Laserfiche WebLink
State of California—Health and Welfare Agency Department of He6lth 4r <br /> Page 1 of 7 pages <br /> RADIOACTIVE MATERIAL LICENSE <br /> Pursuant to the California Administrative Code, Title 17, Chapter 5,Subchapter 4, Group 2,Licensing of Radioactive Material,and in reliance <br /> on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive,use,possess, <br /> transfer, or dispose of radioactive material listed below,,and to use such radioactive material for the purpose(s)and at the place(s)designated <br /> below. This license is subject to all applicable rules,regulations,and orders of the Department of Health Services now or hereafter in effect and <br /> to any conditions specified in this license. <br /> 1. Licensee 3. License No. <br /> St. Joseph's Medical Center 1276-39 Amendment No. 57 <br /> 2 Address 1800 North California Street 4, Expiration date <br /> Stockton, CA 95204 November 19, 1995 <br /> 5. Inspection agency <br /> Attention., Lawrence A. Philipp Radiologic Health Branch <br /> Chief Operating Officer Sacramento <br /> In response to the letter dated Mardi 16, 1994, signed by Jeffery L. Hall, M.S_, <br /> Radiation Safety Officer, Moense Number 1276-39 is hereby amended as follows: <br /> In accordance with Article 4, Section 30195, the Medical Use Groups specified below <br /> grant the use of radioactive material, as approved by the U.S. Food and Drug <br /> Administration, the California State Board of Medical Quality Assurance and/or the <br /> California State Board of Pharmacy, for diagnosis and treatment of patients, when <br /> prescribed and as directed by an appropriately authorized physician listed on this <br /> license. <br /> GROUPS AUTHORIZED UNDER THIS LICENSE: <br /> Group 1 - Diagnostic studies involving measurement of uptake, dilution, or excretion <br /> but not involving imaging. <br /> Group 2 - Diagnostic studies involving imaging excluding the use of Xenon 127 and/or <br /> Xenon 133 gas. <br /> Group 3 - Use of reagents kits for preparation of radiopharmaceuticals listed in <br /> Group 2. <br /> Group 4 - Internal therapy not usually requiring hospitalization. <br /> Group 5 - Internal therapy usually requiring hospitalization for purposes of <br /> radiation safety. <br /> Group 6 - Sealed or solid sources manufactured, labeled, packaged, and distributed <br /> in accordance with a specific license issued pursuant to 10CFR32.74 or a <br /> specific license issued by an agreement state pursuant to equivalent state <br /> regulations (except for sources manufactured prior to August 16, 1974) . <br /> 6. Nuclide 7. Form 9. Authorized Use <br /> A. Cesium 137 A. Sealed Sources A. Treatment of Cancer <br /> B. Iridium 192 B. Seeds in Ribbon B. Treatment of Cancer <br /> C. Palladium 103 C. Seeds C. Treatment of Cancer <br /> For the State Department of Health Services <br /> Date April 21, 1994 by 3 <br /> Radiologic Health Section <br /> 744 P Street,Sacramento,CA 95814 <br /> RH 2550(2/81) <br />