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State of California-Health and Human Se*Agency 1 �` Department of Health Services RADIOACTIVE MATERIAL LICENSE�} E E V of 3 pages Pursuant to the California Code of Regulations,Division 1, Title 17, Chapter 5, Subchapter 4, Groupz 1Z4& s2 dioacvve Material,and in reliance on statements and representations heretofore made by the licensee,a license is hereby l authorizing the licensee to receive, use, possess, transfer, or dispose of radioactive material listed below; and to use such radioac ° F f ose(s) and at the places(s)designated below. This license is subject to all applicable rules,regulations, and ord 't Health Services now or hereafter in effect and to any standard or specific condition specified in this license. �ERITISE 1. Licensee: City of Lodi 3. License Number: 3206-39 Amendment Number; 9 2. Address: P.O. Box 3006 4. Expiration date: Lodi, CA 95241-1910 June 13,2008 (5) Attention: William M. McVicker 5. Inspection agency: Radiologic Health Branch Radiation Safety Officer Sacramento License Number 3206-39 is hereby amended as follows: 6. Nuclide 7. Form S. Possession Limit A. Cesium 137/Americium 241:Be A. Sealed sources (CPN #131) A. 3 source pairs not to exceed 10 mCi of Cesium 137 and 50 mCi of Americium 241 each. B. Cesium 137/Americium 241:Bc B. Sealed sources B. 1 source pair not to exceed 9 mCi (Troxler Dwg. No. A-102112 and of Csl37 and 44 mCi of Am 241. A-102451) 9. Authorized Use A. To be used as components of gauges, CPN Corporation Models A. BR„ MC, or 500 series, for determination of moisture/density in engineering materials. B. To be used as components of gauges, Troxler Model 3400 series, for determination of moisture/density in engineering materials. LICENSE CONDITIONS 10. Radioactive materials may be used at temporary job sites of the licensee in areas not under exclusive federal jurisdiction throughout the State of California (see condition 22). Radioactive materials mai' be permanently stored only at: (a) 1331 South Ham Lane, Lodi, CA (storage capacity: 4 gauges) 11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at dnv 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 30230-302.32 and is also subject to an annual cost-of-living adjustment pursuant to Section 100425 of the California Health and Safety Code. 12. Radioactive material may be used only by, or under the supervision and in the physical presence of. individuals who: (a) have satisfactprily completed a course, accepted by the Department as adequate, in safe use of soil/asphalt content gauges containing radioactive material and also; (b) have been provided with a statement, signed by the Radiation Safety Officer, which designates that individual as an authorized user qualified to use radioactive material under this license. Copies of these documents shall be maintained for inspection by the Department.