New Philips Medical Systems (Cleveland) Inc., Termination Request … · 2019. 12. 22. · IPL...

PHI LI PS Philips Medical Systems

June 5,2007 N m - d t

Licensing Assistance Section Nuclear Medicine Safety Branch Division of Radiation Safety and Safetguards U.S. Nuclear Regulatory Commission, Region I 475 Allendale Road King of Prussia, PA 19406-1 41 5

RE: License Number: 3d-31170-01

Philips Medical Systems Termination of License & Close Out Survey

7 L’if 3+ $03

Amendment Request ‘W

Dear License Reviewer:

We request the above referenced byproduct material license be terminated. A “Close-Out Survey” of the vacated hot lab was completed on May 25,2007. Summary results reveals that ambient exposure rates and removable contamination results were measured at background radiation levels. Please refer to the Attachment Section for details.

Radioactive waste was allowed to decay for ten half lives and monitored at the time of disposal.

Sealed sources used for instrument calibration were transferred to our corporate facility located in Cleveland, Ohio. The Sealed Source Inventory and last leak test report has been enclosed in the sleeve section of this report. Please refer to this section for details.

If you have additional questions, please contact me.

We thank you in advance for your assistance with this licensing request.

S inye ly , ,,(

Gjegory Breznai Radiation Safety Officer Philips Medical Systems 595 Miner Road Highland Heights, OH 44143 (440) 483-2222

Philips Medical Systems (Cleveland), Inc. 595 Miner Road Cleveland, OH 44 I43 Tel: (440) 483 3000

w 0

/+o 62-1

NMSS/RGN 1 MATER I ALS-002 . ,

w.medical.philips.com

http://w.medical.philips.com

Attachment A

SEALED SOURCE INVENTORY

FACILITY: Philips Medical Systems

LOCATION: Philadelphia, PA

Nuclide:

Type:

Location:

Assay: (Date)

Mgr:

Serial No.:

Model:

Cs-137

Vial

Hot Lab

204.1 uCi 1 1 IO 1 12002

I PL (Syncor)

935-62-6

RV-137.20011

CS-I 37

Rod

Hot Lab

5.0 mCi 10102/2002

IPL

CZ-290

HEG-0096

CS-137

Rod

Hot Lab

20.0 rnCi 0311 512001

IPL

CZ-714

HEG-137-M

CS-1 37

Rod

Hot Lab

5.0 mCi 611 12000

IPL

DEPARTMENT: PET Facility

CZ-186

cs-137

Rod

Hot Lab

.500 uCi 0611 12003

IPL

780-1 6-44

GF-0008

Cs-137

Rod

Hot Lab

5.0 rnCi 02/01/2001

IPL

CZ-172

HEG-0096

c s - I 37

Rod

Hot Lab

10 mCi 08/01 /04

IPL

89-033

DATE

1211 9/05 X X X X X X X

05/03/06 X X X X X X X

9/01 106 X X X X X X X

12/5/06 X X X X X X X

03/06/07 X B X E X B B

05/25/07 B B Y B B B B

X - INDICATES SOURCE INVENTORIED A - Returned for disposal B - Sent to Phillips Cleveland on 3/5/2007

RSO Signature

* See Report

12

992




Nuclide:

Type:

Location:

Assay: (Date)

Mgr:

Serial No.:

Model:

DATE

1211 9/05

05/03/06

09/01 106

12/5/06

03/06/07

05/25/07

Na-22

Disc

Hot Lab

0.10 mCi 02/01 I2001

IPL

747-7-8

GF-0227

X

X

X

X

X

B

Na-22

Disc

Hot Lab

0.10 mCi 05/01 12002

IPL

730-92-30

GF-0227

Na-22

Disc

Hot Lab

0.10 mCi 05/01 12002

IPL

730-92-29

GF-0227


Na-22

Disc

Hot Lab

0.10 mCi 01 11 812001

IPL

7 4 7 - 7 - 5

GF-0227

Na-22

Disc

Hot Lab

0.10 rnCi 12/01 12000

IPL

730-20-9

GF-0227

X - INDICATES SOURCE INVENTORIED A - Returned to Manufacturer B - Sent to Cleveland Office

RSO Signature

Na-22

Disc

Hot Lab

100 uCi 1 1 I01 12000

IPL

730-20-5

GF-0227

Na-22

Disc

Hot Lab

100 uCi 08/01 12000

IPL

730-3

GF-0227

* See Report 992

13


FACILITY: Philips Medical Systems DEPARTMENT: PET Facility


Nuclide:

Type:

Location:

Assay: (Date1

Mgr:

Serial No.:

Model:

DATE

1211 9/05

05/03/06

09/01 106

12/5/06

03106l0 7

Ge-68

Cylinder

Hot Lab

0.75 rnCi 07/10/2001

IPL

730-50-01

EG-0310

X

X

X

X

X

05/25/07 B

Ge-68

Rod

Hot Lab

10.0 mCi 0 1 12712000

I PL

RR-450

HEG-0108

Ge-68

Rod

Hot Lab

7.0 rnCi 12/01 I2003

I PL

84-763

___.

Ge-68

Rod

Hot Lab

5.0 rnCi 03/01 I1 996

IPL

FF-942

...-

X B X

X B X

X - INDICATES SOURCE INVENTORIED A - Returned to Manufacturer B. Sent to Cleveland offices

Ge-68 Ge-68 Ge-68

Rod Rod Rod

Hot Lab Hot Lab Hot Lab

5.0 mCi 5.0 mCi 5.0 mCi 0211 611 990 0210311 994 1 111 511 991

I PL I PL IPL

30R 2379 R-553

_ _ _ _ ___. ....

X X X

X X X

X X X

X X X

X X X

E B B

Ge-68

Rod

Hot Lab

10.0 mCi 0711 1120 0 1

IPL

22-992

.___

X

X

RSO Signature

* See Report 992

14





Nuclide:

Type:

Location:

Assay: (Date)

CO-57

Point Marker

Hot Lab

90.3 uCi 09/30/1993

Na-22

Button

Hot Lab

100 uCi 03/01 I2000

Na-22

Button

Hot Lab

100 uCi 0711 511 999

Na-22

Button

Hot Lab

20 uCi 1011 4/04

Na-22

Button

Hot Lab

100 uCi 05/01 I06

Cs-137

Rod

Hot Lab

1 0 mCi 08/01 I04

Mgr: Med-Phvs IPL IPL I PL IPL IPL

Serial No.:

Model:

OK346 567-93 61 4-87 1053-24 1142-74

D2886

89-033

DATE

05/03/06 X

09/01/06 X

12/5/06 C

03/06/07 C

05/25/07 C

X - INDICATES SOURCE INVENTORIED A - Sent to Penn 211 412007 - 2/26/07 B - Sent to Cleveland office C - Disposed As Normal Trash

RSO Signature

* See Report 992

15

MEDICAL PHYSICS SURVEY SEALED SOURCE LEAK TEST ANALYSIS REPORT


LOCATION: Philadelphia, PA Gregory M. Breznai, RSO

Analysis of the WIPE used to conduct a leak test on the sealed sources identified below was performed by gas or scintillation detection and reveals removable contamination was less than 0.001 uCi, unless otherwise noted, when compared against NIST traceable standards.

Source: 6 1 3 7 , Vial; 204.1 uCi on 11/01/2002; IPL S/N: 935-62-6; RV-137-200U

Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/27/07

Wipe No.: PM127 PM 166 PM191 PM278 PM369

MDA (uCil: 5.6E-5 5.6E-5 5.6E-5 5.6E-5 5.6E-5

Net CPM: 7 29 6 25 16

Net uCi: < MDA < MDA < MDA < MDA < MDA

CPM for 0.001 uCi: 236 236 236 236 236

Analyst: M. Lairmore M. Lairmore M. Lairmore M. Lairmore M. Lairmore

Source: Cs- 137 Rod, 5.0 mCi on 10/02/2002, IPL, S/N: CZ-290; Model #HEG-O096

Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/2 7/07

Wipe No.: PM128 PM168 PM192 PM279 PM368

MDA luCil: 5.6E-5 5.6E-5 5.6E-5 5.6E-5 5.6E-5

Net CPM: 9 29 22 7 18

Net uCi: < MDA < MDA < MDA <MDA < MDA

CPM for 0.001 uCi: 236 236 236 236 236


Source: Cs-137, 20.0 mCi on 03/15/2001; IPL; S/N: XX-714; Model #: HEG-137-M

Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/2 7/0 7

Wipe No.: PM129 PM 169 PM193 PM280 PM367

MDA (uCil: 5.6E-5 5.6E-5 5.6E-5 5.6E-5 5.6E-5

Net CPM: 27 16 1 7 16 10


CPM for 0.00 1 uCi: 236 236 236 236 236


RSO Signature

* See Report

16

992



LOCATION: Philadelphia, PA Gregory M. Breznai, RSO

Analysis of the WIPE used to conduct a leak test on the sealed sources identified below was performed by gas or scintillation detection and reveds removable contamination was less than 0.001 uCi, unless otherwise noted, when compared against NIS T traceable standards.

Source: Cs-137, Rod; 5.0 mCi on 6/1/2000; IPL SIN: CZ-186 Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/2 7/0 7

Wipe No. : PM130 PM170 PM195 PM283 PM336

MDA luCil: 5.6E-5 5.6E-5 5.6E-5 5.6E-5 5.6E-5

Net CPM: 38 22 8 17 7


CPM for 0.001 uCi: 236 236 236 236 236

Analyst M. Lairmore M. Lairmore M. Lairmore M. Lairmore M. Lairmore

Source: C s

Date:

Wipe No. :

MDA (uCil:

Net CPM:

Net uCi:

CPM for 0.00 1 uCi:

Analyst:

.I37 Rod, 5.0 mCi on 02/0 1/200 I ; 12/19/05 05/03/06 09/0 1/06

PM132 PM 1 72 PM197

5.6E-5 5.6E-5 5.6E-5

27 16 7

< MDA < MDA < MDA

236 236 236

M. Lairmore M. Lairmore M. Lairmore

IPL; S/N: CZ- 172; Model #I HEG-0096

12/5/06 03/2 7/07

PM285 PM334

5.6E-5 I . 7OE-5

29 9

< MDA < MDA

236 297

M. Lairmore M. Lairmore

RSO Signature

* See Report 992

17



LOCATION: Philadelphia, PA Gregory M. Bremai, RSO

Analysis of the WIPE used to conduct a leak test on the sealed sources identified below was performed by gas or scintillation detection and reveals removable contaminah'on was less than 0.001 uCi, unless otherwise noted, when compared against NIST traceable standards.

Source: Ge-68 Rod; 10.0 mCi on 07/11/2001; IPL S/N: ZZ-992: Model Number: HEG-0108

Date: 12/19/05 05/03/06 09/01/06 12/5/06 03/27/07

Wipe No.: PM133 PM 172 PM 198 PM286 PM33 1

MDA fuCil: 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 28 11 31 8 9


CPM for 0.00 1 uCi: 297 297 297 297 297


Source: Ge-68 Cylinder, 0.75 mCi on 07/70/200 I , Date: 12/19/05 05/03/06 09/01/06

Wipe No.: PM 134 PM 1 73 PM199

MDA luCil: 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 6 26 9

Net uCi: < MDA < MDA < MDA

CPM for 0.001 uCi: 297 297 297

Analyst: M. Lairmore M. Lairmore M. Lairmore

IPL, S/N: 730-50-01: Model Number: EG-0370

12/5/06 03/27/07

PM287 PM330

1.7OE-5 1.7OE-5

23 15

< MDA < MDA

297 297


Source: Ge-68 Rod, 10.0 mCi on 0 1/27/2000; IPL; S/N: RR-450; Model #: HEG-0 108

Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/27/07

Wipe No.: PM135 PM 1 74 PM200 PM288 PM329

MDA IuCi): 1.7OE-5 1.7OE-5 1.7OE-5 1.70.5-5 1.7OE-5

Net CPM: 2 27 4 19 1


CPM for 0.001 uCi: 297 297 297 297 297


RSO Signature

* See Report 992

18



LOCATION: Philadelphia, PA Gregory M. Bremai, RSO ATTENTION:


Source: Ge-68 Rod; 10 mCi on 08/01/2004; IPL; S/N: 08/01/2004; IPL; SIN: BO-033

Date: 12/19/05 05/03/06 09/0 1/06 12/5/06 03/27/07

Wipe No.: PM137 PM 175 PM20 1 PM290 PM328

MDA luCil: 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 22 18 27 7 19


CPM for 0.001 uCi: 297 297 297 297 297


Source: Ge-68 Rod, 5.0 mCi on 03/01/1996, IPL, S/N: FF-942

Date: 12/19/05 05/03/06 09/01/06 12/5/06 03/27/07

Wipe No.: PM138 PM176 PM202 PM29 1 PM327

MDA (uCil: 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 11 8 25 6 8


CPM for 0.001 uCi: 297 297 297 297 297


Source: Ge-68 Rod, 5.0 mCi on 02/16/1990; IPL; S/N: 30R

Date: 12/19/05 05/03/06 09/01/06 12/5/06 03/27/07

Wipe No.: PM139 PM177 PM203 PM292 PM326

MDA luCi): 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPICI: 21 9 29 16 8


CPM for 0.001 uCi: 297 297 297 297 297


RSO Signature

* See Report 992

19



LOCATION: Philadelphia, PA Gregory M. Breznai, RSO ATTENTION:

Analysis of the WIPE used to conduct a leak test on the sealed sources identifled below was performed by gas or scintillation detection and reveals removable contamination was less than 0,001 uCi, unless otherwise noted, when compared against NIST traceable standards.

Source: Ge-68 Rod; 5.0 mCi on 02/03/1994; IPL S/N: 2379 Date: 12/19/os 05/03/06 09/01/06 12/5/06 03/27/07

Wipe No.: PM140 PMI 80 PM204 PM294 PM324

MDA (uCi): I . 70E-5 1.7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 1s 3 17 1 16


CPM for 0.001 uCi: 297 297 297 297 297


Source: Ge-68 Rod, 5.0 mCi on 11/15/1991, IPL, SIN: R-553 Date: 12/19/05 05/03/06 09/01/06 12/5/06 03/27/07

Wipe No.: PM141 PMI 81 PM205 PM295 PM323

MDA (uCi): 1.7OE-5 I . 7OE-5 1.7OE-5 1.7OE-5 1.7OE-5

Net CPM: 14 26 11 9 I 7


CPM for 0.001 uCi: 297 297 297 297 297


RSO Signature

* See Report 992

20



LOCATION: Philadelphia, PA Gregory M. Bremai., RSO ATTENTION:


Source: Ge-68 Rod; 10.0 mCi on 07/11/2001; Date: 12/19/05 05/03/06 09/01/06

Wipe No.: PM142 PMI 82 PM206

MDA (uCi): I . 7OE-5 I . 7OE-5 I . 7OE-5

Net CPM: 25 5 3

Net uCi: < MDA < MDA < MDA

CPM for 0.001 uCi: 297 297 297

Analyst: M. Lairmore M. Lnirmore M. Lairmore

IPL: S/N: 22-992 12/5/06 03/2 7/07

PM297 PM322

1.7OE-5 1.7OE-5

25 6

< MDA < MDA

297 297


Source: Cs- 137 Rod, 10.0 mCi on 08/0 1/2004; IPL; S/N: 69-033

Date: 031.2 7/07

Wipe No.: PM334

MDA (uCi): 1.7OE-5

Net CPM: 9

Net uCi: < MDA

CPM for 0.001 uCi: 236

M. Lairmore

RSO Signature

* See Report 992

21

Philips Medical Systems Philadelphia, PA

Area Ambient Exposure Survey Removable Contamination (mR/hr) (DPM/300 cm2)

Close-Out Survey Results

Initials

May 25,2007

9

10

11

12

13

14

15

16

Hot Lab (Refer to Diagram)

0.03 741 dpm - 742 dpm = 0 dpm MWL

0.03 746 dpm - 742 dpm = 4 dpm MWL

0.03 777 dpm - 742 dpm = 35 dpm MWL

0.03 743 dpm - 742 dpm = 1 dpm MWL

0.03 788 dpm - 742 dpm = 46 dpm MWL

0.03 771 dpm - 742 dpm = 29 dpm MWL

0.03 MWL

0.03 748 dpm - 742 dpm = 6 dpm MWL

71 1 dpm - 742 dpm = 0 dpm

1

Philips Medical System Philadelphia, PA

(Refer to

Area Ambient Exposure Survey

Bkg 0.03

17 0.03

18 0.03

19 0.03

20 0.03

21 0.03

22 0.03

23 0.03

24 0.03

25 0.03

26 0.03

27 0.03

28 0.03

29 0.03

30 I 0.03

(mR/hr)

Close-Out Survey (Continued)

Diagram)

Removable Contamination (DPM/300 cm2)

645 cpm x 1 . 1 5 = 742 dpm

740 dpm - 742 dpm = 0 dpm

735 dpm - 742 dpm = 0 dpm

744 dpm - 742 dpm = 2 dpm

755 dpm - 742 dpm = 13 dpm

760 dpm - 742 dpm = 18 dpm

740 dpm - 742 dpm = 0 dpm

727 dpm - 742 dpm = 0 dpm

749 dpm - 742 dpm = 7 dpm

739 dpm - 742 dpm = 0 dpm

757 dpm - 742 dpm = 15 dpm

744 dpm - 742 dpm = 2 dpm

730 dpm - 742 dpm = 0 dpm

766 dpm - 742 dpm = 24 dpm

I 754 dpm - 742 dpm = 12 dpm

May 25, 2007

Initials

MWL

MWL

MWL

MWL ~

MWL

MWL

MWL

MWL

MWL

MWL

MWL

MWL

MWL

MWL

MWL

1. Counting Efficiency = 86.4% (Correction Factor = 1 .I 5) 2. Survey Meter Used For Testing = Ludlum 14C, S/N 21 3275 (Calibration Date = 03/20/2007) 3. Ludlum 261 SCA & Well Counter Used For Testing 4. Survey conducted by Michael W. Lairmore Associates. 5. Survey Results analyzed b y Michael W. Lairmore, Medical Physics Consultant

2

Philips Medical Systems Philadelphia, PA

Close-Out Survey (Continued)

May 25,2007

2. Survey Meter Used For Testing = Ludlum 14C, S/N 213275 (Calibration Date = 03/20/2007) 3. Ludlum 261 SCA 81 Well Counter Used For Testing 4. Survey conducted by Michael W. Lairmore Associates. 5. Survey Results analyzed b y Michael W. Lairmore, Medical Physics Consultant

3

Philadelphia Medical Systems Philadelphia, PA

Close-Out Survev (Continued)

Area

Bkg

44

45

46

47

48

49

50

51

Mav 25,2007

Ambient Exposure Survey Removable Contamination (mR/hr) (DPM/SOO cm2)

0.03 645cpmx1.15 = 742dpm

0.03 702 dpm - 742 dpm = 0 dpm

0.03 745 dpm - 742 dpm = 3 dpm

0.03 736 dpm - 742 dpm = 0 dpm

0.03 732 dpm - 742 dpm = 0 dpm

0.03 750 dpm - 742 dpm = 8 dpm

0.03 732 dpm - 742 dpm = 0 dpm

0.03 761 dpm - 742 dpm = 19 dpm

0.03 740 dpm - 742 dpm = 0 dpm

54

55

56

Initials

0.03 746 dpm - 742 dpm = 4 dpm MWL

0.03 749 dpm - 742 dpm = 7 dpm MWL

0.03 739 dpm - 742 dpm = 0 dpm MWL

MWL

~~

59

60

61

62

63

~

MWL

MWL

MWL

MWL

MWL

MWL

MWL

MWL

~ -~ ~ ~

0.03 736 dpm - 742 dpm = 0 dpm MWL

0.03 755 dpm - 742 dpm = 13 dpm MWL

0.03 715dpm-742dpm = Odpm MWL

0.03 740 dpm - 742 dpm = 0 dpm MWL

0.03 743 dpm - 742 dpm = 1 dpm MWL

52 I 0.03 I 742 dpm - 742 dpm = 0 dpni

53 I 0.03 I 744 dpm - 742 dpm = 2 dpm

MWL

MWL

57 I 0.03 1 735dpm-742dpm = Odpm 1 MWL

58 -1 0.03 I 745dpm-742dpm = 3dpm I MWL

1. Counting Efficiency = 86.4% (Correction Factor = 1 . I 5) 2. Survey Meter Used For Testing = Ludlum 14C, S/N: 213275 (Calibration Date = 03/20/2007) 3. Ludlum 261 SCA & Well Counter Used For Testing 4. Survey conducted b y Michael W. Lairmore Associates.

Philips Medical System Philadelphia, PA

Close-Out Survey May 25,2007

Hot Lab Work Area

1 2 3 4 5 A 6 7 8 9 10 1 1 12 13 14

22 23 24 25 26 B 27 28 29 30 31 32 33 34 35

15 16 17 c la 19 20 21

36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 -******

Legend:

A. L-Shield & Preparation Area B. Phantom Storage & Waste C. Sealed Source Storage Cabinet ** Locked Door

Location: PET Service Training (circle one) PMRS Philly

mCi

Sealed Source Return From Philadelphia to Cleveland

Source mEuhr Date

3-5-07 Nuclide Amount Serial # 1 meter CS-137 9.42 B9-033 1.4

3-5-07

3-5-07

3-5-07 ICs-137 [ 4.28 [ CZ-186 0.85

(3-137 4.52 CZ-290 1.4

(3-137 4.35 CZ-172 0.85

mR/hr Surface

45

45

18.5

18.5

dPm BKG

63 8

63 8

638

63 8

Net dpm Pckg wipe 34

34

0

Meter Serial #

2511

2511

251 1

2511

Print Name

Greg Breznai &$

Greg Breznai 0

Greg Breznai 6- 8

Greg Breznai C b

_ __- _ _ _ _--_C- ---- L._ . Location: PET Service Training S e w %ur€e-Return

(circle one) PMRS From Philadelphia to Cleveland

-

- n / 7/21/m -37 ST -- A n * -

3 81 251 1 Greg Brezr -- - .

3' 5/21/07 Ge-68 I nCi 30R 0.01 2.6 384 249 2511 crreg Breznai

P

5/21/07 Ge-68 0.2 uCi FF-942 0.01 2.6 384 249 251 1 Greg Breznai

5/21/07 Ge-68 6 nCi R553 0.01 2.6 384 249 251 1 Greg Breznai

5/21/07 Ge-68 16 uCi RR-450 0.01 2.6 384 249 251 1 Greg Breznai

5/21/07 Ge-68 43 nCi 2379 0.01 2.6 384 249 251 1 Greg Breznai

5/21/07 Ge-68 59 uCi ZZ-992 0.01 2.6 384 249 251 1 Greg Breznai - - - -

5/21/07 Na-22 26 uCi 730-92-30 0.01 2.6 3 84 249 251 1 Greg Breznai

--

5/21/07 Na-22 26 uCi 730-92-29 0.01 2.6 384 249 251 1 Greg Breznai

---- " - m 0.01 P

-- -- -

--.- - .- - . - ----

Date 5/21/07

Nuclide Ge-68

Print - - A

Name. - - - - Greg Breznai

mCi Amount 4 uCi

Souree Serial #

730-50-1

~ R R K 1 meter

0.02

nWhr Surface 0.06

dPm BKG

384

Net dpm Pckg wipe 140

Meter Serial #

2511

- Location: Service Training- .

(circle one) PMRS Philly

Date 1 iii - 1 Nuclide 1 o ! F r 5/23/07 1: 15 p Ge-68

Sealed Source Receipt ---- -.. - -.- - - A- - . - .-

NMC-110-05 Rev. A Ju12006

.

mRkr Meter dpm Net dpm mCi Source Print Surface Serial # BKG Pckg wipe Amount Serial # Name

0.1 3630 399 25 4 uCi 730-50-1 Greg Breznai @

--

2.6 3630 399 46 * 1 * 1 Greg Breznai fl I I I I I I

2.6 1 3630 1 3630 1 46 1 *2 1 *2 1 Greg Bremai @

‘ mUNIVERSITYOF PENNSYLVANIA VY HEALTH SYSTEM

Richard Freifelder, Ph.D.

Department of Radiology Physics and Instrumentation Group

University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania

23-Apr-2007

Richard Freifelder 1 10 Donner/HUP 3400 Spruce St. Phila., PA 19104 215.662.721 3

Gregory Breznai Radiation Safety Officer Philips Medical Systems -- Cleveland Nuc Med 595 Miner Road Highland Heights, OH 44143 Phone: 440-483-2222

To Whom It May Concern:

This is to acknowledge the receipt of three radioactive sources from Philips Medical Systems.

We are in possession of a 100 pCi rod source, a 20 pCi point source in a plastic cube and a 20 mCi point source. Relevent information is in the table below. Shown in the table is the original date of purchase and the new ID#

Nuclide Date of ID # Location Original Last Visual Description Purchase Activity Leak Inspect.

22Na 5/06 30C Physics 100 pc i 3/27/07 3/27/07 Rod source

22Na 11/04 30D Physics 20 pc i 3/27/07 3/27/07 Plastic Cube Point source

I3’Cs 3/0 1 30YY Physics 20 mCi 3/27/07 3/27/07 Point source

Sincerely,

1 10 Dormer Bulding 3400 Spruce Street Philadelphia, PA 19104-4283 Phone: (215) 6627213 *Fax: 2 15-573-3880 Email freifeld0,rnail.med.uuennedu

UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM

Richard Freifelder, Ph.D.

Department of Radiology Physics and Instrumentation Group

University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania

Richard Freifelder, Ph.D. Cyclotron Facility Director Department of Radiology

110 Donner Bulding 3400 Spruce Street Philadelphia, PA 191044283 Phone: (2 15) 66372 13 Fax: 2 15-573-3880 5mail fi-eifeld@,mail.med.uuennedu

FedEx I Ship Manager I Label 7917 0082 5763

From: Origin ID: LNNA (440)483-2222 Grea Bremai

595 Miner Road

Highland Heights, OH 44143

CLS822S7Rv23

SHIPTO: (610)337-5000 BILL SENDER Licensing Assistance Sect ion U.S. NRC Region I 475 Allendale Road

King of Prussia, PA 19406

Page 1 of 1

;hip Date: 06JUN07 idwgt: 1 LB ;ystem#: 726287611NET2600 ,p$ccwnt#: s t**tt.ttt Delivery Address Bar Code

Ill llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll Ref # Invoice # PO # Dept #

STANDARD OVERNIGHT THU Deliver By:

'RK# 7917 0082 5763 'o"2"o": 07JUN07

PHL A2

XB KI L9406 -PA-US

IDA

This is to acknowledge the receipt of your letter/application dated ' /' 1 *"7 , and to inform you that the initial processing which includes an administrative review has been performed.

g* -3?/70--/ d T h e r e 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.

c] 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 & Accounts Receivable Branch, who will contact you separately if there is a fee issue involved.

Your action has been assigned Mail Control Number / W U When calling to inquire about this action, please refer to this control number You may call us on (610) 337-5398, or 337-5260.

NRC FORM 532 (RI)

(6-eel Sincerely, Licensing Assistance Team Leader

New Philips Medical Systems (Cleveland) Inc., Termination Request … · 2019. 12. 22. · IPL...

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