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COMPLIANCE INFO_1975-2013
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4500 - Medical Waste Program
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PR0450009
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COMPLIANCE INFO_1975-2013
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Last modified
12/20/2022 12:55:09 PM
Creation date
7/3/2020 10:18:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1975-2013
RECORD_ID
PR0450009
PE
4522
FACILITY_ID
FA0002562
FACILITY_NAME
Sutter Valley Hospitals dba Sutter Tracy Community Hospital
STREET_NUMBER
1420
Direction
N
STREET_NAME
TRACY
STREET_TYPE
Blvd
City
Tracy
Zip
95376
APN
233-081-01
CURRENT_STATUS
01
SITE_LOCATION
1420 N Tracy Blvd
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4522_PR0450009_1420 N TRACY_1975-2015tif
Tags
EHD - Public
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State of Callfornia+lealth and Welfare Agency <br />E. Group 9 as specified in <br />Item 9. <br />Any radionuclide with <br />atomic number 3-83 <br />inclusive, except: <br />Strontium 90 and <br />Lead 210. <br />WEEM <br />E° Sealed or solid sources <br />manufactured in accordancewith <br />a specific license issued by the <br />United States Nuclear <br />Regulatory Commission or an <br />Agreement State. <br />Department of Health Service <br />Page 2 of 5 pages <br />Ucense Number: 4097-39 <br />Amendment Number: 11 <br />E. Total not to exceed 10 mCi. <br />Each source not to exceed 10 mCi. <br />A. Group 1 Diagnostic studies involving measurement of uptake, dilution, or excretion but not involving <br />imaging - <br />B. Group 2 Diagnostic studies involving imaging including the use of Xenon 127 and/or Xenon 133 <br />gas. <br />C. Group 3 Reagent kits for preparation of radiophannaceuticals listed in Group 2. <br />D. Group 4 Internal therapy not usually requiring hospitalization and palliative treatment. <br />E. Group 9 Nonhuman use: Marker and calibration sources. <br />LICENSE CONDITIONS <br />10. Radioactive material shall be used only at the following locations: <br />(a) 1420 North Tracy Boulevard, Tracy, CA <br />11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any <br />one time as specified in Item 6, 7, 8 and 9 of this license. The annual fee for this license is required by and <br />computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also <br />subject to an annual cost -of -living adjustment pursuant to Section 113 of the California Health and Safety <br />Code. <br />12. The individuals named below are authorized the specific uses of radioactive material described in Items 6, 7, <br />8 and 9 of this license as follows: <br />(a) R Walter Pepper, NLD. <br />(b) Anil K. Sain, NLD° <br />(c) Robert A. Lee, M.D. <br />11 <br />Groups 1,2,3 and 9 <br />Groups 1,2,3,4 and 9 <br />Groups 1,2,3 and 9 <br />11 <br />
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