IR 05000199/2013001
| ML24200A188 | |
| Person / Time | |
|---|---|
| Site: | 05000199, 03019521 |
| Issue date: | 07/18/2024 |
| From: | Latischa Hanson NRC/RGN-IV/DRSS/MLB |
| To: | Document Control Desk |
| References | |
| License-640619-222110 | |
| Download: ML24200A188 (1) | |
Text
U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE NRC FORM 374 PAGE OF
4 Amendment No. 54 PAGES Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10, Code of Federal Regulations, Chapter I, Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s)
and at the place(s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified belo Licensee Ketchikan, AK 99901-5794 2. 3100 Tongass Avenue 1. Peace Health Ketchikan Medical Center 4. Expiration Date: October 31, 2037 Docket No.:
5.
030-19521 License No.: 50-19913-01 is amended in its entirety to read as follows:
Reference No.:
3.
In accordance with application dated May 3, 2024; and E-mail dated July 10, 2024.
6.
7.
8.
Byproduct, source, and/or special nuclear material Chemical and/or physical form Maximum amount that licensee may possess at any one time under this license 9.
Authorized use A.
A.
A.
A.
For use in uptake, dilution and excretion studies permitted by 10 CFR 35.100.
Any As Needed Any byproduct material permitted by 10 CFR 35.100 B.
B.
B.
B.
For use in imaging and localization studies permitted by 10 CFR 35.200.
Any As Needed Any byproduct material permitted by 10 CFR 35.200
License No.:
Docket or Reference No.:
U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET PAGES OF PAGE
2 50-19913-01 030-19521 Amendment No. 54
CONDITIONS 10. Licensed material shall be used or stored at the licensee's facilities located at 3100 Tongass Avenue, Ketchikan, Alaska, 99901-5794.
11. The Radiation Safety Officer (RSO) for this license is Christopher S. Green, M.D.
12. Licensed material shall only be used by, or under the supervision of:
A.
Individuals permitted to work as authorized users in accordance with 10 CFR 35.13 and 10 CFR 35.14.
B.
The following individuals are authorized users for the material and medical uses as indicated:
Authorized User (M.D.,D.O.,etc.)
Material and Use Sarah Anderson, M.D.
35.100; 35.200 Charles Ariz, M.D.
35.100; 35.200 Laura Kay Backer, M.D.
35.100; 35.200 Valerie Smith Behrndt, M.D.
35.100; 35.200 Michael Patrick Buetow, M.D.
35.100; 35.200 Peter Christopher Buetow, M.D.
35.100; 35.200 Stephen John Buetow, M.D.
35.100; 35.200 David Daskam Calahan, M.D.
35.100; 35.200 Alan Chu, M.D.
35.100; 35.200 Lars Gustaf Crabo, M.D.
35.100; 35.200 Christopher Green, M.D.
35.100; 35.200 Robert Milton Hughes, M.D.
35.100; 35.200 Dag Andre Jensen, M.D.
35.100; 35.200
License No.:
Docket or Reference No.:
U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET PAGES OF PAGE
3 50-19913-01 030-19521 Amendment No. 54
Authorized User (M.D.,D.O.,etc.)
Material and Use Asra Sultana Khan, M.D.
35.100; 35.200 Sarah E. Nobles 35.100; 35.200 Gita R. Rabbani, M.D.
35.100; 35.200 Elliot James Rapp, M.D.
35.100; 35.200 Jacob Clark Smith, M.D.
35.100; 35.200 Michael Ted Smith, M.D.
35.100; 35.200 Jason Marsh Stoane, M.D.
35.100; 35.200 Mathew Thomas Studley, M.D.
35.100; 35.200
License No.:
Docket or Reference No.:
U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET PAGES OF PAGE
4 50-19913-01 030-19521 Amendment No. 54 13. Except as specifically provided otherwise in this license, the licensee shall conduct its program in accordance with the statements, representations, and procedures contained in the documents, including any enclosures, listed below. This license condition applies only to those statements, representations, and procedures that are required to be submitted in accordance with the regulations. Additionally, this license condition does not limit the licensee's ability to make changes to the radiation protection program as provided for in 10 CFR 35.26.
The U.S. Nuclear Regulatory Commission's regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence impose on the licensee requirements that are more restrictive than or in addition to the regulations.
A.
Application dated August 29, 2022 (ML22257A275) and letter dated September 29, 2022 (ML22276A083)
B.
Letter dated December 2, 2022 with enclosed diagrams (ML22354A188)
FOR THE U.S. NUCLEAR REGULATORY COMMISSION By:
Date:
Latischa M. Hanson Region IV July 18, 2024 LATISCHA HANSON Digitally signed by LATISCHA HANSON Date: 2024.07.18 12:08:37 -05'00'