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CORRESPONDENCE_1978-2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ACACIA
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4500 - Medical Waste Program
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PR0450001
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CORRESPONDENCE_1978-2005
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Last modified
4/19/2023 3:20:27 PM
Creation date
8/24/2021 8:22:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
CORRESPONDENCE
FileName_PostFix
1978-2005
RECORD_ID
PR0450001
PE
4522
FACILITY_ID
FA0002864
FACILITY_NAME
DAMERON HOSPITAL
STREET_NUMBER
525
Direction
W
STREET_NAME
ACACIA
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13715304
CURRENT_STATUS
01
SITE_LOCATION
525 W ACACIA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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i Staff of California -Health and Human ServindlMne <br />ncy <br />ff-11CO7TAliPLWF-11%114:7M44193:4Z <br />• <br />Department of Health Services <br />Page 4 of 4 pages <br />License Number: 1812-39 <br />Amendment Number: 53 <br />(c) Performs only those procedures for which the physician is specifically authorized by the U.S. Nuclear <br />Regulatory Commission, an Agreement State or a Licensing 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 />25. 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 />26. 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 525 West Acacia Street, Stockton, CA. <br />4/1 , _ <br />Prepared By: <br />al i <br />Reviewed By: <br />Issued r t e De art e t f ealth <br />Servic By <br />Printed Name: rcia Y. Smith <br />Printed Name: Heidi S. O'Connell <br />Prin ed me: 18onzilo L. Perez <br />Date: February 4, 2004 <br />Radiologic Health Branch P.O. Box <br />942732 -MS 178 Sacramento, CA <br />94234-7320 <br />
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