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Mate of California -Health and Human Serviogency J RADIOACTIVE MATERIAL LICENSE Department of Health Services Page 2 of 4 pages License Number: 5766-39 Amendment Number: 13 11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any one time as specified in Items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual cost -of -living adjustment pursuant to Section 100425 of the California Health and Safety Code. 12. The individuals named below are authorized the specific uses of radioactive material described in Items 6, 7, 8, and 9 of this license as follows: (a) Michael D. Reitz, M.D. (b) B. Rama Rao, M.D. Groups 1, 2, 3, 4 and 9 Groups 1, 2, 3, 4 and 9 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material described in Items 6, 7, 8 and 9 of this license in accordance with the 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 correspondence are more restrictive than the regulations. (a) The renewal application, with attachments, dated June 7, 1999, supplemented by the letters, all with attachments, dated April 26, 2002, August 28, 2002, and October 7, 2002, all signed by Michael D. Reitz, M.D., Chief, Department of Radiology, Radiation Safety Officer. 14. (a) The Radiation Safety Officer in this program shall be Michael D. Reitz, M.D. (b) The Chairperson of the Radiation Safety Committee shall be Michael D. Reitz, M.D. (c) The Custodian of sealed sources shall be Michael D. Reitz, M.D. (d) The Alternate Radiation Safety Officer in this program shall B. Rama Rao, M.D. 15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by Title 17, California Code of Regulations, Section 30275 (c). 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 in writing by the Radiation Safety Officer 17. The licensee is authorized to hold radioactive materials with a physical half-life of less than 65 days for decay in storage before disposal in ordinary trash provided: (a) Radioactive waste to be disposed of in this manner shall be held for decay in storage for at least 10 half-lives (b) Before disposal as normal waste, radioactive waste shall be surveyed to determine that its radioactivity cannot be distinguished from background. All radiation labels shall be removed or obliterated. 18. The licensee may use one constancy source for the dose calibrator constancy test provided that the dose calibrator manual indicates that only one constancy source is needed for proper Quality Control.