ML23233A180
| ML23233A180 | |
| Person / Time | |
|---|---|
| Issue date: | 08/22/2023 |
| From: | NRC/NMSS/DMSST |
| To: | |
| References | |
| Download: ML23233A180 (1) | |
Text
Condition Name Condition Description Program Codes Animals/Animal Products Not for Human or Animal Experimental animals, or the products from experimental animals, that have been administered 01100, 01110, 01120, 02110, 02400, 03610, 03611, 03612, 03613, Consumption licensed material shall not be used for human or animal consumption. 03620, 04410, 04411, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 ARSO The Associate Radiation Safety Officer (ARSO) for this license is <<!ARSONames!>>. 02110, 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240 Authorized to Distribute, Specific Products The licensee is authorized to distribute the following series of self-luminous [specify products, (e.g. 03254 compasses and knives models, gunsights)] devices provided the amount of [hydrogen-3] does not exceed the amount specified in the following table: Device Model, Maximum Activity Certain Non-Routine Maintenance Allowed [Insert the services authorized in this license, delete remaining: (i) Installation, (ii) initial radiation 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, surveys, (iii) relocation, (iv) removal from service, (v) dismantling, (vi) alignment, (vii) replacement, 04437 (viii) disposal of the sealed source, and (ix) non-routine maintenance or repair of components related to the radiological safety of the gauge] shall be performed only by [insert name(s)], or other individuals who have completed the training specified in [insert application/letter] dated [insert date],
or by persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Cleaning, Maintenance, Repair of Gauges Any cleaning, maintenance, or repair of the gauge(s) that requires detaching the source or source rod 03121, 04416, 04417 from the gauge shall be performed only by the manufacturer or by other persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Contaminated Equipment Except for calibration sources, reference standards, and radioactively contaminated equipment 03219, 03234 owned by the licensee, receipt, storage, and use incidental to any activity involving licensed material at a temporary job site shall be limited to material originating from that site. This material must either be transferred to an authorized recipient or remain at the site after licensee activities are completed.
Decay In-Storage (A) Before disposal as ordinary trash, the waste shall be surveyed at the container surface with the 01100, 01110, 01120, 02110, 02400, 02410, 02500, 02511, 02513, appropriate survey instrument set on its most sensitive scale and with no interposed shielding to 02600, 03112, 03210, 03211, 03212, 03213, 03214, 03220, 03232, determine that its radioactivity cannot be distinguished from background. All radiation labels shall be 03240, 03241, 03242, 03243, 03244, 03610, 03611, 03612, 03613, removed or obliterated, except for radiation labels on materials that are within containers and that 03620, 03800, 03810, 04010, 04011, 04012, 04013, 04014, 04015, will be managed as biomedical waste after they have been released from the licensee. 04110, 04111, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04424, 04425, 04430, 04431, 04432, 04433, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 Decay In-Storage (B) A record of each such disposal permitted under this license condition shall be retained for 3 years. 01100, 01110, 01120, 02110, 02400, 02410, 02500, 02511, 02513, The record must include the date of disposal, the date on which the byproduct material was placed in 02600, 03112, 03210, 03211, 03212, 03213, 03214, 03220, 03232, storage, the radionuclides disposed, the survey instrument used, the background dose rate, the dose 03240, 03241, 03242, 03243, 03244, 03610, 03611, 03612, 03613, rate measured at the surface of each waste container, and the name of the individual who performed 03620, 03800, 03810, 04010, 04011, 04012, 04013, 04014, 04015, the disposal. 04110, 04111, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04424, 04425, 04430, 04431, 04432, 04433, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 Decay In-Storage (Header) The licensee is authorized to hold radioactive material with a physical half-life of less than or equal to 01100, 01110, 01120, 02110, 02400, 02410, 02500, 02511, 02513, 120 days for decay-in-storage before disposal in ordinary trash provided: 02600, 03112, 03210, 03211, 03212, 03213, 03214, 03220, 03232, 03240, 03241, 03242, 03243, 03244, 03610, 03611, 03612, 03613, 03620, 03800, 03810, 04010, 04011, 04012, 04013, 04014, 04015, 04110, 04111, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04424, 04425, 04430, 04431, 04432, 04433, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 Destructive Tests The licensee shall not conduct destructive tests involving source material such that airborne 11221 radioactivity would be released to the unrestricted areas.
Device Components Not Related to Radiological Safety (A) The licensee may maintain, repair, or replace device components that are not related to the 03120, 03130, 03214, 04110, 04111, 04414, 04415, 04436, 04437 radiological safety of the device containing licensed material and that do not result in the potential for any portion of the body to come into contact with the primary beam or result in increased radiation levels in accessible areas.
Device Components Not Related to Radiological Safety (B) The licensee may not maintain, repair, or replace any of the following device components: (i) the 03120, 03130, 03214, 04110, 04111, 04414, 04415, 04436, 04437 sealed source, (ii) the source holder, (iii) source drive mechanism, (iv) on-off mechanism (shutter), (v) shutter control, (vi) shielding, or (vii) any other component related to the radiological safety of the device, except as provided otherwise by specific condition of this license.
Distribution Device Info Each device distributed pursuant to the conditions of this license shall be in accordance with the 02513, 03240, 03241, 03242, 03243, 03244, 04214, 04215 following table: Device Model Number Isotope Source Model Number Maximum Activity Per Source Distribution Device Info, Not Exceeding Amounts Specified The following products [if needed: manufactured in accordance with NRC Sealed Source and Device 03250, 03251, 03254, 03255 Registration No. (insert number)], may be distributed, provided the amount of [insert isotope]
contained in the device does not exceed the amounts specified in the following table: Device/Series Model Maximum Activity per Device Distribution Location of Use The licensee may distribute licensed material from its facilities located at <<!LicenseLocations!>> 02511, 02513, 03211, 03214, 03221, 03240, 03241, 03242, 03243, 03244, 03250, 03251, 03252, 03253, 03254, 03255, 03256, 03257, 04010, 04011, 04110, 04111, 04212, 04213, 04214, 04215, 04426, 04427, 11240 Distribution of Products under 10 CFR 32.14 Each lot of timepieces, hands and dials received, containing tritium for distribution pursuant to a 10 03251 CFR 32.14 exempt distribution license, must be accompanied by a certificate, provided by the manufacturer, which attests to the following: The timepieces, hands, and dials have been manufactured in accordance with the International Standards Organization, American National Standards Institute, or equivalent industry standard and the amount of tritium on the timepieces, hands, and dials is not in excess of the maximum permissible amount authorized in 10 CFR 30.15(a).
Distribution of Products under 10 CFR 32.18 Special condition (for licensees to distribute sources along with a device): The check sources 03253 distributed under 10 CFR 32.18 may be attached to the outside of radiation detection instruments for the convenience of the user.
Distribution of Products under 10 CFR 32.22 The following device containing byproduct material designed and manufactured in accordance with 03254 NRC registration certificate No. [NR-xxxx-D-101-E], may be distributed according to this license provided the amount of [e.g., americium-241] contained in the device does not exceed the amount specified in the following table: Device Model Maximum Quantity Per Device Watch Tritium M 160 microcuries (5.92 MBq)
Distribution of Products under 10 CFR 32.26 The following device containing byproduct material designed and manufactured in accordance with 03255 NRC registration certificate No. [NR-xxxx-D-101-E], may be distributed according to this license provided the amount of [e.g., americium-241] contained in the device does not exceed the amount specified in the following table: Device Model Maximum Quantity Per Device ChemPro 100 V2 160 microcuries (5.92 MBq)
Distribution of Products under 10 CFR 32.30 The following industrial device containing byproduct material designed and manufactured in 03257 accordance with NRC registration certificate No. [NR-xxxx-D-101-E], for the purpose of [e.g.,
measuring qualitative or quantitative chemical composition], may be distributed according to this license provided the amount of [i.e. Nickel-63] contained in the device does not exceed the amount specified in the following table: Gas Chromatograph Model ECD Model SCION 436GC and 456GC 02-001972-02 15 millicuries (555 MBq)
Distribution Product Info Each product distributed under this license shall not contain, as of the assay date, more than the 02511, 03240, 03241, 03242, 03243, 03244, 04212, 04213 quantity of byproduct material listed in the following table:
Byproduct Material Product Name Maximum Activity Distribution Source Info Each sealed source distributed under this license shall not contain, as of the assay date, more than the 02513, 04214, 04215 quantity of byproduct material listed in the following table: Byproduct Material Model Number Chemical and/or Physical Form Maximum Activity
Duties of the Teletherapy Physicist Notwithstanding the requirements of 10 CFR 35.1690, [insert name] may perform the duties of the 02300, 02310, 04510, 04511, 04512, 04513 teletherapy physicist for those full-calibration measurments and periodic spot-checks specified in 10 CFR Part 35.
Emergency Action to Protect Public Health and Safety If approved by a Radiation Safety Officer specifically identified in this license, the licensee may take 03219, 03234 reasonable action in an emergency that departs from conditions in this license when the action is immediately needed to protect public health and safety and no action consistent with all license conditions that can provide adequate or equivalent protection is immediately apparent. The licensee shall notify the U.S. Nuclear Regulatory Commission Headquarters Operations Center at 301-816-5100 and the U.S. Nuclear Regulatory Commission Regional contact before, if practicable, and in any case immediately after taking such emergency action using the contact information specified in Appendix D of 10 CFR Part 20.
Emergency Plan (A) Obtain U.S. Nuclear Regulatory Commission approval of an evaluation demonstrating that an 03219, 03234 emergency plan is not required pursuant to 10 CFR [30.32(i), 40.31(j), and 70.22(i)], or Emergency Plan (B) Submit written confirmation to the U.S. Nuclear Regulatory Commission, using contact information in 03219, 03234 Appendix D of 10 CFR Part 20, that licensee personnel have been trained and will follow the provisions of an existing emergency plan approved by the U.S. Nuclear Regulatory Commission or an Agreement State for the temporary job site.
Emergency Plan (Header) The licensee is not required to establish an emergency plan. Before taking possession of licensed 03219, 03234 material at a temporary job site in quantities requiring an emergency plan, the licensee shall either:
Energy Compensation Source The opening, repair, or modification of any Energy Compensation Source must be performed by 03111 persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Exempt Distribution Not Authorized This license does not authorize distribution to persons exempt from licensing. 02500, 04210, 04211 Exempt from Independent Backup Access Control Notwithstanding the requirements of 10 CFR 36.23(b), the licensee is exempt from the requirement 03511, 03521 to have an independent backup access control to detect personnel entry while sources are exposed based on the commitments described in the [letter/application] dated [insert date].
Exempt from Monitor Integrated with Personnel Access Door Notwithstanding the requirements of 10 CFR 36.23(c), the licensee is exempt from the requirement to 03511, 03521 Locks integrate the radiation monitor with personnel access door locks to prevent room access when radiation levels are high based on the commitments described in the [letter/application] dated [insert date].
Exempt from Source Movement Control Part 36 Notwithstanding the requirements of 10 CFR 36.23(f), the licensee is exempt from the requirement to 03511, 03521 have a control that prevents the sources from moving from the shielded position unless the control has been activated and the door or barrier to the radiation room has been closed within a preset time based on the commitments described in the [letter/application] dated [insert date].
Exempt from Visible and Audible Alarm Part 36 Notwithstanding the requirements of 10 CFR 36.23(d), the licensee is exempt from having a visible 03511, 03521 and audible alarm within the radiation room, based on the commitments described in the
[letter/application] dated [insert date].
Exemption from Console Key Attached to Survey Meter Part Notwithstanding the requirements of 10 CFR 36.31(a), the licensee is exempt from the requirement to 03511, 03521 36 have a console key attached to a portable survey meter by a chain or cable and the door to the radiation room to have the same key, based on the commitments described in the [letter/application]
dated [insert date]. The radiation room door key shall be attached to the portable survey meter.
Exemption from Position Indicator Requirement for Source in Notwithstanding the requirements of 10 CFR 36.31(b), the licensee is exempt from the requirement 03511 Transit Part 36 to have a source position indicator to indicate when the source is in transit, in accordance with the
[letter/application] dated [insert date].
Exemption from Radiation Room Control Requirement Part Notwithstanding the requirements of 10 CFR 36.67(b)(2), the licensee is exempt from the 03511, 03521 36 requirement to have a control in the radiation room that must be activated prior to irradiation and that would not allow the source to be moved from the shielded position unless the door to the radiation room is locked within a preset time, based on the commitments described in the
[letter/application] dated [insert date].
Exemptions from 10 CFR 36.27 Part 36 Notwithstanding the requirements of 10 CFR 36.27, the licensee is exempt from [insert what is 03511, 03521 exempted], based on the commitments described in the [letter/application] dated [insert date].
Extended Time for Inspection/Servicing Teletherapy/Gamma Notwithstanding the requirements of 10 CFR 35.655, the licensee is not required to fully inspect and 02300, 02310, 04510, 04511, 04512, 04513 Stereotactic Unit service [insert teletherapy unit or gamma stereotactic unit] every [insert 5 or 7 years]. The licensee shall inspect the [insert teletherapy unit or gamma stereotactic unit] every [insert number of years].
Field Station, Radiographic Installation, Temporary Job Sites (A) Licensed material may be only at the licensee's facilities located at <<!LicenseLocations!>> 03111, 03112, 03310, 03320, 03800, 03810, 04430, 04431, 04432,
<<!FieldStations!>> <<!RadiographicInstallations!>> 04433 Field Station, Radiographic Installation, Temporary Job Sites (B) Licensed material may be stored or used at the following: (i) Field Station(s): <<!FieldStations!>> (ii) 03111, 03112, 03310, 03320, 03800, 03810, 04430, 04431, 04432, Permanent radiographic installation(s): <<!RadiographicInstallations!>> (iii) Temporary job site(s): 04433 Anywhere in the United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating the use of licensed material, including areas of exclusive Federal jurisdiction within Agreement States. If the jurisdiction status of a Federal facility within an Agreement State is unknown, the licensee should contact the Federal agency controlling the job site in question to determine whether the proposed job site is an area of exclusive Federal jurisdiction. Authorization for use of radioactive materials at job sites in Agreement States not under exclusive federal jurisdiction should be obtained from the appropriate state regulatory agency.
Financial Assurance Exempt for Sealed Source Exchanges This licensee is exempt from decommissioning financial assurance requirements for possession of 02300, 02310, 04510, 04511, 04512, 04513 licensed material in sealed sources in quantities greater than the limits in 10 CFR 30.35(d) for the purpose of source changes only. This exemption is granted for no more than 30 days for any one source change.
Financial Assurance Exemption for Decontamination Services Pursuant to 10 CFR 30.11, 40.14, 70.17, and Condition 10 of this license, the licensee is exempted 03219 from requirements of 10 CFR 30.35, 40.36, and 70.25 to provide decommissioning financial assurance.
Financial Assurance not required [If needed] In addition to the possession limits in Item 8, the licensee shall further restrict the 01100, 01110, 01120, 02110, 02120, 02200, 02201, 02230, 03610, possession of licensed material to quantities below the minimum limit in 10 CFR [30.35(d) or 40.36(b) 03611, 03612, 03613, 04610, 04611, 04612, 04613, 04614, 04615, or 70.25(d)] for which decommissioning financial assurance is required. 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 Financial Assurance Required In addition to the possession limits in Item 8, as specified in 10 CFR [insert: 30.35(d) or 40.36(b) or 01100, 01110, 01120, 02110, 03610, 03611, 03612, 03613, 04610, 70.25(d)], the licensee shall further restrict the possession of: (i) unsealed byproduct material or 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, unsealed special nuclear material to quantities less than or equal to [insert: 10^4 or 10^5] times the 04620, 04621, 04622, 04623, 04710, 04711 applicable limits in Appendix B of 10 CFR Part 30, or (ii) readily dispersible source material to quantities less than or equal to [insert: 10 or 100 millicuries], or (iii) sealed byproduct material to quantities less than or equal to [insert: 10^10 or 10^12] times the applicable limits in Appendix B of 10 CFR Part 30.
Gas Chromatograph Operating Temperature Control Detector cells containing a titanium tritide foil or scandium tritide foil shall only be used in 03123, 03610, 04420, 04421 Mechanism (A) conjunction with a properly operating temperature control mechanism that prevents the foil temperature from exceeding that specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission pursuant to 10 CFR 32.210 or equivalent regulations from an Agreement State.
Gas Chromatograph Operating Temperature Control When in use, detector cells containing a titanium tritide foil or scandium tritide foil shall be vented to 03123, 03610, 04420, 04421 Mechanism (B) the outside.
Gauge Mounting Requirements (A) The gauge must be mounted in accordance with written instructions provided by the manufacturer. 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, 04437 Gauge Mounting Requirements (B) The gauge must be mounted in a location compatible with the Conditions of Normal Use and 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, Limitations and/or Other Considerations of Use in the certificate of registration issued by the U.S. 04437 Nuclear Regulatory Commission or an Agreement State.
Gauge Mounting Requirements (C) The on-off mechanism (shutter) must be locked in the off position, if applicable, or the source must be 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, otherwise fully shielded. 04437 Gauge Mounting Requirements (D) The gauge must be received in good conditions (e.g., the package was not damaged). 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, 04437 Gauge Mounting Requirements (E) The gauge must not require any modification to fit in the proposed location. 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, 04437
Gauge Mounting Requirements (Footer) Mounting does not include electrical connection, activation, or operation of the gauge. The source 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, must remain fully shielded, and the gauge may not be used until it is installed and made operational 04437 by a person specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such operations.
Gauge Mounting Requirements (Header) The licensee may initially mount a gauge, if permitted by the certificate of registration issued by the 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, U.S. Nuclear Regulatory Commission or an Agreement State, and under the following conditions: 04437 Gauge Shutter Testing (A) Each gauge shall be tested for the proper operation of the on-off mechanism (shutter) and indicator, 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, if any, at intervals not to exceed 6 months or at such longer intervals as specified in the certificate of 04437 registration issued by the U.S. Nuclear Regulatory Commission pursuant to 10 CFR 32.210 or the equivalent regulations of an Agreement State.
Gauge Shutter Testing (B) The periodic on-off mechanism (shutter) and indicator test requirement does not apply to gauges that 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, are stored, not being used, and have the shutter lock mechanism in a locked position. The gauges 04437 exempted from this periodic test shall be tested before use. Records of test results shall be maintained for 3 years from the date of each test.
Incineration Disposal Pursuant to 10 CFR 20.2002, the licensee is authorized to dispose of licensed material by incineration 03235
[NOTE: add reference (i.e, as described in Attachment 11-1 to application dated Month, DD, YYYY)],
provided the gaseous effluent from incineration does not exceed the limits specified for air in Appendix B to 10 CFR Part 20, Table 2.
Incinerator Ash/Disposal Pursuant to 10 CFR 20.2002, [NOTE: add reference (i.e, as described in Attachment 11-1 to application 03235 dated Month, DD, YYYY)], the licensee may dispose of incinerator ash containing radioactive materials with Atomic Nos. 1 through 83, except as identified below, as ordinary waste in [specify the landfill(s)], provided that the concentration of radionuclides (in microcuries per gram of ash) at the time of disposal are no greater than the values in Appendix B of 10 CFR Part 20, Table 2, Column 2. For hydrogen-3, carbon-14, aluminum-26, chlorine-36, silver-108m, niobium-94, iodine-129, technetium-99, and thallium-204, the concentration can be no greater than one-tenth of the value in Appendix B of 10 CFR Part 20, Table 2, Column 2. If more than one radionuclide is present in the ash, the sum of fractions rule applies.
Inspecting/Servicing Intravascular Brachytherapy Afterloader The intravascular brachytherapy afterloader device shall be inspected and serviced at intervals 02110, 02240, 04710, 04711, 04826, 04827 Device recommended by the manufacturer, and maintenance and repair shall be performed by the manufacturer or persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Installation Survey - Maximum Radiation Levels Determined After installation of the [irradiator/calibrator/HDR/etc.] and prior to the initiation of the 02110, 02120, 02230, 02240, 03221, 03222, 03225, 03226, 04426,
[irradiator/calibration/medical program], a radiation survey shall be conducted to determine the 04427, 04428, 04429, 04710, 04711, 04810, 04811, 04822, 04823, maximum radiation levels in each area adjoining the [irradiaton/calibraton/HDR/etc.] room. 04826, 04827 Installation Survey - Open Shutter Required Prior to initial use and after installation, relocation, dismantling, alignment, or any other activity 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, involving the source or removal of the shielding, the licensee shall assure that a radiological survey is 04437 performed to determine radiation levels in accessible areas around, above, and below the gauge with the shutter open. This survey shall be performed only by persons authorized to perform such services by the U.S. Nuclear Regulatory Commission or an Agreement State.
Irradiator Installation Survey After installation of the irradiator and/or Cobalt-60 or Cesium-137 source(s) and prior to initiation of 03511, 03521 the irradiation program, a radiation survey shall be conducted to determine the maximum radiation levels in each area adjoining the irradiation room.
Irradiator Procedures The procedures contained in the manufacturer's instruction manual for the irradiator authorized by 03510, 03511, 03520, 03521 this license shall be followed, and a copy of the procedures shall be made available to each person using or having responsibility for the use of the device.
Irradiator Requirements J.L. Shepherd Mark I/81-22 (A) Permit the use of the irradiator only when a calibrated and operable radiation survey meter or room 03510, 03520 monitor is available; and Irradiator Requirements J.L. Shepherd Mark I/81-22 (B) Permit the irradiator door to be opened only after the operator has checked visual indicators to verify 03510, 03520 that the source has returned to its safe storage position; and Irradiator Requirements J.L. Shepherd Mark I/81-22 (C) Have room monitors installed that will: (i) Operate at all times when the irradiator is in use; and (ii) 03510, 03520 Activate a visible and audible alarm when radiation exceeds 2 millirems per hour; and (iii) Detect any radiation leaking from the irradiator door; and (iv) Be visible to the irradiator user when he is next to the irradiator; or
Irradiator Requirements J.L. Shepherd Mark I/81-22 (D) If a room monitor is not installed, have available a calibrated and operable survey meter that will be 03510, 03520 used to: (i) Determine the radiation level at the irradiator door when the door is closed; and (ii)
Check for any increase in radiation levels each time the irradiator door is opened.
Irradiator Requirements J.L. Shepherd Mark I/81-22 (E) If abnormal radiation levels or any malfunctions of the irradiator are detected at any time, cease using 03510, 03520 the irradiator, restrict access to the area housing the irradiator, immediately notify the Radiation Safety Officer, and submit all reports required under 10 CFR Part 20, Part 21 or Part 30.
Irradiator Requirements J.L. Shepherd Mark I/81-22 (F) Not repair or authorize repairs of the irradiator except by the manufacturer or other persons 03510, 03520 specifically authorized by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Irradiator Requirements J.L. Shepherd Mark I/81-22 (Header) For each J.L. Shepherd and Associates, Mark I or Model 81-22, Cesium-137 irradiator installed and 03510, 03520 used, the licensee shall:
Labeling Except for maintaining labeling as required by 10 CFR Part 20, or Part 71, the licensee shall obtain 02500, 03120, 03121, 03122, 03124, 03210, 03510, 03520, 04210, authorization from the U.S. Nuclear Regulatory Commission before making any changes in the sealed 04211, 04414, 04415, 04416, 04417, 04418, 04419, 04422, 04423 source, device, or source-device combination that would alter the description or specifications as indicated in the respective certificate of registration issued either by the U.S. Nuclear Regulatory Commission pursuant to 10 CFR 32.210 or by an Agreement State.
Labeling Requirements The licensee shall mark the following statements, [name of manufacturer or initial transferor] or 03251, 11240 Distributed under US NRC License No. [License Number] and Contains Radioactive Material Kr-85 and/or thorium on each immediate container, as described in the labeling guidance in Consolidated Guidance About Materials Licenses: Program-Specific Guidance About Exempt Distribution Licenses (NUREG-1556 Volume 8 Revision 1, Pages 9-11).
Labeling Requirements Tags (A) Each sealed source containing licensed material to be used outside of a shielded exposure device shall 03710 have a durable, legible, and visible tag permanently attached by a durable ring. The tag shall be at least 1 inch square, shall bear a conventional radiation symbol prescribed in 10 CFR 20.1901(a), and a minimum of the following instructions: "DANGER - RADIOACTIVE MATERIAL," "DO NOT HANDLE" and "NOTIFY CIVIL AUTHORITIES IF FOUND."
Labeling Requirements Tags (B) Replacement of durable rings shall be carried out by the licensee or in accordance with [describe 03710 instructions or procedure].
Labeling Source Holder/Tool The licensee shall ensure that each source holder or tool containing radioactive material bears a 03110, 03111 durable and clearly visible label bearing the radiation symbol and the words "Caution, Radioactive Material." The label must be on the smallest component that contains the licensed material and is transported as a separate piece of equipment.
Leak Test (A) Sealed sources and detector cells shall be tested for leakage and/or contamination at intervals not to 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, exceed the intervals specified in the certificate of registration issued by the U.S. Nuclear Regulatory 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, Commission under 10 CFR 32.210 or by an Agreement State. In the absence of a registration 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, certificate, sealed sources shall be tested for leakage and/or contamination at intervals not to exceed 03521, 03610, 03611, 03612, 03613, 03620, 03710, 04010, 04011, 6 months, or at such other intervals as specified. 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (B) Notwithstanding Paragraph A of this Condition, sealed sources designed to primarily emit alpha 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, particles shall be tested for leakage and/or contamination at intervals not to exceed 3 months. 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825
Leak Test (C) Each sealed source fabricated by the licensee shall be inspected and tested for construction defects, 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, leakage, and contamination prior to any use or transfer as a sealed source. 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (D) In the absence of a certificate from a transferor indicating that a leak test has been made within the 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, intervals specified in the certificate of registration issued by the U.S. Nuclear Regulatory Commission 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, under 10 CFR 32.210 or by an Agreement State, prior to the transfer, a sealed source received from 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, another person shall not be put into use until tested and the test results received. 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (E) Sealed sources need not be tested if they contain only hydrogen-3; or they contain only a radioactive 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, gas; or the half-life of the isotope is 30 days or less; or they contain not more than 100 microcuries of 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, beta- and/or gamma-emitting material or not more than 10 microcuries of alpha-emitting material. 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (F) Sealed sources need not be tested if they are in storage and are not being used. However, when they 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, are removed from storage for use or transferred to another person, and have not been tested within 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, the required leak test interval, they shall be tested before use or transfer. No sealed source shall be 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, stored for a period of more than 10 years without being tested for leakage and/or contamination. 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (G) The leak test shall be capable of detecting the presence of 185 becquerels (0.005 microcuries) of 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, radioactive material on the test sample. If the test reveals the presence of 185 becquerels (0.005 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, microcuries) or more of removable contamination, a report shall be filed with the U.S. Nuclear 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, Regulatory Commission in accordance with 10 CFR 30.50(c)(2), and the source shall be removed 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, immediately from service and decontaminated, repaired, or disposed of in accordance with 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, Commission regulations. 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (H) Authorized for Collection and Analysis [THE LICENSE CONDITION IS USED IF THE LICENSEE IS AUTHORIZED TO COLLECT AND ANALYZE LEAK 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, TEST SAMPLES.] Tests for leakage and/or contamination, including leak test sample collection and 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, analysis, shall be performed by the licensee or other persons specifically licensed by the U.S. Nuclear 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, Regulatory Commission or an Agreement State to perform such services. 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825
Leak Test (H) Not Authorized for Analysis [THIS LICENSE CONDITION IS USED IF THE LICENSEE IS NOT AUTHORIZED TO PERFORM LEAK TEST 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, ANALYSIS.] Analysis of leak test samples and/or contamination shall be performed by persons 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, such services. The licensee is authorized to collect leak test samples but not perform the analysis. 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test (I) Records of leak test results shall be kept in units of becquerels (microcuries) and shall be maintained 01100, 01110, 01120, 02231, 02400, 02500, 02513, 03111, 03120, for 3 years. 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, 03220, 03221, 03222, 03225, 03226, 03234, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03614, 03620, 03710, 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04824, 04825 Leak Test Well Logging (A) Notwithstanding the periodic leak test required by 10 CFR 39.35, the requirement does not apply to 03110, 03111, 03112, 03113 sources, except sources containing plutonium, that are stored and not being used. The sources exempted from this periodic test shall be tested for leakage before use or transfer to another person.
Leak Test Well Logging (B) Sealed sources authorized for use other than well logging shall be tested for leakage and shall be 03110, 03111, 03112, 03113 inventoried in accordance with 10 CFR 39.35 and 10 CFR 39.37.
Leak Test Well Logging (C) No sealed source shall be stored for a period of more than 10 years without being tested for leakage 03110, 03111, 03112, 03113 and/or contamination.
Leak Test Exemption (A) Notwithstanding the periodic leak test required by 10 CFR 34.27(c)(1) and (e), the requirement does 03310, 03320 not apply to radiography sources that are stored and not being used. These radiography sources must be leak tested before they are used or transferred to another person. No sealed source may be stored for a period of more than 10 years without being tested in accordance with 10 CFR 34.27(c)(1) and (e).
Leak Test Exemption (B) Sealed sources authorized for uses other than radiography shall be tested for leakage and shall be 03310, 03320 inventoried in accordance with 10 CFR 34.27 and 10 CFR 34.29, respectively.
Leak Test Exemption (C) This licensee is authorized to analyze leak test samples in accordance with the [application/letter] 03310, 03320 dated [insert date].
Leak Test for MML (A) The licensee shall require permittees to conduct leak tests of sealed sources and detector cells. Sealed 03614 sources and detector cells 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 by an Agreement State. In the absence of a registration certificate, sealed sources shall be tested for leakage and/or contamination at intervals not to exceed 6 months, or at such other intervals as specified.
Leak Test for MML (B) Notwithstanding Paragraph A of this Condition, sealed sources designated to primarily emit alpha 03614 particles shall be tested for leakage and/or contamination at intervals not to exceed 3 months.
Licensee Shall Not Open/Remove Sources [Insert: Sealed sources, Source rods, Foil sources, or Detector cells] containing licensed material shall 01100, 01110, 01120, 02110, 02120, 02230, 02231, 02240, 02400, not be opened [Insert: or sources removed from source holders or detached from source rods, or foil 02500, 03120, 03121, 03122, 03124, 03130, 03210, 03211, 03219, sources removed from detector cells] by the licensee, except as specifically authorized. 03220, 03221, 03222, 03225, 03234, 03310, 03320, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03710, 04010, 04011, 04210, 04211, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711, 04810, 04811, 04822, 04823, 04824, 04825, 04826, 04827
Location of Storage Licensed material shall be stored at the licensees facilities located at: 03111, 03112, 03310, 03320, 03800, 03810, 04430, 04431, 04432, 04433 Location of Use Licensed material shall be used or stored at the licensee's facilities located at: <<!LicenseLocations!>> 01100, 01110, 01120, 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240, 02300, 02310, 02400, 02410, 02500, 02511, 02513, 02600, 02700, 02710, 03120, 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03212, 03213, 03214, 03215, 03220, 03221, 03222, 03225, 03226, 03310, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03620, 03710, 03800, 03810, 04010, 04011, 04012, 04013, 04014, 04015, 04110, 04111, 04112, 04113, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04430, 04431, 04432, 04433, 04436, 04437, 04510, 04511, 04512, 04513, 04610, 04611, 04612, 04613, 04614, 04615, 04618, 04619, 04620, 04621, 04622, 04623, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827, 04828, 04829, 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900, 22110, 22111, 22120, 22140, 22150, 22151, 22160, 22170, 22200, 23300, 23310 Location of Use - Temporary Job Sites Licensed material may be [used or stored] only at temporary job sites of the licensee anywhere in the 02220, 03120, 03121, 03123, 03124, 03211, 03219, 03225, 03226, United States where the U.S. Nuclear Regulatory Commission maintains jurisdiction for regulating the 03234, 04010, 04011, 04414, 04415, 04416, 04417, 04420, 04421, use of licensed material, including areas of exclusive Federal jurisdiction within Agreement States. If 04422, 04423, 04820, 04821, 11200, 11210, 11220, 11221, 11230, the jurisdiction status of a Federal facility within an Agreement State is unknown, the licensee should 11300, 11800, 11810, 11900 contact the Federal agency controlling the job site in question to determine whether the proposed job site is an area of exclusive Federal jurisdiction. Authorization for use of radioactive materials at job sites in Agreement States not under exclusive Federal jurisdiction should be obtained from the appropriate state regulatory agency.
Location of Use and Temporary Job Sites Licensed material shall be used or stored at the licensee's facilities located at <<!LicenseLocations!>> 03111, 03112, 03120, 03121, 03122, 03124, 03210, 03211, 03219, and may be used at temporary job sites of the licensee anywhere in the United States where the U.S. 03225, 03226, 03234, 03310, 03320, 03800, 03810, 04010, 04011, Nuclear Regulatory Commission maintains jurisdiction for regulating the use of licensed material, 04414, 04415, 04416, 04417, 04418, 04419, 04422, 04423, 04430, including areas of exclusive Federal jurisdiction within Agreement States. If the jurisdiction status of 04431, 04432, 04433, 11200, 11210, 11220, 11221, 11230, 11300, a Federal facility within an Agreement State is unknown, the licensee should contact the Federal 11800, 11810, 11900 agency controlling the job site in question to determine whether the proposed job site is an area of exclusive Federal jurisdiction. Authorization for use of radioactive materials at job sites in Agreement States not under exclusive Federal jurisdiction should be obtained from the appropriate state regulatory agency.
Location of Use and Users Licensed material shall be used at [insert MML: (e.g., United States Air Force)] facilities by: (1) [United 03614 States Air Force] personnel as authorized by permits issued by the [insert name of Radiation Safety Committee, (e.g., National Radiation Safety Committee)]; and (2) users who are not [insert MML:
(e.g., United States Air Force)] personnel when such use is authorized by the [insert name of Radiation Safety Committee, (e.g., National Radiation Safety Committee)] and is conducted in work spaces under the control of the [insert MML: (e.g., United States Air Force)].
Location of Use Off-Shore Licensed Material shall be used at the licensee's facilities located at: [specify the Producer, Official 03110, 03111 Protraction Diagram Oil Field Name, Block Number, Gulf of Mexico (or Pacific Ocean), Platform OSC assigned number or latitude/longitude if the platform number has not been assigned or if the device is placed subsea.]
Location of Use/Specific Address for Material Licensed material listed in Subitem Nos. [insert subitem] through [insert subitem] shall be used at the 01100, 01110, 01120, 02110, 02120, 02121, 02200, 02201, 02210, licensee's facilities located at <<!LicenseLocations!>>. 02220, 02230, 02231, 02240, 02300, 02310, 02400, 02410, 02500, 02511, 02513, 02600, 02700, 02710, 03110, 03111, 03112, 03113, 03120, 03121, 03122, 03124, 03130, 03210, 03211, 03212, 03213, 03710, 04010, 04011, 04012, 04013, 04014, 04015, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04414, 04415, 04416, 04417, 04418, 04419, 04422, 04423, 04436, 04437, 04510, 04511, 04512, 04513, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827, 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900 Loss of Contact with Nuclear-Powered Pacemaker Patient The licensee shall report to the U.S. Nuclear Regulatory Commission using the contact information in 04828, 04829, 22160 Appendix D of 10 CFR Part 20, within 10 days after discovery of loss of contact with a nuclear-powered pacemaker patient.
Maintenance, Repair, Cleaning, Replacement, and Disposal... Maintenance, repair, cleaning, replacement, and disposal of foils contained in detector cells shall be 01120, 02110, 03123, 03124, 03211, 03610, 03611, 03612, 03620, performed only by the device manufacturer or other persons specifically authorized by the U.S. 04010, 04011, 04420, 04421, 04422, 04423, 04610, 04611, 04612, Nuclear Regulatory Commission or an Agreement State to perform such services. 04613, 04614, 04615, 04622, 04623, 04710, 04711 Material Not for Use in Field Applications The licensee shall not use licensed material in field applications where activity is released except as 01100, 01110, 01120, 02110, 03610, 03611, 03612, 03613, 03620, provided otherwise by specific condition of this license. 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711 Material Not for Use In/On Humans The licensee shall not use the licensed material in or on humans. [NOTE: if needed add the following: 01100, 01110, 01120, 02400, 03240, 03241, 03242, 03243, 03244, except as provided otherwise by specific condition of this license]. 03610, 03611, 03612, 03613, 03620, 04410, 04411, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623 Mobile Nuclear Medicine Activities Licensed material incident to mobile nuclear medicine activities may be delivered to the licensee's 02220, 02231, 04820, 04821, 04824, 04825 mobile van located at temporary job sites when trained licensee personnel are present to receive the licensed material.
Modifications to the Source Rack The licensee is authorized to make modifications to the source rack as requested in 03521
[application/letter] dated [insert date]. The licensee shall test the movement of the source rack for proper operation in accordance with 10 CFR 36.41(f) and (i) prior to source loading.
No Irradiator Repairs The licensee shall not perform repairs or alterations of the irradiator involving removal of shielding or 03510, 03511, 03520, 03521 access to the licensed material. Removal, replacement, and disposal of sealed sources in the irradiator shall be performed by persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
No Possession at Customer Facility The licensee may not take possession of the radioactive materials and/or sealed sources while at the 03219, 03226, 03234 customer's facility [insert as needed - for example "except for analytical samples"].
No Possession or Use This license does not authorize possession or use of licensed materials. 02511, 02513, 03240, 03241, 03242, 03243, 03244, 03250, 03251, 03252, 03253, 03254, 03255, 03256, 03257, 04212, 04213, 04214, 04215, 11240 No Temporary Job Sites Authorized If a customer also holds a license issued by the U.S. Nuclear Regulatory Commission or an Agreement 03219, 03234 State, the licensee shall establish a written agreement between the licensee and the customer specifying which licensee activities shall be performed pursuant to the customer's license and supervision, and which licensee activities shall be performed under the licensee's supervision pursuant to this license. A copy of this agreement shall be included in the notification required by license condition [insert number].
Non-Commercial Distribution This license does not authorize commercial distribution of licensed material. 03214, 03220, 03232, 03610, 03611, 04110, 04111, 04424, 04425, 04610, 04611, 04612, 04613 Non-Commercial Distribution 10 CFR 30 This license does not authorize commercial distribution to persons exempt from licensing pursuant to 03214, 04110, 04111
[insert applicable regulation, such as 10 CFR 30.19 or 10 CFR 30.14 through 30.21, inclusive].
Non-Commercial Distribution 10 CFR 31 This license does not authorize commercial distribution of licensed material to persons generally 03214, 04110, 04111 licensed pursuant to 10 CFR Part 31 or to persons exempt from licensing pursuant to [insert applicable regulation, such as 10 CFR 30.18].
Non-Commercial Distribution Pursuant to 10 CFR 31 and/or 32 This license does not authorize commercial distribution of licensed material pursuant to 10 CFR 32.72 03210, 03214, 04110, 04111 or 10 CFR 32.74 to persons generally licensed pursuant to 10 CFR Part 31 or equivalent regulations of any Agreement State; or to persons exempt from licensing pursuant to 10 CFR 30.14 through 10 CFR 30.21 inclusive, or equivalent regulations of any Agreement State.
Non-Routine Maintenance Not Allowed The following services shall not be performed by the licensee: [Insert which services are NOT 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, authorized in this license, delete remaining:] (i) installation, (ii) initial radiation surveys, (iii) 04437 relocation, (iv) removal from service, (v) dismantling, (vi) alignment, (vii)replacement, (viii) disposal of the sealed source, and (ix) non-routine maintenance or repair of components related to the radiological safety of the gauge (i.e., the sealed source, the source holder, source drive mechanism, on-off mechanism (shutter), shutter control, shielding). These services shall be performed only by persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Non-routine Maintenance of Gauges The licensee may detach the source rod from the gauge(s) for the purpose of cleaning, maintenance, 03121, 04416, 04417 or repair of the gauge(s) in accordance with procedures outline in the [application/letter] dated
[insert date].
Not Authorized to conduct source retrieval The licensee is not authorized to conduct source retrieval activities. 03310, 03320, 04310, 04311, 04312, 04313 Not Authorized to Perform Source Changes The licensee is not authorized to perform source changes in radiographic exposure devices. These 03310, 03320 services shall be performed by persons specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such activities.
Notification of Transferring or Disposing of Depleted Uranium The licensee shall inform the U.S. Nuclear Regulatory Commission, [insert name of Regional Office], 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900 Shielding prior to transferring or disposing of depleted uranium shielding.
Notification to NRC (A) The licensee shall notify the U.S. Nuclear Regulatory Commission, using contact information in 03219, 03234 Appendix D of 10 CFR Part 20, in writing, at least 14 days before initiating activities under this license at a temporary job site, excluding routine packaging or repackaging for purposes of transporting and not requiring a job or site specific work package, and characterization and/or final surveys where neither radioactive materials nor radiation are likely to be detected. This notification shall include: (1)
The estimated type, quantity, and physical/chemical forms of licensed material to be used, (2) The specific site location, (3) A description of planned activities including waste management and disposition, (4) The estimated start date and completion date for the job, (5) The name and title of a point of contact for the job, including information on how to contact this individual, and (6) Copy of the written agreement between the licensee and the customer as described by license condition
[insert number for license condition No Temporary Job Sites Authorized].
Notification to NRC (B) Within 30 days of completing activities at each job site location, the licensee shall notify the U.S. 03219, 03234 Nuclear Regulatory Commission, using contact information in Appendix D of 10 CFR Part 20, in writing, of the temporary job site status and the disposition of any licensed material used.
Nuclear-Powered Pacemakers The physician(s) responsible for follow-up, explantation and return of nuclear-powered pace makers 04828, 04829, 22160 to the manufacturer for proper disposal is [insert name(s)].
Operating Requirements The licensee shall operate each device containing licensed material within the manufacturer's 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, specified temperature and environmental limits such that the shielding and shutter mechanism of the 04437 source holder are not compromised.
Outdoor Target Area The total amount of depleted uranium contained in spent munitions which may remain in the 11221 Outdoor Target Area under the authorization of this license shall not exceed [insert amount]
kilograms. Records of inventory of material fired into and retrieved from the Outdoor Target Area shall be maintained.
Ownership/Possession Written Approval The licensee may not take ownership or possession of radioactive material(s) or source(s) originating 03219, 03234 from a client's site, without prior notification and written approval from the U.S. Nuclear Regulatory Commission.
Patient Follow-Up Nuclear-Powered Pacemakers The licensee shall continue patient follow-up and replacement procedures for the nuclear-powered 04828, 04829, 22160 pacemaker during the life of the patient. Procedures for recovery and authorized disposal of the nuclear-powered pacemaker by return to the manufacturer shall be followed upon the death of the patient. If return of the explanted pacemaker by return to the manufacturer is not possible, explanted pacemakers may be disposed of in accordance with the commitments, representations and procedures in the [letter/application] dated [insert date].
Physical Inventory The licensee shall conduct a physical inventory every 6 months, or at other intervals approved by the 01100, 01110, 01120, 02110, 02400, 02500, 02513, 03120, 03121, U.S. Nuclear Regulatory Commission, to account for all sealed sources and/or devices received and 03122, 03123, 03124, 03130, 03210, 03211, 03214, 03219, 03220, possessed under the license. Records of inventories shall be maintained for 3 years from the date of 03221, 03222, 03225, 03226, 03240, 03241, 03242, 03243, 03244, each inventory, and shall include the radionuclides, quantities, manufacturer's name and model 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03710, numbers, and the date of the inventory. 04010, 04011, 04110, 04111, 04210, 04211, 04214, 04215, 04410, 04411, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711, 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900 Physical Inventory MML (A) The licensee shall require permittees to conduct a physical inventory every 6 months to account for 03614 all sources and/or devices received and possessed under their respective permits.
Physical Inventory MML(B) The licensee shall require that permittees maintain records of physical inventories for 3 years from 03614 the date of each inventory. Records shall include the quantities and kinds of licensed material, manufacturer's name and model numbers, location of the sources and/or devices, and the date of the inventory.
Portable Gauge Barriers Each portable nuclear gauge shall have a lock or outer locked container designed to prevent 03121, 04416, 04417 unauthorized or accidental removal of the sealed source from its shielded position. The gauge or its container must be locked when in transport or storage, or when not under the direct surveillance of an authorized user.
Possession for Broad Type B If only one radionuclide is possessed, the possession limit is the quantity specified for that 01110, 03611, 04612, 04613, 04620, 04621 radionuclide in 10 CFR 33.100, Schedule A, Column I. If two or more radionuclides are possessed, then the possession limit is determined as follows: For each radionuclide, determine the ratio of the quantity possessed to the applicable quantity specified in 10 CFR 33.100, Schedule A, Column I, for that radionuclide. The sum of the ratios for all radionuclides possessed under the license shall not exceed unity.
Possession for Broad Type C If only one radionuclide is possessed, the possession limit is the quantity specified for that 01120, 03612, 04614, 04615, 04622, 04623 radionuclide in 10 CFR 33.100, Schedule A, Column II. If two or more radionuclides are possessed, then the possession limit is determined as follows: For each radionuclide, determine the ratio of the quantity possessed to the applicable quantity specified in 10 CFR 33.100, Schedule A, Column II, for that radionuclide. The sum of the ratios for all radionuclides possessed under the license shall not exceed unity.
Possession Limit for Nuclear-Powered Pacemakers The specified possession limit for nuclear-powered pacemakers includes all licensed material 04828, 04829, 22160 possessed by the licensee under this license whether in storage, implanted in patients, or otherwise in use.
Products under 10 CFR 32.11 Gemstones (A) Notwithstanding the requirements of 10 CFR 32.11(c), the licensee may distribute processed 03250 gemstones as described in the application dated [insert date], for the purpose of being worn by human beings. These may contain radionuclides that do not appear in 10 CFR 30.70 at concentrations up to those specified in the application, applying NOTE 2 of 10 CFR 30.70; and Products under 10 CFR 32.11 Gemstones (B) The licensee shall evaluate any gemstones that the licensee has determined are below the exempt 03250 concentrations, and have subsequently been irradiated with an accelerator, using appropriate instrumentation and following appropriate procedures to ensure that any induced radionuclides do not exceed the concentration limits specified in 10 CFR 30.70, Schedule A, and the approved derived concentration limits for radionuclides not appearing in 10 CFR 30.70; or Products under 10 CFR 32.11 Gemstones (C) The licensee shall not accept any material unless it is accompanied by documentation indicating that 03250 the material has been analyzed and found to contain less than exempt concentrations as specified in 10 CFR 30.14 and 30.70, and in accordance with NOTE 2 to 10 CFR 30.70. The licensee shall ensure that the measurement process was adequate to measure radioactivity below the exempt concentrations. The licensee shall perform periodic confirmatory measurements, as approved, of the material received to ensure the regulatory requirements are met.
Program Changes to Procedures (A) The proposed revision is documented, reviewed, and approved by the licensee's Radiation Safety 01100, 02110, 03211, 03610, 04010, 04011, 04610, 04611, 04618, Committee in accordance with established procedures prior to implementation; 04619, 04710, 04711
Program Changes to Procedures (B) The revised program is in accordance with regulatory requirements, will not change the license 01100, 02110, 03211, 03610, 04010, 04011, 04610, 04611, 04618, conditions, and will not decrease the effectiveness of the Radiation Safety Program; 04619, 04710, 04711 Program Changes to Procedures (C) The licensee's staff is trained in the revised procedures prior to implementation; and 01100, 02110, 03211, 03610, 04010, 04011, 04610, 04611, 04618, 04619, 04710, 04711 Program Changes to Procedures (D) The licensee's audit program evaluates the effectiveness of the change and its implementation. 01100, 02110, 03211, 03610, 04010, 04011, 04610, 04611, 04618, 04619, 04710, 04711 Program Changes to Procedures (Header) Notwithstanding the requirements of License Condition [Insert Tie-Down Condition Number], the 01100, 02110, 03211, 03610, 04010, 04011, 04610, 04611, 04618, licensee is authorized to make program changes and changes to procedures specifically identified in 04619, 04710, 04711 the [application/letter] dated [insert date], which were previously approved by the U.S. Nuclear Regulatory Commission and incorporated into the license without prior Commission approval as long as:
Proposed Changes in Packaging, Labeling, Shielding, Any proposed changes in packaging, labeling, shielding, or instructions for use and storage shall be 02511, 02513, 03240, 03241, 03242, 03243, 03244, 04212, 04213, Instructions submitted for review to the U.S. Nuclear Regulatory Commission in accordance with Appendix D of 10 04214, 04215 CFR Part 20. The approval of the changes shall be received by the licensee prior to implementing any of the changes.
Pulsed Neutron Generator Tool Not Energized The pulsed neutron generator tool should not be energized before going down-hole to a depth of at 03110, 03111 least 200 feet or into a calibration tank.
Pulsed Neutron Generator Tool Not Retracted The pulsed neutron generator tool should not be retracted to the surface or from the calibration tank 03110, 03111 until sufficient time has allowed for activation products in the tool to decay in accordance with
[application/letter] dated [insert date].
Radiation Safety Committee Licensed material shall only be used by, or under the supervision of, individuals designated, in writing, 01100, 03211, 03610, 03613, 04010, 04011, 04610, 04611, 04616, by the [Note: enter licensee's Radiation Safety Committee name]. The licensee shall maintain records 04617, 04618, 04619 of individuals designated as users for 3 years after the individual's last use of licensed material.
Radiation Safety Committee Requests [Insert name of Radiation Safety Committee, e.g., National Radiation Safety Committee] shall submit 03614 requests for approval to the U.S. Nuclear Regulatory Commission for exemptions from the Commission's regulations.
Radiation Safety Criteria - Authorized Nuclear Pharmacists Pharmacists, as defined in 10 CFR 35.2, designated in writing to work as authorized nuclear 02500, 04210, 04211 pharmacists by the licensee's Radiation Safety Committee, shall meet the requirements in accordance with letter(s) dated [insert date]. The licensee shall maintain records of individuals designated as authorized nuclear pharmacists for 3 years following the last use of licensed material by the individual.
Records for Decommissioning The licensee shall maintain records of information important to decommissioning for each temporary 03219, 03234 job site pursuant to 10 CFR [30.35(g), 40.36(f), and 70.25(g)]. The records shall be made available to the customer upon request. At the completion of activities at a temporary job site, the licensee shall transfer these records to the customer for retention.
Redistribution of Alpha-, Beta-, or Photon-Emitting Radioactive Notwithstanding the requirements of 10 CFR 32.72(c), the licensee may redistribute alpha-, beta-, or 02511, 04212, 04213 Drugs photon-emitting radioactive drugs, which have been initially distributed by another radiopharmaceutical supplier licensed pursuant to 10 CFR 32.72, without verifying the radioactivity of the dosage. The licensee must not manipulate the dosage, including the packaging and label.
Registration Certificate Reference The following device containing byproduct material designed and manufactured in accordance with 03255 NRC registration certificate Nos. [NR-xxxx-D-101-E and NR-xxxx-D- 101-E], may be distributed according to this license provided the amount of [e.g., americium- 241] contained in the device does not exceed the amount specified in the following table:Device Model, Maximum Quantity Per Device Registration Certificate Reference-Industrial Device The following industrial device containing byproduct material designed and manufactured in 03257 accordance with NRC registration certificate No. [NR-xxxx-D-101-E], for the purpose of [e.g.,
measuring qualitative or quantitative chemical composition], may be distributed according to this license provided the amount of [e.g., Nickel-63] contained in the device does not exceed the amount specified in the following table: Gas Chromatograph Model, Device Model, Maximum Quantity Per Device
Registration under 10 CFR 32.210 The licensee shall not acquire licensed material in a sealed source or device unless the source or 02110, 03211, 03610, 03611, 03612, 03620, 04010, 04011, 04610, device has been registered with the U.S. Nuclear Regulatory Commission pursuant to 10 CFR 32.210 04611, 04612, 04613, 04614, 04615, 04710, 04711 or equivalent regulations of an Agreement State.
Report of Nuclear-Powered Pacemaker Death or Issue The licensee shall report to the U.S. Nuclear Regulatory Commission in accordance with Appendix D of 04828, 04829, 22160 10 CFR Part 20, within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> of occurrence, discovery of the death of any nuclear-powered pacemaker patient, and any adverse reaction and/or malfunction involving a pacemaker system, including the leads. A written report giving details of the adverse reaction and/or malfunction shall be submitted within 30 days.
Requirements in 10 CFR 35.14 for MML (notifications) Notwithstanding the requirements in 10 CFR 35.14 to notify the U.S. Nuclear Regulatory Commission, 03614 the [insert MML name: e.g., Department of Veterans Affairs] medical use permittees are authorized to make the notification required in 10 CFR 35.14 to the [insert MML entity e.g., Department of Veterans Affairs National Health Physics Program Director] provided the appropriate requirements in 10 CFR 35.13 (b) and 35.14 are met.
Requirements in 10 CFR 35.6 for MML (human research [Insert name of Radiation Safety Committee, e.g., National Radiation Safety Committee] shall assure 03614 subjects) that all uses of byproduct material on human research subjects are authorized and performed in accordance with the requirements in 10 CFR 35.6.
Restricted Possession for 10 CFR 30.72 for Emergency Plan In addition to the possession limits in Item 8, the licensee shall further restrict the possession of 01100, 02110, 03211, 03212, 03213, 03214, 03219, 03232, 03234, licensed material in the form of unsealed material and foil or plated sources to quantities below the 03610, 03611, 03613, 04010, 04011, 04012, 04013, 04014, 04015, limits specified in 10 CFR 30.72, which require consideration of the need for an emergency plan for 04110, 04111, 04610, 04611, 04612, 04613, 04616, 04617, 04710, responding to a release of licensed material. 04711 Restriction of Irradiator Maintenance The licensee shall not repair, remove, replace, or alter any of the following: electrical and mechanical 03510, 03511, 03520, 03521 systems that control source or shielding movement, the irradiator's shielding or sealed source, safety interlocks, or any component that may affect safe operation of the irradiator. These activities shall be performed by a person specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Restriction of Irradiator Maintenance Exception Except for the repair or maintenance operations described in [letter/application] dated [insert date], 03510, 03511, 03520, 03521 the licensee shall not repair, remove, replace, or alter any of the following: electrical and mechanical systems that control source or shielding movement, the irradiator's shielding or sealed source, safety interlocks, or any component that may affect safe operation of the irradiator. These activities shall be performed by a person specifically licensed by the U.S. Nuclear Regulatory Commission or an Agreement State to perform such services.
Retrieve, Receive and Dispose of Radioactive Waste The licensee is authorized to retrieve, receive and dispose of radioactive waste from its customers, 02500, 04210, 04211 limited to radiopharmacy-supplied syringes and vials and their contents.
RSO The Radiation Safety Officer (RSO) for this license is <<!RSOName!>>. 01100, 01110, 01120, 02110, 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240, 02300, 02310, 02400, 02410, 02500, 02511, 02513, 02600, 03110, 03111, 03120, 03121, 03122, 03123, 03124, 03130, 03210, 03211, 03212, 03213, 03214, 03215, 03219, 03220, 03221, 03222, 03225, 03226, 03232, 03235, 03236, 03240, 03241, 03242, 03243, 03244, 03310, 03320, 03510, 03511, 03520, 03521, 03610, 03611, 03612, 03613, 03620, 03710, 03800, 03810, 03900, 04010, 04011, 04012, 04013, 04014, 04015, 04110, 04111, 04112, 04113, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04430, 04431, 04432, 04433, 04436, 04437, 04510, 04511, 04512, 04513, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04710, 04711, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827, 04828, 04829, 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900, 22110, 22111, 22120, 22140, 22150, 22151, 22160, 22170, 22200, 23300, 23310
Sealed Sources Inspection/Test Prior to Transfer Each sealed source fabricated by the licensee shall be inspected and tested for construction defects, 01100, 01110, 01120, 03210, 03212, 03213, 03214, 03610, 03611, leakage, and contamination prior to any use or transfer as a sealed source. Records of leak test results 03612, 03613, 03620, 04012, 04013, 04014, 04015, 04110, 04111, shall be kept in units of microcuries and shall be maintained for 3 years. 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623 Separate Keys for Personnel Lock and Barrier Entrance Notwithstanding the requirements of 10 CFR 36.23(a), the licensee may use separate keys to operate 03511, 03521 the lock on the personnel entrance door or barrier and to move the sources in accordance with procedures described in the [letter/application] dated [insert date].
Shipment of Plutonium Except for plutonium contained in a medical device designed for individual human application, no 04828, 04829, 22110, 22111, 22120, 22140, 22150, 22151, 22160, plutonium, regardless of form, shall be delivered to a carrier for shipment by air transport or 22170, 22200, 23300, 23310 transported in an aircraft by the licensee except in packages the design of which U.S. Nuclear Regulatory Commission has specifically approved for transport of plutonium by air.
Shutter Locked The licensee shall assure that the shutter mechanism of each device containing licensed material is 03120, 03124, 03130, 03310, 04414, 04415, 04422, 04423, 04436, locked in the closed position during periods when a portion of an individual's body may be subject to 04437 the direct radiation beam. The licensee shall review and modify, as appropriate, its "lock-out" procedures whenever a new device is obtained to incorporate the device manufacturer's recommendations.
Site Remediation Special LC to Eliminate Need for EA/NEPA Except as provided for in paragraph B of this license condition, any activity performed by the licensee 03219, 03234 Review (A) at a temporary job site related to site characterization or the decontamination and decommissioning of facilities, equipment, and containers, including any waste packaging incidental to these activities, must be performed in accordance with the customer licensees NRC-approved decommissioning plan that pertains to that temporary job site.
Site Remediation Special LC to Eliminate Need for EA/NEPA If the customer licensee is not required to submit a decommissioning plan to the NRC and if the 03219, 03234 Review (B) customer licensees operations at a temporary job site have been limited to the use of: (1) small quantities of short-lived radioactive materials, or (2) radioactive materials in sealed sources provided there is no evidence of leakage of radioactive material from these sealed sources, then any activity performed by the licensee at that temporary job site related to site characterization or the decontamination and decommissioning of facilities, equipment, and containers, including any waste packaging incidental to these activities, must be performed in accordance with the licensees decommissioning procedures approved by the NRC under this license.
Site Remediation Special LC to Eliminate Need for EA/NEPA Any activity proposed to be performed by the licensee at a temporary job site that is not covered by 03219, 03234 Review (C) either paragraph A or B of this license condition must be approved by the NRC through a site-specific license amendment or exemption request.
Source Retrieval The licensee is authorized to conduct source retrieval activities in accordance with [application/letter] 03310, 03320 dated [insert date].
Storage of Waste Radioactive waste possessed under this license shall be stored in accordance with the statements, 01100, 01110, 02110, 03211, 03225, 03226, 03610, 03611, 03620, representations, and procedures included with the licensee's waste storage plan described in the 04010, 04011, 04610, 04611, 04612, 04613, 04618, 04619, 04620, licensee's [application/letter] dated [insert date]. 04621, 04710, 04711 Supervision 10 CFR 33.15(b) Licensed material shall only be used by or under the supervision of individuals meeting the 01120, 03213, 03612, 04014, 04015, 04614, 04622, 04623 requirements stated in 10 CFR 33.15(b) for the materials and uses as indicated:
<<!AuthorizedUsers!>>
Supervision 10 CFR 35.13 and 35.14 (A) Individuals permitted to work as [insert either authorized users, authorized nuclear pharmacists, 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240, and/or authorized medical physicists, as appropriate] in accordance with 10 CFR 35.13 and 10 CFR 02300, 02310, 04510, 04511, 04512, 04513, 04810, 04811, 04812, 35.14. 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827 Supervision 10 CFR 35.13 and 35.14 (B) The following individuals are authorized users for the material and medical uses as indicated: 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240,
<<!AuthorizedUsers!>> <<!AuthorizedUsersMDMO!>> 02300, 02310, 04510, 04511, 04512, 04513, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827 Supervision 10 CFR 35.13 and 35.14 (C) The following individuals are authorized users for nonmedical uses as indicated: 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, 02240,
<<!AuthorizedUsers!>> <<!NonMedicalUsers!>> 02300, 02310, 04510, 04511, 04512, 04513, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827
Supervision 10 CFR 35.13 and 35.14 (D) The following individuals are authorized medical physicists [or ophthalmic physicists] for the materials 02120, 02121, 02200, 02210, 02220, 02230, 02231, 02240, 02300, and uses as indicated: <<!AuthorizedUsers!>> <<!MedicalPhysicists!>> 02310, 04510, 04511, 04512, 04513, 04810, 04811, 04812, 04813, 04814, 04815, 04818, 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827 Supervision Medical with RSC (A) Medical use shall be by an authorized user as defined in 10 CFR 35.2. 02110, 04710, 04711 Supervision Medical with RSC (B) Individuals designated to work as [insert either authorized users, authorized nuclear pharmacists, or 02110, 04710, 04711 authorized medical physicists, as applicable] as defined in 10 CFR 35.2, shall meet the training, experience and recentness of training criteria established in 10 CFR Part 35 and shall be designated in writing by the licensee's Radiation Safety Committee.
Supervision Medical with RSC (C) Licensed material for other than human use shall be used by, or under the supervision of, individuals 02110, 04710, 04711 designated by the Radiation Safety Committee.
Supervision Medical with RSC (D) [AS NEEDED] Licensed material [in item #] shall only be used by, or under the supervision of, 02110, 04710, 04711 individuals who have received the training described in the [application/letter] dated [insert date],
and have been designated in writing by the Radiation Safety Officer. The licensee shall maintain records of individuals designated as users for 3 years following the last use of licensed material by the individual.
Supervision 10 CFR 32.72 (A) A pharmacist working or designated as an authorized nuclear pharmacist in accordance with 10 CFR 02500, 04210, 04211 32.72(b)(2)(i) or (4).
Supervision 10 CFR 32.72 (B) Authorized Nuclear Pharmacists: <<!NuclearPharmacists!>> 02500, 04210, 04211 Supervision 10 CFR 32.72 (C) Authorized Users for Non-Medical Use: <<!NonMedicalUsers!>> 02500, 04210, 04211 Supervision 10 CFR 32.72 (Header) Licensed material shall only be used by, or under the supervision of: 02500, 04210, 04211 Supervision and Physical Presence by Trained Individuals Licensed material shall only be used by, or under the supervision and in the physical presence of, 03510, 03511, 03520, 03521 Designated by the RSO individuals who have received the training described in the [application/letter] dated [insert date],
and have been designated in writing by the Radiation Safety Officer. The licensee shall maintain records of individuals designated as users for 3 years following the last use of licensed material by the individual.
Supervision and Physical Presence of Individuals Designated by Licensed material shall only be used by, or under the supervision and in the physical presence of, 03310, 03320 RSO individuals who have been designated in writing by the Radiation Safety Officer and have been trained: (A) As specified in the [application/letter] dated [insert date]; and (B) In accordance with the provisions of 10 CFR 34.43 Supervision and Physical Presence of Name Listed Licensed material shall only be used by, or under the supervision and in the physical presence of, 03221, 03222, 03232, 03900, 04426, 04427, 04428, 04429, 22120
[insert name(s)].
Supervision and Physical Presence of Trained Individuals Licensed material shall only be used by, or under the supervision and in the physical presence of, 03121, 04416, 04417, 22140 individuals who have received the training described in the [application/letter] dated [insert date].
The licensee shall maintain records of individuals designated as users for 3 years following the last use of licensed material by the individual.
Supervision by Individuals Designated by the RSC MML Licensed material shall only be used by, or under the supervision of individuals designated by [insert 03614 name of Radiation Safety Committee, e.g., National Radiation Safety Committee].
Supervision by Individuals Designated by the RSO Licensed material shall only be used by, or under the supervision of, individuals designated, in writing, 01110, 03212, 03611, 04012, 04013, 04612, 04613, 04620, 04621 by the Radiation Safety Officer. The licensee shall maintain records of individuals designated as users for 3 years after the individual's last use of licensed material.
Supervision by Name Listed Licensed material shall only be used by, or under the supervision of: <<!AuthorizedUsers!>>. 02400, 02410, 02513, 03122, 03123, 03124, 03210, 03214, 03215, 03219, 03220, 03221, 03222, 03225, 03226, 03235, 03236, 03240, 03241, 03242, 03243, 03244, 03612, 03613, 03620, 03710, 03800, 03810, 03900, 04110, 04111, 04112, 04113, 04214, 04215, 04410, 04411, 04412, 04413, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04430, 04431, 04432, 04433, 04614, 04615, 04616, 04617, 04828, 04829, 11200, 11210, 11220, 11221, 11230, 11300, 11800, 11810, 11900, 22110, 22111, 22120, 22140, 22150, 22151, 22160, 22170, 22200, 23300, 23310
Supervision by Trained Individuals Designated by the RSO Licensed material shall only be used by, or under the supervision of, individuals who have received 03120, 03122, 03130, 03220, 03225, 03226, 03234, 03710, 04414, the training described in the [application/letter] dated [insert date], and have been designated in 04415, 04418, 04419, 04424, 04425, 04436, 04437 writing by the Radiation Safety Officer. The licensee shall maintain records of individuals designated as users for 3 years following the last use of licensed material by the individual.
Supervision of the RSO or Trained Individuals Well Logging Licensed material shall only be used by, or under the supervision and in the physical presence of the 03110, 03111, 03112 Radiation Safety Officer, or individuals who have been trained in accordance with the
[application/letter] dated [insert date]. The licensee shall maintain records of individuals designated as logging supervisor(s) and logging assistant(s).
Tiedown Except as specifically provided otherwise in this license, the licensee shall conduct its program in 01100, 01110, 01120, 02400, 02410, 02500, 02511, 02513, 02600, accordance with the statements, representations, and procedures contained in the documents, 02700, 02710, 03110, 03111, 03112, 03113, 03120, 03121, 03122, including any enclosures, listed below. This license condition applies only to those statements, 03123, 03124, 03130, 03210, 03211, 03212, 03213, 03214, 03215, representations, and procedures that are required to be submitted in accordance with the 03219, 03220, 03221, 03222, 03225, 03226, 03232, 03234, 03235, regulations. The U.S. Nuclear Regulatory Commission's regulations shall govern unless the 03236, 03240, 03241, 03242, 03243, 03244, 03250, 03251, 03252, statements, representations, and procedures in the licensee's application and correspondence impose 03253, 03254, 03255, 03256, 03257, 03310, 03320, 03510, 03511, on the licensee requirements that are more restrictive than or in addition to the regulations. 03520, 03521, 03610, 03611, 03612, 03613, 03620, 03710, 03800, 03810, 03900, 04010, 04011, 04012, 04013, 04014, 04015, 04110, 04111, 04112, 04113, 04210, 04211, 04212, 04213, 04214, 04215, 04410, 04411, 04412, 04413, 04414, 04415, 04416, 04417, 04418, 04419, 04420, 04421, 04422, 04423, 04424, 04425, 04426, 04427, 04428, 04429, 04430, 04431, 04432, 04433, 04436, 04437, 04610, 04611, 04612, 04613, 04614, 04615, 04616, 04617, 04618, 04619, 04620, 04621, 04622, 04623, 04828, 04829, 11200, 11210, 11220, 11221, 11230, 11240, 11300, 11800, 11810, 11900, 22110, 22111, 22120, 22140, 22150, 22151, 22160, 22170, 22200, 23300, 23310 Tiedown - Medical Except as specifically provided otherwise in this license, the licensee shall conduct its program in 02110, 02120, 02121, 02200, 02201, 02210, 02220, 02230, 02231, accordance with the statements, representations, and procedures contained in the documents, 02240, 02300, 02310, 04510, 04511, 04512, 04513, 04710, 04711, including any enclosures, listed below. This license condition applies only to those statements, 04810, 04811, 04812, 04813, 04814, 04815, 04816, 04817, 04818, representations, and procedures that are required to be submitted in accordance with the 04819, 04820, 04821, 04822, 04823, 04824, 04825, 04826, 04827 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 impose on the licensee requirements that are more restrictive than or in addition to the regulations.
Tiedown - MML Except as specifically provided otherwise in this license, the licensee shall conduct its program in 03614 accordance with the statements, representations, and procedures contained in the documents, including any enclosures, listed below ([insert any disclaimers, if necessary, e.g., excluding VHA Directive 1105.1, VHA Handbook 1105.1, and the internal procedures listed in NHPP Internal Procedure No. 1, etc.]). This license condition applies only to those statements, representations, and procedures that are required to be submitted in accordance with the regulations. The U.S. Nuclear Regulatory Commissions regulations shall govern unless the statements, representations, and procedures in the licensees application and correspondence impose on the licensee requirements that are more restrictive than or in addition tothe regulations.
Tiedown for 35.1000 Uses [USE THIS TIE-DOWN LICENSE CONDITION IF THE LICENSEE IS APPROVED TO CHANGE/REVISE LICENSE 02240, 04826, 04827 COMMITMENTS FOR 35.1000 USE (IF NRC GUIDANCE IS UPDATED AT LATER DATE)] 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 statements, representations, and procedures that are required to be submitted in accordance with the regulations. Additionally, this license condition does not limit the licensees ability to make changes to the radiation protection program as provided for in 10 CFR 35.26 and applicable guidance updates for 10 CFR 35.1000 uses.
The U.S. Nuclear Regulatory Commissions regulations shall govern unless the statements, representations, and procedures in the licensees application and correspondence impose on the licensee requirements that are more restrictive than or in addition to the regulations.
Transportation Public Roads Except for vehicle maintenance, the licensee shall not move mobile non-intrusive inspection systems 03130, 04436, 04437 on public roads unless specific authorization is obtained from the U.S. Nuclear Regulatory Commission.
Use of Licensed Material [Insert MML name: e.g., United States Air Force] requirements, policies, and directives governing the 03614 use of licensed material must be consistent with the Nuclear Regulatory Commission's regulations.
Use of Material Licensed material shall only be used by, or under the supervision and in the physical presence of, 03121, 04416, 04417 individuals who have received the training described in the [application/letter] dated [insert date].
The licensee shall maintain records of individuals designated as users for 3 years following the last use of licensed material by the individual.
Use of Radioactive Markers for Subsurface Monitoring Notwithstanding the requirement of 10 CFR 39.47, pursuant to 10 CFR 39.91, and in accordance with 03110, 03111 statements, representations, and procedures contained in [insert reference: e.g., the letters dated Month, DD, YYYY, Month, DD, YYYY, and Month, DD, YYYY], the licensee may use radioactive markers with activities of 100 microcuries or less of cobalt-60 and 50 microcuries or less of cesium-137 for subsurface monitoring in surface cased oil and/or gas wells, provided that a member of the public would not receive more than 100 millirems annually, in the event the sources ruptured.
Utilization Facility on Human Subjects This license does not authorize the use of radiation from an NRC licensed utilization facility on human 03614 subjects.
Watches under 30.15 The timepieces, hands, and dials have been manufactured in accordance with the International 03250 Atomic Energy Agency, International Standards Organization, OECD Nuclear Energy Agency, American National Standards Institute or equivalent industry standard; and the amount of tritium on the timepieces, hands, and dials is not in excess of the maximum permissible amounts authorized in 10 CFR 30.15(a)(1).
Watches under 30.15 (Header) Each lot of timepieces, hands and dials received, containing tritium for distribution for use under 10 03250 CFR 30.15, must be accompanied by a certificate which attests to the following: