Hotwell Services, Inc. · 2009. 4. 28. · v. t 2, King of Prussia, PA 19426 ., Re: Request for...

Hotwell Services Inc

March 18~ 2011

NRC Region I - LAT Division of Nuclear Materials Safety 475 Allendale Road

t shy 2v

King of Prussia PA 19426

Re Request for License Termination Docket N o

No 030-38024 and License No 37-31365-01

To Whom It May Concern

Due to an asset sale of all Hotwell Services Inc assets to Phoenix Well Services LLC Hotwell Services Inc has officially terminated operations in the oil and gas logging and perforating business At the timeofthe sale Hotwell Services did not possess any licensed materials

LicensePennit Number NRC-4 2-31298-01 Storage Location 2315 Rt 66 Delmont Pa 15626 Description Logging and Perforating Business Attached NRC Fonn 314 (Transfer Document) and Leak Test

If you have any questions or need more data from Hotwell please do not hesitate to call or email me My contact infonnation is listed below

--

Timothy Shear CEO

Hotwell Services 2315 Rt 66 Delmont Pa 15626

Cell Email com

gt71f 7~-3 NMSSRGN1 MATER1ALS-002

APPROViD BY OlE Ito 31SO~28 ~ 10tUnt2US NUCLEAR REGULATORY COMMISSION Es~ bwittn I ~ t) olI1lIY IIIIllhls ~andary~ I11QlIIrt 3~ miru15L TIll ~ Is uJld by ilRC 8i pari of M basil for its ~1iOI II tlle ~Hit is It~ for 1IlIIIIIGIIIIl Send CIIl1IlI18Ilfll ragardI~ llliiWa ~ igt lilt ItfOt7IatiCn Seriwlllillld (T~F5J) UsUlIUrRQQlI_~ WesflliglDII00 21S5S4X11 or W 1n1eme1 e-mal III InrcJCOllaclsRs~ and Ie he Desk 0IIiQIr 0I1C8 ofCERTIFICATE OF DISPOSITION OF MATERIALS IntmBliIIn lI4 ~u1i1D1Y WIS NEQB1l202 131 ~OO2lll 0IIQrI rI Ia~1 aMi ~lWlSllrglDn DC 21503 II bull ~ _ III illpOBf en inimsIioI1 cDleclian doas no( ~ISIIaY II cunfMJr Vi1d QMI IXIIItOI nlllllber IN IRC may ~o COIICud pariICf and I

PEfSlIn is noll1l~uir9d tl ~d 1DltWIlItIllTlalior coilUlOI

LICENSE NUMBER DOCKET NUMBER

L A LICENSE STATUS (Check the appropriate box) n This lcense has expired tI This IicertSe has not YElt expired plaase terminate it

B DISPOSAL OF RADIOACTIVE MATERIAL (Chedc tile app~ lJiWeS and cmrtphfo lIS IKICaSSaty addlrlGnai spaca is 1lCIOdtld proIirIG aftllchmsRts) The loons or any individual executing this cattiflcate on behalf of the licensee cartifies that

[J 1 No radioactive materials haw ever been proC1Jred or possessed by the licensee unCler this llcenee

~ All activities authQrized by this license hale ceased and all radioactive materials procured andor possessed by the licensee ~CIer this license number cited above have been 1iiampposed or in the following manner

rra Transfer of radioac1i49 materials to the licensee listed below

~OD~~ uS t ~ ~ ~el -5 oJ0~ ~ Db Oisposalofradioactivematarials -~ltfo-STQ-a~~ ~ ~a1O

o 1 Directly by thiil IicenSEi8 - ~0 1 - ~ ~-00

o 2 By lioensed disposal site

o 3 By waste corrtradcr

C AlIIadoactive materials have been removed sucn that any remaining residual radIOaCtiVity is witllin the limits Of 10 CFR Part 2Q Subpart E and is ALARA

C SURVEYS PERFORMED NO REPORTED

o 1 A rildiation liiUrvey was conducted by the Ucensee The survey confirms o a the absence of licensed rsdirJaclive materias

o b that any remaining resioual radloactivit~ is witlin 1he limits of 1 0 CFR 20 Subpart E and is ALARA

2 A copy of the radiatian survey tesults

n Iil ls attaclleCl or Ii b is not attached (ProVide exp1a~ation) or [J e was forwanied to NRC on

r-A radialloo survey is not required as only sealed sources were ever passessed under this licese and

~The results of the latest leallt test are attached andlor ~reaking sources have ever been identified

UNINQ FAlSE $TATIIIIENT$ IN THIS call1llrICATIi IlIAY BE SUBJECTTO CMl ANDIIJR SUIlMISSIClNS m1ltE NRC BE CQIIlIILFJEAND ACtURATE IN ALL MATER1M RSPECT U U 9eCTIOH1I101 IoIIAIU$1TACRIMINAL OIJqIiTO MAIcE A WUFUU Y FALSe STAlIiMENT (lJl RBRpoundlIIIiNTATIOTII TO APN OIi1lAAlMENT OR ACENeY 01 THE UNITED STATES AS TO AN( MATTIR WlTMIN IU JURISDlCTfON

~ FORM 310 (1~0I

I bullI~ ___________O_ffi_lc_i_a_I_U_s_e_O_n4ly_-_S_e_c_u_r_jtiy_-R_el_ate_d---In_fo_r_matio__________

i NRC FORM 374 PAGE _1_0F _3_PAGES

I US NUCLEAR REGULATORY COMMISSION Amendment No 01

MATERIALS LICENSE i Pursuant to the A~omjc Energy Act of 1954 as amended the Energy Reorganization Act of 1974 (Public Law 93-438) and Title 10 Code of i FGdcral Reguations Chapter I Parts 30 31 32 33 34 35 363940 and 70 and in re[iance on statements and representatio[1s I heretofore made by the licensee a license is hereby issued authorizing the licensee to receive acquire possess and transfer byproduct I

~()lJrte and special nuclear material designated below to use such material for the purpose(s) and at the place(s) designated below to

I deliver or tra nsfer such material to persons authorized to receive it in accordance with the regulations of the applicable Partes) Thislicense I shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954 as amended and is subject to all nplicable rules regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified

bellow

I~_-------------------------------------------r------------------------------------------In accordance with letter da1ed

April 28 2009

3 License number 37-31365-01

Is amended in its entirety to read as follows

4 Expiration date March 31 2018

5 Docket No 030-38024

Reference No 42-31298-01f030-37612

Licensee

I Hotwell Services Inc

2 2315 Route 66N

Delmont Pennsylvania 15626

--------------------------------------------~-------------------------------------------

Byproduct source andor soecial 7 Chemical andior physical form 8 Maximum amOIJlt that licensee may luclasr material possess at anyone time under this

license

A Cesium 137 A Sealed Sources (Gamma A 16 clries total Industries Model VD-HP Thermo Measure Tech ModeJ 57157C Isotope Products Laboratories Medels P13 series P17 series QSA Global Model CDCCY4 Gulf

e Nuclear Model CSV)

ii B Americium 241 B Sealed Sources (Gulf Nuclear B 90 curies to1alI

Models AmBe-71-2A 71-1 Gammatron Inc Model AN-NP Gamma Indus1ries Model NB-HP QSA Global Made AMNCY6 Isotope Products Laboratories Model Am1N03)

9 Authorized use

I A ald B For use in oil and gas well logging I jI II i i

_---------------------------------------- shyOfficial Use Only - Security-Related Information II

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_----------~----[I Official Use Only - SecuritywRelated Information NRC FORIII 374A PAGE 2 OF 3 PAGES

License Number

37-31365-01

MATERIALS LICENSE SUPPLEMENTARY SHEET

Docket or Reference Numoer

030-38024 42-31298-01030-37612

Amendment No 01

CONDITIONS

10 Licensed material may be stored at the Ilcensee(s facilities located at 315 Riverside Of-ve Clarksburg West Virginia and may be used at temporary job sites of the licensee located anywhere in 1he United

States where the US Nuclear Regulatory Commission maintains jurisdiction for regulating the use of i Icensed material including areas of exclusive Federal jurisdiction within Agreement States ~

I If the jurisdiction status of a Federal facility within an Agreement State is unknown the licensee should contact the Federal agency controlling the job site in question to determine whether the proposed job site

j

is an area of exclusive Federal jurisdiction Authorization for use of radioactive materials at job sites in Agreement States not under exclusive Federal jurisdiction shall be obtainedfrom the appropriate state regulatory agency

11 Licensed material shall be used by or under the supervision and in the phy~ical presence of individuals who have received the training described in the application dated January 25 2008

- 2 The Radiatlon Safe1y Officer for1his license is Andrew Kachonik j

Notwithstanding the periodic leak test required by 10 CFR 3935 the requf~ement does not apply to sources except sources containing plutonium that are stored and not being used The sources exempted from this periodic test shall be tested for leakage before use or transfer to another person No sealed source shall be stored for a period of more than 10 years without being tested for leakage andor contamination

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

15 The opening repair or modification of any Energy Compensation Source must be performed by persons specifically approved to do so by the US Nuclear Regulatory Commission or an Agreement State

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

I~ Official Use Only w SecuritywRelated Information

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Official Use Only - Security~Related Information NRC FORM 374A I PAGE 3 OF 3 PAGES

i License Number 37-31365-01 Docket or Reference Number MATERIALS LICENSE 030-38024SUPPLEMENTARY SHEET 42-31298-01030~37612

Amendment No 01

iI I 17 Except as specifically provided otherwise in this I1cense the licensee shall conduct its program in

accordance with the statements representations and procedures contained in the documents including any enclosures listed below The US Nuclear Regulatory Commissions regulations shall govern unless the statements representations and procedures in the licensees application and correspondence are more restrictive than the regulations

A Application dated January 252008 (ML080390555) S Letter dated February 22 2008 (M L080650235) C Letter dated April 3 2008 (ML081140625) D Letter dated March 62009 (ML0909aO 1 95)

Letter dated April 17 2009 (ML0911 00144) F Letter dated April 28 2009 (ML091250519)

I G Facsimile received May 7 2009 (ML09128D313) i I

For the US Nuclear Regulatory Commission

Original signed by Jenny Johansen Date May 11 2009 By

Jenny Johansen Materials Security and Industrial Branch Division of Nuclear Materials Safety Region I King of Prussia Pennsylvania 19406

Official Use Only ~ Security~Related Information

8d 113MlOH

I

Applied Health PhysicsInc 2986 Industrial Blvd Bethel Park Pa 15102 Phone (412) 835-9555 Fax (4 12 835-9559

E-Mail address ahpinccomcastnet Web Page address WWW APPLIEDHEALTHPHYS[CSCOM

Mark V Leak Test Certificate

This certificate shall not be reproduced except in full without the written approval of Applied Health Physics Inc

Device Information

Dvict Serial Nunb(r XI3Cl Source Serial ~umbcr 41130B

Device y1anufaclurer QSAGlobal Source Manufacturer QSA Global

Device Model Source ModeJ CDCc74

LocationDevice Type Other ivlake

Radioisotope Cs-I37 Activity 2 Ci

Leak Test Information

L~ak Test Pcrtonned by Andrew Kachanik Leak Test Pertbrmed on 8292008

Leak Test Specimen Number A028534 Leak Test Analysis Date 9f42008

ua Test Analysis Performed by K Mobley

Leak Test Results Indicate an Activity of lt0005 uCi

Notification

The analysis of this leak test sample was provided by Applied Health Physics Inc US Nuclear Regulatory Commission License umber 37-09135 and State License Number PA-022S In the event this specimen indicates leakage and or contamination in excess of 0005 microcuries Applied Health Physics Inc will notifY you promptly by telephone at such time you will need to take the appropriate actions required by the goveming regulatory agency Applied Health Physics Inc is required by our license to report leakage andor contamination in excess of 0005 microcuries

Client Information

Andrew Kacholllk Hotwell Servrces Inc Contact

[4(2) 260-3327 2315 Rc 66 Phone

Contact FAX

Phone (412) 253-93 [9

Delmont Pa 15626

This certificate is an essential record and should be maintained for inspection by the regulatory agency

Next L T Due 22812009

Applied Health PhysicsInc 2986 Industrial Blvd Bethel Park Pa 15102 Phone (412) 835-9555 Fax (412) 835-9559

E-Maii address ahpinc~omcastnet - Web Page address WWWAPPLIEDHEALTHPHYS[CSCOM


This certificate sball not be reproduced except in full without the written approval of Applied Health Physics Inc

Device Information

Device Serial Number 08middot004 Source Serial Number 08middot004

Oevielt Manufacturer Source ManufactJrer Eckert amp Ziegler

Devielt ModeJ Source Model AMNOI

Location Truck it 3401Device Type Other Make

Radioisotope Am-24J Be Activity 16 Ci


213-2009Leak Test Performed by Andre Kachonik Leak Test Performed 00

Leak Test Specimen Number A-02Sl33 Leak Test Analysis Date 25121)09

Leak Test Anaysis Performed by K Mobley

Leak Test Results Indicate an Activity of lt OOO5uCi Actual Activity (uCi )

Notification The analysis oftbis leak test sample was provided by Applied Health Physics Inc US_ Nuclear Regulatory Commission License Number 37-09135 and State License Number PA-0228 In the event this specimen indicates leakage and or contamination in excess of 0005 microcuries Applied Health Physics Inc will notify you promptly by telephone at such time you will need to take the appropriate actions required by the governing regulatory agency Applied Healdl Physics Inc is required by our license to report leakage andor contamination in excess of 0005 microcuries

Client Information

Hotwel Services Inc Contact Andrew Kachollik

2315 Rt 66 Phone (412) 260-3327

Contnct FAX

Phone (412) 253-9319

Delmont Pa 15626

This certificate is an essential record and should be maintained for inspection by the regulatory agency_

Next L T Due 832009

Radioactive Source Inventory

bull Distribution o Original to local Files o COpy to RSO

A Physical Inventory Must be Completed Every Quarter

LOCATION REGION INVENTORY FOR Month Year

Physical LocationRemarks Source Type Serial No Isotope Activity

~ uh c1 ~ lp~1 tshy hl IIltO~-(M ~ fI~ 1 ~lt l- C)tl

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SOURCES RECEIVED OR SHIPPED OUT SINCE LAST INVENTORY

Source Type Serial No Shipped To 1 Received From Transfer

Isotope Date No1

Ucmiddot IJA ~-( 14~nl ~S ~ -I i~hJcfl ~~~~~~~j JIll

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Remarks

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bull Distribution ) Original to local Files o Copy to RSO




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~lt ~ ~~ ~- ~ ~ r1 ~ctl Clt2t I ~

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SOURCES RECEIVED OR SHIPPED OUT SINCE lAST INVENTORY

Source Type Serial No Isotope I Date Shipped To Received From I Transfer

INo

If ~k ~ ct -- ~-J~ k t) ~~nAtl ~- ) ~ I I~bull ~~J t-lk -~1 ~ d-~ ~ -LA-t fJ~~ ~~~~ ~ I

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~ ~l ~~1 ~ ( gtt ll -((1f ~tlL A l hA 0- c lt~ t ~h ~Q Ci bull LlImiddotU 14 cn u I~ lt gtIt 1LI A

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Remarks

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-~ HEALTH PHYSICS Inc l

2986 Industrial Blvd Bethel Park PA 15102 Phone (412) 835-9555 Fax (412) 835middot9559

PICKING LIST

SOLD TO NA SHIP TO Hotwell Services 2315 Rt 66 Delmont PA 15626

Inc

ACCOUNT NO SA=~N PURCHASE ORDER NO SHIPVIA DATE SHiPPED TERMS

AH QTY 01l

ORDERED SHIPPED

01 01

arv 6fCI(

OAOEREC

00

ITEM NO

1

Hotwell Svcs 4910 DESCRIPTION

(1) DOT Type 7A Transport shield contain1ng~ (1) Gamma I~dustries Model NB(HP) Serial Number NB256 3 C1 Am-241Be

01 01 00 2 (1) DOT Type 7A Transport Shield containing (1) Gulf Nuclear Model 71-1 Serial Nunber 71-1-127 3 Ci Am-241Be

Devices listed above are being removed from secure storage at Applied Health Physics Inc and transported within DOT Regulations by Hotwell Services personnel to the address listed above

Material Released By

Print l111amp1J ~tL-

Sign ~ y 4 ~middot7

Date u9t Material Received By ~_ bull ~

~~) a~ Date - -Qlt ~D

I

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CERTIFICATE OF TRANSFER

HOTWELL CANADA LTD located at 516 Moraine Road NE Calgary Alberta T2A 2P2 is the owner of the following listed nuclear substances as special form sealed sources

MANUFACTURER RADIOISOTOPE(S) f SOURCE MODEL JNUMBER NOMINAL SOURCE SERIAL OF SOURCES ACTIVITY NUMBER(S)

Gulf Nuclear (NEEI) 171-11 Americium-241tBe 111 GBq 71-1-127 Gamma Ind NB(HP) 1 Americium-241 Be 111 GBq 256

Hotwell Canada Ltd operates under Canadian Nuclear Substances and Radiation Devices License Number 13678 which allows for the possession use export and transfer of nuclear substances and radiation devices

Hotwell Canada Ltd has transferred the abole listed special form sealed sources to Hotwell Services Inc located at 2315 Route 66 N Delmont Pennsylvania 15626 for the purpose of well logging on May 12 2009 Hotwell Services Inc operates in the United States under NRC License Number 42-31298Q1 and Pennsylvania DEP Radioactive Material License Number PA-109 which both allow for the import possesson use and transfer of the above listed special fonn sealed sources

For HOTWEll CANADA lTD Dated May 12 2009

~------Hermann Kramer PEngo President

516 Moraine loalt NE (algiuV Alberti T2A 2P2

WWWhotwellaI T~t A03j 247 34B() Fox 4J31 247 3ltB2 WWWHOTWELLCA

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bull Distribution o Original to Local Files o Copy to RSO


LOCATION RfGION INVENTORY FOR Month Year I Physical LocationRemarks SourceType Serial No Isotope Activity

~~ n~ ~ ~l~ ~i~ Ii f1Q _lli4 i ~v_ ~ Iv- (1 So- flk

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hbull ~ ~~_ ~~shy h1 It ~ ~uA J ~Lc -shy

l - ~ shy

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Source Type Serial No Isotope Shipped To

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Received From Transfer

No

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Remarks

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Radioactive Source Inventory t

bull Distribution o Original to Local Files o Copy toRSO


LOCATION REGION INVENTORY FOR Montn Year


~~U~ _~ ~~( ~ 1 - ~ I~ ~

(-~ ~u

1t-rt~7r ~a ~ ~w t1l~ iii M~~ -Q~~t ~ r~ 1 ~ (~~ l -shy

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i SOURCES RECEIVED OR SHIPPED OUT SiNCE LAST INVENTORY

Source Type Serial No Jsotope Date Shipped To I Received From Transfer

Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

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s-Date


ampMail address ahpinCComcastnet Web Page address WWWAPPUEDHEALTHPHYSICSCOM

l1ark V Leak Test Certificate

This certificate sball not be reproduced except in full without the written appr()val of Applied Health Pllysics Inc

Device Information

Device Serial Number 256 Source Serial Number NB256

Device Manufaeturer

Device Model

Device Type Other

Radioisotope Am-241Be

GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci

SOllrce Manufacturer

Source Model

Location

Gamma Incustries

NB (HP)


Leak Test Performed by Andy Kachonik

Leak Test Specimen Number A-J2754

Lcak Test Performed on

Leak Test Analysis Date

312212010

3242010

Leak Test Analysis Performed by K Mobley


Notification

The analysis of this leak test sample was provided by Applied Health Physics Inc Pennsylvania Department of Environmental Protection License Number PA-0228A In the event this specimen indicates leakage and or contamination in excess of 0005 microcuries Applied Health Physics Inc will notify you promptly by telephone at such time you win need to take the appropriate actions required by the governing regulatory agency

Client Information

Hotwell Sergtices Inc Contact Andrew Kachonik

2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626


Next LT Due 92212010

EMERGENCY TELEPHONE NO 1-800-255-3924 Page -l-of-l

Hotwel SeNioes Inc 2315 Route 66 Delmont PA 1562S ~07wEtIrJ US DOT HAZARDOUS MATERIALS CERTIFICATE OF REGISTftATION NUMBER 033108700001 PR US COT NUMBER 1760058

HAZARDOUS MATERIAL SHIPPING o

~( L ~T ~ ILocation Code Ii

PAPER I t0JI3 (k( to

RADIOACTIVE MATERIALS CONT-NoRADIOshy AINER LABEL TRANSPORT PACKAGE

FORM ACI1IITY SHIPPING DESCRIPTIO (Description Hazard Class UN NUCLIDE MASS CATEGORY INDEX TY1E Pkgs

(kgs) RO RadiDBCIi Arn241~ )1110 GBq 841lt9 i YELLOW II ~ Type A i Hazara Class 7 UN 3332 OnTI bull

I~~ioadive Material Type A Package Special Form Special 11HIGBc -- Type A Am241-Be 84119 YELLOW II o--~ lCsss 7 UN 3332 Form

INeutron GenerOitor (Do1gerous Goods in Appara1us)Hazard I NIA NlA HlA Class 9 UN 3303 Radioactive Matertal Excepled Package - NlA NlA NA 318 kg

Instruments Hazard Class 7 UN 2911

Before LoadirIJ Sources Confirm All Raliation WOI1ters Are Wealing Radiation Badges (YesNo) COrldilion of Source Receplade of Neutron Tool (Yes4llo) Condition or Source Handling Tool YesNo

rillAD Unnecessary gtersonnelCleared Frol1 Source Area (YeslNo)

Fre-OOTtOutOfPitl SUMIV Wellsite SIriev I t-o I Iy have idelt1li1ied wI1h bull proper SlJMgty melerll et sour IS SUIIey Meter No 1~lib~on Date

pfIIIsent anti seeursl cQI3Lained in I(S ptergter housing JeatrlIg sIlield

Cate IIRIB Loaa1na TOol twhile riIlaed UD OIl rig floor

4 Q ~1 0 ~- Berore Readings (After Reactings

Sl~~k~ J~~~I

I ~ j

Post Job Wellsite I Post-DOT (Into Pitl Survev vJ-71

I I Poltsonoll) hiM dbullbulljfledwilh $Y mt~~~ is OASerItanlt1$8OIetiamtamedinrs~hltIuiog( tekt

10m Time

I

i t Personally h Id81lifi1ld will a prop survey ft8er tIlaci1 ooio ~I aCSncurelyltomallledlt bprtlpfUhgtLLliin9J~ shl8ki

Date ITime

I I

I SiQnatute i Signature

I

This is 10 ~ tral Ihe above-named artides are ~ classified descrbed packaged marlted and labeled and ate in proper cxlnditicn for nnsportation accordinQ 101heaoDlieabie ulations oflhe Deoartment of TransDOftation

StartAddress~Q)rtshy 4l ~ ~ C L~ l~ ~p 2 ~~ation and Via Route

DeslJnaUon TO~A S h~- --aV- lI ~~ aer Date Via Route lRtfurn to Base fra Route a~l--middot~r ~ l-l~ --v)oil--s) Art

Per~~~A ~ J ~ Date t -rn ~1fi Per )ate ~ shy~

PICK-UP VEHICLE SURVEY

These slrveY5 are required by the NRC 10 CRf 3967 and must be performed each 6 montns A copy of this sheet must remain on the

transport vehide at all times and 1t1e original must be stored in the locationS radiation files itn the HAZMAT sheets fur 3 years

TRUCK NUMBER a-O ~ PERFORM~~~~ ---gtltyen=-==---~~-~t-~

SURVEY MITER ~~ CAUBRATION DATE_amp~~_lIoJOG-_--Jltb--IiPgtoonloDIol-_

Pick-up right side (mrem thr) a

Pick-up ieftside mrem hr) f 9 n

FRONT SEAT

Survey in drivers seat (mremhrJ II 10 0 Survey in passenger seat [mremhr) C ()

SOURCES USED

ACTIVITY

SURVEY AT SHIELD

id-upfront (mrem hr) D

Pick-up back (mrem thr) ~

BACKSEAT

Survey in drivers side seat Imremhr) k 01 Survey in passenger side seat Imremhr) )-

The surveys must not exceed 200 mremhr at any exterior surface nor 2 nremjhr in the drivers or recorder cabins

v pi j I

Engineer --------------------shy Manager LrIirr-r-----4---_

Date - shy ffi - N)0

I Shipper ~ Freight charges are prepaid on this Driver ~ If single shipment Please Note~ Bill of Lading unless marked collect Please Notet=---V Check box below

STRAIT BILL OF LADING - SHORT FORM - NOT NEGOTIABLE APPLIED HEALTH PHYSICS INC

24 Hour Emergency Phone Number 1-800332-6648 ~ Single Shipment Pickup

Pface PRO abel here

Hotwell US LTD

15905 Waverl Drive CITY STATE ZiP

Houston TX 77267 Attenlioo

No SHIPPING UNITS

HM DescriptiDn

Hotwell Services

2315 Route 66 CITY STATE ZIP

Delmont PA 15626

Contact Andy Kachonik

Phone No 412-260-3327 0

NMFC No CLASS

(1 )

HS-D20308-1 RQ Radioactive material Type A package special fomn 7 UN3332 SolidMetal

Cs-137 74 E+04 MBq (71 ~ti) RVNE 70

Radioactive Label =Yellow-II TI = 03

WEIGHT(lbS) (Subject 10 Correclion)

2111bs

REMIT COD TO COD COD FEE ADDRESS Amount 0 Prepaid 0 Collect

CITY STATE ZIP FREIGHT CHARGES -----------------1---------------- 0 Prepaid Collect

NOTE - Where tr rate is depend on alue shippEi are 18jUired 10 stale specifically

Bill To The all or declaed value o he properly is hereby specifICally slat by Ihe shier consignor the consignor lIIIall sign the 1lt1_9 ~ent

IX) be nol ltlXcseor)9 nw carrier shai nO mke d91iVOlY or Ihi stipmenl_ut

$ 040 ___ ~r POUnd

For Less Than Minimum Value

COMMODITY DESCRIPTION(S) THE Bill OF LADING SHAll CERTIFY THAT THE MATERJALS NAMED ON THE BILL OF LADING ARE PROPERLY CLASSIFIED DESCRJBED PACKAGED MARKED AND lABELED AND ARE IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO THE APPLICABLE REGULATIONS OF THE DEPARTMENT OF TRANSPORATION

Shipment Received Subject to the National Motor Freight ClassifiC3lions the Hazarderdou5 Material Transportation Regulations(TiUe 49) - CFR Subtitle 6 Chapter A-C) the Household Goods Mleage Guide (HHGB 105 Series) The C3rriers tariffs pricing schedules terms conditions and rules maintained at carriers general office in effect on the date of issue oHms Bill of Lading the property described cn the Bill of Lading in apparent good ortIer except as noted (coolents and conditions of contents of packages unknown) marked consigned and destined as indicated above which said Carrier (the word Carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees 10 C3rry to its usual place of delivery of said destination and as to each party at any time interested in all or any of said property that every service to be perfonned hereunder shall be subject to al the Bill of fading terms and conditions in the governing classification on the dale of sh lpment Carrier shall in no event be liable for loss of profit income interest atorrey fees or any special incidental or consequential damages

bAlE

No of PIECES RECEIVED

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~ ~~ EMERGENCY TELEPHONE NO 1-800-255-3924 Page iof-i

ii~~ I-ltotweu Services Inc 2315 Route 66 Delmont PA 15626 IIofWEuJ IfJr US OOT HAZARDOUS MATERIALS CERTIFICATE OF REGISTRATION NUM3ER OJ3108700DO~ PR

USDOTNUM~ HAZARDOUS MATERIAL SHIPPING Dislrid IJCi( No ILocaIion Code

PAPER t0il i t((t ~ ~( i ~(ltI RADIOACTIVE MATERIALS tONTshy

TRANSPORT IPAcwERADIOmiddot AINER WBEL No

5riPPlNG DESCRIPTION (DeSeription Hazard Class UN NUCLIDE FORM IACTIVITY

MASS CATEGORY INDEX I TlPE Pkgs

Number) i (kgs i pe A I-S(lI(age Special Form

Am241middotBe Special 11110 GBc 84lt9 I YELLOW II ~ltr I TypeA Class 7 UN 3332 Form J--_ I

adioadi~e Materia Type A Package Special Foml Am241-Be Special 1110GBc 84 kg i YELLOW II ~~J TypeA ~Cass 7 UN 3332 Form Generator (Daf1gerous Goods in Apparatus)Hazaro -

I 1Class 9 UN 3363 i Radioactive MaIeriaJ Excepted Package shy IllA NlA i NA 31B kg NA NlA MIA Ins1ruments Hazard Class 7 UN 2911

BefonI Loadillg Sources Confinn All Radiation Workers Are Weanng Radialioo Badges YeslNo) Coodition or Sourte R~cle of Neutron ToollY~slNoJ Condilion or SOurce Hamling Tool (VesNo)

fi I I n All Unnecessary Personnel ClelilJed From SOurce Area (YesNo

P-OOT (OutOf Pitl Survey I Wellsite Sl~~I ~

I Per5ooallIIavo ideoUfiedOl1h a proper iIllIgteym tla SCU Survey MeteT No ICjllbrliOn Date prwJStfll and Seeur1ll~ conLaJneltl In ils p-roper housing I cartym $lied

Date jllllle LOQlino Tool [while riG_ UD on rJQ floor

m ~)n n7 BefoJe Readings After Reaclings

Sl~rampA -( ~ I

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I Past Job 1Ne11s1te Ii Post-DOT lInfll pit SwY~_ I II I I Person1Iy hIwe dntiflCltlwilh a prol)er OUll _yenj~C I I P oaIy a iO_1Id w1h prope SUNey mecer 1101 rir ~1 i

tbullbullYccntailldiniSprltlP9Ihougting1 oelltI (1 Jocurelr torHamptMd1 rs prcpethgtusirtgl carrylng stlleld

I10m ITlme Oate ITlme i I

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This is to certify tIlat lI1e above-named al1ides are properly claSSified described packaged marked amllabered and are in proper condition for tra nsporlation acconlinQ to tne-acDIleabie reaulalions ofll1e Depsrlment ofTransOOltatioo

StartAdclresSbullbullJQ)~-r_~ ~t~ -~ll ~a ~ 2 ~~ation and Via Route

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-~ Per ~-l A ~oo~ Date~ -rn ~-fi Per Date ~ -shy

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PICK~UP VEHICLE SURVEY

These surveys are required by the NRC 10 CRf 3957 and mU$t be performed each 6 months A copy of this sheet must remain on the

transport ve1ide at all times and the originat must be stored in the locations rdiation files with tfe HAzr~AT sheets for 3 years

TRUCK NUMBER _=-k-=Ocl==-_____

ERFOR~ 5ev~~~ SURVEY METER It ~~

CALIBRATION DATE -fbOLgt----J-4~EJ_--1hu-O-nJ-shy

Pick-up right side (mrem hr) 0

Pick-up left side (mrem hr) 1[ FRONT SEAT

Survey in drivers seat [mremhrJ 0 0 Surve~ in passenger seat (mremhr) 0 12

SOURCES USED

ACTIVITY --~~1~~~~~~~~

SURVEY AT SHIELD ----~~~~--~=-~~

Pi de-up front (mrem hr) D

Pickmiddotup back (mrem Ihr) II ~

BACKSEAT

Survey in drivers side seat lmremhrl 01 Survey in passenger side seat jrnremhr) )-1

The surveys must not exceed 200 mremhr at any exterior suriace nor 2 mremhr in the drivers or reoorder cabins

Comments _=+--t~~iIo~~~~---_~ ri1uV)JJi4s~r~o---_ll-~JIIoai~uA~--~~Vr~~~~=41do-

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Hotwell US Ltd 15905 Waverly Dr Houston TX 77032 Phone (281) 598-9990 FAX (281) 59~9995 Email philforbesholwelluscom

Vendor

HotwefJ Services

PA PhoneI IContact HotweJI Services

May 192009Purchase Order

10151

1111l1li11111111111111

Ship To

Hotwell US Ltd 15905 Waverly Dr Houston IX 77032

Buyer Payment Terms FOB Point Shipping Terms

admin COD Origin Prepaid 8 Silled

Ship Via Fulfillment Date

Will Call 519109

Item Type Item I Description

Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc

AM241-16ci Am241 AroSe 592GBq (16C1) JAmBe N03 Capsule

AM241-00I1t Shipping Container

$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000

SubTotal $ 9020000 Approval____________ I-----~---I

Date~____ TOTAL $ 9020000L-___~_--

of 1

nipper ~ Freight charges are prepaid on this Driver ~ If single shipment llease Note L-V Bill of Lading unless marked collect Please Nottf----V Check box below

f STRAIT BILL OF LADING - SHORT FORM - NOT NEGOTIABLE

APPLIED HEALTH PHYSICS INC IIIII~ 11111 ~J 111111111111111111111111111111111111 24 Hour Emergency Phone Number 1-800-332-6648 J

72~~0541DO Single ShIpment PickupDr1gnoCQacltdg~ltlffrElgn uSamp 11ag edlltl ~ ulgtle_llOlecoruaa til IIYIltond 0 CNWY 99 appil ~ bull

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5905 Waverly Drive 2315 Route 66 Contact Andy Kachcnik ITY STATE ZiP _nOOn CITY STATE ZIP

-Iouston TX 77267 Phillip Forbes Jr Delmont PA 15626 Phone No 412-260-3327 HON=No KOUI Ivttiltut No

WElGH1(lbs HM Description NMFC No (Sullject toCLASSNo SHIPPING

Correction)UNITS

(1 ) RQ 1851bs

-15-052109-1 RVNE 70Radioactive material Type A package special form 7 UNl332 SolidfMetal

Ammiddot241 Be 592 GBq

Radoacfule Label yellow n Tl= o q

~

EMIT COD TO COD COD FEE - o Prepaid o Collect~DDRESS Amount ~ITY STATE ZIP FREIGHT CHARGES D Prepaid 0 Collect

SulEd I() S~lo 7 01 t~e cQn~ilIOI1S if thO Ghlpmorrt Is

to be delveted to ~ cenGlQne wtnOJi retOilfSe on I~e Bi11 To

be oteXCeiing

consignor 1Mlt cangrof Mall sign the rol owing S1a1ement

1111 carrier malt n(Y make de1ivery of hil ipllent II

S O~ ~ ~~ paymenl 01 frltlg and all other lawful c~ije$

For Less Than Minimum Value (SIGNAtURE oFcosfGNORl

OMMODITY DESCRIPTIONS) THE Bill OF lJIDING SHALL CERTIFY THAT THE MATERIALS AMEn ON THE BILL OF lJIDING ARE PROPERLY LASSIFIED DESCRIBED PACKAGED MARKfD AND LABELED AND ARE IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO THE PPUCABLE REGUlJITIONS OF THE DEPARTMENT OF TRANSPORATION

Shipment Received Subject to the National Motor Frei1lt Classifica1ions the Hazarderdous Material Transportation Regulations(Titie 49) CFR SUbtitle 6 Chapter Ashy) the Household Goods Mleage Guide (HHGB) 105 Series) The carriers tariffs prioing schedules terms conditions and rules maintained at Carriers general office in ~ffect on the date of issue of this BDI of lading the property described on the B~l of lading in apparent good order except as noted (contents and condioons of ontenls of packages unlcnown) marked consigned and des1i1ed as indica1ed above which said Carrier (the word Carrier being understood throughout this contract as neaning any person or OOporation in possession of the property under the contract) agrees to carry to its usual place of delivery of said destirlation and as to each party It any time interesled in al or any of said property that every service to be performed hereunder shaD be subject to all the Bm of lading terms and conditions in the ltJveming ciassifrcation on the date of shipment Carrier shall in no elent be liable for loss of profit income interest atomey fees or any special incidental (lr onsequentiat damages


--~ HEALTH PHYSICS Inc ~

COMPLETE RADIOLOGICAL SERVICES

Hotwell Services May 192009 2315 Route 66 Delmont PA 15626 Attention Andy Kacbonik

Quote Number HS-0509-]

Dear Mr Kachonik

Applied Health Physics Inc (AHP) is pleased to provide Hotwell Services with the following cost proposal

AHP will provide one health physics professional to visit the Hotwen Services facility in Delmont) PA to survey label and manifest one device for transportation to Texas

Hotwell Services is responsible for the following

Valid leak test certificate sent to AHP prior to scheduled date

DOT Type 7 A Shipping container

All transportation fees

Valid Purchase Order 1umber

Our quoted price includes preparation time travel time time on-site and expenses The cost for this service iiIl be $59500 and is based upon (2) bours of time oosite Should any additional time be required it will be billed at the rate of$9000 per hour

The cost of the services quoted above remains in effect for up to 30 days from the date of this proposal and can be scheduled upon receipt ofa valid purchase order

Ifyou have any questions in regard to this proposal please contact our office at (412) 835-9555

Sincerely

~~ Anthony HuH Technical Specialist Applied Health Physics Inc

2986 Industrial Blvd Bethel Park PA 15102 Phone (800) 332-6648 (412) 835-9555

Fax (412) 835middot9559 E-Mail addressahpinccomcastnet

Web Page address vvwwappliedhealthphysiltscom

bull f


Hotwell Services January 27 2009 2315 Route 66 Delmont PA 15626 Aft Andy Kachonik

Quote Number HS-12609

Dear Andy

Applied Health Physics Inc (AHP) is pleased to provide Horwell Services with the following cost proposaJ

AHP ill provide one health physics professional to visit the Hotwell Services facility in Delmont P A to survey label and manifest one device for transportation to Texas

Hotwell Services is responsible for the fo11oing


Shipping container


Valid Purchase Order Number

The cost for performing these services is $59500 and includes pre-site preparation time on-site time travel time and expenses This pricing is based on up to 2 hours of onsile time should additional time be required it will be billed at the rate of $9000 per hour

The cost ofthe services quoted above remains in effect for up to 30 days from the date of this proposal and can be scheduled upon receipt of a valid purchase order

If you have any questions in regard to this proposal please contact our office at (412) 835-9555

Sincerely

Ellen Teprag Applied Health Physics Inc


Fax (412) 835-9559 E-Mail addressahpinccomcastnet

Web Page address wwwappliedhealthphysicscom

~R( ann 12middot1 Page I of J lilSl04

Departmem or tate Health Services

RADIOACTIVE MATERIAL LICENSE Pursuant to the Texas Radiation Control Act and Texas Department of State Health Services (Agency) regulations on radiation and in reliance on statements and representations heretofore made by the licenSle a license lS hereby issued authorizing the licensee to receive acquire possess and transfer radioactive material listed below and [0 use such radioactive material for the purpose(s) and at the place(s) designated below This license is subject to all applkable niles regulations and orders of the Agency now or hereafter in effect and Lv any conditions specified below

This license is issued in response to a letter LICENSEE

Dated September 092010 I Name HOTWELL US LTD

ATTN PHILIP A FORBES JR Signed By Philip Forbes 2 Address POBOX 672721

HOUSTON TX 77267 3 License Number lAmendment Number L06145 I 10

PREVIOUS AMENDMENTS ARE VOID 4 Expiration Date

----R-A-D-IO-A-C--TIV--E---M-A-TE=R--IA----L-A-U--TH--O~RIZ--E=-D-----I April 30 20] 8 5 Radioisotope 6 Form of Material 7 Maximum Activity 8 Authorized Usc

A H-3 A Tilanium hydride matrix

A No single source to exceed 2 curies Total 40 curies

A Acceptance testing commercial distribution of Hotwell ModelING 101 and ING-IO-20-1S0shyTBT neutron generator tube to specific licensees of the US Nuclear Regulatory Commission an Agreement State or a Licensing State and logging tool calibration

B Am-241 B Sealed source (EZ Model Aml-N02)

B 1 source not to B Calibration Reference source exceed 10 millicuries

C Am-241 C Sealed sources (EZ Model Aml-N03)

C2 sources not to C Logging tool calibration exceed 16 curies

D Cs-137 D Sealed sources (QSA Model CDCCY4)

D 2 sources not to exceed 3 curies each

D Logging tool calibration

E Am-241 E Sealed source (EZ Model Am1N09)

E 2 source not to E Logging tool calibration or reference source exceed 400 millicuries

F Ir-192 F Any (except sealed sources)

F No single unit to F Logging tool calibration or reference source exceed toO millicuries Total 1 curie

G Ir-194 G Any (except sealed sources)

G No single unit to G Logging tool calibration or reference source exceed 10 millicuries Total 40 millicuries

H Sc-46 H Any (except sealed sources)

H No single unit to H Logging tool calibration or reference source exceed 100 millicuries Total 1 curie

fRC FOnll 12middot Page 2 or 4 bull JW04

Department of State Health Services

RADIOACTIVE MATERIAL LICENSE ~L~IC~E~NS~E~NU~middotM~B~E~R~-~AM~~~middot~DM~E~N~T~NU~M~B~ER~

L06145 10

5 Radioisotope (Continued)

L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241

6 Form of Material (Continued)

I Any (except sealed sources)

7 Maximum Activity (Copoundllinued)

L No single unit to exceed 100 millicuries Total 1 curie

J Any (except sealed J No single unit to sources) exceed 100 millicuries

Total 1 curie

K Any (except sealed K No single unit to sources) exceed 20 millicuries

Total 1 curie

L Sealed sources (QSA Model CDC 800)

L 4 sources not to exceed 100 millicuries each

M Sealed Source M No single source to (EZ Model HEG-137 exceed 700 Series) microcuries

N Sealed Source (IPLModel AM1P08)

Total 9 millicuries

N No single source to exceed 600 mircocuries Total 6 miUicuries

8 Authorized Use (Continued)

1 Logging tool calibration or reference source

J Logging tool calibration or reference source

K Logging tool calibration or reference source

L Logging tool calibration

M Calibration or reference source

N Calibration or reference source

9 Radioactive material shalI only be stored and used at

Site Number Location 000 Houston - 15905 Waverly Drive

10 The licensee shall comply with the provisions (as amended) of Title 25 Texas Administrative Code (TAC) sect289201 sect289202 sect289203 sect289204 sect289205 sect289251 and sect289252

11 Each site shall maintain documents and records pertinent to the operations at that site Copies of aU documents and records required by this license shall be maintained for Agency review at Site 000

12 The individual designatedmiddot to perform the functions of Radiation Safety Officer (RSO) for activities covered by this license is Philip A Forbes Jr

D Radioactive material shall only be used by Philip A Forbes Jr andor Jody Adams

TRCForn 12-1 Page 3 of 4 bull Olt1I0


RADIOACTIVE MATERIAL LICENSE LlCENSE NUMBER AMENDMENT NUMBER

L06145 10

14 Sealed sources containing radioactive material shall not be opened or removed from their respective source holders

15 The interval of testing for leakage of the sources described in Parts F through K of Conditions 5 6 7 and 8 shall not exceed six months

16 The licensee shall comply with the requirements described in U S Nuclear Regulatory Commissions (NRC) Order EA-07-305 (the Order) with attachments The requirements listed in tlJe Order shall be implemented as part of the trustworthiness and reliability program of the Increased Controls requirements

A By October 6 2008 the licensee shall provide under oath or affirmation a certification that the Trustworthiness and Reliability Official (TRO) is deemed trustworthy and reliable by the licensee as required in paragraph B2 of the Order

B All fingerprints obtained by the licensee pursuant to this requirement must be submitted to the NRC for transmission to the US Federal Bureau of Investigation (FBI) Additionally the licensees submission of fingerprints shall also be accompanied by a certification lmder oath and affirmation of the trustworthiness and reliability of the TRO as required by paragraph B2 of the Order

C The licensee shall complete implementation of the fingerprinting requirements by January 5 2009 The licensee shall notify DSHS Radioactive Material Licensing Group Manager when they have achieved full compliance with the requirements described in the Order The notification shall be made within thirty (30) days after full compliance has been achieved

D The licensee shall notify Manager Radioactive Material Licensing Group DSHS at (512) 834shy6688 ext 2207 within 24 hours if the results from a criminal history records check indicate that an individual is identified on the FBIs Terrorist Screening Data Base

TRC Form 12middot1 Page 4 of 4 bull ltlIN14


RADIOACTIVE MATERIAL LICENSE LICENSE NUMBER AMENDMENT NUMBER

L06145 10

17 Except as specificaU y provided otherwise by this license the licensee shall possess and use the radioactive material authorized by this license in accordance with statements representations and procedures contained in the following

application dated January 152008 letters dated March 25 2008 August 12008 February 102009 June 16 2009

and April 12 2010

Title 25 T AC sect289 shan prevail over statements contained in the above documents unless such statements are more restrictive than the regulations

KEE ~~THEDEP MEN1 OF STATE HEALTH SERVICES V

f~-- -(--vid B

lI

- w~Date September 242010

_t~le Program CORr~inator AdvatlcedJchnology LicetiSffig Program

This is to acknowledge the receipt of your letterapplication dated

J~ 2egt11 and to inform you that the initial processing which includes an administrative review has been performed

-rft(MampM~u J7- Jllts--c1 LJ 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 57(-755 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) Sincerely (6-96) Licensing Assistance Team Leader

APPROViD BY OlE Ito 31SO~28 ~ 10tUnt2US NUCLEAR REGULATORY COMMISSION Es~ bwittn I ~ t) olI1lIY IIIIllhls ~andary~ I11QlIIrt 3~ miru15L TIll ~ Is uJld by ilRC 8i pari of M basil for its ~1iOI II tlle ~Hit is It~ for 1IlIIIIIGIIIIl Send CIIl1IlI18Ilfll ragardI~ llliiWa ~ igt lilt ItfOt7IatiCn Seriwlllillld (T~F5J) UsUlIUrRQQlI_~ WesflliglDII00 21S5S4X11 or W 1n1eme1 e-mal III InrcJCOllaclsRs~ and Ie he Desk 0IIiQIr 0I1C8 ofCERTIFICATE OF DISPOSITION OF MATERIALS IntmBliIIn lI4 ~u1i1D1Y WIS NEQB1l202 131 ~OO2lll 0IIQrI rI Ia~1 aMi ~lWlSllrglDn DC 21503 II bull ~ _ III illpOBf en inimsIioI1 cDleclian doas no( ~ISIIaY II cunfMJr Vi1d QMI IXIIItOI nlllllber IN IRC may ~o COIICud pariICf and I

PEfSlIn is noll1l~uir9d tl ~d 1DltWIlItIllTlalior coilUlOI

LICENSE NUMBER DOCKET NUMBER

L A LICENSE STATUS (Check the appropriate box) n This lcense has expired tI This IicertSe has not YElt expired plaase terminate it

B DISPOSAL OF RADIOACTIVE MATERIAL (Chedc tile app~ lJiWeS and cmrtphfo lIS IKICaSSaty addlrlGnai spaca is 1lCIOdtld proIirIG aftllchmsRts) The loons or any individual executing this cattiflcate on behalf of the licensee cartifies that

[J 1 No radioactive materials haw ever been proC1Jred or possessed by the licensee unCler this llcenee

~ All activities authQrized by this license hale ceased and all radioactive materials procured andor possessed by the licensee ~CIer this license number cited above have been 1iiampposed or in the following manner

rra Transfer of radioac1i49 materials to the licensee listed below

~OD~~ uS t ~ ~ ~el -5 oJ0~ ~ Db Oisposalofradioactivematarials -~ltfo-STQ-a~~ ~ ~a1O

o 1 Directly by thiil IicenSEi8 - ~0 1 - ~ ~-00

o 2 By lioensed disposal site

o 3 By waste corrtradcr

C AlIIadoactive materials have been removed sucn that any remaining residual radIOaCtiVity is witllin the limits Of 10 CFR Part 2Q Subpart E and is ALARA

C SURVEYS PERFORMED NO REPORTED

o 1 A rildiation liiUrvey was conducted by the Ucensee The survey confirms o a the absence of licensed rsdirJaclive materias

o b that any remaining resioual radloactivit~ is witlin 1he limits of 1 0 CFR 20 Subpart E and is ALARA

2 A copy of the radiatian survey tesults

n Iil ls attaclleCl or Ii b is not attached (ProVide exp1a~ation) or [J e was forwanied to NRC on

r-A radialloo survey is not required as only sealed sources were ever passessed under this licese and

~The results of the latest leallt test are attached andlor ~reaking sources have ever been identified

UNINQ FAlSE $TATIIIIENT$ IN THIS call1llrICATIi IlIAY BE SUBJECTTO CMl ANDIIJR SUIlMISSIClNS m1ltE NRC BE CQIIlIILFJEAND ACtURATE IN ALL MATER1M RSPECT U U 9eCTIOH1I101 IoIIAIU$1TACRIMINAL OIJqIiTO MAIcE A WUFUU Y FALSe STAlIiMENT (lJl RBRpoundlIIIiNTATIOTII TO APN OIi1lAAlMENT OR ACENeY 01 THE UNITED STATES AS TO AN( MATTIR WlTMIN IU JURISDlCTfON

~ FORM 310 (1~0I







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April 28 2009




5 Docket No 030-38024

Reference No 42-31298-01f030-37612

Licensee


2 2315 Route 66N


--------------------------------------------~-------------------------------------------


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Delmont Pa 15626







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Delmont Pa 15626


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2

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$ 8600000

$420000

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Date~____ TOTAL $ 9020000L-___~_--

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L06145 10


L Sb-124

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L Cs-137

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L06145 10











L06145 10



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April 28 2009




5 Docket No 030-38024

Reference No 42-31298-01f030-37612

Licensee


2 2315 Route 66N


--------------------------------------------~-------------------------------------------


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030-38024 42-31298-01030-37612

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GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















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ACTIVITY --~~1~~~~~~~~




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ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries















TRCForn 12-1 of 4 bull Olt1I0



L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI












License Number

37-31365-01



030-38024 42-31298-01030-37612

Amendment No 01

CONDITIONS




j









113MlOH



Amendment No 01










8d 113MlOH

I





Device Information











Notification


Client Information


[4(2) 260-3327 2315 Rc 66 Phone

Contact FAX

Phone (412) 253-93 [9

Delmont Pa 15626







Device Information












Client Information


2315 Rt 66 Phone (412) 260-3327

Contnct FAX

Phone (412) 253-9319

Delmont Pa 15626


Next L T Due 832009







[

r- I

i

i

i i

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Isotope Date No1


I I I

I i I

I I I

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ll3NUOH






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Inc


AH QTY 01l

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s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

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I


Date ITime

I I


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Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















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ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

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10151

1111l1li11111111111111

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Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10








TRC Form 12middot1 of 4 bull ltlIN14



L06145 10



and April 12 2010



f~-- -(--vid B

lI













Amendment No 01










8d 113MlOH

I





Device Information











Notification


Client Information


[4(2) 260-3327 2315 Rc 66 Phone

Contact FAX

Phone (412) 253-93 [9

Delmont Pa 15626







Device Information












Client Information


2315 Rt 66 Phone (412) 260-3327

Contnct FAX

Phone (412) 253-9319

Delmont Pa 15626


Next L T Due 832009







[

r- I

i

i

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Isotope Date No1


I I I

I i I

I I I

I I jI

i i I

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ll3NUOH






~-t~ )11 ~ ~ Mlt ~_ -~-l nk~ 1 ( ~ I ( t i Ishy

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PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

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s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

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10m Time

I


Date ITime

I I


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SOURCES USED

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Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




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ll3fvUOH


















Sl~rampA -( ~ I

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SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

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Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI















Device Information











Notification


Client Information


[4(2) 260-3327 2315 Rc 66 Phone

Contact FAX

Phone (412) 253-93 [9

Delmont Pa 15626







Device Information












Client Information


2315 Rt 66 Phone (412) 260-3327

Contnct FAX

Phone (412) 253-9319

Delmont Pa 15626


Next L T Due 832009







[

r- I

i

i

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Isotope Date No1


I I I

I i I

I I I

I I jI

i i I

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Remarks

ll3NUOH






~-t~ )11 ~ ~ Mlt ~_ -~-l nk~ 1 ( ~ I ( t i Ishy

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I


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PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

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s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

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10m Time

I


Date ITime

I I


I












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SOURCES USED

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SURVEY AT SHIELD



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v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

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SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI















Device Information












Client Information


2315 Rt 66 Phone (412) 260-3327

Contnct FAX

Phone (412) 253-9319

Delmont Pa 15626


Next L T Due 832009







[

r- I

i

i

i i

I I



Isotope Date No1


I I I

I i I

I I I

I I jI

i i I

I I i

Remarks

ll3NUOH






~-t~ )11 ~ ~ Mlt ~_ -~-l nk~ 1 ( ~ I ( t i Ishy

~lt ~ ~~ ~- ~ ~ r1 ~ctl Clt2t I ~

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I

I

I



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I


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113NUOH



PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

arv 6fCI(

OAOEREC

00

ITEM NO

1







Sign ~ y 4 ~middot7



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I

I

I

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s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












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SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

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SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI

















[

r- I

i

i

i i

I I



Isotope Date No1


I I I

I i I

I I I

I I jI

i i I

I I i

Remarks

ll3NUOH






~-t~ )11 ~ ~ Mlt ~_ -~-l nk~ 1 ( ~ I ( t i Ishy

~lt ~ ~~ ~- ~ ~ r1 ~ctl Clt2t I ~

~ ~ t~ ~~k-~ II ~ -r- ~I ~~ ~ -r--~lt-



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I

I

I



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I


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Remarks

113NUOH



PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

arv 6fCI(

OAOEREC

00

ITEM NO

1







Sign ~ y 4 ~middot7



I

ll3MLOH











Zd ll3M10H






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I

I

I

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s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












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SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

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SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI
















~-t~ )11 ~ ~ Mlt ~_ -~-l nk~ 1 ( ~ I ( t i Ishy

~lt ~ ~~ ~- ~ ~ r1 ~ctl Clt2t I ~

~ ~ t~ ~~k-~ II ~ -r- ~I ~~ ~ -r--~lt-



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I

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I



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I


I 1 ~ ltIv ~

Remarks

113NUOH



PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

arv 6fCI(

OAOEREC

00

ITEM NO

1







Sign ~ y 4 ~middot7



I

ll3MLOH











Zd ll3M10H






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l - ~ shy

I I i

II

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I I I I

I J I

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No

I

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Remarks

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~~U~ _~ ~~( ~ 1 - ~ I~ ~

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Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

I

I

I

I Remarks

s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI













PICKING LIST


Inc


AH QTY 01l

ORDERED SHIPPED

01 01

arv 6fCI(

OAOEREC

00

ITEM NO

1







Sign ~ y 4 ~middot7



I

ll3MLOH











Zd ll3M10H






~



l - ~ shy

I I i

II

~ 1

I I I I

I J I

I I



i I I

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No

I

I

Remarks

ll3M10H






~~U~ _~ ~~( ~ 1 - ~ I~ ~

(-~ ~u


I

I

i I



Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

I

I

I

I Remarks

s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI





















Zd ll3M10H






~



l - ~ shy

I I i

II

~ 1

I I I I

I J I

I I



i I I

i


No

I

I

Remarks

ll3M10H






~~U~ _~ ~~( ~ 1 - ~ I~ ~

(-~ ~u


I

I

i I



Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

I

I

I

I Remarks

s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI
















~



l - ~ shy

I I i

II

~ 1

I I I I

I J I

I I



i I I

i


No

I

I

Remarks

ll3M10H






~~U~ _~ ~~( ~ 1 - ~ I~ ~

(-~ ~u


I

I

i I



Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

I

I

I

I Remarks

s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI
















~~U~ _~ ~~( ~ 1 - ~ I~ ~

(-~ ~u


I

I

i I



Nobull

~J~~o ~ ~~ t ~-~- ~Jb~ )-- S-a~C ~ ~~-2~l~ - LO~

I

I

I

I Remarks

s-Date





Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI















Device Information


Device Manufaeturer

Device Model

Device Type Other


GtdfNuclear

GNGmiddot5

Make

Activity 3 Ci


Source Model

Location

Gamma Incustries

NB (HP)






312212010

3242010



Notification


Client Information


2315 RL 66 Pbone (412) 260-3327

Contact FA)

Phone (412) 253-9319

Delmont Fa 15626




















Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI




























Sl~~k~ J~~~I

I ~ j



10m Time

I


Date ITime

I I


I












FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI


















FRONT SEAT


SOURCES USED

ACTIVITY

SURVEY AT SHIELD



BACKSEAT



v pi j I






Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI














Pface PRO abel here

Hotwell US LTD



No SHIPPING UNITS

HM DescriptiDn

Hotwell Services


Delmont PA 15626


Phone No 412-260-3327 0

NMFC No CLASS

(1 )


Cs-137 74 E+04 MBq (71 ~ti) RVNE 70



2111bs






$ 040 ___ ~r POUnd




bAlE


ll3fvUOH


















Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI




























Sl~rampA -( ~ I

~ j





I i






)










SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI




















SOURCES USED

ACTIVITY --~~1~~~~~~~~




BACKSEAT




ii$ - 0 SQ~ ~)5

Engineer --------------------shy


J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI











J bull I 11


Vendor

HotwefJ Services



10151

1111l1li11111111111111

Ship To





Will Call 519109


Unit Price

Qty Ordered

Extended Price

1

2

Misc

Misc



$ 8600000

$420000

1 ea

1 ea

$ 8600000

$420000


Date~____ TOTAL $ 9020000L-___~_--

Page 1 of 1







bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI

















bull

(10)





Correction)UNITS

(1 ) RQ 1851bs




~




be oteXCeiing












Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI















Dear Mr Kachonik











Sincerely





bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI











bull f




Dear Andy





Shipping container






Sincerely



































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI









































L06145 10


L Sb-124

J Sb-l22

K Na-24

L Cs-137

M Cs-137

N Am-241






Total 1 curie


Total 1 curie





Total 9 millicuries


















L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI














L06145 10











L06145 10



and April 12 2010



f~-- -(--vid B

lI














L06145 10



and April 12 2010



f~-- -(--vid B

lI











Hotwell Services, Inc. · 2009. 4. 28. · v. t 2, King of Prussia, PA 19426 ., Re: Request for...

Documents

Transcript of Hotwell Services, Inc. · 2009. 4. 28. · v. t 2, King of Prussia, PA 19426 ., Re: Request for...