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6 IL r <br /> State of California—Health and Welfare Agency men f Health Services <br /> Page 1 of 4 pages <br /> t{U 4v It.+ <br /> RADIOACTIVE MATERIAL LICENSE <br /> 93 I 0 <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. Dominic's Hospital 5790-39 Amendment No. 1 <br /> 2. Address 1777 West Yosemite Avenue 4. Expiration dare <br /> Box 1307 October 6, 1998 <br /> Manteca, CA 95336 5. Inspection agency Radiologic Health Branch - <br /> Attention: Patricia Dickey <br /> amento <br /> Assistant Administrator <br /> In respimse to the letters dated December 12, 1992, and April 13, 3.993 bath signed by <br /> Richard Berkowitz, License Number 5790-39 is bereby amended in part as follows: <br /> These authorizations are as specified below except that for Groups 1 through 5, when <br /> granted herein, these authorizations are as specified in the Department's form RH <br /> 2010R, "Well Established Medical Uses." <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 reagent kits for preparation of radiopharmaceuticals listed in Group <br /> 2. <br /> Group 9 - Nonhuman Uses <br /> A. Any radionuclide with A. Sealed sources, A. Marker sources and <br /> atomic numbers 3-83 manufactured, calibration. <br /> inclusive except: labeled, packaged, <br /> and distributed <br /> (1) Strontium 90 and in accordance with <br /> (2) Lead 210 a specific license <br /> issued to the manu- <br /> facturer by the U.S. <br /> Nuclear Regulatory <br /> Commission or an <br /> Agreement State, <br /> not to exceed 15 <br /> mCi each. <br /> For the State Department of Health Services <br /> April 23, 1993 3 <br /> Date by <br /> Radiologic Health Section <br /> 744 P Street,Sacramento,GA 95314 <br /> RH 2550(2/81) <br />