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{{#Wiki_filter: | {{#Wiki_filter:NRC FORM 374 PAGE 1 OF 3 PAGES | ||
U.S. NUCLEAR REGULATORY COMMISSION | |||
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, Code of Federal Regulations, Chapter I, | |||
Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued | |||
authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s) | |||
and at the place(s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This | |||
license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and | |||
orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below. | |||
Licensee In accordance with application 4. Expiration Date: June 30, 2037 | |||
dated March 8, 2022; and letter | |||
1. Alyeska Imaging Center | |||
dated June 22, 2022, | |||
5. Docket No.: 030-39310 | |||
2. 2480 S. Woodworth Loop 3. License No.: 50-35674-01 Reference No.: | |||
Suite 140 | |||
Palmer, AK 99645 | |||
6. Byproduct, source, 7. Chemical and/or physical form 8. Maximum amount that licensee 9. Authorized use | |||
and/or special nuclear may possess at any one time | |||
material under this license | |||
A. Any byproduct material A. Any A. As Needed A. For use in uptake, dilution and | |||
permitted by 10 CFR excretion studies permitted by 10 CFR | |||
35.100 35.100. | |||
B. Any byproduct material B. Any B. As Needed B. For use in imaging and localization | |||
permitted by 10 CFR studies permitted by 10 CFR 35.200. | |||
35.200 | |||
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 2 OF 3 PAGES | |||
License No.: 50-35674-01 Docket or Reference No.: | |||
MATERIALS LICENSE 030-39310 | |||
SUPPLEMENTARY SHEET | |||
CONDITIONS | |||
10. Licensed material shall be used or stored at the licensee's facilities located at 2480 S. Woodworth Loop, Suite 140, Palmer, Alaska, 99645. | |||
11. The Radiation Safety Officer (RSO) for this license is Jason Bernard Ivey. | |||
12. Licensed material shall only be used by, or under the supervision of: | |||
A. Individuals permitted to work as authorized users in accordance with 10 CFR 35.13 and 10 CFR 35.14. | |||
B. The following individuals are authorized users for the material and medical uses as indicated: | |||
Authorized User (M.D.,D.O.,etc.) Material and Use | |||
Daniel Andrew Davignon, Jr., D.O. 10 CFR 35.100,10 CFR 35.200 | |||
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 3 OF 3 PAGES | |||
License No.: 50-35674-01 Docket or Reference No.: | |||
MATERIALS LICENSE 030-39310 | |||
SUPPLEMENTARY SHEET | |||
13. 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 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. | |||
A. Application dated March 8, 2022 with enclosures (ML22117A097) | |||
B. Letter dated June 22, 2022 with enclosures (ML22173A174) | |||
FOR THE U.S. NUCLEAR REGULATORY COMMISSION | |||
Digitally signed by Roberto J. | |||
Roberto J. Torres Torres Date: 2022.06.23 09:36:33 -05'00' | |||
Date: June 23, 2022 By: | |||
Roberto J. Torres | |||
Region IV | |||
}} | }} |
Revision as of 08:21, 29 June 2022
ML22174A286 | |
Person / Time | |
---|---|
Site: | 03039310 |
Issue date: | 06/23/2022 |
From: | Ricardo Torres NRC/RGN-IV/DRSS |
To: | Document Control Desk |
References | |
License-630776-170719 | |
Download: ML22174A286 (1) | |
See also: IR 05000356/1974001
Text
NRC FORM 374 PAGE 1 OF 3 PAGES
U.S. NUCLEAR REGULATORY COMMISSION
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, Code of Federal Regulations, Chapter I,
Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued
authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s)
and at the place(s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This
license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and
orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below.
Licensee In accordance with application 4. Expiration Date: June 30, 2037
dated March 8, 2022; and letter
1. Alyeska Imaging Center
dated June 22, 2022,
5. Docket No.: 030-39310
2. 2480 S. Woodworth Loop 3. License No.: 50-35674-01 Reference No.:
Suite 140
Palmer, AK 99645
6. Byproduct, source, 7. Chemical and/or physical form 8. Maximum amount that licensee 9. Authorized use
and/or special nuclear may possess at any one time
material under this license
A. Any byproduct material A. Any A. As Needed A. For use in uptake, dilution and
permitted by 10 CFR excretion studies permitted by 10 CFR
35.100 35.100.
B. Any byproduct material B. Any B. As Needed B. For use in imaging and localization
permitted by 10 CFR studies permitted by 10 CFR 35.200.
35.200
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 2 OF 3 PAGES
License No.: 50-35674-01 Docket or Reference No.:
MATERIALS LICENSE 030-39310
SUPPLEMENTARY SHEET
CONDITIONS
10. Licensed material shall be used or stored at the licensee's facilities located at 2480 S. Woodworth Loop, Suite 140, Palmer, Alaska, 99645.
11. The Radiation Safety Officer (RSO) for this license is Jason Bernard Ivey.
12. Licensed material shall only be used by, or under the supervision of:
A. Individuals permitted to work as authorized users in accordance with 10 CFR 35.13 and 10 CFR 35.14.
B. The following individuals are authorized users for the material and medical uses as indicated:
Authorized User (M.D.,D.O.,etc.) Material and Use
Daniel Andrew Davignon, Jr., D.O. 10 CFR 35.100,10 CFR 35.200
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 3 OF 3 PAGES
License No.: 50-35674-01 Docket or Reference No.:
MATERIALS LICENSE 030-39310
SUPPLEMENTARY SHEET
13. 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 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.
A. Application dated March 8, 2022 with enclosures (ML22117A097)
B. Letter dated June 22, 2022 with enclosures (ML22173A174)
FOR THE U.S. NUCLEAR REGULATORY COMMISSION
Digitally signed by Roberto J.
Roberto J. Torres Torres Date: 2022.06.23 09:36:33 -05'00'
Date: June 23, 2022 By:
Roberto J. Torres
Region IV