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{{#Wiki_filter:UNITED STATES NUCLEAR REGULATORY COMMISSION WASHINGTON, D.C. 20555-0001 May 15, 2020 TO:              Users of Devices Subject to General License Registration
 
==SUBJECT:==
ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices.
Information about the general license registration program is available NRC website at http://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:
Director, Office of Nuclear Material Safety and Safeguards ATTN: GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: The NRC has acted to temporarily mitigate the financial impacts and economic disruptions caused by the COVID-19 Pandemic. The registration fee(s) for your generally licensed device(s) scheduled to be issued in April will be deferred until July 22, 2020.
For more information on the invoice deferral, you can go to NRCs public website: www.nrc.gov.
NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.
 
==Attachment:==
NRC Form 664 -- General Licensee Registration and Instructions Sincerely,
                                                          /RA/
U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials Safety Licensing and Tribal Liaison Branch
 
TO:              Users of Devices Subject to General License Registration
 
==SUBJECT:==
ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices.
Information about the general license registration program is available NRC website at http://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:
Director, Director, Office of Nuclear Material Safety and Safeguards ATTN: GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: The NRC has acted to temporarily mitigate the financial impacts and economic disruptions caused by the COVID-19 Pandemic. The registration fee(s) for your generally licensed device(s) scheduled to be issued in April will be deferred until July 22, 2020.
For more information on the invoice deferral, you can go to NRCs public website: www.nrc.gov.
NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.
 
==Attachment:==
NRC Form 664 -- General Licensee Registration and Instructions Sincerely,
                                                          /RA/
Donald Lowman U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials Safety Licensing and Tribal Liaison Branch Distribution:
MSST r/f ML20141L566 Office                    NMSS Name                    D. Lowman Date                  05/04/2020 OFFICIAL RECORD ONLY
 
*GL-725731-25*                                                                                                      *SEC1P1*
GL-725731-25                                                                                                                                            SECTION 1 05/06/2020 PAGE 1 of 2 NRC FORM 664 (09 - 2019)                                                                                                          U.S. NUCLEAR REGULATORY COMMISSION 10 CFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY OMB: NO. 3150-0198                                                                                              OMB EXPIRATION DATE: 09/30/2022 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability. Send comments regarding burden estimate to the Information Services Branch (T-6 A10M), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.
Complete all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.
General License                              SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-725731-25 Enter the company name and the street address for the physical location of use for your device(s). For portable devices, specify the primary storage location. Do not use P.O. Boxes.
Company Name: SHELL EXPLORATION & PRODUCTION COMPANY Department:                  UPSTREAM AMERICAS-URSA Address Line 1:              LAT=28DEG 3FT 23.27IN Address Line 2:              LONG=89DEG 3FT 14.54IN City:                      NEW ORLEANS State: LA                                      Zip Code: 70161
 
*GL-725731-25*                                                                    *SEC1P2*
GL-725731-25 05/06/2020                                                                                          SECTION 1 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)
Enter the name, telephone number and title of the person who is the responsible individual for the device(s).
Last Name: MICHEL H    E    N  D    E    R    S    O    N First Name: KIMARIE                                              Middle Initial: M S    T    E  V    E    N                                      T Business Telephone Number:        (504) 425-7250                Extension:
5    0  4  4  2    5    4  3  9    8 Business E-mail Address:
S    T  E  V  E    N  . H  E  N    D  E  R  S  O N @  S  H    E  L  L . C O    M
 
==Title:==
OPERATIONS MANAGER-URSA Enter the mailing address where correspondence regarding your device(s) should be sent.
Department:        KIMARIE MICHEL S    T    E    V    E    N        H    E    N  D  E  R  S O    N Address Line 1:    ONE SHELL SQUARE H    A    N    C    O    C    K        W    H  I  T  N  E Y        C    E  N  T E  R Address Line 2:    P.O. BOX 61933 City:              NEW ORLEANS State: LA                    Zip Code: 70161
 
  *GL-725731-25*                                                                                  *SEC2*
GL-725731-25 05/06/2020 SECTION 2 - DEVICES SUBJECT TO REGISTRATION                                      SECTION 2 Our records indicate that you have these devices. Please update the information as necessary.                      PAGE 1 of 1 NRC Device Key                    818573    (Internal Control Number)
Distributor/Distributed By:    ROXAR, INC.
Distributor License Number:    42-27765-01 Manufacturer name:          ROXAR, INC.
Device Model (Not Source Model): RFM SH-7950 Device Serial Number:      1297-05 Transfer Date:    11/15/2006 Not in possession of device (Also complete Section 4.)
MM          DD            YYYY Isotope (e.g. AM241)                  Activity (e.g. 1005)                                                Unit (e.g. mCi) 1    CS137                                  30                                                                mCi 2
3 4
5 6
 
    *GL-725731-25*                                                                                *SEC3*
GL-725731-25 05/06/2020                                                                                                      SECTION 3 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 Provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.
Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)
Device Model Number (Not Source Model)
Device Serial Number How acquired and date (e.g.,      Manufacturer/Initial Transferor listed above from a distributor/manufacturer,                                    Date Transferred:
Other General Licensee other licensee, other source)?
Other Sources                                          MM        DD            YYYY Isotope (e.g. AM241)              Activity (e.g. 100)                                                  Unit (e.g. mCi) 1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
 
*GL-725731-25*                                                                                    *SEC4*
GL-725731-25 05/06/2020                          SECTION 4 - NOT IN POSSESSION OF DEVICE                                      SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession.                    PAGE 1 of 1 Part 1                                                          Transfer Date:
NRC Device Key:
(from Section 2 or 6)
MM            DD          YYYY Location of the Device:
Whereabouts Unknown (Complete Part 1 only)              Transferred to another general licensee (Complete Parts 2 and 3)
Never Possessed the Device (Complete Part 1 only)      Transferred to a Specific Licensee (Not the manufacturer)
(Complete Part 2)
Returned to Manufacturer (Complete Part 1 only)
Part 2      License Number of Recipient (if transferred to a specific licensee):
Company Name:
Department:
Address Line 1:
Address Line 2:
City:
State:                  Zip Code:
Part 3          Enter the name of the individual responsibe for this device:
Last name:
First name:                                                                                      Middle Initial:
Business Telephone                                                                  Extension:
Number:
 
==Title:==
*GL-725731-25*                                                                              *SEC5*
GL-725731-25 SECTION 5 - CERTIFICATION                                  SECTION 5 05/06/2020 PAGE 1 of 1 I hereby certify that:
A.      All information contained in this registration is true and complete to the best of my knowledge and belief.
B.      A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.
C.      I am aware of the requirements of the general license, provided in 10 CFR 31.5.
(Copies of applicable regulations may be viewed at the NRC website at:
http://www.nrc.gov/reading-rm/doc-collections/cfr)
Steven T Henderson 7/22/2020 SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1)                    DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.
 
*GL-725731-25*                                                              *SEC6*
GL-725731-25 05/06/2020 SECTION 6 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION                    PAGE 1 of 1 NRC Device Key:  853579            Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER      VX #:
Serial    13252                Transfer Date: 08/29/2019 Isotope: BA133                        Activity: 10                    Unit: mCi NRC Device Key:  853580            Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER      VX #:
Serial    13248                Transfer Date: 09/26/2019 Isotope: BA133                        Activity: 10                    Unit: mCi NRC Device Key:  853582            Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER      VX #:
Serial    13250                Transfer Date: 06/01/2017 Isotope: BA133                        Activity: 10                    Unit: mCi NRC Device Key:  853615            Manufacturer License No: L05867 Manufacturer Name: OneSubsea Processing AS Model Number: PhaseWatcher VX Type E Serial Series#:  40311                Transfer Date: 04/15/2019 Isotope: BA133                        Activity: 10                    Unit: mCi}}

Latest revision as of 11:50, 19 January 2022

Glts - Annual Registration of Devices Shell Exploration & Production Company: Upstream Americas-URSA (GL-725731-25)
ML21161A351
Person / Time
Issue date: 05/15/2021
From: Don Lowman
Office of Nuclear Material Safety and Safeguards
To: Henderson S
Shell Exploration & Production Co
Lowman D
References
GL-725731-25
Download: ML21161A351 (9)


Text

UNITED STATES NUCLEAR REGULATORY COMMISSION WASHINGTON, D.C. 20555-0001 May 15, 2020 TO: Users of Devices Subject to General License Registration

SUBJECT:

ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices.

Information about the general license registration program is available NRC website at http://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:

Director, Office of Nuclear Material Safety and Safeguards ATTN: GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: The NRC has acted to temporarily mitigate the financial impacts and economic disruptions caused by the COVID-19 Pandemic. The registration fee(s) for your generally licensed device(s) scheduled to be issued in April will be deferred until July 22, 2020.

For more information on the invoice deferral, you can go to NRCs public website: www.nrc.gov.

NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.

Attachment:

NRC Form 664 -- General Licensee Registration and Instructions Sincerely,

/RA/

U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials Safety Licensing and Tribal Liaison Branch

TO: Users of Devices Subject to General License Registration

SUBJECT:

ANNUAL REGISTRATION OF GENERALLY LICENSED DEVICES The U.S. Nuclear Regulatory Commission (NRC) requires annual registration of certain devices that are possessed under the general license issued in Section 31.5 of Title 10 U.S. Code of Federal Regulations (10 CFR 31.5). Devices subject to registration include those containing the radioactive material and activity listed in Table 1 of the attached NRC Form 664. You are receiving this notice because NRC records indicate that you have one or more such devices.

Information about the general license registration program is available NRC website at http://www.nrc.gov/materials/miau/miau-reg-initiatives/gen-license.html Note that under 10 CFR 31.5(c)(11), the attached General Licensee Registration Package must be completed, signed, and returned to the NRC within 30 days from the date of this letter. Read all of the instructions prior to completing the package. Mail the completed package in the enclosed envelope to:

Director, Director, Office of Nuclear Material Safety and Safeguards ATTN: GLTS U.S. Nuclear Regulatory Commission Washington DC 20555-0001 Registration Fee: The NRC has acted to temporarily mitigate the financial impacts and economic disruptions caused by the COVID-19 Pandemic. The registration fee(s) for your generally licensed device(s) scheduled to be issued in April will be deferred until July 22, 2020.

For more information on the invoice deferral, you can go to NRCs public website: www.nrc.gov.

NRC amended 10 CFR Parts 170.11 and 170.31 to provide that 10 CFR Part 170 fees be assessed to Federal agencies, where applicable, in accordance with the Energy Policy Act of 2005. Therefore, those Federal facilities required to register certain generally licensed devices in their possession will be required to pay the annual registration fee.

Attachment:

NRC Form 664 -- General Licensee Registration and Instructions Sincerely,

/RA/

Donald Lowman U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards Division of Material Safety, State, Tribal and Rulemaking Programs Materials Safety Licensing and Tribal Liaison Branch Distribution:

MSST r/f ML20141L566 Office NMSS Name D. Lowman Date 05/04/2020 OFFICIAL RECORD ONLY

  • GL-725731-25* *SEC1P1*

GL-725731-25 SECTION 1 05/06/2020 PAGE 1 of 2 NRC FORM 664 (09 - 2019) U.S. NUCLEAR REGULATORY COMMISSION 10 CFR 31.5 GENERAL LICENSEE REGISTRATION APPROVED BY OMB: NO. 3150-0198 OMB EXPIRATION DATE: 09/30/2022 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability. Send comments regarding burden estimate to the Information Services Branch (T-6 A10M), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0198), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

Complete all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-725731-25 Enter the company name and the street address for the physical location of use for your device(s). For portable devices, specify the primary storage location. Do not use P.O. Boxes.

Company Name: SHELL EXPLORATION & PRODUCTION COMPANY Department: UPSTREAM AMERICAS-URSA Address Line 1: LAT=28DEG 3FT 23.27IN Address Line 2: LONG=89DEG 3FT 14.54IN City: NEW ORLEANS State: LA Zip Code: 70161

  • GL-725731-25* *SEC1P2*

GL-725731-25 05/06/2020 SECTION 1 PAGE 2 of 2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued)

Enter the name, telephone number and title of the person who is the responsible individual for the device(s).

Last Name: MICHEL H E N D E R S O N First Name: KIMARIE Middle Initial: M S T E V E N T Business Telephone Number: (504) 425-7250 Extension:

5 0 4 4 2 5 4 3 9 8 Business E-mail Address:

S T E V E N . H E N D E R S O N @ S H E L L . C O M

Title:

OPERATIONS MANAGER-URSA Enter the mailing address where correspondence regarding your device(s) should be sent.

Department: KIMARIE MICHEL S T E V E N H E N D E R S O N Address Line 1: ONE SHELL SQUARE H A N C O C K W H I T N E Y C E N T E R Address Line 2: P.O. BOX 61933 City: NEW ORLEANS State: LA Zip Code: 70161

  • GL-725731-25* *SEC2*

GL-725731-25 05/06/2020 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 1 NRC Device Key 818573 (Internal Control Number)

Distributor/Distributed By: ROXAR, INC.

Distributor License Number: 42-27765-01 Manufacturer name: ROXAR, INC.

Device Model (Not Source Model): RFM SH-7950 Device Serial Number: 1297-05 Transfer Date: 11/15/2006 Not in possession of device (Also complete Section 4.)

MM DD YYYY Isotope (e.g. AM241) Activity (e.g. 1005) Unit (e.g. mCi) 1 CS137 30 mCi 2

3 4

5 6

  • GL-725731-25* *SEC3*

GL-725731-25 05/06/2020 SECTION 3 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 Provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name Initial Transferor Name Initial Transferor License Number (if known)

Device Model Number (Not Source Model)

Device Serial Number How acquired and date (e.g., Manufacturer/Initial Transferor listed above from a distributor/manufacturer, Date Transferred:

Other General Licensee other licensee, other source)?

Other Sources MM DD YYYY Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi) 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

  • GL-725731-25* *SEC4*

GL-725731-25 05/06/2020 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1 of 1 Part 1 Transfer Date:

NRC Device Key:

(from Section 2 or 6)

MM DD YYYY Location of the Device:

Whereabouts Unknown (Complete Part 1 only) Transferred to another general licensee (Complete Parts 2 and 3)

Never Possessed the Device (Complete Part 1 only) Transferred to a Specific Licensee (Not the manufacturer)

(Complete Part 2)

Returned to Manufacturer (Complete Part 1 only)

Part 2 License Number of Recipient (if transferred to a specific licensee):

Company Name:

Department:

Address Line 1:

Address Line 2:

City:

State: Zip Code:

Part 3 Enter the name of the individual responsibe for this device:

Last name:

First name: Middle Initial:

Business Telephone Extension:

Number:

Title:

  • GL-725731-25* *SEC5*

GL-725731-25 SECTION 5 - CERTIFICATION SECTION 5 05/06/2020 PAGE 1 of 1 I hereby certify that:

A. All information contained in this registration is true and complete to the best of my knowledge and belief.

B. A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling.

C. I am aware of the requirements of the general license, provided in 10 CFR 31.5.

(Copies of applicable regulations may be viewed at the NRC website at:

http://www.nrc.gov/reading-rm/doc-collections/cfr)

Steven T Henderson 7/22/2020 SIGNATURE - RESPONSIBLE INDIVIDUAL (Listed in Section 1) DATE WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL ASPECTS. 18 U.S.C SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER IN ITS JURISDICTION.

  • GL-725731-25* *SEC6*

GL-725731-25 05/06/2020 SECTION 6 SECTION 6 - DEVICE NOT SUBJECT TO REGISTRATION PAGE 1 of 1 NRC Device Key: 853579 Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER VX #:

Serial 13252 Transfer Date: 08/29/2019 Isotope: BA133 Activity: 10 Unit: mCi NRC Device Key: 853580 Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER VX #:

Serial 13248 Transfer Date: 09/26/2019 Isotope: BA133 Activity: 10 Unit: mCi NRC Device Key: 853582 Manufacturer License No: L05867 Manufacturer Name: FRAMO ENGINEERING AS Model Number: SUBSEA PHASE WATCHER VX #:

Serial 13250 Transfer Date: 06/01/2017 Isotope: BA133 Activity: 10 Unit: mCi NRC Device Key: 853615 Manufacturer License No: L05867 Manufacturer Name: OneSubsea Processing AS Model Number: PhaseWatcher VX Type E Serial Series#: 40311 Transfer Date: 04/15/2019 Isotope: BA133 Activity: 10 Unit: mCi