application for license,authorizing dn sattem as radiation officer
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O ONRC FORM 313M
U.S. NUCLE AR REGULATORY COMMISSION Approved by OMB"
APPLICATION FOR MATERIALS LICENSE - MEDICAL fs 30 8310 CFR 35
INSTR UCT|0NS - Convkte trens 7 shmue nr tns e a,imt,ar av cata, or a,a,viatoon for rewm,o or a owe >seu use metenentas stwarswhere twtessary, item 26 must be compktat on aN avlwatern aunt sgnal. Retaon one copy Sutwnst orogenal and one copy of entorewptwatoon to : Dwector,0ffwr ot Nuclear Matenals Satory arntSafeguards. ll 5 k tear Repolatory Commession Washington. O CM555 lipan opmvat of tks av wstum, the avheant mit receove a Matonals t weme An NRC Matenas t unse os esmoet m ut ont-o
ance auth the pereret renuarements contannnt m Foto 70. Conte of fearral eteestarmns. Part 30. ant the iocewe os nobrec t to Titse 10.Code of fateral Reputatoons. Parts 19. 20arnt 35 auf the inmuse for provision of Tette 10, Code of fnkral Regulatoes, Part 170 Theloconse fee category shouks be statnt m trem 26 amt the syyvoorrate fee wartasnt
1.a. NAME AND MAILING ADDRESS OF APPLICANT (onscrution, 1. lt STREET ADDRESS (ES) AT WHICH HADIOACTIVE MATERIAL/,rm, clinic, physician, etc) INCLUDE ZIP CODE WILL BE USED II/ defkrent from F.41 INCLUDE ZIP CODE
COMPUTERIZED MEDICAL IMAGING2010 Esmond RoadEau Claire, Wis 54701
TELEPHONE NO.: ARE A CODEl7/T I N
2. PERSON TO CONTACT REGARDING THIS APPLICATION 3. THIS IS AN APPLICATION FOR: (ChecA muropnate item)sL |Q NEW LICENSEBill Stangl, President 4 O AMENDME NT TO UCENSE No,c. O HENEWAL OF LICENSE NO.
TE LEPHONE NO.: ARE A CODE I 713 M$-80084. INDIVIDUAL USERS (Name inde, duals who will use or darctly 5.R ADIATION SAFETY OFFICER (RSO)(Name o/ person desisrtated
supervose use of radioachee materval. Compkte supplements A and B as raroatoon sa ety o!!wer If other than ornhvnAoat usw. ecorekte remo.rFor each mdwdual, j me of tranene and esponerace as m Sewkment A )
See attached supplemental sheet David N. Sattem, M.D.
6.a RADIOACTIVE MATERIAL FOR MEDICAL. USEMAXIMUM MARK MAXIMUM
ITEMS POSSESSION - ITEMS POSSESSIONRADIOACTIVE MATERI AL DESIRED LIMgis ADDI TION AL ITEMS: DESIREo yugygLISTED IN: . x** IIn enouncurresl "x" (In mottocurresi
IODINE.131 AS lODIDE FOR TRE ATMENT10 CFR 31.11 FOR IN VITRO STUDIES OF HYPERTHYROIDISM
10 CFR 35.100 SCHEDULE A, GROUP i AS NEE DE D PHOSPHORUS-32 AS SOLUBLE PHOSPH ATEX FOR TRE ATMENT OF POLYCYTHEMI A
VER A,LEUKEMI A AND DONE METASTASES10 CFR 35.100, SCHEDULE A, GROUP 11 X AS NEEDED
PHOSPHORUS 32 AS COLLOlD AL CHROMICPHOSPHATE FOR INTRACAVITARY TRE AT-
10 CF R 35.100. SCHE DU LE A, GR OUP 111 MENT OF MALIGN ANT E FFUSIONS.X 2 Curien GOLD tm AS COLLOID FOR INTRA.
CAVITARY TRE ATMENT OF MALIGNANT10 CFR 05.100,5CHEDULE A, GROUP IV AS NEEDE D E F F USIONS.
IODINE.131 AS IODIDE FOR TRE ATMENT10 CFR 35.100, SCHEDULE A, GROUP V AS NEE DED OF THYROlO CARCINOMA
XENON 133 AS GASOR GASIN SALINE FOR10 CFR 35.100. SCHEDULE A, GROUP Vi flLOOD FLOW STUDIES AND PULMONARY
FUNCTION STUDIES
6.b. RADIOACTIVE MATERIAL FOR USES NOT LISTED IN ITEM 6.a. /Sesiassoortesup to3mCiumtrorcalibration and reference standards are authorsted under sottron 35.74(dl,10 CfR Part 35, and NEED NO F BE LIS FEDJ
CHEMICAL M AXIMUM NUMBE RELEMENT AND MASS NUMBER AND/OH OF MILLICURIES DESCRIBE PURPOSE OF USEPHYSICAL FORM OF EACH FORM
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INFORMATION REQUIRED FOR ITEMS 7 THROUGH 23
For items 7 through 23, check thnpprop-iate box (es) and submit a d: tailed description of til the requested information. Begineach item on a separate sheet. Identify the item numtwr and the date of the application in the lower right corner of each page, ifyou indicate that an appendix to the medical licensing guide will be followed, do not submit the pages, but specif y the revision
p number and date of the referenced guide: Regulatory Guide 10.8 . R ev. Date:>> ,
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GENER AL RULES FOR THE SAFE USE OF7. MEDICAL ISOTOPES COMMITTEE RADIOACTIVE MATERI AL (Check Onel
^ P P" * " "* '
X Names and Specialties Attached; and X
X Duties as in Appendix 8;or Equivalent Rules Attached(Check One)
Equivalent Duties Attached 10. EMERGENCY PROCEDURES (Check Oncl
8. TRAINING AND EXPERIENCE Xv Appendix H Procalures Followed; or
Supplements A & 8 Attachal for Each Individual User; Equiva'ent Procedures Attachedand
,
X Supplement A Attached for RSO. 17 vAREA SURVEY PROCEDURES (Cherk One)
9. INSTRUMENTATION (Check One) Appendix I Procedures Followal;ory
Appendix C Form Attached;or Equivalent Procedures Attached.
X List by Name and Model Number 18. WASTE DISPOSAL (Check One)
10. CAllBR ATION OF INSTRUMENTS X' Appendix J Form Attached;or
j Appendix D Procedures Followed for Survey'
Equivalent information Attachedv X Instruments; or
(Clurk One)"^ "^ ' ^"
Equivalent Procedures Attachnd;and 10* (Check One)Appendix D Procedures Followed for DoseCalibrator; or Appendix K Procalures Followed;or
(Check One)
'X Equivalent Procedures Attached Equivalent Procedures Attachal
11. FACILITIES AND EQUIPMENT 20. THERAPEUTIC USE OF SEALED SOURCES
X Description and Diagram Attached Detailmj information Attached;and
Appendix L r rocedures Followed;ore12. PERSONNEL TRAINING PROGR AM(Check One)
y X Description of Training Attached Equivalent Procalures Attachal
PROLEDURES FOR ORDERING AND RECEIVING PROCEDURES AND PRECAUIlONS FOR USE OFR ADIOACTIVE MATERIAL 21. R ADIO ACTIVE GASES (e.g., Xenon - 133)
9 X Detailed information Attached Detailed Information Attached
PROCEDURES AND PRECAUTIONS FOR USE OFPROCEDURES FOR SAFELY OPENING PACKAGES
22. RADIOACTIVE MATERI AL IN ANIMALS14. CONTAINING RADIOACTIVE MATERIALS(Check One) Detailed Information Attached
PROCEDURES AND PRECAUTIONS FOR USE OFy Appendix F Procedures Followed;or
23. RADIOACTIVE MATERlAL SPECIFIED IN ITEM 0 h,,
uj Equivalent Procedures Attachal Detailed Information Attached
NRC FORM 313M(9 en Page 2
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i 24. PERSONNEL MONITORING DEVICES
'SUPPLIE R EXCHANGE FREQUENCY
f ,,,, g ;
FILM$
C:TFMFNg monthly ['
6 a.WHOLEtt.O ,BODY '
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; OTHE R (Specofy) ;'
tFILM
, STEMENS monthly*
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OTHER (Specifyl ;
j d. OTHER (Specity)
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! 25. FOR PRIVATE PRACTICE APPLICANTS ONLY;
i s HOSPITAL AGHEEING TO ACCEPT PATIENTS CONT AINING HAOlOACTIVE M ATE HI AL [| N AME OF HosPIT AL tt ATTACH A COPY OF THE AGREEMENT LETTER '
| Various llOspitals, see suppicmental sheet SIGNED BMHE HNITAL ADMINISTRATOR. |
MAILiN 4 nessc. WHEN REQUESTING THER APY FROCEDURES,
ATTACH A COPY OF R ADIATION SAFETY PRECAV-
| STATECliv ZIP cooE TlONS TO BE TAKEN AND LIST AVAILABLE
;
R ADI ATION DETECTION INSTRUMENTS.i
26. CERTIFICATEi,
1 (This itern mus t to completed by applican t)
l'J The applicant and any of ficial esecuting this cartificate on behalf of the applicant named in item la cortif y that this application is prepared inj conform 6ty mth Tetle 10, Code of Federal Regulations, Parts 30 and 35, and that allinformation contained herein,6ncluding any supplements '
] attached hereto,is true and correct to the best of our knowledge and beleef,
I
r lA APPLICAN OR CER IF ING OFFir L (SP'sturel (e -
|a. LICENSE FEE REQUIRED # D i
{ ISee Seetoon 11031,10 CFR 110) g1y n Aya ip'ype of Printij Id 1 I St,angl., '" I
I 11) LICENSE FEE CATEGORY:! President
c. D A TE(2) LICENSE FEE ENCLOSED: $ 0. @ 6-1-85;
NRC FORM 313M 19 811-
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g~0NTROL NO. 7 9 2 9 2.
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PRIVACY ACT STATEMENT-si iN~|
Pursuant to 5 U.S C. 552aleH3), enacted into law by section 3 of the Privacy Act of 1974 (Pubhc Law 93 579), the followmqstatement is furnished to individuals who supply information to the Nuclear Regulatory Commission on NRC Form 313M,This information is mamtained in a system of records designated as NRC 3 and described at 40 Federal Remster 45334(October 1,1975).
1. AUTHORITY Sections 81 and 161(h) of the Atomic Energy Act of 1954, as amended (42 U S C 2111 and 2201(h)).
2. PRINCIPAL PURPOSE (S) The information is evaluated by the NRC staf f pursuant to the creeria set forth in 10 CF RParts 30 3G to determme whether the apphcation meets the requirements of the Atomic Energy Act of 1954,as amended,and the Commission's regulations, for the issuance of a radioactive materiallicense or amendment thereof,
3. ROUTINE USES The information may be uvd. (a) to provide records to State health departments for then mformationand use, and (b) to provide information to Federal, State, and local health of ficials and other persons in the event of ince-dent or exposure, for their mformation, investigation, and protection of the pubhc health and safety The mformationmay also be disclosed to appropriate Federal State, and local agencies in the event that the information indicates aviolat:on or potential violation of law and in the course of an administrative or judicial proceeding In addition, this information may be transferred to an appropriate Federal, State, or local agency to the extent relevant and necesury fora NRC necmon or to an appropriate Federal agency to the extent relevant and necessary for that agency's decision aboutyou. A copy of the hcense issued will routinely be placed in the NRC's Pubhc Document Room,1/17 H Street, N.W ,Washmgton, D.C
4 WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDINGINFORMATION Disclosure of the requested information is voluntary, If the requested mformation is not furnished,however, the apphcation for radioactive material hcense, or amendment thereof, will not be processed,
5 SYSTFM MANAGER (S) AND ADDRESS Director, Divson of Fuel Cycle and Material Safety, Of fice of Nuclear Mate-p riat Safety and Safeguards, U.S Nuclear Hegulatory Commission Washmyton, O C. 20555
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( \ NHC FORM 313Mt- m ati
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NRC FORM 313M SUPPLEMENT A U.S. NUCLE AR REGULATORY COMMISSION(9 81)
TRAINING AND EXPERIENCEAUTHORIZED USER OR RADIATION SAFETY OFFICER
1
1. N AME OF AUTHOHilED USE H OH H ADI ATION SAFETY OFFICEH 2 ST An E OH TE HHiiOHY IN |'WHICH LICE NSE D TO
David N. Sattem, M.D. NRC license 48-03116-01 PR ACTICE ME DICINE
_4&-20214-01 Wiscesin3. CERTIFICATION
SPECI ALTY BOARD CATEGORY MONTH AND YE AR CEHTIFIEDA B C
American College of Radiology
American Board of NuclearMedicine 1972
4. TR AINING HECEIVED IN BASIC H ADIOlSOTOPE HANDLING TECHNIOUES
TYPE AND LENGTH OF TRAINING
LECTURE / SUPE H VISE DFIELD OF TRAINING LOCATION AND D ATE (S) OF TH AINING L ABO H A TO R Y LABOHATOHY
A B COU RSE S E X PE RIE NCE
(Hours) (Hour s)C D
a H ADI ATION PHYSICS ANDINSTRUVE N T ATION X
._.
h H ADI ATION PHOTECTION
X_ , _ . _ . - _ . _ . _ _ _ _ _ . _ _ _ _ , _ - _ _ _ _. _ ..
c MATHEMATICS PERTAINING TOTHE USE AND ME ASUHEYENTOF H ADIOACTIVITY
vf H ADI ATION HtOLOGY
X
e. H ADIOPH AR M ACE UitC ALCHF MIS T R Y
5. EXPEn|ENCE WITH H ADI ATION. (Actualuse of Radioisotopes or [quivalent Emerience)
ISOTOPE MAXIMUM AMOUNT WHEHE EXPEnlENCE WAS O AINED OURATION OF EXPEnlENCE TYPE OF USE
1972 to present
Sacred llenrt ilospital
Sound Expans1On Ent,
| | I Eau Claire, Wis.
NHC FORM 313M Supplerrwnt AC 811 Page 5
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INFORMATION TO BE SUBMITTED FOR MOBILE NUCLEAR MEDICINE
1. A complete application in accordance with the MedicalLicensing Guide (Regulatory Guide 10.9 ) is attached.
2. Diagnostic Nucicar Medicine Imaging procedures will befurnished to the smaller community hospitals. The mobilearrangement provides a way to effectively enhance localdiagnostic capabilities at a minimal cost to the hospitalsinvolved.
3. Statements from the hospitals which will be utilize themobile services are attached.*
,
4. A physician, Radiologist, will be on-site at the time- that the radiopharmeceuticals are administered. The
identities of the physicians are included on the licenseapplication.
<5. The doses will be precalibrated before arriving at thehospital. Only in emergency or add-on circumstances willthe doses be prepared at the hospital. The dose calibrator ,
'will be taken with on a daily basis to the hospitals andcalibration procedures will be followed before its use.
(G 6. Radioactive materials located in the bed section of the,/van or truck will beept in a storage box secured to the truckfloor. The box will always be kept locked when the radio-active material is kept inside. Included are diagram ofthe vehicle, procedure for emergency situations.
7. Included as mention above.
8. Included will be the procedure that the drivers ofthe vehicles containing radioactive materials willfollow.
9. Find attached descriptions of the imaging area at eachhospital.
10. Find attached the daily quality control procedurewhich specifies routine calibration of equipmentprior to its use.
11. Find attached the procedure used for contaminationsurvey at each imaging area after exam has been performed.
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INFORMATION NEEDED FOR MATERIALS LICENSE
( )U 12. The technologists have been instructed not to leave radio-
active materials in the vehicle overnight and a vehiclesurvey (see item #6) will be performed after each days work.
13. Under the terms of CMI NRC license, all radioactive materialswill be received at CMI " base station" or hot laboratory site.
14. No radioactive gases will be used. Radioactive aeorsol imagingfor ventilation lung imaging will be used.
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&ntTRCL NO. ? 9 2 O O
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APPLICATION FOR MATERIAL LICENSE-MEDICAL
(~) Information required for items 7 through 23v
7. MEDICAL ISOTOPES COMMITTEE
NAME SPECIALTY
David N. Sattem, M.D. Nuclear Medicine, Radiology
Dennis Wolf, CNMT Nuclear Medicine
David Robinson, CNMT Nuclear Medicine
Bill Stang1, RDMS Corporate President
Steve Nelli, RDMS Corporate Vice-President
8. Supplement A attached for RSO
9. G.E. Porta Camrea IIC-ImagingTexas Nuclear Model 2592 Cutie Pie Ion Chamber- SurveyLudium Model 2 Gieger-Mueller Meter with model 44-7thin end window probe-SurveyCapintec CRC-5R dose calibratorO (see attached information for specifications)
10. Appendix D attached
11. Description and diagram attached.
12. Attached find the curriculum vitae on the technologists.All personnel working with radioactive materials, willattend local and national seminars, meetings and refreshercoures given by the consulting firm of Stan lluber.
13. By-Product material authorized in Groups I-III by the MedicalIsotopes Committee will be ordered by the Nuclear MedicineTechnologist via a standing order with the supplier.
14. Shipments will be received at Computerized Medical Imaging,2010 Esmond Road, Eau Claire, Wis, by one of the nuclearmedicine technologists: The package will b6 visually inspectedf'r damage, the exterior of the package surveyed by wipe smearsomonitored by a thin end window G-M detector. If the wipe smearsindicate contamination, a survey will be done of the shippingvehicle. If the shipping vehicle demostrates removabic contamin-ation, the company will be notified and the contaminationremoved. In the abscence of contamination, procedures for
(^T safely opening packages, as outlined in Appendix F, will beV followed.
15. Appendix G followed16. Appendix 11 followed17. Appendix I followed18. Appendix J Attached
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Two "D* cell flashlight batteries. replaceable from the front panel, operate .
this survey meter and also the speaker. The meter is housed in a cast aluminum .,bezel. The audio system is standard on this counter. Any GM probe offered by '|Ludlum is compatible with this unit, as well as many scintillators, since anADJUSTABLE HIGH VOLTAGE is provided. .
HIGHLIGHTS: !
* Individual ranDe calibration potentiometers * Ruggedized Meter * IC '.,,
Circuitry * Temperature compensated * Electronically regulated power*
supply * Corrosion resistant * All gomponents derated to insure long life *Liberal one year warranty * Probe clips furnished at no extra charge, upon
,request.
.
SPECifr6 CATIONS:.
Range: Three linear ranges from 0-50 MR/Hr. Meter scale presentation ' 'i
0-5 MR/Hr (0-5K CPM upon request) with multiples of X.1, X1, and X10. i
Response: Toggle switch selection for 3 or 11 seconds.,
Sensitivity: 40 Millivolts. *r
.,4.Reset: Push button switch for meter reset. '
High Voltage: 900 Volts f.or Geiger Mueller probeExternally adjustable from 400 to 1500 volts.Audio: A built-in L)nimorph speaker system with.On-Off switch.
',*
Connector:"C" Series.'
Lineerity: Plus or minus 5% of full scale. *
Catitiration Statsty: Less than 5% variance to battery end point.Meter: 50 Micro-amp,2%" diameter.Slae: 3.4" X 3.5" X 7.0" (H x W x L, exclusive of handle).Weight: 3.2 pounds, less batteries and detectors. *
*
I..
4
'
THE MODEL 3 )
This unit incorporates all of the deluxe features found in the Model 2 plus an iadditional range. The four scale unit allows operation from 0 to 200 MR/Hr. Fourscales of 0-2 MR/Hr with multiples of X.1, XI, X10, and X100, (0-5K CPM or 0-50CPS upon request).
,
.
.
.'-
\
LUDLUM MEASUREMENTS,INC.501 Oak Street e Sweetwater, Texas 79556 * Telephone (915) 235-5494
,
Porped In USA 12180 ,,
I
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CENTROLNO. 7 9 2 9 2
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SCINTILLXTION CAMERAjSJSTEMQ,
rMSWWN 'M$s$Y1$0A ,,Y |. .Yidt Va a YUN.Qr5 da'D*YebimN Nalaa
-,
Control Cabinet hight: 1300 lbs (590 kgb. . . .
5 .., Scater/ Timer IWxtule Height Vertical: Lowest DistanceColbmator to Floor, facing up. 22 5
'di .I \ Scaler: Sewm decando scaler with five.m- "eches (57 cmb Highest Destance' digit suhd stato re4mluut. DisplayCulhmator.to-Floor, facmg down,arwi preset ris'Uo of 1.000 to 9.9ty).90049 m. (124.5 cmbunmt s.
imwe: F evtedigit solid-state with five, Power Retpiirtmants: Without optims,#
degit display axi gweset time targe 102-125 v AC or 195-240 v AC atof 1 to 9.993 secoexts. 40 66 Hz. Maunsan power 450 VA.
Mam mum guiwer dissipated 425 W.' '~ ' Ratemeter and Analog Computer tukxtufe 1500 DTU hr. Dedicated AC lue
rec mnemled. Third wiro AC grourut,
Digital H.Wemeter: Fiverdigit solid-''
"" E"htate re.uiout with targe of 1 to
itJ.trf) unmits gn3r second. Time I"Vi'0' mental Rnpurements: Aminentbase is I secoruf. tenverature not less than 13 C (55 FI
.
3,d not nm>re than 32*C (90'Fl withPatented Mechaniem ReducesSetup Time Permitt6twJ Fest. b'W P' Or eentation: Switch for mter. riun.conden$ng hurmdity 5% to 80%Precise Detector Position 6ng chantP2 of X nus auf rotation of Rate of tes,perature change not to
wn.mf=s m iW steps on all displays, enceed 2.8'C (5'F) por hour.Wuutsw htth: Sumle rotary switch
SPECIFICATIONS g.h us wnew wnh% f roen 15 to
Performance 40's m steps of 2.5%Energy Rarwje of 60-200 kev. An.itimmtal M.uker: Snuto dut com tmintrinsic Spatial Resolut n wi Withm I""'' t"8 *d 8'Y*he''' m d spl.sy are.
UFOV* at 140 it eV. tetter than hv X d"8 Y lusetuni untrols. PhotoIn A tainon nwurds dot on fihn. OPTIONAL EQUIPMENT4.Ornm F mN.
Uniformity- 15% corrected.over UFOV. Power Supply ModuleH2501 AB Persistence Oscilloscope:Count Rate: Above 100.000 (ps m 20% Hiuh Voltage- Adjuntatsle to accommo- The optional Persistence Osc61to.window at 140 kev ove-r UFOV* d4e erwegy vary of 60 2@ rew
scope provides a contimu)usField Sere With parallel huto cuthma. """ "'" S#'* '"" F'*" I"'bh bu"U"* cumulative efisplay for monitoring
tors. 250mm at 10 cm from the f ace. antest hally betect f e vo ddlere"8 aeuf aids in patient positiorurm. TheEnergy Resolution- Better than 13% nt peewt nuciates. F ive precision scope mounts directly atrwe the gier>
140 reV over C7 OV". tismus controls germit ch.mu mo of bal where it is out of the way yet
Absolute Lineanty: Butter than 1.2% P"vi taittimis to other nuclutes conveniently accessible. It swevels*'""" 'h" U"C'UY ' '8 '9"- 3GO* on its mount for viewing at anyover UFOV. angle. H2501FG Persistence Oscil.
Uniformity Conputer Module loscope Cabinet reccmmeruted toImaging Detecto, Coiretts field umformity to 25% for house P scope. .
Crystal Site: 13 in.1330 nin) diamete,'"'"""''''d " " uniform'ti"# up to Storace time 1 to 30 minutes. Pet.by .375 in. (9 tnml thick. 50 % N<wiuru formity factors re- sistence contmuously adjustable.
Photomott plier Tutmr Utahres 31 i.m., t n,le unit in tranhoortation. Ont size. 0.25 nun. Storage rate.high gain, biatkali ptotomultipher gg g g,ttd>es selected and matcted for tuoh Imagmg Oscdloscope crede control is provided. Alluniformely Irwt sensitivity. Umf twm. distortiostfre+t 8 x 10 cm CRI s.tandard oscilloscope controls
do4 ay. Controls for pnwor. X muf located on the front panel,dShielding With the colhmator in place, V losi tion, focus 4pwl intensity,the crystal is surrounded by leal
Acupts Phutographic C4mwrea. Photographic floadouts: To provideshield ng for encroies up to fleutmlity in the selection of the
photographic films and ima09 sites.* Scmtujraph CamerosDetector Motions: Vertical vanon from the followmg cameras are available
TophHmaue Polarouf C4mimra provi+s en aldition H2501AF Triple ima0e22.5 in.157,1 cnq to 49 in. (124.5 three images of 36rrun chameter, pg,,,ggg. H2501 AG Single. imagecml; side.to sule rot ation 44m>ut each with thfierent intensity. Polaroid. H2505FA Single Lensborltontal exis 175'; detector hesidtotation 360*. Detectne nrul counter- Polaroid with Shutter. H250188balance rotate 360' atout pivot. 70eran Autrunatic. H2503f 8 fC/FD
GE Film Formatter (stationary | andAll motions are wittumt nul of SV5ffM DIMEN540NS WEIGHT AND H2504CF Scope Formatter (portatslet.motors. using the patented O'mbalPOWER REQUIRfAIENT'Scruf counterweight mechanism. H2502CA Camera-Computer InterfaceL engui 82 5 inches (209 6 cm) Module: For Med th Medstor andDetector Lot.ks- Friction lor.ks wrv,,,. *
b686:e detector motions. Width- 28.5 andwis (72 cm) nor>GE computers.
* OFOV - Useful Field of View. def enm1 as a circular area with a diminuter that is the lartusst inscrited circle with6rt thecolhmatml feeld of view.
" CFOV - Central Field of view, defered as a circle with 75% dionwter of UF0V centered on the detector.6
ym. . - - .
ni W T," '77 m a, r y p ".t r a v3 y k 3)} k $ N O E N' N [| y p p T ; i. p.7 5M M h M' Mt.n M.b,7,% m D l., y ~%-
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The Detector holder features a rotary beta shield with4.
'' 1.000 mg/cm2 stainless steel wall thickness. '
',
' ~ OPERATING POINT: 900 volts.DIMENSIONS: 1-3/16* diameter by 6%" fong.
'*^*''".1-* WEIGHT: 12 ozs.' ' " "'
WALL THICKNESS: 30 mg/cm2 stainless steel. ;' . ,
h EFFICIENCY FOR RADIUM 226: 1,700 counts per min.
'. per MR/Hr.
.N CUENCH: Halogen, j'
,.
1 / MoOEL 44.s -.
,TH6N WALL GEIGER-MUELLER PROSE
..'. i.
-
'sW WINDOW: 1.4 to 2.0 mg/cm' mica.
J g et.a tj' ' ~-r>- WINDOW DIAMETER: 1-3/32" diameter.
,
WALL: 0.046 inches stainless steel, plus 0.062 aluminum *.
If ,., 'si 9 Q |; .. T'> '' holder. *
~. i MOU!4 TING: Aluminum holder.. ,
.J , m's . M. .: . . . ' . 2 DIMENSIONS: 1%" diameter by 5%" long.WEIGHT: 10 oz.
g~ Replaceabte GM tubeMODEL 44 7 . Removable protective wire screen.
| END WINDOW GEIGER-MUELLER PROSE,
'
. O .
i
| "'' I f. WINDOW 1.5 to 2 mg/cm8 mica,
i .
WINDOW DIAMETER: 1.75"MOUNTING: Aluminum holder, handle and window' '
:
i protector. ,
DIMENSIONS: 2%" wide,11" long 1.050" dia. Handle.'
WElGHT: 12 oz.'
_,-s'
/ '
,.
/ MODEL 44-9'
' PANCAME GElGER-MUELLER PROSE }-
,
|
'
The beta scintittator is similar in performance to a 1.5 mg/cm'endwindow G. M. detector with the added advantage of lower gamma
E_'b'N q hQs. Ofi, ftf_ _ _
7M' background and the ability to utillie disenmmation. Carbon 14'#M ,T - detection is possible with reasonable gamma rejection.WJ ,i pgN3U4 e.
DETECTOR: NE/102 plastic crystat,0 01 thick. (thinner. i L .* crystats on request)7 1-
k ;i b f ( ~ ' g,j*M ' WINDOW: $ mg/cm' aluminized mytar.* '
" EFFICIENCY; Function et discrimination setting.* ' - *DIMENSIONS: 6'4" fong by 2" diameter.WEIGHT: 12 02.
MODEL 44-1DETA SCINTILLATOR
.
Q *
LUDLUM MEASUREMENTS,INC. *
Telephone (915) 235 5494! $01 Oak Street * Sweetwater, Texas 79556 *
'"rnnted in u s ACONTROL f40. 7 9 2 9 3
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af. ;3 50 pa taut band. meter with a 3 inch (7.62 cm) scale length. l,.y;. p.
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s ., g ..'
7.< . '' y. .tJi i V. . .. .Q ,g.g.W, ENVIRO, NME, NTAL, EFFECTS 3 -|.% Temperature:. Operating temp 5rature. O' C to +55' C, Storage temperature, --55;..C to.,y. .c * -
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WgN!,t6$$CJemphrature dependence, less tha' -1: 0.4% of full scale per 'C'(with or withou$i " ,, ,
Ch:b.Ln ,
rfty.,*,9 'df41pt
M[46 .1(hy .erpe,l.ba.fterles)*k..'if f %h.Cdressu, tion,,w)tf(aA"enternal supply is piot recommended.,'.'..,,'t,f g n .] j,U t { , ,fi,. j . ',
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g .vy. .,.Tder.'djie.ailldpc.c, haag 6 0 .0034%/ft, of altitude. ." ' ret (Jnseale'd, air ion chismber. Pressurs' dependence of output approximately + .13% -.1,)M. f'."r
' ,A M.
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%.h I-knl@I'.[qMculate, %ticle | energy td penetrate |the.lon chamber'end window,,h;'i,thouty%{'.y, . ' ", * ' ,i.. ..
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dh? [h'kdI ;[' 6. h.l'* I '
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h' ' ;3 ,,ldlated beta particle energy to penetrate the chamber wall.' :.}\;[<. '% % 1,e.(]f5. Bel 8. j0.025 MeV ~ ' -- ,
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) a timd: 36 sec.' max'imum ; '.'"
N N5NfNhlekIIrabel$nts: 15 sec. maximum recovery tir'ne aft $,jwitching trorn zero tomRhi, , ., m.
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j g I NTRODUCTION"
I ''
* The Series 2590 Cutie Pie is a portable, ;onization chamber survey motor for ";
s C , measuring exposure rate or accumulated exposure from x and gamma radiation'
o
- V g');r@'y A, beta fadiation. Because of its excellent energy and angular response, the Cutio-
#Q .dsources.,, Thin chamber windows also allow relative measurements of, alpha,and3"
,, Q ft~
f Mt.bc.,,, w[ Pie type lnstrument has been almost a universal standard for radiation monitoring'for over two decades. The series 2590 instruments represent the most' advancedp' ' ' ' N Tand versatile versions available today. Applications include: measuring direct beam 'a
b-N, ;%.,.or.siray radiation from x-ray machines and particle accelerators,. decontamination. , ',
F
-;O %, .j;p./ procedures, radioisotope experiments, industrialradiography,and generalradiation ,''-
-.
F % , M'%;gg: ? v {, | 'MY. area surveys.N , ',# y6''
NMMD'ESCRIPTION AND USE FEATURES- ,
*. .
-! . ,o"
=
-n.t ?h,f. c n ,, +Three models of the 2590 Series are available. Each consists of a basic monitoring/ . <'
{, M t"& y$d%Mefuriit?{Model 2592) and one or both interchangeable ton chambers. The '2595 Cutie.p, '-
'
'
M M'k.1 ?,wPle consists of the basic monitoring unit and alow-rangelon chamber (Model2593)+ .-
w
k h. D.~
Jfor rate of-exposure measurements up to 1000 mR/h arid accumulated. exposure ,'
,,
' Q[|,Yq.go(monit,oring unit and a high range ion chember (Model 2594) for rate-of-exposure , x'y measurements up to 10mR in 3 linear ranges. The 2596 Cutie Pie includes 160 basic'
,
is 7 Nmeas'urements up to 1000 R/h and accumulated exposure measurements.up to 10R-
'k_ ]^ ,2 V D'in $ linear ranges. The third model,2597 Cutie Pie, includes the basic' monitdring .
'
.'th ** 3 M QNunit and both interchangeable ion chambers as described above. .' *
~
'
-
'py A.'y ( . N A.Tf16 2590 Series Cutie Pie Survey Meters are entirely self-contained and are'sd '
, , . ,-_ ~ . . . < -
-
'g b j.O $ . , p".designed that a proper balance for hand-held operation is obtained. in addition, two ."M
,'
>,
r g " fofdmg fe'gs''at the front of the instrument provide support on a level surface. Thd%h j ',-[ %' , chambers can be remoted from the monitoring unit by an optional extension ' rod
* '
E '/ .;pp N , (Model 2598) or a flexible cable (Model 2599). All frequently used controls are con +.' r -,r
' veniently located on the top of the basic monitoring unit so that rapid switching ofE 3eF 4, .M.t,& %%Il operating modes including the rate-of-exposure and accumulated-exposure "
.
i p$ WV[Q d , ;,mqdes,ls possible, even with remote chamber operation.~ '
-
kb TICHNI' CAL SPECIFICATIONS 7~ '
bhM .
N > N.E.( bESIGNATIONS I . < . 'ai('
y -
,e t .( po gg t Q F'.,*.IModel 2592: Das;c monitoring unit; requires either Model 2593 or 2594 lon chamber,
'4
y*.. +9.
r s %, * . . . .f.or operation. . .,+ . . . ,-= . . , ", ,, .
. . ,j..- u
e . ,. 7 Model 2593: Low Range ion chamber; requires Model 2592 monitoring ' unit for ,'
i-
I h. ' '7,, Wh. '# 2 '.' operation.'
' '' '
%g h. - Model 2594: Hi Range ion chamber! requires Model,'2592 monitoring un t 'fo'
o.,. ,
,
gid (Yyf j/u r
h,,f., A . d :'t %|) operatiori.M4 del 2595: Low Range Survey Meter; consists of Model 2592 and 14odel 2593.-
,
M j) J M k \ v,. b ' , Measures exposuro rates to 1000 mR/h r<
; . Mo^ del 2596: Hi Range Survey Meter; consists of Modal 2592 ardi hiodel'2594.4,_ Q # Gq' Easures exposure rates to 1000 R/h ''). ' y , [ ,';.)
>s
---
M@-{[% j h|,,$$y"4 E,.
i
M del 2597: Multi-Range Survey Meter; consists of Model 2592, Mod,el 2593, ande'
9 < ,:
, .E;/ p,gf .y i',%.? D jJAodel,2594. (Operates es a Model 2595 cr 2596 depending on lon chamber used)'' f,
ggi 'Model 2598: Rigid Extension Arm (6 feet) '" ',p,
.- . E Av #r me' '
.*6 ' Mode Flexibfe Cable (10 feet) ' ' .
h f;TNkh'hNN !huse.l 2599:*
% eme p.4. 1;h,3 j ;,
#. -
,
? h[g%f. yi +, ,
' ,'' ''s,
f'4 ' c ESTERNAL CONTROLS.\.,'.JA;(General Specifications applicable to all units'6-
. , ,
I( [,,I '
'Jc i-
hh' /'d.M .M.,h '' Range: Five position rotary switch-OFF, DAT, XI, Xt0, Xt00'4f '
h 'a[m[e.,tb * -Mode: Three position rotary switchmR, Zoro, mR/he
I Zero Control: One turn potentiomoter, . .-
. .,, W 4', s. . .
y - }' f,)i t , ''.%,, W'. , ' .' |.% |, .* ' . ' & '-
Ey 4M.W , ,,
y. im:=-g
- _ _ _ _ - - _ _ _ _ _ _ .
.
9WAppfNDIX D-
CALIBRATION OF INSTRUMENTS
| kbl
METHODS FOR CALIBR ATION OF (X- AND G AMMA. RAY) SURVE) METERS,INCLUDING PROCEDURES. STANDARDS, AND FREQUENCY
|,
j
A. Calibration of survey meters shall be perforrned with wier, a cautionary note that they have not been checkedradionuclide sources, should be placed on the instrument.
,
I
I. The sources shall be approximate point sources. B. A reference check source of long half-Isfe, e.g.. Cn 137or Ra D and E, shall also be read at the time of the above
2. The source activities or exposure rates at given calibration or as soon as the instrument is receiveddistances shall be traceable bydocumented mea- from a calibration laboratory. The readings shall heaartments to a standard source certified within taken with the check source placed in specific geometry5 percent accuracy to the U.S. National Bureau relative to the detector. A reading of this reference
1 of Standards (NBS) calibrations. check source should be taken:
; 3. The frequency shall be at least annually and after 1. Before each use and also after each survey to en-'
servicing. sure that the instrument was operational duringthe survey,
, 4. Each scale of the instrument shall be calibratedat least at two points located at appronimately 2. After each maintenance and/or battery change.
| I/3 and 2/3 of full scale.'
3. At least quarterly,i 5. The exposure rate measured by the instrument
shall differ from the true exposure rate by less if any reading with the same geometry is notthan 10 percent at the two points on each scale within 120 percent of the reading measured(read appropriate section of the instrument immediately after calibration, the instrumentmanual to determine how to make necessary should be recalibrated (see item A).adjustments to bring instrument into calibra-tion). Readings within 120 percent will be con- C. The instrument must be calibrated at lower energies ifodered acceptable if a calibration chart, graph, its response is energy dependent and if the instrument isor response factor is prepared, attached to the to be used forquantitative measurementsin the Xe 133instrument, and used to interpret meter readings or Tc 99m energy ranges.to within 10 percent for radiation protectionpurposes. The calibration may be done either:
Note: 1. As in item A above with calibrated standards ofradionuclides at or near the desired energies of
Sources of Co 137, Ra 226, or Co dO* are appropriatefor use in calibrations. Since these sources emit rather 2. As a relative intercomparison with en energy-high energy photons. they are not suitable for low- independent instrument and uncelibrated radio-energy calibrations that may be required under special nuclides.
j circumstances (see item C below). The activity of theenlibration standard should be sufficient to calibrete Alternatively, the manufacturer's energy response'
die survey meters on each scale to be used for radia. curve (s) may be used to correct instrument readingtsoon protection purposes. Scales up to 1 R/hr should appropriately when lemerwegy radiation is monitored.he calibrated. but higher ranse scales above i R/br noednot be calibrated when they wel n.t be needed for D. Records of the above items A,5 2. B 3, and C must heradiation protection marveys. If there are higher ranges, maintained.they should at least be checked for operation andapproximately correct response to rediation. Other. E. Use of Inverse Square Law and Itadioactive Decay Law
*
teinemem setevouse er erpma esseems ese as no or Ca 131 3. A calibrated source will have a calibration certifi-no code,and sa n o asa ten arve se some too mR/hr ,,,, ,g,g,,gg, ,,,,,,,, ,,,, ,, , ,,,,,g,,,,,,,,
' " ''
WJrract no 7 9 2 9 21, - _ _ -
- _ _ -- _. . _ _ _ _ - - - _ - - _ - _ _ _- -. - -_-
.
or its utivity, measured on a specified date by wherethe manufacturer or NBS.
R, and Rt are in the same units (e.g.,s. The Inverse Square Osw mry he used withmR/ta or R/hr).any poinisource to calculats the exposure
rate at other distances. R, is exposure rate on the speci.fled calibration date,
b. The Radioactive Decay Law may be sed tocalaalate the esposure rates or source activi- R is esposure rate t units of timegties at times other than the cabbration date. later.
2. Inverse Square Law T and t are in the same units (years,gsnonths, days, etc.).
Omeider a" point ** source of radiation at posithn3, as shown in Figure D l. Then, tie relationAip T is radionuclide half Ufe.gbetween esposure rates R and R et deterforpositloes P, and P ,which,are at distancesD, and
3
3 t is number of units of timeD I'*" I* respectively. is given by the following elapsed between calibretfor,2equation:
and present time.
R= 8xR'3 D 8
3 4. Example: Source output is given by calibrationcertificate as 100 mR/hr at I foot on March 10,
where R, and R are exposure rates in the same 1975. Radionuclide half-life is 127 years.anits (e.g., mR/hr, R/hr), and D and D are thedistanas in Figure D 1 in the s,ome units (e.g., Ouestfoa: What is the output at 3 feet on
3
m, em, f t). March 10.1977 (2.0 years)*
_I P P1 2-
''
ou put at I toor,2.0 years aftercalibration_ a.
date :D -- -2
3,
_
D (0.693 s 2.0) '-
2 R = 100 mR/hr a e' 5.31
Fip ro D 1 " 300 x 0 77 " 77,mR/hr atI foot on March 10,1977.
3. Radioactive Decay Lawb. Output at 3 feet,2.0 years after calibration
flate :Esposure rate t units of time after specified cali-bretion date 3
R feet =R, = R m e [[gx tl 3 x 77 mR/hr-
(3 feet)8o'
"II *
s" eaurce who the source ' t 77 = 8.6 mR/hr atA eserce seer be come6deved a p"ENN EE CEe desseYeYunacEE7enYo sie s! '
| dessener showed se es dueseems D, or D as sho== en Facute D.s.3 feet 2.0 years afterd . r
2 calibration.
.
O10.g24
- __ . - _ _ .
_ _ . . _.
.
,
*
CALISRATION OF SURVEY INSTRUtdENTS
Check appropriate items.'
1. Survey instruments wSI be caubreted at least annually and fouowing repai!. i,
2. Calibration wel be performed at two points on each scale vasd for radiation protection purpassa, i.e., at least upto | R/tr. |
The two pc4sts wSI be appiosimetely 1/3 and 2/3 of full scale. A survey instrument may be considered properlyenlibrated when the lastrument readings are within i10 percent of the calculated or known values for each pointshocked. Readings within 120 percent are considered acceptable if a calibration chart, graph, or response factoris prepared, attached to the instrument, and used to interpret readings to within 110 percent. Also, when higherscales ase not checked or calibrated, an appropriate precautionary note will be posted on the lastrument.
3. Survey instruments wSI be calibrated
a. By the manufacturst
b. At the licensee's facGity
(1) Calibration source !
Manufacturer's nameModel no.
___
j Activity in millicunesor
Exposure rate at a specified distanteAccuracy;
Traceabuity to primary standard
(2) The calibration procedures in Section I of Appendia D wGI be usedOr,
| (3) The step-by step procedures, including radiation safety procedures. are attached.
X c. By a consultant or outside firm
(t) Name CTAN HURFR CON CITT .T A NT9
(2) Location NEW LENOX, ILLINOIS 60451
i (3) Procedures and sources
have been approved by NRC and are on file in License No.i
have been approved by an Agreement Statete copy of the Agreement State license, theprocedures. and a description of the sources are attached, and the coneeltant's report wulcontain the information on
the attached " Certificate of instrument Calibration.".
the consultant's reporting form as attached.
are described in the attachenent, and the consultant's report wGI cantain the information on
the attached " Certificate of lastrument Calibration."the consultant's reporting form as attached.
O!
10.8 25
.-. _ . . - . _ . _ , _. _ _ . _ . . _ . . _ _ _ , _ _ , ,____ _ __ _ , _
. - _ _ _ - ____
,
CERTIFICATE OF INSTRUMENT CALIBRATION
For:
.
Instmment:
Manufacturer
Type
Model No.
Serial No.
Calibration Data:
Exposure Instrument Exposure Instrument Exposure Instrumentrate reading rate reading rate reading
Scale (mR/hr) (mR/hr) (mR/hr) (mR/hr) (mR/hr) (mR/hr)
.
O
_
Comments:
Activityor Calibration
Nuehde Exposure Rate at Specified Distance Accursey
Calibration Source:
Calibrated by Date -
|1
-
10.8-26
1-
I
Aassy Time *(br) Correction Factor as in st p I. (Follow good radiation safety prac-tices to avoid contamination and to minimize
0 31.633 r_adistion saposure.)6 15.853
j 24 1.995 3. Select one volume as a standard (such as the p30 I volume of reference standard usedin performing a48 0.126 the test for instrument accuracy),and calculate
the ratio of measured actrvities for each volumeEJungpie If the net activity measured at 30 hours to the seImace volume activity. This representswas 15.625 mci, the calculated activities for 6 and the volume correction factor (CF).48 hours would be 15.625 mci a 15.853 = 247.7
~
mci and 15.625 mci x 0.126 = 1.97 mci,respec- Semple: If activities of 2.04, 2.02, and 2.00 mcitively. are measured for 4,8 and 10 mi volumes and
10 ml is the reference volume selected..
4. On log-lag coordinate paper, plot the measuredmet activity (for each time interval) versus the 2.00calculated activity (for the same time interval). 4 ml Volume CF = g = 0.98
1
5. The activities plottad should be within15 pereentof the calculated activity if the instrument is 4. Plot the correction factors assinst the volume onlinear and functioning properly. Errors greater linear graph paper. Use this graph to select thethan 15 percent indicate the need for repair or proper volume correction factors for routine
;adjustnient of the instrument. assay of that radionuclide.
|t
6. Ifinstrunnent hnearity carmot he corrected,it will 5. The true activity of a sample is calculated as{be necessary in routine assays to use either(s)an follows: '
aliquot of the sluate that can be accurately mes-sured or (b) the graph constructed in step 4 to True Activity = Measured Activity aselate measured activities to calculated activities. Correction Factor
F. Test for Geometrical Variation where the correction factor used is for the same !
volume and prometrical configuration as theThere may be significant geometrical variation in activi- sample measured.;
ty measured as a function of sample volume or configu.ration, depending on the volume and size of the ioniza- 6. E-larly, the same activity of Co 57 in a syringe
| tion chamber used in the dose calibrator. The extent may be compared with that of 10 mlin a 30 ce' of geometrical variation should be ascertained for viel, and a correction factor asay be calculated.
commonly used radionuclides and appropriate correc-tion factors computed if variations are significant, Le., 7. It should be noted that differences of E0 percentgreater than 12 percent. (Even though correction fac- in dose calibrator readings between glass andtors may be provuled by the manufacturer, the accu- plastic syringes have been observed for lower-racy of these should be checked.)When available from energy redsonucEdes such as 1-125, which shouldthe manufacturer, certified data on geometrical varia- he assayed in a does calibrator only if the relia-tions may be used in lieu of these meanarements. bility of such an assey can be established. Glass
. tubes and syringes may also vary enough in thick.To means variation with volusse Wliquid, a 30.cc mess to cause significant errors in assaying I-125.vial containing 2 mci of Co 57 or other appropnate Hence, adequate correction factors must beradionuclide in a vcAume of I al will be used. establ. sited.
i
1. Assey vial at the appropriate instrument setting. An alternative to providing syringe calibration;'and subtract background level to obtain met factors is to simply assey the stock vial beforeactivity. and after filling the syringe. The activity in the
syringe is then the difference in the two readings2. Increase the volunie of liquid in the vial in steps (with a wohrase correction if significant).-
to 2,4,8,10,20, and 25 ml by adding the appro-priate amount of water or saline. After each addi- G. Test forInstrument Accuracytion, gently shake viel to mia contents and ammy
Check the acessrecy of the dose calibrator foe severalradionuclides, including Co 137, 0o 57, and Ba 133,, ,,,,
sessee se emed he messe es se utete homes and eersecuan using appropriate reference standards whose activities
sesseehas Y etE a m Yemne Di dYM*ns have been calibrated by comparisons with standard"use un earreeseen seceers. , A sources that have been assayed by NBS and docionented.
10.8 28
. - - . _ _____ __ . _ _ _ _ _ _ .. _ _. _ _ _ .. _ _ _ _ _ _ . .. _ _ _ _ ..
-____ _ - _ - . _ - .
.
APPENDIX D (Continued) '*
OSection 2
METHODS FOR CALIBR ATION OF DOSE CALIBRATOR *
.
All radiopharmaceuticals must be amayed for activity to 3. Calculate net actMty of each source subtractingan accuracy of 10 percent. The most common instrument for out background levetaccosephalung this is an ionization-type dose calibrator. Theinstrwnent nest be checked for accurate operation at the timeof installation and penodically thereafter. 4. For each source, plot net activity versus the day
of the year on semilog graph paper.A. Test for the fo8owing:
5. Los the background leveis.I. Instrument constancy (daHy)
2. Instrument accuracy (at installation and annually 6. Indicate the predicted activity of each sourcethereafter) based on decay calculations and the 15 percent
limits on the graph.3. Instrument lineanty (at installation and quarterly
thereafter)7. Itepeat the procedure used for the Cs 137 source
4 Geometncal variation (at installation) for all the commonly used radionuclide settings.
B. After repair or adjustment of the dose calibrator, repeat 8. Variations greater than 15 percent from the pre-all the appropriate tests listed above (dependent upon dicted actMty indicate the need for instrumentthe nature of the repairs). repair or adjustment.
C. Test for lastrument Coastancy 9. Investigate higher than normal background levelsto determine their origin and to eliminate them
Austrument coassency uneens that there is reproduci- if possible by decontamination, relocation,etc.bility, within a stated acceptable degree of precision,in measuring a constant actMty over time. Assay atleast one relatively long-trved reference sorce such as D. Inspect the instrument on a quarterly basis to ascertainCh 137, Co 57," or Ra-226" using a reproducible that the measurement chamber liner is in place andgeometry before each day's use of the instrument. that instrument zerois property set (see manufacturer'sPreferably, at least two reference sources (foresample, instructions).3-5 asCI of Co 57 and 100 200 pCl of Co 137 or I-2sus Ra 226 (with appropriate decay corrections) willbe alternated each day of use to test the instrumer,t's E. Test of lastrument Linearityperformance over a range of photon energies andsource activities. The Imearity of a dose calibrator should be ascertained
over the entire range of activities employed. This test1. Assey each reference source using the appropriate will use a vialof Tc 99m whose activityis equivalent to
instrument setting (i.e., Co 137 setting lor Ca 137). the maximum anticipated activity to be asasyed (e.g.,the first slution from a new generator).
2. Measure hackground level at same instnanent set-ting, or check that aut -matic background sub- 1. Assay the Tc 99m vial in the dose calibrator. andtraction is operating property when blanks arc subtract background lovsl to obtain net activityinserted in the calibrator. In millicuries.
*2. Repeat step I at time intervals of 6,24,30, andma m e,,,c,, ,,, ,, ,,
temasseine Chamares ter me Amor of "d---eness"_(Ameetcee 48 hours after the initial assay,emma 3 enderes leasthee, Inc.,3430 areedsey, peew Tera, M.V.essial.
3. thing the 314our activity measurement as a start-"co s? and as.zas are een endset se satc messeses; me respeceive las point, calculate the predicted activities at O.ames shamed emmened se answeses se sogeme== re'
6, 24, and 48 hours using the following table:
10.827
. . ,- - . , . _ . _ ._, . _ _ _ _ _ _ .
.
.
.
The activity levela of the reference sources used should d. Repeat the above steps for other commonly usedapprosimate thcee levels normally encountered in clin- radionuclides for which adequate reference starul-ical use (e.g., Co 57,3-5 millicuries) giving adequete ards are available.attention to source configuration. Identify in your
O application the three sources that you will use. State S. Keep a log of these calibration checks.anclide, activity, and calibration accuracy. The lower-energy aference standards (Tc 99m, Xe 133, l-125) 6. Calibration checks,that do not agree withinmust he in vials with the same thickness of glass as the 1,5 percent indicate that the instrument shouldactualsamples to be measured for best accuracy. be npaired or adjusted. If this is not possible, a
calibration factae should be calculated for use i
during routine asseya of radionuclides.|1. Assay the reference standard in the dose calibra-|tot at the appropnate setting. and subtract the 7. At the asme time the instrument is beinginitially|background level to obtain the net activity, calibrated at the ticensee's facility with the refer- i
ence standards, place a longlived source in the {calibrator, set the instrument, in turn, at the vari-
2. Repeat step 1 fora otalof 3 determinations,and ous radionuclide settings used (Co 137,1131,average results. Tc-99m,1-125, etc.), and record the readings.
These values may later be used to check instru-ment calibration at each setting (after correcting
3. The average activity determined in step 2 should for decay of the long-lived source) without re-agree with the certified activity of the reference quiring more reference standards. Keep a log ofsource within + 5 percent after decay corrections. these initial and subsequ nt readings.
.
O
.
1
0:
10.5 29
f$iNTROLNO. 7 9 2 9 2. _ . . - - - . - . - - . . - . _ - - -
CALIBRATION OF DOSE CALIBRATOR
A. Sources Used for 1.incarity Test
(Check sa appropriate).
First clution from new Mo 99/Tc-99m senerator
or
Other* Ispecify)
3. Sources Used for lastrument Accuracy and Constancy Tests
SussestedRadionuclide Activity (mci) Activity (mci) Accuracy
Co-57 35*
Be-133 0.1-0.5
Cs-137 0.1-0.2
Ra-226 1-2
OC. The procedures described in Section 2 of Appendix D will be used for calibration of the dose calibrator
or
.. . Equivalent procedures are attached.
'For licensees who are not authorised for Wu 99/Tc 99m generators. ectivity must he equivalent to the highest settvity used.
.
O
10430.
-- - -,
.
APPENDIX F
PROCEDURES FOR SAFELY OPENING PACKAGESCONTAINING RADIOACTIVE RAATERIAL
I. Special requirvaseats wEl be foBowed for packages con- (2) Open inner package and verify thet con-tassing quantities of rodeosctive material in saceas of tents agree with those on pecking slip.es Type A quantity limits as specified in paragraphs Compare requisition.' pecking slip, and2L235(aXI) and (c)(1) of IOCFR Part 2)(more than label on bottle.20 Ci for Mo 99 and Tc 99as). They will be moonitoredfor surface coetamination and enternal radiation levels (3) Check integrity of final source containerwithin 3 hours after receipt if received during working (Le., inspect for breakage of seals or vials,hours or within 18 hours if received after working loss of liquid, and discoloration of pack-hours, in accordance with the requirements of para- aging material).ymphs 2L2kS(a) through (c). AI shipments of liquidsgreater than esempt quantities wSI be tested for leak- (4) Check also that shipment does not exceedage.The ISC Responal Ofrace will be notified in accord- & limita.ance with the regulations if removable contamination
8emesses 0.01 pCi/100 can or if external radiationlevels exceed II)meR/hr at the package morface or f. Wipe external surface of final source container30 mR/kr at 3 feet (or I m). and remove wipe to low background area. Amay
the wipe and record amount of removable radio-2. For as packages, the fonowing additional procedures activity (e.g., pCi/100 cm', etc.). Check wipes
for opening packages wEl be carried out; with a thin <nd-window G-M survey meter, andtake precautions against the spread of contamina-
a. put on gloves to prevent head contasmination. tion as necessary.
h. VimaaDy inspect package for any sign of damage
O (e.g., wetnem, crushed). If damage is noted, stop g. Monitor the packing material and packages forprocedure and notify Radiation Safety Officer. contamination before discarding.
c. Measure expoeste raes at 3 feet (or I m) from (I) If contaminated, treat as radioestive waste.package surface and record. If >10 mR/hr, stopprocedure and actify Radiation Safety Officer. (2) If not contaminated, obliterate radiation
labels before discarding in regular trash.d. Measure surface exposure rate and record. If
>2I)adt/hr stop procedure and notify RadiationSafety Officer. 3. Maintain records of the results of checking each sockage,
assing " Radioactive Shipment Receipt Record"(see nexte. Open the package with the following precau- page) or a form containing the same information.
toomary steps;
(1) Open the outer package (fouowing manu-facturer's directions, if supplied) and *
g, ,,, ,,,, ,, . g, %,, g, m ,,remove pecking slip. week physkM nen mgpest.
O ;
10.5 33
- .-. . . . _ . _- . - - . _ - , , _ .
- _ _ _ __ -
.
RADIOACTIVE SHIPT 4ENT RECEIPT REPORT
1. P.O. No.: Survey Dete Time
Surveyor
2. CT)NDITION OF PACKACE :'
O.K. Punctured Status Wet
Crushed Other
3. RADIATION UNITS OF LABEL: Units (mR/hr)
4. MEASURED RADIATION LEVELS :
a. Package surface mR/hr
b. 3 feet or I meter from surface mR/hr
5. DO PACKING SLIP AND VIAL CONTENTS AGREE?
a. Radionudide yes no, difference
b. Amount yes no. difference
c. Chem Form yes no, difference
6. WIPE RESULTS FROM:
a. Outer CPM = DPM
eff = ( )
b. Final source container CPM = nPM
eff = ( )
3. SURVEY RESULTS OF PACKING M ATERIAL AND CARTONS mR/hr, CPM
9. DISPOSITION OF PACKAGE AFTER INSPECTION
10. IF NRC/ CARRIER NOTIFICATION REQUIRED,GIVE TIME, DATE. AND PERSONS NOTIFIED.
Signature Date
.
O
10.834
_ - _ _ _ _ _ _ _ _ _ _ _ - - -
.
.
ApFENDIX G
O GENERAL RULES FOR SAFE USE OF RADIOACTIVE ARATERIAL
1. Wear laboratory coats or other protective clothing at ity vs. the order written by the physician who willau times in areas where radioactive materials are used. perform the procedure.
2. Wear disposable gloves at aD times while handling 7. Wear personnel monitoring devices (Tdm hedge or TLD)radioactive materials. at all times while in areas where radioactive materials
are used or stored. These devices should be worn at3. Monitor hands and clothing for contamination after chest or waist level Personnel monitoring devices when
sech procedure or before leaving the area. not being worn to monitor occupational esposuresshould be stored in a designated low hackground area.
4. Always use syringe shields for routine preparation ofpatient doses and administration to patients,enceptin S. Wear TLD finger badges during elution of generalor andcircumstances such as pedistric cases when their use preparation, essay, and injection of radiopharmaceuti-would compromise the patient's well-being. In these cols.exceptional cases, use other protective methods suchas remote dehvery of the due (e.g., through use of a 9. Dispose of radioactive meste only in specially designatedbutterfly valve). and properly shielded receptacles.
5. a. Do not est, drink, smoke, or apply cosmetics in any 10. Never pipette by mouth,area where radioactive material is stored or uord.
II. Survey generator, kit preparation, and irsection areasb. Do not store food, drink, or personal effects with for contamination after each procedure or at the end
radioactive matenal. of the day. Decontaminate if necessary.
6. a. Assay each patient done in the donc catiorator prior 12. Confine radioactive solutions in covered containers~
O- to administration. Do not use any doses that differ plainly identified and labeled with name of compound.from the prescribed dose by more than 10 percent. radionuclide, date, activity, and radiation level, if
applicable.
b. For therapeutic doses, also check the patient's name, 13. Always transport radioactive matcrial in shieldedthe radionuclide, the chemical form, and the activ- containers
|
|
|
|.
1O.
i
10.8 35
i
_ _ _ _ _ _ _ _ . - , , . . - . . - - -- - - - - . - , - , - -----r-w-- *~~ 'm------v ' ' ~
.
APPENDIX H
EMERGENCY PROCEDURES
Minor Spels 3. SHIELD THE SOURCE:If poamible, the spill shouldbe shielded, but only if it can be done without further
1. NOTIFY: Notify persons an the area that a spill has contamination or without significantly increasingoccurred. your radiation exposure.
2. PREVENT TH E SPRE AD : Cover the spill with absorb. 4 CLOSE THE ROOM: Leave the room and lock thesat paper. door (s) to prevent entry.
|3. CLEAN UP: Use disposable gloves and remote handling 5. CALL FOR HELP: Notify the Radiation Safety Offhtongs. Carefully fold the absorbent paper and pad. In- cet immediately.sert into a plastic bag and dispose of in the radioactiveweste container. Also insert ine the plastic bag n!! ather 6. PERSONNEL DECONTAMINATION: Contaminatedcontaminated materials such as disposable gloves. clothing should he removed and stored for further evalu-
stion by the Radiation Safety Officer. If the spillis on4 SURVEY: With s low-range, thin-wmdow G-M survey the skin, flush thoroughly and then wash with mild
meter, check the area around the spill, hands and soap and lukewarm water.clothing for contamination.
RADIATION SAFETY OFFICER: *
5. REPORT: Report incident to the Radiation Safety OFFICE PHONE:Officer. HOME PHONE:
Major Spills ALTERNATE NAMES AND TELEPHONE NUMBERSDESIGNATED BY RADIATION SAFETY OFFICER:
1. CLEAR THE AREA: Notify all persons not involvedin the spill to vacate the room.
2. PREVENT THE SPRE AD: Cover the spill with absorb-ent pads, but do not attempt to clean it up. Confine ,
the movement of all personnel potentia!!y contami- , g*Pg@jfg,**ag Four facGhy altou sup
nated to prevent the spread. wusi tese oppucathm.
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CONTROL NO. 7 9 2 9 2 I~
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AltEA RHIVEY PROCEDURES
1. AB elution, pseparation, and isdection areas wSt be 5. A perinanent record wSI be kept of all survey results,serveyed de0y with an appropriately lowgence marvey tecluding negative results. The record wn! include:meter and decontaminated if necessary.*
a. Location, date, and identification of equipment2. Laboratory areas where only annaR quantities of redio- used, including the serial number and pertinent
active material are used (less than 3D AsC1) wSI be sounting efficiencies.serveyed snonthly.
h. Nanne of person conducting the survey.3. Weste storage areas and all other laborotory areas wGl
be wrveyed weekly. c. Drawing of area surveyed. identifying relevantfeatures such as active storage areas, active waste
4. The weekly ahd monthly serveys will cosast of: areas,etc.
d. Measured esposure retea, kend to location on thea. A measuresnent of radiation levels with a survey drawing (point out rates that require corrective
meter afficitatly sensitive to detect 0.1 mR/hr. actson).
b. A series of wipe tests to mensmo contamination e. Detected containimation levels, keyed to loca-levels. The method for perfornsing wipe tests will tions os drawing.be afficiently sensitive to detect 200 dpm per
a151 cm for the contaminent involved. Wipes of f. Corrective action taken in the case of contamine-elution and preparation areas or other "high tion or excessive esposure rates, reduced con.background" areas wRl be removed to a low back- tamination levels or esposure rates after correc-ground area for measurennent. tive action, and any appropriate comments,
enwI:nedEstnSiNoaOpen"e"n he"e=an"s E N,$ $ 6. Area wSI be cleap if the contamination level escoeds~
semy ressem =es se meeerd. 200 dpm/100 cm .
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APPENOlX J,
WASTE DISPOSAL
Note : In view of the recent problems with shallow land burial sites used by commercial waste disposalfirms, NRC is encouraging its licensecs to reduce the volume of wastes sent to these facilities.Important steps in volume reduction are to segregate radioactive from nonradioactive waste, tohold short-lived radioactive waste for decay in storage, and to release certain materials in thesanitary newer in accordance with { 20.303 of 10 CFR Part 20.
1. Liquid waste will be disposed of(check as appropriate) Disposed of by commercial waste disposal serv-ice (see also item 4 below).
X . In the sanitary sewer system in accordance with
520.303 of 10 CFR Part 20. Other(specify):
By commercial waste disposal service (see alsoitem 4 below).
3. Other solid waste will be (check as appropriate)Other (specify):
X lleid for decay * until radiation levels, as men-sured in a low background area with a low levelsurvey meter and with all shielding removed, have
2. Mo-99/Tc 99m generators will be(check as appropriate) reached background levels. All radiation labelswill be removed or obliterated. and the waste
Y Returned to the manufacturer for disposal, will be disposed of in normal trash.
_ _. Ileid for decay * until radiation levels, as mea- Disposed of by commercial waste dispoesi serv-O sured in a low b.ckground area with a low-level ice (see also item 4 below).survey meter and with all shielding removed, havereached background levels.- All radiation labels Other (specify):will he senemved or obliterated, and the generatorswill be disposed of as normal trash.**
4 The commercial waste disposal service used will be,
Be sere that weste esees were esecstbed in Isem 81 andshot ther ese sorwred pTre6enyis== 37h Nuclear Engineering**
Thsee armatoesse ener eenteen ines46ved red 6ainotepic conteng. (Narne) (City. State)nants. Thesefere, she gemeensat retumes wlIl be ergeogated so that
me snandested esperately to ensure decay to hockground,
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10.8-41
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APPLICATION FOR MATERIALS LICENSE-MEDICAL
{; 1. Hospitals to be served with nuclear medicine:
RUSK COUNTY MEMORIAL HOSPITAL AND NURSING HOME900 College Avenue WestLadysmith, Wisconsin 54848
BLOOMER COMMUNITY HOSPITAL1501 Thompson StreetBloomer, Wisc.
TRI-COUNTY MEMORIAL HOSPITAL AND NURSING HOMEWhitehall, Wisc,
VICTORY MEMORIAL HOSPITAL230 East Fourth Ave.Stanley, Wisc,
CHIPPEWA VALLEY HOSPITAL AND NURSING HOME111 Oakwood DriveDurand, Wisc.
OSSEO AREA MUNICIPAL HOSPITAL AND NURSING HOME674 Eighth StreetOsseo, Wisc.
BUFFALO MEDICAL CENTERf3V Mondovi, Wisc
MEMORIAL HOSPITAL AND NURSING HOME216 Sunset placeNeillsville, Wisc.
MYRTLE WERTH MEDICAL CENTER2321 Stout RoadMenomonie, Wisc.
COMPUTERIZED MEDICAL IMAGING OFFICE2010 Esmond RoadEau Claire, Wisc
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([oNTROL NO. 7 9 0 9 2-
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,
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g4 RUSK COUNTY MEMORIAL! HOSPITAL AND NURSING HOME~
s a
.dS m' ~j 900 College AvenueWest Ladysmith, Wisconsin 54848
[- ,n g]Q7_ L Phone 715/532-5561
_s-
h Len Meysembourg, Administrator*
May 3, 1985
Mr. Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, WI 54701
Dear Mr. Stangl:.
This letter will serve as Rusk County Memorial Hospitaland Nursing Home's letter of intent to contract formobile nuclear services with Computerized MedicalImaging, Inc. The Medical staff within our systemis interested in these services being provided by CMI.
We are also in support of the amendment byComputerized Medical Imaging for the necessary licensurefrom the Nuclear Regulatory Commission. We hope thisamendment could be secured as soon as possible.
Sinjerely,
Jn Meysembourg
Administrator
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t Mr. Bill Stangl! Computerized Medical Imaging,
2010 Esmond Road; Eau Claire, W1 54701
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Dear Mr. Stangl:i
; This letter will serve as letter of ;; intent to contract for mobile nuclear.se(vices with
Computerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services beingprovided by CMI. ;
We are also in support of.the amendment by Computerized;
Medical Imaging for the neccessary licensure from the1
; Nuclear Regulatory Commission. We hope this amendmentcould be secured as soon as possible.
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Sincerely.yours,,
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OMay , 1985
Mr. Bill StanglComputerized Medical Imaging,
; 2010 Esmond RoadEau Claire, WI 54701'
i
! Dear Mr. Stangl:
,Tri County MemorialHospital, Inc.
This letter will serve as Whitehall, WI 54773etter ofintent to contract for mobile nuclear services withComputerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services being
; provided by CMI.
O We are also in support of the amendment by ComputerizedMedical Imaging for the neccessary licensure from the '
Nuclear Regulatory Commission. We hope this amendmentcould be secured as soon as possible.
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OMay , 1985
Mr. Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, WI 54701
Dear Mr. Stangl:
This letter will serve asVictory Memorial's letter ofintent to contract for mobile nuclear services withComputerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services beingprovided by CMI.
We are also in support of the amendment by ComputerizedO(_j Medical Imaging for the neccessary licensure from the .
Nuclear Regulatory Commission. We hope this amendmentcould be secured as soon as possible.
,
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Sincerely yours,,
|
ft|Aahk'Ytwxk'AdministVator !
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OMay , 1985
Mr. Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, WI 54701
Dear Mr. Stangl:
.
This letter will serve as W' *11 letter of,
intent to contract for mobile nuclear services withComputerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services beingprovided by CMI.
We are also in support of the amendment by ComputerizedO. Medical Imaging for the neccessary licensure from the,
Nuclear Regulatory Commission. We hope this amendment !+
could be secured as soon as possible, j
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Sincerely yours,/ '|'
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Administrator i!.
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: 'ba Osseo Area Municipal Hospitaland Nursing Homei ;
- 674 EIGHTH STREETOSSEO WISCONSIN 854758
(715)697 3121May 3, 1985
Mr. Bill StanglComputerized Medical ImagingEau Claire, WI. 54701
Dear Mr. Stangl:
This letter will serve as Osseo Area Municipal Hospitaland Nursing Home's letter of intent to contract for mobilenuclear services with Computerized Medical Imaging, Inc.The Medical staff within our facility is interested in theseservices being provided by CMI.
We are also in support of the amendment by ComputerizedMedical Imaging for the necessary licensure from the NuclearRegulatory Commission. We hope this amendment could besecured as soon as possible.
You very . },/
). [Richardb.Rau,CEO
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5%fnibt.no. 7 9 2 9 2L
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May , 1985
Mr. Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, WI 54701
Dear Mr. Stangl: j!1
This letter will serve as narraio seaical ctrletter of 3
intent to contract for mobile nuclear services with i
Computerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services beingprovided by CMI.
We are also in support of the amendment by ComputerizedO Medical Imaging for the neccessary licensure from the |
,
Nuclear Regulatory Commission. We hope this amendment jcould be secured as soon as possible. '
Sincerely yours,
Administrator,
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MEMORIAL HOSPITAL & HOME216 SUNSET PLACE
NEILLSVILLE, WISCONSIN 54456
(]715-743-3101
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NOSPliAt AND N0aps--
3 7
May 15, 1985
Mr. Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, W1. 54701
Dear Mr. Stang1:
This letter will serve as Memorial Hospital's letter of
intent to contract for mobile nuclear services withComputerized Medical Imaging, Inc. The Medical staffwithin our system is interested in these services beingprovided by CMI.
We are also in support of the amendment by ComputerizedMedical Imaging for the necessary licer,sure from theNuclear Regulatory Commission. We hope this amendmentcould be secured as soon as possible.
Sincerely yours,
-
GlenE. Grad [,Administrator
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T MYRTLE WERTH MEDICAL CENTERi 2321 Stout Road Menomonio. WI 54751715-235-5531
g\ QM()
May 15, 1985
Bill StanglComputerized Medical Imaging2010 Esmond RoadEau Claire, WI 54701
Dear Bill:
I received your letter dated May 3,1985. Because CMI and Sound ExpansionEnterprises have reached agreement to transrer SEE assets for nuclear medicineservices to CMI, I indicate herein our intent to contract with CMI for mobile
.
nuclear medicine services.!
Further, Myrtle Werth Medical Center is in support of the license applicationof CMI from the Nuclear Regulatory Commission. We would expect that servicewould not be impeded during this transfer process nor while awaiting NRCapproval of your application.
Sincerely,
MKThomas Miller IIIChief Executive Officer
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(O_) ITEM 4. Individual users (Name individuals who will use or super-vise the use of radioactive materials.)
NAME SPECIALITY
David N. Sattem,M.D. Diagnostic Radiology, NuclearMedicine
Bruce Kirkham, M.D. Diagnostic Radiology
J.H. Cupery, M.D. Diagnostic Radiology
K.P. Stein, M.D. Diagnostic Radiology
Steven Liegal,M.D. Diagnostic Radiology
Micheal Altman, M.D. Diagnostic Radiology
Leighton Mark, M.D. Diagnostic Radiology
Micheal Spak, M.D. Diagnostic Radiology
Vangalla Reddy, M.D. Diagnostic Radioogy
David Ellis, M.D. Diagnostic Radiology7s,
NUCLEAR MEDICINE TECHNOLOGISTS: ;,
* David Robinson, B.S. CNMT, Certified in Nuclear Medicine
* Dennis Wolf,R.T. CNMT Certified in Radiology and NuclearMedicine
* Resumes are included in this application -
INFORMATION FOR MATERIALS LICENSEn
ITEM 8. The drivers of the vehicles are the nuclear medienetechnologists. Both technologists are formally trainedand registered in their specialty.They will be advice in changes in NRC regulations,or changes in CMI license on a quartely basis at theradiation safety committee meetings.They will be familiar with items specified in 10 CFR 19.12as well as instructions for handling spills andother emergencies.
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| j RUSK COUNTY MEMORIAL 110 SPITAL AND NURSING 110ME| 900 College Avenue Westi Ladysmith, Wisconsin
llallway/4 -.-]. _ _ . _ _ _ _ . _
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Emergency Cast Room and RoomDesignated for Nuclear Imaging Emergency
NursesDesk
Hallway
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Bathroom Bathroom Waiting Room
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BLOOMER COMMUNITY HOSPITAL1501 Thompson StreetBloomer, Wisconsin
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Hallwayb,
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Emergency Room and RoomDesignated for Nuclear Imaging Office Radiology Exam Room
De>005.4
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Darkroom
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TRI-COUNTY MEMORIAL HOSPITAL AND NIIRSING HOMEWhitehall, Wisconsin
___ . Outside_ _.______.- _. _ _ _. ._.
Hospital Room Office and Room Designated Office -
for Nuclear Imaging;
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VICTORY MEMORIAL IIOSPITAL240 East Fourth AvenueStanley, Wisconsin
Resident Activity _ Center_ _
Waiting Area Emergency Room and RoomDesignated for Nuclear Imaging Radiology
Exam Room
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Hallway1
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CHIPPEWA VALLEY HOSPITAL AND NURSING HOME111 Oakwood Drive
_ _ Durand, Wisconsin _ . _ _ _ Laboratory _ ______ _
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Emergency Room and Room desingatedfor Nuclear Imaging
Hallway | ot
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OSSEO AREA MUNICIPAL 110 SPITAL AND NURSING 110ME674 Eighth StreetOsseo, Wisconsin
Outside_ _ __
BathroomPatient Room
Special Procedures Roomand Room designated forNuclear Imaging Outside'
Bathroom
Closet.s
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HallwayExit
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BUFFALO MEDICAL CENTERMondovi, Wisconsin
._. . _ .
Hallway_
N,
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Patient Room and Room i
Designated for Nuclear imaging!
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MEMORIAL HOSPITAL AND NURSING HOME216 Sunset PlaceNeillsville, Wisconsin
Surgery_ - .
NCbNGExam Room Emergency Room and Room
Designated for Nuclear Imaging Surgery b*
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MYRTLE WERTil MEDICAL CENTER2321 Stout RoadMenomonie, Wisconsin
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Emergency Room and Room !Designated for Nuclear Imaging | Exam Room
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COMPUTERIZED MEDICAL IMAGING OFFICE2010 Esmond RoadEau Claire, Wisconsin
OfficesI
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Examination Roomw t|o
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ITEM #6DAILY VAN SURVEY
COMPUTERIZED MEDICAL IMAGING.Monitor the following areas: Month of
,,
,4?-g A. Front o'f trocliu-! j B. Cab of truck Surveyed by:
C. Storage mr6a for Isotopes
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Survey results (cpm) Survey results (com)
Date A B C Date A B C
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Enract.NO. 7 9 2 9 2
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n(_/ Dave Robinson
Education
University of Wisconsin - Lacrosse August 1973 - May 1977
Hines VA Hospital -Nuclear Medicine Technology Internship July 1977 - June 1978
Degree Earned: B.S. Nuclear Medicine TechnologyMinor: Chemistry
Triton College - February 1978 - April 1978Evening class in diagnostic ultrasonography
Work Experience
St. Francis Medical Center Volunteer in Sept. 1976 - May 1977Lacrosse, WI Nuc. Med. Dept.
Gottlieb Hospital Part time Nov. 1978-April 1979- Melrose Park, IL Nuclear Medicine
St. Francis Medical Center Nuclear June 1979 - Feb 1981Lacrosse, WI Medicine Technologist
Gundersen Clinic Nuclear Medicine Feb 1981 - Feb 1984Lacrosse, WI and Ultrasound Technologist
Sound Expansion Enterprises Ultrasound Feb 1984 - Nov 1994Eau Claire, WI Technologist
Computerized Medical Imaging Ultrasound Nov 1984 - PresentEau Claire, WI Technologist
--
Professional Registrations:
American Society of Clinical PathologistsAmerican Registry of Radiological TechnologistsNuclear Medicine Technology Certification BoardAmerican Registry of Diagnostic Medical Sonographers
.
. . _ . _ _ . _ _ _ . . . _ . - _ _ _ _ . _ _ . . . _ . . _ . _ _ _ _ . _ _ _ _ _ _ . . _ _ _ _ _ . _ . = _ . . . . _ _ = _ _ _ . _ _ _ . _ _ . . _ - . . _ , _ ._
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! Professional Societiest
Society of Nuclear MedicineSociety of Nuclear Medicine Technologists i
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| Central Chapter - Society of Nuclear Medicine
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CURRICULUM VITAEi
() DENNIS B. WOLF MARCH 22, 1985
PRESENT ADDRESS Rt 1, Box 144JIM FALLS, WIS 54748
DATE OF BIRTH 1-20-1955
PLACE OF BIRTH Cloquet, Minnesota.
MARITAL STATUS Married, two children
EDUCATION 1968-1973 .
Carlton High SchoolCarlton, MinnesotaHigh School Diploma, 1973
1975-1977St. Lukes Hospital School ofRadiologic TechnologyDuluth, MinnesotaCertificate and ARRT RegisteredRadiologic Technologist
1977-1978
{^}/Penrose Hospital. School of Nuclear'
Medicine Technologys-
Colorado Springs, ColoradoCertificate and ARRT -NMTCB RegisteredNuclear Medicine Technologist
<
EMPLOYMENT July 1978 to October 1978Logan County HospitalN.E. Colorado Radiologists P.C.Sterling, Colorado, 80751Staff technologist in charge ofall in-vivo and in-vitro nuclearmedicine procedures
October 1978 to April 1979Memorial Hospital1400 East BoulderColorado Springs, Colorado 80907Staff technologist performingvarolus in-vivo and in-vitronuclear medicine prodedures.
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"4 f CURRICULUM VITAE (cantinued)-
~[T}. EMPLOYMENT dpril 1979 to July 1981(,)' Diagnostic Services Inc.
P.O. Box 27,
. _ Forest Lake, Minnesota 55025Technical Director of mobile imaginggroup that provided ultrasound and
- nuclear medicine imaging to approximately15 community hospitals.
!
Responsiblities included schedulingtechnologists, licensing and overseeingthe operation of the service,
,
; July 1981 to PresentSound Expansion Enterprises, Inc.-
2010 Esmond Road4
Eau Claire, Wisc. 54701Director of mobile nuclear medicineimaging. Implemented mobile serviceto 9 commiinity hospitals in theWest Central Wisconsin area.4
In charge of daily operations, all; licensing with the NRC, providing! both nursing personnel and physicians
with educational information throughin-service seminars, and some limited,
experience performing ultrasound()> examinations.
,
! EXTRACURRICULAR Presented scientific exhibit at the'
ACTIVITIES 25th Annual Meeting of the Society ;;
; of Nuclear Medicine. Anaheim, Calif.'
Presented scientific exhibit at theTechnologist Section of the Society: .
,
of Nuclear Medicine Annual Meeting i
'Orlando, Florida. February, 1978 !
I'REFERENCES Furnished upon your request i
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COMPUTERIZED MEDICAL IMAGING
" HOT LABORATORY"
PROCEDURE MANUAL
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COMPUTERIZED MEDICAL IMAGING
/m ) PROCEDURE FOR RECEIVING RADIOACTIVE MATERIALSv
When a package has arrived for Computerized Medical Imagingcontaining radioactive materials, the following steps shouldbe taken:
1. Inspect the package for wetness and visible damage.
2. If you feel the package has been damaged or is leaking,notify the Radiation Safety Officer (RS0) and begin de-contamination procedures.
3. If the package has not been damaged and appears intact,take it to the Hot Lab.
4. Perform a wipe test and mansure the wipe with the G-MMeter. Be sure to move to an area of low background tomeasure wipe.
5. Measure the package at a distance of one meter and at thesurface with the Cutie-Pie ion chamber.
6. If the meter exceeds 10mr/hr at a distance of one meter7 s.
( ) or exceeds 200 mr/hr at the surface, notify the RSO andtreat the package as contaminated. The wipe test reading''
should be within the normal background range or decotaminationprocedures should be taken.
7. All materials should be logged in the C.M.I. RadiopharamceuticalDisposal Log.
8. Below are the telaphone numbers of the persons to notifyin case of emergency or problems:
Dr. D.N. Sattem, M.D. Office: 715-834-8418Radiation Safety Officer Home: 715-835-3017
Dennis Wolf, CNMT Office: 715-835-8008Home: 715-382-4327
Dave Robinson, CNMT Office: 715-835-8008Home: 715-835-7343
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GEIERAL PREPARATION OF RADI0 PHARMACEUTICALS
_
( 1. Always follow the manufactures package insert for the preparation; of the radiopharmaceutical kits. Check the lot number and expiration''
date on all vials before preparing them.
2. Prior to manufacturing the kits or drawing up any material, checkthe label three times: 1) Ghen you select your kit, 2) When youare ready to use it for a patient dose, 3) ~,? hen you return it to
the hot area or disposal.
3. It is the responsibility of the technologist to provide clearlegible records of all radiopharmaceuticals used and prepareddaily. Necessary record information must include: Lot number,assay time and date, activity per volume, expiration time,patient name, activity per volume dispenced for patient doce.
4. s/ hen working with any type of radioactive materials, handle themas quickly and carefully as possible. You MUST wear rubber glovesand use vial and syringe shields when ever possible.
5. NEVER leave any centainer of radioactivity unlabeled. Alvayslabel the container imme 'intely af ter preparation. The labelshould contain the following information: type of material,assay time and date, activity per volume, C.M.I. lot #, expiration
*time.
6. A radiation survey of the hot lab area should be perform on adaily basis. If any contamination is present, use thede-contamination procedure to remove it.
/x) 7. All radioactive materials tast be held for a period of 10(ten);''
half-lifes before disposal to the trash. A radiation survey ofthe material should be performed and documented before the materialis sent out to trash.
8. All materials, whether prepared or received, must be given aC.M.I. Lot #. All prepared radioactive materials need only besurveyed for disposal purposes. Any other radioactive materials,must be surveyed when the shipment is received and eventuallydisposed of.
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99-MoamERATORLOGSi[IT.
DATE RECEIVED C.M.I. LOT #
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DISPOSAL jCOMPANY LABEL HERE 1
Date 1
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DATE C . M. L. LO: F ACTIVITY /VOL. Mo-99 EEEAK. Al Ion TECH
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Il0T LABORATORY
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i Hot Lab Floor Plani
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; 1. Stainless steel sinkBarn will be constructed of 2 x 4 x 6" lead bricks -|
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j 30" long by 16" wide with 12" walls.will be built on a i" thick piece of sheet lead.
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Generator with company's additional i" lead shield,
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4. Table top lead work station,
5 Dose calibrator
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! Daily Room Survey - Wipe Test ,
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3 Outside barn'
! 4. Work area.
| 5 Dose calibrator'
6. Floor below work area_
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O! .C.M.I. DAILY DOSE CALIBRATOR QUALITY CONTROL!
|
| I. Instrument Accuracy (Co-57,'5 moi)
1. Assay Co-57 reference source in the dose calibrator atthe appropriate setting.
! 12. Repeat step 1 for a total of three determinations and ?
| average the results.
3 Record these results on the appropriate record sheet.
I 4. Be sure to subtract background levels to obtain a netactivity.
5. The average activity detenntred should agree to within |1
1 + 5% of the certified activity of the Co-57 reference i] source after decay correction. I:
'. 6. If an error in the activity is displayed between + 5%! to + 10%, correction factors should be detemined to: conEinue the use of the calibrator. If any error is
incurred that is greater than + 10%, a Squibb represen-tative must be called for service on the unit.
1, II. Instrument Constancy (Cs-137, 200 uci)4
| 1. Assay Cs-137 reference source in the dose calibratorj at the appropriate settings. Reconi results, i
}- 2. Repeat step 1 with Cs-137 reference source still in| place using all radionuclide settings listed on the; reconi sheet. Record results.
3 Be sure to subtract background levels to obtain netactivity. The activity displayed, with backgroundand decay considered, nust fall within + 5% of thepredicted activity.
1
! 4. The acceptable range of error for the constancy checksi may be extended to + 10%. If variations greater than! + 10% are noted, arrangements should be made for{ service.i
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C.M.I. QUARTERLY GEOMETRICAL VARIATION CHECK
1. Assay the 30 m1 vial containing 2 mie of Technetium 99m ina volume of 1 milliliter. Record results.
2. Increase the volume of liquid in the vial in a stepwisefashion, such as 2, 4, 8, 10, 20, and 25 m1, by adding thenecessary amount of water. After each increase in volume,gently shake the vial to ensure uniform distribution ofactivity and then assay as in step 1.
3 Select one volume as a standard and calculate the ratio ofmeasured activities for each volume to the reference volumeactivity.
4 Plot the correction facto"s against the volume on lineargraph paper.
5. Calculation of true activities can be measured by thefollowing formula: True act. = measured act. x correctionfactor.
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C.M.I.. QUARTERLY DOSE CALIBRATOR LINEAriITY CHECK
1. Assay the vial containing a minimum activity of 100 m1111 curiesof Technetium - 99M eluent in the dose calibrator.
2. Repeat step 1 at the following time intervals: 1,2,4,6,10, 16, 20, 24 hours. All activities are to be measured inmli.
3 Calculate the predicted activities at each time interval forwhich a reading was taken and plot the calculated activityversus time on semilog paper.* Plot activity on the vertical logarithmic scale and timeon the horizontal linear scale.
I
4. Plot the measured net activity for each time interval vercusthe predicted curve as plotted in step 3
5 The activity as plotted should agree to within + 5% or theinstrument should be serviced.
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DAILY DOSE CALIBRATOR QUALITY CONTROL FOR:
(VManufacturer f Model No. Serial No.._._
A of Dose calibrator reading for 6 12/M as'dAct. of Bkg.Date Co-57 source on setting for... in pCi for Ini-Co-57Ref. Tc-99m ial:Ref.Std.
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) (mci) Tc-99m' In 111 T1-201 Ga-67 Cs /77 J 12.7 (PCi)
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Date: . Manufacturer 6 Model No. :
Assayed DecayTime Tc-99m Activity Elapsed Correction Calculate
,
Date of Assayed of Co-57 Init- Time based Tc-99m- ,Assay Activity Vial fals (t) on t=0 Activit)
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Instructions:1. Picase obtain and record data indicated in columns one thru fous2. Place 120 to 150 mci of Tc-99m in a standard clution vial. The
total volume contained in the vial shall be 20 ml.3. Assay the vial for four consecutive days. Each day the vial
should assayed at Icast 4 times, two of these being at the beginning and end of the day.
4 Whenever the Tc-99m vial is assayed the Co-57 standard vialshould also be assayed.
%) 5. Record all values on this data sheet, initial ,each measurement
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COMPUTERIZED MEDICAL IMAGING
NUCLEAR MEDICINE TECilNOLOGISTS
en0CEDURE MANUAL
1985i
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') C.M.I .DERGENCY DECOUTAMINATION PROCEDUPE'
1. Notify persons in the immediate area that a spill har occurred.Assure them they are in no innediate danger.
2. Assess the spill area. Mark the area out with radioactive warninglabel tape and cover with absorbent pads. All steps to be carriedout while wearing disposable booties and gloves.
3 Survey the area with a G-M survey meter and continue to decontaminatewith "radiac wash" until the count rate is within the range ofnomal background level. Also, perform a wipe test with theprovided swab. Count this swab on the (G-M) meter. The resultsshould also be within the range of normal background level orcontinue until this level is obtained.
4 The following personnel should be notified:
Dennis Wolf, C.N.M.T. 715-382 4327Dave Robinson,.C.N.M.T. 715-835-8008Dr. D. N. Sattem, R.S.O. 715-834-8418Chief Radiologic Tech at the hospital
) 5 Technologists should always have the following materials on boani'" their cameras for decontamination purposes:
Radiac wash Absorbent pads or churDisposable booties; gloves G-M survey meterPlastic bags Cutie Pie meterAlcohol wipea Radioactive warning tape
* In the event of any fire, theft, or accident of a vehicle containingradioactive materials, notify thc following innediately:
1. Dr. D. N. Sattem, R.S.O. Office: 715-834-8418Home: 715-835-3017
2. Dennis Wolf, N.M.T. Office: 715-835-8008Home: 715-382-4327
3 Dave Robinson,.C.N.M.T. Office: 715-835-8008
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f <0 ACTIVE MATERIALS SPILL RECORD
DATE LOCATICN OF SPILL G-M SURVEY READING WIPE TEST TECHK)LOGIST NOP#ALBKG.
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() DAILY QUALITY CONTROL FOR THE
GENERAL ELECTRIC SCINTILLATION CAMERA
FOR
, COMPUTERIZED MEDICAL IMAGING
This procedure should be performed in the morning prior.to patientimaging, before nad after the camera is serviced and whenever the cameramalfunctions.
1. Place 450-800 uCi of 99m-Tc contianed in 1 ml in a 3 m1 syringe,assay the syrince and record the activity and the time of assay.
2. Remove the collimator. Rotate the camera head so the crystal isfacing the ceiling. Place the co.11sr with appropriate insidediameter on the camera makin6 sure not to damage or come intocontact with the crystal portion.
3. Place the 3 ml syringe containing the 99m-Tc in the quality controlsource positioner (tripod). Proceed to place this tripod in positionon the collar.
4. Obtain a voltage peak using the smallest possible w'ndow (15%).(~} Record thid data.
5. Set orientation to the zero degrees position and open the window''
to the 20% setting.
6. Obtain the following floods and information: (nine image format)
A) 1 million count flood with the correction circuit on.B) 1 million count flood with the correction circuit off, record
the time. At this time you can obtain the correction for theunifcrmity computer.
C) After uniformity computer has accumulated it's correctionobtian a 1 million count flood with the correction circuil onand record results.
7. Record CRT setting used for flood fields.
8. Calculate the percent increase in counting time between steps B.&C.as follows:TIME (Correction-ON) -- TIME (coerrection-OFF) Percent
X 100 IncreaseTIME (Correction-OFF) in Counting
Time
9. Record this data.
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INSTRUCTIONhFOR
DAILY SCINTILLATION CAMERA QUALITY CONTROL LOG.
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Quality control studies are performed to insure consistent day-to-day. performance of the scintillation camera'. The purpose ofmaintaining a daily quality control log for each scintillationcamera is so that daily trends in camera performance can be readilydetected. Space is provided to insure that the physician or super-visory technologist reviews,the quality control data on a weeklybasis and makes appropriate comments or takes appropriate action.The quality control procedure for the scintillation camera can be-found in the quality control manual.
,
1. Enter the date on data sheet.
2. After calibrating camera for the radionuclide used in the qualitycontrol study, enter isotope gain setting and gain used for CRTto obtain the field flood image. -
3. Record the intrinsic background counts for one minute using thenoted isotope gain setting.
4. Calculate the sensitivity (CPS /pCi) as specified in the qualitycontrol manual and record the value.
5. Calculate the percent counting time increase for cameras withuniformity correction circuit (excluding the Z-pulse modulationtype correcting circuit) as specified in the quality controlmanual and record the value.
6. Count the extrinsic background for.one minute. Record the colli-mator type and background on the data sheet.
7. Review the data and make sure it is consistent with the previousday's results; if not, notify supervisory technologist or physician.Initial the data sheet.
8. On a weekly basis, the physician or supervisory technologist should-
review the prior week's results to insure that the camera isoperating in a reproducible manner. If this is not true, correc-tive action should be taken as soon as possible.
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WEEKLY QUALITY CONTROL FOR THEGEliERAL ELECTRIC SCII;TILLATION CAMERA
FOR( )'''' COMPUTERIZED MEDICAL IMAGING
These quality control procedures should be performed at a convenienttima every week and before and after the camera is serviced. All imageschould contain 1 million counts and be performed on the "nine image format".The count rate when the images are taken can be approximately 25,000-35,000,counts per second. Use approximately 1-2 mci 99mTc for the quadrant barphantoms and 2-3 mci 99m Tc for the orthogonal hole phantom.
The following images should be obtained:
A) 1/8" orthogonal hole phantom,
B) quadrant bar phantom, 2.5mm, 3.0mm, 3.5mm,4.0mmO degrees 180 degrees90 degrees 270 degrees
C) Extrinsic field floodc chould be performed on all collimatorsduring this time. A flood phantom can be used for this purpose.
These images chould be reviewed and compared with the previousimages. If there is any significant variations from the previous weeksimages, notify the General Electric service personnel.
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DAILY. QUALITY CONTROL LOG FOR*
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G . E. PORTA DAMERA SCINTILLATION CAMERA.
Intrinsic EXTRINSICIso- -
tope CRT Back- S e n s.i,- t Counting Colli- Back- Init-
Date Gain Gain ground tivity Time mator- ground ials
(CPM) (CPS /pCi) Increase* **
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C.M.I. HAND AND BODY SURVEY FORM
Technologist must survey both hands and clothing before leaving ahospital. If contamination is present, please follow thedecontamination procedure found in this manual.
DATE | LOCATION I HANDS CLOTHING BKG TECH'
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APPENDlX 0
MODEL PROGR AM FOR MAINTAINING OCCUPATIONAL RADIATION EXPOSURESAT ME0lCAL INSTITUTIONS ALARA
(Licensee's Name)
(Dets)
1. , Management Commitment2. Radiation Safety Committee (RSC)2
We, the management of this (medical facility,< a.
Review of Proposed Users and Usesa.hospital, cle.), are committed to the program
4
! de tribed in this paper for keeping exposurest (1) The RSC will thoroughly review the.
(individual and collective) as low as is reasonablyqualifications of each applicant with
achievable (ALARA). Ir: accord with this com-i mitment, we hereby describe an administrative respect to the types and quantities of; materials and uses for which he hasorganization for radiation safety and will develop
the necessary written policy, procedures, and applied to ensure that the applicant will,
instructions to foster the ALAR A concept with- be able to take appropriate measures to
in our institution. The organization willinclude maintain exposure ALARA.
a Radiation Safety Committee (RSC)' and a(2) When considering a new use of hyproductRadiation Safety Officer (RSO).
material, the RSC will review the effortsb. We will perform a formal annual review of the of the applicant to maintain exposure
radiation safety program, including ALARA ALARA. The user should have systema tized
considerations. This shall include reviews of procedures to ensure ALAR A and shall
operating procedures and past exposure records, have incorporated the use of specialinspections, etc., and consultations with the equipment such as syringe shiclJs. rubber
radiation protection staff or outside consultants. gloves, etc., in his proposed use.
(3) The RSC willensure that the userjustifiesModification to operating and maintenance pro-c.
cedures and to equipment and facdities will bc his procedules and that dose will be AIARA
made where they wdl reduce exposures unless (individual and collective).the cost, in our judgment, is considered to be b.unjustified. We wdl be able to demonstrate, if Delegation of Authority
necessary, that improvements have been sought,
thal modifications have been considered and that (The judicious delegation of RSC authority isthey have been implemented where reasonable. essential to the enforcement of an ALAR Aprogram.)Where modifications have been recommendedbut not implemented, we will be prepared to
(1) The RSC will delegate authority to thedesenbe the reasons for not implementing them.RSO for enforcement of the ALARA
d. In addition to maintaining doses to individuals concept.
as far below the limits'as is reasonably achievable,( 2) The RSC will support the RSO in thosethe sum of the doses received by all exposed
individuals will also be maintained at the lowest instances where it is necessary for the RSOto auert his/her authority. Where thepracticable level. It would not be desirable, for
example, to hold the highest doses to individuals RSO has been overruled, the Committee
to some fraction of the applicable limit if this will record the basis for its action in theinvolved exposing additional people and signif- minutes of the Committee's quarterlyicantly increasing the sum of radiation doses meeting.
received by allinvolved individuals.
9g 2Private practice physician Ilcenses do not include an RSC The RSO on private practice physician licenses will assume the
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c. ' Revie'w of ALAR A Program (2) The RSQ willensure that authorind users,'workers, and ancillary personnel who may
(I) The RSC will encourage all users to review be exposed to radiation will be instructedcurrent procedurcs and develop new pro- in the ALARA philosophy and informed
( cedures as appropriate to implement the that management, the RSC, and the RSO;
M ALAR A toncept. are committed to implementing theAIARA concept.
(2) The RSC will perform a quarterly reviewof occupational radiation caposure with c. Cooperative Efforts for Development of ALAR Aparticular attention to instances where ProceduresInvestigational Levels in Table 0-1 below ,
are exceeded The principal purpose of Radiation workers will be given opportunitiesthis review is to assess trends in occupa- to participate in formulation of the procedurestional exposure as anindex of the ALARA that they will be required to follow.program quality and to decide if action iswarranted when Investigational Levels are (1) The RSO will be in close contact with all
3exceeded (see Section 6L users and workers in order to developALARA procedures for working with
(3) The RSC will evaluate our institution's radioactive materials.overall efforts for maintaining exposuresALAR A on an annual basis. This review (2) The RSO will establish procedures forwillinclude the effortsof the RSO, autho- receiving and evaluating the suggestions ofnzed users, and workers as well as those individual workers for improving healthof management. physics practices and will encourage the
use of those procedures.'
3. Radiation Safety Officer (RSO)d. Reviewing Instances of Deviation from Good
a. Annual and Quarterly Review ALAR A Practices
t1) Annual review of the radiation safety pro- The RSO will investigate all known instancesgram. The RSO will perform an annual re- of deviation from good ALAR A practices and,view of the radiation safety program for if possible, will determine the causes. When the (
o)l adherence to ALARA concepts. Reviews cause is known, the RSO will require changes' of specific procedures may be conducted in the program to maintain exposures ALAR A.
on a more frequent basis.4 Authorized Users
(2) Quarterly review of occupational expo-sures. The RSO will review at least quar- s. New Procedures involving Potential Radiationterly the external radiation exposures of Exposuresauthorized users and workers to determinethat their exposures are ALARA in accord- (1) The authorized user will consult with,andance with the provisions of Section 6 of receive the approval of, the RSO and/orthis program. RSC during the planning stage before using
radioactive materials for a new procedure.(3) Quarterly review of records of radiation
level surveys. The RSO will revicw radia- (2) The authorized user willevaluate all proce-tion levels in unrestricted and restricted dures before usir:g radioactive materialsareas to determine that they were at to ensure that exposures will be keptA L AR A levels during the previous quarter. ALARA. This may be enhanced through
the application of trial runs.h. Education Responsibilities for ALARA Program
b. Responsibihty of Authorized User to Persons(l) The RSO will schedule briefings and educa- Under His/Her Supervision
tional sessions to inform workers ofALARA program efforts. (1) The authorized user will explain the
AL AR A concept and his/her commitmentto maintain exposures ALARA to all per-
supesoA -
3The NRC has emphasized that the Investigational f.evels in thinsr:m are not new dose limits but, as noted in ICRP Report 26,
testion, ,dations of the Internationst Commhsion on Radiolosical (2) The authorized user will ensure that per- !.c mmenserve as check points above wh6ch the results are con.
red sufficiently important to justify further investigations. sons under his/her supervision who are
10.8-58,
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~subject to occupational radiation expo- a. Quarterly exposure of individuals to less thar,sure are trained and educated in good Investigational Level I.health physics practices and in maintaining
-) exposures ALARA. Except when deemed appropriate by the RSO,'
no further action will be taken in those caseswhere an individual's exposure is less than
j 5. 1%rsona Who Receive Occupational Radiation Exposure Table Owl values for the Investigational level I.
a. He worker wdl be instructed in the ALARA b. Personnel exposures equal to or greater thanconcept and its relationship to working proce- Investigatienal Level 1, but less than Investiga-dures and work conditions. tional Level II.
b. The worker will know what recourses are avail- The RSO will review the exposure of each mdi-able if he/she feels that ALARA is not being vidual whose quarterly ex posures equal or exceedpromoted on the job. Investigational Levell and will report the results
of the reviews at the first RSC meeting following6. Establishment of Investigational Levels In Order to the quarter when the exposure was recorded. If
Monitor Individual Occupational External Radiation the exposure does not equal or exceed Investiga-Exposures tional Levelli, no action related specifically to
the exposure is required unless deemed appro-This institu tion (or private practice)hereby establishes priate by the Committee The Committre will.Investigational Levels for occupational external radia- however, consider each such exposure in com-tion exposure which, when exceeded, wdl initiate parison with those of others performing simdarreview or investigation by the RSC and/or the RSO. tuks as an index of ALARA program qualityThe Investigational Levela that we have adopted are and wdl record the review in the Committeelisted in Table O-1 below. These levels apply to the minutes.
, ex posure of individual workers.
c. Exposure equal to or greater than Investiga-tional LevelII.
Table 01
The RSO wdlinvestigate in a timely manner theInrestigational leFelt Cause(s) of all personnel ex posu res eq ualing Or e x-
(mrems per calendar quarter) ceeding Investigational levelIl and,if warranted,wdl take action. A report of the investigation. ac-
LevelI Lerellt tions taken,if any,and a copy of the individual'sForm NRC.5 or its equivalent wdl be presented
1. Whole body; head and 125 375 to the RSC at the first RSC meeting followingtrunk; active blood-forming completion of the inves*igation. The details oforgans; lens of eyes; or
, . these reports wi!! be remrded in the RSC minutes.gonads
Committee minutes will be sent to the manage-ment of this institution for review. The minutes,2. Hands and forearms; feet 1875 5625 containing details of the investigation, will be
and anklesmade avadable to NRC inspectors for review atthe time of the next inspection.
3. Skin of whole body * 750 2250d. Reestabhshment of an individual occupational
worker's Investigational Leveill to a levelaboveNot normally applicable to nuclear medicine operations escept '
those using significant quwtities of beta <mitting isotopes.
In cases where a worker's or a group of workers'exposures need to exceed Investigational Level D.a new, higher Investigational LeveIII may be
The Radiation Safety Officer will review and recordestabhshed on the basis that it is consistent with
on l'orm NRC-5, " Current Occupational External good ALARA practices for that individual orRadiation Exposures," or an equivalent form (e g., group. Justification for a new Investigationaldosimeter processor's report), results of personnel level 11 will be documented.monitoring not less than once in any calendar quarteras required by { 20.401 of 10 CFR Part 20. The follow- The RSC wdt review the justification for, and willing actions will be taken at the Investigational Levels approve, all revisions of Investigational Level Ilas stated in Table 01 : In such cases. when the exposure equals orexceeds
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the newly eshblished Investigational Leveill. - 4"c- $'=' / 'I !/' # '. .
#those actiores listed in paragraph 6.c above will S'; maturebe followed. a a . ., }.+a na / -s
7. Signature of Certifying Official" Name (print or type) d $g
1 hereby certify that this institution (or private prac- P M' ''''i
tice) has implemented the ALARA Program set forth Title Il
above.|
| .Institution (or Private Practice) Name and Address
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lerrry, L ai 1 e./ !$ndeal 7 mava-,The person who is authortaed tu saane commitments for the d d /O f e m c.,r/ /./ .,
dministration of the institution (e.g.. hospital administrator) or.a the case of a private practice, the licensed physic 6an. 6a Ga u- v 'I < < V <' W ,
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1. Please find enclosed the final radiation wipe and monitorsurvey for the laboratory located at 623 Sibley Avenue
; South, Litchfield, Minn.
The proposed lab site at Second and Trott, Willmar,'.Minn,
; was never used and radioactive materials were neverj brought into this location, t
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Sound Expansion Enterprises' original laboratory siteat.2010 Esmond Road, Eau Claire, Wisc. is still being |
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Dennis Wolf,. Nuclear Medicine.
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RICE\ Y
June 27, 1985
Dennis WolfNuclear Medicine ManagerSound Expansion Enterprises, Inc.2010 Esmond RoadEau Claire, WI 54701
Dear Dennis:
On June 24, 1985, we performed a close out survey at the Litchfield,Minnesota lab at 623 Sibley Avenue South. The survey was performed byLori Huls RT (NM) and identified readings of less than .1 mr/hr at thefour survey points shown on the attached diagram. There were no readingsgreater than background throughout the lab area as no radioactive materialhas been delivered to or stored at this site for a period of 2 weeks.Additional survey information per your request is as follows:
Surveyor: Lori Huls RT(NM)Date of survey: 6-24-85Instrument used: Technical Associates
Model TBM-3 survey meterserial number 083172calibrator date 5-8-85calibrated by Richard Geise M.S. (CRP)
The lab has been released by Rice back to the manager of the office complex.I wish to thank you for the cooperative arrangement we shared during theacquisition of our license. If eny annitional information is required inthis matter, please call and we will help in any way.
Sincerely,
N
Tony Rime RT, RD!lSDirector of Radiology .
TR:smk
Enclosure
ORICE MEMORIAL HOSPITAL301 Becker Avenue S.W. * Wmmar. M.nnesota 56201(612)235 4543
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