ML20128H024

Informs That Copy of Questionnaire Sent Before 781219 & Forwards Survey Questionnaire for Completion by 790209. W/O Encl

ML20128H024
Person / Time
Issue date:	01/31/1979
From:	Mcclintock R NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I)
To:	Waglein E MALDEN MILLS, INC.
Shared Package
ML20126B318	List: IA-96-372, Informs That Copy of Questionnaire Sent Before 781219 & Forwards Survey Questionnaire for Completion by 790209. W/O Encl ML20128H024
References
FOIA-96-372 NUDOCS 9610090210
Download: ML20128H024 (1)

Text

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JAh 31 gy, 1

Malden Mills, Incorporated I Finishing Department ATTN: Mr. Ernst Waglein 4

46 Stafford Street i

, Lawrence, Massachusetts 01841 4

Gentlemen:

A copy of this questionnaire was sent to your office before December 19, 1978.

, If you have not already completed and returned this questionnaire, please 1

do so by February 9,1979.

Sincerely, ggg. Robert 0. McClintock, Chief Materials Radiological Protection Section

Enclosure:

l Survey Questionnaire i

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, SURNAMc > ,,,O m ,,

s C intOCk i ou,, 1/30/79 1/7//79 NRC Form 318 (RI) (5-76) NRCM 02040 *u. 5. sovtammrt riitattna ontct: 1978.tn.ssi 9610090210 960930 PDR FOIA SAVASTA96-372 PDR

! . ,,,cfC-313 UNITED STATES ATOMIC ENECGY COMMISSICD$

a 8 ,mm .

iD C,o o.ed Ra nam APPLKATION FOR BYPRODUCT MATERIAL LKENSE + +' i ~o ~o 4

IN5ftUCflON$. Comples items 1 through 16 if this is on instiof opphceion or on opplication for renewal of a license. Informohoa contoined m previous applications filed wdh the Commesson with respect to l'enis 8 through 15 nay be incorporated by reference provided references are clear and

! specific.

Use supplemental sheets where necessary. reem to must be completed on all opplications. Moil two copies to. U.S. Atomic Energy Com.

l mission, Washington, D.C., 20545, Attenhon: Isotopes Branch, Division of Motorials Licensing. Upon opproval of this opplication, the opplicont will receive on AEC Dyproduct Motorial License. An AEC Syproduct Material License es issued in occordonce with the general requirements contained in i

I Title 10, Code of Federal Regviot ons, Port 30, and the Licensee is subject to Title IO, Code of federal Regulations, Port 20.

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I (e) NAME AND STREET ADDRESS Of APPLICANT #fasuyooe, f.,m. hosp..el (b) STREET ADDRf 55tf 5) AT wHICH BYPRODUCT MAf telAt wtLL Bt u5g0 gr#

Person, est buclude llP Code )

dh b I (s). enclude lfP Code )

Italden Hille, luce h6 3tc?? ford :.:trecr .. .,

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meur en ce, t

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2 DEPARTMf NT TO USE BYPRODUCT MATERIAL 3 PREvlOUS LICENSE NUMMR(5) (if fhes es on appl.cof.on for senewal of a u o.ss.. es d o.e o.d ..e n.mbe, o I

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31nishinc 0cpcw.p..n 3 t

4 INDtVIDUAL USER (5) (Nome oad t,#8e of sad.v dvolf si 8,o -.88 ese or d.re<#fy 5 RADIAtlON PROff CTION OFFICER (Name of person des.,aosed os rod oe.on pre s.pe,..se .se o, b,,,od.rr me,e,.o, c..e oo .d e.oer.e e . , ,, ems e o,,d Me ,, o%er .u. ., .,,d...d.o, .se, A,.. ,es.,m , of .s s, .., o,,d e.

,i 9) pee e.we os en f# ems 8 cad 9 j f

l9 2nnt locloin ---

I e (o) SYP#ODUCT MAfttlAL. (flemea's (b) CHfMICAL AND.Os PHYSICAL FORM AND MAXIMUM NUMBER OF MILLICuriE5 OF E ACH CHEMICAL AND/OR PHY5 cad moss number of each ) ICAL FORM TH AT YOU witt POSSE 5S At ANT ONE TIME (if sealed sourcers). ofso s' ore come of moav8orturer. mode 8 numbe,. number of soortes cod man.mem .t...tr per sourse i GAJ ' . ,

e a .,. e u a crc.6m o

. s =* 90 . t 1 00 n',M

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t.)* ?.D 5 0 J o G O. . l y ). U I

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l 7 Of 5C8lSt PUaPOSE foe wHICH BYPRODUCT MAf ta:At wtLL BE U5ED. lif b, product me=< ol es for humon use. swpplemear A iform Af C-313al =vst t.e com pJeled .e f.eu of W.s dem 40 bypredust monpr.of es e me term of a sealed soorte, u <fude the mohe end model number of We storage tonto net and f or de..<e m

.sas , so e ..n be s,o,ed di.. . sed.>

To be ucc,e-' aJn n.--op 'ci: L loM! GTI, t.,.u u.o av dth 2 d T' yp pm e i. ., . n. s

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uy o-of neight o ? v.nii c m n 1- frW e p '~% e 1

-( 1.1 N -..wt (Continued on reverse s.de) h (,_10 - 0 D l 7 7- 2 pp.

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TR AINING AND EXPERIENCE OF EACH INDIYlDUAL NAMED IN ITEM d (Use supplemental sheses a necasorr) -

8 TYPi Of TRAINING (*URATION Of DN THE JOB FORMAL COURSE WHERE TRAINED TRAINING (Cnis psy (Carch ansM

o. Pr.nciples and pecctecer of rod.ohon Protaaaa To be provided 2 [")"

(9 '

b Rodeocchedy eneosure ment stondordiso-f on ou mo .to,,ng tahn.gves and .n. by Ohnart at to ( va) No va [ Nc) se,v~nts i

• Mothe8notacs need colCulohons teaseC to the

, ose ou ~~u,ement ce rod.oocs.v.tr

__TIno_oLI)lacinc 1 daya__(_) ()  ;

so va l s .a g.cae n atsof d.#.ca device in service. total. (ves) (so) i

9. EXPf RIENCE WtTN RADIATION (Actual use of rodeorsotopes or eqvsvolent esperes..ee j ISOTOPE MAXIMUM AMOUNT WHERf EXPERIENCE WA5 GAINED DURATION Of EXPERifNCE TYPE OF USE (List any) Jono I I i

10 RADIAflON DETECYlON INSTRUMENT 5 (Use supplemental sheets of aecessary ) j TYPE Of INSTRUMINT5 NUMBE R RAD:ATION SEN5fflVITY RANGE WINDOW THtCKNE55 USE l (include mo6e oad model aumhee of each) A V AIL ASLE DETECTED (mr /hr) (mg/cv) (Momtereag, surwereng, meosvreng)

Senu requirode Ohaart .till :mko occupan cy ovaluation cud 1 radiction survey at timo of placing in scrvicce r

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g II. METHOD FRIOU(NCY, AND ST ANDARDS USED IN CALIBRATING INSTRUMENT 5 (ISTED ABOYE.

i not application - soc Iten 10 ,

12. FILM SADGES, DO50 METERS. AND 810 A55AV PROCEDulrE5 USED (For f.im badges speedy method of celebrateng and processeng. or naene of suppler )

onc roquired INFORMATION TO BE SUBMITTED ON ADDITIONAL SHEETS IN DUPLICAff l 13 f ACillflES AND EQUtPMENT Emplonotory sketch i

.. .oc.i.8, .s o,,oct.ed ,m.e Deso.be lobo

.swe,) ves'<overyNo ) (foc.hhes and eemote handding . eqv pment, soo<oge conto.ne<s. shield.ng, fu!

not applu,n,n i 14 RADIATION PROTECTION PROGR AM Desc,.be the red.ohon peotect.on progvom encivding conteel meosv es if oppbcohon covers sealed sources, submit teob eesting procedvees where opplecoble, noms, troepeng, and esperience of person to perform leek tests, and oveengements for performeng enshal rodestion servey, serv- 1 ering. mosatenonce end sepo , of the sovece j

$ t': P nhhC/b(Y l

15. W A5f t DISPOSAL lt a comme c.ol messe d.sposal service es emplored, spec.fy nome of compoar Otherwise, submes dees led descriphon of methods which well t.e used Ice d spos ng of eod.cochee westes and enhmoses of the type and omount of ochve*y involved.

n r- c 4= + n e.% n A CERTIFICATE (This item must be completed by applicant) 16 THE APPLIC ANT AND ANY Of flCIAL tIECUTING THis CERTIFICATE ON SE HALF OF THf APPLICANT N AMED IN litM l, CERTIFY THAT THIS APPLICATION 15 PREPARED (N CONFORMITV WITH TITLE 10. CODE 07 fEDER AL REGULATIONS, PART 30, AND THAT ALL INFORMATION CONTAINED HEREIN, INCLUDING ANY SUPPLtMtNTS ATT ACHED HERETO. t5 TRUE AND CORRECT 10 THE BEST OF OUR KNOWLEDGE AND REllEF.

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JM d on "47le d uc, 1 Apphcont n sie F Date 7/ 9 74 By: .( b /.h_ ,o.- 'in3 Oi ce,t.fr,ng ow.c.oi T.two,rCC k Acf M g OD" %O _

WARNING.- 18 U. 5. C., Section 100 34 Act of June 25,19d8; 62 Stat. 7d9; makes it a criminal oHense to make a willfully false statement or representation to any deportment or ogency of the United States on to any notter within its ivrisd.ction.

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