Hill, Carol

From: Sent: To: Subject: Attachments:

Schoppers,Kay < Kay.Schoppers@SanfordHealth.org > Thursday, June 19, 2014 1:47 PM RidsRgn4MaiiCenter Resource; Hill, Carol; Murnahan, Colleen Amendment request amendment request 001Jpg; DASwanson_SD_License.pdf

RECEIVED Please find attached an amendment request along with 1 document. RML #40-26865-01 (docket #030-11252) JUN l 9 201~

Thank you.

Kay Schoppers~ CNMT Sanford Nuclear Medicine Clinic 1205 S. Grange Ave. Ste 402 Sioux Falls, SD 57105 {605) 328-8974

PUBLIC 0 IJ;Imediate Release [l;V'Normal Release

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

Reviewer:...:..ft1S....::;...... ___ Date: ?;4-o/ /' f

DNMS

Confidentiality Notice: Thi s e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain privileged and confidential informat i on. 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 al l copies of the original message.

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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: Carol.Hill@nrc.gov CoUeen.Murnahan(wnrc.gov

RidsRgn4MailCenter.Resource@nrc.gov

We hereby submit a notification under 10CFR35.13(b)(4)(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 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 10CFR35.100, 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,

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

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

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NRC FORM 532 (1-2012)

U. S. NUCLEAR REGULATORY COMMISSION

DATE

06/19/2014

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

40-26865-01 Sanford Nuclear Medical Clinic ATTN: Fred C. Lovrien, M.D. MAIL CONTROL NUMBER

Radiation Safety Officer Nuclear Medicine Department

584106

1205 South Grange A venue, Suite 402 Sioux Falls, South Dakota 57105

LICENSING AND/OR TECHNICAL REVIEWER

ch

This is to acknowledge the receipt of your:

[{] LETTER and/or 0 APPLICATION DATED: 06117/2014

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

[{] AMENDMENT 0 TERMINATION 0 NEW LICENSE 0 RENEWAL

0 There were no administrative omissions identified during our initial review.

D 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.

D 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 ifthere 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:

NRC FORM 532 (1-2012)

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

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: 06/30/2019 Fee Comments: Decem Fin Assur Reqd : N

License Fee Worksheet - License Fee Transmittal

A. REGION

1. APPLICATION ATTACHED

ApplicanULicensee:

Received Date:

Docket Number:

Mail Control Number:

License Number:

Action Type:

2. FEE ATTACHED

Amount:

Check No.:

I 3. COMMENTS

Sanford Medical Clinic

06/19/2014

3029708

584106

40-26865-01

Amendment

Signed:

Date:

B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered

1. Fee Category and Amount:

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

Amendment:

Renewal :

License:

3.0THER -------------------------------

Signed:

Date: