ML20196B241

Corrected Page 1 of 6 to Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model D-0062.Certificate:NR-121-D-101-S

ML20196B241
Person / Time
Issue date:	07/15/1998
From:	NRC
To:
Shared Package
ML20195J356	List: ML20195J353 ML20195J367 ML20196B219 ML20196B241
References
SSD, NUDOCS 9906230127
Download: ML20196B241 (2)

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REGISTRY OF RADIOACTIVE SEALED SOURCES AND DEVICES l SAFETY EVALUATION OF DEVICE CORRECTED PAGE JUNE 11, 1999 l NO.: NR-0121-D-103-S DATE: July 15, 1998 PAGE: 1 OF 6 DEVICE TYPE: Calibration Device 1

l MODEL: D-0062 I

l MANUFACTURER / DISTRIBUTOR: AFMOA/SGOR 110 Luke Avenue, Room 405 i Bolling AFB, DC 20332-7050 ,

1 SEALED SOURCE DESIGNATION: ICN Radiopharmaceutical Model 375 OR:

Isotope Products Laboratories Model 193 OR:

J.L. Sheperd and Associates Model 6810 i ISOTOPE: MAXIMUM ACTIVITY:

Cesium-137 150 millicuries (5.55 GBq)

LEAK TEST FREOUENCY: 6 Months PRINCIPLE USE CODE: (Y) Calibrator CUSTOM DEVICE: X YES NO CUSTOM USER: Department of D.fense and it's contractors Any place in the United States gk62p127990611 ^

SSD pg _

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NRC FORM 567 U.S. NUCLEAR REGULATORY COMMISSION (1-1999)

REQUEST FOR A SEALED SOURCE OR DEVICE EVALUATION INSTRUCTIONS: Send this rerquest AND a copy of all related letters / applications and drawings to the Chief, Sealed Source Safety Section, OWFN Mail Stop O-6 H3. Change the License Tracking System milestone to 19 and assign to reviewer code 1-5.

NOTE: Retain a copy of this request with the application and background files.

HLQUESTER fibGION/LOGA l lON.

Department of the Air Force ii 1 IV TELEPHONE NUMBER DATE p

LJ L- J L -

gi; Li --

HQ ~~ LFARB TYPE OF ACTION REQUESTED (Check as appropriate)

NAME OF APPLICANT Don Jordan p SOURCE REVIEW y AMENDMENT OF MAIL CONTROL NUMBER (S) i i DEVICE REVIEW NUMBER (S)

-~~

LETTER /APPLIC4 TION DATE LICENSE NUMBER (S)~ ~ ~ - '

CUSTOM REVIEW 05/13/1999 , --

cOMMLhib 110 Luke Avenue, Room 400 Bolling AFB, DC 20332-7050 FOR SSSS USE ONLY REVIEWER . MODEL NUMBERS , NUMBER ASSIGNED Eric Compton 42000PD & D-0062 99-36 DATE RECEIVED ;DATE AS$1GNED . DATE TO FEES 05/21/1999 i 05/21/1999 05/21/1999 TYPE OF ACTION (Indicate the numberof each type)

COMMERCIAL DISTRIBUTION RMAL) USE/nBY A SINGLE APPL! CANT (CUSTOM)

- m

) SOURCIE 9A) SOURCE D) sop (98)

[] NEW g NE N t: EW

[~! AMENDMENT y AMENDMENT [] AMENDMENT [~~jAMENDMEN{

'g" NO SAFETY EVALUATION REQUIRED i ; LICENSING ACTION [] YES NO FEES REQUIRED ' " REQUIRED r NO ,,

(IF KNOWN) g y OTHER (Specify) t/

, NOTES l TOTAL NUMBER OF

REVIEW HOURS _ _ i Address Change only.

! NUMBER OF NR-121-D-101-S & NR-121-D-103-S.

DEFICIENCY LETTERS

~

_ _ _ _ _ _ _ NUMBER OF ~ ~l '

! DEFICIENCY CALLS

_ _ . _ _._F. .OR_. FEE USE ONLY ~ ~ ~ ' ' ~ - ~ ^ ~ - ~ ~ - ~ ' ~ ~ ~ -

, FEE CATEGORY ~~-~~--- ~~~ --

i 9A [~~l 9B ~ 9C ~ 9D

~ ~ ~~ ~ ~ ' ~ ~ '~ " ~

Au6uNT REcEn/tD' ~~icsEcx NUMBER ~ ' ~ ~ ~ " DATE OF CHECK ~ 'iOG ~

APPROVED BY  : DATE OF RETURN

~ ~ - - ~ ~ - " - ' - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - ~ ~~- ~~-"-~ ~ ~~~~~' "-~

COMMENTS ~~~~' ~~ '-~ ~ ~

NRC FORM b61 (1-1999) PRINILD ON RLGYGLLD PAFER This Ivrm wins pengreo undg kiF orms