ML18215A391
| ML18215A391 | |
| Person / Time | |
|---|---|
| Site: | 03001253 |
| Issue date: | 07/31/2018 |
| From: | Janice Nguyen NRC Region 1 |
| To: | Manchester Memorial Hosp, Prospect Manchester Hospital |
| References | |
| 608629 | |
| Download: ML18215A391 (4) | |
Text
NRC FORM 374 U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE PAGE 1 OF 4 PAGES Amendment No. 49 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. Prospect Manchester Hospital, Inc. d/b/a The Manchester Memorial Hospital 2. 71 Haynes Street Manchester , CT 06040 In accordance with letter dated April 23, 2018. IJ 4. Expiration Date: March 31, 2024 1----------------'
- 5. Docket No.: 030-01253
- 3. License number: 06-03413-01
- is amended in its entirety to read as follows: Reference No.: 6. Byproduct , source , and/or special nuclear material 7. Chemical and/or physical form 8. Maximum amount that licensee 9. Authorized use may possess at any one time under this license A. Any byproduct material A. Any " -~ A. As Needed A. For use in uptake , dilution and li4-permitted by 10 CFR excretion studies permitted by 10 CFR ,fl'°' .. -.:a:, 35.100 I 35.100. *~y~ '* 0 B. Any byproduct material B. Any B. As Needed -~I B. For use in imaging and localization permitted by 10 CFR +-!I' studies permitted by 10 CFR 35.200 . *, ,,I' .,,....,,~.
35.200 C. Any byproduct material C. Any I" C. 500 millicuries total C. For any use permitted by 10 CFR permitted by 10 CFR 35.300. 35.300 NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 06-03413-01 Amendment No. 49 6. Byprodu c t , source , and/o r spe c ial nuclear material 7. Chem i cal and/or physical form Docket or Refe r ence Number 030-01253
- 8. Maximum amount that licensee 9. Author i z e d use may possess at any one time under this license PAGE 2 O F 4 PAGES D. lodine-125 permitted by 10 CFR 35.400 D. Sealed Sou r ces (lsoaid, Model 1A1-125A; lsoStarTexas, Inc. d/b/a lmagyn Medical Technologies , Model IS-12501; Medi-Physics , Model 6711; North American Scientific , Model MED 3631; Source Tech Medical , Model STM 1251; Theragenics Corporation , Model AgX100) D. 500 millicuries total D. For any manual brachytherapy procedure permitted by 1 O CFR 35.400. :;.. CONDITIONS
- 10. Licensed material may be used or stored at the licensee's facilities located at 71 Haynes Street , Manchester , Connecticut.
- 11. The Radiation Safety Officer (RSO) for this license is Edward Denstman , M.D. 12. A. Indiv i duals 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 Alok Azad Anand , M.D. Helaine Bertsch , M.D. Timothy S. Boyd , M.D. Edward Denstman , M.D. Material and Use 10 CFR 35.100, 10 CFR 35.200; Oral administration of sodium iodide 1-131 10 CFR 35.400 10 CFR 35.400 10 CFR 35.100 , 10 CFR 35.200 , 10 CFR 35.300
'I NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET Authorized Users Robert Dowsett , M.D. Stephen H. Hauser , M.D. Thomas Kilkenny , M.D. Susan Y. Kim , M.D. Gary W. Kravetz, M.D. Kenneth Leopold , M.D. Jacqueline M. Lyon , M.D. Vinay Madan , M.D. Ted Stuart Metzger , M.D. Arthur A. Ostrowitz, M.D .* Edward M. Rosenblatt , M.D. Andrew L. Salner, M.D. Frederick J. Shuler , M.D. Christopher Taubes , M.D. U.S. NUCLEAR REGULATORY COMMISSION License Number 06-03413-01 Amendment No. 49 Material and Use 10 CFR 35.400 10 CFR 35.400 10 CFR 35 , 100 , 10 CFR 35.200 10 CFR 35.400 Docket or Reference Numbe r 030-01253 10 CFR 35.100 , 10 CFR 35.200 , 10 CFR 35.300 10 CFR 35.400 10 CFR 35.400 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 35.400 10 CFR 35.100 , 10 CFR 35 , 200 10 CFR 35.100 , 10 CFR 35.200 PAGE 3 OF 4 PAGES 13. In addition to the possession limits i n 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 assurance.
't '* NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 4 OF 4 PAGES MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 06-03413-01 Amendment No. 49 Docket or Reference Number 030-01253
- 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 November 27, 2013 [ML 13346A170]
B. Letter dated February 11, 2014 [ML14059A117]
C. Letter dated June 6, 2016 [ML 16159A359]
D. Letter dated September 29, 2016 [ML 16274A110]
\)> Date: July 31 , 2018 , J_ () FOR THE U.S. NUCLEAR REGULATORY COMMISSION ByE*/7~ J~ Region 1