ML18205A536
| ML18205A536 | |
| Person / Time | |
|---|---|
| Site: | 03010133 |
| Issue date: | 07/11/2018 |
| From: | Simmons M R NRC Region 4 |
| To: | Ivinson Memorial Hosp |
| References | |
| 608604 | |
| Download: ML18205A536 (5) | |
Text
U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE NRC FORM 374PAGE OF 1 5 Amendment No. 27PAGES 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 Laramie, WY 82072-5195 2.255 North 30th Street 1.Ivinson Memorial Hospital 4.Expiration Date:
March 31, 2019 Docket No.:
5.030-10133 License number: 49-15978-01 is amended in its entirety to read as follows: Reference No.:
3.In accordance with letter dated March 19, 2018.
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 1 curie total Any byproduct material permitted by 10 CFR 35.300 License Number Docket or Reference Number U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEETPAGES OFPAGE 5 2 49-15978-01 030-10133 Amendment No. 27 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 D.D.D.D.For any manual brachytherapy procedure permitted by 10 CFR 35.400.
Sealed Sources (Bard Brachytherapy, Inc., Model STM 1251; Best Medical International, Inc. (Formerly Best Industries, Inc.), Model 2300 Series; Core Oncology, Inc. (Formerly Mills Biopharmaceuticals, LLC), Model I-125 SL or I-125 SH; International Brachytherapy SA., Model OptiSeed103 Model 1032p or Model 1251L; IsoAid, L.L.C., Model IAI-125A or IAPd-103A (AdvantageŽ Pd-103); Medi-Physics, Inc./Amersham Health, Model 6711 (OncoSeedŽ) or 6733 (EchoSeedŽ);
North American Scientific, Inc., Model MED3631 or MED3633; Theragenics Corporation, Model I-Seed I25.S06 or TheraSeed Model 200)5 curies total Any byproduct material permitted in 10 CFR 35.400 CONDITIONS 10.Licensed material may be used or stored only at the licensee's facilities located at 255 North 30th Street, Laramie, Wyoming , 82072-5195.11.The Radiation Safety Officer (RSO) for this license is Jeanne M. Henneman, M.D.
License Number Docket or Reference Number U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEETPAGES OFPAGE 5 3 49-15978-01 030-10133 Amendment No. 27 12.Licensed material shall only be used by, or under the supervision of:
A.Individuals permitted to work as authorized users, authorized nuclear pharmacists, and/or authorized medical physicists 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 Michael J. Geraghty 35.100; 35.200; Oral administration of sodium iodide I-131 Jeanne M. Hennemann, M.D.
35.100, 35.200; Oral administration of sodium iodide I-131 less than or equal to 33 millicuries Christine Lauro, M.D.
Oral administration of sodium iodide I-131; 35.400 John D. Purviance, M.D.
35.300; 35.400 Robert Lawrence Tobin, M.D.
35.300; 35.400 13.For sealed sources not associated with 10 CFR Part 35 use, the following conditions apply:
A.Sealed sources shall be tested for leakage and/or contamination at intervals not to exceed the intervals specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission under 10 CFR 32.210 or under equivalent regulations of an Agreement State.B.Notwithstanding Paragraph A of this Condition , sealed sources designed to primarily emit alpha particles shall be tested for leakage and/or contamination at intervals not to exceed 3 months.
C.In the absence of a certificate from a transferor indicating that a leak test has been made within the intervals specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission under 10 CFR 32.210 or under equivalent regulations of an Agreement State, prior to the transfer, a sealed source received from another person shall not be put into use until tested and the test results received.
License Number Docket or Reference Number U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEETPAGES OFPAGE 5 4 49-15978-01 030-10133 Amendment No. 27 D.Sealed sources need not be tested if they contain only hydrogen 3; or they contain only a radioactive gas; or the half-life of the isotope is 30 days or less; or they contain not more than 100 microcuries of beta- and/or gamma-emitting material or not more than 10 microcuries of alpha emitting material.
E.Sealed sources need not be tested if they are in storage and are not being used; however, when they are removed from storage for use or transferred to another person and have not been tested within the required leak test interval, they shall be tested before use or transfer. No sealed source shall be stored for a period of more than 10 years without being tested for leakage and/or contamination.
F.The leak test shall be capable of detecting the presence of 0.005 microcurie (185 becquerels) of radioactive material on the test sample.
If the test reveals the presence of 0.005 microcurie (185 becquerels) or more of removable contamination, a report shall be filed with the U.S. Nuclear Regulatory Commission in accordance with 10 CFR 30.50(c)(2), and the source shall be removed immediately from service and decontaminated, repaired, or disposed of in accordance with Commission regulations.
G.Tests for leakage and
/or contamination, including leak test sample collection and analysis, shall be performed by the licensee or by other persons specifically licensed by the U.S.
Nuclear Regulatory Commission or an Agreement State to perform such services
.14.The licensee shall conduct a physical inventory every 6 months, or at other intervals approved by the U.S. Nuclear Regulatory Commission, to account for all sources and/or devices received and possessed under the license.
15.Sealed sources containing licensed material shall not be opened or sources removed from detector cells by the licensee, except as specifically authorized.
16.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 decommissioning.
License Number Docket or Reference NumberU.S. NUCLEAR REGULATORY COMMISSION NRC FORM 374AMATERIALS LICENSESUPPLEMENTARY SHEETPAGES OFPAGE55 49-15978-01 030-10133 Amendment No. 27 17.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 September 17, 2008 (ML082900601)B.Letter dated October 21, 2008 (ML090150665)
C.E-mail dated March 3, 2009 (ML090640901)
D.Application dated May 10, 2010 (ML101540472)
E.Letter dated February 1, 2018 (ML18051B292)FOR THE U.S. NUCLEAR REGULATORY COMMISSION By: Date: Region 4 Michelle R. Simmons