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State of California-Health and Welfare Agen. Department of Health Services
<br /> Page 4 of 7 pages
<br /> RADIOACTIVE MATERIAL LICENSE License Number: 1276-39
<br /> Amendment Number. 80
<br /> (w) Eric C.Trefelner,M.D. Groups 1,2,3, (4 and 5,I-131 only)and 9
<br /> (x) Douglas McGirr,M.D. Groups 1,2,3 and 9
<br /> 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material
<br /> described in Items 6, 7, 8 and 9 of this license in accordance with the statements, representations, and procedures
<br /> contained in the documents listed below. The Department's regulations shall govern unless the statements,
<br /> representations, and procedures in the licensee's application and correspondence are more restrictive than the
<br /> regulations.
<br /> (a) The letter dated July 21, 1999, and the letter, with attachments, dated October 8, 1999, and the letter, with
<br /> attachments, dated October 26, 1999, all signed by Jiun-Der Chem, M.S., Radiation Safety Officer, as
<br /> supplemented by the letter, with attachments, dated July 28, 1999, signed by Jiun-Der Chem, M.S., Radiation
<br /> Safety Officer, and Donald J. Wiley, Chief Operating Officer, regarding vascular brachytherapy commitments
<br /> and procedures and duties and responsibilities of the Radiation Safety Officer.
<br /> (b) The letter dated October 16, 2000, and the letter,with attachment, dated November 5,2000,both signed by Jiun-
<br /> Der Chem, M.S., Radiation Safety Officer, regarding the removal of a transportable HDR service, the
<br /> acquisition of a fixed HDR and associated procedures and commitments.
<br /> (c) The License renewal application, with attachments, dated April 7, 2000, signed by Donald Wiley, Senior Vice
<br /> President;the letters, both with attachments, dated September 29, 2000, and November 14, 2000, and the letter,
<br /> with attachment, dated December 19,2000,all signed by Jiun-Der Chem,M.S.,Radiation Safety Officer.
<br /> (d) The letter, with attached survey reports, dated February 2, 2001, signed by Jiun-Der Chem, M.S., Radiation
<br /> Safety Officer.
<br /> (e) The letter dated April 25,2001, signed by Jiun-Der Chem, M.S., Radiation Safety Officer, regarding the request
<br /> for use of the Novoste device for IVB procedures.
<br /> (f) The letter, with attachment, dated April 25, 2001, and the letter, with attached diagram, dated August 28, 2001,
<br /> both signed by Jiun-Der Chem, M.S., Radiation Safety Officer, regarding the addition of a mobile PET coach
<br /> provided by Alliance Imaging, Inc. (RML 6640) and the procedural change for the Novoste Beta-Cath IVB
<br /> system.
<br /> 14. (a) The Radiation Safety Officer in this program shall be Jiun-Der Chem, M.S.
<br /> (b) The Chairperson of the Radiation Safety Committee shall be Royce J. Biddle,M.D.
<br /> (c) The Custodian of sealed sources shall be Royce J.Biddle,M.D.
<br /> (d) The Alternate Radiation Safety Officer in this program shall be Royce J.Biddle,M.D.
<br /> 15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by Title 17,
<br /> California Code of Regulations, Section 30275 (c).
<br /> 16. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license
<br /> using leak test kits acceptable to the California Department of Health Services:
<br /> (a) The Radiation Safety Officer
<br /> (b) Qualified individuals designated in writing by the Radiation Safety Officer
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