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State of Califon-da-Health and VWftre Agency Depart nent of Health Services Page 3 of 6 pages RAI)IOACnVE MATEPUL LICENSE Vcense Number: -5 94-39 Suppkwmrtary Sheet Amendment Number 6 (b) The letter with attachments dated August 30, 1993,as modified by the letter dated March 8, 1994,both signed by Richard Berkowitz,NLD.,Radiation Safety Officer,regarding the use of Bicron 2000 Surveyor for wipe test and well counter for sealed sources leak test, and informing the Department relating the use of radioactive materials sign. (c) The letter dated May 13, 1994, signed by Richard Berkowitz, regarding the ECT Scintillation Camera, Manufacturer Picker, Model Prism 1000 NP. (d) The letters with attachments dated May 19, 1994 and July 9, 1994,both signed by Richard Berkowitz, MLD., Radiation Safety Officer, regarding the authorization for Group 4 and the use of Strontium 89. 14. (a) The Radiation Safety Officer in this program shall be Richard J. Berkowitz, MLD.. (b) The Chairperson of the Radiation Safety Committee shall be Judie Brown, CNMTI'. (c) The Custodian of sealed sources shall be Richard J. Berkowitz, NLD. (d) The Alternate Radiation Safety Officer(s) in this program shall be Judie Brown, CNMT. 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. Any 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,Sacramento,CA 942347320,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. 19. Any licensed sealed source is exempt from such leak tests when the source contains 100 microcuries or less of beta and/or gamma emitting material or 10 microcuries or less of alpha emitting material. 20. Except as otherwise specifically provided by this license,radiopharmaceuticals to be administered to humans shall be procured in prepackaged, precalibrated form from a supplier who is registered with the U. S. Food and Drug Administration,or prepared and compounded,from a prescription,in accordance with the regulations of the California Board of Pharmacy.