COMPLIANCE INFO_2004-2020 - Laserfiche WebLink

Home Browse Search

s State of California-Health and Welfare Agency Department of Health Services Page 2 of 5 pages RADIOACTIVE MATERIAL LICENSE license Number. 5790-39 Supplementary Sheet Amendment Number. 9 9. Authorized Use To be used for nuclear medicine procedures as specified in the groups below: A. Group I Diagnostic studies involving measurement of uptake, dilution, or excretion but not involving imaging. B. Group 2 Diagnostic studies involving imaging excluding the use of Xenon 127 and/or Xenon 133 gas. C. Group 3 Reagent kits for preparation of radioparmacuticals listed in Group 2. D. Group 4 Palliative treatment. E. Group 9 Marker and calibration sources. LICENSE CONDITIONS 10. Radioactive material shall be used only at the following locations: (a) 1777 West Yosemite Avenue, Manteca, CA 11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any one time as specified in items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual cost-of-living adjustment pursuant to Section 100425 of the California Health and Safety Code. 12. The individuals named below are authorized the specific uses of radioactive material described in Items 6, 7, 8 and 9 of this license as follows: (a) Richard J. Berkowitz, M.D. Groups 1, 2, 3 and 9 (b) Henry Y. T. Wong, M.D. Group 4 (Sr- 89 only) (c) David Howard, M.D. Groups 1, 2, 3 and 9 (d) Firas Al-Ali, M.D. Groups 1, 2, 3 and 9 13. Except as specifically provided otherwise by this license,the licensee shall possess and use radioactive material described in Items 6, 7, and 8 of this license in accordance with statements, representations,and procedures contained in the documents listed below. The Department's 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 July 15, 1992, signed by Richard Aldred. (b) The letter with attachments dated August 30, 1993, as modified by the letter dated March 8, 1994, both signed by Richard Berkowitz, M.D., 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.