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R - 4 5011v � w State of California-Health and Welfare Ageriv Department of Health Services Page I of 3 pages RADIOACTIVE MATERIAL LICENSE Pursuant to the California Code of Regulations, Division 1, Title 17, Chapter 5, Subchapter 4, Group 2, Licensing of Radioactive Material, and in reliance on statements and representations heretofore made by the licenses, a license is hereby issued authorizing the licensee to receive, use, possess, transfer, or dispose of radioactive material listed below, and to use such radioactive material for the purpose(s) and at the place(s) designated below. This license is subject to all applicable rules, regulations, and orders of the Department of Health Services now or hereafter in effect and to any standard or specific condition specified in this license. Licensee City of Lodi 3. License No. 3206-39 AmendmentNo: 6 2. Address P.O. Box 3006 4. Expiration date Lodi, CA 95241-1910 June 13, 1998 (5) Attention: William M. McVicker on agency Radiologic Health Branch Radiation Safety Officer Sacramento License Number 3206-39 is hereby amended as follows: 6. Nuclide 7. Foran 8. Possession Limit A. Cesium 137/ A. Sealed sources A. 3 source pairs not to exceed Americium 241:Be (CPN #131) . 10 mCi of Cesium 137 and 50 mCi of Americium 241 each. B. Cesium 137 B. Sealed source (Troxler B. 1 source not to exceed 10 mCi. Dwg. No A-102112) 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 a component of a Troxler Model 4640 Series gauge for determination of density of construction 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. Radioactive materials may be permanently stored�;nly at: (a) 1331 South Ham Lane, Lodi, California. t = 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 Item 8 of this license. The annual fee for this license is required by and computed in accordance with Sections 30230-30232 of the California Radiation Control Regulations and is also subject to an annual cost-of-living adjustment pursuant to Section 113 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 satisfactorily completed a course, accepted by the Department as adequate, in safe use of soillasphalt 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.