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c -a y State of California -Health and Welfare Agency Department of Health Services clm Page 1 of 4 pages ~M` RADIOACTIVE MATERIAL L NSEVU' Pursuant to the Pafifornia Code of Regulations, Division 1, Title 17, Chapter 5, Subchapter 4, diolup,A?, Licensing of Radioactive Material, and in reliance on statements and representations heretofore made by the licensee, a license is hereby iss �,a thorizing the licensee to receive, use, possess, transfer, or dispose of radioactive material listed below; and to use such radioactive rrrrate for the purpose(s) and at the places(s) designated below. This license is subject to all applicable rules, regulations, and orders of the Department of Health Services now or hereafter in effect and to any standard or specific condition specified in this license. 1. Licensee Sutter Tracy Community Hospital 3. License Number 4097-39 Amendment Number: 17 2. Address 1420 North Tracy Boulevard 4. Expiration date Tracy, CA 95376 September 15, 1997 (3) Attention: H. Walter Pepper, M.D. 5. Inspection agency Radiologic Health Branch Radiation Safety Officer Sacramento In response to the letter dated June 6, 2000, signed by H. Walter Pepper, M.D., Radiation Safety Officer, Gary Rapaport, Chief Executive Officer, and Dave Bowlsby, Diagnostic Imaging Manager, License Number 4097-39 is hereby amended as follows: 6. Nuclide 7. Form 8. Possession Limit A. Group 1, 2, 3 and 4 as specified in A. Any A. Combined possession limit for Item 9. Excluding generators Groups 1, 2, 3 and 4 not to exceed Any radionuclide with atomic 490 mCi. number 3-83. B. Group 6 as specified in Item 9. B. B. 1. Total 100 mCi. Each seed not 1. Iodine-125 1. Seeds to exceed 0.6 mCi. 2. Palladium -103 2. Seeds 2. Total 500 mCi. Each seed not to exceed 2.0 mCi. C. Group 9 as specified in Item 9. C. Sealed or solid sources C. Total not to exceed 10 mCi. Each Any radionuclide with atomic manufactured in accordance with a source not to exceed 10 mCi. numbers 3-83, inclusive, except: specific license issued by the Strontium -90 and Lead -210. United States Nuclear Regulatory Commission or an Agreement ' State or a LicensinE State. c 9. Authorized Use c;p r To be used for nuclear medicine procedures as specified in groups below:' A. Group 1 Diagnostic studies involving measurement of uptake, dilution, or excretion but not involving imaging. Group 2 Diagnostic studies involving imaging including the use of Xenon -127 and/or Xenon -133 gas. Group 3 Reagent kits for preparation of radiopharmaceuticals listed in Group 2. Group 4 Internal therapy and palliative treatment not usually requiring hospitalization. B. Group 6 Brachytherapy utilizing sealed or solid sources manufactured, labeled, packaged, and distributed in accordance with a specific license issued pursuant to Title 10. Code of Federal Regulations, Part 32.74, or a specific license issued by an Agreement State or a Licensing State pursuant to equivalent state regulations (except for sources manufactured prior to August 16, 1974). C. Group 9 Marker and calibration sources.