ML18198A065
| ML18198A065 | |
| Person / Time | |
|---|---|
| Site: | 03013805 |
| Issue date: | 07/16/2018 |
| From: | Forster S A NRC/RGN-III |
| To: | Dekalb Memorial Hosp |
| References | |
| 608927 | |
| Download: ML18198A065 (3) | |
Text
NRC FORM374 U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE PAGE 1 OF 3 PAGES Amendment No. 26 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 below. Licensee 1. DeKalb Memorial Hospital, Inc. 2. P.O. Box 542 Auburn, IN 46706 6. Byproduct, source, and/or special nuclear material A. Any byproduct material permitted by 10 CFR 35.100 B. Any byproduct material permitted by 10 CFR 35.200 7. A. Any B. Any In accordance with letter dated 4. Expiration Date: September 30, 2023 May 1~.1~201~ .. *.* u\" . j\ t----------....11o-....11o---1
- 5. Docket No.: 030-13805 Reference No.: 3. License number: 13-18506:on amended in its entirety to rea ""'; follows: }*-Of;l~ITip!SJS
- 9. Authorized use A. For use in uptake, dilution and excretion studies permitted by 10 CFR 35.100. B. For use in imaging and localization studies permitted by 10 CFR 35.200. 10. Licensed material listed in Subitem Nos. 6.A. through 6.8. may be used at the licensee's facilities located at 1316 E Seventh St., Auburn, Indiana, 46706. 11. The Radiation Safety Officer (RSO) for this license is Brett A Hagedorn, M.D.
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 13-18506-01 Amendment No. 26 12. Licensed material shall only be used by, or under the supervision of: Docket or Reference Number 030-13805 A. Individuals permitted to work as authorized usersJt}t~~ntl t1£)(g~~}5.13 and 10 CFR 35.14. . "4<1 8. The following individuals are authorized
.~~s~for the material and medical us;~
- Authorized User(M.D.,D.O.,etc.)
~terial and Use James A. Arata, M.D. 10 C~i~:100, 10 CFR 35.200
- 3 .. h1' *** John L. Bormann, M.D. Daniel Branam, M.D. Brett A. Hagedorn, M.D. Andre Byard Stovall, M.D. Ji"' PAGE 2 OF 3 PAGES 13. Except as s_pecifically provided otherwi~~this i~~'. th.{Jid#~Jo~fr6t its prq;,m in accord_an~e with the ~t~temen~s, representations, and procedures contarnef/Di~
!he aocaMentS,)~~4g.an¥;7:ric1osures4Sfed below. This license condrtron applies only to t~ose proced~_res that are required to be su~~d in acc?rda~fr.~it~ltfie fe~lation~~itionally, this license condition does not limit the licensee's abrhty to make changes to the radrat+erotectron progr;:lM as prov1dedi~NJ110 CFR 35.26. The U.S. Nuclear Regulatory Commission's regulations shall govern unless thei'~tements, representatiol')s, an<iprocedures in the licensee's application and correspondence are more restrictive than the regulationl
- .. ' A. Application dated June 4, 2013 (ML 13168A565)
- 8. Letter dated December 2, 2013 (ML 13339A970)
- NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 3 OF 3 PAGES MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 13-18506-01 Amendment No. 26 C. Letter dated May 15, 2018 (ML 18149A588)
Date: July 16, 2018 Docket or Reference Number 030-13805 FOR THE U.S. NUCLEAR REGULATORY COMMISSION By: :A&u,-11. 2"'tJ\t£G.,_, Sara A. Forster Region 3