S e n t By: K; 4 1 06652074 ; A U G - 1 9 - 0 3 14: 5 7 ; Paae 5

3601 E. Joppa Road Baltimdre, Maryland 21 2 3 4

141 0-665-5447 147 0-665-2074 7. ACTNmES T U 88 CONDUCTED UNDER THE GENERAL LICENSE ONEN IN 10 CFR 160.20

0 WELL LOWING 8 LEAK TESTING AND/OR CALIBRATIONS 0 TELETHERAPYllRRADlATOR SERVICE

0 PORTABLEGAUQES 0 OTHER (Spwify)

REGISTERED A S USER OF DAGBUV~INO (CWTIPICATES OF COMCUANCP N U M W RADIOGRAPHY e

Nanticoke Memorial Hospital B O 1 Middleford Road Seaford, DE 19973

same as 8

CS-137 ICM MLD-01#309389, 250uCi ( 1 1 / 2 3 / 8 7 ) = Cs-137 NAS MED 3550 #1A7380, 1 8 2 . 5 uCi ( 1 7 / 1 / 9 7 )

S e n t By: K; 41 06652074; A U g - 1 9 - 0 3 14:59; Page 8 / 1 5

. Milford Memorial Hospital 21 W. Clark Avenue Milford, DE 19963

Xrueger-Gilbert Health Physics, Inc INITIAL REVISION CLARIFICATION kODRe69OPUCENSEE ( M a W n p a d W a o b Y I m b w h r a h - n s y b r b b d ) 4. U E S C O N T m AND TfnE *

same as # 8

11, WORKLOCAWNlE!.EPHOHE NUM- 10. p K - W < E NUMam pnQJwskaCMy

3 2-422- 311 302-422-331 1

3601 E. Joppa Road B a l t i m d r e , Maryland 21 234

la. NUMBEROF 14. 1 a. I I= D A ~ SctieouLm WORK DAYS ADD DCLETE

:OM m

141 0 -665-5447 141 0-665-2074 7. ACTTVITIES TO BE CONDUCTED UNDER THE GENERAL LICENSE QNEN IN i o CFR 16020

WELL LOGGING LEAK TESTING AND/OR CALIBRATIONS c] TELETHERAPYIIRR9DIATOA SERVICE

16. LOCATION R m N C E NUMBW

WMRW TO Oe melorn BY NRC

0 PORTABLEGAUGES 0 OTHER (Specify) =@

4 1 06652074 ; A u ~ - 19-03 15 : 03; Page 1 1 / 1 5 Sent By: K; . ,I

. . . -

Krueger-Gilbert Health Physics, f n c 3. MCRK'3E OF UCfiN9(;E; p d l n g rddnas CY ulhuIohx~if@~ w h r s h n m may be/oa&J

INITIAL 0 REVISION @ CLARIFICATION 4, UCEMEEcor(TAcTANDTI"LE

I .

3601 E. J o m a Road - - B a l t i m d r e , Maryland 21234

Donnn Thim ./Health Phys ic 1 -~ -. -

e. F K g M l c e m-%= 8. m P H N6NUMQtR ( * l d l p b . L - ,

4 1 0-665-5447 4 1 0-665-2074

0 WELL LOGGING LEAK TESTING AND/OR CALIBRATIONS 0 TELETHERAPYARRAD1ATOR SERVICE

0 PORTASLEQAUGES 0 OTHER (Specify) + 0 RADIOGRAPHY

Rl!GIST€!REO AS UCER OF PACWQWG (CER'TlIPIcATW W CQMPWNCE! NUb!0ERSJ

3, CUSHT NAIAE, A309ESS, arr/rCOUKn. S A = HP CCXX 0. ACTUAL PWYSICAL ADOW38 OF WORK LOCal7DN (SbrrlmdMnW&U~Wdhfhrl~&Wl, h a ? m p M h M .ddnar W d i a O l i w a5 p c X S d d

- Bayhealth Medical Center Kent General Hospital I same as #8

640 South State Street Dover, Delaware 19901 la alEHTlELEPt40NENUHBW , 11. WORKLOCA'ITQN T E l 6 P W N B N U M ~

fzndudn A m Cod.) (brckrd8h-d

302-674-4700 302-674-4700

CS-137 I C N MLD-O1#309389, 25OUCi (11/23/87) Cs-737 NAS MED 3550 #A7380, 182.5 uCi ( 1 1 / 7 / 9 7 )

THE UNDEIPSIGN~D, HERZRY cmnw THAT: All Infoimatlon In thla mart tS bum urd complrta. 1 haw rrad and U n a r M d the ptovlsbn of the gmnaral Ilcmm 10 CPR 1 6 0 3 rrprlntod on t h m InatnrcUons d t h l a farm: and I unduldsnd +hat I am required to cornplywtth these provlshna as tn all byproduct, sourer, or spdol nudsar mstarlal whldr I possaa and use tn non4grarmont strtas or oflshom WmtMs under tha gcnatd llcuua tor whlcn Lhls rrport 1s tlld Wm tho US. ~ c l r r Regvlatwy Comnbdon

E. I undwstand ~ h d actlvftlrn, lncludfng sturage, conducted In non4prmmntSUt.r undrr gmaral ilmnsc 10 CPR 18020 are Ilmtbd b a rotd d I80 Cp In calendar year. Wkh the excrprfon ol work candudd In d - x h w e watcm, whlch la wtho&sd for an unllmttad perlod af tfms In the a J e n h r p r .

I understand thhrt I may ba inspactad by NRC at the rbovr 1kad work a b I d o n s and at tho Uc- home otflce ad- tar advtt iW wormed In non.&mamozrt Statu or ofhhorr wltrr+.

e. I undmratmnd that cmdud d any sdvrtlas not Uwcdbed above. lncludlnp conduct cdadvttlm on aaNs or l o m o m amfemtmrn thoae drt~llb.d above or Mhout NRC ouMorlznWon, may subJact rn. to enforcement adan, indud&g dvll or cftmlnd pmsl t ler

b.

d.

I I I O A Y J - A /

S e n t Ey: K ; 41 06652074; AUg-19 -03 1 5 : O I ; Page 1 2 / 1 5 . ., . . \. , : . . .

Krueger-Gilbert Health P h y s i c s , Inc I. mo~wuC%iNBE€ ( ~ ~ ~ d a n o r a m r r o o r l Y o l r r ~ U c u u w ~ y b . l c c r * d )

. . / . ' . . ..,.. , . . . . . . !., . . . . v . : ' . ".

INlnAL 0 REVISION ClARlFICAnON I .

4. UCEMEECQNTACTA"D~

.- - . Bay;@ealth Medical Center Kent eeneral it3a'ricBr' Cehter 793 S. Queen Street Dove?, Delaware 1 9 9 0 4

same as # 8

11. V ~ U U X A I ' ~ O N E L D " E N U ~ ~ W 5wkJumhOPY . la cxIENll"PM?M NUHPgl

(baitdwAmlcdrJ

3601 E. Joppa Road . B a l t i m Q r e , Maryland 21 234

' Donna Thlm ./Health Phys ic LE MBQI I @a'Yd.-%

1. NUMBW W h M . J

14 10-665-544 7 141 0-665-2074 7. ACTWLTIES TO BE CONI3WCTU) UNDER THE GENERAL UCENSE GWEN IN 10 CFR 180.20

0 WELL LOQOING LEAK TESTING AND/OR CAUBRATfONS TELETHERAPYARfUDlATOR SERVlCE

I

c

Cs-137 ICN MLD-01W309369, 25OuCi (11 /23/87) Cs-137 NRS MED 3550 kdA7380,. 7 8 2 . 5 UCf ( 1 1 / 1 / 9 7 )

I

31

Sen t P y : K; 41 06652074; AUg-19-03 15:31; Paae 1 3 i 1 5

Baltimere, Maryland 21234

0 WELL LOGGING @ LEAK TESTING AND/OR CALIBRATIONS TELETHERAPYflRRADlATOR SERVICE

Molecular Ima.ging Services 613 High Street Seaford, DE 19973

CS-1 37 I C N MLD-01 ly309389, 250uC.i ( 1 1 /23/87) (3 -137 NAS NED 3 5 5 0 #A7380, 182.5 U C i ( 1 1 / 1 / 9 7 )

S e n t By: K; 41 06652074; A u ~ - 19- 03 15: 32; Page 14 /15

3601 E - Jappa. Road Baltimdre, Maryland 21 234

147 0-665-2074 7. ACTIVITIES TO BE CONDUCYeO UNDER THE QE)lWUV UCENGE QlVEN IN 10 CFp 19010

I CJ ~ L ~ L O ~ Q I N Q LEAKTESTING AND/OR CALlBRATlONS c] ..TELETHERAWIIR&UlATOR SERVICE .

I ' I 0 PORTABLECXAUQES I? OTHER (Spedfyl

Habib . B q l & c h k , M. D ; 4503 Sjrlqhwav 'One . . .

abova or VAClrout

S e n t By: K;

5. ELEPHONE '+UMBER [krdda +VU# U&oJ

Baltimdre Maryland 21 234 47 0 -665-5447

4 1 06652074 ;

6. FAfXWIG NUMSR p m l d m h Cod.)

4 1 0-665-2074

A u ~ - 19-03 15: 0 3 ;

. c u m NAME. mmw. cnv~coum. SATE ZIP CODE

Page 1 5 / 1 5

9 ACTUAL P H W W AoDRE98 OF WORK LOCARON 1SbrtadNvmbUff amrral fM. Ghrur9mpI6leMed&ua UdbwliM6 rSOoalibk) c-

10. CUEMTELWHaW MlMES37

302- 892-6200 @xjtds A=U M o J

q i . WORKL03?lONlELEPHC"NUM9W @d&m CmwJ 302-892- 6200

I 0 PORTABLEGAUGES 0 OTHER (Spedty) + '

-"'SER OP PACKAQING (CGRWICATSJ OFCOhtRlANCENUMDSRS) --._.e

9 ACTUAL P H W W AoDRE98 OF WORK LOCARON 1SbrtmdNvmbuff amrral fM. Ghrur9mpl6leMed&ua udbwliM6 rspoal ibk)

d. I undbmmd that I mny be Inspectad by NRC at the sbwe llded work slta locatlons and at tho Llcenme home otnca ilddrana?oc ac(lVltI0s prflomsd In nort4grcement Statrs or offahore wntwa.

0. 1 undersrsnd that condud of any rctlvitiefi not dlrcrlbsd above. lncludlng conduct of rctlvWes on mfL8 or IocaUons dlffsrant from th!se dctlcrlbod &VE or wkhout NRC authorIration. may subled mo to rnf<

a NRC be compIPta and acmrat. in all material F8

41 06652074; A U a - 1 9 - 0 3 14 :55 ; Paae 2 S e n t B y : K;

TC FORM 201 1-

REPORT OF PROPOSED ACTIVfTlES IN

FEDERAL JURISDICTION, OR OFFSHORE WATERS \ION-AGREEMENT STATEB, AREAS OF €XCLUSIVE

~

NAME OF UCGNSEE m m r h n pwg tnawfucf tlm .obvlllu d&d bkw)

Krueger-Gilbert Health Physics, Inc INITIAL 0 REVISION C U R I FICATION A O D R E S ~ O F L I ~ ~ E E [ M u l k r p u l ~ ~ ~ ~ ~ o u L d n m t i v ~ w h l R I I o . M m ~ ~ ~ y & h ~ )

3601 E. Joppa Road B a l t i m d r e , Maryland 21 234

( 4 ? 0 -665-5447 141 0-665-2074 7. AcnvinEs TO BE CONDUCTED UNDER THE GENERAL LICENSE QWEN IN i a CFR iw2o

Genishpere/PoLyprobe . 2'807 - S t e r l i n g Drive H a t f i e l d , PA 1 9 4 4 0 same as # 8

12 - 9 9 6 - 3 0 0 6 121 5 996r3006 *a. wrmm?& 14. le. 18. LOCATION WORK DAYS ADD D a m REFEWNCE NUMBER 1 2 DATES SCHPDuLED

OM 1

Cs-I 37 I C N MLD-01#309389F 250uCi ( 11 /23/87) (25-137 NAS MED 3550 #A?380, 182.5 UCi ( 1 1 / 1 / 9 7 )

3601 E- Joppa Road Mw w d d f # H e a l t h Physi B a l t l m d r e , Maryland 21 234 NUMBER

b VU?PHWBNU la LF--, f%uwm-wF 141 0-665-5447 141 0-665-2074

7. ACTIVITIES TO ee CONDUCTED UNDER THE GENERAL UCWSE QNEN IN i o CFR 160.20

CS-137 ICN mD-01#309389, 25OuCi (11/23/87) Cs-137 NAS MED 3550 #A7380, 182.5 uCi ( 1 1 / 1 / 9 7 }

US. NUGLfAR REGULpTORY COMMESlON 3C FORM 141 leea)

REPORT OF PROPOSED ACTIVITIES IN qON-AGREEMENT STATES, AREAS OF EXCLUSIVE FEDERAL JURISDICTION, OR OFFSHORE WATERS

(Phse mad fho Insf~~~ctionc behm campleilng ihis form)

I 0 PORTABLEGAUGES 0 OTHER (Spacify) 39

BXPIIPLOS: 0713ln#n Wk5hl-l

PPeROMD SY O M L NO. S l y & whh Ihh wrmssdburdan W m J request- 16 m d a 4 Z Z t n a t t o n ia u i d ua 01.t NRC may

. snhdulo inupmdon df V ~ J Oawkbs -% l h T n d u u ? n d In Moordo~u wlyl rqulramota for p- d (ha puhlh Mlth and d a y . Sond cammams mrdin burdon bstlmnte lo the Ramrds

U d . Nudm mulptory Cornrnlatbn

NEOB-10202 (JlsO-dOl3 , Offloe of MMnaement and Bud * I , Wnehingbn. dc R a maam usmi loirnpm.e an infomrJ1w disclian dmn M! de ley P ownndg valld OM8 control numbrr. tttn NRC may not conduJor rponwr. and a p m o n 16 not raquirad to mpond to. Ihs lnbrmnhan 0olbdOn.

ment Branch E$$!%%&&, ~ ~ , ~ ~ ~ ~ { & ~ / ~ o ~ & ~ ~

CUEM NAME. ADORESS. CmiCOUNTy, S A T E IIP CODE

American Red Cross Blood Serv. Musser Blood Canter 700 Spr ing Garden Street

I I

16. LOCATION 13. NUMBOROF 14. 16. 1 2 DATES scneDuLm WORK DAY5 ADD nmmi R W R E N C E NUMBIW

x, M M B Q l ID BE ASlCNeD Bv NRC

I dllo3/03 q/dJ! d009SZ UST ADDITIONAL WORK SITES ON SGPARAfE SHEET(5) TO INCLUDE ALL INFORMATION CONTAINED IN ITEMS 8-16 ABOVE.

usT R C L D I O A ~ MATERIAL WHICH WILL is WSS~?~SFD, us=, IHSTALLPD, SERW, oa nwrm

a. ACTUAL PHYSICAL Aouam OP WORK LcanoN (sent we Numdr w Mhtw WbUm. 6 N a Y oompm. M rddrars dn-zbwx an poa81hh

same as # 8

(I- dmacrBWn Dp. Md qWrrmY OI ndfWUW l~Wm& x w h d m w a s . ut d.r/Gm m be mod}

CS-137 ICN MLD-O1#309389, 25OuCi ( 1 1 / 2 3 / 8 7 ) Cs-137 NAS MED 3550 #A7380, 1 8 2 . 5 uCi ( 1 1 / 1 / 9 7 )

'WE UNDERSIGNED, HEREBY CEATtM THAT:

,. All lnfa#matlon In thtu nport k 1rv1 and cornplate I have rand and undsratmd lhm pkimlon Mthb gansral Ikonor 10 CFR 150.20 nprlntod on t h m lndmetlons af thla form; and 1 und-,stand that I am required to comply Wlth thcie prwlsbns asto 811 bypmduct, source, or apmlsl Rucleir mstarlsl whlch I posmss and use In non+3ramrn@nt S t a t e or uffshorm waaw under the ganaral I I C l n f l for whlch thls report I8 ?lld wlth the U.S. Nudtrr RaguI~Iory Commtaeion.

I undrrnond vlnt odVmes, lncludlno storage, conductad In nowlgmmrnt Statas undrr gmml llcansa 10 CPR 1S030 are flmtted Ua a totnl at 180 d w s In colwxiar year. Wlth ar rxtrptlon Ot work conducted In offshore waterq which is nuthodzed fur an onllmltad p d o d of t h e In M a alrndnr par .

I undarsLand tha! 1 may bo impacted by NRC at the aDwe llstcd worK site locadan6 and at thm Ucensas home D~RCU nddrua for ac(1vitIcs perfomad In non-Agmement 9LXw or affshora waters.

e.

d,

tlom dtthrentfrom those descdbmd

41 06652074; AuCJ-19-03 1 4 1 5 7 ; Page 6 1 ‘ 5 S e n t ey: K;

Riddle-Memorial Hospital 1068 W. Baltimore Pike Media, PA 19063

US. N U C W R RWULATORY COMMEiSION

same as 8

TE!B”ONe NUMISER 11. W ~ L ~ ~ ~ , ) W ~ E N V M B E E ~ lo. 3% h cad.)

61 0-566-9400 6 1 0 - 5 6 6 - 9 4 0 0

ST OF PROPOSED ACfNlTlES IN ,AMENT STATES, AREAS OF EXCLUSIVE

AL JURISDICTION, OR OFFSHORE WATERS ~.

(Phase mad #e lnsinrcflona bohm compleilng &is lam) N*MEW IXSlS66 (Pason c r t f r m ~ b&& scffhtm M a d

Krueger-Gilbert Health P h y s i c s , Inc Asaam OF UC6NBSE fU.* damu amMrkra&m w7wu bausL.inmyWIoD.BLd)

3 6 0 1 E. Joppa Road B a l t i m & ) r e , Maryland 2 1 2 3 4

7. A C ~ I E S Ta BE CONDUCTED UNDER THE QENEF

INrlAL REVISION @ CLARIFICATION L WSEECMvTAGTANOTRLE I -

&+Lp& -&Health P h y s i c i s

-LICENSE GIVEN IN 10 CFR 760.20 - I I n WELL LOGGING LEAK TESTING ANDGR CALIBRATlONS I TElFTHERAPY/IRRADlATOR SERWCE

- J ASSIGNED BY NRC q-)&h3 !&/& b o d N 8 SEPARATE SHEEt(3) TO lNCLClOE ALL INFORMATION CONTAINED IN ITEMS 9-18 ABOVE.

Cs-137 I C N MLD-01#309389, 250uCi ( 1 1 / 2 3 / 8 7 ) CS-137 NAS MED 3550 H A f 3 8 0 , 182.5 UCF ( 1 1 / 1 / 9 7 )

1. Ail hfomtnth h thIS IapoIl IS trOI J?ld comptds.

b, 1 have read and undtrabnd thc provldon d t h ~ general llcrnae 10 CFR l 6OZO rcprlntcd on tha Inmctlonr af mlr Ton: and I undanund ma! I om requlrad to complywkh them^ pmvldont asto all byproduct, source, or sprclol nuclrsf msterlal whlch I pocuess and u f a In nongagrearnent strnr of OflShotm wntcrs undar thr prnrril Ucanse kr which thls report lo n1.d wUh the U.S. Nudmr Rcgulstory Ccmmlnaion.

c. I und.ratand that advMas, Includhg otrrrqgc, condudad In non4grrement Slatas undw arneful I l m s r l a CFR 16020 am ItrnRed 10 a tutal In calendar ymar. W7th Ihs axcoplon of work condusted In olT-shcrcwmrrr, whkh fa nuthodzrd lor an unllmlted prrlod of tima In the cslandir p a r .

d. I unduztand that I may ba 1nsprct.d by NRC at Ihr obova llded worK aka Incatlons and at the Llcenrrr horn. offlcr addmas lor acllvklu pmfomed In nonAgrnmant 5Mss or &om watus.

180 dtYa

RNING: False eatemranto in this cartiflcefa. may be subject lo c NRC ba carnolate and accurate in all material r r r~gacto. 1s U . t . b

’ Sactton 1 ~ 0 1 maker Pa criminal ohnsm to miin a WEII~UIIY raise

merit or repmsntatran l o any department or ngancy of the United Stet- as to any matter wlthln Its jurisdiction.

S e n t Ey : K; 41 06652074; A U g - 1 9 - 0 3 14 : 5 8 ; Pace 7 1 ' 5

Krueger-Gilbert Health Physics, Inc Or L

INITlAL c] REVISION @ CLARIFlCaTlON

3@R OF 14, 16. DAYS ADD D a n P

3601 E. Joppa Road Baltimdre, Maryland 21234

16. LOCATION REFERENCE NUMBER

NUMBER TO BE

I Malek DaneshJtas/ .

1 ) . l

141 0-665-5447 141 0-665-2074 7. ACTNITIES TO BE CONDUCTED UNDER THE Q'kNntAL LICENSE GIVEN IN 10 CFR 180.20

i I n39101iEO 8'1 NRC

0 WELL LOGGINQ a LEAKTESTING AND/OR CALIBRATIONS 0 TELEfHER4PYIIRWDiATOR SERVICE

0 PORTABLEGAUGES 0 OTHER (Sp~lfy) *

REVIEWINO OFFKIAL fTyp&n(ad Neme and EUoJ

-

R B 6 t S ~ A$ USER OF PACUGING {CWTlFICAm OF COMPUANCE NUMB- 0 RADIOGRAPHY *

TOTAL USAGE - OAYS TU DATE

6 6

Sacred.Beart Hospi ta l 421 Chew Street Allentown, PA 18102

13, NU WOR 12 DATK3 SCHEDULED

same as 8

S e n t By: K; 4106652074; AUCJ - 19-03 14: 59; P2Ge 9 / 7 5

3601 E. Joppa Road Baltlrndze, Maryland 21 234

.. '

I /Llm-m l/Kealth P h y s f c i s

0. FACSMUN M eR

41 0-665-2074 **- u.1 6. W H O N E N U -

41 0-665-5447 ( W o d . M

0 WELLLOGGING a LEAK T E S T " ANO/OR CALIBRATIONS TEL~ERAWI IRRADIATOR SERVICE

13 PORTABLEGAUQES OTHER (Spuffy)

American .Medical Laboratories, I n c t s a m ~ as 8 1 4 2 2 5 Mowbtook Drive P.O. Box 10841 S I

~~

41 06652074; A u ~ - 19-03 15: 33; P a s e 1 0 / 1 5 Sen t 0 y : K;

Xruegar-Gilbert Health Physics, Inc ClARIFlCAllON , . 3. moREsS OF UCENBEE ( u Y n r r r w a CY oYlrhbbwh*1 l h r f n q y M kumdJ 4. WS§ CONTACT #NO TmT

3601 E. Joppe Road I B s l t i m B r e , Maryland 21 234 1410-665-5447 141 0 - 6 6 5 - 2 0 7 4

7. ACTIVPTlES TO 86 CONDUCTED UNDER fCfE CIIENWL LJCCNSE ONEN IN 10 CFR 18030 1 0 WELLLOGGING WTESTtNG AND/OR CAUBRATtONS ..TELE-rrrERAPY/lXRADlATOR SERVICE

Cs-137 I C N MLD-01 d309389, 25OuCi ( 1 1 / 2 3 / 8 7 ) I CS-1.37 NAS MED 3550 5A7380, 1 8 2 . 5 UCi ( 1 1 / 1 / 9 7 )

. .