ML18212A057
| ML18212A057 | |
| Person / Time | |
|---|---|
| Site: | 03002041 |
| Issue date: | 07/31/2018 |
| From: | Frazier C F NRC/RGN-III |
| To: | McLaren Oakland |
| References | |
| 608765 | |
| Download: ML18212A057 (4) | |
Text
NRC FORM374 U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE PAGE 1 OF 4 PAGES Amendment No. 62 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 letter dated 4. Expiration Date: June 30, 2024 1. McLaren Oakland May 1 2. 50 N. Perry St. t-------------+---+.-----1
- 5. Docket No.: 030-02041 Reference No.: Pontiac, MI 48342 6. Byproduct, source, 7. Chemical alrt:tk>r physical fotdila 1\: 1 t w.,~: Maxiffidlllllliount that licensee 9. Authorized use and/or special nuclear material A. Any byproduct material A. Any 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. For use in imaging and localization permitted by 10 CFR studies permitted by 10 CFR 35.200. 35.200 C. Any byproduct material C. Any C. 1 curie total C. For any use permitted by 10 CFR 1'*"*" permitted by 1 O CFR A ,<f,s,~"s 35.300. 35.300 NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 2 OF 4 PAGES MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 21-04081-03 Amendment No. 62 Docket or Reference Number 030-02041
- 6. Byproduct, source, and/or special nuclear material D. lodine-125 permitted by 10 CFR 35.400 E. Palladium-103 permitted by 10 CFR 35.400 7. Chemical and/or physical form D. Sealed Sources (Bard Brachytherapy, Inc., 1251; Best Medi Inc. (formerly Inc.), Model 23~; Medi-Physi#c.
d .\ Healthcare~del 673 (EchoSee~Alfl!~nd 6711 (OncoSee~)p Therageni CorporatidnlModel 1-Seei 125.S06 ap"'21-Seed~aX10 E. Sealed Sc:(/oes ( lnternationa~~nc. ( Industries, liu,~. M Theragenics OQ}porat TheraSeed 2 8. Maximum amount that licensee , 9. Authorized use may possess at any one time e~ ti~ license s&frrlufG(ries total -v;',, D. For any manual brachytherapy procedure permitted by 10 CFR 35.400. E. For any manual brachytherapy procedure permitted by 10 CFR 35.400. -1 CONDITIONS
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- 10. A. Licensed material listed in Subitem Nos. 6.A. through:6.e:ornay-fe
'Used at the licensee's facilities located at 50 N Perry St., Pontiac, Michigan, 48058. B. Licensed material listed in Subitem Nos. 6.A. through 6.C. may be used or stored at the licensee's facilities located at McLaren Diagnostic Imaging, 5701 Bow Pointe Dr., Clarkson, Michigan, 48346. 11. The Radiation Safety Officer (RSO) for this license is Kenneth P. Tarr, D.O.
NRC FORM 374A U.S. NUCLEAR REGULATORY COMMISSION PAGE 3 OF 4 PAGES MATERIALS LICENSE SUPPLEMENTARY SHEET License Number 21-04081-03 Amendment No. 62 12. Licensed material shall only be used by, or under the supervision of: Docket or Reference Number 030-02041 A. Individuals permitted to work as authorized users~~cJrlarB6tGcu,r 35.13 and 10 CFR 35.14. B. The following individuals are authorized
~'"for the material and medical u:!~ Authorized User(M.D.,D.O.,etc.)
Kevin R. Carter, D.O. Stephen D. Franklin, M.D. Arthur J. Frazier, M.D. Adam R. Schwaderer, D.O. Kenneth P. Tarr, D.O. R 35.3°trtlimited to the oral administration of sodium equal to ~,millicuries)
'" , , 0 CFR 35.30~mited to the oral administration of sodium an ~(i.ifqual t~ millicuries) t;i*Jt r'*' mW (~
NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET U.S. NUCLEAR REGULATORY COMMISSION License Number 21-04081-03 Amendment No. 62 Docket or Reference Number 030-02041 PAGE 4 OF
- 4 PAGES 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 procedures that are required to be submitted in accw:~c~i£611Qulations.
Additionally, this license condition does not limit the licensee's ability to make changes to the radiation
~o~fo?I program as pM(eq,,tor in 10 CFR 35.26. The U$. Nuclear Regulatory Commission's regulations shall govern unless ttiGMements, representations, ~cedures in the licensee's application and correspondence are more restrictive than th~~ulations.
0 A. Application dated January 16, 2014 (M~21A094)
B. Letter dated June 27, 2016 (ML 1618(931)
C. Letter dated August 19, 2016 (ML 1~A198) D. Letter dated July 11, 2017 (ML171 5 051) E. Letter dated August 14, 2017 (ML 1 3A023) F. Letter dated August 29, 2017 (ML 1~8A2 G. Letter dated September 13, 2017 (~1726 H. Letter dated October 10, 2017 (ML 1~A2 I. Letter dated November 2, 2017 (ML 17~.QA569)
J. Letter dated March 14, 2018 (ML 18075 K. Letter dated May 10, 2018 (ML 18134A212)
JUL 31 2018 Date:--------