atlantic coast laboratories, inc., termination request ... · from': atlantic coast...

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 Apr 29 2011 0232PM P1

() (hLltdlllal~ 1(0(1

ATLANTH COAST ~wrk Iklawu 1)711_Ilhomlor it~s [IH(lrp()rllt~ci ~()2-~flmiddot)121middot I~middotI S7211 (1lt1

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April 29 2011

Mr Steve Courtemanche US Nuclear Regulatory Commission Region 1 475 Allendale Road King of Prussia Pennsylvania 19406-1415 01017 raquo)

RE Termination of NRC License 07middot19404-01

Dear Mr Courtemanche

Per your telephone conversation this morning with Warren Van Arsdall we are requesting termination of our NRC license 07-19404~Ol All sealed sources used in the gas chromatographs are covered under a general license for Agilent (fonnerIy HewlettshyPackard)

The following items are enClosed at your request to aid in termination of the license

1 Copy of the last wipe test conducted on the sealed sources (electron capture detectors) currently in our possession under general license for Agilent

2 Copy of Acknowledgement of Receipt of Electron Capture Detector from Hewlettapackard for the electron capture detector in a model 5840 gas chromatograph

3 Copy of correspondence and Certificate of Disposition of Materials for the Varian electron capture detector contained in the Varian gas chromatograph

If you should have any questions or require additional information please contact Wanen Van Arsdall

Sincerely

Keith A Hausknecht President

Enclosures (3)

~--- --i

RECIO IN LAT APR 2 9 2011 J7SafS NMSSIRGN1 MATERIALSo02

fOcneral Corrll~pondcnceNRC Lictllle Tcrminalioll Requesl 04062011doc

-----------------------

------------------------- ------------------------

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 Apr 29 2011 0233PM P2 ~gt~(yf -if CH h~~ L r=rH ~lf~~gt f gt(~rt~lmiddotmiddot E jof

~IL TC 11lt Ir i rnt P O 80 ll~J(t 11 TJnvJf)klt IV Ill ~1

Phone 716 603-0550 FRX 71S-773-12G

OATE 121 lJ 2010

ciJs~rdMER NVl1~rR l Hlll ~ middot~r~ ~~ ~v~~i~ ~

fHLL1poundHmiddotmr1rrt)vmiddot ~

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M~~ll ATLANTIC CQA5TLRaS ATLANT I C COAST LAaS 630 CHURCHMAN ROAO 630 CHURCHMAN RORD NEWRRK DE 19702 NEWA~K)E 19102

- - --- - - ------------------- ----------------shy EXTENSION bull TOTAL DUE bull

bull DESCRIPTION QUANTITt PRICE

$5000 $20000NI -63 LEAK TEST --J

4

$000 $20000

--------~~-----------------bull LEAK TEST CERTIFICRTE ~

TEST METHOD DRY WIPENUMBER OF SAMPLES 12

~ADloNUtLIDEAS~DENTIFleD BVCUSTOMER IS NICtltEL-G3

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SjU1PLESiA~eN 8YCUSTOMER ANAL(SED BY L KEATING

------

TEST RESULTS ltIshy

--~---__----------

bull DEVICE I D SAMPLE I D laquo MICROCURIESSAMPLE bull PASSFAIL AgH ent sin FSB93 Entrance lt 14 x 1121pound-5 PASS

AgUent 5n F58ltj3 HOIIS i n9 lt 14 )( 10E-G PASS

~9j~el)t 51 ~S89~ i ~ Etltit if 1laquo 14 ~ 10pound ~ gt bull R~~S

Agi hnt sin U12784 Entrance lt 14 )( 10E-6 PASS

Agi lampnt 511 U12784 HOl~s i ng lt 14 )( 10pound-6 PASS

Agi lent sin U127e~ E)( it lt 14 ( 1121pound-6 PASS

Agilnt sIn U12654 Entlance lt 14 )( 1Q1E-1) PASS

Agilent sIn U12G54 Housing lt 14 10pound-6 PASS)I

AgHent sIn Ul~654 E)lit lt 104 gt 10pound-6 PASS

LIMIT IS 5000 )( 10pound-6 MICROCURIES PER DEVICE

----------~---------------------------------TESTED UNDER NYS DOL L I CENSE

DATE 12102010 SIGNED BY

PAGE 1 OF 2

FROM ATLANTIC COAST LABORATORIES PHONE NO 30~~4548720 Apr 29 2011 0233PM P3

~ TEST RESU TS A llt

~ ~ nEI t CE 1 D yen 5A~1PLE D MICROCURIESSAMPLE PASSFALl

HP an F7B0lt Entrance lt 14 x 10E-6 P~~SS

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LIMlT I S0~0 x lrt1E-6 MICROCUfHES PER DEVICE - - - - - -~ - -- -- - - - - - - - - - - - - - - - --7 - -- - --- - - - - - -- - - - - ~ - - - - -- - _~ -- - ~

TESTED UNDER NVS OOL L[C~NSE

DATE 12t02010 SIGNED BV

PAGE 2 OF 2


FliJi HEWLETT 1 PACKARD-

mpoundmiddot D~ Aid 1) JllfnL t

Jj~nSBN Lahs ~30 ChLlRCbmAclS 1d New8~K n~l 1470~

I

Re Acknowledgment of Receipt of Electron Capture Detector

Dear Customer

This is to acknowledge that Electron Capture Detector(s) Serial Number(s)

were received on a - 9 _ 9 Lj and are in possession ofthe

Hewlett-Packard Company Wilmington DE USA

Sincerely yours

middot~middot~r HEWLETT~PACKARD COMPANY

NRC License No 07-28762-01

___


913024536986 P02DEC-05-1994 1644 FROM TO

2 Fer lew purehoas8 mall tllls f UI yQr IOlt(lJ tIreu-aoltarlil liales Cffic

3 For returrl8 for eXchampII4IJServicinO of uted detectOrs Gee section C reVsr slda --I CIJSTOMeP- INFOAMATION

COMPANY_AC~SfJ ~r t) CUSTOMER NAMe PoJette ~ifv_ CUSiOMERPONO __________________________ADCFESS $0 dVccbampU tl

YtHM-S 0 t l~-Vj iliEwtSTTPACKARO SALES OI=FfCE_-=i~+~ltii-~n=-j_~_

HEWlliTT-PACKARC SAI-ES ORDER NO______-- shyTEIPHONI NO 321- ~ pound)- b9a-o

YA~ STATUS TAlAeLG C SXMFT a

a LICENSE VSRIFICA TION - Falltre o oomply with lieensj~g roquiremfntamp can causa serious ecn~QUeeos for Yol1r Ilompall) and for Hewlett-Packard Havin9 a C1vsiil111ted lie$rlsee read and complete ~ha ~pRcable CEtnifiClltlon statemem (s~aciflCt IIeStl$(I below geMrallicens~ on reverse sidtil) Will servft ali _A _- 1t~~~or~~ ~tiat ted ~

SPECIFIC LICENSE CeRTlFlC ~bull~~~-- ~~ -~ii~~ The NuQI~ar ~eOuratClry Comr ~$tyCPJ _OItltltd to havtion file veri fvoiir- NRC He-ant (01 State Ifcan$e If you liva in ltif( araquo ycio bullbullotor Tr14 Iierrlill rnct be current and It mlot gpply to th lYfJEJ quan( f i)t)4- bull -referenced order (Sat CfF Title 10 and N~C form 213 and R~guatory Quid CO

f

TI14$ I to e~~at our NRC J if ent ltlnd l)e1llts loll to receiv~ the type QUAntity and form of radioatlte matenals I ~ middot~i~3 Ilow lliew DEtECTOR

I OTv )CJ(T-D PlmCHASE eXCHANGE SERIAL NO

HI 19235 eC Oetectcr IV ffl1 NI o-platad pan for USB ~ 0 D -- HP 58S0A Seriejt ~~ ehromatorll)ho

HP18113A e Detector 15 mor Ni 8l-platscS Part for use 01 -~ IofP 41QQ and HP 5790 Serfes Gai Chmmatogral)l9 o

I I-fcwft-la~1rAIrd EC Deteeor tlIrt nflmbor teaOS-60S20 - Hi mOi Ni3-plalec1 part for Ie on HP S830S114C Series

Gas Chromatographs o KP 19303 EC Ctettor 1$ mel Ni 63-plottd part tor usa on

- HPSeaO Serrell Galt e~~tOQaph bull

_ KP 181425 Accassol) fe conyerting 9t11ffal ~ee$e cCo fHP 9212) to specifiC-Ifce~e (11 1ell3A) - ~

_HP1S3f3 AccenolY for convettlng general Hcanst ECO (HP 11312) to speClfic Ies (Jw4p 19~03J

_ HP19235D Acoencrv for covrtinA General Il~ense (liP lIuea lv speojflc J(G~H (rtP 1S23Sj o

_ HP ~co Dt~r no G1224A 15 mel for U$e on HI saao Series Clair ChrOmatograp~ o

IICENSSNUMBIlA 7- (110(-0 r f( 0 L1CfNSigt 1J5liR

ISSUING AaeNCY---_J~~L__~______

EXPIRATION OATS ~ tdertJ tb [)ATE___---L~I_I_-~_--____


niln lahNltncics Inc (~i Chuchll)lll Road

middotpmiddot~rk J)(iwJrI Iv7Dl

I i (~[ bull l)(ilt~~middot FX

~61996

us Nuclear Regulatory Commission Director of Nuclear Material Safety and Safeguards 475 Allendale Road King of Prussia Pennsylvania 19406

RE Transfer of Electron Capture Detector

Dear Sir

This letter is being submitted in response to the letter received from Dr Tim Borges dated July 3 1996 Dr Borges letter was sent to me in reference to the return of an electron capture detector to Varian Chromatography Systems on 1596

The report required by 10 CFR 31S(c)(B) was not submitted within the thirty (30) day peri~d The report was filed before I was able to submit it to your office I have enclosed the aforementioned report and also a copy of the leak test performed by Varian Chromatography Systems

I apologize for the delay in forwarding this report to your office Future reports concerning the transfer of electron capture detectors will be submitted in a timely manner

If you should have any questions or require additional information please contact me at (302) 453-6920

Warren Van Arsdall Laboratory Operatrons Manager

enclosures

A suhsidiary of rtcsi1n Resources Corporation

FROM ATLANTIC COAST LABORATORIES PHONE NO 31212454872121 Apr 29 212111 1Zl236PM P7

OAK RIDGE NATIONAL LASORATORY HMitir Sdet1CilR ReSIINJrch DivisiM MANAGED BV LOCKHEED MARTIN eNe~GVAESEAACH CORPORATION PHONE (423)574-6425 FOR THE US OEPRTMeNT OF ENERGY FAX (423) 674middotgesa

EmiddotMAIL H18Ornlgov 1Q6Q COMMERCE PARK OAK RIDGE TN 37930

July 31996

ARTESIAN LABS ATTN RADIATION SAFETY OFFICER 630 OnrRCliMANS ROAD NEWARK DE 19702

ELBCTRON CAPTURE DEVICE RETURNED TO VARIAN CHROMATOGRAPHY SYSTEMS ON 115196 SERIAL NO A707

Our office walks with the N1CJear ReguIattuy COlllmission in recording information from material trarisf~ reports Concerning your general domestic license for byproduct material issued pursuant to 10 CFR 315 the following discrepancies were found

You are required to submit a report within 30 days ofthe transfer ofa device containing byproduct material to a specific licensee The report is required by 10 CFR 315(c)(8) which states Except as provided in Plllapph (c)(9) ofdUs section shall transfer or dispose of the device containing byproduct material only by transfer to a person holdine a specific license pursuant to paris 30 and 32 ofthis chapter or from an Agreement State to receive the device and within 30 days after transfer ofa device to a specific licensee shall furnish to the Director of Nuclear Material Safety and Safeguards US Nuclear Regulatory Commission WlI$hington DC 20555 a report containing identification althe device by manufactUrers name and model number and the name and address ofthe person receiving the device No report is rCquired ifthe device is transferred to the specific licensee in order to obtain a replacement device We have notified the Director ofNuclear Material Safety and Safeguards (NMSS) US Nuclear Regulatory Commission (NRC) that this report bas not been submitted Please submit a report in accordance with 10 CFR 315(c)(8) and also send a letter ofexplanation to the Director ofNMSS

You are required to submit a report within 30 days ofthe transfer ofa device contaming bYllroduct material to another general licensee This report is required by to CFR 315(0)(9) which states shall transfer the device to another general licoRiee only (i) Where the device remains in use at a particular location In such case the transferor shall give the transferee a coPy ofthis section and any safety documents identified in the label ofthe device and within 30 days ofthe tranSfer report to the Director of Nuclear Material Safety and Safeguards US Nuclear Regulatory Commission Washington DC 20555 the manufacturers name and model number ofdevice transferred the name and address ofthe transferee and the name andor position ofan individual who may constitute a point ofcontact betlveen the Commission and the transferee or (ji) Where the device is beld in storage in the original shipping container at its intended location of use priorto initial use by a general licensee We have notified the Director of Nuclear Material Safety and Safeguards (NMSS) us Nuclear Regulatory Commission (NRC) that this report has not been submitted Please submit a report in accordance with 10 CFR 315(0)(9) and also send a letter ofexplanation to the Director ofNMSS

Sincerely

Tim Borges PhD

cc Director ofNuclear Material Safety and Safeguards US Nuclear RegulatorY Commission

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 t_

US uCteAR R~GULATORV COMMISSIONNile POliN 314 16891 fa CIR 3036141 11 11M 10 CFR ~bullbull21(1)(1HNI 10 ClA 70JlI(IJllIl(lvl CEPTlFCATE OF OlSPOS1TION OF MATERIALS

(All hem MIJSTIx compififrClt$shyINSTRUCTIONS SEND THIi COMPleTlO CERTIFICATe TO THE NRC OltFIcamp SPCIFIEO ON THe aeVEASe print OfyptI

LicENSEE iliA ME AND ADDRESS

ARTESIAN LABS 630 CH(lRCBMANS aD NEWARK DE 19702

Apr 29 2011 0236PM P8

AlPIOVIlO tV 01048 3ISltlmiddotOn~ xPUHOS 413092

esTuIATiiD QVflOEJII PIlR flllSIONSE TO COMnv WITH THtS INFOfIMATION COIIECTION REQuEST $ HRS ~OAWAg COMMENTS luaaRDING OIROEfN eSTIMATE TO THE RECOIIDS ANO RIiPORTS MANAGEAlEtOT IiRANCH IPS30I US NtlCLiAA RIGUIATORV COIAMIS SlOlll WII$HINGTONOC ~ AND TO THe PAPERWORK ReCUCIIOM PROJECT 1l16Q(IQltlel DF~leE OF M NACmiddot MErtT ANO BUOGlT WASI(INiZTON oe OU

LICeNSS NUMB~R

07 -90- f) j

LICENSIO eXllAATION DATE

~I~()tJl

THe LlCENseSOR ANY INDIVIDUAL iixeCUTING THIS CSRTIFICATE ON BIiHAIF Ot THE LICENSes CERTIIIESTMAT fCIuJtr 1M 1IOMIJtIbullbull elf1(J101iH _oJ ~I DON DAPOLITO

A MATERIALS DATA (ChlaquoJlttJllud~mpJIltIlJ~J

W t NO MATEAIALS HAVE evER aeeN IAOCURiD Of fgtOSSlisseo BY nn lceNSEE UNOpoundR THIS LICENSE

OR The described mx I GENERAL LICENSEE ~ t ALI MATERIALS PROCURED ANDIOR gtO$ESSEio BY THIi IICENSEE UN)ER YHE LICENSi NUMBER CITeD A80VE HAVe BEEN Dlsposeo OF

IN THE POl10WING MANNIIt IIIlIdditiOItt _I~ U2 1M _1St ltItt Mil_

Sh~gg~ to VARIAN CHROMA1g~RAPHY ~YSTEMS dmiddot nd d peeilie mltter1 ttansfar 1110 i bull I e wlaquore fa IO~fle arn gcnetsd 1ft rermlnallng thll hctnse the POlll iClIOIY I U IlIg lfte di$PO(irion of low-level nJdioaetllll wme mixed WIIStc GrHtermiddotthinmiddotCIC llSU afld seallld $Ources jf aDpliQbl~

GAS CHROMATOGRAPH ELECTRON CAPTURE DETECTOR PIN 02-001972-00 SIN A707

RA9J~rtlilirI~~ Ih~~~h~e 9hfer N19JlJi1the ~~~ red 61( the IlIclgti~ntmiddot NAC lceISl nllnltlef Of Agreement $fle ~Imamp aM UCfnse lumber

DATE 1-5-96 VARIAN LICENSE 0256-07 (CALIFORNIA) IIlNttrjal~ were d~ed of dircctlv by t~e licen ramptIItt lhan umltlerrel 10 ~olher Ijcen lieftlold disposal site or ute cont~~tor de$Crille tile sl)eeific ilislIIOsal llIoccdWII$ (~ dtICIIV ~ 1

STORED AT VARIAN CHROMATOGRAPHY SYSTEMS 2700 MITCHELL DRgt RAlNOT CREEK t CA 94598 DUfJamp 1~1f Q~QJnn

B OTHER OATA I bull

U t OUR UCiNSe HAS NOT YET EXPIREOPLeA$E TERMINATE IT

2 WAS It RAOiATION SURViY CONDUCTiO TO CONtIAM TME A9SliNCS OF LICENSED RAtllOACTIVE MATeRIAIS AND TO OETEIIMINE WHETHER ANYCONTAMINATION REMAINS ON THE PREMISES COViREo fII THE LICeNSE (~laquok 1

~ NO (Att_ 10111 xx Eli THE ReSULTS fCoKItOIl1

~AR6 ATTACHEO til

middotWE1Umiddot FORWARoeD TO NRC ON (JUlJ

3 THe peRSON TO IlIi CONTACTEO REGARDING THE INfORMATION PROVIDEO ON THIS FORM gtlAMI

Larrv Steinwandt Radiation Sapound~ty Officer 4 MAIL ALI t=U1URe COAAesPOND~NCS REGA$lOING THIS liCENSE TO

CERTIFYING O=~ICIAL

CERTIFY UNDER PENALTY OF PERJURY THAT THE FOFtEGDrNG IS TRUE AND

S1CATUAE

1L ~ 1gt

IIIINTEO NAME AIIIt) TITIV

Larry Steinwandt Radiation Safety Officer

JITIiiLEPIltOlllt NUMB~A

(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S

WARNING FALSE STATEMENTS IN THIS CERilFICATE MAY BE SUBJECT TO CIVIL ANOOR CRIM(NA~ PENALTIES NRC ReGULATIONS ReQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAl RESPECTS 18 USc SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE STATeMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY Or THE UNITED STATes AS TO ANY MAlTeR WITHIN ITS JUFUSOICTlON

I

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 Apr 29 2011 02 37Pt1 P9

IMPORTANT DOCUMENT

Keep this certificate and future leak test records for display on request by an inspecting radiation official Failure to supply records may result in a citation suspension of your license andor a fine

CERTIFICATE OF LEAK TEST

The Electron Capture Det$CtOr (ECD) indicated below has been surveyed for external radioactive contamination as indicated in the 63Ni Radiation Safety Manual Publication 03-91399~OO paragraph 3

Isotope ANi

ModeJ No 02-ro1l112l-ltO Serial No ft 707 cell NO __~___

The r~movable radioactivity from the surface of this ECD ceU was measured to be

00001 microcuries

NOTE Varian Chromatography Systems is required by the Us NRC and the C8fifomia Depanrne~ of Health to inform you that the 83Ni ECC must be leak tested every 36 months

The California Department of Heaithmiddot Radiation Authority has granted an extension of the time required be~een leak fests (for Varian ECDs) from the standard 6 month interval to a 36 month interval Per Registry of Radioactive Sealed Sources and Devices Safety Eva uation of Devicesmiddot Number CA662D101B which is on file with aU radiation authorities

~L~middot larry Steinwandt bull Radiation Safety Officer Yerian Chromatography Systemsmiddot 2700 MitcheU Olive Walnut Creek CA 94598-1675

03-913999-021 spec 03middot91441100 10f1 tZJ4

FROM ATLANT I C COAST LABORATOR I ES PHONE NObull 3024548720 Apr 29 2011 0237PM P10

r-~=--~---~-lll I NRC FORM 374 PACE _1_ OF _3_ PAGES

US NUCLEAR REGULATO~Y COMMISSION Amendment No 6

MATERIALS LICENSE

Pursuant to the Atomic Energy Act of 1954 as amended the Energy Reorganization Act of 1974 (Public Law 93-438) and Title 10 Code of Federal Regulations Chapter I Parts 30 31 32 33 34 35 36 39 40 and 70 and in reliance on statements and representations heretofore made by the licensee a license is hereby issued authorizing the licensee to receive acquire possess and transfer byproduct source and speaal nuclear material designated below to use such material for the purpose(s) and at the place(s) designated below 10 deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s) This license shall be deemed to coltain the conditions specified in Section 1a~ of the Atomic Energy Act of 1954 as amended and is subject to all applieable rules regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions speCified below

Licensee In accordance with current NRC Policy

1 Atlantic Coast Laboratories Inc 3 License number 07-19404-01 is administratively aro~nded in its entirety to read as follows ~- ~

2 630 Church mans Road 4 Expiratioh4tftApriI30 2011 ~

Newark Delaware 19702 5 Docket No 03Cf1J555 ]

Reference No gt~~ 1shy

wi

6 Byproduct source andor sp-ectal 7 ChemIcal andofphysical form a mum amount that licensee may nuclear material at anyone time under this

r~~~

A e Nickel63 A 7~illicunestotal and no A~~~~~~~l~~~~ scm1ce to exceed limit on SSD

NUGI~ar Regulatory ~ficate Ii~()mmission under 10 CFR

iti~g21 a9r with an Ag~emeht (State bullbull

r 1

9 Authorized use i~

A To be use~ for sample analysis in comp~tibl~~fJas ~rroll)~~tog~phY devices that have been registered either with the US Nuclear Regulatory Commissiori under 10 CFR 32210 or with an Agreement State and have been distributed in accordance with a Commission or Agreement State specific license authorizing distribution to perSons specifically authorized by a Commission or Agreement State license to receive possess and use the devices

CONDITIONS

10 Licensedmaterial may be used or stored only at the licensees facilities located at 630 Churchmans Road Newark Delaytare

11 A Licensed material shall be used by or under the supervision of Warren Van Arsdall Don DApolito and Tom Amao

B The Radiation Safety Officer for this license is Warren Van Arsdall

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 Apr 29 2011 0238PM Pi1

NRC FORM 374A PA~ 2 Or 3 PA~S

I UC~T$e Number 07-19404-01

MATERIALS LICENSE SUPPLEMENTARY SHEET

OoCket or ReferencE Number

030-17555

Amendment NO6

12 Maintenance repair cleaning replacement and disposal of foils contained in detector cells shall be performed only by the device manufacturer or other persons specifically authorized by the US Nuclear Regulatory Commission or an Agreement State to perform such services

13 Sealed sources or detector cells containing licensed material shall not be opened orsources removed from source holders by the licensee i~ ~

~lt j

14 A Sealed sources shall be tst~df6r leakage and()r corithriijnEl~on at intervals not to exceed six months or at the interva~SPecifjed in the certificate of regis1(8tjQn issued by the US Nuclear Regulatory CommissiOjunder 10 CFR 32210 or under equival~n regulations of an Agreement St t ~laa A

t ~I bull i $ f J

B In the absence Q~~ certifi9ate from a transferor indicatingth~t a leamst has b(en made within the intervaJs specifi~in the celtificate~f registration issued by the US ~ldclear Regulatory Commission Ulder 10 CFRmiddotmiddot32210 or under equivaleAt regulations of-an Agreement State prior to the transfer a y1ialed source)eceived from alother persoh shall not qitput into use until tested and the test re~nJlts receivedmiddot ~~I

~J ~gtmiddotmiddotfmiddot gt ~

c Sealed source~ n~ed nCcentt ~~~d if tti~yi~~fkstorageand are noet~ing used however when they are remov~om st bull middot Jo(use or transferred to an0ther person and have not been tested within the requir~reak te~~~~t~rvall they shall b~ test~dbeore uslor transfer No sealed source shall be stored for ~Periodtifliiorethan 1p yearS Witlout being teSed for leakage andlor contamination ~

i ft ) ~ ~~J_ ~J

D The Ieak test shall be clpable of detectingfhe presence of dd05 microcurie (185 becquerels) of radioactive material on the test$~mpl~ If the te~t re~fl~ls the presence 0(0005 microcurie (185 becquerels) or more of removaifjl~ cor~miMtiori a report shall be filed with the US Nuclear R~gulatory Commission in accordance with 10 CFR 30S0c)(2) and the source shall be removed immediately from service and decontaminated repaired or disposed of in accordance with Commission regulations

E Tests for leakage andlor contamination limited to leak test sample collection shall be performed by the licensee or by other persons specifically licensed by the US Nuclear Regulatory Commission or an Agreement State to perform such services The licensee is not authorized to perform the analysis analysis Qf leak test samples must be performed by persons specifically licensed by US Nuclear Regulatory Commission or an Agreement State to perform such servic~s

F Records of leak test results shall be kept in units of microcurles and shall be maintained for 5 years

15 The licensee shall conducta physical inventory every six months or at other intervals approved by the US Nuclear Regulatory Commission to account for all sources andor devices received and possessed under the license Records of inventories shall be maintained for 5 years from the date of each inventory and shall include the radionuclides quantities manufacturers name and model numbers and the date of the inventory

FROM ATLANTIC COAST LABORATORIES PHONE NO 30~14548720 Apr 29 2011 0239PM P12

NRC FORM 374A PAGE 3 OF 3 PAGES

License Number 07~19404~01


Docket or Reference Number 030-17555

Amendment No6

16 The licensee is authorized to transport licensed material in accordance with the provisions of 10 CFR Part 71 Packaging and Transportation of Radioactive Material

17 Except as speeifically provided otherwi~e in this license the licensee shall conduct its program in accordance with~e statements repre~e9ta~q~siaptp~p~edures O~tained in th~ documents including any enclosures listed below The ~J~NUelear Regutatary ~prpmISSlons regulations shall govern unless the statements represel)teUampns and procedures in tne f~~sees application and correspondence are more r8tifrjc(iv~ lh4UI lh~ ~Julclil)f1middot

NI gt1 ~

A Application dated ~a~~~ 19 2001 (ML010320306) ~o B Letter dated April ~~001 (ML011 000061) gtr-l~

~

~

For the US Nuclear Regulatory Commission

Date ~_--MaYL=62010______ By Dennis R Lawyer Commercial and RampD Branch Division of Nuclear MatenalsSafety Region J King of Prussia Pennsylvania 19406

Thursday May 62010124812

This is to acknowledge the receipt of your letterapplication dated

--~f0L-_t_t(-tltgt=-~__-- and to inform you that the initial processing which includes an administrative review has been perflgtrmed

- [6 t (jJJ f-tcltgt 0 7 -V-oy -01 ~There were no administrative omissions Your application was assigned to a

technical reviewer Please note that the technical review may identify additional omissions or require additional information

o Please provide to this office within 30 days of your receipt of this card

A copy of your action has been forwarded to our license Fee amp Accounts Receivable Branch who will contact you separately if there is a fee issue involved

Your action has been assigned Mail Control Number 57gt 0 yg When calling to inquire about this action please refer to this control number You may call us on (610) 337middot5398 or 337middot5260

NRC FORM 532 (RI) Sincerely (6-96) Licensing Assistance Team Leader

-----------------------

------------------------- ------------------------

FROM ATLANTIC COAST LABORATORIES PHONE NO 3024548720 Apr 29 2011 0233PM P2 ~gt~(yf -if CH h~~ L r=rH ~lf~~gt f gt(~rt~lmiddotmiddot E jof

~IL TC 11lt Ir i rnt P O 80 ll~J(t 11 TJnvJf)klt IV Ill ~1

Phone 716 603-0550 FRX 71S-773-12G

OATE 121 lJ 2010

ciJs~rdMER NVl1~rR l Hlll ~ middot~r~ ~~ ~v~~i~ ~

fHLL1poundHmiddotmr1rrt)vmiddot ~

A~CrS P~VAgL~

M~~ll ATLANTIC CQA5TLRaS ATLANT I C COAST LAaS 630 CHURCHMAN ROAO 630 CHURCHMAN RORD NEWRRK DE 19702 NEWA~K)E 19102

- - --- - - ------------------- ----------------shy EXTENSION bull TOTAL DUE bull

bull DESCRIPTION QUANTITt PRICE

$5000 $20000NI -63 LEAK TEST --J

4

$000 $20000

--------~~-----------------bull LEAK TEST CERTIFICRTE ~

TEST METHOD DRY WIPENUMBER OF SAMPLES 12

~ADloNUtLIDEAS~DENTIFleD BVCUSTOMER IS NICtltEL-G3

middot~V$SDmiddotmiddotmiddot~RBT iOpq)$l~AT~bN USING WINDOWLESS PROPORTloN~L couNtER

SjU1PLESiA~eN 8YCUSTOMER ANAL(SED BY L KEATING

------

TEST RESULTS ltIshy

--~---__----------

bull DEVICE I D SAMPLE I D laquo MICROCURIESSAMPLE bull PASSFAIL AgH ent sin FSB93 Entrance lt 14 x 1121pound-5 PASS

AgUent 5n F58ltj3 HOIIS i n9 lt 14 )( 10E-G PASS

~9j~el)t 51 ~S89~ i ~ Etltit if 1laquo 14 ~ 10pound ~ gt bull R~~S

Agi hnt sin U12784 Entrance lt 14 )( 10E-6 PASS

Agi lampnt 511 U12784 HOl~s i ng lt 14 )( 10pound-6 PASS

Agi lent sin U127e~ E)( it lt 14 ( 1121pound-6 PASS

Agilnt sIn U12654 Entlance lt 14 )( 1Q1E-1) PASS

Agilent sIn U12G54 Housing lt 14 10pound-6 PASS)I

AgHent sIn Ul~654 E)lit lt 104 gt 10pound-6 PASS

LIMIT IS 5000 )( 10pound-6 MICROCURIES PER DEVICE

----------~---------------------------------TESTED UNDER NYS DOL L I CENSE

DATE 12102010 SIGNED BY

PAGE 1 OF 2






bull =

gt~~~l~~ ~ t




PAGE 2 OF 2





I


Dear Customer




Sincerely yours



___


913024536986 P02DEC-05-1994 1644 FROM TO









f



















~61996



Dear Sir






enclosures





July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~

















bull =

gt~~~l~~ ~ t




PAGE 2 OF 2





I


Dear Customer




Sincerely yours



___


913024536986 P02DEC-05-1994 1644 FROM TO









f



















~61996



Dear Sir






enclosures





July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~
















I


Dear Customer




Sincerely yours



___


913024536986 P02DEC-05-1994 1644 FROM TO









f



















~61996



Dear Sir






enclosures





July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~












___


913024536986 P02DEC-05-1994 1644 FROM TO









f



















~61996



Dear Sir






enclosures





July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~
















~61996



Dear Sir






enclosures





July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~















July 31996






Sincerely

Tim Borges PhD







Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~

















Apr 29 2011 0236PM P8



LICeNSS NUMB~R

07 -90- f) j


~I~()tJl











B OTHER OATA I bull




~AR6 ATTACHEO til




CERTIFYING O=~ICIAL


S1CATUAE

1L ~ 1gt




(510) 9392400 I j I I J

CORRECT

1deggtTE -j- 7S


I


IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~













IMPORTANT DOCUMENT




Isotope ANi



00001 microcuries




03-913999-021 spec 03middot91441100 10f1 tZJ4




MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~















MATERIALS LICENSE







wi


r~~~




r 1

9 Authorized use i~


CONDITIONS









030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~

















030-17555

Amendment NO6



~lt j


t ~I bull i $ f J




i ft ) ~ ~~J_ ~J










Amendment No6



NI gt1 ~


~

~

















Amendment No6



NI gt1 ~


~

~












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