ML20155F607
| ML20155F607 | |
| Person / Time | |
|---|---|
| Issue date: | 06/16/1988 |
| From: | Wallace W NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I) |
| To: | |
| References | |
| REF-QA-99990001-880616 88-067, 88-67, NUDOCS 8806160443 | |
| Download: ML20155F607 (3) | |
Text
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F66 UV '06 15 24 NkU REGION 3B P03' 3 '
amit:#iW Q%N GENERAL LICENSE STATIC ELININATOR DEVICE i COLLECTION F0lm
- 1. Name and Address of General Licensee:
Fisher ce;edik . chem;c~l oasis ~
one Recd Lne ,
Fa:< L wn , NT 03w o
- 2. Date of Inspection: 824rck /l, , /'} f f Signature of Inspector (s):_ // 24xe [d b t/ !
- 3. Principal Business of Licensee:
AC1N M hackv re r Ch hlNC Cf1&n1 Eca J l
l
- 4. Purpose for which device (s) are used :
P> \ ow i on ;ze-cl a;e i <> Ne to loo Oles k, remo n dush l>eSer S'll;)v9
- 5. Device Specifics:
- a. Model Number:
g g Activity of Po-210 source b.
- c. Date Received:
aCl @ j RENRN ORIoINAL M rag 10s I
- d. Date lease expires: _
- 6. Did it*ensee receive 3M notification: Yes No _
li c e u s e_ c_ Oogha d
- JoIW Sk l.e r bogt # [Jol) 7% -7/ 00 m4ie_:_57. , sJJy ,J t q N~~4 a-Cow b eo_kee Pcc. stet X '6 s -- No.
M e - ard. er ene W ea h cle k % d : _ soo o oem 8806160443 880616 REG 1 OA999 ENVFSC ._2(__. rn t.k e A 5 tr uut 99990001 PDR
FEB 09 '80 15:24 NRC REGION 3B PO4 l i
3 l
- 7. Survey:
- a. Has survey been performed by 3M: Yes No By Consultant: Yes 1 No If Yes list consultant's name and location:
% W w M % c n rA % t/.7 m eL a &<nnrT k v.s& :
1 1
- b. Survey Perfonned by Inspector:
Serial Number of Device:
Direct Survey Of Device: _ alpha dpm/ cm8 l Direct Survey Of Work Area:
Smear Survey of Device: , alpha dpn/ car Smear Survey of Work Area:
l Survey Instrwnent Used: _
l Model: _
Serial No.: 1 Date of Calibration:
(If more than one unit use additional sheets)
If direct survey shws contamination, samples of product must be obtained.
Type of product:
a
Phb UV '80 lb:2b NRC REGION 3B P05 s
I ,
llo,'
Serial Number of Device: _
Direct Survey of Devica: alpha dps/
co' Direct Survey Of Work Area:
Smear Survey of Device: alpha dpm/ cm8 Smear Survey of Work Area:
Survey Instrument Used:
Model:
Serial No.:
Date of Calibration: _
Serial Number of Device:
Direct Survey Of Device: alpha dpm/ cm' Direct Survey Of Work Area: __
Smear Survey of Device:
alpha dpm/_cm2 Smear Survey of Work Area: _ ___
Survey Instrument Used:
Model:
Serial No.:
Date of Calibration:
_ _ ___ _