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COMPLIANCE INFO_1993-2006
Environmental Health - Public
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COMPLIANCE INFO_1993-2006
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Last modified
1/4/2023 2:01:04 PM
Creation date
7/3/2020 10:17:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1993-2006
RECORD_ID
PR0450003
PE
4522
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\cfield
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FilePath
\MIGRATIONS\MW\MW_4522_PR0450003_975 S FAIRMONT_1993-2006.tif
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EHD - Public
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• <br />«' a State of California-Health and Welfare Agenft <br />RADIOACTIVE MATERIAL LICENSE <br />Department of Health Services <br />Page 4 of 4 pages <br />License Number: 1368-39 <br />Amendment Number. 27 <br />23. If there is reason to suspect that a medical radium source may be leaking or contaminated, it shall be tested before <br />further use, by a method acceptable to the Department of Health Services, and a report of the test results and the <br />action taken shall be submitted within 30 days to the Radiologic Health Branch. <br />24. Production or processing of radiopharmaceuticals for the purpose of commercial distribution to other licensees is not <br />authorized by this license. <br />25. Radioactive materials shall be used by occupational workers in such a manner that the dose limits specified in <br />Title 10, Code of Federal Regulations, Part 20, Subpart C, Sections 20.1201 through 20.1208 are not exceeded. <br />26. The licensee shall monitor occupational exposures to radiation and shall supply and require the use of individual <br />monitoring devices by personnel as required by Title 10, Code of Federal Regulations, Part 20, Section 20.1502 (a). <br />27. The licensee shall monitor occupational intakes of radioactive material by, and assess the committed effective dose <br />equivalent to, individuals who may have exceeded or are likely to exceed, the limits specified in Title 10, Code of <br />Federal Regulations, Part 20, Section 20.1502 (b). Suitable and timely measurements used for determination of such <br />internal exposures shall be performed as specified by Section 20.1504. <br />28. For a period not to exceed 60 days in any calendar year, a visiting physician is authorized to use licensed materials <br />for human use under the terms of this license, provided the visiting physician: <br />(a) Has the prior written permission of the hospital's Administrator and its Radiation Safety Committee. <br />(b) Is specifically named as a user on a U.S. Nuclear Regulatory Commission or Agreement State license <br />authorizing human use. <br />(c) Performs only those procedures for which the physician is specifically authorized by the U.S. Nuclear <br />Regulatory Commission or Agreement State license. <br />The licensee shall maintain for inspection copies of the written permission specified in (a) above and the licensee(s) <br />specified in (b) and (c) above. These records shall be maintained for five years from the time the licensee grants its <br />permission under (a) above. <br />29. In addition to the possession limits in Item 8, the licensee shall further restrict the possession of licensed material so <br />that at no time will the total quantity of radioactive material possessed require financial surety for decommissioning <br />in accordance with the California Code of Regulations, Title 17, Section 30195.1. A value of 100 microcuries is <br />assigned to Cobalt -57 to supplement the Code of Federal Regulations, Title 10, Part 30, Appendix B. <br />30. A copy of this license and a copy of all records and documents pertaining to this license shall be maintained available <br />for inspection at 975 South Fairmont Avenue, Lodi, CA. <br />For the State Department of Health Services <br />Date: July 13, 1998 By: �fj , �, -� <br />Rac�iiologic Health Branch <br />P.O. Box 942732 -MS 178, Sacramento, CA 94234-7320 <br />
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