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State of Califomla-Health and Welfare Department of Health Services
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<br />Page 2 of 3 pages
<br />License Number: 5766-39
<br />Amendment Number: 8
<br />11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any one time
<br />as specified in Items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in
<br />accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual
<br />cost -of -living adjustment pursuant to Section 100425 of the California Health and Safety Code.
<br />12. The individuals named below are authorized the specific uses of radioactive material described in Items 6, 7, 8, and 9
<br />of this license as follows:
<br />(a) Michael D. Reitz, M.D.
<br />(b) B. Rama Rao, M.D.
<br />(c) Susan Osova, M.D.
<br />Groups 1, 2, 3, 4 and 9
<br />Groups 1, 2, 3, 4 and 9
<br />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 application received on May 28, 1992, as modified by letter, with attachments, dated June 29, 1992, both
<br />signed by Michael D. Reitz, M.D.
<br />(b) The letters dated June 24, 1994, and August 9, 1994, both signed by Michael D. Reitz, M.D., as modified by the
<br />letter, with attachment, dated August 30, 1994, signed by Diane D. Banning, Radiology Manager, regarding the
<br />use of the Strontium-89.
<br />14. (a) The Radiation Safety Officer in this program shall be Michael D. Reitz, M.D.
<br />(b) The Chairperson of the Radiation Safety Committee shall be Michael D. Reitz, M.D.
<br />(c) The Custodian of sealed sources shall be Michael D. Reitz, 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
<br />17. The licensee may use any commercially available device, acceptable to the U.S. Nuclear Regulatory
<br />Commission, an Agreement State or a Licensing State, for doing linearity tests of its dose calibrator provided
<br />the procedures described by the manufacturer of the linearity device are followed.
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