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State of Califomia4iealth and Wbftr+e . ' Departrnent of Health Services <br />q Page 1 of 7 pages <br />' ' <br />RA�OAa VE MA NS <br />UCEE <br />142 <br />Pursuant to the Califomia Code of Regulations, Division 1, Title 17, Chapter5, Subchapter 4, Group 2 Licensing of Radioactive Material, and in reliance <br />on staterwts andrepresentations heretofore made bythe licensee, a license is herebyissued authorizing the licensee to receive, use, possess, transfer, <br />ordispose of radioactive material listed below; andto use such radioactive material forthe purpose(s) and at the places) designated below. This license <br />is subject to all applicade roles regulations, and orders of the Department of Health Services now or hereafter in effect and to any standard orspecific <br />condition Ted ed in this license. <br />1. Licensee Lodi Memorial Hospital <br />2. Address 975 South Fairmont Avenue, P.O. Box 3004 <br />Lodi, CA 95241-1908 <br />Attention: Roger P. Vincent, M.D. <br />Radiation Safety Officer <br />3. License hb. <br />1368-39 <br />Amendment m. 25 <br />14. B#ratibn date <br />March 21, 2002 (3) <br />5 Inspection agency Radiologic Health Branch <br />Sacramento <br />license Number 1368-39 is hereby conmW as follows on September 25, 1995. <br />6. <br />Nuclide <br />7. <br />Form <br />8. Possession Limit <br />A. <br />Group 1 as specified in <br />A. <br />Any <br />A. -C. Combined possession limit <br />Item 9. <br />for Groups 1, 2, and 3 not <br />Any radionuclide with <br />to exceed 765 mCi. <br />atomic number 3-83. <br />B. Group 2 as specified in <br />B. Any <br />Item 9. <br />Any radionuclide with <br />atomic number 3-83. <br />C. Group 3 as specified in <br />C. Any <br />Item 9. <br />Excluding Generators <br />Any radionuclide with <br />atomic number 3-83. <br />D. <br />Group 4 as specified in <br />D. <br />D. Total not to exceed 60 mCi. <br />Item 9. <br />1. Iodine 131 <br />1. Capsule <br />2. Phosphorus 32 <br />2. Any <br />