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COMPLIANCE INFO_1991-2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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4500 - Medical Waste Program
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PR0450112
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COMPLIANCE INFO_1991-2019
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Last modified
6/12/2024 2:22:36 PM
Creation date
7/3/2020 10:20:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1991-2019
RECORD_ID
PR0450112
PE
4530
FACILITY_ID
FA0002435
FACILITY_NAME
ARC STOCKTON COMMERCE ST
STREET_NUMBER
65
Direction
N
STREET_NAME
COMMERCE
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13728012
CURRENT_STATUS
01
SITE_LOCATION
65 N COMMERCE ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4530_PR0450112_65 N COMMERCE_.tif
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EHD - Public
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.a <br />State of California-Health and Welfare Agen Department of Health Services <br />Page 1 of 2 pages <br />RADIOACTIVE MAtERIAL'U6ENSE <br />Pursuant to the California Code of Regulations, Division 1 Tito f 7,Chapte , Su apter 4, Group 2, Licensing of Radioactive Material, and in reliance <br />on statements and representations heretofore made by (hs )!OerlSfe,`a licefis � fi y issued authorizing the licensee to receive, use, possess, transfer, <br />or dispose of radioactive material listed below, and to use such radioactive material for the purpose(s) and at the place(s) designated below. This license <br />is subject to all applicable rules, regulations, and orders of the Department of Health Services now or hereafter in effect and to any standard or specific <br />condition specified in this license. <br />1. Licensee Delta Blood Bank <br />2. Address 65 North Commerce <br />Stockton, CA 95201 <br />Attention: Benjamin J. Spindler, M.D. <br />Radiation Safety Officer <br />License Number 5556-39 is hereby renewed in its entirety. <br />3. License No. <br />5556-39 <br />Amendment No: 5 <br />14. Expiration date <br />February 19, 2005 (5) <br />5. Inspection agency Radiologic Health Branch <br />Sacramento <br />6. Nuclide <br />7. Form <br />8. Possession Limit <br />A. Cobalt 60 <br />A. Sealed sources (J. L. Shepard <br />A. One source array, not to exceed 100 <br />Model 7810) <br />curies per source, total not to exceed <br />1200 curies. <br />9. Authorized Use <br />A. To be used as components of a J. L. Shepherd Model 109-85 irradiator for the irradiation of blood <br />products. <br />LICENSE CONDITIONS <br />10. Radioactive material shall be used only at the following location: <br />(a) 65 North Commerce, Stockton, CA <br />11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any <br />one time as specified in items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and <br />computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also <br />subject to an annual cost -of -living adjustment pursuant to Section 100425 of the California Health and Safety <br />Code. <br />12. Radioactive material shall be used by, or under the supervision of, the following individuals: <br />(a) Benjamin J. Spindler, M.D. <br />(b) Carmelita G. Camorongan <br />(c) Joan Barker <br />4 <br />
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