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State of Ca1lo=a44ea1t,and VVeHare Agency Department of HaaM servkes Page 2 of 2 pages RADIOACTIVE MATERIAL LICENSE license Number: 5399-39 SupI*rrtertary Sheet Artierxknert Klur ber.3 14. The Radiation Safety Officer in this program shall be Jay Leslie. 15. Sealed sources described in Subitem A of this license shall be tested for leakage and/or contamination at intervals not to exceed three years. 16. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Health Services: (a) The Radiation Safety Officer (b) Qualified individuals designated m writing by the Radiation Safety Officer 17. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 18. Records of leak test results shall be kept in units of microcuries and maintained for inspection. Records may be disposed of following Department inspection. Any leak test revealing the presence of 0.005 microcuries or more of removable radioactive material shall be reported to the Department of Health Services,Radiologic Health Branch, 601 N. 7th Street P.O. Box 942732, Sacramento,CA 94234-7320,within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken. 19. Installation, relocation, maintenance, repair, and initial radiation survey of devices containing radioactive material and installation,replacement, and disposal of sealed sources containing radioactive material used in devices shall be perfornred only by persons specifically licensed to perform such services. For the State rtrnent AFI--al Services Date January 17 1997 By: Racr,oiogVHemuxYanch P.O. Box 942732, Sacramento, CA 94234-7320