ML18206A279
| ML18206A279 | |
| Person / Time | |
|---|---|
| Site: | 03012966 |
| Issue date: | 07/24/2018 |
| From: | Parker B A NRC/RGN-III |
| To: | Nuclear Diagnosis |
| References | |
| 608599 | |
| Download: ML18206A279 (5) | |
Text
NRCFORM374 U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE PAGE 1 OF 5 PAGES Amendment No. 77 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. Nuclear Diagnosis, Inc. In accordance with letter dated April 14.1 20.te. . ... H 4. Expiration Date: May 31, 2024 2. P.O. Box 3371 Springfield, MO 65808 I ..
- 1 5. Docket No.: 030-12966
- 3. License number: 24-17561.:bf"IJ Reference No.: 6. Byproduct, source, and/or special nuclear material A. Any byproduct material permitted by 1 O CFR 35.100 B. Any byproduct material permitted by 10 CFR 35.200 *~* 7. Chemical alrttn,r physical form A. Any B. Any amended in its entirety to reacfaS\ follows: itjfr 8. Maximum.amount that Ii may piint* at any one er thls:Jicense
- e. As Needed *,*boNbtT1AN~( .... , .{ "-t""""':,, Yi\, e 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. A. Licensed material listed in Subitem Nos. 6.A. and 6.8. may be used at the licensee's facilities located at: A. Texas County Memorial Hospital, 1333 S. Sam Houston Blvd., Houston, Missouri, 65483 B. Cox Medical Center Branson, 251 Skaggs Rd., Branson, Missouri, 65616 C. Mercy Hospital Aurora, 500 Porter St., Aurora, Missouri, 65605 D. Cox-Monett Hospital, 801 Lincoln, Monett, Missouri, 65708
-NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET U.S. NUCLEAR REGULATORY COMMISSION License Number 24-17561-01 Amendment No. 77 Docket or Reference Number 030-12966 E. Missouri Baptist Hospital-Sullivan, 751 Sappington Bridge Rd., Sullivan, Missouri, 63080 PAGE 2 OF 5 PAGES F. Mercy Hospital Cassville, 94 Main, Cassville, Missouri, 65ij'i,5 '" G. Mercy Hospital Carthage d/b/a Mercy McCu~.ef~flto(p\tir; l'itJ')J Russell Smith Way, Carthage, Missouri, 64836 H. Cox Heart Center Bronson, 1150 State ~~1 24tBranson, Missouri, 6S8~ ),, I. Carroll County Memorial Hospital, 1s9,1). Jefferson, Carrollton, Missouri, 641:l~~;i \w+ ~+++\ I B. Licensed material in Subitem Nos. 6.-'t)md 6.B. may be used at temporary Job sites a,4where in the United States where the U.S. Nuclear Regulatory Commission maWtains jurisdiction for regulating the use of license~aterial, including areas of exclusive Federal jurisdiction within Agreement State~***
"' ' If the jurisdiction status of a Feder~,J.fecility wi.thin an.,Agri controlling the job site in question t~termiriewhethettb tor use of radioactive materials at job JJtes 1nAoreement s appropriate state regulatory agency. 0 1 , ,o O,'#' ¥ 1/IC\IIW'i.'.
- 1l1 unknown, the 1!5~see should contact the Federal agency job site is an arell,V exclusive Federal jurisdiction.
Authorization under exclusive F*al jurisdiction shall be obtained from the 11. The Radiation Safety Officer (RSO) for this lice Charles A. Hillis, Sr., CNMn;::::ir, I NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 24-17561-01 Amendment No. 77 12. Licensed material shall only be used by, or under the supervision of: Docket or Reference Number 030-12966 A. Individuals pennitted to work as authorized users i~nfUiiGrt.9r~5.13 and 10 CFR 35.14. " 1, 8. The following individuals are authorized u~ for the material and medical uses"~dicated: '\,~' c:';* Authorized User(M.D.,D.O.,etc.}
C;r*:)Mater{ll 1.od Use 11. '"' '" Bradley K. Baker, M.D. 10 CFR 3SAOO, 10 CFR 35.200 Lance H. Borup, D.O. 10 CFR 3S;100,10 CFR 35.200 Paul Ren Chu, M.D. 10 CFR 3~;2()0 Edward F. Downey, Jr., 0.0. Norman B. Ely, M.D. John T. Engles, M.D. Dale M. Fletcher, M.D. Geoffrey S. Hamill, M.D., Ph.D. Jeffrey Brian Judd, M.D. Christine Keesling, M.D. Joseph L. Mailloux, M .0. Robert McNaughton, M.D. William Mehard, M.D. Randall Newth, M.D. Robert Newth, M.D. John H. Niemeyer, M.D. Lisa M. Oakley, M.D. George William Pogson, M.D. 10 CrR 35:100,J 10CFR35.100,1.
,10 CFR~!.10Q,1oi<Jft
~l.2fl0 \~ CFR 38.100,1~
CFR 35.200 ~~FR 35.100,10C~R 35.200 35.100,10 CFR 35.200 10 CFR 35JtQOl1Q CF~ 35 1?90*.;. w-\J \ > ",,--}. '"7 "('.: / '.., 10 CFR 35.100,10 Cf'IR 3&.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100, 10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.200 PAGE 3 OF 5 PAGES NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 4 OF 5 PAGES MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 24-17561-01 Docket or Reference Number 030-12966 Authorized User(M.D.,D.O.,etc.}
Timothy Raveill, M.D. Floyd E. Scales, M.O. Jeffrey L. Shore, M.D. Steven L. Solomon, M.D. Brandon C. Stroh, M.D. Steven J. Taggart, M.D. Christopher O. Thorton, M.D. Prasert Vijitbenjaronk, M.D. James R. Wolski, M.D. Amendment No. 77 Material and Vst 10 CFR 35.100,10 C~ 35.200 10 CFR % ~Ji\ ~lisGr>(/J 10 q,~k'100, 10 CFR 35.200 L~.,1 1~l='R 35.100,10 CFR 35.200 CFR 35.100, 10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 36:"100, 10 CF~ 35.200 10 CFR 36.200 13. Except as specifically provided otherwi~1~
t .. hisjf~e.~
.* e .* the*** 11J.~11.*, .. ~. :.** fl,. afl***conduct its pro representations, and procedures contain~n the;dQC"'ments~
iU1f4ilg any enclosures," those procedures that are required to be ~itted fn *ece.ordancewith the regulations.
licensee's ability to make changes to the radt~.n protection proi1ram as provided for i Commission's regulations shall govern unles<~~~tements, representations, a~~'** correspondence are more restrictive than the regwfjlions.
\~** in accordance with the statements, below. This license condition applies only to ltionally, this license condition does not limit the CFR 35.26. The U.S. Nuclear Regulatory edures in the licensee's application and A. Application dated October 15, 2013 (ML 133268084)
- 8. Letter dated August 15, 2013, with attachments excluding reference to add Michelle Gamble as a second RSO (ML 13247A764)
C. Letter dated September 12, 2013 (ML 13267A417)
D. Letter dated December 16, 2013 (ML 14002A434)
E. Letter dated March 14, 2014 (ML 14133A238)
F. Letter dated April 9, 2014 (ML 14133A278)
G. Letter dated April 9, 2014 (ML 14133A264)
H. Letter dated April 29, 2014 (ML 14133A203)
- NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 24-17561-01 Amendment No. 77 I. Letter dated May 2, 2014 (ML 14133A199)
J. Letter dated May 21, 2014 (ML 14168A234)
K. Letter dated September 8, 2014 (ML 14260A433) 1~:J>i, t\ L. letter dated January 30, 2015 (ML 15040A6~ \.-M. Letter dated September 28, 2016 (ML 16~481) N. Letter dated April 14, 2018 (ML 18122A Date: JUL 2 4 2018 --------Docket or Reference Number 030-12966 FOR THE U.S. NU By:
- Bryan A. Parker Region Ill PAGE 5 OF 5 PAGES COMMISSION