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State of Coillotnia—Heolih and Welfare Agency Department of Health Services Page 3 of 5 Pages RADIOACTIVE MATERIAL LICENSE License Number: 1294-39 Supplementary Sheet Amendment Number: 48 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material described in Items 6, 7, and 8 of this license in accordance with statements, representations, and procedures contained in the documents listed below. The Department's regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondenge are more restrictive than the regulations. (a) The license renewal application with attachments dated March 31, 1989 signed by Michael N. Smith as modified by the letters with attachments dated June 29, 1990, July 12, 1990 and September 18, 1990 all signed by Douglas McGirr, M.D. 14. (a) The radiation safety officer in this program shall be Douglas McGirr, M.D. (b) The chairperson of the radiation safety committee shall be Douglas McGirr, M.D. (c) The custodian of sealed sources shall be Douglas McGirr, M.D. 15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by Section 30275(c) of the California Radiation Control Regulations. 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 by the radiation safety officer 17. Analytical 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, 744 P 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. For the State Department of Health Services Date: December 28, 1993 By: 3 Radiologic Health Branch P.O. Box 942732 Sacramento, CA 94234-7320 R14 2551 (Int.) (1 /91)