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COMPLIANCE INFO_1975-2013
EnvironmentalHealth
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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 Califomia-Flealth and Welfare Agency <br />SPC 7'®ot. urn <br />Department of Health Services <br />Page of pages <br />A <br />.tMOAC11VE MATEPJAL <br />Pursuant to the California Code of Regulations, Division 1, Title 17, Chapter 5, Subchapter 4, Group 2, Liaensih j 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 reieivq, use, possess, transfer, <br />or dispose of radioactive material listed below, and to use such radioactive material for the purpose(s) and at the plaoe(s) designated k6w. This license <br />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 spec <br />condition specified in this license. <br />1. Licensee Sutter Tracy Community Hospital <br />2. Address 1420 North Tracy Boulevard <br />Tracy, CA 95376 <br />Attention: H. Walter Pepper, M.D. <br />Radiation Safety Officer <br />a License Iva <br />4097-39 <br />Amendment No: 13 <br />4. Expiration date <br />September 15, 1997 (3) <br />5. Inspection agency Radiologic Health Branch <br />Sacramento <br />In response to the letter dated N bmh 6, 1996, as amended by ttte letter dated May 9, 19%, both signed by Latey <br />L Meyer, CEO, Administrator, License Number 4097-39 is hereby amended as follows: <br />6. Nuclide <br />7. Form <br />8. Possession Limit <br />A. Group 1 as specified in <br />A. Any <br />A. -C. Combined possession limit for <br />Item 9. <br />Groups 1, 2 and 3 not to <br />Any radionuclide with <br />exceed 460 mCi. <br />atomic number 3-83. <br />(See Condition 34) <br />B. Group 2 as specified in <br />B. Any <br />Item 9. <br />Any radionuclide with <br />atomic number 3-83. <br />C. Group 3 as specified in <br />C. Any <br />Item 9. <br />Excluding generators <br />Any radionuclide with <br />atomic number 3-83. <br />D. Group 4 as specified in <br />D. <br />D. Total not to exceed 30 mCi. <br />Item 9. <br />i. Strontium 89 <br />1. Any <br />2. Phosphorus 32 <br />2. Any <br />3. Iodine 131 <br />3. Capsule <br />E. Group 9 as specified in <br />E. Sealed or solid sources <br />E. Total not to exceed 10 mCi. <br />Item 9. <br />manufactured in accordance with a <br />Any radionuclide with <br />specific license issued by the <br />Each source not to exceed 10 mCi. <br />atomic number 3-83 <br />United States Nuclear Regulatory <br />inclusive, except: <br />Commission or an Agreement <br />Strontium 90 and <br />State. <br />Lead 210. <br />
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