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State of California -Health and Human Services Agency California Department of Publle Health Page 3 of 4 pages RADIOACTIVE MATERIAL LICENSE License Number: 68 2-1 Amendment Number: 17 16, The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Public Health: (a) The Radiation Safety Officer (b) Qualified individuals designated in writing by the Radiation Safety Officer 17. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 18. Records of leak test results shall be kept in units of becquerls (microcuries) and maintained for inspection, Records may be disposed of following Department inspection. Any leak test revealing the presence of 185 Bq (0.005 µCi) or more of removable radioactive material shall be reported to the California Department of Public Health, Radiologic Health Branch, MS 7610, P.O. Box 997414, Sacramento, CA 95899-7414, within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken. 19. Maintenance and repair of soil/asphalt content gauges shall be performed only by persons specifically authorized to perform those services. 20. At any time the licensee is engaged in making measurements by authority of this license at either a permanent or temporary job site, the licensee shall have a current copy of each of the following documents available for inspection at the job site: (a) A statement authorizing each qualified individual to use radioactive material (See Condition 12). (b) This license. (c) The manufacturer's instruction manual with appropriate emergency procedures. 21. The licensee shall comply with all requirements of Title 17, California Code of Regulations, Section 30373 when transporting or delivering radioactive materials to a carrier for shipment. These requirements include; packaging, marking, labeling, loading, storage, placarding, monitoring, and accident reporting. Shipping papers shall be maintained for inspection pursuant to the U.S. Department of Transportation requirements (Title 49, Code of Federal Regulations, Part 172, Sections 172.200 through 172.204). 22. The licensee shall conduct a physical inventory every six months to account for all sealed sources and/or devices received and possessed under the license. Records of the inventories shall be maintained for inspection, and may be disposed of following Department inspection. 23. Before radioactive materials may be used at a temporary job site at any federal facility, the jurisdictional status of the job site must be determined. If the jurisdictional status is unknown, the federal agency should be contacted to determine if the job site is under exclusive federal jurisdiction. A response shall be obtained in writing or a record made of the name and title of the person at the federal agency who provided the determination and the date that it was provided. Authorization for use of radioactive materials at the job sites under exclusive federal jurisdiction shall be obtained either by: (a) Filing an NRC Form-241 in accordance with the Code of Federal Regulations, Title 10, Part 150.20 (b), "Recognition of Agreement State Licenses", or (b) By applying for a specific NRC license. Before radioactive material can be used at a temporary job site in another State, authorization shall be obtained from the State if it is an Agreement State, or from the NRC for any non -Agreement State, either by filing for reciprocity or applying for a specific license.