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State of Califomia4-lealth and Welfare Agency Department of Health Services <br /> Page 4 of 7 pages <br /> RADIOACTIVE MATERIAL LICENSE License Number: 1276-3 <br /> Supplementary Stmt Amendment Number.AOL <br /> 13. Continued <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, MD. <br /> (g) The letter dated March 9, 1992, with attached survey procedure and diagram, signed by Jeffrey L. Hall. <br /> 14. (a) The Radiation Safety Officer in this program shall be Maria R Chan, PhD. <br /> (b) The Chairperson of the Radiation Safety Committee shall be Jack L. Funamura, MD. <br /> (c) The Custodian of sealed sources shall be Jack L. Funarnura, MD. <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 /> 18. Records of leak test results shall be kept in units of microcuries and maintained for inspection. Records may <br /> be disposed of following Department inspection. Any leak test revealing the presence of 0.005 microcuries or <br /> more of removable radioactive material shall be reported to the Department of Health Services, Radiologic <br /> Health Branch, 601 N. 7th Street P.O. Box 942732, Sacramento, CA 94234-7320,within five days of the test. <br /> This report shall include a description of the defective source or device,the results of the test,and the corrective <br /> action taken. <br /> 19. Any licensed sealed source is exempt from such leak tests when the source contains 100 microcuries or less <br /> of beta and/or gamma emitting material or 10 microcuries or less of alpha emitting material. <br />