RECEIVED 03/01/2023

RECEIVED 03/01/2023

.BJM$POUSPM/VNCFS %PDLFU/VNCFS -JDFOTF/VNCFS

-JDFOTFF/BNF'PVOEBUJPO)FBMUI--$

From: To: Cc: Subject: Date: Attachments:

Diez, Donna-Marie C r4licensingsubmittals@ Jason Dykert [External_Sender] FMH License Amendment Tuesday, November 8, 2022 6:02:48 PM image001.png 2022NRC_313.pdf

Dear Sir/ Madam:

Please amend our radioactive materials license to remove Essam Shihadeh M.D. as an authorized user. He will no longer be performing brachytherapy and we will no longer be receiving Palladium103 at our facility. There are no remaining Pd-103 seeds in our Nuclear Medicine hot lab storage as of 11/08/2022.

Attached is NRC Form 313. If you require additional information or documentation, please call (907) 458-6914.

We respectfully request your prompt attention to this amendment request.

Thank you.

Regards,

Donna

Donna Diez CNMT, R.T. (N)(ARRT) Medical Imaging Supervisor Nuclear Medicine Fairbanks Memorial Hospital 1650 Cowles Street Fairbanks, AK 99701 907-458-6914 (office) 907-458-6904 (dept) 907-458-6926 (fax) donna-marie.diez@

cid:image001.png@01D8B7B8.D8C22FE0

People First. Community Focused. Excellence Every Time. *Upcoming Out of Office Dates : December 17, 2022 ? January 1, 2023

From: To: Cc: Subject: Date: Attachments:

Hi Carol,

Jason Dykert Carol Hill Lizette Roldan-Otero Licensee asking about status of amendment request Monday, February 27, 2023 1:25:57 PM External_Sender FMH License Amendment.msg

Foundation Health called me and asked about the status of this license amendment request, but I didn't see it anywhere in Report 23 or WBL.

Could you check and see where this request is at? It was received by the NRC in Nov. 2022, but no updated documents are in ADAMS or WBL.

Thanks,

Jason Dykert

Health Physicist Materials Inspection U.S. NRC - Region IV Phone: 817-200-1427

From: To: Cc: Subject: Date: Attachments:

Carol Hill Diez, Donna-Marie C; r4licensingsubmittals@ Jason Dykert; R4 Licensing Action Submittals RE: FMH License Amendment Wednesday, March 1, 2023 9:13:00 AM image001.png

We never received it (until now) because it was not sent to the correct email address: r4licensingactionsubmittals.resource@

From: Diez, Donna-Marie C Sent: Tuesday, November 8, 2022 6:02 PM To: r4licensingsubmittals@ Cc: Jason Dykert Subject: [External_Sender] FMH License Amendment

Dear Sir/ Madam:

Please amend our radioactive materials license to remove Essam Shihadeh M.D. as an authorized user. He will no longer be performing brachytherapy and we will no longer be receiving Palladium103 at our facility. There are no remaining Pd-103 seeds in our Nuclear Medicine hot lab storage as of 11/08/2022.

Attached is NRC Form 313. If you require additional information or documentation, please call (907) 458-6914.

We respectfully request your prompt attention to this amendment request.

Thank you.

Regards,

Donna

Donna Diez CNMT, R.T. (N)(ARRT) Medical Imaging Supervisor Nuclear Medicine Fairbanks Memorial Hospital 1650 Cowles Street Fairbanks, AK 99701 907-458-6914 (office) 907-458-6904 (dept) 907-458-6926 (fax) donna-marie.diez@

People First. Community Focused. Excellence Every Time. *Upcoming Out of Office Dates : December 17, 2022 ? January 1, 2023

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