// TW LANL ACCEI'TANCE SIGNATURE:
DATE: Y 2/a!98 '
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DATE: May 13. 1998 LOS ALAMOS NATIONAL LABORATORY Side (2) e LOS ALAMOS, NEW MEXICO 87545 239PuBe RECOVERY PROGRAM FACILITY NAME: University or linwall DEPARTMENT: Environments! IIenith & Safety RIS: 711W CONTACT NAME: Irene Saklmoto TELEPIIONE: (808) 936-6475 FAX: (808) 956-3205 ADDRESS: 2040 Fact West Rnnel finna,1ulu. III 96A22 239PuBe SOURCE INFORMATION SERIAL # M 1191 ELEMENT 15.g._ ISOTOPE 14e CURIES /TBq 1CI/.037TBo MT/% 52 6.66 %
SERI AL # M 1192 ELEMENT lig_, ISOTOPE 14e CURIES /TBq 1Ci/.037TBa MT/% 52 6.66 %
SERIAL # M 1193 ELEMENT ifig._ ISOTOPE._lig_ CURIES /TBq 1CI/.037TBo MT/% 52 6.25 %
SERIAL # M 1194 ELEMENT lig_. ISOTOPE 15e CURIES /TBq 1Cl/.037TBo MT/% 52 6.25 %
SERIAL # M 1195 ELEMENT lig._ ISOTOPE 14e CURIES /TBq 1C1/.037TBa MT/% 52 6.66 %
l SERIAL # ELEMENT ISOTOPE CURIES /fBq MT/%
SERIAL # ELEMENT ISOTOPE CURIES /Tiki MT/%
i SERIAL # ELEMENT ISOTOPE CURIES /TBq Afr/%
l SERIAL # ELEMENT ISOTOPE CURIES /TBq MT/%
L.ANL CONTA!NER(S)
YES XX NO AMOUNT TWO rev. 2/20s7 2
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4 University o Hawaii at Manoa 2040 East-West Road Honohdu, HI 9(iB22 (808) 956 8591 Fax: (808) 956 3205 FAX TRANSMISSION COVER SHEET Date: August 25,1998 -
To: Ms. Bcth Prange Fax: 925-975-0381 Re: NMMSSfann 741 Sender: Irrne Saktinoto YOU SHOULD RECEIVE 2 PAGE(S), INCLUDING THIS COVER SHEET. IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL (808) 956 8591. l Hi Beth, Here's the form 741. It's a little hard to read since the print is so small.
Thanks for your help!
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- fAR88188G: FALSE STATEMENTS IN THIS CERTIFtCATE MAY BE SUBJECT TO CWit_ AND]OR C518tBINAL FEMALTIES NBC REGULATION 5 REOUIRE T TO THE NRC BE COMPLETE AND ACCUAATE IN ALL MATERRAL flESPEC1$.18 tJ.S.C SECT 10N 1001 MAKES IT A reentma4L OFFEW3E TO WAKE A 4, STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AMMCY OF THE (MITED STATES AS TO ANY nsATTER WITHIN ITS JUR'.SDFCTIONL e
O University of Hawai'i at M&noa c.
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l Environmental Health and Safety OfIlce 2040 East West Road Honolulu. Hawai'i 96E22 Telephone: (808) 956-8660 Facsimile: (808) 956-3205 ,
August 12,1998 Ms. Beth Prange l U. S. Nuclear Regulatory Commission Region IV, Walnut Creek Field Office 1450 Maria Lane Walnut Creek, California 94596-5368 Docket No.: 070-0578 License No.: SNM-536
Dear Ms. Prange,
The University of Hawaii at Manoa is requesting to terminate our SNM-536 license for the 5 Ci PuBe sources. The sources were transferred to the Los Alamos National Laboratory on June 26, 1998. LANL received the sources on July 14,1998.
Enclosed are the NRC Form 314, leak test results prior to shipment, and the DOE /NRC Form 741. If you have any questions regarding this matter, please call me at 808-956-6475.
Sincerely, ju k. flad Irene K. Sakimoto Radia. tion Safety Officer An Equal Opportunity / Affirmative Action Institution M$
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NRC FORM 314 U.S. NUCLEAR REGULATORY COMMISSION APPROVED 8V OMB: N0 3120028 1
r3 33 EXPlRES: OW3005 Io CFR 30.36icH1 Hav) ESTIMATED BURDEN PER RESPONSE TO COMPLY WITH THIS NFORMATION COLLECTION i f 10 CFR do.42(ol(1Hsvl REQUEST: 30 MhuTES. THIS MANDATORY SUBMITTAL 18 USED BY NRC AS PART OF l lo CFR 70.381cH1Hivl THE BASIS FOR ITS DETERMMATION THAT THE FACIUTY MAS BEEN CLEARED OF l
RADICACTIVE MATERIAL BEFORE THE FACluTY 13 RELCASED FOR UNRESTRICTED USE 1 CERTIFICATE OF DISPOSITION OF MATERIALS r0RwARD COMMENTS rem 0nD bur 0EN ESTmn TO m n,0RMATim ANO l RECORDS MANAGEMENT BRANCH lhWBS U141, U.S. NUCLEAR REGUL.ATORY INSTRUC" ALL ITHMS MUST BE COMPLETED -- PRINT OR TYPE DC Mm M M M Mmm mCm SEND Tw , . DC 20503.
PLETED CERTIFICATE TO THE NRC OFFICE SPECIFIED ON THE REVERSE uahw ' **
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l Universi ty of Hawaii at Manoa 6 2040 East-West Road UcENSE EXPlRATION DA17 Honolulu, HI 96822 December 31, 1999 l 1
A. MATERIALS DATA (Check one and complete as necessary/
THE LICENSEE OR ANY INDIVIDUAL EXECUTING THIS CERTIFICATE ON BEHALF OF THE LICENSEE CERTIFIES THAT: l (Check and/or enmplete the appropriate item (s) below.) l
]1. NO MATERIALS HAVE EVER BEEN PROCUREC OR POSSESSED BY THE LICENSEE UNDER THIS LICENSE. '
- 2. ALL ACTIVITIES AUTHORIZED BY THE LICENSE HAVE CSASED AND ALL Mt.TERIALS PROCURED AND/OR PCSSESSED BY THE l LICENSEE UNDER THE LICENSE NUMBER CITED ABOVE HAVE BEEN DISPOSED OF IN THE FOLLOWING MANNER. (// additional I space is needed, me the reverse side or provide attachments.) l Describe specific rratenal transfer actions and, if there were radioactive wastes generated in terminating this license, the disposal i actions including tt's disposition of low-level radioactive waste, mixed waste, Greater than-Class-C waere, and see'ed sources, if ]
applicable.
For transfers, specify the date of the transfer, the name of the licensed recipient, and the recipient's NRC license number or Agreement State narle and license number.
Date of Transfer: 06-26-98 Transferred to: Los Alamos Natical Laboratory .
Transfer series: ZHW-AUA-000001 l If matenols were dispt4ed of directly by the licensae rather than twnsferred to another licensee, licensed disposal ate or waste enntracto., describe the specific disposal procedures (e.g., aecay in storagel.
B. OTHER DATA d 1, OUR LICENSE HAS NO1 YET EXPIRED: PU ? SE TERMidATE IT.
- 2. A RADIATION SURVEY"NAS CONDUCTED BY THE LICENSEE TO CONFIRM THE ABSENCE OF LICENSED RADIOACTIVE MATER'ALS AND TO DETERMINE WHETHER ANY CONTAMINAT ON REMAlltiS Oy THE PREMISES COVERED BY THE LICENSE. (Check onef
{ NO (Attach explanahon)
YES, THE RESULTS /Checa onel ARE ATTACHEP,-or
-WERE FORNARDt D TO NRC ON (Date)
- 3. THE PERSON TO BE CON" ACTED 7,$*[","cj" REG ARDING THE INFORM ATION Irene Sakimoto 808-956-6475 PROVIDED ON THIS FORM
- 4. Mall ALL FUTURE CORRESPO NDEtJCE REGARDING THIS LICENSE 10 Irene Sakimoto, University of Hawaii at Aanoa, 2040 East-West Road, Honolulu, HI 90822 CERTIFYING OFFICIAL i CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORREET l iwwTro NAME ANo riitt sioNArunt DATE Irene Sakimoto jbd Y 08-12-98 j Radiation Safetv Officer WARNING: FALSE STATEMENTS IN THis CERTIFICATE MAY BE SUBJEC T TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUlMISSIONS TO THE NRC DE COMPLETE AND ACCURATE IN ALL MATERIAL RESPtiCTS. 18 U.S.C.
SECTlON 1001 MAKES IT A CRMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTIONS.
edL FOHM 314 13 gjg PHINI t,U ON HtcRLt U PAPlH l
FILE CERTIFICATES hD}OLLOWS: IF YOU ARE LOCATED IN:
IF YOU ARE A DISTRIBUTOR OF EXEMPT PRODUCTS, SEND TO: ILLINOIS, INDIANA, IOWA, MICHIGAN, MINNESOTA, MISSOURI, OHIO, OR WISCONSIN, SEND APPLICATIONS TO:
DIVISION OF INDUSTRIAL AND MEDICAL NUCLEAR SAFETY OFFICE OF NUCLEAR MATERIAL SAFETY AND SAFEGUARDS MATERIALS LICENSING SECTION U.S. NUCLT AR REGULATORY COMMISSION U.S. NUCLEAR REGULATORY COMMISSION, REGION lil WASHINGTON, DC 20555MI 801 WARRENVILLE ROAD ALL OTHEGS,IF YOU ARE LOCATED IN:
ARKANSAS, COLORADO, IDAHO, KANMS, LOUISIANA, C,0NNECTICUT, DELAWARE, DISTRICT OF COLUMBM, MAINE. MONTANA, NEBRASKA, NEW MEXICO, NORTH DAKOTA, MARYLAND, MASSACHUSETTS, NEW HAMPSHIRE, NEW OKLAHOMA, SOUTH DAKOTA, TEXAS, UTAH, OR WYOMING" JERSE6 NEW YORK, PENNSYLVANIA, RHOEE ISLAND, OR SEND APPLICATIONS TO:
VERMONi SEND APPLICATIOi4S TO:
MATERIAL RADIATION PROTECTION SECTION LICENNNG A SSISTANCE SECTION U.S. NUCLEAR REGULATORY COMMISSION, REGION IV NUCLEAR M,\TERIALS SAFETY BRANCH 811 RYAN PLAZA DRIVE, SUITE 400 U.S. NVCLEAP REGULATORY COMMISSION, REGION t ARUNGTON, TX 78011 8084 475 ALLENDAli ROAD KING OF PRVS$1A, PA 19406-1415 ALASKA, ARIZONA, CALIFORNIA, HAWAll, NEVADA, OREGON, PACIFIC TRUST TERRITORIES, OR WASHINGTON, SEND ALABAMA, FLORIDA, GEORotA, KENTUCKY, MISSISSIPPI, APPLICATIONS TO:
NORTH CAROLINA, PUERTO RICO, SOUTH CAROLINA, TENNESSEE, VIRGINIA, VIRGIN ISLANDS, OR WEST VIRGINIA.
SENO APPLICATIONS TO: NUCLEAR MATERIALS SAFETY SECTION U.S. NUCLEAR REGULATORY COMMISSION, REGION V 1450 MARIA LANE NUCLEAR MATERIALS SAFETY SECTION V.S. NUCLEAR REGULATORY CCMMISSION, REGION 11 WALNUT CREEK. CA 94596-5368 101 MARIETTA STREET NW, SUITE 2900 ATLANTA. GA 30323-0199 I
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ATTACHMENT FOR ITEM B. 2. OTHER DATA NRC FORM 314 B.2. A radiation survey was not conducted because all leak tests performed over the last 20 years showed no leakage from the sources. The final leak test survey taken prior to shipping is c.aached.
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UNIVERSITY OF HAWAII Radiation Safety Program SURVEY SHEET P.I.: Dr. Michael Peters Room: Watanabe 215 Date: 24-25 June 1998 i
Isotope PuBe Amount (mci) 5 mci MDA (dpm) 9.97 Radiation Survey Meter: Eberline PRN-4. Serial Number 1901 Counting Instrument: Packard 1900 CA Liquid Scintillation Analyzer. Serial Number 102434 Contamination Survey Meter: Ludlum 2. Serial Number 11602 Sample dpm/100cm 2 Sample dpm/100cm 2 Remarifs/ Follow-Up: This survey is in regards to the transfer of Dr. Michael Peter's PuBe sources from his laboratory located in Watanabe 215. A leak test for each of the five PuBe sources were taken. All swipes were below MDA.
Surveyed By: E f.
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jProtocol # 9 Name:AM-241 samoles 24-Jun-98 15:13 jRegion As LL-UL= 0.0-600. Lcr= 0 Bkg= 0.00 %2 Sigma =0.OO
! Region B: LL-UL= 4.0-156. Lcr= 0 Skg= 0.00 %2 Sigma =0.OO 1 Region C: LL-UL= 0.0-2000 Lcr= 0 Bkg= 0.00 %2 Sigma =0.OO Time = 5.00 QIP = SIS jPETERS PU/BE SHIPMENT LEAK TEST ',/N : 33253 S#' TIME CPMA CPMB CPMC tSIE FLAG 1 5.00 18.40 15.40 2 5.00 12.60 20.40 0.00 EadU p d 9.60 13.80 0.00 SW4 ' M i l9 Z-
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8 5.00 14.80 11.80 16.00 0.00 Id M'y b O N U4 9 5.00 16.80 14.00 10 5.00 18.40 0.00 Umve M 16.20 13.00 19.20 0.00 'On Cf 6%
11 5.00 13.00 9.60 15.00 0.00 id s 12 13 5.00 5.00 13.80 14.40 10.60 11.80 15.60 15.60 0.00 0.00 m% *edien boitDw.Adhm tAmbiw;.h ( k%
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'H3 IPA DATA PROCESSED H3 CHI SQUARE IPA DATA PROCESSED BKG IPA DATA PROCESSED k
- UNCLASSIFIED ******
U.S. DEPARTMENT OF ENERGY AND U.S. NUCLEAR REGULATOF 'OMMISSION 07/16/98 NUCLEAR MATERIAL TRANSACTION REPORT PAGE 1 OF 3 PAGES DOE /NRC FORM 741 TRANSFER SERIES: ZHW -AUA -000001 DISTRIB b oY i 1.SH RIS 2.R -RIS 3.T -No 4. CORR-NO 5. g-CODgg OgCODE COPY 1 OF 1 COPIES j B OF COPIES .
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- UNCLASSIFIED ******
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07/16/98 -
U.S. DEPARTMENT OF ENERGY AND U.S. NUCLEAR REGULATORY COMMISSION l
DOE /NRC FORM 741 NUCLEAR MATERIAL TRANSACTION REPORT PAGE 2 OF 3 PAGES l' TRANSFER SERIES: ZHW -AUA -000001 I
3 ! 24. SHIPPER'S DATA' ! A. SIGNATURE OF AUTHORIZED OFFICIAL AND DATE SIGNED:
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! LN TYP NO OF PROJECT COMP P O COUNTRY KEY MEAS. NET ELEMENT ELEM WEIGHT ISOTOPE ISTPE
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- UNCLASSIFIED ******
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. DOE /NRC FORM 741 TRANSFER SERIES: ZHW -AUA -000001 l RECEIVERS ITEM AND PARTS DETAIL INFORMATION ASMBLYS PROJECT ..O PRCNT, COMP TV NET ELEMENT WEIGHT ISOTOPE ELEM ISTPE DECAY C j SEQ LE NUMBER C ASSAY CODE IC MT- WEIGHT. WEIGHT. PERCENT WEIGHT 1DE LOE DATE SL F
- NO. VN ITEM IDENTIFICATION ITEMS SUBS i '001 32 M1191 00 00 ADPO405503 G.- 781- .52 15.00 6.6700 14.00 01 002 32 M1192 00 00 ADPO405503 G' 781 52 15.00 6.6700 14.00 01 7
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SHIPPERS ITEM AND PARTS DETAIL INFORMATION @
SEQ LE C D ASMBLYS PROJECT O PRCNT COMP TY NET ELEMENT WEIGHT ISOTOPE NO. VN ITEM IDENTIFICATION ITEMS SUBS NUMBER C ASSAY CODE IC MT WEIGHT ELEM ISTPE DECAY WEIGHT PERCENT WEIC:IT LOE LOE DATE SL F %
Col 32 M1191 00 00 J 781 52 15.00 6.6700 022 32 M1192 00 00 J 14.00 01 Ot3 32 M1193 -781 52 15.00 6.6700 14.00 01 00 00 J 781 52 16.00 6.2500 15.00 004 32 M1194 00 00 J 781 52 01 005 32 M1195 00 00 16.00 6.2500 15.00 01 J 781 52 15.00 6.6700 14.00 01
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(FOR LFMS USE)
- INFORMATION FROM LTS
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- 1. - APPLTCATION ATTACHED Appl 4cant / Licensee: HAWAII, UNIVERSITY OF Received Date: 980817 Docket No: 7000578
. C9ntrol No.: 466889 Lic9nse No.. SNMv536 Action Type: Termination
- 2. FEE ATTACHED Amount:
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nuva reo nun iu a nu-WUPU FAX 110. 5109750381 P.02 e>.
University of .Hawai'i at MRuoa -
Environmental IIealth anel Safety Office Tel p on ( 08) 56-8660 Fa s i e (no ) 956 320 ()Y.@ hh August 12,1998 AUG 1 'T 1998
.ae Ms. Beth Prange U. S. Nuclear Regulatory Commission RegienIV, Walnut Creek Field Office 1450 Maria Lane Walnut Creek, California 94596-5368 Docket rio.: 070-0578 License No.: SNM-536
Dear Ms. Prange,
The University of Hawaii at Manoa is renuesting to terminate our SNM-536 licence for the 5 Ci PuBe sources. The sources were transferred to the Los Alamos National Laboratory on June 26, 1998. LANL received the sources on July 14,1998.
Enclosed are the NRC Form 314, leak test results prior to shipment, and the DOE /NRC Form 741. If you have any questions regarding this matter, please call me at 808-956-6475.
Sincerely, ju k. $d Irene K. Sakimoto Radiation Safety Officer An Equal Opportunity / Affirmative Action Institution I' r. <
m 6
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Nac popu 3iA U.S. NUCLEAR RFOULAT ORY COMMISSION Arreovwsrout Ro.3:wec2s '
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fo cFR 40.42ter:1pM tocfmFO.Sete1m M M SA55 90R f73 DETf9tMN&TWPt TMAT TifE TAC #17Y N48 ftDt CttAtt3 or PAINCACTNT MATTF'At $FFORE TFI FatltlTV ft RNf 4*f0 fo# tanttvrty Tfc vg I
,c.uno c.,uun,n woen emn, emmi To m m-1,,, ,,,, j CEf1TIFICATE OF DISPOSITION OF MATERIALS 9tC0Pfit MANA4Ewirt BR ANUt (MMet D)ti, 11. 3 NTp ge t pir:'F ATDef IN STRUCTION$t ALL fiftet MmT PJ COMPLITED - FRINT OR TYPE # #8" #8N *NE00 M SEHO THE COWLETED CERTr*1cATE TO THE NRC CFFICE $PECl't!D OM THE REvtR$E autrm um kreu n + mss WWMW 8
University of Itawaii at Manoa g ,, , 7 -
uw.si omAnon p*Ta nW > >
2040 East-West Road Honolulu , ,5fI 96822 December 31, 1999 A. MAT ERIAL5 liAl A (Check one and complete os neeereeryl THE LICENSEE OR ANY INDIVtDt At. EXECUllNG THIS CFR11FICATE ON REHALF OF THE LICENSEE CERTIFIES THA1:
(Check end/hr complete the appmpriate frem(si below./
]1. NO MATFRIALS HAVE EVER BEEN PROCURED 09 POSSESSED BY THE LICENSEE UNDER TH OR
- 2. ALL ACTIVITIES At!THORIZED BY THE LfCENSE HAVE CEASED AND ALL MATERIALS PROCURED AND/OR POSCE LICENSEE UNDER THE LICENSE NUMBER CITED ABOVE HAVE REEN DIGPOSED OF IN THE FOLLOWING MANNER. (if edditione space is needet use the reverse side or provide ettschments.) ,
Deserte specific rnaterief transfet actions and,if there were redicactive wastes generpied in termina*ing thls licente, the disposal i actions including the disposition of low-level rec;teactive weste, enized waste. Greater than-Class C Weste, and sealed eeurces, if l
applicable.
For transfers, epecify the date of the transfer, the nome of the licented reeipient, and the reelpient's NRC licenee number of Agreernent State neme and license number.
Date of Transfer: 06-26-98 Transferred to: Los Alamos Natical Laboratory Transfer series: ZHW-AUA-000001 If materinle were disposed of directfy ty the licensee rather than transferred to another liennece, fleensed diyosal site or weste contreetor, describe the speelfio disposal procedures (e.g., decay /n storspef.
B. OTHER UATA d1. 0U9 LICENSE HAS NQl YET ExrmED: PLEASE TERMINATE IT.
- 2. A RADIATION SURVEY WAS CONDUCTFD BY THE LICFNSEE TO CONF {BM THE ASSENCE Of LICENSED R A AND TO DETERMINE WHETHER ANY CONTAMINATION REMAINS Off THE PREMfSES COVERED BY THE tlCENSE. (Ch NO (Atwch expbmetion)
YES, THE REsulTS (Check pael ARE ATTACHED, or
~WERE FORWARDED TO NRC ON /Date)
- 3. THE PERSON TO BE CONTACTED INNN" REG ARDING THE INFORM ATION 1rene Sakimoto 808-956-6475 PROVIDED ON THIS FORM 4, Matt ALL FUTV'tE CORRESPONDENCf RPGARDING THIS LICENSE TO Irene Sakimoto, University of Hawaii at Manoa, 2040 East-West Road,
!!onolulu , HI 96822 _.
CFRilFYlNO OTT!CIAL _
l CERTirY UNDER PENALTY OF PERJURY THAT THE FOREGO!NG LS TRUE AND CORRECT sionafum oars cremtonaur erm fir 6t l Irene Sakirnoto jW 4
- 08-12-98 t
RadiaLion__Safelv Officer WA RN:NG: TALSE STATEMENTS IN THis CEntirlCATf MAY PE SUBJECT 10 civil A ND/OR C RIMIN AL F'ENAL IltX NPC REGUt ATIONS REQUIRE THAT SU9 MIS $f0NS To THE NRC BF COMf'LFTE AND ACCURATE IN All MATERIAL RESficis.1R U SECTION t001 MAKES IT CRIMINAL CFFENSE TO MAFE A WILLFULLY FALSE STATEMENT OR REPRESENTAflON TO ANY OtrPARTMENT Oft AGFNCY t fME UNITED STATES AS TO ANY MATTER WITHIN ITS JuniSDICTIONS.
Nurn eo nn r tc vu en rartn Nm eoau m 9.* m b
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nw-i reo iut nu.co liu WUPU PAX NV. S'109/bO381 P.04 ATTACHMENT FOR ITEM B. 2. OTHER DATA NRC FORM 314 B.2. A radiation survey was not conducted because all leak tests performed over the last 20 years showed no leakage from the sources. The finalleak test survey taken prior to shipping is attached.
> m m m ma r:wo l
l L .
l l UNIVERSITY OF IIAWA11 I Radiation Safety Program SURVEY SilEhT l P.I.: Dr. Michaele. ten Room: Watanabe 211. L)nte: 24-25 June 1998 Isotope PuBe Amount (mCl) SmCi MDA (dpm) 9.97 Radiation Survey Meter: Eberline ERN-4. Serial Number 1901
- Counting Instrument
- Eaclard_120_0_CA_liquREcintillAjon t Analyzer. Serial Number 102434 Contamination Survey Meter: Ludium 2.Scrial. Number 11602 i Sample dpm/100cm 2 Sample dpm/100cm2 l
l l
Remarks / Follow-Up: This stuvey is in regards to the transfer of Dr. Michael Peter's PuBe sources from his laboratory located in Watanabe 215. A leak test for each of the five PuBe l
sources were taken. All swipes were below MDA.
1 l
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