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Nj 241 2018
Activities described below)
2. Type of Report
Annual
3. ADDRESS OF LICENSEE
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4. LICENSEE CONTACT AND TITLE
5. TELEPHONE NUMBER
6. FACSIMILE
NUMBER
EMAIL:
7. ACTIVITIES TO BE CONDUCTED UNDER THE GENERAL LICENSE GIVEN IN N.J.A.C. 7:28-62.1 (See 10 CFR150)
SERVICE PROVIDER
PORTABLE GAUGES
RADIOGRAPHY
LEAK TESTING AND/OR CALIBRATIONS
WELL LOGGING
OTHER - Specify:
IRRADIATOR SERVICE
LOCATIONS OF USE - LIST ADDITIONAL WORK SITES ON SEPARATE SHEET(S)
8. CLIENT NAME &...
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