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State of California-Health and Welfare Agency Department of Health services <br /> Page 4 of 7 pages <br /> RADIOACTIVE MATERIAL LICENSE License Number: 1276-39 <br /> Supplementary Sheet Amendment Number: 62 <br /> 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material <br /> described in Items 6, 7, 8 and 9 of this license in accordance with statements, representations, and procedures <br /> contained in the documents listed below. The Department's regulations shall govern unless the statements, <br /> representations, and procedures in the licensee's application and correspondence are more restrictive than the <br /> regulations. <br /> (a) The application with attachments dated September 28, 1987, signed by Jack L. Funamura, M.D. <br /> (b) The letter with attachments dated October 6, 1988, signed by Lawrence A. Philipp. <br /> (c) The letter with attachments dated November 18, 1988, signed by Jack L. Funamura, M.D. <br /> (d) The letter dated February 21, 1989, and the letter with attachments dated February 22, 1989, both signed <br /> by Jack L. Funamura, M.D. <br /> (e) The letters dated April 19, 1989 and May 18, 1989, both signed by Richard A. Seidler, Vice President. <br /> (f) The letter dated August 4, 1989, signed by Jack L. Funamura, M.D. <br /> (g) The letter dated March 9, 1992, with attached survey procedure and diagram, signed by Jeffrey L. Hall. <br /> (h) The letters dated April 1, 1996, May 21, 1996 and June 5, 1996, all signed by Maria Chan, Ph.D., <br /> Radiation Safety Officer, regarding the request for use of a Strontium 90 applicator and the <br /> associated procedures. <br /> 14. (a) The Radiation Safety Officer in this program shall be Maria F. Chan, Ph.D. <br /> (b) The Chairperson of the Radiation Safety Committee shall be Jack L. Funamura, M.D. <br /> (c) The Custodian of sealed sources shall be Jack L. Funamura, M.D. <br /> 15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by <br /> Section 30275 (c) of the California Radiation Control Regulations. <br /> 16. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall <br /> be performed only by persons specifically authorized to perform that service. <br /> 17. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this <br /> license using leak test kits acceptable to the California Department of Health Services: <br /> (a) The Radiation Safety Officer <br /> (b) Qualified individuals designated in writing by the Radiation Safety Officer <br />