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Department of Haal A SeMces State of alifomia—H 1th and Welfare Agency Page 1 of 7 pis RADIOACTIVE MATERIAL LICENSE Pursuant to the California Administrative Code, Title 17, Chapter 5,Subchapter4, Group 2,Licensing of Radioactive Material,and in reliance on statements and representations heretofore made by the licensee, 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 purposes)and at the place(s1 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 conditions specifled in this license. 1. Licensee 3. License No. St. Joseph's Medical Center 1276-39 Amendment No. 58 2 Address 1800 North California Street 4, Expiration date November 19, 1995 Stockton, CA 95204 S. inspection agency Radiologic Health Branch AMsnrion: Lawrence A. Philipp Chief Operating Officer Sacramento in respcnsr to the letter with attachments dated August 16, 1994, signed by Jack L. Funaaura, M.D., Chairman, Radiation Safety Cvlmtittee, License Number 7276-39 is hereby amended as follows: In accordance with California Radiation Control Regulations, Title 17, Subchapter 4, Article 4, Section 30195, the Medical Use Groups specified below grant the use of radioactive material, as approved by the U.S. Food and Drug Achninistration, the California State Board of Medical Quality Assurance and/or the California State Board of Pharmacy, for diagnosis and treatment of 'patients, when prescribed and as directed by an appropriately authorized physician listed on this license. GROUPS AUTHORIZED UNDER THIS LICENSE: Group 1 - Diagnostic studies involving measurement of uptake, dilution, or excretion but not involving imaging. imaging excluding the use of Xenon 127 and/or Group 2 - Diagnostic studies involving Xenon 133 gas. Group 3 - Use of reagents kits for preparation of radiopharmaceuticals listed in Group 2. Group 4 - Internal therapy not usually requiring hospitalization. Group 5 - Internal therapy usually requiring hospitalization for purposes of radiation safety. Group 6 - Sealed or solid sources manufactured, labeled, packaged, and distributed in accordance with a specific license issued pursuant to 10CFR32.74 or a specific license issued by an agreement state pursuant to equivalent state regulations (except for sources manufactured prior to August 16, 1974) . 6. Nuclide 7. Form 9. Authorized Use A. Cesium 137 A. Sealed Sources A. Treatment of Cancer B. Iridium 192 B. Seeds in Ribbon B. Treatment of Cancer C. Palladium 103 C. Seeds C. Treatment of Cancer For the State Department of Health Services October 11, 1994 3 Date by Radiologic Health Section 744 P Street,Sacramento,CA 95814 RH 2550(2/81)