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COMPLIANCE INFO_1991-2005
Environmental Health - Public
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4500 - Medical Waste Program
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PR0450116
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COMPLIANCE INFO_1991-2005
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Last modified
12/20/2022 12:11:51 PM
Creation date
7/3/2020 10:16:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1991-2005
RECORD_ID
PR0450116
PE
4520
FACILITY_ID
FA0002602
FACILITY_NAME
KAISER PERMANENTE
STREET_NUMBER
7373
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09416023
CURRENT_STATUS
01
SITE_LOCATION
7373 WEST LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\cfield
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FilePath
\MIGRATIONS\MW\MW_4520_PR0450116_7373 WEST_1991-2005.tif
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EHD - Public
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State of California—Health and Welfare Agency <br />Group 9 - continued <br />6. Nuclide <br />A. Any radionuclide with <br />atonic numbers 3-83 <br />inclusive except: <br />(1) Strontium 90 and <br />(2) Lead 210 <br />Supplementary Sheet <br />7. Form <br />A. Sealed sources, <br />manufactured, <br />labeled, packaged, <br />and distributed <br />in accordance with <br />a specific license <br />issued to the manu- <br />facturer by the U.S. <br />Nuclear Regulatory <br />Com-nission or an <br />Agreement State, <br />not to exceed 10 <br />mCi each. <br />Department of Health Se0,4CeS <br />Page 2 <br />License Number: <br />Amendment Number: <br />of 5 Pages <br />5766-39 <br />9. Authorized Use <br />A. Marker sources and <br />calibration. <br />8. Possession -Limits <br />Conbined Possession Limit for Group 1, Group 2, Group 3, Group 4, and Group 9: <br />Not to exceed 500 millicuries. <br />10. Radioactive material shall be used only at the following locations: <br />(a) 7373 West Lane, Stockton, CA <br />11. This license is subject to an annual fee for sources of radioactive material <br />authorized to be possessed at -any one time as specified in Item 8 of this license. <br />The annual fee for this license is required by and computed in accordance with <br />Sections 30230-30232 of the California Radiation Control Regulations and is also <br />subject to an annual cost -of -living adjustment pursuant to Section 113 of the <br />California Health and Safety Code. <br />12. The individuals named below are authorized the specific uses of radioactive <br />material described in Items 6, 7, 8 and 9 of this license as follows: <br />(a) Michael D. Reitz, M.D. Grohs 1, 2, 3, 4, and 9 <br />(b)' B. Rama Rao, M.D. Groups 1, 2, 3, 4, and 9 <br />(c) David J. Moitoza, M.D. Groups 1, 2, 3, 4, and 9 <br />For the State Department of Health Services <br />Date: September 15, 1994 By: 3 <br />Radiologic Health Branch <br />P.O. Box 942732 <br />Sacramento, CA 94234-7320 <br />RH 2551 (Int.)(1/91) <br />
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