ML20238F849
ML20238F849 | |
Person / Time | |
---|---|
Site: | 07000190 |
Issue date: | 01/30/1998 |
From: | Henderson P NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I) |
To: | |
References | |
125382, NUDOCS 9809040383 | |
Download: ML20238F849 (17) | |
Text
y I jRC FORM 374 } U.S. NUCLEAR nEGULATORY COMMISSION PAGE OF 1 PAGES b *I* MATERIALS LICENSE Amendment No. 16 f..
g Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10 Code of g;
g Federal Regulations Chapter I, Parts 30,31,32,33,34,35,36 39,40, and 70, and in reliance on statements and representations heretofore made g by the licensee, a license is hereby issued authorizmg the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuc g
material designated below; to use such material for the purpose (s) and at the place (s) designated below; to deliver or transfer such mate ;al to N
perrons authorized so receive it in accordance with the regulations of the applicable Part(s). This license shall be deemed to contain the conditions j
~ l N
specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and orders of the k N Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below. N 'l N
R E!i ,
E l In accordance with the letter dated f
y I' The Catholic University of America 3'Januag6,1998
'**"S" '
g SNM-164 is amended in ll, y
620 Michigan Avenue, N.E.
its entirety to read as follows:
4 i
)
2.
l Washington, D.C. 20064 ,
' 4, Expiration Date g November 30, 2001 g
g 5. Docket or -
Reference No. 070-00190 g i g
gl g 6. Byproduct, Source, and/or 7. Chemical and/or Physical 8. Maximum Amount that Licensee Special Nuclear Material g g
g Form May Possess at Any One Time Under This License g ll l
N A. Uranium enriched to not A. Any A.'S kilograms El N
more than 2% , ,H N
B. Uranium enriched to not B.'Any B. 10 kilograms El i N more than 1% E N C. Plutonium 238 B
C. Any- C. 30 microcuries E ll El N D. Plutonium 239 D. Plated alpha sources D. 1 microgram El 5 E. Plutonium 239 E. Any E. 20 microcuries E N F. Plutonium 240 F. Any F. 3 microcuries E ll N G. Plutonium 241 -G. Any G. 760 microcuries El N H. Plutonium 242 H. Any H. 200 microcuries !l N 1. Plutonium 244 I. Any I. I microcurie 3l 8
B 9. Authorized use 3! j B
3!
3l N A. through I. To be used for research and development as defined in 10 CFR Part 70; 3l 5 animal studies; for source calibration; and for teaching and training of Rl N students. El B
N
!l CONDITIONS p Rl El
{1 R 10. Licensed material may be used only at the licensee's facilities at 620 Michigan nl 9 Avenue, Washington, D.C. El g ( i l I
W 11. A. Licensed material shall be used by, or under the supervision of, indivMuals E!
B designated in writing by the Radiation Safety Committee, Aaron Barkatt, El {
p Ph.D., Chairperson. The licensee shall maintain records of individuals El {
N designated as users. El B. The Radiation Safety Officer for this license is Donald Luster.
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Nl B j 9809040383 980130 PDR C
ADOCK 07000190 /
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( C FORM 374A-.m--,m---,,n g U.S. _ EAR REU(f) NRY COMMISSION - PAGE S OF PAGES 4l .( -
License Number 3
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RNM-164 %
1 MATERIALS LICENSE 1 SUPPLEMENTARY SHEET Docket or Reference Number
(
n7n_nnu n N 1
3
(
Amendmont_Nn 16 I 1
1 12. A.
(
3 Sealed sources and detector cells shall be tested for leakage and/or Ni I contamination at intervals not to exceed 6 months or at such other intervals E-as are specified by the certificate of registration referred to in E 1
10 CFR 32.210, not to eaceed 3 years. N 1
E 1 B. Notwithstanding Paragraph A of this Condition, sealed sources designed to N:
1 emit alpha particles shall be tested for leakage and/or contamination at d' 1 intervals not to exceed 3 months. (l 1
g ,
1 C. In the absence of a certificate from a transferor indicating that a test has (
- been made within six months fl detectorcellreceivedfromkpriorSto the transfer, anot anothedpsrson,shall sealed be putsource into or until use g!
tested. s
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i D. Each scaled sou'rci. fabricated by the licensee shall be inspected and tested gl j for construction defects, leakage, and contamination prior to any use or gl 3 transfer as a~ sealed source. ,g g 1
j E.
QS
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e, g ll Sealedsourcesandd(t,ectorcellsneednot)be-leaktestedif:
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xt , - f/ g ,
i (i) th;eycontainonlyihy/ droge,n 3; or' f " (,,1 gl i
g ., g , i g
I (ii) they contain onlita< gas;>or_l,,\ ; " : ([y g
- i i .
..L .. W L;9f: /, e gl 1 (iii) ths; half, life'w of'th,etiso, -
.t tope Lisw30, days 'or, .less;"or ze. gl j 4 i F l u_ g,i j (iv) they' cont'im9,.4aninot'more]thain;gnnb100 microcuries of beta and/or
~
gl ga l
emitting materiahotnot more than.10-microcuries of alpha emitting i 1
matdrial; or: $. 1:bs^^ M k
\f , t> '
, ; Q ,qh : G, El 3
3 (v) theyarknotdesigned'to, emit 2alphi particl'es, are in storage, and are Ul 1
not beingused. However,'when they are removed from storage for use Ul or transfer /to another person, and have'not been tested within the El 3
required leak test interval, theyJshall be tested before use or El 3
3 transfer. No s'ealed^ sour'ce oRdetector cell shall be stored for a El period of more than 10 ysars without being tested for leakage and/or E 1
1 contamination. U El ll 1
F. The test shall be capable of detecting the presence of 0.005 microcurie of E 3
radioactive material on the test sample. Records of leak test results shall Ul 3
be kept in units of microcuries and shall be maintained for inspection by E 1 the Commission. If the test reveals the presence of 0.005 microcurie or N ll 1 more of removable contamination, a report shall be filed with the U.S. El 1 Nuclear Regulatory Commission and the source shall be removed from service El i 3 and decontaminated, repaired, or disposed of in accordance with Commission El I regulations. The report shall be filed within 5 days of the date the leak El 1
test result is known with the U.S. Nuclear Regulatory Commission, Region I, El I ATTN: Chief, Nuclear Materials Safety Branch, 475 Allendale Road, King of El 3 Prussia, Pennsylvania 19406. The report shall specify the source involved, El 1 the test results, and corrective action taken. Nl t i NI 1 E 1 '
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j gc@E8tn u.s.WLEAR RE!ULATORY COMMISSION E PAGE 3 OF G g .{
- License Number g
l I RNM-164 E ,
[
p MATERIALS LICENSE Docket or Reference Number l l l SUPPLEMENTARY SHEET 070-00100 i N
E l N Amendmont Nn. 16 E l l 6I I G. The licensee is authorized to collect leak test samples for analysis by the E I licensee. Alternatively, tests for leakage and/or contamination may be E I performed by persons specifically licensed by the Commission or an Agreement E
! b State to perform such services. E l l E l I 13. Sealed sources or detector cells containing licensed material shall not be opened E l b or sources removed from source holders or detector cells by the licensee. E I E l
l 14. The licensee shall conduct a physical inventory every six months, or at other E p interval approved by NRC, to account for all sealed sources and/or devices y
- p. received and possessad under the license.c E l p g
- 15. < f 6 n C Q_ f Licensed material shall,not, tie used in or on huma,n'be,ings.
E y
y *~
( p 16. Thelicenseeshallno't:aYquirelicensedmaterialin['sealedsourceordevice E g
g unless the source ohdevice has been registered with the"U.S. Nuclear Regulatory g l g Commission pursuant to 10 CFR 32.210 or equivalent regulations of an Agreement g State. G
- 'j 6 +
g l g g 17.
_fe Ay Thelicenseesh3;,11 not use,. licensed material ,ingfield applications where activity y
g l g isreleasedexceptasprovidedotherwisebyppecificcondition'ofthislicense.
, g j y 23 -
fj <
j gn. p g y 18. Experimental animals, or the_; products; from. experimental animals, that have been g l g administered licensed materi.als shall not berused- for. human consumption. g y O VP ' y G j p~ t rr WMf , . "
g I 19. The licensee is authoriied'to transport! licensed material in?accordance with the
~
g i provisions of 10'CFR Paftf71, "Pabkag~ing fahd. Transportation -of Radioactive g l
I Materi al . "
Q i ' M ij d!' {
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- 20. Except as specificiIlly provided otherEise'in.thiIlicensshthe licensee shall I
I conduct its programlin,accordance withxthe statements, representations, and f g
procedures containedtip-the documents, including any enclosures, listed below.
l I The Nuciear Regulatorf Commission's regulations shalls govern unless the t I statements, representations land procedures injthe licensee's application and l
correspondence are more restrictive than the regulations.
l g I A. Application dated October 30, 1990 N l I B. Letter dated August 13, 1991 I I C. Lette dated September 10, 1991 excluding enclosure (2) I 1 D. Letter dated July 19, 1996 I 1,
l E. Letter dated October 25, 1996 I I,, F. Letter dated October 15, 1997 including enclosure 1 I I
I( t i t i For the U.S. Nuclear Regulatory Commission E f Original Signed By: (
f JAN30gg Pamela J. Henderson (
/ Date By g
( Nuclear Materials Safety Branch E
( Region I E King of Prussia, Pennsylvania 19406 (
(( t rrmorm = = = = = m a m m a = m m - mrnTm m IMerM
JAN 301998 Sr. Rosemary Donley, S.C.
Executive Vice President The Catholic University of America 620 Michigary Avenue, NE Washington, D.C. 20064
Dear Sr. Donley:
This refers to your license amendment request. Enclosed with this letter is the amended license.
Please review the enclosed document carefully and be sure that you understand and fully implement all the conditions incorporated into the amended license, if there are any errors or questions, please notify the U.S. Nuclear Regulatory Commission, Region i Office, Licensing Assistance Team, (610) 337-5093 or 5239, so that we can prcvide appropriate corrections and answers.
Thank you for your cooperation.
Sincerely, Original Signed By:
Pamela J. Henderson Division of Nuclear Materials Safety License No. SNM-164 Docket No. 070-00190 Control No. 125382
Enclosure:
Amendment No.16 cc:
Donald R. Luster Radiation Safety Officer N
- OFFICIAL RECORD COPY ML 10 b____ __- ---
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i DOCUMENT NAME: R:\WPS\MLTR\LSNM-164 T. . ,y . em - c m e. 6.=: c - conv wie .it.cni.nci - copy wi.tt.cni.ne w - we copy OFFICE DNMS/Ridpl N f DNMS/RI l l l NAME PHendersort/
DATE 01/27/98 01/ /98 01/ /98 01/ /98 f
l OFFICIAL RECORD COPY
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- i. THE CATHOLIC UNIVERSrIT OF. 'AMERIC, A . .
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Subject:
R. .equest for License' Amendments: SNM-164. Docket Ko.p 070-@N No. 030'00638
, l ByP.Iiic.08-02075l-03,DocR' 14 7 :
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, CUA requests lice,nsing action to amend its special nuckar 1
licene nutd mdits typrogoct !
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} license as follows; !
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- 1. ! Add thd fol wingisotopes: , !' : Ii"
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Chemib,aland/or MaximdnNossessidN, 4
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, 2. Decrease,the, possession limit of Po.239 (Lines 6.F! 7.F, and 8. from thejcurmntly ;
approved 200 uCito 20 Ci.
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lete pines 6.C 7.C, and S.C or the sealed Pu.Be ,
125382 i i-
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' 0FFICIAl.SECORDiCOPY! ML 10 l l ,
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- ; Grounds for Amendm6nt Request
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'! 1. Amendmenit 15 to he university's SNM Licen$e approve ot r reque o possest 2 Ci of ';
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' .subsequently Pu 242,placed which with the represeints Oak RidgeINational a massLaboratoryequiva'ent [dRNL] to An of order 50 milligrams waseparethis i
{of
' material for us. The ORNL has notified us that 50 milligmmslof Pu 242 mathrialhadbec6f j i ; 1
' I successfully prepared at an enrichment o'f 99.9531% and they ha've providdd anisot6pic dhalysis
! identifying the'traice residualisotopes and their masses which'mue up th6dmaming' 0.04$9%.Ij i ORNL representatives'indibate thst these residuals are an unavoidable cahover from '
tlie 'l enrichment process. i
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Nt,these residudis sh uld' l i
' ',beIn subsequent added to the bcense. Therefore, discussions the isotope ad'ditionswith rehesiedNRC representatives, in thEde} amendments' are !, : it w I : :
designed to enable us to take possession;of the 50 milligram mass of Pu-hj2 and the residual isotopes as identified by ORNL in their analysis report attached! We are 8
achepting jhipp' d r's l ,
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values for',the Pu-242' material. ,
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l . i thin the uni y rule as' :
' ,defined2. The rekuested 'ndban hi 10 CFR 70.25. The Pu-239 pi)sseiston limii was i6crdased fro in Pu-239 possession'is made to,plab I the Pu-24'2 possessionilimit was established at 200 pCi as a lesuIt of' Arridndment 13 whidh wa's l .' .
issued on!10/15/97. For the research pla' ned, wo : opted to wprY with Pu[242 rather;tharlPu-239 ji n
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' because the formet yielded more mass for the same amount of gtivity. We have noi takerk .
i possessioh of any Pu-239 in this interim! !, t I!!. ll l
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- 3. The reknested eEndnation of the Pu-Be sealed sources p6ssession is Mde to update the SNMP l j-l
- . bcense to' reflect the fact that all Pu-Be sources previously possessed underkhis ke!itemhvei I i !
, ; been transfermd to the plutonium soured reposito'ry af IAs Alanics Natiornallaboratory.!Shippin'gj! l
%oiarces have been ' li j i
l documentation, included as Attachment'B, verify that the licen sed Pu-Be i
' ' transferred to an authoriud receiver.
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lIk descri$n, sa; fety; analysis, and facihties to be used for the proposed #6 sea;mh involvinge th' !:. ,
u's e of the ORNL shipment of Pu-242 were previohsly submitted!in suppdf of c I which resdited in amediment 15 being issued. This scope of=wdri: has noi chlan;thelidensiAg ged.- . E i actionl
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'The Pu-242 will be rechived in solution form and will be comp, le, tsly consmed in a glass 4 i yl e'xamination!.iThe :
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! vitrification process in Wder to prepare some Pu doped glass fo'r knierosed l !
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l .licensing a' d presence bf the additional residual impact the! safety of thi's operation. .
! isotopes[ presen't j ,
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. 'The Univehuty has beeh 'and continues to' be fee exempt e forl libens !
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. request yok timely consideration of this kmendment in order' t olieet ain$ly established j I n $rishouki you require y l
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- The Pin-242 that we'are pre]Arangh enrichecl to 99,9531 WE The other radioisoq opes presEntin a sample cddraining 50 i I milli 6rams of Pu-242 are as follop i l 4 I l ,
Isotope !
I Weight (mgs) i Activity mid0 ! '
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1 0-238 l O.0017 , . 29.25 , ! >
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0.0025 i ll 0.15 i >h i l
. ,jPti-240 ! l {0.0109 2.47 l ; j l> b ,
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'Pa-241 :
' O.0074 -
759.48- 'l ' ;. '
- l Pu-242 ! 50.00 l i 196.s0! ! .' il
' Pu-244 i 0.0010 -
0.006077 ll ,: ! [ ].
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'Tdtal Pu (50.0338 zigs) and in,groith daughters (Am-24' 1 , U-234) 41' 2,17 michocories, ; :o In reviewing your thoactive catse itlimits outo 10microcuries 238 wh1 !c c:.ceeded in 5his sample.I ;
The otier radiormelldes conthined iin the sataple are not;specificaHy mentioned in t!A license c1 cept for Pu!239 and %242;J,
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D Pisase ildvise on your autheiity to receive based on the content of the material. ' : ; q j '.
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' ATTACIIMENTB: Documentation Verifying Disposalof PuiBe S' oun,es j u ; :,
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i' License SNM-164 authorizes the posses,sion of sealed PuBe peutroti d
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l amount o'f% grams $1 at any'one time. I, Under this authorization the Unbfsl i
' ' three scaled sources, first as a loan from{ s g
' the AEC and then a' a ' rant. '
T1Ssc sourceh haE been : I identified!in exhibit I hs follows: (
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Pu-Be Scaled diries GramsI !u Disposal -
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- C l M-245 l1 16 i 2/15/91
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2/15/91 ljj -
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Exhibit I v U.S. AEC Special Nuc; lear Agreement dated 8/1/73:lDescribd t% PulBe Sources i ;
i totaling approximately % grams of Pu. These sobces were prepouslyno' loan to the: ;
I university and licensed in thei early 1950's; I ; ]i i.
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, Exhibit 2 - Los Alamos Nuclear Material Shipment' Authorization: Specifies authorihy to Niip two Pu Be' sources at 1 Curie each l'
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U d l Exhibit 3 Nuclear Materials Transaction Report:!
s Document' tht two Phe souds, h425i ,
l and M1967j at approximately!16 grams Pu each, dere transfer.itd to Los Alamos l!! !
l National Lab. on 2/15/91. These were the two I cpry sourced.
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l Exhibit 4 t Letter, S. Jones, Los Alamos NationalL' ab to Dori Luster, CaSlic Universit[ dated ; i I' l l 12/2/94:'Ihis letter transmits 'a DOE Relinquishmini Forrn fo@uBe source End l ! ' !! I I acknotvledpes the receipt of a 4 Curie Pu-Be soured,l# M968lst l'hpproxi2na ,
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- This so Ib numljer has been tran sed and the transposition has b nfsubseg enti
! ' repeated in records available from the 70's and 80's. It cannot be i determixd when this first h ,
h j , occurred tmt there is no doubt that the source disposed of as Md25 is thh! h 5245 source d
. originaDy possessed by the university under an AEC loan agreement in th6 50's. This; loan was d
. ' rebooked as a grant in he 70's as indicated in the exhibit I docurnent, p y
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, Plena To.tnin the copy ~and rsturn elle or..ialitl to: ' ,
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l DivisiohofPhyaical!Rese' arch U. S. dkomic Energy Commiss' ion i
Washindon,D.C. 20545'
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U. S. ATOMICENERGYCo$f15510N . !
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! ,! ji : 4 l i SPECIAL NUCLEAR MATERIALS GRANT! AGREEME!G 'l 'h
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Norde; of (Grantee) Educational Instityti' n: ,CA*fMOLIC; UNIVERSITY OF ABERICAl;l o l 5 j l ! i ji i ll i 'i ! i Washington,' D. C. I 20017 j! i;
, I - :i l Grarit tiumber i(Assigned by the AEC): Tv-370-74 l '
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Description of Materini Granted .! ll I ../ '
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, l. ti Approx. 96 Grams of Plutonium in! Source:Nos. M245,: M967, told!M968 l 0(Apph. !
. Values l $4,049) '
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' This Materiale Crant Agreement replaces Loan Agrfenbats R3158) add 6h2. '
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The Division of Physic 51 Reacarch hasiapproved she re '
Dr'. B. 8.1,eonard) Univ.! Radiological hafety Officiala!quert subm tted byrhnts ovel !
the ab' nd{hereby , i described material (s). ! This grant isj subject td the ' etms p and ohditions shown on the rSverse side. A ' duly authorized contracting: officer'h s!ignaturs' is reqhirey acknowl- '
edgingacceptanceofthegrant.inacebrdancewiththese{termsand, conditions,.
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$ 1 16 l John M!. Teem, Dhector ,t i
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,' l Date: AUG 1 1973! '
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A' ented by: _,m.. _.
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j uly Aut giz6d Contractor Officer Signature) j j
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Mall TO: LOS AMMOS NATIONAL LABONATORY l
DATE: '10 DEC 0 i P.O. BOX-166b, MS E508, LOS ALAMOS lNM 87545 i .I 4
' SI-i!PPER ORGANIZATION: : i THE' CATNOLIC UNIVERSITY .0FI A!ERICh: < l ii il i j
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.g i TECHNICAL REPRESENTATIVE: DR. ' WARREN E. KEENE ! , l 319ES: 0'6 PHONE #:i 202d i i'_ !
! LOS ALAMOS TECHNICAI REPRESENTATIVE: susan roth I . '!
- SN1PMENT CLASSIFICATION:h MATERIAL CtNSSIFICAhN: U 1 N REQUESTED SHIP UATE: JAN 91 N/Ai I
PURCHASE.OkDER #: , l l 4
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' 741 #: ZDCrAUA-1
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l NUCLEAR MATERIAL T!YPESi; AND COMPOSITIOl i '!,
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- U-233 i n__ PU-239 .
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U-235 ! PU-242 ! ,i ; i :: i :;
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SHIPPER NM REPRESENTATIVE:
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N ijh i DATE: .f 0 DEC 90 i
LANL'NM REPRESENTATIVE: i'~
DATE: .
1 lob ALAM,OS AUTHORIZAh0N # (LAN): .
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- ; ', N A T I O N A L L A D OlR A T O F) Y
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Don Luster ' '
{: I Catholic University of hmerica (ZDC) -
j i ; Radihtion; Safety Offiae, Rm. B18A Panj;bom 620 Michigan AvenueNE '
,1 Washington,DC 20064 ii b' :
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Dear Mr. Luster:
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Subject:
, PuBe Neutron Source R linquishment of Oplnershir 'I'[orm l l
. For your flies,I am endlosing a signed cNpy of the DOE Relirigihshment c/ bwner
! :for the 239 PuBe sound (s) that you recently sent to the Los Alainos National' Laboratory.
,1 would like to thank y u for working closely with me to enstire blat you ces w rc shipped i correctly andin a timelp manner, !
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Sherry W. ones I- ,!
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,;' CIC-10, NMRT/PO w/o encl., $ encl.
File, w/ ; ';;
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[i NMRT/SS File, w/4 enc 1. F660 .
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- i DbE AUTHORIZWION TO SHIP / RELINQUISHMENT OPi!bWNERSHIP
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! 1: Sign Below and Return to the Followiiag'Addr ess: , i l
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- . Ios Alamos National Laboratory P. OJ Box 1653
l; 1.os Alamos'. New Mexico 87545 Sherry W. Jones
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j l ! ' pi Youlare authorized by the Department of Energy (DOE) o hhip th 239PuBh source (s on '
l , the reverse side of this form to the 14s Alamos National Laboratory. I '}
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i NOTEd i 'Name and signatpre must be of an ofBelal of the facility that has the authority to l relidquish ownership of the 239PuBe source (s). This fo'rni must N signed hnd returned i
before:Los Alamos will authorize the shipment of your source (s). 'I i
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hereby relinquishes all ownership of:the 239Pc Be
-, 'Ihe neutron Ca'tholic sourceUniversity (s) indica'ted: _pfonAmerleathe reverse side of thisiform F lo' the , United States j
Dep'artment of Energy (bOE) upon receipt / acceptance of the source (s) by the Los Alamos' National Laboratory.
! OFh,lCIAL NAME/ TITLE: Duald T.usur- i i nm . &6m % r. 4 <w n - _
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rMME Uhse PdntRype) TITI.E (Please PhntflypE g
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- SIGNA tr7to '
DATE: 3 - 97 94
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'LAN t , CCEN'TANCE SIGNATURI:. // . /7?r DATE: / eb g - <
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l 146 AIAMOS NADOMAL LABOkATORT CIDE (2)
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DATE Anest L 19W '
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148ll AIAMOS. NEW MFECO C[544 ; Vi P3d3 le l i ,
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239PuBe RECOVERY PROGRAM
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ji . I 1 FADIJIYNAME: Catholle Unim dy of Amedca ' ' .
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RIS: ZDC I j l *, i .
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L ADE RarHatkm Salsty OfBm. Rm. BIRA PanAnrn l i: I l
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- i g30 T 1 'r- As= NE Wa*Maston.DC 20064 IIi I L 239PuBe SOURCE INFdhtMMhlON.
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%u/ : INFG v ATION FROM LTS BETWEEN:
- License Fee Management L> ranch, ARM : P rograrn Code: 22110 and : Status Code: O Regional Licensing Sections a Fee Category: EX 1D
- Exp. Date: 20011130
- Fee Ccements: 170.11 ( A ) (4 )
- Decom Fin Assur Reqd: Y LICENSE FEE TRAlJSMITTAL A. REGION 7 I
- 1. APPLICATION ATTACHED Applicant / Licensee: CATHOLIC UNIVERSITY OF AMERICA. THE Received Date: 980127 Docket No: 7000190 Control No.: 125382 License No.: SNM-164 Action Type: Arnendmen t
- 2. FEE ATTACHED Amount: ___ . _ _ _ _ _
Check No.: -. _-.____
- 3. COMMENTS Signed __ .s. .[$_ .-_-__ _______
Date _ _ _ __ _ _ _./ .2,.7/fS-__ _ _ _ _ _ _
B. LICENSE FEE MANAGEMENT ERANCH (Check when mi1estone 03 is entered /__/)
- 1. Fee Category and Amount: ________ _-._ ____________________________
- 2. Correct Fee Paid. Application may be processed for:
Amendment _ _ _ _ _ _ _ _ _ . _ _ . _ _
Renewal _ _ _ _ _ _ _ _ _ . _ _ _
License _._____________
- 3. OTHER _ _ _ _ _ . - . _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _
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