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COMPLIANCE INFO_2004-2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1777
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4500 - Medical Waste Program
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PR0450109
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COMPLIANCE INFO_2004-2020
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Entry Properties
Last modified
11/8/2024 3:08:48 PM
Creation date
7/3/2020 10:18:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2004-2020
RECORD_ID
PR0450109
PE
4522 - ACUTE CARE FACILITY
FACILITY_ID
FA0003978
FACILITY_NAME
KAISER FOUNDATION - MANTECA
STREET_NUMBER
1777
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
20018034
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4522_PR0450109_1777 W YOSEMITE_.tif
Site Address
1777 W YOSEMITE AVE MANTECA 95337
Tags
EHD - Public
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IL <br /> Stole of California—Health and Welfare Agency Department of Health Services <br /> Page 2 of 4 Pages <br /> RADIOACTIVE MATERIAL LICENSE license Number: 5790-39 <br /> Supplementary Sheet Amendment Number: 1 <br /> 8. Possession Limit <br /> Combined Possession Limit for Group 1, 2, 3 and 9, Not to exceed 460 mCi. <br /> 10. Radioactive material shall be used only at the following locations: <br /> (a) 1777 West Yosemite Avenue, Manteca, CA <br /> 11. This license is subject to an annual fee for sources of radioactive material <br /> authorized to be possessed at any one time as specified in Item 8 of this_ <br /> license. The annual, fee for this license is required by and computed in <br /> accordance with Sections 30230-30232 of the California Radiation Control <br /> Regulations and is also subject to an annual cost-of-living adjustment pursuant <br /> to Section 113 of the California Health and Safety Code. <br /> 12. The individuals named below are authorized the specific uses of radioactive <br /> material described in Items 6, 7, 8 and 9 of this license as follows: <br /> (a) Richard J. Berkowitz, M.D. Groups 1, 2, 3 and 9. <br /> 13. Except as specifically provided otherwise by this license, the licensee shall <br /> possess and use radioactive material described in Items 6, 7, and 8 of this <br /> license in accordance with statements, representations, and procedures contained <br /> in the documents listed below. The Department's regulations shall govern unless <br /> the statements, representations, and procedures in the licensee's application <br /> and correspondence are more restrictive than the regulations. <br /> (a) The application, with attachments, dated July 15, 1992, signed by Richard <br /> Aldred. <br /> 14. (a) The radiation safety officer in this program shall be Richard J. Berkowitz, <br /> M.D. <br /> (b) The &mrperson of the radiataon safety camittee shorn be Judie Brown. <br /> (c) The custodian of sealed sources shall be Richard J. Berkowitz, M.D. <br /> 15. Sealed sources possessed under this license shall be tested for leakage and/or <br /> contamination as required by Section 30275 (c) of the California Radiation <br /> Control Regulations. <br /> For the State Department of Health Services <br /> Date: April 23, 1993 By: 3 <br /> Radiologic Health Branch <br /> P.O. Box 942732 <br /> Sacramento, CA 94234-7320 <br />
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