ML20204C255
| ML20204C255 | |
| Person / Time | |
|---|---|
| Issue date: | 10/01/1988 |
| From: | Tyler R NRC |
| To: | |
| References | |
| SSD, NUDOCS 9903220394 | |
| Download: ML20204C255 (3) | |
Text
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[(pf**o uq'o UNJTED SJATES
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NUCLEAR REGULATORY COMMISSION
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WASHINGTON. D. C. 20555
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CATA COLLECTION (SITE VISITS) 1 INTERVIEWER:
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1 DATE:
1 GENERAL LICENSEE INFORMATION:
NAME:
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ADDRESS:
rvto u.s. am avan n CITY / STATE:
u wtos NT ovos3 (ARmW ) 6-EC#M A CONTACT PERSON:
CiwTm A WILROR i
em MKT [ RES EARCH POSITION IN COMPANY:
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TELEPHONE NUMBER:
(cy) en t-zweca COMPANY'S PRINCIPAL BUSINESS:
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- WATEA TREA7ME4 ECuiPNMT PRIMARY USE OF DEVICE:
6W CHRomrwocritAPai DOES THE GEN. LIC. HAVE A COPY OF THE GENERAL LICENSE REGS. (31.5)YES_ N0,1(
NAME OR TITLE OF EMPLOYEE RESPONSIBLE FOR ASSURING COMPLIANCE WITH THE PROVISIONS OF THE GENERAL LICENSE:
cw wTatA (Anmm general license is issued to commercial, 531.5(a) educational and medical institutions, to individuals in the conduct of their business and to federal, state or
.s O local government agencies to acquire, j.pV 'l0
- receive, possess, use or transfer s'
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l'le:na fald in fourths (with addr$ss visab$e). Srapste and return worhaut tielay. Thank you.
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Note of Acknowledgernent To Varian Radiation Gafety Of ficer:
I am aware of the fact that Nickel G3 Electron Captu.e Detectors must be tested for leakage every six (6) months or in accordance with my license. I know that I am required to keep records which indicate that these leak tents have been performed I know that non-license holders may use the 03 049041 -00Varian Wipe Kits, but that the analysis must be performed by a specific hcensee.
O Please send me a wipe kit in the month of b [rs and every b
months thereafter.
O Do not send me anything. I will take care of this myself.
For Varian's records, as required by the Radiation Authorities, I give you:
b crin g- (n Company Name & Address.
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(Location of Use)
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- bdnion, is) 7 6 ~/() E '3 Responsible Person's Name & Function; C-
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f.ke es s Telephone Number 2OI 9[p V r2b/O ECD Senal Number: M NI7 Date Received U
f have inore than one ECD and plan to test thern simultaneously:
Total Number:
Month Wanted Other Serial No.mbers-Manufacturer (s)
Signature.
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0 Our organization has a Radiation Safe:y Officer and he is informed of my possession.
Edread the Radiation Safety Manual and am prepared to follow the regulations.
I arn aware of the following; o The wipe kit is sent to me at no charge. For analysis, I return th-kit with a $20 00 check enclosed Canadian customers, please enclose U.S. S22.00. U S. bank check.
o i may include a $200 00 purchase order for a 10 leak analysis contact. (United States only) o Varmn's wipe kit may also be used on Ni' 3 ECD s of dif ferent make W-50%
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co ADDITIONAL DEVICES (vARfAfd]
USER:
C'8LA"E A (CidPAw y tut.
DEVICE TYPE: F oretRcN CAP. DET.
MODEL:
01-0o1971-00 CR 61-9 e t3 l'1 -o ci DATE RECEIVED:
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