IR 05000293/1957001

640304-Amendment 10 License 50-29357-01/030-38077 for Providence Imaging Center (PIC)

ML24164A242
Person / Time
Site:	Pilgrim, 03038077
Issue date:	06/12/2024
From:	Latischa Hanson NRC/RGN-IV/DRSS/MLB
To:	Document Control Desk
References
License-640304-219317
Download: ML24164A242 (1)

Text

NRC FORM 374 PAGE OF1 3PAGES U.S. NUCLEAR REGUL ATORY COMMISSION Amendment No. 10 MATERIALS LICENSE 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 In accordance with letter dated Expiration Date: March 31, 2035 Providence Imaging Center (PIC) March 13, 2024; and email dated April 4, 2024 with attachment. Docket No.: 030-38077 Providence Drive License No.: 50-29357-01 is Reference No.:

Anchorage, AK 99508 amended in its entirety to read as follows:. 8.Byproduct, source,Chemical and/or physical form Maximum amount that licensee Authorized use and/or special nuclear may possess at any one time material under this license For use in imaging and localization Any byproduct materialA.Any As Needed permitted by 10 CFR studies permitted by 10 CFR 35.20.200 NRC FORM 374A U.S. NUCLEAR REGUL ATORY COMMISSION P AGE 32OFPAGES License No.: Docket or Reference No.:50-29357-01 MATERIALS LICENSE 030-38077 SUPPLEMENTARY SHEET Amendment No. 10

CONDITIONS 1 Licensed material may be used or stored at the licensee's facilities located at 3340 Providence Drive, Anchorage, Alask Licensed material may be received and stored at the licensee s facilities located at the loading dock of Providence Alaska Medical Center, 3200 Providence Drive, Anchorage, Alask. The Radiation Safety Officer (RSO) for this license is Natalie Shimasaki-Alenepi, The Associate Radiation Safety Officer (ARSO) for this license is Thomas H. Essig, M.S., CH. Licensed material shall only be used by, or under the supervision of: Individuals permitted to work as authorized users as appropriate in accordance with 10 CFR 35.13 and 10 CFR 35.1 The following individuals are authorized users for the material and medical uses as indicated:

Authorized Users Material and Use Max W. Berry,.200 Jonathan P. Coyle,.200 Chakri S. Inampudi,.200 Christopher L. Kottra,.200 Erik John Maurer,.200 Scott R. Naspinsky,.200 Brittany L. O'Steen,.200 Christopher M. Reed,.200 Heather Tauschek,.200 Wandal B. Winn,.200 NRC FORM 374A U.S. NUCLEAR REGUL ATORY COMMISSION P AGE 33OFPAGES License No.: Docket or Reference No.:50-29357-01 MATERIALS LICENSE 030-38077 SUPPLEMENTARY SHEET Amendment No. 10

1 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 financial assurance for decommissionin. 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 regulation A. Application dated September 23, 2019 (ML19290D016) (excluding radiation safety program, policies, and procedures)

B. Letter dated March 19, 2020 (ML20090A630)

C. Letter dated September 30, 2020 (ML20293A451)

D. E-mail dated December 10, 2020 with attachments (ML21021A066)

E.Letter dated April 13, 2023 (ML23116A118)

F. Letter dated March 13, 2024 (ML24101A057)

G.Email dated April 4, 2024 with attachments (ML24164A216)

FOR THE U.S. NUCLEAR REGULATORY COMMISSION

Date: June 12, 2024 By:

Latischa M. Hanson Region IV