IR 05000290/1959001
| ML18044B069 | |
| Person / Time | |
|---|---|
| Site: | 03033011, 05000290 (50-29059-01) |
| Issue date: | 01/19/2018 |
| From: | Latischa Hanson NRC Region 4 |
| To: | Mat-Su Regional Medical Ctr |
| References | |
| 601589 | |
| Download: ML18044B069 (3) | |
Text
U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE NRC FORM 374 PAGE OF
3 Amendment No. 24 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 Palmer, AK 99645 2. P.O. Box 1687 Imaging Department 1. Mat-Su Regional Medical Center 4. Expiration Date: July 31, 2023 Docket No.:
5.
030-33011 License number: 50-29059-01 is amended in its entirety to read as follows:
Reference No.:
3.
In accordance with letter dated October 31, 2017 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 C.
C.
C.
C.
For any use permitted by 10 CFR 35.300.
Any 400 millicuries total Any byproduct material permitted by 10 CFR 35.300 CONDITIONS 10. Licensed material may be used or stored at the licensee's facilities located at:
A.
2500 South Woodworth Loop, Palmer, Alaska, 99645
License Number Docket or Reference Number U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET PAGES OF PAGE
2 50-29059-01 030-33011 Amendment No. 24 11. The Radiation Safety Officer (RSO) for this license is Richard R. Gardner, CNMT.
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 Users Material and Use Julee K. Holyater, M.D.
35.100; 35.200; 35.300 Lester B. Lewis, M.D.
35.100; 35.200; 35.300 Lawrence P. Wood, M.D.
35.100; 35.200; oral administration of sodium iodide I-131 Douglas Swank, D.O.
35.100; 35.200 Andrew Moran, M.D.
35.100; 35.200 Bradley K. Cruz, M.D.
35.100; 35.200; 35.300 Chris T. Glenn, M.D.
35.100; 35.200; 35.300 13. In addition to the possession limits in Item 8, the licensee shall further restrict the possession of licensed material to quantities below the minimum limit specified in 10 CFR 30.35(d) for establishing decommissioning financial assuranc License Number Docket or Reference Number U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET PAGES OF PAGE
3 50-29059-01 030-33011 Amendment No. 24 14. 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 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 are more restrictive than the regulations.
A. Application dated January 17, 2013 (ML13032A171)
B. Letter received July 19, 2013 (ML13203A124)
C. Letter dated October 31, 2017 (ML17325A362)
FOR THE U.S. NUCLEAR REGULATORY COMMISSION By:
Date:
Region 4 Latischa M. Hanson January 19, 2018
/RA/