Text

Amend 17 to License 50-17838-01 for Providence Hosp,Amending License in Entirety
	ML20212D508
Person / Time
Site:	03013426
Issue date:	06/16/1986
From:	Riedlinger B; NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION V)
To:	;
Shared Package
ML20197E946	List: ML20212D508; ML20212D530; ML20212D594; ML20212D751;
References
	50-17838-01, 50-17838-1, NUDOCS 8608120514
	Download: ML20212D508 (5)
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U.S. NUCLEAR REIULAToRY CoMMISSloN

Amendment No. 17

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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,

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Code of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,40 and 70, and in reliance on statements and representations

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heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct,

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source, and special nuclear material designated below; to use such material for the purpcse(s) and at the place (s) oesignated below;to

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deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This

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license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is jN

subject to all applicable rules, regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any

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conditions specified below.

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Licensee

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In accordance with letter

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dated May 15, 1986

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itsentiretytoreadasfc11ows:j

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Providence Hospital

3. License number 50-17838-01 is amended in

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Radiation Safety Office

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3200 Providence Drive; Pouch 6604

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31, 1988

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Anchorage, Alaska 99502

4. Expiration date August

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5. Docket or

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030-13426

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Reference No.

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6. Byproduct, source, and/or

7. Chemical and/or physical

8. Maximum amount that licensee

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special nuclear material

form

may possess at any one time

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this license

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undeIs necessary for uses

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Any byproduct materfal

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Any radiopharmaceutical.

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listed in Groups I and

listed in Groups I and II

authorized in

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II of Schedule A,l

of Schedule A, 'Section

Subitem 9.A.

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Section 35.100 of.

35.100 of 10 CFR 35'

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10 CFR 35

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Any byproduct material

B.- Any form listed in Group III

B.

3 curies of each

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listed in Group III

of Schedule A, Section 35.100

--byproduct material

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of Schedule A,

'of 10.CFR 35"

authorized in

Section 35.100 of 10 CFR 35

Subitem 6.B.

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Any byproduct material

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Any radiopharmaceutical

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As necessary for uses

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listed in Group IV

listed in Group IV of

authorized in

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of Schedule A,

Schedule A, Section 35.100

Subitem 9.C.

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Section 35.100 of 10 CFR 35

of 10 CFR 35

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Any byproduct material

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Any radiopharmaceutical

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As necessary for uses

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listed in Group V

listed in Group V of

authorized in

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of Schedule A,

Schedule A, Section 35.100

Subitem 9.D.

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Section 35.100 of 10 CFR 35

of 10 CFR 35

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Any byproduct material

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Any sealed source listed

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2 curies total

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listed in Group VI of

in Group VI of Schedule A,

for all sources

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Schedule A, Section

Section 35.100 of 10 CFR 35

authorized in

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35.100 of 10 CFR 35

Subitem 6.E.

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Strontium 90

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source No. 2503/3)

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Cesium 137

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100 mil 11 curies

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C Form 374A

U.S. NUCLEAR RE"ULATOCY CoMMISSIO N

PAGE

OF

PAGES

50-17838-01

MATERIALS LICENSE

pocket or Reference number

SUPPLEMENTARY SHEET

030-13426

Amendment No. 17

9.

Authorized use

A.

Any diagnostic procedure listed in Groups I and II of Schedule A, Section 35.100

of Title 10, Code of Federal Regulations.

B.

Preparation and use of radiopharmaceuticals for any diagnostic procedure listed

in Group III of Schedule A, Section 35.100 of Title 10, Code of Federal

Regulations.

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Any therapeutic procedure listed in Group *IV of ^ Schedule A, Section 35.100 of

Title 10, Code of Federal Regulations.

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Any therapeutic procedure, listed in Group V of Schedule #A,'Section 35.100 of

Title 10, Code of Federa1' Regulations.

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Any procedure listed.in Group.VI of Schedule A, Section-35.100 of Title 10, Code

of Federal Regulatio'ns.

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Licensed material shall be'used.only.'atiPro'vidence Hospital, 3200 Providence

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11. Licensed material listed in Item 6 above is authorized for,use by, or under the

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supervision of, the fo11'owing individual (s)>for the! materials and uses

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indicated:

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Maurice J. Coyle, M.D.

Groups,I, II, III and VI

Iodine'131 contained in capsules for

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treatment of hyperthyroidism and

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cardiac dysfunction

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John J. Kottra, M.D.

Groups I, II and III

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Iodine 131 contained in capsules for

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treatment of hyperthyroidism and

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cardiac dysfunction

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Charles Sternhagen, M.D.

Groups IV, V and VI

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Peter MeMott Swift, M.D.

Group VI

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Darwin L. Zellmer, M.S.

Non-human use

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C Form 374A

U.S. NUCLEAR REIULATORY CoMMISSl!N

PAGE

OF

PAGES

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Lic;nse number

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50-17838-01

I

MATERIALS LICENSE

'

"** * *

SUPPLEMENTARY SHEET

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030-13426

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Amendment No. 17

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CONDITIONS

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(c ntinued)

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Denise 0. Cook, M.D.

Groups I, II and III

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Iodine 131 contained in capsules for

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treatment of hyperthyroidism and

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cardiac dysfunction

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David Allen Moeller, M.D.

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C M ( f lodine 131 contained in capsules for

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treatment of hyperthyroidism, cardiac

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dysfunction, or thyroid carcinoma

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Colloidal phosphorus 32ffor

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Kenneth Allen Fox,u,M.D.

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Group VI

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12. For a period not to. exceed sixty L(60) days <in any; calendar year, la visiting

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physician is authorized to use licensed. material'for human use under the terms

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of this license, [provided the.visitingfphysician::

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A.

Has the priorswritten permission of the: hospital's Administirator and its

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Radiation Safety Committee, andiJ[; & 2 )V '

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Is specificallyfnamed asia user on;a Nuclear Regulatory Commission license

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authorizing human use,!and 6

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Performs only those-procedures which the' physician isaspecifically

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authorized to perform, pursuant to a license issued'by the Nuclear

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Regulatory Commission.,'

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Thelicenseeshallmaintainfor'inspectioirbytheCommissioncopiesofthe

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written permission specified in A. above'a'nd of the license (s) specified in B.

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and C. above for a period of 5 years from the date permission is granted under

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A. above.

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Patients containing iodine 131 for the treatment of thyroid carcinoma

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(or patients containing therapeutic quantities of gold 198) shall remain

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hospitalized until the residual activity is 30 mil 11 curies or less.

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Sealed sources containing licensed material shall not be opened.

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U.S. NUCLEAR RE!ULAToRY CoMMISSCN

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PAGE

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Lic:nse number

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50-17838-01

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Docket or Reference number

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SUPPLEMENTARY SHEET

030-13426

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Amendment No. 17

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CONDITIONS

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15.

A.

(1) The source (s) specified in Item (s) 7.E.,

7.F., and 7.G. shall be

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tested for leakage and/or contamination at intervals not to exceed 6

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months, except that Series 6500 or 6520 (formerly Model 6D6C) Minnesota

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Mining and Manufacturing Cesium 137 sources shall be tested at intervals

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not to exceed three years._ Any source received from another person

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which is not accompanded by{a certificate, indicating that a test was

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performed within 6 months' be' fore tiie' transfer shall not be put into

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(2) Notwithstanding* the periodic leak test required bjj this condition, any

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licensed sealed source is exempt from such leak tests when the source

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contains ,100 microcuries or less of beta and/orjgamma. emitting

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material. o'r' 10 microcuries or less of alpha. emitting' material.

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Any source in; storage and-not beingiused nsedLnot be tested. When the

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sourceisremovedfromstoragelforjuse(or'transfertoanotherperson,it

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shall be tested before use ori ransfer.t

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The test shd11 be capable'of. detecting the-presenc'e;of 0.005' microcurie of

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radioactive material'on 4the test sample? DIf the~ test' reveals the presence

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of 0.005 microcurie or.more of removable [ contamination, the4 source shall be

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removed from service'and-decontamindted,Jrepaired, or disposed of in

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accordance withlCommission! regulations. x A~ report shall,be* filed within 5

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days of the date the leak test result is known with the'U. S. Nuclear

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Regulatory Commihsfon, Region V;'Nuclea'r Materials Safety and Safeguards

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Branch; 1450 Maria % ne, Suite 210; Walnut Creek,,Cdlifornia 94596. The

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report shall specify'the source involved, the test 7results, and corrective

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action taken. Records of le'ak test results .shall be kept in units of

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microcuries and shall be maintained for-inspection by the Commission.

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Records may be disposed of following Commission inspection.

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D.

Tests for leakage and/or contamination shall be performed by the licensee

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or by other persons specifically licensed by the Commission or an Agreement

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State to perform such services.

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RC Form 37 A

U.S. NUCLEAR RE!ULATtRY CoMMISSl!N

PACE

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License number

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MATERIALS LICENSE

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' * * ' * " ' * " "

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030-13426

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SUPPLEMENTARY SHEET

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Amendment No. 17

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CONDITIONS

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(c:ntinued)

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16. The licensee is authorized to hold radioactive material with a physical

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half-life of less than 65 days for decay-in-storage before disposal in ordinary

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trash provided:

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Radioactive waste to be disposed,of in this manner shall be held for decay

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a minimum of ten (10) half -lives.' n [" b Q,j

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Prior to disposal as; normal waste, radioactive' waste shall be surveyed to

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determine that its radioactivity cannot be distinguished from background.

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All radiation labels'shall be removed or obliterated.f)

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Generator columns shall_be segregated so that they-may be~ monitored

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separately to, ensure decaysto background levels? prior tordisposal.

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The licensee may use the Lineato'r device'~ for; doing'linearity test's of its dose

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calibratorprovideditfollowsthejroceduresintheAtomicProductsCorporation

Lineator Instructions Manual da'ted4 June % 20,31983.1

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Except as specifically provided otherwise'in:this .licen'see the J.idensee shall

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conduct its program'in accordanceTwith thd' statements', representations, and

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procedures contained 1n the' documents including any enclosures?" listed below.

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The Nuclear Regulatory Commission!s regulations shall govern unless the statements,

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representations and(procedures 'in the -licensee's' app /lication!and correspondence

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are more restrictivesthan thh regulations.

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Application dated N6vember 30, 1982 '

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B.

Application dated February 21, 1983

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Letter dated July 13, 1983

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Letter dated August 17, 1983;

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Letter dated January 20, 1984

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Letter dated February 13, 1984

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Telegram dated February 22, 1984

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Letter dated March 6, 1984

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Letter dated May 15, 1986

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FOR Tile U.S. NUCLEAR REGULATORY COMMISSION

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original signed by B. A. Riedlinger

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Dr.te June 16, 1986

By

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Beth A. Riedlinger

Health Physicist (Licensing)

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Nuclear Materials Safety Section

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Region V

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ML20212D508

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