3 January 2013

Michelle Simmons United States Nuclear Regulatory Commission 1600 E. Lamar Blvd.

Arlington. TX 7601 1

Dear Michelle:

DNMS

Please add Mary Fischer Murphy, MO as an authorized user for our NRC license .

Sincere ly,

//Lruv{ Q GvJ21A-Keith Carnaha n. RT N RSO License #49-17940-01

307-352-8387

Enclosure : {l J •

_ PUBUC o !J:pmedlate Rei .... I!t'NorTnll Rele ...

HON-PUSUC o 1...3 Sensrtjye-Securlly Rtlat:ed Q 1...7 Sensitive Internal CI Othor.'-. ___ _

Rev, .... r. M o ... ,olj':s;b3

1200 College Drive · Rock Springs, WY 82901 • 307· 362 -) 711 • Fax 307· 352-8180 www.sweetwatermemorial.com

.. 579669

12 M XI,,,, OI~J-1OU '" PACiE ~ Of' --1...- P.o.QES

u..s, NUCLEAR REGULATORY COMMlSSION Amendment No 37

MATERIALS LICENSE

PutIuartt ~ !he AIomoc Energy Ac;I of 1~, .. .....oed. fIoI Enrgy "-~ Ac;I of 1514 tputnc I..w 93-138) Ind T,:!II 10.

Code of F .... R~ CllllIItI I. pan, lO, 31, 32, 3.), 34, ~, 3G 3$, 40. IJ<1d 70, Inc! on rell .... Qr\ $1at1llT'Cll11S 1M

~ ....... ,-. by'1!W ___ , I bile II '*-tyicsutd ~". a-IOI'8C8M. -.n,~ • .-.d

Inwfet byp'vduc1, acun:e, _ *1*'&1 I'IIJdM' frIIIoIW de~ bIIow; 10 ..- ....ctI ......,.. br "... ~.) lind M IN ~s)

delolgM:ed ~ 10 ~ Of 1tInIIftr wch ~ ..... 10 C*WOnI lIII!Iorti:ed 10 _ • ., ac:cotd __ willi I~ ~. of !tie

~ P"",.) ThilIIc8nIoI -'III be ~ WI ~ Ilecvldllonllf*Mlld In $edICIn 183 of !!Ie "'-e ... 'VY Ac;I of I~ ..

1IIIlIIIIded,.-.cIli ~ 10 .... ~ ,,*-,~, lind O!defsol'" ~ R~ ~ now Of '-U'W"1flIoct

~ to lOY cond.1loM sc-;r..d below

1. 51 Peter's CommUOlty Hospital

2 2475 Broadway

Helena, Montana 59601

A. My byproduct: ';~f5.loO permitted by 10 I

8 Ally byproduct m~1 permitted by 10 $ 35200

C Any bypmduct ma~ permitted by 10 CFei5

o GadolinlUm-153 ~

9 Authonzed use

~ 1-Q

3, 2011, and facumle received JUI'll 13, 2011

ue.>Mranber 25-12.:53-02 is amended In

("" j,\.,.,,-.;rq ..-.0UlI\1hIII1t:..-­~ ....,.~

.. '"Y ___

~1mdef""1anH

4.. As needed

("l El As,,",,'"

~ ~ 500 mlllloJnes - 300 lTUilcuries per

source and 1 curie tolal

A Any uptake, dllJtion and excretion study permit1ed by 10 CFR 35.100,

B Any maglng and localIZation study pemutted by 10 CFR 35 200

C Any U!e permitted by 10 CFR 35 300 o For U$I in ADAC Labofatonefo Model Vantage line source housing for sPEeT came'as

CONDITIONS

Ucensed m~erial may be used or .torad only allhe lic8nsee's faCilities located at.

A. Nuclear MediCine Department, 2475 Broadway. Helena Moot.na.

B CardIOlogy CII/'IIC, Mana Dean Medical Offices, 2475 Broadway, SUlte 203 Helena, Montana

~11H

MATERIALS LICENSE SUPPLEMENTARY SHEET

Amendment No 37

11 The RadiiilllJon Safely OffICer for ttus Ikzme is Rodney Knable, ARRT{N)

12. LJcensed m8lenaJ II only authodzed for Ole by, or IXIder the supervl$lO(l of

A Indivlduiillls permitted to work as an authorized user. authorized nudear pharmacist andlor iluthol'izad med!c.l phYSIc:!st In accordance with 10 CFR 35.13 and 35. , 4

8 The following II'Idlvlduals are autl'loriHd UHfa for !hi matenal and medical uses incheated'

... ",""" 111m ~ ~ e.,,5 ~ I RIChard Karah. MO ." (j \" 35 100, 35.200, 3~CIJ(~cl.Idlng OI1tI.cImll\tllra\JOn of

V aodium iodide ,·131 i'llI\,Idhtibes greater than 33 mnQlrles): ~ MId gadolirwurn-153 for us{) ADAC Varuge Sys!em for

" transmission dsagnostit Ima~

Mary FISCher Mutqf. use In AOAC I- Im~1ng

James C S,;;bt", 0

Jamet K""'d'lf_" 13 In add~JOn to

mateoal

14 For se-*I.ources ...... ,.,1:.1,,.,~

A. Sealed soorcel .haH be ~~~~~~:~~E2'~~mterva:s not to exceed L"e intervals .peClfied in the certificate Nuclear Reguliilllory Commission u~der 10 CFR 32.210 of an Agreement Stale

B Notwithstanding Paragraph A of !his Condit jon. sealed sources designed 10 primarily emit alpha partides shall ~ , •• :eeI for leakage andiOf contamination at inlervllll$ nollo exceed 3 months

C In the abaence oIa tertdicale from a tTansi8f'Ol1ncllc:.lllting that a leak 18SlMS been made w<lhIn the Irn8fVall Jpeafled In \tle cenlfiea:e of reglsttabon Iuuod by the U S Nuclear Regu:atory ComrruuJOn urtder , 0 CFR 32.210 or l.r"Ider equivalent regulations of an Agl'M!'1"'lenl State poor 10 the transfer. I sealed source receIVed from another per.on 5hal no! be puI Inlo use un!~ tested and the lesl resull. f'eCefVed

o Sealed ~a need not be lested d Il'Iey contaln only hydrogen':~, 0: they contain only III rad!oactlVe gas, or tile I'IaIf-life of the isotope Is 30 dlllY5 or less; Of l"ey contain not more tl1an 100 mltfOClJriea of bela- and/or gamma..emitting matenal or not more Ihan 10 mictoo .. lliea of alph4l-emJlting mlltorial

I.fi7Aaon

15

16

MATERIALS UCENSE SUPPLEMENTARY SHEET

~-25.124S3-02 ~o<"*'-__ OJG.l0917

Amendment No. 37

..

E Sealed sources need not be tested if they are n storage and are not belng used, hcM'ever, wilen they Ire removed from sle>rage for use ortranslenecllo another ptl'$on and nave not been tested wittvn the reqUired leak test InteNaI, tJ'\ey shall be tested before use or transfer No sealed source Shall be stored for. peood of more than 10 years wtthou1 being tesled for leaka.gl andlor contammation

F The leak test shall be capab~ of detedirog the preael'\Ce 01." ;,:,,,m.";.',oc:,l1rie (laS beC<luerels) of radioactive millarlal on the te!t If the test r8'l8.1s Ir of 0,005 m~ocune

becquerels) or mont of I be filed ...... tl'! II-oe U.s, Nuclear CommisSIon In louree

leak lesl result is Suite

G Tests for

H for 3 years.

be O~d ~ource. removed from source

*~ 17. The IiclJI'Is" i. authorized to transport Ucerlsed materiaim accordance with Ihe pt'OVl$lonS 01

10 CFR Part 71, ·PIIQ(,agrng and Transportation of Radioactive MatINlI:

MATERIALS l1CENSE SUPPLEMENTARY SHEET

~-25-12453-02

Amendment No 37

,,' PAGE 4 III 4 PACtS

, 8 Except as specdjc.Jly provdecl otherWIse In tI'n icense, the liceo," shall conduct Its prog-am In IJccon:lance WIth the statement .. repre$enlabonl, IIJ'Id procedures conl,lNId in the Oocuments. Indlldlng any enclosures, bsled beloW This license concfrtlOn applies only to those proc:edura that are required to be subM:tted in Iccordance with the reguiaIJons Addillona!ly, this .cense eondf'Jon does not Imrt the licensee's abifrty 10 make Changes to the radaation protection program as prov!dfId (Of In 10 CFR 35 26 The U S Nuclear Regulatory Commls&ion', regulalJOns shaY govern unless the statements. representations, and procedures In the licensee's applica:tkln and correspondence are mOle restnctlVe than the regulatJons

A Applleabon dilled Man;h 18. 200~_ G B. leiter dated Oeeember 14. 2 of7'4lr l.J C letler dated May 20. 2008!~ 790492) l..A D let!erdated Decembet~~~(ML09055002A} -.., " E leiter dated FebnJa~~OO9 (Ml090550024) 0 F. Letlerdated June t;;b10 (Mll02010304) ~

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FOR THE US NUCLEAR REGUlATORY COMMISSION

Date Jun. 20. 291'

Region rv Arlington, Texas 76011 -4125

",57 9 6 69

NRC FORM 532 U. S. NUCLEAR REGULATORY COMMISSION (1·2012)

DATE

01 /07/2013

NAME AND ADDRESS OF APPLICANT AND/OR LICENSEE LICENSE NUMBER

Memorial Hospital of Sweetwater County A'ITN: Keith Carnahan

Radiation Safety Officer 1200 College Drive Rock Springs, Wyoming 8290 1

This is to acknowledge the receipt of your:

[{] LEDER and/or D APPLICATION

49-17940-0 I

MAIL CONTROL NUMBER

579669

LICENSING AND/OR TECHNICAL REVIEWER

,h

DATED: 01 103/2013

The initial processing, which included an administrative review, has been performed.

[{] AMENDMENT D TERMINATION D NEW LICENSE D RENEWAL

[{] There were no administrative omissions identified during our initial review.

o This is to acknowledge receipt of your application for renewal of the material(s} license identified above. Your application is deemed timely filed, and accordingly, the license will not expire until final action has been taken by this office.

o Your application for a new NRC license did not include your taxpayer identification number. Please fill out NRC Form 531 , located at the following link:

http://WWW . nrc. gov fread in g-rmldoc-collections/fo rmsfnrc53 1. p'df

Send the completed NRC Form 531, by facsimile, to the following number: (301) 415-5387

A copy of your action has been emailedtoourlicenseFeeandAccountsReceivableBranch.in our Headquarters office in Rockville, MD. You will be contacted separately if there is a fee issue involved.

Your application has been assigned the above listed MAIL CONTROL NUMBER, When calling to inquire about this action, please refer to this control number. Your application has been forwarded to a technical reviewer. Please note that the technical review, which is normally completed within 180 days for a renewal application (90 days for all other requests), may identify additional omissions or require additional information. If you have any questions concerning the processing of your application, our contact information is listed below:

Region IV U. S. Nuclear Regulatory Commission DNMS/NMSB - B 1600 E. Lamar Boulevard Arlington , TX 76011-4511 (817) 200-1103 or (817) 200-1140

NRC FQRM 532

1'2~'113

BETWEEN:

Accounts Receivable/Payable

,"" Regional licensing Branches

I FORARPB USE I INF9RMATION FROM WBl

Program Code: 02120 Status Code: Pending Amendment

Fee Category: 7C Exp. Date: 06130/2014 Fee Comments: CODE 13 Decom Fin Assur Reqd: N

License Fee Worksheet - License Fee Transmittal

A. REGION

1. APPL\CATIONATTACHEO

AppIicanVUcensee: MEMORIAl HaSP OF SIfoIEETWATER COUNTY

Received Date: 0110412013 Docket Number: 3013672 Mail Control Number: 579669 License Number: 49-17940-01

Action Type: Amendment

2. FEE ATTACHED I

AmolXlt

Check No.:

3. COMMENTS

Signed:

Dale:

B. L.ICENSE FEE MANAGEMENT BRANCH {Check when milestone OJ is en tered I I

1, Fee CategOfy and Amount:

2. Correct Fee Paid. Application may be processed for.

Amendment:

Renewal :

Ucense:

J . OTHER _____ ________ _

Signed:

Date:

-