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State of Cal'ifomia-Health and Welfare Agency Deparbnent of Health Services Page 3 of 5 pages License Number: 4097-39 Amendment Number: 11 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material described in Items 6, 7, 8 and 9 of this license in accordance with statements, representations, and procedures contained in the documents listed below. The Departmerifs regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more restrictive than the regulations. (a) The application with attachments dated August 24, 1989, signed by Anil K. Sain, NLD., Radiation Safety Officer. (b) The letter with attachments dated November 13, 1991, signed by PL Walter Pepper, NLD., (relative to clearance survey of the old lab), and letter with attachments dated December 20, 1991, signed by John Atherton and Anil Sao NLD., relative to new nuclear medicine and cardiology laboratories and new quality assurance procedures on cameras. (c) The letter with attachments dated Febniary 26, 1992, signed by John Atherton and Anil Sain, MD., relative to storage location. (d) The letter dated July 13, 1992, with attached revised package receipt procedure, signed by K Walter Pepper, MD.. (e) The letter with attachments dated March 13, 1995, signed by Win Howard II, Director, Diagnostic Imaging, regarding changes in policies as a result of the inspection conducted on March 1, 1995. 14. (a) The Radiation Safety Officer in this program shall be IT Walter Pepper, MD. (b) The Chairperson of the Radiation Safety Committee shall be H. Walter Pepper, MD. (c) The Custodian of sealed sources shall be Anil K. Sain, MD. (d) The Alternate Radiation Safety Officer in this program shall be Anil K. Sam, MD. 15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by Title 17, California Radiation Control Regulations, Section 30275 (c). 16. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 17. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Health Services: (a) The Radiation Safety Officer (b) Qualified individuals designated in writing by the Radiation Safety Officer 18. Records of leak test results shall be kept in units of microcuries and maintained for inspection. Records may be disposed of following Department inspection y leak test revealing the presence of 0.005 microcuries or more of removable radioactive material shall be reported to the Department of Health Services, Radiologic Health Branch, 601 N. 7th Street P.O. Box 942732, ramento, CA 94234-7320, within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken.