RC Form 12-1 Page 1 of 7 Texas Department of State Health Services Pursuant to the Texas Radiation Control Act and Texas Department of State Health Services (Agency) regulations on radiation, and in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess and transfer radioactive material listed below; and to use such radioactive material for the purpose(s) and at the place(s) designated below This license is subject to all applicable rules, regulations and orders of the Agency now or hereafter in effect and to any conditions specified below _1, LCENSEE ~~ o 3 License Number L00485 1 Name THE UNVERSTY OF TEXAS AT AUSTN ATTN W SCOTT PENNNGTON CHP 2 Address ENVRONMENTAL HEALTH AND SAFETY 4 Expiration Date June 30, 2020 1 PO BOX 7729 AUSTN TX 78713-7729 Amendment Number 93 -, This license is amended in accordance with correspondence dated July 22, 2018 t 5 Radioisotope 6 Form of Material 7 Maximum Activity 8 Authorized Use A Americium-241 A Sealed source (MRC A 1 source not to A n vitro research and development as Model MRC-G-SS-W- exceed 1 curie AM) B Americium- B Sealed source (CPN B 2 sources not to B n vitro research and development as 241/Beryllium Model CPN-131) exceed 50 millicuries,, each education using CPN nternational Division of nstrotek, nc (CPN) Model 503 moisture/densit~ gauge C Any radioactive C Any, except sealed C Not to exceed 25 C n vitro research and development as material with an sources millicuries per Atomic Number radionuclide, Total 84 or greater, 250 millicuries except specia nuclear material, except as otherwise listed -
RC Form 12-1 Page 2 of 7 LCENSE NUMBER 5 Radioisotope 6 Form of Material 7 Maximum Activity 8 Authorized Use D Any radioactive D Sealed sources as D Not to exceed 50 D n vitro research and development as material with an authorized under 25 millicuries per Atomic Number TAC 289252(v) or radionuclide, Total 1 f 84 or greater, NRC or Agreement curie except special State equivalent nuclear material, -- except as - otherwise listed E Any radioactive E Any, except sealed E Not to exceed 300 E n vitro research and development as material with sources, millicuries per defined in 25 TAC 289201(b); animal ~r atomic numbers 3 ; radionuclide, Total 3 studies; and 1 ; through 83, < curies,,, f i except as,- ~ ; otherwise listed F Any radioactive F Sealed sources as F Not to exceed 15 F n vitro research and development as material with authorized under 25 millicuries per atomic numbers 3 TAC 289252(v) or radionuclide, Total 1 through 83, NRC or Agreement curie except as State equivalent otherwise listed - G Cesium- 137 G Sealed source (3M G 1 source not to G nstrument calibration using a JL Model 4F6H) exceed 606 millicuries Shepherd and Associates Model 28 series instrument calibrator H Cesium-137 H Sealed source (TN H 1 source not to H n vitro research and development as Model 570-57157C) exceed 200 millicuries education using a Robertshaw Controls C_() Model 770-A gauging device
RC Form 12-1 Page 3 of 7 LCENSE NUMBER 5 Radioisotope 6 Form of Material 7 Maximum Activity 8 Authorized Use Cesium-137 Sealed source (AEA 1 source not to n vitro research and development as Technology Model exceed 90 millicuries 77302) education using a AEA Technology-QSA, J 0 nc, Model 773 calibrator instrument "~~, calibrator J Cesium-137 J Sealed source J 1 source not to J nstrument calibration, education, and in (JLS Model 6810) exceed 35 curies vitro research and development as defined in 25 TAC 289201(b) using a JL Shepherd and Associates Model 28-6 t instrument calibrator \ K Fluorine-18 K Any -- K 1 curie K n vitro research and development as,, ~ defined in 25 TAC 289201(b); animal, studies; and L Hydrogen-3 L Any, except sealed L 1,000 curies L n vitro research and development as sources ~ - "~ i M Hydrogen-3 - M Sealed neutron M 1 source not to M n vitro research and development as l; \ : generator tubes exceed 35 curies education using a Thermo Scientific Model MP 320 accelerator 1 N Plutonium-238 N Sealed sources as N 0005 grams (85 N n vitro research and development as authorized under 25 millicuries) TAC 289252(v) or, NRC or Agreement ; :> c State equivalent 0 Plutonium-238 0 Any solid or liquid 0 001 millicuries (058 0 n vitro research and development as micrograms) ----- -----
RC Form 12-1 Page 4 of 7 5 Radioisotope 6 Form of Material 7 Maximum Activity P Plutonium-239 P Any solid or liquid P 01 millicuries (161 milligrams) Q Plutonium- Q Sealed sources as Q 176 grams (11-239/Beryllium authorized under 25 curies) TAC 289252(v) or NRC or Agreement State equivalent R Plutonium-240 R Any solid or liquid R 001 millicuries (440 micrograms) S Plutonium-241 S Any solid or liquid S 001 millicuries (01 t ~ li micrograms) T Plutonium-242 T Any solid or liquid T 001 millicuries (254 milligrams) U Uranium-233 U Any solid or liquid U 01 millicuries (102 milligrams) V Uranium-235 V Any solid or liquid V 4322 microcuries (2 grams) i LCENSE NUMBER 8 Authorized Use P n vitro research and development as Q n vitro research and development as / 1 j R n vitro research and development as S n vitro research and development as T n vitro research and development as U n vitro research and development as V n vitro research and development as education 9 A Radioactive material shall be stored and used at: Site Number 000 002 003 Location Austin - 304 East 24th Street (Main Site) Port Aransas - 750 Channel View Drive Austin - 10100 Burnet Road
RC Form 12-1 Page 5 of 7 LCENSE NUMBER Site Number 004 005 Location Austin - 1400 Barbara Jordan Boulevard Port Aransas - 1300 Port Street B The authorized place of use is at temporary sites, in areas not under exclusive Federal jurisdiction, throughout Texas C The licensee is authorized to use Carbon-14 or Hydrogen-3 labeled reagents, with activities of no more than 6 millicuries, on board the research vessel Kctty while in port or in waters where the Agency maintains jurisdiction 10 This license is issued in accordance with Title 25 Texas Administrative Code 289252(h), "Specific Licenses for Broad Scope Authorization for Multiple Quantities or Types of Radioactive Material for Use in Research and Development" 11 The individual designated to perform the functions of Radiation Safety Officer (RSO) for activities covered by this license is W Scott Pennington, CHP 12 Radioactive material shall only be used by, or under the supervision of, individuals designated by the Radiation Safety Committee, Kevin N Dalby, PhD, Chairperson The licensee shall maintain records of individuals designated as users for 3 years after the individuals last use of radioactive material under the license 13 The licensee shall not open sealed sources containing radioactive material or remove sources from source holders 14 The licensee is authorized to analyze tests for leakage or contamination from sealed sources in accordance with procedures identified in the application dated May 29, 2009 and electronic mail dated May 3, 2018 15 The licensee is authorized to perform in-house radiation survey instrument calibrations The calibrations shall be performed in accordance with procedures identified in the application dated May 29, 2009 and electronic mail dated May 3, 2018
RC Form 12-1 Page 6 of 7 LCENSE NU MBER 16 The licensee shall not use radioactive material in or on human beings, or in field applications where such activity is released unless otherwise provided by a specific condition of this license 17 Experimental animals administered radioactive materials or their products shall not be used for human consumption 18 The licensee is authorized to discard radioactive material authorized in Conditions 5, 6, 7 and 8 and listed in 25 TAC 289202(ggg)(7), whose half-lives do not exceed 300 days, in a Type municipal solid waste site in accordance with the provisions of 25 TAC 289202(fff)( 4) and procedures described in the application dated May 29, 2009 19 The licensee is authorized to hold radioactive material with a physical half-life of less than or equal to 120 days for decay-in-storage and dispose of it as non-radioactive in accordance with procedures described in the application dated May 29, 2009 20 The licensee shall conduct at intervals not to exceed six months visual inspections and operational checks of all gauges to ensure that the equipment is in good working condition, the sources are adequately shielded, and required labeling is present and legible A record of each inspection shall be maintained for inspection by the Agency for three years and shall include the date of the inspection, name and signature of the individual performing the inspections, equipment involved, any problems found, and what, if any, corrective action was taken 21 Any cleaning, maintenance or repair of the gauges that requires detaching the source or source rod from the gauge shall be performed only by the manufacturer or other persons specifically licensed by the Agency, the US Nuclear Regulatory Commission or an Agreement State to perform such services 22 The licensee shall maintain the financial assurance Statement of ntent for $1,125,000 current and in good standing
RC Form 12-1 Page 7 of 7 LCENSE NUM BER 23 Except as specifically provided otherwise by this license, the licensee shall possess and use the radioactive material authorized by this license in accordance with statements, representations, and procedures contained in the following: Application dated May 29, 2009, Letters dated July 10, 2009, August 28, 2009, February 15, 2010, May 14, 2010, June 15, 2010, July 31, 2013, December 19, 2013, April 29, 2016, July 28, 2017, February 14, 2018 and Electronic mail dated May 3, 2018 Title 25 TAC 289 shall prevail over statements contained in the above documents unless such statements are more restrictive than the regulations VJD:vjd FOR THE DEPARTMENT OF STATE HEALTH SERVCES Date August 7, 2018 4-~~~~~ /J Scott < Program Coordinator Medical and Academic Licensing Program