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September 11, 2013

U.S. Nuclear Regulatory Commission Region Ill- Division of Nuclear Materials Safety 2443 Warrenville Rd, Suite 210 Lisle, IL 60532-4352

Cardinal Health Nuclear Pharmacy Services 7000 Cardinal Place

Dublin, OH 43017 614.757.5000 main

800.234.8701 toll free

cardinalhealth.com

Re: Amendment Request for Radioactive Materials License 34-29200-01 MD, Cardinal Health Nuclear Pharmacy Services, Dublin, OH.

Radioactive Materials Licensing:

Cardinal Health 414, LLC (Nuclear Pharmacy Services, hereafter Cardinal Health) requests the release of the restricted area for unconditional use in our pharmacy located at 2131 E. 32nd Street, Suite 1, Joplin, Missouri. Please remove the location from the above referenced license condition 10. The Decommissioning Report is attached in support of this request. Cardinal Health has no plans to use this location for any future licensed activities.

Please use the corporate address for all correspondence and invoicing as follows: Cardinal Health Nuclear Pharmacy Services, Quality and Regulatory, 7000 Cardinal Place, Dublin, Ohio 43017.

If you have any questions regarding this request, please contact Dan Hill at 614.757.5074.

Sincerely,

lJ.~g~ Corporate Radiation Safety Officer Director, Health Physics Nuclear Pharmacy Services

/dh

cc: Sarah Pekarek, RSO, Loc. 182 Brent Marion, Loc. 182 Consolidated NRC File (3)

.ft&G61VED SfP 2 3 2Dl3

U.S. NRC- Region Ill Radioactive Materials Licensing

John Alexander, RSO, Lac. 7002 Dan Burton, RSO, Lac. 7010 Joseph Zuehl, RSO, lac. 7011 Mathew Svejk, RSO, Lac. 7013 Christie Holland, RSO, Lac. 7016 Bill Thompson, RSO, Lac. 7025 Asma Abassi, RSO, Lac. 7028 Earl Robertson, RSO, Lac. 7030 Jay Simmons, RSO, Lac. 7088 Brian Porter, RSO, Lac. 7109 Dane Dishman, RSO, Lac. 7120 John A. Miller, RSO, Lac. 7128 Bruce Jorgensen, RSO, Lac. 7172 Mark Peters, RSO, Lac. 7200 Nate Johnson, RSO, Lac. 7201 Ligi Matthews, Lac. 7231 Mark Rotman, RSO, Lac. 7306 Doug Sopp, RSO, Lac. 7341 Justin Goodnite, RSO, Lac. 7545 Michael Chee, RSO, Lac. 7232

Encl: Decommissioning Report Original + 1 copy

NRC License 34-29200-01 MD

September 11, 2013

Page2

FACILITY DECOMMISSIONING REPORT

Cardinal Health Nuclear Pharmacy Services

2131 E. 32nd Street Suite 1

Joplin, MO 64804

Report by:

EvanT. Western, Health Physicist Quality & Regulatory

Cardinal Health Nuclear Pharmacy Services

Facility and Operations

The nuclear pharmacy is one of multiple pharmacies licensed by the Nuclear Regulatory Commission on Cardinal Health's license. The former mailing address and location resided at the street address listed below. Use of radioactive materials was previously conducted under the license at the location referenced below.

Pharmacy Location:

Radioactive Materials License:

Sources of Radiation

2131 E. 32"d Street, Suite 1 Joplin, MO

34-29200-01 MD

The information presented below addresses the requirements set forth in Title 10 Code of Federal Regulations, Section 30.36 for vacating and decommissioning a facility under a radioactive materials license.

1. Please see Attachment D for the Certificate- Disposition of Radioactive Materials.

The facility used radioactive materials for nuclear pharmacy operations and instrument calibrations or constancy checks. The facility located at 2131 E. 32"d Street, Suite 1, Joplin, MO ceased using the materials on August 16th, 2013. Sealed sources and radioactive waste were transferred to other Cardinal Health Nuclear Pharmacy Services facilities authorized on the same radioactive materials license prior to conducting the decommissioning surveys. Sealed sources were transferred to the facility in Springfield, MO while waste was transferred to the Kansas City, MO facility.

2. The table below lists all isotopes used at the facility over the span of the licensed activities, and includes the date of last use for each.

Barium-133 8/16/2013 Sealed 250 uCi

Carbon-14 N/H Cesium-137 8/16/2013 Sealed 250 uCi

Chromium-51 N/H

Cobalt-57 8/16/2013 Sealed 6mCi

Flourine-18 N/H

Gallium-67 6/30/2013 L 10 mCi

lndium-111 7/31/2013 L 10 mCi

lodine-123 8/1/2013 s 1 mCi

lodine-125 N/H lodine-131 9/30/2011 s 1 mCi

.------------------- --~~~

Molybdenum-99 8/16/2013 s 15 Ci

Phosphorus-32 N/H

Samarium-153 11/30/2012 L 150 mCi

Strontium-89 12/31/2007 L 4mCi

Technetium-99m 8/16/2013 L 15 Ci

Thallium-201 7/31/2013 L 6mCi

Xenon-133 N/H

Yttrium-90 10/31/2009 L 40 mCi

Depleted Uranium 8/16/2013 s 50 kg

[ N/H - nuclide never handled at this facility ]

There have been no major radiological spills of any licensed material (e.g., greater than 100 mCi ofTc-99m or 1 mCi of 1-131) requiring assistance in clean-up and monitoring from persons other then the user. During the life of the license, no sealed sources have been determined to be leaking.

Surveys and Monitoring

Surveys were conducted in both the restricted and unrestricted areas. All surfaces were surveyed for contamination in the restricted areas. Wipe tests for removable contamination were taken over a 100 cm2 area every square meter in the restricted areas. In the unrestricted area, wipes and contamination surveys were taken on a larger grid and in areas of most probability for finding contamination (e.g., door handles, walkways from the restricted areas, etc.). The locations are identified on the diagram in Attachment A.

Contamination surveys were taken with the instrument listed below. Wipes were taken dry, unless otherwise indicated, with absorbent paper. Each wipe was counted on the analytical detector listed below. Operating specifications, efficiencies, and minimum detectable activities are also provided below.

Exposure Rate Surveys

Make and Model of Survey Meter

Serial Number

Last Calibration Date

Background

Make and Model Number of Probe

Ludlum 2350-1 Data Logger

260149

6/11/2013

12 IJR/hr (44-38) 178

Ludlum 44-38 Ludlum 44-89

Make and Model Number Ludlum 2200

Serial Number 177305

Window (should be open, this is 50-400 keV

usually 20 to 400 keV) Efficiency of Well Counter

46.2% (for 1-131 or Ba-133 open window)

Wipes Date of Efficiency 7/31/2013

Region of Interest (should be the 50-400 keV

same as for efficiency) Count Time 1.0 minute

Background 87CPM

MDA (must be <200 dpm) 101 DPM

Please see Attachment A for the impacted area map with wipe test locations indicated.

Please see Attachment B for the results of the wipe test survey of the impacted area.

A reference background was established for the portable survey meter in the non-impacted area, where there is similar construction to the materials encountered the impacted area. This was determined to be 12 11R/hr for the facility.

Waste and RAM Disposition

A search for radioactive materials and radioactive waste was performed, resulting in none found. All materials were transferred to another authorized location for this license prior to the survey. Please see Attachment C for a copy of the shipping paper which details this transfer of material.

During the life of the license, no underground piping or sink/sewer piping was used for disposal of radioactive materials (excluding excreta).

Please see Attachment D for a copy the Certificate of Disposition of Radioactive Materials and Surveyor Certification.

Please see Attachment E for a copy of the logs showing transfer of sealed sources to another authorized location for this license.

ATTACHMENT A

Survey Map

_ __ _ _ . . , -;~tef119 ,~_: . _ .. · ; ·. Facilities and Equipment

· ... : .. : . . ·. . ~ : ..

Figure 15: Floor plan and layout of the facility with restricted area outlined in solid black.

2131 E. 32nd Street, Suite 1, Joplin, MO 64804

NRC Consolidated (34-29200-01MD} July 20, 2011 Page9-18

ATTACHMENT 8

Wipe Test & Area Radiation Survey Results

RESTRICTED AREA SCA Serial Number: 177305 ·.·

Efficiency Date: 7/31/13 ·.

Window: 50-400 keV .. Efficiency: 46.2% for Ba-133 l . '· ..

. : ..

. • j Count time (minutes): 1.Q min~te ·l< .• ... :.· .•. .. I

Background (cpm): 8(cpm 101

MDA (dpm): dpi . m. SURVEY DATE. 8/28/2013

Packaging C7 Counter/Wall 7 149 73 0 0 OK Packaging D3 Floor 5 159 90 3 6 OK Packaging D4 Floor 3 153 98 11 24 OK Packaging DS Floor 6 146 90 3 6 OK Packaging D6 Floor 19 116 113 26 56 OK Packaging D7 Counter/Wall 20 111 88 1 2 OK Packaging E3 Counter 13 103 92 5 11 OK Packaging E4 Counter 7 105 86 0 0 OK PackaQing ES Floor 13 135 82 0 0 OK Packaging E6 Floor 12 135 86 0 0 OK Packaging E7 Counter/Wall 8 146 96 9 19 OK Packaging F3 Counter 16 163 88 1 2 OK Packaging F4 Counter 14 165 89 2 4 OK Packaging FS Floor 28 184 79 0 0 OK Packaging F6 Floor 18 175 85 0 0 OK PackaginQ F7 Counter/Wall 12 148 100 13 28 OK Packa_ging G3 Counter 14 151 99 12 26 OK Packaging G4 Counter 11 153 92 5 11 OK Packaging GS Floor 11 177 86 0 0 OK Packaging G6 Floor 13 159 78 0 0 OK Packaging G7 Counter/Wall 8 158 87 0 0 OK Packaging HS Floor 6 185 92 5 11 OK Packaging H6 Floor 10 137 89 2 4 OK Packaging H7 Counter/Wall 6 143 78 0 0 OK Dispensing

Area E1 Hood 4 137 85 0 0 OK Dispensing

Area E2 Floor 3 141 98 11 24 OK Dispensing

Area F1 Hood 14 127 99 12 26 OK Dispensing

Area F2 Floor 14 89 77 0 0 OK Dispensing

Area G1 Hood 10 117 97 10 22 OK Dispensing

Area G2 Floor 8 124 88 1 2 OK Dispensing

Area H1 Hood 5 114 87 0 0 OK Hot Box Area H2 Floor/Wall 7 113 96 9 19 OK Hot Box Area H3 Floor/Wall 5 105 92 5 11 . OK Hot Box Area H4 Floor/Wall 11 100 84 0 0 OK

Waste Storage 11 Sink 12 157 89 2 4 OK Waste Storage 12 Counter/Wall 16 218 86 0 0 OK Waste Storage 13 Counter/Wall 16 245 88 1 2 OK Waste Storage J1 Floor/Wall 24 163 98 11 24 OK Waste Storage J2 Floor 15 169 81 0 0 OK Waste Storage J3 Door 14 171 93 6 13 OK Waste Storage K1 Floor/Wall 10 134 89 2 4 OK Waste Storage K2 Floor 12 179 77 0 0 OK Waste Storage K3 Floor/Wall 12 161 98 11 24 OK Waste Storage L1 Floor/Wall 18 172 79 0 0 OK Waste Storage L2 Floor 21 213 67 0 0 OK

Waste Storage L3 Floor/Wall 7 126 94 7 15 OK Waste Storage M1 Floor/Wall 10 132 87 0 0 OK Waste Storage M2 Floor/Wall 7 108 94 7 15 OK Waste Storage M3 Floor/Wall 6 121 94 7 15 OK

Entry 14 Floor/Wall 8 135 94 7 15 OK Entry 15 Floor 11 135 93 6 13 OK Entry 16 Floor 15 116 96 9 19 OK Entry 17 Counter/Wall 14 103 76 0 0 OK Entry 18 Counter/Wall 11 107 91 4 9 OK Entry 19 Counter/Wall 17 120 93 6 13 OK Entry J4 Floor 15 150 73 0 0 OK Entry J5 Floor 14 138 99 12 26 OK Entry J6 Floor 9 215 90 3 6 OK Entry J7 Floor 18 186 72 0 0 OK Entry J8 Floor 13 184 69 0 0 OK Entry J9 Floor/Wall 9 155 82 0 0 OK Entry K4 Floor/Wall 12 146 91 4 9 OK Entry K5 Floor 12 139 113 26 56 OK Entry K6 Floor 12 127 87 0 0 OK Entry_ K7 Floor 7 107 98 11 24 OK Entry K8 Floor 5 154 78 0 0 OK Entry K9 Floor/Wall 4 146 79 0 0 OK Entry L4 Floor/Wall 11 170 83 0 0 OK Entry L5 Floor 18 152 108 21 45 OK Entry L6 Floor 16 196 95 8 17 OK Entry L7 Floor 11 173 91 4 9 OK Entry L8 Floor 11 131 77 0 0 OK Entry L9 Floor/Wall 9 143 80 0 0 OK Entry M4 Floor/Wall 6 133 83 0 0 OK Entry M5 Door 8 160 111 24 52 OK Entry M6 Floor 6 131 117 30 65 OK Entry M7 Floor 8 101 96 9 19 OK Entry M8 Floor 6 97 76 0 0 OK Entry M9 Floor/Wall 8 117 93 6 13 OK

Blood Room N6 Floor/Wall 11 98 87 0 0 OK Blood Room N7 Floor/Wall 16 129 86 0 0 OK Blood Room N8 Door 13 126 92 5 11 OK Blood Room N9 Floor/Wall 26 141 75 0 0 OK Blood Room 06 Floor/Wall 26 124 109 22 48 OK Blood Room 07 Floor 17 117 85 0 0 OK Blood Room 08 Floor 15 105 95 8 17 OK Blood Room 09 Floor/Wall 8 143 93 6 13 OK Blood Room P6 Floor/Wall 6 134 97 10 22 OK Blood Room P7 Floor 4 154 82 0 0 OK Blood Room P8 Floor 12 136 102 15 32 OK Blood Room P9 Floor/Wall 23 150 80 0 0 OK Blood Room 06 Floor/Wall 15 140 86 0 0 OK Blood Room Q7 Floor 10 152 91 4 9 OK Blood Room Q8 Floor 15 140 109 22 48 OK Blood Room 09 Floor/Wall 10 149 87 0 0 OK

Blood Room R6 Floor/Wall 7 167 84 0 0 OK Blood Room R7 Floor/Wall 11 151 88 1 2 OK Blood Room R8 Floor/Wall 9 142 103 16 35 OK Blood Room R9 Floor/Wall 16 166 94 7 15 OK

Room Map (e.g. Break Loc

Room) #

Manager Office

Manager Office

NW

NE

SE

Floor

Floor

Floor

UNRESTRICTED AREA SCA Serial Number: 177305

Efficiency Date: J/31113 .. 50:i400>

Window: keV · ·.· ~~~~~~~----~--~-----.

Efficiency: 46.2% for Ba~.1 ~3 Count time (minutes): 1--~.,.--~~-~--..c..-"'-'-'

Background (cpm): ~--=-"~~4 MDA (dpm): L.......:...::....:.......J~

j.JR/h cpm

12 158 110 23 50

10 133 99 12 26

9 151 82 0 0

OK

OK

OK

ATTACHMENT C

Shipping Paper for Transfer of Radioactive Material

SHIPPING PAPER FOR DANGEROUS GOODS

CARRIER: SAME AS SHIPPER

SHIPPER: Cardinal Health Nuclear Pharmacy Services Location 182 2131. E 3200 StSui!e 1 Joplin, MO 64804

Proper Shipping Name

SHIPMENT 08142013

CONSIGNEE NAME AND ADDRESS:

Car~inal Health Nuclear Pharmacy Services Location 28 9668 Marion Ridge Kansas City, MO 64137

UN No.

Radioactive material, low specific activity (LSA-H}

Hazard Class

7 UN 3321

NATURE AND QUANTITY OF DANGEROUS GOODS

NO. OF PACKAGES

1

1

1

RAD!ONUCLIDES

Mo-99

Sm-153, Sr-89

CHEMICAL FORM/PHYSICAL STATE

Solid

Liquid

Total Activity Contained:

ACTIVITY- GBq

(.85 ~

MAX. ExPOSURE RATE

1 mrem/hr

4 mrem/hr

Emergency Spill-Leak-Fire-Exposure or Accident Contact: CHEMTREC S00-424-9300 I Customer# 204503

This is to certify that the above named materials are properly classifsed, described, packaged, marked and labeled, and are in proper condition for transportation according to applicable regulations fur the Department of Transportation.

Consignee Signature:

Time: 1 :'I z._ Date: Time:

BEV.06/13

ATTACHMENT D

Certificate of Disposition of Materials

Surveyor Certification

NRC FORMa14 U.S. NUCl.J!AR REGUl.ATORY COMMISSION APPROVED BY OMS: NO. 3160-0028 EXPIRES; 10/31/2013

(05-21"112) MOiled bunlea per mpomo lo tomply .,.lh lhls mandelcwy tdlec.IIM leq~t 30 .millllt(!S. 10 CFR 30.~::!j1!1l: ~M2fll\11: Tllb st~btnillli rs um by N~c ~ part o1 1M oow for 11s delllfl"l"ioatton !hat 1110 IIY,:ii!y ~ 70.~Kll: o 72JH(I<)(6 )(IJ released lor UM!$lricled U$8, Ssnd <:QIIIm;nl$ ~ ~ es~e lo ""' I!!~

Sell'fCOJilcaach (T-6 F63}, U.S. Nudear Regulallxy ~. \Yasllbg\On, DC ~1,

CERTIFICATE OF DISPOSITION OF MATERIALS or by ln!emel e-DN~Ilo lnloco~~~@nll:.gov, alii lo ll)o .Qesk Oilil;er, O/Rca ot lnformal1oo ~nd ~ry Af(l!lcs. llE00-10202, (3100.0028~ 0/I!Ce Of /danagM!tniMd illldge~ Wi1$lingb0, 00 20S03, II a MeaM 11&11<1 10 lmpote an infomiaion wludOJn dooi nol dlsjllay a cut!OIIIIy wld 0/.JJ conlrd numbet, fhe NRC 1M}' 1101 C!llldutl Of sponw, illld a pel$0111$ not~ 1o respood 10, lheltlfOI!Ilalloo «iieclial.

LICENSEE NAME AND ADDRESS LICENSE NUMBSl DOCKET NUMBER

Cardinal Health 414, LLC Facility: Cardinal Health 34-29200-0 lMD 030-36973

7000 Cal'dinal Place 2131 E. 32nd Street, Suite 1 LICENSE. EXPIRATION DAlE Dublin OH 43017 Joplin, MO 64804 January 31, 2022

A. LICENSE STATUS (Chock the appropriate box) 0 This license has expired. 0 This license has not yet expired; please tennioate il 0 License remains active

B. DISPOSAL OF RADIOACTIVE MArERIAL (Chack tho appropriate boXa$ and complet11 as necessary. If addlflonal spac11 Is na11dad, provide attachments}

The licensee, or any Individual execuHng this certificate on behalf of the ilcensee, certifies that:

D 1. No radloacflva materials have ever been procured or possessed by the licensee under this license.

.0 2. All aclivil!es authorized by this license have ceased, and all radioactive materials procured andlor possessed by the licensee under this license number clted above have been disposed of in the rouowlng manner •

. [{] a. Transfer of radioactive materials to the licensee listed below: Cardinal Health and Cardinal Health

[{] b. Disposal of radioactive materials: 3040 E. Elm Street 9668 Marion Ridge

.. [{] 1. DlrecHy by the licensee: Springfield, MO 65802 Kansas City, MO 64137

I Decay in Storage or Transfer to Authorized Recipient NRC License No. 34-29200-01 MD

I . D 2. By licensed disposal site:

0 3. By waste contractor.

[ZJ c. All radloaclfva materials have been removed such that any remaining residual radioactivity is within the limits of 10 CFR Part 20, l:ltlbpart E, and is ALARA.

C. SURVEYS PERFORMED AND REPORTED {{) 1. A ~adlatron suJVey was conducted by the licensee. The survey confirms:

[{] a, the absence of licensed rad(oacllve materials

[{) b. that any remaining residual radioactivity is within the limits of 10 CFR 20, Subpar! E, and is AlARA.

- [{] 2. A copy of the radiation swvey results:

' [{] a. Is al!ached; or 0 b. Is not attached {Provide explanation); or 0 c. was forwarded to NRC on: p. ~ ..

0 3~ A radlaUon survey is not required as only sealed sources were ever possessed under this Jlcense, and Dale

0 ·a. The resuf!s of the latest leak test are attached; and/or 0 b. No leaking sources have ever been identified.

The person to be contacted regarding the information provided on this form: NAME

~~~ TEI.EPHONE · (ln.W. ArB<I Code) Jo-MAILIIIJMESS

Willie Regits, Ph.D. Corporate Radiation Safety Officer (614) 757-4120 I he~f~~physics@cardirialhealth.com Mail all Mvle OOIIO'fl'!fldon«io rogO(dlng l~l$1ic:onoa to:

Cardinal Health Nuclear Pharmacy Services, 7ooo Cardinal Place, Dublin OH 43017

C. CERTIFYING Of:FtCIAL .• ____ .--- I 4?ERTIFY U.N.D.E.R PENALTY 01! ~ERJU_!!.YTHAT~UEAND CO~IU!~T .. • .. ··-PRMEONAMEANO~T!E -. R {)1 P-i L Jill~ 8-m~ttY ~li}jJP.., H-ft~Acf 6 -:r.;(?l'/ . ~~(3 WA~NING: FALSE BTAlEMEHTSIN THIS CI:HUIFICATE MAYBE SUBJECTTO Cwlf.. AND/OR CRIMI~j. pf:fMi.TJES, NRC REGULATIONS REQUIRe TtiAT SUBMIS~IONS TO THI; NRC PE! COMPLETE AND ACCURATE IN ALL MATERIAL RESPI!OT. 18 U.S.C. S cnON 1001 MAKES IT A CRlMINAL OI'FENSI: TO MAKE A

·-WILLFULLY FALSI! STATEMENT OR REPRESENTA'I'ION TO ANY DEPARTMENT OR AGENCY OP THE! ONI'J'I{D STATES AS TO ANY MATTER WIT Hill ITS JURISIJICTION. .'NU!lrORU314 (O~l2) :1

Surveyor Certification

Surveyor: Brent Marion Authorized User RAM License No. 34-29200-01 MD Cardinal Health

Survey Location: 2131 E. 32nct Street Suite 1 Joplin, MO 64804

Survey Date: 8/28/2013

Certification Statements:

Nuclear Pharmacy Services

1. All non-exempt radioactive material and waste was moved out of the areas to be released for unrestricted use and into permanent restricted areas prior to performing the clearance surveys.

2. A gross search for radioactive material was performed and no material was present.

3. The background radiation levels measured at several locations in the non-impacted area of the facility measured 12 !JRihr, therefore the readings listed as "Survey gross !JR/h" in the closeout survey data form are background at all locations measured in the impacted area of the facility.

4. The wipe test results on the Closeout Survey data sheet are shown in dpm per 100 cm2. All

wipe measurement results were less than the MDA and less than 200 dpm per 100 cm2.

I certify the above data and statements to be true.

Date: -J-9---4-j'--0--{---'---'3"-----

ATTACHMENT E

Sealed Source Transfer Log

Sealed Source Receipt Confirmation

SEALED SOURCE TRANSFER LOG

DATE OF TRANSFER: 8-7-13

TRANSFER FROM: Cardinal Health NPS Location #182 2131 E 32nd St Suite 1 Joplin, MO 64804 License # 2009033156

TRANSFER TO: Cardinal Health NPS Location #120 3040 E Elm Springfield, MO 65802 License #2009033158

Type Serial Assay Assay Nuclide (b/g) Number Activity Date

Ba-133 vial 986-44-8 250 uCi 1/1/04 Ba-133 rod 757-71-6 0.1 uCi 11/1/02 Co-57 vial 1393-48- 5mCi 1/1/11

0004 Co-57 rod 1594-47-3 0.1 uCi 12/1/12 Cs-137 vial 956-17-2 200 uCi 11/1/02 Cs-137 Rod 851-57-5 0.1 uCi 11/1/02

*Pass=Removable contamination less than 0.005 uCi.

Print Name

Radiation Safety Officer

Current Activity

_(JJ.Ci} 133 uCi

450 uCi

165 uCi

Leak Test Leak Test Results*

Date (Pass/Fail) 8fi/13 Pass 8fi/13 Passj 8fi/13 Pass

8/7/13 Pass 8fi/13 Pass 8/7/13 Pass

Sep. 9. 2013 3:32PM Cardinal Health NPS #120

-~ r ~--cardinaiHealth

o.,.te September 9, 2013

To Quality & Regulatory Department

Memo

From Dane Dishman, RSO, Location 120, Springfield, MO

cc Sarah Pekarek, RSO, Location 182, Joplin, MO

subject Sealed Source Receipt

No. 9906 P. 2

This memo serves as confirmation that the Cardinal Health Nuclear Pharmacy in Springfield,

MO {location 120), RAM license number 34-29200-01MD, has received the following sealed

sources, sent from the Cardinal Health Nuclear Pharmacy in Joplin, MO (location 182), which

operates under the same RAM license:

Nuclide Source Type

Ba-133 Vial

Ba-133 Rod

Co-57 Vial

Co-57 Rod

Cs-137 Vial

Cs-137 Rod

Dane Dishman, Radiation Safety Officer

Location 120, Springfield, MO

Serial Number

986w44-8

757-71-6

1393-48-0004

1594-47-3

956-17-2

851-57-5

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Cardinal Health Nuclear Pharmacy Services 7000 Cardinal Place Dublin, OH 43017

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US Nuclear Regulatory Commission Region Ill-Division of Nuclear .. Material Safety 2443 Warrenville Rd, Suite 210 Lisle, IL 60532-4352

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