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State of California -Health and Human Services Agency <br />California Department of Public Health <br />Page 2 of 3 pages <br />RADIOACTIVE MATERIAL LICENSE Liccnsc Number x313-3b <br />Amendment Number I <br />13. Pxeept as specifically provided orbeiwise by this liecnsc, the licensee shall poiiess and Use radioactive Inaterial <br />described in Items 6, 7, 8 and 9 of [his license in accordance with the state]IIVIIK representations, and procedures <br />cowaineci in the documents listed below. The Dcpartmenl's regulations shall govenl unless the slatemcnL, <br />representa11o115, and procedures in the licensee's application a id coriesponderice are more restrictive than the <br />regulation. <br />(a) The liecnsc application, with auachrncnrs, dated Match 29, 2010, and the letter, with auachrnetus, dated <br />Ally 24, 2019, both signed by Krcctha Mckchai, Radiation Safety Officer. <br />14. 1 he Radiation Safety Officer in this program shall be Kreetha Mekchai. <br />I S_ Before radioactive materials may be used at a tempoiaiyjob site at any tzderal tacilit-y, the jurisdictional status of <br />Job site must be determined_ if the jurisdictional sratus is unknown, the federal agency should he contacted to <br />deterltnlnC It the 1oh ]Ire k 11ndC1' CXClrlilt'C federal hll'131111 tIUn. A rCipUll iC shall he ohtamcd In wlitln✓g or a "CCUr'll <br />made of the naune and title of the person at the fecic7al agency who provided the detenuination and the date that it <br />was provided. Authorization for use of radioactive nnaterials at the jab sites under exclusive federal jurisdiction shall <br />be obtained either bv' <br />(a) Piling an NRC Pnrrn-241 in accordance with the Code of Federal Regulations, Title 10, Part 150.10 (b), <br />"Rceognition of Agreement Stoic T.iocnses", or <br />(b) By applying for a. specific N RC: liecnsc. <br />Before radioactive material can be used at a temporaryjob site in another Stare, authorization shall be obtained from <br />the State if it is an Agreement State, or lions the NRC for any non -Agreement State, either by tiling till reciprocity nr <br />applying tina Specific license- <br />16. Sealed sources unaaincd ill soil/asph dr. gauges shall bC ICNICII. fur Ic:ik:af;c anti/or cuntalninaiioii aL. iiu.civals not to <br />exceed 12 months. <br />17. Quantitative analytical assays lo- the purpose of LCSIS for leakage and/or contamination of scaled somres shall be <br />performed only by persons specifically authorized to pertornt that service. <br />1 S. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license <br />using leak tesl kits ac "p[able to the California Department of Public Hcahh: <br />(a) The Radiation Safely Officer <br />(11) Qualified individuals designated in writing by the Kadiation Safety Officer <br />19. Records of leak test results shall he kept in units of becquerels (microcuries) and maintained for inspection. Records <br />maybe dicposcd of following Dgrartincnt inspecrion_ Any leak test revealing. the presence of IRS RLI (OA05 it(' i) or <br />more of removable radivadivC malpial .hall be rc1301-11A to the California DcparLmeni of Public TTcalth, Rmliologic <br />Hcallh Branch MS 7610I'.O. Box 997414, Sacramctrlo, CA 95699-7414, within five days of tllc lest. This rcporl <br />shall include a description of the defective source or device, the results of the test, and the corrective action taken. <br />20. The licensee shall conduct a physical inventory every six months to account tier all sealed sources and/or devices <br />received and possessed under the license. Records ol'the inventories shall he maintained for in;pection, and may be <br />disposed of following Dcporti nxa inspection. <br />21. Maintenance and repair of soillasphalt content gauges shall be performed only by persons specifically authorized to <br />per lot W;W SIN - <br />City Council 21 — 228 7/6/2021 <br />