ML20196B241
| ML20196B241 | |
| Person / Time | |
|---|---|
| Issue date: | 07/15/1998 |
| From: | NRC |
| To: | |
| Shared Package | |
| ML20195J356 | List: |
| References | |
| SSD, NUDOCS 9906230127 | |
| Download: ML20196B241 (2) | |
Text
.
e REGISTRY OF RADIOACTIVE SEALED SOURCES AND DEVICES SAFETY EVALUATION OF DEVICE CORRECTED PAGE JUNE 11, 1999 l
NO.:
NR-0121-D-103-S DATE:
July 15, 1998 PAGE: 1 OF 6 DEVICE TYPE: Calibration Device MODEL:
D-0062 MANUFACTURER / DISTRIBUTOR:
AFMOA/SGOR 110 Luke Avenue, Room 405 i
Bolling AFB, DC 20332-7050 SEALED SOURCE DESIGNATION:
ICN Radiopharmaceutical Model 375 OR:
Isotope Products Laboratories Model 193 OR:
J.L.
Sheperd and Associates Model 6810 i
ISOTOPE:
MAXIMUM ACTIVITY:
Cesium-137 150 millicuries (5.55 GBq)
LEAK TEST FREOUENCY:
6 Months PRINCIPLE USE CODE: (Y) Calibrator CUSTOM DEVICE:
X YES NO CUSTOM USER:
Department of D.fense and it's contractors Any place in the United States gk62p127990611
^
SSD pg
b NRC FORM 567 U.S. NUCLEAR REGULATORY COMMISSION (1-1999)
REQUEST FOR A SEALED SOURCE OR DEVICE EVALUATION INSTRUCTIONS: Send this rerquest AND a copy of all related letters / applications and drawings to the Chief, Sealed Source Safety Section, OWFN Mail Stop O-6 H3. Change the License Tracking System milestone to 19 and assign to reviewer code 1-5.
NOTE: Retain a copy of this request with the application and background files.
HLQUESTER fibGION/LOGA l lON.
Department of the Air Force p
ii gi; 1 IV HQ ~~ LFARB TELEPHONE NUMBER DATE LJ L-J L
Li TYPE OF ACTION REQUESTED (Check as appropriate)
NAME OF APPLICANT Don Jordan p SOURCE REVIEW y AMENDMENT OF MAIL CONTROL NUMBER (S) i i DEVICE REVIEW NUMBER (S)
LETTER /APPLIC4 TION DATE LICENSE NUMBER (S)~ ~ ~ - '
-~~
CUSTOM REVIEW 05/13/1999 cOMMLhib 110 Luke Avenue, Room 400 Bolling AFB, DC 20332-7050 FOR SSSS USE ONLY REVIEWER
. MODEL NUMBERS
, NUMBER ASSIGNED Eric Compton 42000PD & D-0062 99-36 DATE RECEIVED
- DATE AS$1GNED
. DATE TO FEES 05/21/1999 i
05/21/1999 05/21/1999 TYPE OF ACTION (Indicate the numberof each type)
- COMMERCIAL DISTRIBUTION RMAL)
USE BY A SINGLE APPL! CANT (CUSTOM)
/n m
)
SOURCIE 9A)
SOURCE D) sop (98)
[] NEW g NE N t:
EW
[~! AMENDMENT y AMENDMENT
[] AMENDMENT
[~~jAMENDMEN{
'g" NO SAFETY EVALUATION REQUIRED i ; LICENSING ACTION
[] YES NO FEES REQUIRED
' " REQUIRED r
NO (IF KNOWN) g y OTHER (Specify) t/
l TOTAL NUMBER OF
, NOTES
- REVIEW HOURS _ _ i Address Change only.
! NUMBER OF NR-121-D-101-S & NR-121-D-103-S.
DEFICIENCY LETTERS
_ _ _ _ _ _ _ NUMBER OF
~ ~l
~
! DEFICIENCY CALLS
_._F..OR_. FEE USE ONLY
~ ~ ~ ' ' ~ - ~ ^ ~ - ~ ~ - ~ ' ~ ~ ~ -
FEE CATEGORY ~~-~~--- ~~~ --
i 9A
[~~l 9B
~ 9C
~ 9D Au6uNT REcEn/tD'
~~icsEcx NUMBER ~ ' ~ ~ ~ "
DATE OF CHECK ~
~~
'iOG ~
~ ~ ' ~ ~
'~ " ~
~
~
APPROVED BY
- DATE OF RETURN COMMENTS ~~~~' ~~ '-~ ~ ~
~ ~ - - ~ ~ - " - ' - ~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - ~
~~- ~~-"-~ ~ ~~~~~' "-~
NRC FORM b61 (1-1999)
PRINILD ON RLGYGLLD PAFER This Ivrm wins pengreo undg kiF orms