ML18198A069
| ML18198A069 | |
| Person / Time | |
|---|---|
| Site: | 03018527 |
| Issue date: | 07/16/2018 |
| From: | Parker B A NRC/RGN-III |
| To: | Munson Healthcare Otsego Memorial Hospital |
| References | |
| 608489 | |
| Download: ML18198A069 (3) | |
Text
NRC FORM374 U.S. NUCLEAR REGULATORY COMMISSION MATERIALS LICENSE PAGE 1 OF 3 PAGES Amendment No. 24 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 1, Parts 30, 31, 32, 33, 34, 35, 36, 37, 39, 40, 70 and 71, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, source, and special nuclear material designated below; to use such material for the purpose(s) and at the place(s) designated below; to deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the applicable Part(s). This license shall be deemed to contain the conditions specified In Section 183 of the Atomic Energy Act of 1954, as amended, and is subject to all applicable rules, regulations, and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any conditions specified below. Licensee 1. Munson Healthcare Otsego Memorial Hospital 2. 825 N. Center Ave. Gaylord, Ml 49735 In accordance with letter dated 4. Expiration Date: October 31, 2025 April 1f{ol~* t------------
........ ---1 5. Docket No.: 030-18527 Reference No.: 3. License No.: 21-24363-01 is amended in its entirety to read as follows: 6. Byproduct, source, and/or special nuclear material 7. Chemical a~for physical form 6. 9. Authorized use ii' ljl'i Maximum amount that lice~e .may posse11 at any one t!Me' A. Any byproduct material permitted by 1 O CFR 35.100 B. Any byproduct material permitted by 10 CFR 35.200 A. Any B. Any er thla tlcense e. As needed ';OONDITIONS
"', i,-'",' 'l A. For use in uptake, dilution and excretion studies permitted by 10 CFR 35.100. B. For use in imaging and localization studies permitted by 10 CFR 35.200. 1 O. Licensed material may be used or stored at the licensee's facilities located at 825 N. Center Ave., Gaylord, Michigan, 49735. 11. The Radiation Safety Officer (RSO) for this license is Ryan R. Hoenicke, M.D.
NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET U.S. NUCLEAR REGULATORY COMMISSION License No. 21-24363-01 Amendment No. 24 Docket or Reference No. 030-18527
- 12. licensed material shall only be used by, or under the supervision of: A. Individuals permitted to work as authorized use:s t,~,d(tiJar,Q wlth:J{~5rR
- "5.13 and 10 CFR 35.14. ,.. ~, B. The following individuals are authorized us~~1~r the material and medical us;,:;ipdicated:
Authorized User Michael A Angileri, M.O. Lisa M. Fortin, M.0. J. Scott Greene, 0.0. Mark P. Heilala, M.0. William E. Henry, M.O. Ryan R. Hoenicke, M.O. Kimberly Sue Johnson, M.0. Michael W. Kuhn, 0.0. Anthony R. Pucci, 0.0. William K. Riordan, 0.0. Janice M. Schwinke, M.O. Michael T. Sunday, M.O. (,:~ Material ~od Use 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 10 CFR 35.100,10 CFR 35.200 1 O CFR 35.100, 1t~,,-~OO 1~ :: ::: :~~: :~m tt:: CFR 35.100,10CFR 35.200 . FR 35. 100, 10 CFR 35.200 1oe'~35.100,10 CFR 35.200 10 CF~ 35:100,10 CFR 35.20Cl . i ;' <~Jt.: -,,;A\,/ ~-,C "~" ;~,s 10 CFR 35.100,18 CFR 35~00 10 CFR 35.100,10 CFR 35.200 -,;,'Jilllii PAGE 2 OF 3 PAGES NRC FORM 374A MATERIALS LICENSE SUPPLEMENTARY SHEET U.S. NUCLEAR REGULATORY COMMISSION License No. 21-24363-01 Amendment No. 24 Docket or Reference No. 030-18527 PAGE 3 OF 3 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 ~cC/\!:dAcefli£t'l l}'QUl.ations.
Additionally, this license condition does not limit the licensee's ability to make changes to the radiation,~\o~-program aspfW'i(ed,.tor in 10 CFR 35.26. The U.S. Nuclear Regulatory Commission's regulations shall govern unless \tl(~atements, representations, 11')cedures in the licensee's application and correspondence are more restrictive than th~fre,ulations. ,v A. Application dated July 29, 2015 (ML 1!~~5A685).
B. Letter dated April 11, 2018 (ML181~181)
C. Letter dated June 1, 2018 (ML 181~~"~582)
Date: JUL 16 2018 --------