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State of Califomia-Health and Welfare Agency Department of Health Services
<br /> Page 2 of 2 pages
<br /> RADIOACTIVE MATERIAL LICENSE License Number. 3764-39
<br /> Amendment Number. 19
<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 renewal application with attachments dated October 23, 1987, signed by Gordon W. Butler, as modified by
<br /> the letters, with attachments, dated April 5, 1990 and October 30, 1990, signed by Ronald Jones, April 3, 1990
<br /> and October 16, 1990, signed by James K. Cook and Bernard Lopez, September 24, 1992 signed by
<br /> James K. Cook and Redentor S. Sabilano and December 16, 1992, signed by Redentor S. Sabilano.
<br /> (b) The letter, with attachments, dated June 1, 1993, signed by Redentor S. Sabilano, relative to modification of
<br /> Itere Model 1014-BII Krypton-85 Activation System.
<br /> (c) The letter, with attachments, dated December 27, 1993, signed by Redentor S. Sabilano, regarding refresher
<br /> training.
<br /> (d) The letter, with attachment,dated June 16, 1994, signed by Redentor S. Sabilano, regarding new radiation safety
<br /> organization chart.
<br /> (e) The letter dated December 1, 1997,signed by Larry Jorstad,relative to ownership change.
<br /> (f) The letter, with attachments, dated September 17, 1998, signed by Gary Hubble relative to venting and
<br /> preparation of Tracer-Flo unit for disposal.
<br /> 14. (a)The Radiation Safety Officer in this program shall be Thomas P. Joyner.
<br /> (b)The Alternate Radiation Safety Officer in this program shall be Allen Reinero.
<br /> For the Stat rtment of HeaI Services
<br /> Date: September 21, 1998 By: �) >r.
<br /> Radio,411c Hea[K Branch
<br /> P.O. Box 942732-MS 178, Sacramento,CA 942347320
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