Corrected Page to Registry of Radiactive Sealed Sources & Devices Safety Evalutaion of Device for Model Step. Certificate:NR-104-D-101-SML20128M166 |
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Issue date: |
09/16/1996 |
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From: |
NRC |
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To: |
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Shared Package |
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ML20128M155 |
List: |
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References |
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SSD, NUDOCS 9610160015 |
Download: ML20128M166 (4) |
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Similar Documents from NRC |
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Category:CERTIFICATES OF COMPLIANCE
MONTHYEARML20217H4251999-10-13013 October 1999 Amended Registry of Radioactive Sealed Sources & Devices,Se of Gamma Gauge for Model NW-201,NW-301 Series & NW-401 series.Certificate:NR-186-D-117-B ML20211B0631999-08-23023 August 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Gammamed 12it & Gammamed 12i.Certifcate:NR-726-D-801-S ML20210R2641999-08-11011 August 1999 Amended Registry of Radioactive Sealed Sources & Devices, Safety Evaluation of Ionization Smoke Detector for Model SA-4 Series,3000 Series,Micro 300 Series,330 Series,350 Series,370 Series & 570 Series.Certificate NR-255-D-102-E ML20210E6481999-07-26026 July 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model Dwg A200234-D. Certificate:NR-474-S-801-S ML20210A3701999-07-20020 July 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Amended in Entirety for Model Series 1, 2,3,4,5 & 6.Certificate:NR-172-D-101-E ML20196B6941999-06-22022 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source (Amended in Entirety) for Model CDC.T1.Certificate:NR-136-S-255-S ML20196B6481999-06-21021 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models 500A series,700A series,1000K Series Ion Chambers in Various Smoke Detector models.Certificate:NR-547-D-101-E ML20209C9671999-06-0707 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model C-100,C-200 & C-300. Certificate:NR-587-D-104-S ML20207A9241999-05-26026 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model GH-11. Certificate:NR-8109-D-801-S ML20206U0231999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Corrected Pages 1 & 7) for Models T1000,T1000E & Elite 100.Certificate:NR-687-D-101-S ML20206U0341999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Corrected Pages 1,4 & 8) for Models Theratron 780 Series (780,780C,T780E,Phoenix,Elite 80). Certificate:NR-687-D-105-S ML20206U1941999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Dops,Heps,Leps,Saps,Slps, Ssps (Formerly 820,840 & 880) Probes & Courier 8 Analyzer. Registration certificate:NR-701-D-101-B ML20207E3211999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Dops,Heps,Leps,Saps,Slps & Ssps Formerly 820,840 & 880 Probes & Courier 8 Analyzer. Certificate:NR-701-D-101-B ML20206M2771999-05-10010 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models SMD1,0805,0905,0906,0908, 1225,1255 & 200 Series. Registration Certificate:NR-1047-D-101-E ML20206M4081999-05-10010 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models SMD1,0805,0905,0906,0908, 0914,0915,0916,0918,1225,1235,1255,1275 & 1285. Certificate:NR-8106-D-801-E ML20205R0321999-04-21021 April 1999 Corrected Pages 4 & 5 of Registry of Radioactive Sealed Sources & Devices Safety Evaluation of Sealed Source for Therapeutic Brachytherapy Seeds.Certificate:NR-569-S-101-S ML20205R1361999-04-21021 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model RSNP-Au. Certificate:NR-569-S-101-S ML20205R1411999-04-21021 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Models RSNP-Ir & RSNP-2. Certificate:NR-569-S-801-S ML20205J9691999-04-0707 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 2314-0-0 Ds. Certificate:NR-345-D-104-S ML20205H2071999-04-0505 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Type self-shielded Irradiator,Models Husman 520,521 & 521a.Certificate:NR-8107-D-801-S ML20207L1641999-03-11011 March 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Amended in Entirety Re Models N610-0063,N610-0134 & Voyager.Certificate:NR-536-D-110-B ML20206U0501999-02-23023 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models T1000, T1000E & Elite 100.Certificate:NR-687-D-101-S ML20206U0541999-02-23023 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models Theratron 780 Series (780,780C,T780E,Phoenix,Elite 80). Certificate:NR-687-D-105-S ML20203A6181999-02-0505 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Source for Model TALC-PC. Certificate:NR-277-S-802-S ML20199J1791999-01-20020 January 1999 Corrected Registry of Radioactive Sealed Sources & Devices Safety Evaluation of Device for Model IMS Detector Series. Certificate:NR-1018-D-101-E ML20206Q9191999-01-11011 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model Agt 400.Certificate: NR-1064-D-101-G ML20198R1441999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator for Model 8050-XXXAB. Certificate:NR-8150-D-802-S ML20198R2491999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator for Model 8150-120-Cs. Certificate:NR-8150-D-801-S ML20198R4861999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Calibration Device for Model 1000. Certificate:NR-8105-D-803-S ML20198R5741999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Scs 1001 Through 1008. Certificate:NR-8105-S-806-S ML20198R6191999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 1000 B. Certificate:NR-8105-D-805-S ML20198R9071999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator Devices for Model 64-764.Certificate:NR-8105-D-804-S ML20198D6851998-12-21021 December 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Models C-188 Series Types 1-12 & C-306 Series Types 1-3.Certificate:NR-220-S-103-S ML20198F1521998-12-21021 December 1998 Amended Registry of Radioactive Sealed Sources & Devices, SE of Gamma Irridator for Models Gammacell 40 (Serial 1 Through 133) & Gammacell 40 Exactor (Serial 134 & Higher). Registration certificate:NR-220-D-101-S ML20198G5181998-12-21021 December 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 8992 Smoke Detector. Certificate:NR-782-D-101-E,amended in Entirety ML20195B2031998-11-12012 November 1998 Amended Registry of Radioactive Sealed Sources & Devices, Safety Evaluation of X-Ray Fluorescence Analyzer for Model Sips Probe.Certificate:NR-701-D-104-B ML20155K5061998-11-0909 November 1998 Amended Registry of Radioactive Sealed Sources & Devices SE of Ionization Smoke Detector for Models SMD1,0805,0905,0906. 0908,1225,1255 & 200 series.Certificate:NR-1047-D-101-E. Certificate:NR-1047-D-101-E ML20206P5761998-11-0909 November 1998 Amended Registry of Radioactive Sealed Sources & Devices SE of Ionization Smoke Detector for Model 9.0 V Series,120 V/Ac Series.Certificate:NR-0545-D-101-E ML20155C7661998-10-29029 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model Sips Probe.Certificate: NR-0701-D-104-B ML20155C5241998-10-29029 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models EI100BUS,EI100SUS,EI100LUS & 1001.Certificate:NR-1040-D-101-E ML20154S1531998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiographic Source Assembly for Model A-13-A. Certificate:NR-300-S-875-S ML20154R1861998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Models Nb,Nbg,Nb (Hp). Certificate:NR-300-S-856-S ML20154R2791998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source for Model Npx. Certificate:NR-300-S-857-S ML20154R3291998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Gauging Source for Model Tp. Certificate:NR-300-S-859-S ML20154R3391998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Gauging Source for Model RC-1 (Hp). Certificate:NR-300-S-858-S ML20154R6481998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiographic Exposure Device for Model Gammatron 50-A.Certificate:NR-300-D-862-S ML20154R7131998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source Assembly for Model D Series.Certificate:NR-300-S-863-S ML20154R7411998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Industrial Radiography Source Assembly for Model T Series.Certificate:NR-300-S-864-S ML20154R7471998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source Assembly for Model C-1-R. Certificate:NR-300-S-853-S ML20154R7671998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source Assembly for Model R Series.Certificate:NR-300-S-865-S 1999-08-23
[Table view]Some use of "" in your query was not closed by a matching "". Category:TEXT-LICENSE APPLICATIONS & PERMITS
MONTHYEARML20217H4251999-10-13013 October 1999 Amended Registry of Radioactive Sealed Sources & Devices,Se of Gamma Gauge for Model NW-201,NW-301 Series & NW-401 series.Certificate:NR-186-D-117-B ML20211B0631999-08-23023 August 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Gammamed 12it & Gammamed 12i.Certifcate:NR-726-D-801-S ML20210R2641999-08-11011 August 1999 Amended Registry of Radioactive Sealed Sources & Devices, Safety Evaluation of Ionization Smoke Detector for Model SA-4 Series,3000 Series,Micro 300 Series,330 Series,350 Series,370 Series & 570 Series.Certificate NR-255-D-102-E ML20210E6481999-07-26026 July 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model Dwg A200234-D. Certificate:NR-474-S-801-S ML20210A3701999-07-20020 July 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Amended in Entirety for Model Series 1, 2,3,4,5 & 6.Certificate:NR-172-D-101-E ML20196B6941999-06-22022 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source (Amended in Entirety) for Model CDC.T1.Certificate:NR-136-S-255-S ML20196B6481999-06-21021 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models 500A series,700A series,1000K Series Ion Chambers in Various Smoke Detector models.Certificate:NR-547-D-101-E ML20209C9671999-06-0707 June 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model C-100,C-200 & C-300. Certificate:NR-587-D-104-S ML20207A9241999-05-26026 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model GH-11. Certificate:NR-8109-D-801-S ML20207E3211999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Dops,Heps,Leps,Saps,Slps & Ssps Formerly 820,840 & 880 Probes & Courier 8 Analyzer. Certificate:NR-701-D-101-B ML20206U1941999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Dops,Heps,Leps,Saps,Slps, Ssps (Formerly 820,840 & 880) Probes & Courier 8 Analyzer. Registration certificate:NR-701-D-101-B ML20206U0341999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Corrected Pages 1,4 & 8) for Models Theratron 780 Series (780,780C,T780E,Phoenix,Elite 80). Certificate:NR-687-D-105-S ML20206U0231999-05-21021 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Corrected Pages 1 & 7) for Models T1000,T1000E & Elite 100.Certificate:NR-687-D-101-S ML20206M4081999-05-10010 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models SMD1,0805,0905,0906,0908, 0914,0915,0916,0918,1225,1235,1255,1275 & 1285. Certificate:NR-8106-D-801-E ML20206M2771999-05-10010 May 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models SMD1,0805,0905,0906,0908, 1225,1255 & 200 Series. Registration Certificate:NR-1047-D-101-E ML20205R1411999-04-21021 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Models RSNP-Ir & RSNP-2. Certificate:NR-569-S-801-S ML20205R1361999-04-21021 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model RSNP-Au. Certificate:NR-569-S-101-S ML20205R0321999-04-21021 April 1999 Corrected Pages 4 & 5 of Registry of Radioactive Sealed Sources & Devices Safety Evaluation of Sealed Source for Therapeutic Brachytherapy Seeds.Certificate:NR-569-S-101-S ML20205J9691999-04-0707 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 2314-0-0 Ds. Certificate:NR-345-D-104-S ML20205H2071999-04-0505 April 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Type self-shielded Irradiator,Models Husman 520,521 & 521a.Certificate:NR-8107-D-801-S ML20207L1641999-03-11011 March 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device Amended in Entirety Re Models N610-0063,N610-0134 & Voyager.Certificate:NR-536-D-110-B ML20206U0541999-02-23023 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models Theratron 780 Series (780,780C,T780E,Phoenix,Elite 80). Certificate:NR-687-D-105-S ML20206U0501999-02-23023 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device (Amended in Entirety) for Models T1000, T1000E & Elite 100.Certificate:NR-687-D-101-S ML20203A6181999-02-0505 February 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Source for Model TALC-PC. Certificate:NR-277-S-802-S ML20199J1791999-01-20020 January 1999 Corrected Registry of Radioactive Sealed Sources & Devices Safety Evaluation of Device for Model IMS Detector Series. Certificate:NR-1018-D-101-E ML20206Q9191999-01-11011 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model Agt 400.Certificate: NR-1064-D-101-G ML20198R1441999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator for Model 8050-XXXAB. Certificate:NR-8150-D-802-S ML20198R5741999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models Scs 1001 Through 1008. Certificate:NR-8105-S-806-S ML20198R2491999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator for Model 8150-120-Cs. Certificate:NR-8150-D-801-S ML20198R4861999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Calibration Device for Model 1000. Certificate:NR-8105-D-803-S ML20198R6191999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 1000 B. Certificate:NR-8105-D-805-S ML20198R9071999-01-0505 January 1999 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Instrument Calibrator Devices for Model 64-764.Certificate:NR-8105-D-804-S ML20198D6851998-12-21021 December 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Models C-188 Series Types 1-12 & C-306 Series Types 1-3.Certificate:NR-220-S-103-S ML20198G5181998-12-21021 December 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model 8992 Smoke Detector. Certificate:NR-782-D-101-E,amended in Entirety ML20198F1521998-12-21021 December 1998 Amended Registry of Radioactive Sealed Sources & Devices, SE of Gamma Irridator for Models Gammacell 40 (Serial 1 Through 133) & Gammacell 40 Exactor (Serial 134 & Higher). Registration certificate:NR-220-D-101-S ML20195B2031998-11-12012 November 1998 Amended Registry of Radioactive Sealed Sources & Devices, Safety Evaluation of X-Ray Fluorescence Analyzer for Model Sips Probe.Certificate:NR-701-D-104-B ML20155K5061998-11-0909 November 1998 Amended Registry of Radioactive Sealed Sources & Devices SE of Ionization Smoke Detector for Models SMD1,0805,0905,0906. 0908,1225,1255 & 200 series.Certificate:NR-1047-D-101-E. Certificate:NR-1047-D-101-E ML20206P5761998-11-0909 November 1998 Amended Registry of Radioactive Sealed Sources & Devices SE of Ionization Smoke Detector for Model 9.0 V Series,120 V/Ac Series.Certificate:NR-0545-D-101-E ML20155C5241998-10-29029 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Models EI100BUS,EI100SUS,EI100LUS & 1001.Certificate:NR-1040-D-101-E ML20155C7661998-10-29029 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Device for Model Sips Probe.Certificate: NR-0701-D-104-B ML20154R3291998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Gauging Source for Model Tp. Certificate:NR-300-S-859-S ML20154Q8651998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model Vxp.Certificate: NR-300-S-861-S ML20154R1581998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Sealed Source for Model CS-1000 (Hp). Certificate:NR-300-S-854-S ML20154R3391998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Gauging Source for Model RC-1 (Hp). Certificate:NR-300-S-858-S ML20154R9811998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Pipewall Thickness Gauge for Model Pipeliner Model 300.Certificate:NR-300-D-871-S ML20154S1821998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiographic Exposure Device for Model 2-15SA. Certificate:NR-300-D-876-S ML20154S2631998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Control Device for X-Ray Crawlers for Model Master Minder Model 2.Certificate:NR-300-D-877-S ML20154S1221998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source for Model PL-3 & PL-4. Certificate:NR-300-S-874-S ML20154S1531998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiographic Source Assembly for Model A-13-A. Certificate:NR-300-S-875-S ML20154R9061998-10-21021 October 1998 Registry of Radioactive Sealed Sources & Devices,Safety Evaluation of Radiography Source Assembly for Model M Series.Certificate:NR-300-S-868-S 1999-08-23
[Table view]Some use of "" in your query was not closed by a matching "". |
Text
. . - . - . . _ . . . . _ . _ . - . _ . . . - - . . . . . . . . . . - . .- _ _ . _ _ . - . _ _ ~ .
I REGISTRY OF RADIOACTIVE SEALED SOURCES AND DEVICES SAFETY EVALUATION OF DEVICE (CORRECTED PAGE 1 - September 16, 1996)
NO.: NR-104-D-101-S DATE: April 28, 1995 PAGE 1 OF 8 DEVICE TYPE: TransmissionfLine Source Housing",
MODEL: STEP MANUFACTURER / DISTRIBUTOR: Picker International (Formerly Ohio Imaging)
Nuclear Medicine Division 595 Minor Road Highland Heights, OH 44143 SEALED SOURCE MODEL DESIGNATION: Isotope Products Laboratories:
Model 3409 ISOTOPE: MAXIMUM ACTIVITY:
Cobalt-57 29 mci (1.07 Gbq)
~
Isotope Product Code HEGL-0021 i
l Gadolinium-153 86 mci ( 3 . 2 Gbq)
Isotope Product Code HEGL-0022
! Technetium-99m (1) 23 mci (0.85 GBq) l l
l LEAK TEST FRI;OUENCY: 6 Months !
PRINCIPAL USE: (B) Medical Radiography i I
j (1) Not a sealed source; user fabricated source at site.
9610160015 960919 PDR RC
PAGE1 NRC FORM 567 ca n) l,U,S i/) efUCIAAR 14 RE!OUMIOSYCOMMISSION la b /U REQUEST FOR A SEALED SOURCE OR DEVICE EVALUATION INSTRUCTIONS: Send this request AND a copy of all related letters /applicahons and drawings to: The Sealed Source Safety Section, ATTN: Chief, OWFN Mail Stop 6 H3. Change the Ucense Tracidng System rnilestone to 19 and assign to reviewer code B-5.
NOTE: Retain a copy of this request with the application and background files.
WEoVEsTE p g REGION / LOCATION:
y /MO 4N l1 U ll Ill IV V HQ U LFDCB TELEPHONE NUMBER DATE TYPE OF ACTION REQUESTED (Check as appropriate)
APPUCANT'S NAME SOURCE REVIEW AMENDMENT OF REGISTRATION SHEET MAIL CONTROL NUMBER (S) DEVICE REVIEW NUMBER (S) 1 LETTER /APPUCATON DATE UCENSE NUMBER (S) CUSTOM REVIEW ~/ 9 -/C /- d l
COMMENTS - F) i
[f[ hNW gg f.ffQ 0N WW3 l
,, FOR SSSS USE ONLY juCA d '
n t DATEMECEffED ' UATE ASSIGNED DATE TO FEES TYPE OF ACTION (Indicate the' number of each type) /
/
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SOURCE (9C) DEVICE (9A) SOURCE (90) DEVICE (98)
NEW NEW ~
NEW -
NEW AMENDMENT t, MdIEENDMENT AMENDMENT AMENDMENT j NO SAFETY EVALUATION REQUIRED NO FEES REQUIRED
] LICENSING ACTION REQUIRED IF KNOWN -
NO
] OTHER (Spec #y)
TOTAL NUMBER OF NOTES REVIEW HOURS NUMBER OF DEFICIENCY LETTERS NUMBER OF DEFICIENCY CALLS FOR BILLING PURPOSES ONLY - -
NAME CHANGE ADDRESS CHANGE ] NEW REGISTRATION - ] PRODUCT INACTIVE - , _
ADD TO BILLING REMOVE FROM BILLING FOR FEE USE ONLY , -
TYPE OF FEE FEE CATEGORY k'Mby9 9A 9B 9C U 9D
~ ~
v '
CMOUNT RECEIVED ,
f \ A _ g(@
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I Jt- AS REQUIRED moved er u DATE RETUR4 DATE
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PAGE1 NRC FORM 567 ,, U, S. NUCLEAR REGULATORY COMMISSION j pos) i J REQUEST FOR A SEALED SOURCE OR -
DEVICE EVALUATION !
INSTRUCTIONS: Send this request AND a copy of all related letters / applications and drawings to: The Sealed Source Safety Sectxm, ATTN: Chief, j OWFN Mall Stop 6 H3. Change the License Tracking System milestone to 19 and assign to reviewer code I-5. .
NOTE: Retain a copy of this request with the application and background files.
REQUESTE r g REGION / LOCATION: 1 7/g M* _ /fMd ]I ll U lil IV V U HQ U LFDCB ,
TELEPHONE NUMBER DATE TYPE OF ACTION REQUESTED (Check as appropriate)
APPLCANT'S NAME SOURCE REVIEW AMENDMENT OF j REGISTRATION SHEET '
MAIL CONTROL NUMBENS) DEVICE 'tEVIEW
" I) o LETTER /APPLCATION DATE LCENSE NUMBER (S) CUSTOM REVIEW
~
) 40 /~d I
COMMENTS . .
f h M..,s Nf /
, FOR SSSS USE ONLY 5 / a 7 M R NUMBERS L gp NUMBER ASSIGN k j DATERECEIVED / DATE AS$1GNED DATE TO FEES
$b lY9N Yh2f$b
/ I TYPE OF ACTION (Indicate theinumber of each type) / / I, l COMMERCIAL DISTRIBUTION (FORMAL) l USE BY A SINGLE APPLICANT (CUSTOM)
SOURCE (9C) DEVICE (9A) SOURCE (9D) DEVICE (98) ;
NEW NEW NEW NEW !
AMENDMENT y dENDMENT ] AMENDMENT ] AMENDMENT
{
j NO SAFETY EVALUATION REQUIRED j LICENSING ACTION REQUIRED IF KNOWN -
NO FEES REQUIRED NO f
) OTHER (Specsty) ~
TOTAL NUMBER OF NOTES REVIEW HOURS NUMBER OF DEFICIENCY LETTERS ,
NUMBER OF DEFICIENCY CALLS i FOR BILLING PURPOSES ONLY - -
NAME CHANGE ADDRESS CHAN'GE ] NEW REGISTRATION - ] PRODUCT INACTIVE - , ,
ADD TO BILLING REMOVE FROM BILLING FOR FEE USE ONLY s - t TYPE OF FEE FEE CATEGORY '
( fM.- b9 9A
~ ~
V'
, ' U 9B 9C U 90 f AMoVNT RECElvED hf]
CHECK NUMBER f MATANN UPDATED
^
k( - AS REQUIRED ~ '
7 DATE OF CHECK (/ ~ ' ~, r
( ,
(o /) / .5 h ,pg ] MATSYS UPDATED " ,
/3 , 1CM- J/ //4-i /6 f AS REQUIRED APPROvg m DQ+,, cHy5 K DATE '
EfATERETURM7/W,/ 7 e6 - -
m e i i -
h NRC FORM $67 (6-93)
- k. OfuGMATOftS COPY
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U. S. NUCLEAR REGULATORY COMMISSION
, FY 96 Annual Materials Fee Invoice Period 10/1/1995 - 9/30/1996 10 CFR 171.16 Invoice Date License Anniversary Month Invoice Number
====== ========================= ========
06/11/1996 April AM3193-96 g/
T//Je./'/j d tG J W 4 L.
PICKER - 2;;IC I M ^. C I N C- l20 C L c}* l- N W 0* # ' "' S ' ^' '
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l ATTENTION: RADIATION SAFETY OFFICER h f30'O MTirc unan S 9 7 /19 A, efa. '#/+p 7j / ggy_] pts > y Q[
BEDFCCC "EIC"TS -GH 44ido~ $
lll$ H LWap ut7 6 M7'/* 6Y b
- Mark THIS COPY with any billing address changes *****
License / Approval /
Registration / Code Annual Fee Certificate Number AA905 Category (s) Fee Amount
============ ===== =========== =========
NR0104D101S ANN 9A $ 6,700.00 TOTAL: $ 6,700.00 TOTAL INVOICE: $ 6,700.00 Make Checks Payable To:
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U.S. Nuclear Regulatory Commission <=== This PO Box address is i 1
License Fee & Accounts Receivable Branch <=== for receipt of payments l F' O Box 954514 <=== only.
St. Louis, MO 63195-4514 For terms and conditions see attached.
Questions: call 301/415-7554.
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> To ensure accurate credit, return this copy of the <
> invoice with your payment. Processing may be <
> delayed if the invoice is not included. <
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