Nuclear Regulatory Commission: United States

UNITED STATES
NUCLEAR REGULATORY COMMISSION

REGION I
2100 RENAISSANCE BLVD.
KING OF PRUSSIA, PA 19406-2713
March 21, 2019
Jennifer Anderson, RN, BSN, CASC

' Director
Delaware Surgery Center, LLC
200 Banning Street, Suite 110
Dover, DE 19904
SUBJECT: DELAWARE SURGERY CENTER, NEW LICENSE, MAIL CONTROL NO.

610914
Dear Ms. Anderson:
This letter refers to your request for an NRC license. Enclosed with this letter is your NRC
License No. 07-35521-01. Please review the enclosed document carefully and be sure that you
understand all conditions. If there are any errors or questions, please contact me at (610) 337-
5358 or via electronic mail at lester.tripp@nrc.gov so that appropriate corrections or answers
can be provided.
An environmental assessment for this action is not required, since this action is categorically
excluded under 10 CFR 51.22(c)(14).
Please be advised that your license expires at the end of the day in the month and year stated
in the license. Until your license has been terminated, you must conduct your program in
accordance with the conditions of your license, representations made in your license
application, and NRC regulations. In particular, note that you must:
1. Operate in accordance with NRC regulations 10 CFR Part 19, "Notices, Instructions and
Reports to Workers: Inspections and Investigations," 10 CFR Part 20, "Standards for
Protection Against Radiation," and other applicable regulations.
2. Notify the NRC in writing 30 days in advance of any change in mailing address.
3. In accordance with 10 CFR 30.36(d), notify the NRC promptly, in writing, within 60 days
and request termination of the license:
a. When you decide to terminate all activities involving materials authorized under
the license;
b. If you decide not to acquire or possess and use authorized material; or
c. When no principal activities under the license have been conducted for a period
of 24 months.
J. Anderson 2
4. In accordance with 10 CFR 35.14, notify the NRC no later than 30 days after:
a. The date that the licensee permits an individual to work as an authorized user
under 10 CFR 35.13(b)(1) through 35.13(b)(4);
b. An authorized user or a Radiation Safety Officer permanently discontinues duties

under the license or has a name change;
l c. The licensee's name changes but the name change does not constitute a
transfer of control of the license as described in 1O CFR 30.34(b ); or
d. The licensee has added to or changed the areas of use identified in the
application or on the license where byproduct material is used in accordance with
either 10 CFR 35.100 or 35.200.
5. Request and obtain a license amendment before you:
a. Change Radiation Safety Officers;
b. Order byproduct material in excess of the amount, or radionuclide, or form

different than authorized on the license;
c. Add or change the areas of use or address or addresses of use identified in the
license application or on the license (except for areas of use where byproduct
material is used only in accordance with either 10 CFR 35.100 or 35.200); or
d. Change the name or ownership of your organization.
6. Submit a complete renewal application or termination request at least 30 days before the
expiration date of your license. You will receive a reminder notice approximately
60 days before the expiration date. Possession of byproduct material after your license
expires is a violation of NRC regulations.
When submitting future license amendments, please have the document signed by a
management representative rather than the Radiation Safety Officer. The NRC views a letter
signed by a management representative as indication that management has reviewed the
application and concurs in the statements and representations contained therein. In addition,
please note that NRC Form 313 requires the applicant, by signature, to verify that the applicant
understands that all statements contained in the application are true and correct to the best of
the applicant's knowledge. The signatory for the application should be the licensee or a
certifying official of the licensee rather than a consultant.
You will be periodically inspected by the NRC. Failure to conduct your program safely and in
accordance with NRC regulations, license conditions, and the representations made in your
license application and supplemental correspondence with NRC will result in enforcement
action(s) against you. This could include issuance of a Notice of Violation, Imposition of a Civil
Penalty, or an Order Suspending, Modifying or Revoking your license as specified in the NRC
Enforcement Policy. The NRC Enforcement Policy is available at:
http://www.nrc.gov/reading-rm/doc-collections/enforcement/.
J. Anderson 3
The NRC's Safety Culture Policy Statement became effective in June 2011. While a policy
statement and not a regulation, it sets forth the agency's expectations for individuals and
organizations to establish and maintain a positive safety culture. You can access the policy
statement and supporting material that may benefit your organization on NRC's safety culture
Web Site at: http://www.nrc.gov/about-nrc/safety-culture.html. We strongly encourage you to
review this material and adapt it to your particular needs in order to develop and maintain a
positive safety culture as you engage in NRG-regulated activities.
&
An electronic version of the NRC's regulations is available on the NRC Web Site at:
www.nrc.gov. Additional information regarding medical uses of radioactive materials may be
obtained on the NRC Web Site at: http://www.nrc.gov/about-nrc/safety-culture.html. This site
also provides the updated Training and Experience NRC Form 313A series of forms and
guidance, as well as information on the revised regulations for naturally-occurring and
accelerator-produced radioactive materials (NARM).
Current NRC regulations and guidance are included on the NRC Web Site at www.nrc.gov;
select Nuclear Materials; Med, Ind, & Academic Uses; then Licensee Toolkits, see our
toolkit index page. You may also obtain these documents by contacting the Government
Printing Office (GPO) toll-free at 1-866-512-1800. The GPO is open from 8:00 a.m. to 5:30 p.m.
EST, Monday through Friday (except Federal holidays).
Please be aware that, as a holder of an NRC license, you may be subject to the NRC's licensing
annual fee in accordance with 10 CFR Part 171. If you have any questions concerning the fee
requirements, please contact the License Fee and Accounts Receivable Branch at
(301) 415-7544.
In accordance with 1O CFR 2.390 of the NRC's "Rules of Practice," a copy of this letter and its
enclosures will be available electronically for public inspection in the NRC Public Document
Room or from the NRC's document system (ADAMS). ADAMS is accessible from the NRC
Web Site at: http://www.nrc.gov/reading-rm/adams.html.
J. Anderson 4
Thank you for your cooperation.
Sincerely,
~_;C. -<~·'°
Lester Tripp
Medical and Licensing Assistance Branch
Division of Nuclear Materials Safety
Region I
License No. 07-35521-01

Docket No. 03039148
Mail Control No. 610914
Enclosures:
1. License No. 07-35521-01
2. NRC Form 3
cc: Adam Raben, M.D., Radiation Safety Officer

J. Anderson
DELAWARE SURGERY CENTER, NEW LICENSE, MAIL CONTROL NO. 610914 DATED
March 18, 2019
DOCUMENT NAME: G:\WBL Documents\WBL License Cover Letter\L07-35521-01.610914.docx

SUNSI Review Complete: Lester Tripp
After declaring this document "An Official Agency Record" it will be released to the Public.
To receive a copy of this document, indicate in the box: "C' = Copy w/o attach/encl "E" = Copy w/ attach/encl "N' = No copy
OFFICE Rl:DNMS IN I I I
NAME Lester Tripp 'fr-

DATE 03/21/2019
OFFICIAL RECORD COPY

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UNITED STATES

NUCLEAR REGULATORY COMMISSION

March 21, 2019

Jennifer Anderson, RN, BSN, CASC

SUBJECT: DELAWARE SURGERY CENTER, NEW LICENSE, MAIL CONTROL NO.

Dear Ms. Anderson:

b. If you decide not to acquire or possess and use authorized material; or

b. An authorized user or a Radiation Safety Officer permanently discontinues duties

5. Request and obtain a license amendment before you:

a. Change Radiation Safety Officers;

b. Order byproduct material in excess of the amount, or radionuclide, or form

d. Change the name or ownership of your organization.

Thank you for your cooperation.

License No. 07-35521-01

cc: Adam Raben, M.D., Radiation Safety Officer

DOCUMENT NAME: G:\WBL Documents\WBL License Cover Letter\L07-35521-01.610914.docx

NAME Lester Tripp 'fr-

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