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GL-719770-21 SECTION 1 02/07/2017 PAGE 1of2 NRC FORM 664 U.S. NUCLEAR REGULATORY COMMISSION 07 - 2015 10CFR31.5 GENERAL LICENSEE REGISTRATION

APPROVED BY OMB: NO. 3150-0198 EXPIRES: 04/30/2016 Estimated burden per response to comply with this mandatory collection request: 20 minutes. NRC will use this information to track general licensees and their devices to ensure a higher level of device accountability. Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections Branch (T-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to [email protected], and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0198), Office of Management and Budget, Washington, DC 20503. lfa means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

Complete all six sections of this registration form. If any of the preprinted information is incorrect, provide the changes in the applicable boxes. USE CAPITAL LETTERS.

General License SECTION 1 - GENERAL LICENSEE INFORMATION Registration Number GL-719770-21

Enter the company name and the street address/physical location of use for your device(s). For portable devices, specify the primary storage location. Do not use a P.O. Box address.

Company Name: -8¥-NTAG COATED PRODUCTS

G o A- T J N & LLc I I I I I ,,) . Department: COATING I I I I I I I I I I I I I Address Line 1: 29 INDUSTRIAL PARK ROAD I I I I I I I I I I I I I Address Line 2: I I I I I I I I I I I City: NEW HARTFORD I I I I I I I I I I I I I I I I I

State: CT rn Zip Code: 06057 - ~I~I ~l~I~I -I I I Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll Illllllll llll lllll llll lllllll Ill llll llll GL-719770-21 SECTION 1 02/07/2017 PAGE 2of2 SECTION 1 - GENERAL LICENSEE INFORMATION (Continued) Enter the name, telelphone number and title of the person who is the responsible individual for the device(s).

Last Name: KRUEGER I I I I I I I I I I I I I I I I I I I I I I First Name: DAN Middle Initial: J

11111111111111 ~ Telephone: (860) 738-2600 Extension: 108 I I I 11 I I 11 I I I I I I I I I I Title: OPERATIOPJS MAPJAGER

Enter the mailing address where correspondence regarding your device(s) should be sent. This address should be specific to the use or storage location of your device(s). Department: I I I I I I I I I I I I I I I I I I I I I Address Line 1: 29 INDUSTRIAL PARK ROAD j I I I I I I I I I I I I I I I I Address Line 2:

I I I I I I I I I I I I I I I I I I I I I City: NEW HARTFORD

I I I I I I I I I I I I I I I I I I I I I I I I State: CT rn Zip Code: 06057 - I I I I I I - I I I I I Illlllll llllll II llllll lllll lllll lllll lllll lllll llll llllll lllll llll llll . 111111111111111111111111111111 GL-719770-21 02/07/2017 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary. PAGE 1 of 2

NRC Device Key 745207 (Internal Control Number)

Distributor/Distributed By: NOC INFRARED ENGINEERING INC I I I I I I I I I I I I I I I I I I I I I I I I Distributor License Number: 1933-19GL I I I I I I I I I I I I I I Manufacturer Name: NOC INFRARED ENGINEERING INC I I I I I I I I I I I I I I I I I I I I I I I I Device Model (Not Source Model): 103 I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number: 13486 I I I I I I I I I I I I I I I I I I I I I I I I I Transfer Date (Receipt Date): 01/31/2006 Not in possession of device (Also DJLDI I I I D complete Section 4.) MM DD yyyy

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)

1 AM241 150.000000000 mCi I I I I I I I I I I I I I I I 2 I I I I I I I I I I I I I I I I I I I 3 I I I I I I I I I I I I I I I I I I I I I 4 I I I I I I I I I I I I I I I I I I I I I 5 I I I I I I I I I I I I I I I 6 I I I I I I I I I I I I I I I I I I Illlllll llllll II 1111111111111111111111111111111 1111 1111111111111111111 Illllllll llll lllll llll llll llll GL-719770-21 02/07/2017 SECTION 2 - DEVICES SUBJECT TO REGISTRATION SECTION 2 Our records indicate that you have these devices. Please update the information as necessary. PAGE 2 of 2

NRC Device Key 752016 (Internal Control Number)

Distributor/Distributed By: NDC INFRARED ENGINEERING INC I I I I I I I I I I I I I I I I I I I I I I I I Distributor License Number: 1933-19GL I I I I I I I I I I I I I I Manufacturer Name: NDC INFRARED ENGINEERING INC I I I I I I I I I I I I I I I I I I I I I I I I Device Model (Not Source Model): 103 I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number: 13487

I I I I I I I I I I I I I I I I I I I I I I I I I

Transfer Date (Receipt Date): 04/27/2006 Not in possession of device (Also rnrn1111 D complete Section 4.) MM DD YYYY

Isotope (e.g. AM241) Activity (e.g. 100) Unit (e.g. mCi)

1 AM241 150.000000000 mCi I I I I I I I I I I I I I I I I I I I 2 I I I I I I I I I I I I I I I 3 I I I I I I I I I I I I I I I I I I I I I 4 .---I.---I .-----.I 1-1~1 I I I I I I I I I I I I I I I 5 ....---, r---1 1.------.1----.1-----,1 I I I I I I I I I I I I 6 I I I I I I I I I I I I I I I I I I I I Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 111111111111111111111111111111 GL-719770-21 02/07/2017 SECTION 3 SECTION 3 - ADDITIONAL DEVICES SUBJECT TO REGISTRATION PAGE 1 of 1 Provide information about other devices you have that are subject to registration. Do not report specifically licensed devices.

Manufacturer Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor Name I I I I I I I I I I I I I I I I I I I I I I I I I I I I Initial Transferor License Number (if known) I I I I I I I I I I I I I Device Model Number (Not Source Model) I I I I I I I I I I I I I I I I I I I I I I I I I I I I Device Serial Number I I I I I I I I I I I I I I I I I I I I I I I I I I 0 Manufacturer/Initial Transferor listed above How acquired and date (e.g., from a distributor/manufacturer, 0 Other General Licensee Date Transferred: OJ OJ I \ \ \ \ other licensee, other source)? . . . . . 0 Other Source (Received) MM DD YYYY

Isotope (e.g. AM241) Activ"ty(eg.100) Unit (e.g. mCi)

1 ·I...___'-----'------'----'-----' 2. I ~~~ 3. ~I~~

4. I ~~~

5.

6.

7.

8.

9.

10. Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 111111111111111111111111111111 GL-719770-21 SECTION 4 - NOT IN POSSESSION OF DEVICE SECTION 4 02/07/2017 Provide information about devices listed in Section 2 or 6, but no longer in your possession. PAGE 1of1 .

Part 1 Transfer Date:

MM DD yyyy Location of the Device: O Whereabouts Unknown (complete Part 1 only) O Transferred to another general licensee (complete Parts 2 and 3) 0 Never Possessed the Device (complete Part 1 only) 0 Transferred to a Specific Licensee (Not the manufacturer) 0 Returned to Manufacturer (complete Part 1 only) (complete Part 2) Part 2 License Number of Recipient (if transferred to a specific licensee): I I I I I I I I I I I I I I Company Name: I I I I I I I I I I I I I I I I I I I I I I I I I I I I Department: . I I I I I I I I I I I I I I I I I I I I I I I I I I I I Address Line 1: I I I I I I I I I I I I I I I I I I I I I I I I I I I Address Line 2: I I I I I I I I I I I I I I I I I I I I I I I I I I I I City: , I I I I I I I I I I I I I I I I I I I I I I I I I I I I State: rn Zip Code: I I I I I I - I I I I I Part 3 Enter the name of the individual responsible for this device: Last Name: I I I I I I I I I I I I I I I I I I I I I I I I I I I First Name: Middle Initial:

11111111111111 D

Telephone Number: J I I I J I I I I I I I I Extension: .---,Ilr---->lr---->lr---->lr---->I Title: I I I I I I I I I I I I I I I I I I I I I I I I I I I I Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 111111111111111111111111111111

GL-719770-21 SECTION 5 - CERTIFICATION SECTION 5 02/07/2017 PAGE 1 of 1

I hereby certify that:

A. All information contained in this registration is true and complete to the best of my knowledge and belief. B. A physical inventory of the devices subject to registration has been completed, and the device information on this form has been checked against the device labeling. C. I am aware of the requirements of the general license, provided in 1O CFR 31.5. (Copies of applicable regulations may be viewed at the NRC website at: http://www.nrc.gov/reading-rm/doc-collections/cfr)

I SIGN:::~ON:a:::AL (Listed in Section 1) DATE

WARNING: FALSE STATEMENTS MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL

MATERIAL ASPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKEA WILLFULLY WRONG STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE AS TO ANY MATTER IN ITS JURISDICTION. Illlllll llllll II llllll lllll lllll lllll 111111111111111111111111111111111 111111111111111111111111111111 GL-719770-21 02/07/2017 SECTION 6 - DEVICES NOT SUBJECT TO REGISTRATION SECTION 6 PAGE 1of1

NRC Device Key: Manufacturer License No: Manufacturer Name: Model Number: Serial#: Transfer Date: Ple~e. /Id-Ii j:J /l~G (d4ccJ /JmJu~

ShurWT!!lll f/JU} aCf u .. , ·/ed. FOR IMMEDIATE RELEASE

Agency Contact: Michelle Rash • 336.553.1733 • [email protected]

Corporate Contact: Laura Pierce • 828.267.8506 • [email protected]

Shurtape Technologies, LLC, Expands Tape Business with Acquisition of Syntac Coated Products, LLC -Syntac to continue operations as Shurtape Specialty Coating, LLC-

HICKORY, N.C. (February 13, 2017) - Shurtape Technologies, LLC, an industry-leading producer of pressure-sensitive tapes, announces the acquisition of Syntac Coated Products, LLC, a designer and manufacturer of specialty adhesive coated products.

Shurtape is a fifth-generation, family owned, global business that delivers tape solutions to the packaging, building and , DIV, HVAC, industrial, maintenance, repair and operations (MRO), arts and entertainment, and transportation industries. Syntac was established in 2001 and designs high performance industrial adhesive and tape products for automotive, medical, construction, graphic arts, sound control and product assembly applications.

Together, the companies will offer a broad product portfolio that includes cloth and duct,, masking and paper, packaging, foil, film, double-coated and transfer tapes, in addition to packaging dispensers and equipment for automated and manual case sealing applications.

"The combination of Shurtape and Syntac enhances our ability to support our customers through expanded research and development capacity, broadened production capabilities and global distribution," said Stephen Shuford, CEO for Shurtape Technologies. "We are excited about the future and look forward to the growth that this merger makes possible for ourselves and for our valued customers."

"Together, we remain dedicated to delivering unmatched innovation, service and quality to the industries we serve and look forward to providing our customers with a broad range of product options and enhanced service capabilities to meet their ever-evolving needs," added Curt Rutsky, CEO for Syntac Coated Products.

Shurtape Technologies, LLC P.O. Box 1530, Hickory, NC 28603 • Phone: 828.322.2700 • Toll-Free: 888.442.8273 Shu

Syntac's staff of approximately 50 will join more than 1,500 Shurtape employees globally. The company, which will be renamed Shurtape Specialty Coating, LLC, will continue to operate its 60,000-square-foot facility in New Hartford, Conn., and new 23,000-square-foot facility in Sarasota, Fla.

Shurtape received financial advice from North Inlet Advisors, LLC, and legal advice from Robinson, Bradshaw & Hinson, P.A., in connection with the acquisition. Terms of the deal were not disclosed. ### SYNTAC COATED PRODUCTS Syntac Coated Products, LLC, New Hartford, Conn., is a designer and manufacturer of high performance, specialty, pressure-sensitive tapes for automotive, medical, construction, graphic arts, sound control and product assembly applications. The Company's product portfolio includes single­ coated, double-coated, unsupported transfer and self-wound tapes. Syntac prides itself on being distinguished as a Responsible Tape Manufacturer by the Pressure Sensitive Tape Council (PSTC), and is also ISO 9001: 2008 and ISO 13485 Certified. Learn more at SyntacUSA.com.

SHURTAPE® Shurtape®, Hickory, N.C., is an industry-leading producer of pressure-sensitive tapes designed to meet the most exacting standards. Products include masking and paper, foil and film, packaging, double-coated, cloth and duct, and other specialty tape products, in addition to packaging dispensers and equipment for automated and manual packaging applications. Recognized as a Responsible Tape Manufacturer by the Pressure Sensitive Tape Council (PSTC), Shurtape proudly serves a variety of markets, from painting and packaging to HVAC and transportation, with facilities in the United States, , , , , , United Arab Emirates and . For more information, visit shurtape.com. find us on Facebook® (facebook.com/Shurtape), follow us on Twitter®(@shurtapetech) or watch our videos on YouTube® (youtube.com/ShurtapeTech).

Facebook® Is a registered trademark of Facebook, Inc. Twitter® is a registered trademark ofTwitter, Inc. You Tube® is a registered trademark of Google Inc.

Shurtape Technologies, LLC P.O. Box 1530, Hickory, NC 28603 • Phone: 828.322.2700 • Toll-Free: 888.442.8273