ML20247H345
| ML20247H345 | |
| Person / Time | |
|---|---|
| Issue date: | 05/17/1998 |
| From: | Kime T NRC OFFICE OF NUCLEAR MATERIAL SAFETY & SAFEGUARDS (NMSS) |
| To: | Ortiz Joel Rivera AFFILIATION NOT ASSIGNED |
| References | |
| SSD, NUDOCS 9805210139 | |
| Download: ML20247H345 (2) | |
Text
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MIy 17,1998 Laboratorio Clinico Penuelas ATTN: Odalis Padilla Rivera Calle Munoz Rivera 405 Penuelas, PR 00624
Dear Ms. Rivera:
This letter verifies the receipt of the completed NRC Form 483 dated March 30,1998. This form is a condition of the general license under 10 CFR 31.11 authorizing in-vitro testing with byproduct material under general license.
The form has been assigned registration number 8322. When making changes to any of the
. Information on the form, please reference the registration number and address the correspondence to Director, Office of Nuclear Material Safety and Safeguards, U.S. Nuclear Regulatory Commission, Washington, DC 20555.
If you have any questions or need further assistance, please contact me at (301) 415-8140.
Sincerely, p/
Traci Kime, Acting Registration Specialist Materials Safety Branch Division of Industrial and Medical Nuclear Safety Office of Nuclear Material Safety and Safeguards f
DISTRIBUTION:
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SBaggett IMNS r/f NEO3 DOCUMENT NAME: P:\\RIVERA.483 Ti receive a copy of this document indcate in the box: *C" = Copy without ottachment/ enclosure "E" = Copy with attachment / enclosure
- N" = No copy OFFICE MSB l
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OFFICIAL RECORD COPY
'OOCOi 9805210139 980517 PDR RC SSD PDR
NRC Form 483 U.S. NUCLEAR REGULATORY COMMISSION Approved by OMB (1241) 31540035 10 CFR 31 REGISTRATION CERTIFICATE-IN VITRO TESTING i.3 3.g 7 WITH BYPRODUCT M ATERIAL UNDER G EN ER AL LICENSE Section 31.11 of 10 Cl R 31 establishes a general heense authorizing phnicia..s. clmical laboratories hospitals, and veterinarians in the practice of vetermary meds:me to possess certain small quantities of byproduct material for us wtro clinical or laboratory tests not involving the internal of external administration of the byproduct material or the radiation therefrom to human bemgs or ammals. Possession of byptoduct material under 10 CFR 31.1I is not authorized umil the physician, clinical laboratory, hospital, or veterinarian m the practice of veterinary medicine. has filed NRC Form 483 and received from the Commission a validated copy of NRC Form 483 with registration number.
e Laboratorio Clinico Pehuelas calle MuBoz Rivera 405
- Penuelas, P.R.
00624
- 3. I hereby apply for a registration number pursuant to 01.11,10 CRF 31 for use of byproduct materials for (pleasecheck one block only).
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Myself, a duly licensed physician ' authorized to dis-
, pense drugs in the practice of medicine.
Ib.. The above-named clinicallaboratory.
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The above-named hospital.
Od Veterinarian in the practice of veterinary medicine.
- 4. To be completed by the Nuclear Regulatory Commission.
INSTRUCTIONS
- 1. Submit this form in triplicate to:
Registration number:
8322-Office of Nuclear Material Safety ar.d Safeguut.
ATTN:MaterialLic nsing Branch
/
8't U.S, Nuclear Rep'latory,genission U.S. Ns. clear Regulatory Commission
. Washington, D.C. 20555
- 2. Please print or type the name and address 5
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.i (including alp code) of the registrant physicis.n.
g clinical laboratory, hospital, or veterinarian in Ihe
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. e1 practice of veterinary medicine for whom or ior -
which this registration form is filed. Position '.he
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first letter of the address below the left dot and do a.ssigned by NRC. If tMs "s"a change ofinformation from a previously,
i not catend the address beyond he right dot. (At NRC, a registration number will be assigned and a registeredgenerallicense, include >outregistration number.). '
validated copy of NRC Form 483 will be returned.)
- 5. If place of use is different from address in item 1. please give complete address:
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- 6. Certification:
o I hereby certify that:
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Allinform.aon in this registration certificate is true and complete.
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The registrant has appropriate radiation measuring instruments to carry out the' tests for which byproduct material wrill be used under the
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general license of 10 CRF 31.11. The tests will be performed only by personnel competent in the use of the instruments and in the handling of the byproduct materials.
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I understand that Commission regulations require that any change in the information furnished by a registrant on this registration certificate be reported to the Director of Nuclear Material Safety and Safeguards within 30 days from the effective date of such change!
1 d.
I have read and understand the provisions of Section 31'.11 of NRC regulations 10 CFR 31 (reprinted on the reverse sid'e of this form)iand i understand that the registrant is requiral to comply with those provisions as to all byproduct material which he receives, acquires, possesses, y j ~ eses, or transfers under the genecallicense for which this Registration Certificate is filed with the Nuclear Q ' Pamimiang7 '
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i WARNING-18 U.S.C.i Section 1001; Act of June 25.1948; 62 Stat. 749; snakes it a crimind ' offense to saate a willfully false statement or representation to any department or agency of the United States as to any matter within its jurisdiction.
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