ML20199D578
| ML20199D578 | |
| Person / Time | |
|---|---|
| Site: | 07100600 |
| Issue date: | 05/27/1986 |
| From: | SHAFER VALVE CO. |
| To: | |
| Shared Package | |
| ML20199D569 | List: |
| References | |
| NUDOCS 8606200392 | |
| Download: ML20199D578 (20) | |
Text
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$. 0 $ Mor G&stAdddf4 RADIOGRAPHIC DEPARTMENT Title 10 CFR Part 71 Quality Assurance Program Scope:
This program is applicable to the procurement, handling, use, storage and shipment by Shafer Valve Company of pack-ages designed to transport radiographic isotopes.
Reference:
Shafer Valve Company By Product Material Licence No. 34-21198-01 Iridium-192 100 Curies Maximum Tech / Ops 650 Shipping Container / Source Changer 10 CFR Part 71.
Policy:
It is the purpose of Shafer Valve Company to provide a program for the safe operation and effective evaluation of radiographic practices and procedures in accordance with the NRC A.L.A.R.A. concept, and all other applicable requirements of the United States Nuclear Regulatory Commissions, Title 10 Chapter 1, Code of Federal Regula-tions Energy, Rules and Regulations.
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8606200392 060527 PDR ADOCK 071*****
C PDR l
PHONE 419 529-4311
[
TWX 810-448 2818
/
ZIP CODE 44906 9
O INDEI
- 1.. Glossary 2.
Organizational Chart 3.
Quality Assurance Program 4.
Procurement 5.
Receipt of Sources 6.
Description of Source Changer 7.
Changing of Sources i.
8.
Preperation for Shipment l-9.
Internal Inspection System / Audits 10.
Quality Assurance Records / Document Control 11.
Exhibits I
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GLOSSARY Carrier:
A person engaged in the transportation of passengers or property by land, air or water.
Low Specific Activity:
Unitradiated natural or depleted uranium or unitradiated natural thorium.
Packaging:
The assembly of components necessary to ensure compliance with the packaging requirements of 10 CFR Part 71.
Special Form Radioactive Material:
Radioactive material in a form that limits leakage or dispersal of the material contained within.
Specific Activity:
The radioactivity of the radionuclide per unit mass of the nuclide.
Transport Index:
The dose rate in MR/HR at one (1) meter from the surface of the shipping container.
The number of which regulates the degree of control to be exercised by the carrier.
Type B Quantity:
A quantity of radioactive material greater than type A.
Depleted Uranium:
Uranium containing less uranium 235 than the naturally occuring distribution of uranium isotopes.
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ORGANIZATIONAL STRUCTURE (Per Item 6 (h), Form NRC-313R)
Chairman Chief Executive Of ficer Radiation Safety Officer.......... Pressure Vessel Engineer Supervisor of Radiography RT Trainees Radiographer Radiographer's Assistant Lines of Responsibility * * * * *
- Lin'es of Communication A.
Management Personnel Ch airman / Chief Executive Of ficer............... Harry C. Kohler Pressure Vessel / Engineer....................... Scott A. Freund Radiation Safety Officer Supervisor of Radiography......................M. Craig McCombs
QUALITY ASSURANCE PROGRAM A.
General 1.
Shafer Valve Company has a personnel qualification and certifi-cation program for nondestructive testing which is designed to
- assure the technical competence and knowledge of safety re-quirements necessary for the safe and efficient practice of is-otope receipt, storage, usage, and disposal.
I These radiation safety and training requirements are performed in accordance with 10CFR34 and Shafer Valve Company NDE Procedure SVQC-9.
B.
Radiographic Shipping Packages 1.
The radiation safety officer will ensure that all radiographic material shipping packages are designed and manufactured under a specific program approved by the Nuclear Regulatory Commis-sion for all packages designed and manufactured after January 1,
1979.
2.
The radiation safety officer shall require the proper Certifi-cates of Compliance from the manufacturer and maintain them on file.
a)
The Shafer Valve Company utilizes Tech / Ops 650 Source i
Changers of the type B design using depleted uranium 238.
This design has been approved by the USNRC and given the Certificate of Compliance No. 9032. (Exhibit 7
)
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s PROCUREMENT 2
This section describes the actions, responsibilities and forms used to assure that required quality characteristics are properly ordered, and that material obtained is acceptable, identifiable and traceable to proper specifications.
A.
The Radiation Safety Officer shall:
- 1. -
Establish a written material requisition containing all technical requirements to be documented on the formal purchase order.
(Exhibit 1
)
2.
Submit material requisition to the manager of purchasing to obtain the formal purchase order.
(Exhibit 2
)
3.
Upon receipt of formal purchase order, radiation safety officer shall contact manufacturer by telephone, placing verbal order and confirming to manufacturers representative.
4.
Forward formal purchase order to manufacturer.
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RECEIPT OF SOURCES A.
The Radiation Safety Officer shall monitor the source at receiving as soon as he is notified of its arrival.
B.
Using a calibrated survey meter, the RSO shall survey the container from 2 points:
First
- One meter from the container.
This reading should not exceed 10 MR/HR.
Second - The entire external surface of the container.
This reading should not exceed 200 MR/HR.
C.
If levels of radiation in excess of the limits specified in (B) above are found, the RSO will immediately notify by telephone and telegraph:
I (1)
The final delivering carrier.
(2)
The US Nuclear Regulatory Commission Office of Inspection and Enforcement Region III 799 Roosevelt Road Glen Ellyn, IL 60137 (312) 790-5500 D.
If the package has been determined to be within acceptable limits, the RSO shall record the pertinent information on form R-124 (Exhibit 3), and retain it in the record file.
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DESCRIPTION OF SOURCE CHANGER A.
The T/0 model 650 source changer consist of two (2) assemblies:
(1)
The shield contains depleted uranium (U-238) covered by a steel shell.
A stainless steel "U" tube is located in the shield and serves as a conducting path to the shielding center.
The outlets of the "U" tube are on the top surface of the shield and there is a stop midway in its length -
permitting the use of two (2) source cables at one time.
B.
The closure mechanism consists of a hold down cap which fits over the two (2) source chambers and screws directly into the steel housing.
The hold down cap keeps the source cable connectors firmly in place, preventing movement of the source f rom its safe position within the container.
e b
CHANGING OF SOURCES Note:
Personnel monitoring equipment must be worn during all source changing operations, along with en operable and calibrated survey meter.
A.
Place source changer next to exposure device in exposure cell.
B.
Remove tamper-proof seal and unbolt cover.
C.
Remove tamper-proof' seal and unbolt hold down cap.
D.
Connect open end of guide tube (from exposure device) to the empty chamber.
E.
Close and latch' source guides.
F.
' Check guide tube for sharp bends.
G.
Leave exposure cell, close and lock door, crank out old source into-empty side of source changer.
H.
After following normal survey procedures for entering the room, as outlined in " Operating and Emergency Procedures", disconnect guide tube from changer, drive cable from source assembly and connect to new source assembly.
Making very certai_n that the connection is complete on the source assem1by.
I.
Leave exposure cell, close and lock door, crank the new source into the exposure device.
J.
After following normal safety procedures for entering the room, disconnect source guide tube from the source changer and prepare '
container for shipment.
K.
Note:
The source changer has been designed to come well within the a
minimum safety requirements.
The only time that excessive radia-j tion does exist is during the actual travel of the source between the changer and the' exposure device.
The transfer of a source is l
actually the same as making an exposure and the same safety measures shall be followed, l
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i PREPERATION FOR SHIPMENT A.
Make certain that the " hold down" cap on the closure mechanism is secure, affix the tam tag l
1s properly attached.per-proof seal and be sure the source I.D.
B.
Survey the shipping container to determine the radiation levels at the surf ace and at one (1) meter from the container.
The reading at one (1) meter is the transport index.
These readings must fall within the limits outlined in paragraph 5.B of this manual.
C.
Record the reading (MR/HR) from one (1) meter on each radiation label in the "Index Number" block.
Record this reading and the surface reading on the decay chart and on form R-125.
(ExEibit 8)
D.
Place a copy of the decay chart in the cap of the source changer, bolt the cap securely, and attach the camper-proof seal.
E.
The sealed source changer is kept in the exposure cell until the designated carrier arrives.
F.
The RSO or a duly trained radiographer designated by the RSO shall turn the shipping container over to the carrier and obtain a copy of the " Bill of Lading", signed by the trucker, which will then be attached to a copy of the decay chart.
G.
All pertinent data shall be recorded on form R-125 (Exhibit 8), up to and including a copy of the " Isotope Receipt" (Exhibit 10) from Tech / Ops.
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INTERNAL INSFECTION SYSTEM / AUDITS (Per Item 6 (g), Form NRC-313R)
A.
Purpose.
This section describes the internal inspection system by which SVCo will control the receipt, possession and use of licensed radioac-tive material in accordance with the provisions of this license, related NRC Regulations and the Operating and Emergency Procedures at SVCo.
B.
Nature and Frequency of Internal Inspection With the assistance of the Radiation Safety Officer, the P.V.Q.A.
Engineer will conduct a Quarterly Management Audit (QMA).
Specific items to be audited are listed on form R-122 (Exhibit 12) of this manual.
In addition, the RSO will conduct unannounced on-the-job inspections at intervals not to exceed three months.
The RSO will i
also inspect the records and review the performance of personnel.
Personnel performance evaluation will consist of (1) Evaluation of Form & Content of a sampling of each individual's required doc-umentation forms, (2) Oral Questions concerning at least one area of the applicable NRC Rules and Regulations and SVCo Operating and Emergency Procedures.
A " Demonstration" of any of the duties of the job function may be requested in addition to or in lieu of oral questions.
C.
Procedures for Reporting Deficiencies 4
The results of the RSO's quarterly inspections shall be recorded and kept on file.
The Radiation Safety Officer shall review these with the P.V.Q.A. Engineer during the QMA (or sooner if deemed necessary by the RS0).
Deficiencies noted during inspections shall be corrected immediately with additional training, if deemed neces-sary, to ensure that the individual (s) have thoroughly eliminated the possibility of a reoccurence.
Follow-up inspections may be made at the discretion of the Radiation Safety Officer or P.V.Q.A.
Engineer to determine that the descrepancies and deficiencies have been resolved.
4
QUALITY ASSURANCE RECORDS A.
In addition to personnel training and qualification files, the following records shall be maintained by the Radiation Safety Officer for a minimum of five (5) years.
1.
Copy of Material Requisition Exhibit 1 2.
Copy of Purchase Order Exhibit 2 3.
Form R-124: Source Receipt Record Exhibit 3 4.
Source Decay Chart Exhibit 4 5.
Manufacturers Packing Slip Exhibit 5 6.
Carriers Source Shipping Tag Exhibit 6 7.
Ce-tification of NRC Approval of Manufacturers Quality Assurance Program Exhibit 7 8.
Form R-125: Source Disposal Record Exhibit 8 9.
Copy of signed Bill of Lading Exhibit 9 10.
Copy of " Isotope Receipt" from Tech / Ops upon return of source Exhibit 10 11.
Copy of SVCo packing slip for return shi pment Exhibit 11 12.
Form R-122: Quarterly Management Audits Exhibit 12 13.
Form R-117: Quarterly Inventory Exhibit 13 14.
Form R-116: Quarterly Maintenance and Inspection Exhibit 14 1
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ORIGINAL PURCHASE ORDE3 No.
YLTE $Ont y
b E'l 2500 PARK AVE. WEST MANSFIELD, OHIO 44906 TELEPHONE (419) 529 4311 TWX 810 448-2818 l
SHIP RADIATION PRODUCTS DIVISION SHAFER VALVE COMPANY TO TO NORTHWEST INDUSTRIAL PARK 2500 PARK AVENUE WEST BURLINGTON, MA 01803 MANSFIELD, OH 44906 OAik OF OMDLM MLouisaleON peo.
EniP veA F 0 s.
16Hws f U26/86 ITEM OUANTITY DESCR6PTION PRICE 1
1 ea Iridium 192 source 100 curies P/N A424-9 for use in T/0 #660 Ganna ray projector 2
6 ea T/0 #518 leak test kits Ref: NRC License #34-21198-01 Ship attn:
R.S.O.
EXHIBIT 2
Confinning by phone Do not duplicate End of order Form 116A Revised 9-80 THE SUPPLIER AGREES TO FURNISH THE ABOVE IN ACCORDANCE CITH STANDARD INSTRUCTIONS AND PROVISIONS SHOWN ON THE I.EVERSE SIDE AND MADE A PART HEREOF.
PURCHASING AGENT PMICE AND DEllVERY MUST BE ACKNOWLEDGED IMMEDI ATELY.
vliNG e oqu ess9% sDf D Mf Mt Wat 4 StatsNG PM6Ct ANO DAtt SM'*WINt W4 4 Of W ADI
SHAFER VALVE COMPANY R-124 Rev. 1 SOURCE RECEIPT RECORD Date Received:
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Survey Meter:
Mfg.
SAWMA
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Mod,e1 No.
ilS~d f Serial No.
45/4 Cal. Due Date:,
/-/#-g4 Survey of Shipping Container:
(1)
@ l Meter from Container -
' /. 8 MR/HR Maximum Reading 6 Surface -
fA.O MR/IIR Shipping Container:
Mfg.:
-77/w/4A$
Model No.:
[f4 Serial No.:
/4M/
Curies:
M
.#SS Condition of Container:
8SSB Source: IR-192 Mfg.
7E'c#/#/5 Model No.:
/ 47V-f Serial No.:
//4 7 Curies:
9/. $
Tamper-Proof Seal:
/4//Wtl.F Ydd,6/7'A* A/6 DisposLtion:
Remarks:
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DX Td3MJ N7/M gg Red *8 tion Pf0dLMt. Olvision SOURCE ao wonn A nu.
CERTIFICATE sumncon. u.is.cnu iti onos Telephone (617) 272-2000 l
r Radionuclide Iridium-192 Source Model:
A 424-9 ISO / ANSI Classification 2 C43515 Source Serial:
7826 1AEA Special Form: USA /0154/S Measured Equivalent Activity:
80.0 Curies on 16-Aug-85 Source Physical Si:e Quelity Control Tests Diameter:
0.107 in 2.72 mm Wipe Test A:
0.01 nC1 Length:
0.103 in 2.62 mm Vacuum Bubble Test: Satisfactory Diagonal:
0.149 in 3.77 mm Tensile Test Satisfactory Wipe Test B:
0.01 nC Decay Data Date Activity Date Activity 16-Aug-85 88.0 14-Mer-86 12.2 23-Aug-85 82.4 2'
-r-86 11.4 30-Aug-85 77.1
-86 10.7 06-Sep-85 72.2
'6 10.0 13-Sep-05 67.6 9.4 20-Sep-85 63.3 8.8 86 8.2 27-Sep-85 59.3 4@4
.iey-86 7.7 04-Oct-85 55.5 11-Oct-85 5?
Dh A-May-86 7.2 18-Oct-85 16-May-86 6.8 25-Oct-85 23-May-86 6.3 01-Nov-85 30-May-86 5.9 08-Nov-85 06-Jun-86 5.5 15-Nov-85 13-Jun-86 5.2 22-Nov-85 20-Jun-06 4.9 29-Nov-85
- b. 8 27-Jun-86 4.6 06-Dec-85 30.7 04-Jul-BE 4.3 13-Dec-85 28.0 11-Jul-86 4.0 20-Dec-85 26.9 18-Jul-86 3.7 27-Dec-85 25.2 25-Jul-86 3.5 03-Jen-86 23.6 01-Aug-66 3.3 10-Jan-86
- .1 08-Aug-86 3.1 17-Jan-86 20.7 15-Aug-8E 0.9 24-Jan-86 19.4 22-Aug-86 2.7 31-Jen-86 18.1 29-Aug-66 2.5 07-Feb-86 17.0 05-Sep-E6 2.4 14-Feb-86 15.9 10-Sep-86 2.2 21-Feb-86 14.9 19-Sep-86 2.1 20-Feb-86 13.9 26-Sep-06 1.9 07-Mor-86 13.1 03-Oct-06 1.8 L
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RADIATION PRODUCTS DMSION
. 40 NORTH AVENUE
- BURLINGTON. MASSACHUSETTS 01803 PAGE'
'l No* 0348a: -Oo PHONE pl?) 272-2000 l TOLL FREE 1 800 225 1383 SOL 2 TO:
SHIP TO:
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PROPER SHIPPING NAME
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NET OU ANTITY PER PA*A AGE
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THIS SHIPMENT IS WITHIN THE LIMITATIONS PRESCRIDED FOR IF ACCEPTADLE FOR PASSENGER AIRCRAFT, THIS SHIPMENT CONTAINS RADIOACTIVE MATERIAL INTENDED FOR USE IN OR IPCDENT
- 10. RESE ARCH. MEDICAL DIAGNOSIS On TRE ATMEN T.
i HEREBY CERTIFY THAT THE CONTENTS OF THIS CONSIGNMENT ARE FULLY AND ACCURATELY DESCRIBED ABOVE BY PROPER SHIPPING NAME AND ARE CLAS$1MED. PACKED, MARKED, AND LABELED, AND IN PROPER CONDITION FOR CARRIAGE Of AIR ACCORDING 10 APPLICABLE NATIONAL GOVERNMENTAL REGULATIONS.
' NAME ANO,Tirit or rf nson sicN'No LtntiticAtiO4 tutnGtucy 1tttrHONt no
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,. CG H F2O CADI ' ACTIVE CATCIALS PACKA2EE e e c.t g cnig NWpta O Ri et$ ION #sWeta o PAL A GE 8DENIA8C(*1'0N N W l'l&4 37ACt N W ble e Igitt NWeat s so t h u
9032 4
USA /9032/B(U) 1 2
3 Pat Assett l
O 1hes te' tit tete es estuod to settefy that the pathogeng and tonients gescobed in Mem S below. enects Inc applicable safety standeeds set forth en Tetie 10 Cooe et f eferat hegulations. Part 71.*Pacheg'ng of Medioactive Meteriets 80' If anspo'l and lienspo' tat *on of Red oetteve Meteesel Undee Certain Conditions '
l C) Thes tertilattle goes not totieve the Consignoe leem Comphante with any regwerement of the tegwtetens of the U S Department of teensportation or othe-l app.tobie regulatory a,encies. enceweing the government of any towntry theowg'i or into which the package w st be transported I
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l;i 3' 31Mr$ CtatissCAf t 15 ellutD ON 1Mt 84515 Of A SA8If v ANA&vli$ RE POA108 THE PACRAGE Ot$iGN OR APPteCA1604 o patPAntD tvisseme aw Aseress) t fl1&t AN0 sDEN16flCAfs0N 0f AtPORY OR APPatCA180N N
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I j Technical Operations, Inc.
Technical Operations, Inc. applicatioW.M #
40 North Avenue dated August 8, 1979.
j, Burlington, FM 01003 1
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. oOCatik w eta 71-9032 1 4 fONoiteONS k
This certificate se conditenas upon tuttilhng the reqws'ements of to CFR Part 71, es applicebte, and the condit.ons specified below I
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Packaging 3e (1) flodel No.:
650 1'
l (2)
Description 1
1, A steel encased, uranium shielded', Iridium 192 source changer.
li Primary components consist of an outer steel shell, polyurethane potting material, uranium shield, Titanium "U" tube, and source holdown assembly.
The source holdown assembly secures the source t
assembly in position within the crimped "U" tube.
Tamper-proof seals 1
and a padlock are provided on the packading.
Total weight of the j
p,ackage is approximately 70 pounds.
f (3)
Drawing i
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The packaging is constructed in accordance with the Technical Oper-i 1
ations, Inc. Drawing No. 65002, Rev. A. Sheets 1, 2 and 3 of 3.
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1 EXHIBIT I
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' Fage 2 - Certific' ate No. 9032 - Revision No. 4 - Docket No. 71-9032 RECOMED 195 p28 I5.
(b) Contents saia M g, i,
I; (1) Type and fom of material 1
l1 Iridium 192 as sealed sources which meet the requirements of special fom radioactive material.
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(2) Maximum quantity of material per package l
I 240 curies
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fi 6.
The source shall be secured in the shielded position of the packaging by the s'
source assembly.
The source assembly must be fabricated of materials capable of i
i I,
resisting a 1475'F fire environment for one-half hour and maintaining their I
lj ositioning function.
The cable of the source assembly must engage the source 3
oldown assembly.
The flexible cable of of the source assembly must be of lt sufficient length and diameter to provide positive positioning of the source at l
i' the crimp of the "U". tube.
i I
i Il I 7.
The nameplates shall be fabricated of materials capable of resisting the fire I
I
[
test of 10 CFR Part 71 and maintaining their legibility.
[ 8.
The package authorized by this certificate is hereby approved for use under the general license provisions of 10 CFR 671.12.
[' 9.
Expiration date:
June 30, 1989.
I, h'
REFERENCE l; Technical Operations, Inc. application dated August 8,1979.
I E
1 FOR THE U.S. NUCLEAR REGULATORY COMMISSION p[,
Chqar.CLh l
s E. MacDonald, Chief I
i I,
Transportation Certification Branch l
Division of Fuel Cycle and
)
Material Safety, MiSS i
!,Date:
MI A I
(!
II l
i t
i
m-SilAFER VALVE COMPANY R-125 Rev.1 SOURCE DISPOSAL RECORD SOURCE:
IR-192 Mfg.:
7Er.g 8
Model No.: A @ t/ - f f
i Serial No.
~/ 2 // 6 Cuties:
/S. 6 Shidning Container:
Mfg.:
7/8 Model No.:
Mf8
/d d /
Serial No.:
lloid Down Cap Secure:
f///
d Source Tag Affixed:
g /f/
Tamper-Proof Seal:
g///
(Internal)
Decay Chart Enclosed:
M
(\\ lith Meter Readings)
Cap Bolted Securely:
fff Tamper-Proof Seal:
ff//
(External)
New Labels Affixed:
IM (1)
Transportation Index No.:
,/
(MR/ilR G 1 Meter)
Surface Reading, Container:
- 8. f (MR/ilR)
/* [_fh RS 0t>
Date Transportation:
EXHIBIT Date Picked Up:
/-/8-N Careier:
SayTWt 7 2 &.3,c 5 p Attachments:
X Packing Slip X
Signed Bill-of Lading N
Copy-Decay Chart _ /-/ 7-8d M f g. Isotope Recelpt m
- w 5:M/n!):$
SMiiH'S TRANSFER CORPORAllON SICS 0.C' Gen;r:I Offic3: St:unt:n. Vrgina 2",f',','
TO:
FROM:
coNSl^ NEE TECH-0PS INC.
SHIPPER Shafer Valve Company STREET h0 North Avenue STREET 2500 Park Avenue West DESTINATION Burlington, MA
,,, coo,01803 oniciN Mansfield, OH kl906
,,,coor C O D charge } Shipper ROUTE Smith Transfer Direct VEHICLE NUMBER to be paid by } Consignee r,,'a,
.nu o.........s...,............
,,a,.,..,,
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1 X
- 650 Source Changer containing 10.0 Curies 85#
of Iridium 192. Radioactive material, Special Form N.O.S. UN2974. Radioactive Device.
DO NOT N.0.S. UN2911. Uranium 238, solid Metal.005 I
Curies. Radioactive Yellow II Labels
^
Transport Index:.1
'U.Am WifH*X ALL HAZARDOUS M ATERI AL
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9.e 9_9_9 919 A 9_99 9.9.9.
- _9D e e e e_e_9 e_ei er si.arge are t. be prep.id serit' PREPAID If sh
- cci,s ng to Ine.pp6.c. Die,egul.t.on. of the Dep.rtm.nt of T,.n po,t.iion ! i I ;,-
., nere. Te he prep is.*
w t c,.u iv.t..o..s.u.e.,.,.c..i i.e.ine.e.,....c i o.n..no..i...........c t on t.h.e. o l.e.o.f. u.e.. t.h.. B l.l.of L d ng o.
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SHIPPER Shnf'er Valve ConDany CARRIER y A',.
2 PER U. IlOSZ PER M
/// c /eg E$U"h500 Park Ave West Mansf.. OH
,,,coobb906 oATE EXHIBIT 9
t
I-SAlFS COPY Tech / Ops, Inc.
RADIATION PRODUCTS DIVISION 7^
Received From [2 f
8
( v v
Address & 6'88, 624 c."
Date [ /
19
//fas'V!da'.
t'?b M 996
/
PREPAIDK gM[/NdMT cottecT o via
/
MODEL 650 /W/ Cap. S.N.
j fc V S
/ ff/k,Deucc =- //de Y
n
/
duk. /$ansNowa 2,6 an s e' l
EXHIBIT I
10 l
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l 110s!sYc::"'ci f
K!IP li U.'.'
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oc e s nes ri 54v. %sGPJ AIUHE
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No.
PURCHASE ORDER O#2.f 4M,y j 4 E%,I-G UE 2500 PARK AVE. WEST MANSFIELD, OHIO 44908
~
TELEPHONE (419) 529 4311 TWX 810 4A8 2818
..f. *
, ],,
' {' SHAFER* HALVE COMPANY TECH / OPS SHIP 2500 PARK AVENUE WEST RADIATION PRODUCTS DIV.
73 NORTHWEST INDUSTRIAL PARK
.TO MAN 8 FIELD, OH 44906 8URLINGTON, MA 01803
.'. i-
{ (800)
]
- 5.,'
225-1383
,S
- ~,
DA1&ofomota mEQUlsiTION NO.
SHIP VLA f.O.S.
TEmass nI/06/96 ITEM OUANTITY SESCRIPTION DATE PfuCE PROMISED 1
1 EA IR1010M 192'SOUhCE 100 CURIES-P/N (ADVISE A424-9 FOR USE IN T/O #660. GAMMA., RAY PROJECTOR REF. NRC LINENCE
- 34-211W8-01 SHIP ATTN:
NICK A L E 8 Z,' ' R. S. D.
f CONFIRMING.TO 8.
MCNKLTYDO.NOT D U P L i C,A T E
.......____________ guo.;og oyng, EXHIBIT 11 t
Form Il6A Revised 4-85 1
l NE SUPPLIER AGREES TO FURNISH THE ABOVE IN ACCORDANCE tlTH STANDARD INSTRUCTIONS AND PROVISIONS SHOWN ON THE REVERSE SIDE AND MADE A PART HEREOF.
/
PRICE AND DELIVERY MUST BE ACKNOWLEDOED IMMEDIATELY.
l PURCHASING AGENT usaNo ponu Pnovioto HanswtTw. sTAnwo Pact AND DAT snipus=T ma es uaos.
SHAFER VALVE COMPANY IS AN EQUAL OPPORTUNITY EMPLOYEQ
.m m
Mu m n at * -
SHAFER VALVE COMPANY
- ~
R-122 QUARTERLY MANAGEMENT AUDIT (QMA)
ITEM COMMENT Facility Survey Quarterly Inventory Receipt & Disposal Records Calibration Records Utilization Log Dosimeter Log Film Badge Reports
(*) Personnel Evaluations 1
Y I
2 l
3 l
Corrective Action Required:
l C/A Disposition Accept Rej ect Date Chief Engineer l
Performed by:
Date Chiet Engineer Reviewed by:
Date Radiation Safety Officer
(*) (Comment on back if additional space is needed)
Individual's performance with regard to: (1) Documentation, (2) Applicable NRC Rules and Regulations, (3) SVCo l
Operating and Emergency Procedures.
SHAFER VALVE COMPANY R-117 QUARTERLY INVENTORY C
(To be performed by RS0)
SOURCE STORAGE CONTAINER
- ACTIVITY ISOTOPE
- SERIAL f
- LOCATION SERIAL f g
l t
\\
l l
l Performed By Date
r.A,--F.b.A-,s.
s 44,=
--,4.*AJ.
u,24 44h4deWJ44-We s Aa 4 4 m.s tr e 4 4
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5
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, ~ +.. ~, _.... _ _. _ _. _ _ _..... _. _ _ _
7 SilAFER VALVE COMPANY R-116 RADIOGRAPHIC DEVICE - QUARTERLY MAINTENANCE AND INSPECTION REPORT (To be performed by the Radiation Safety Officer)
Exposure Device Mfg & Model S/N Isotope Type Isotope S/N Activity (C1)
Date Inspected by INSPECTION COMMENTS Remove the exposure device from storage and note the survey meter readings Inspect the connectors on the exposure device and drive cable Lubricate the locking mechanism and check for proper operation jr,1P%a Clean the control cable as specified.*- A "-
in the procedure,-.
~ ~
.jgpn
~
Disassemble and clean the crank
- cv.s t
+
rnechanism and examine it for wear
~*.
4 g
~~
and chipped gears SUt pi Lightly grease and reassemble the crank machanism 3g
,..u Clean the drive cable guide; tube'.
- ~,'
P M as specified WW Lightly grease and install the. drive
- cable Clean the source guide tubes as s
i specified Check source outlet nipple and all l
tube connections for damage i
Examine the exposure device for proper labelling r
l Return the unit to storage and note the applicable information on the cxposure log Comments and/or repairs made or recommended Review of all characteristics on Form #R-115 - This date.
~
9 h,.
DOC W N0.-
Yb Ok$0 CONTROL NO. _ o7 7dW DATEOF D00.' 8 DATE RCVD. Ob O
[b TCUE-PDR ICAE_
LPOR -
c, I& E REF, f
SAFEGUARDS _
FCTCi OTHER DATEdI b INmAL
( '