ML20210G028
| ML20210G028 | |
| Person / Time | |
|---|---|
| Site: | 07002964 |
| Issue date: | 10/27/1986 |
| From: | Berry K CONSUMERS ENERGY CO. (FORMERLY CONSUMERS POWER CO.) |
| To: | |
| Shared Package | |
| ML20210F960 | List: |
| References | |
| NUDOCS 8702110208 | |
| Download: ML20210G028 (1) | |
Text
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Nec F 3 4 U.S. NUCLE AM REGULATOAY COMMISSION APPnOVE0 8v OM8 n e 426 3150 4078 IISSEESIFd ocruanwn u CERTIFICATE OF DISPOSITION OF MATERIALS (All items MUST be completed, please print) ucessEE haME amo AoonEs3 ucENsE hvMeEn SUM 190h Consumers Power Co=pany ucE=sE Ex,in.T,o., o.TE Midland Energy Center 3500 E Miller Road October 1987 Midland, MI h86h0 THE LICENSEE OR ANY INDIVIDUAL EXECUTING THIS CERTIFICATE ON BEHALF OF THE LICENSEE CERTIFIES THAT:(CPuch armf/or compete the approprate stamts) below.)
A. MATERIALS DATA (Check one arut camp ste, as norsussey)
] 1. NO MATERIALS HAVE EVER BEEN POSSESSED OR PROCURED 8Y THE LICENSEE UNDER THIS LICENSE.
- 2. ALL MATERIALS PROCURED AND/OR POSSESSED BY THE LICENSEE UNDER THE LICENSE NUMBER CITED A80VE HAVE BEEN TRANSFERRED ON Consumers Power Company 08/29/8h Palisades Nuclear Plant WHICH MAS NnC uCENsf NUMSEn Covert, MI h90h3 DPR 20 CC
] 3. ALL MATERIALS PROCURED ANDIOR POSSESSED BY THE LICENSEE UNDER THE LICENSE NUM8ER CITED ABO DATE To j lSSUED ev THE STATE OF WHICH MAS uCENSE huMSEn AN AGREEMENT STATE PURSUANT TO SECTION 274 OF THE ATOMIC ENiiRGY ACT OF 1954, AS AMENDED, AND THE ENERGY REORGANIZATION OR ACT OF 1974.
] 4. MATERIALS HAVE BEEN DISPOSED OF IN THE FOLLOWING MANNER. (Describe anscific oWapess/praesduss-//acWitionaf pace is needed, use the r this form, or provide otrachments) 8702110208 861223 REG 3 LIC70 l
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- 8. OTHER DATA
- 1. OUR LICENSE HAS NOT YET EXPIRED:PLEASE TERMINATE IT.
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- 2. WAS A RADIATION SURVEY CONDUCTED TO CONFIRM THE ABSENCE OF LICENSED RADIOACTIVE MATERIALS AND TO DETERMINE WHETHER ANY
_ CONTAMINATION REMAINS ON THE FREiniSES COVERED BY THE LiCEN5EF ihe onef NO l
1_YES. THE RESULTS ICM one) i ARE ATTACHED, OR
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WERE FORWARDED TO NRC ON (Oste) l 3.
THE PERSON TO BE CONTACTED REGARDING THE INFORMATION PROVIDED ON THIS FORM lTELEPHpNE 3UMSE"h-8913 NAME (bl6 76 Thomas P Neal 4.
MAIL ALL FUTURE CORRESPONDENCE REGARDING THIS LICENSE TO Consumers Power Company, Attn:
Kenneth W Berry, Director Nuclear Licensing, 1945 W Parnall Road, Jackson, MI h9201 RETUT.N TO:
CERTIFYING OFFICIAL l D*TE sicmaTuna DIRECTOR, OlvislON OF FUEL CYCLE AND MATERIAL SAFETY jg:- 2. 7 -[c's OFFICE OF NUCLEAR MATERIAL SAFETY AND SAFEGUARDS
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y U.S. NUCLEAR REGULATORY COMMISSION FRINTEo NAME A',o UTLE WASHINGTON, DC 20555' Kenneth W Berry, Director, Nuclear Licensing
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