ML21118A067

Princeton Community Hospital, NRC Form 591M Part 1, Inspection Report 03010772/2021001

ML21118A067
Person / Time
Site:	03010772
Issue date:	03/04/2021
From:	Robert Elliott NRC Region 1
To:	Princeton Community Hosp
References
IR 2021001
Download: ML21118A067 (1)

See also: IR 07200202/2010001

Text

SAFETY INSPECTION REPORT AND COMPLIANCE INSPECTION

NRC FORM 591M PART 1

U.S. NUCLEAR REGULATORY COMMISSION

(07-2012)

10 CFR 2.201

1. LICENSEE/LOCATION INSPECTED

2. NRC/REGIONAL OFFICE

REPORT NUMBER(s)

Princeton Community Hospital

12th Street Extension

Princeton, WV 24740

Region 1

2100 Renaissance Blvd

Suite 100

King of Prussia, PA 19406-2713

2021001

4.

LICENSE NUMBER(S)

3.

DOCKET NUMBER(S)

47-16307-01

030-10772

5. DATE(S) OF INSPECTION

03/04/2021 though

4/6/21

LICENSEE:

The inspection was an examination of the activities conducted under your license as they relate to radiation safety and to compliance with the

Nuclear Regulatory Commission (NRC ) rules and regulations and the conditions of your license. The inspection consisted of selective examinations of

procedures and representative records, interviews with personnel, and observations by the inspector. The inspection findings are as follows:

1. Based on the inspection findings, no violations were identified.

o

2. Previous violation(s) closed.

3.The violations(s), specifically described to you by the inspector as non-cited violations, are not being cited because they were self-identified,

non-repetitive, and corrective action was or is being taken, and the remaining criteria in the NRC Enforcement Policy, to exercise discretion, were

satisfied.

Non-cited violation(s) were discussed involving the following requirement(s):

o

o

4. During this inspection, certain of your activities, as described below and/or attached, were in violation of NRC requirements and are being

cited in accordance with the NRC Enforcement Policy. This form is a NOTICE OF VIOLATION, which may be subject to posting in accordance

with 10 CFR 19.11. (Violations and Corrective Actions)

I hereby state that, within 30 days, the actions described by me to the Inspector will be taken to correct the violations identified. This statement of

corrective actions is made in accordance with the requirements of 10 CFR 2.201 (corrective steps already taken, corrective steps which will be taken,

date when full compliance will be achieved). I understand that no further written response to NRC will be required, unless specifically requested.

TITLE

PRINTED NAME

SIGNATURE

DATE

Statement of Corrective Actions

Sherri Snead, Director of Imaging

Robin Elliott

Donna Janda

LICENSEE'S

REPRESENTATIVE

NRC INSPECTOR

BRANCH CHIEF

NRC FORM 591M PART 1 (07/2012)

Page 1 of 1

4/7/21

Donna M. Janda

Digitally signed by Donna M.

Janda

Date: 2021.04.27 16:06:42 -04'00'