sanford medical center; amendment request; docket 030 ... · sanf~9rd'" health june 17,...

SANF~9RD'" HEALTH

June 17, 2014

U.S. Nuclear Regulatory Commission, Region IV Division of Nuclear Materials Safety, Branch B Attn: Lizette Roldan-Otero 1600 E. Lamar Blvd., Suite #400 Arlington, TX 76011-4511

Dear Ms. Roldan-Otero:

Via email: [email protected] [email protected]

[email protected]

We hereby submit a notification under 10CFR35.13(b)(4)(i), and 10CFR35.14(a) for our NRC Radioactive Materials License (RML) H40-26865-01 (docket #030-29708). This notification is to add an experienced Authorized User to our RML.

We attach a copy ofthe current South Dakota Medical License for the proposed Authorized User, David Allan Swanson, M.D. Dr. Swanson was previously listed as an Authorized User on NRC Radioactive Materials License #40-16571-01 (Docket #030-11252) from prior to November 30, 2007 until Amendment #46, which was issued 5/4/2011. It is our understanding that Dr. Swanson can be considered as an Experienced Authorized User if he has been listed on an NRC license within the last seven years under the requirements of 10CFR35.57(b) and 10CFR35.59.

Dr. Swanson's authorizations under the cited license #40-16571-01 were for 1 OCFR35 .100, 35.200, 35.300 and 31.11 uses. We request the same authorizations for Dr. Swanson be added to our RML. Dr. Swanson will be joining Sanford Clinic in August 2014 as one of our Nuclear Medicine Physicians. We would like to have him perform as an Authorized User under our RML from that time onward.

Thank you for your kind and prompt attention to this matter. Do not hesitate to contact me or Kay Schoppers, CNMT if there are any questions at 605-328-8974. We look forward to your review of this request.

Sincerely,

,.- d~/~ <}~rrr .

Fred Lovrien, MD., Sanford Clinic Nuclear Medicine Radiation Safety Officer

PUBLIC 0 Immediate Release ~orrnal Release

NON-PUBLIC 0 A.3 Sensitive-Security Related 0 A.7 Sensitive Internal 0 Other:

-~----

Attachments (1 docwnent): Reviewer: ~l?!--oate: cf:,z~ (1) Copy of South Dakota Medical License for David A. Swanson, M.D.

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'Not o/afuf .ft,jter 03/01/201.5

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SOUTH DAKOTA BOARO OF MEDICAL AND 0$1EOPATHIC CXAMl!"f!RS

Phyatclan

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Number. lt3Q

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Hill, Carol

From: Sent:

Schoppers,Kay < [email protected] > Thursday, April 16, 2015 2:23 PM

To: Hill, Carol Subject: FW: Amendment requests inquiry Attachments: amendment request OOljpg; DASwanson_SD_License.pdf; scatr amendment may2014

001.pdf

From: Schoppers,Kay Sent: Friday, February 20, 2015 4:05 PM To: 'Hill, Carol' Subject: Amendment requests inquiry

Ms. Hill, I am inquiring again about two amendment re email dated June 19, 2017. We have not received an amended license for thes had received a confirmation letter with mail control

twas an email dated May 2, 2014, and the second was an

dment requests for RML # 40-865-01, Docket 030-29708. I rthe request dated 6-17-14.

--~ December 9, 2014 the requests could not be located so I emailed them to you. I am attaching the two amendment requests. Please let

Thank you for your help,

Kay Schoppers1 CNMT Sanford Nuclear Medicine Clinic 1205 S. Grange Ave, Ste 402 Sioux Falls, SD 57105 Ph: (605) 328-8974 [email protected]

know if additional information is needed.

Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain privileged and confidential information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message .

1

Hill, Carol

From: Sent: To: Subject: Attachments:

Schoppers,Kay <[email protected]> Thursday, June 19, 2014 1:47 PM RidsRgn4MailCenter Resource; Hill, Carol; Murnahan, Colleen Amendment request amendment request 001.jpg; DASwanson_SD_License.pdf

RECEIVED Please find attached an amendment request along with 1 document. RML #40-26865-01 (docket #030-11252) JUN 1 9 2014

Thank you.

Kay Schoppe rs~ CN MT Sanford Nuclear Medicine Clinic 1205 S. Grange Ave. Ste 402 Sioux Falls, SD 57105 (605) 328-8974

PUBLIC 0 lpimedlate Release C!Y'Nonnal Release

NON-PUBLIC 0 A.3 Sensitive-Security Related 0 A.7 Sensitive Internal 0 Other: _______ _

Reviewer: ...... Af.-..... ___ Date: ?;&o/f f

DNMS


1

SANF;9Ro·· HEALTH

June 17, 2014

U.S. Nuclear Regulatory Commission, Region IV Division of Nuclear Materials Safety, Branch B Attn: Lizette Roldaii-Otero 1600 E. Lamar Blvd., Suite #400 Arlington, TX 76011-4511

Dear Ms. Rolchfu,-Otero:

Via email: [email protected] Colleen.Murnahan(tll.nrc.gov

[email protected]

We hereby submit a notification under 1 OCFR35.13(b )( 4)(i), and 1 OCFR35.14(a) for our NRC Radioactive Materials License (RML) #40-26865-01 (docket #030-29708). This notification is to add an experienced Authorized User to our RML.

We attach a copy of the current South Dakota Medical License for the proposed Authorized User, David Allan Swanson, M.D. Dr. Swanson was previously listed as an Authorized User on NRC Radioactive Materials License #40-16571-0 I (Docket #030-11252) from prior to November 30, 2007 until Amendment #46, which was issued 5/4/2011. It is our understanding that Dr. Swanson can be considered as an Experienced Authorized User if he has been listed on an NRC license within the last seven years under the requirements of 10CFR35.57(b) and 10CFR35.59.

Dr. Swanson• s authorizations under the cited license #40-16571-01 were for 1OCFR35.100, 35.200, 35.300 and 31.11 uses. We request the same authorizations for Dr. Swanson be added to our RML. Dr. Swanson will be joining Sanford Clinic in August 2014 as one of our Nuclear Medicine Physicians. We would like to have him perform as an Authorized User under our RML from that time onward.

Thank you for your kind and prompt attention to this matter. Do not hesitate to contact me or Kay Schoppers, CNMT if there are any questions at 605-328-8974. We look forward to your review of this request.

Sirtcetely,

1]Ntf'~ Fred Lovrien, MD., Sanford Clinic Nuclear Medicirte Radiation Safety Officer

Attachments (1 document): (I) Copy of South Dakota Medical License for David A. Swanson, M.D.

1584106

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If any Information on the certificate above or card below la Inaccurate, contact the SDBMOE at sdbmoe@state ad.us to report the problem. It is your responsibility to ensure your malling address and contact Information Is updated with the SDBMOE office.

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SOUTH DAKOTA BOARO OF M~OICAL AND OSTEOPATHIC EXAMINERS . .

Phyalclan

Name: O•vfd A.. 8wln11111, MD

Number. 11ao

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NRC FORM 632 (1-2012)

U.S. NUCLEAR REGULATORY COMMISSION

DATE

04/23/2015

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

Fred C. Lovrien, M.D. Radiation Safety Officer Sanford Nuclear Medical Clinic Nuclear Medicine Department

40-26865-01

MAIL CONTROL NUMBER

586628

D D

D

1205 South Grange Avenue, Suite 402 LICENSING AND/OR TECHNICAL REVIEWER

CH

This is to acknowledge the receipt of your:

[Z] LETTER and/or 0 APPLICATION DATED: 06/17/2014

The initial processing, which included an administrative review, has been performed.

0 AMENDMENT D TERMINATION D NEW LICENSE D RENEWAL

There were no administrative omissions identified during our initial review.

This is to acknowledge receipt of your application for renewal of the material(s) license identified above. Your application is deemed timely filed, and accordingly, the license will not expire until final action has been taken by this office.

Your application for a new NRC license did not include your taxpayer identification number. Please fill out NRC Form 531, located at the following link:

http://www.nrc.gov/reading-rm/doc-collections/forms/nrc531. pdf

Send the completed NRC Form 531, by facsimile, to the following number: (301) 415-5387

A copy of your action has been emailed to our License Fee and Accounts Receivable Branch, in our Headquarters office in Rockville, MD. You will be contacted separately if there is a fee issue involved.

Your application has been assigned the above listed MAIL CONTROL NUMBER. When calling to inquire about this action, please refer to this control number. Your application has been forwarded to a technical reviewer. Please note that the technical review, which is normally completed within 180 days for a renewal application (90 days for all other requests), may identify additional omissions or require additional information. If you have any questions concerning the processing of your application, our contact information is listed below:

Region IV U. S. Nuclear Regulatory Commission DNMS/NMSB - B 1600 E. Lamar Boulevard Arlington, TX 76011-4511 (817) 200-1103 or (817) 200-1140

NRC FORM 532

(1-201~3

BETWEEN:

Accounts Receivable/Payable and

Regional Licensing Branches

[ FOR ARPB USE ] INFORMATION FROM WBL -·- ---- ------- ------ -- --- ----

Program Code: 02120 Status Code: Pending Amendment Fee Category: 7C Exp. Date: Fee Comments: Decom Fin Assur Reqd: N

License Fee Worksheet - License Fee Transmittal

A. REGION

1. APPLICATION ATTACHED Applicant/Licensee: Sanford Medical Clinic

Received Date: 04/16/2015 Docket Number. 3029708 Mail Control Number: 586628 License Number. 40-26865-01

Action Type: Amendment

2. FEE ATTACHED

Amount:

Check No.:

3. COMMENTS

Signed:

Date:

B. LICENSE FEE MANAGEMENT BRANCH (Check when mllestone 03 Is entered I I

1. Fee Category and Amount:

2. Correct Fee Paid. Application may be processed for.

Amendment:

Renewal:

License:

3. OTHER ---------------

Signed:

Date:

Hill, Carol

From: Sent: To: Subject: Attachments:

Ms. Hill, I am inquiring again about two amendment requests. The first was an email dated May 2, 2014 , and the second was an email dated June 19, 2017. We have not received an amended license for these two amendment requests for RML # 40-865-01, Docket 030-29708. I had received a confirmation letter with mail control #584106 for the request dated 6-17-14. . December 9, 2014 the requests could not be located so I had emailed them to you. .. C, <: .....

I am attaching the two amendment requests. Please let me know if additional informatio'\ 1;'1 .\ -1

'i ']_II\ ':i

Thank you for your help, \\ \ttO

Kay Schoppers, CNMT Sanford Nuclear Medicine Clinic 1205 S. Grange Ave, Ste 402 Sioux Falls, SD 57105 Ph: (605) 328-8974 Kay.schoppers@sa nford hea lth.o rg


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SANFE9RD'" HEAL""i H

June 17, 2014

U.S . .Nuclear Regulatory Commission. Region IV Division of Nuclear Materials Safety, Branch B Attn: Lizette Roldin-Otero 1600 E. Lamar Blvd., Suite #400 Arlington, TX 76011-4511

Dear Ms. Rolrufu-Otero:

Via email: [email protected] [email protected]

Rids.Rp4Mai1Center &[email protected]

We hereby submit a notification under 10CFR35.13(bX4)(i), and 10CFR35.14(a) for our NRC Radioactive Materials License (RML) #40-26865-01 (docket #030-29708). This notification is to add an experienced Authorized User to our RML.

We attach a copy of the current South Dakota Medical License for the proposed Authorized User, David Allan Swanson. M.D. Dr. Swanson was previously listed as an Authorized User on NRC Radioactive Materials License #40-16571-01 (Docket #030-11252) from prior to November 30, 2007 until Amendment #46, which was issued 5/4/2011. It is our understanding that Dr. Swanson cart be considered as an Experienced Authorized User if he has been listed on an NRC license within the last seven years under the requirements of 10CFR35.57(b) and 10CFR35.59.

Dr. Swanson's authorizations under the cited license #40-16571-01 were for 1OCFR35.100, 35.200, 35.300 and 31.11 uses. We request the same authorizations for Dr. Swanson be added to our RML. Dr. Swanson will be joining Sanford Clinic in August 2014 as one of our Nuclear Medicine Physicians. We would like to have him perform as an Authorized User under our RML from that time onward.

Tharik you for your kind and prompt attention to this matter. Do not hesitate to contact me or Kay Schoppers, CNMT ifthere are any questions at 605-328-8974. We look forward to your review of this request.

Sincerely,

UJ~ Fred Lovrien. MD., Sanford Clinic Nuclear Medicine Radiation Safety Officer

Attachments (1 document): (1) Copy of South Dakota Medical License for David A. Swanson, MD.

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South (])a~ta (]Joartf of :Medlca( ancf Osteopathic 'b;_aminers

£icense !/'fo. 9130

lssuea on 04/18/2014

!Not 'rlafuf .ft.fter 03/01/2015

If any Information on the certificate above or card below la inaccurate, contact the SOBMOE at sdbmoe@state ad.us lo report the problem. It is your responsibility to ensure your mailing address and contact Information is updated with the SDBMOE office.

SOUTH DAKOTA BOARO OF MEDICAL AND OSTf:OPATHIC EXAMINERS

' Phyafclan

Name: Ctvld A. tw;aion,.MO

Number: 9130

l&auad; 0(111112Df4 NOi Vallcl Mer 0310t'2iltl The above nam111tict .. ~ltt l!CINGd P~Ul'dlrlhn provia!on1 ot lht•f'f'~Mi.<ll'~Dakora

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SANF;ttRDN HEALTH

May2, 2014

Sanford Nuclear Medicine Clinic 1205 S. Grange Ave., Ste 402 Sioux Falls, SD 571 OS Phone: (605) 328-8974 Fax: (605) 328-8972

Via email: [email protected]

U.S. Nuclear Regulatory Commission Region N Nuclear Materials' Safety Branch B Attn: Jacqueline D. Cook 1600 E. Lamar Blvd., Suite #400 Arlington, TX 76011-4511

Dear Ms. Cook:

[email protected] [email protected]

[email protected]

We would like to request an amendment to our NRC Materials License #40-26865..,0l (Docket # 030-29708) t remove the storage authorization for a sealed source that was originally for 1 OCFR35.500 uses. This Gadoliniurrt-153 source is listed in Items 6-9 line Din our license. This source was enrolled in the SCATR program managed by the CRCPD (Conference ofRadiation Control Prograin Directors} and was transferred from our facility on April 30, 2014 for disposal under that program. We wiU maintain for inspection the disposal records from Bionornics, the waste broker contracted by the SCATR program.

If there are any questions, do not hesitate to contact myself or Kay $choppers, CNMT, at 605-328-8974. Th you for your attention to this amendment request.

Sincerely,

o~ DarinBerg L Director of Operatio~ Management Representative of:R.adiation Safety Committee

sanford medical center; amendment request; docket 030 ... · sanf~9rd'" health june 17,...

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