April 2, 2001

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Mr. David J. Collins U.S. Nuclear Regulatory Commission Region II, Division of Nuclear Materials 61 Forsyth Street, S.W. Suite 23T85 Atlanta, GA 30303

Dear Mr. Collins:

Buchanan General Hospital wishes to amend its Radioactive Materials License No. VA112-06. Our current license will expire May 31, 2001.

We wish to make the following amendments to our license. We would like to have Dr. Jose Alemparte added to our current license as an Authorized User for Cardiac procedures only.

I am enclosing documents which I trust will serve as sufficient documentation for this purpose.

1. Introductory Letter from Jose Alemparte, M.D. 2. Curriculum Vitae 3. Addenda to Supplement A:

A. Certification of 200-Hour Academic Requirement of 10 CFDR, Subpart J

B. Certification of five (5) supervised Inert Generator Elutions 4. Reference letter from B. Chandramouly, M.D., Chief of Nuclear Medicine

at Long Island College Hospital. 5. Certification for "Radiation Safety Officer" medical course - May 24 - 28,

1999 6. Certification for "Radiation Safety Officer" medical course - February 19

24, 2001 7. Certificate from Long Island College Hospital certifying fellowship in

Cardiology 8. Certificate from American Board of Internal Medicine certifying Dr.

Alemparte as a diplomat in Internal Medicine 9. Certificate from American Board of Internal Medicine certifying 6r.

Alemparte as a diplomat in Cardiovascular Disease 10. Authorized User Application Letter to the U.S. Nuclear RecP oVi&rna 24614

Commission 540 935.1000

Fax 540 935.4959

April 2, 2001 Page 2

Please let me matter.

Sincerely,

if additional material is needed. Thank you for your attention to this

)nai

SP:kg

enclosures

BUCHANAN HEALTH CARE, LLC. BUCHANAN ORTHOPEDICS * BUCHANAN INTERNAL MEDICINE * KEEN MOUNTAIN MEDICAL ASSOCIATES

HURLEY INTERNAL MEDICINE * THE CENTER FOR WOMEN'S HEALTH * BUCHANAN ANESTHESIA

March 12, 2001

United States Nuclear Regulatory Commission Region II Atlanta Federal Center 61 Forsyth Street SW, Suite 23T85 Atlanta, Georgia 30303

RE: Authorized User Application

Dear Sir/Madam

I am a cardiologist practicing in Grundy, southwestern Virginia. I started working at Buchanan General Hospital in February of 1998. Since then I have performed 700 Nuclear Cardiology procedures ( mostly stress tests) under the supervision of Dr. Dillip Patel, Chief of radiology and Radiation Safety Officer.

I am board certified in Internal Medicine and Cardiology.My fellowship training at The Long Island College Hospital in New York included more than 500 hours of Nuclear Medicine training. This included performing and interpreting Nuclear Cardiology tests under the direct supevision of the Cardiology and Nuclear Medicine attendings. Also included lectures emphasizing radiation safety protocols, technical aspects of the Nuclear Cardiology procedures and handling of the radiopharmaceuticals. We also attended a monthly Nuclear Cardiology Journal Club.

Enclosed, please find copies of my CV, Board certifications, letter from Dr. Belur Chandramouly (Chief of Nuclear Medicine at The Long Island College Hospital) and certificates from Physics Associates in Roanoke, Virginia.

Sincerely,

Jose A. Alemparte, M.D., F.A.C.C.

P.O. BOX 669 GRUNDY, VA 24614 TELEPHONE 540-935-2139 FAX 540-935-7132

CURRICULUM VITAE JOSE A. A LEMIPA R TE, Al. D., F A. C C TEL (540) 566-8424 P. 0. BOX 1959 FAX (54(0) 566-8114 (;rnndy, VA 24614

December 1998-Present Buchanan Healthcare Inc. Hurley Internal Medicine, Hurley, VA. hluternal Medicine/ Cardiology.

June 1998-December 1998 Private practice, Internal Medicinei( ardiology, Grundy VA. A ctive member o?f the medical staff at Buchanan General Hospital.

1997-May, 1998 Plhysician, Itterntal Medicine ('ardiology', Rural Health Clinics, hIc., Whitewood, VA. Meiber of the active medical .staff at Buchanan G(eneral Ho.%pital, (Grundy,, [IA.

Hospital Affiliatons Buchanan General Ho.spital, Grundy, VA. Since 11/97. Clinch Valley Medical (Center, Richlands, VA. Since 08198.

Training 1994-1997. Fellow in cardiology at The Long Island College Hospital, Brooklyn,NY. A three year fellowship with formal training in all aspects of invasive anid non-invasive cardiology: cardiac catheterization, stre.ss testing (including stress echocardiography), 7'E, pacenlakers and nuclear cardiology. Mandatoty rotations (1-2 months every year) include: lElectrophysiology at Mount Sinai Medical Center, New York, NY ('ardiothoracic Surgety at Beth Israel Medical Center, New York, NY. Cardiac Catheterization anid Interventional ('ardiology at Maimonides Medical ('enter, Brooklyn, NY.

1993-94. ('hief resident, Internal Medicine, at Woodhull Medical (Center; Brooklyn, NY, affiliated with State I Iniversity of New York HSC at Brooklyn.

1990-93. Residency in Intiermal Medicine at Woodhull Medical Center. 1989-90. Rotating Internship, Clinica A breu, Santo Domingo, Dominican RIepubiic. 1986-89. t'rimary ('are physician, Dominican Institute of Social Security, Dominican Republic.

Education Umiivemsidad A utonoma de Santo Domingo, School ofMedicine, Dominican Republic. Degree: Doctor o/fMedicine, October 28, 1986.

Board Certifications Board certified in Ititer',al Medicine, 1993. Board certified in Cardiology, 1998.

lonors and A wardIs Graduated "('urn laude ", No. 3 in class qf 250, 1986. hitern of the )iear 1990-91, Woodhlull Medical ('euter.

Membership in Prof, ssiontil Scielies Fellow ?f the Americau (College qf ( 'ardiology. Member of the Buchanan-I)ickensvo (C'ounly Medical Society. A fenher of the 7itzeiell ( Couuly Medical Society.

MEDICAL PHYSICS SHIELDING RECOMMENDATIONS

RADIATION PHYSICS EMERGENCY CONSULTATION

Lee S. Anthony, Ph. D.

Certified Health Physicist Certified Medical Physicist

Certified Radiologic Physicist

9 March, 2001

PHYSICS ASSOCIATES 5346 Peters Creek Road Roanoke, Virginia 24019

Tel: (540) 563-0165

Robert C. Hudson, M.S. Kay A. Saul, B.S.

Lee S. Anthony, Jr., B.S.;M.A.

ADDEENDA TO SUPPLEMENT A, DR. J. ALEMPARTE'

Previous Academic History on Supplement A:

Physics Associates' Nuclear Medicine/Radiation Safety Course 2/19-24/01

Directed Study, week of 3/5-9/01

Tutorial on 3/9/01

Directed Study: (1) Wick manual (2) NUREG 1556 Consolidated Guidance About Materials Licenses (3) NUREG 1516 Management of Radioactive Material Programs at

Medical Facilities (4) 10 CFR 19, 20, & 35

TOTAL:

100 hrs

45hrs

3 hrs

8 hrs

8 hrs 8 hrs

8 hrs 8 hrs

204 hrs

I hereby certify that Dr. J. Alemparte has met the 200-hour Academic Requirements of 10 CFDR, Subpart J toward the requirements for Radiation Safety Officer.

I further certify that Dr. Alemparte has performed five (inert) generator elutions under my supervision.

In summary, I hereby recommend Dr. J. Alemparte be named as an Authorized User for those materials described in 10 CFR 35.100 and 35.200.

Lee S. Anthony, Ph.D.

C.H.P., C.R.P., C.M.P.

DEPARTMENT OF RADIOLOGY

BELUR S. CHANDRAMOULY, M.D. CHIEF, DIVISION OF NUCLEAR MEDICINE

THE LONG ISLAND COLLEGE HOSPITAL BROOKLYN, NY 11201 718-780-1167

"ebruaty 2, 1999

no Whom It May Concern:

This letter is in reference to Dr. Jose A. Alemparte. Dr. Alemparte actively participated in Nuclear Cardiology procedures during his cardiology fellow-ship training at the Long Island College Hospitalfrom July 1994 to dune 1997. The Nuclear Cardiology training included performing the Stress Test for the Stress-ihallium studies, Rest-Thallium studies, Multigated Blood Pool studies and Technetium 99m Pyrophosphate Imaging studies. He was involved in interpreting the studies with the Nuclear Medicine attendings.

In addition, Dr. Alemparte attended Nuclear Cardiology lectures emphasizing radiation safety protocols, technical aspects of the Nuclear Cardiology procedures and handling the radiopharmaceuticals. The monthly Nuclear Cardiology Journal Club covered several recent Nuclear Cardiology Journals. 7his training in Nuclear Cardiology was more than 500 hours in total, during the 3 years period The Nuclear Medicine License Number is 91-2843-01, at LICH.

Dr. Alemparte actively participated in following the patients who had Nuclear Cardiology procedures with other imaging modalities.s

I wish him all the success.

Sincerely,

B. Chandramouly, M.D. Chief Nuclear Medicine

BC:ac

ich

THIS IS TO CERTIFY THAT

J. ALEMPARTE, M.D.

HAS SUCCESSFULLY COMPLETED THE

"RADIATION SAFETY OFFICER"/MEDICAL COURSE TAUGHT BY PHYSICS ASSOCIATES

AT Bluefield, West Virginia

FROM May 24 TO May 28 ,19 99.

THIS COURSE WAS BASED ON THE DRAFT REGULATORY GUIDE "QUALIFICATIONS FOR THE RADIATION SAFETY OFFICER IN A LARGE-SCALE NON-FUEL-CYCLE RADIONUCLIDE PROGRAM"

BY THE U.S. NUCLEAR REGULATORY COMMISSION.

Lee S. Anthony, P.D., Instructor Certified Health Physicist Certified Radiologic Physicist Certified Medical Physicist

THIS IS TO CERTIFY THAT

J. A. A L E M P A R T E

HAS SUCCESSFULLY COMPLETED THE

"RADIATION SAFETY OFFICER"/MEDICAL COURSE TAUGHT BY PHYSICS ASSOCIATES

MARION,AT

VIRGINIA

FROM F E B R U A R Y 1 9 TO FEBRUARY 244 2001

THIS COURSE WAS BASED ON THE DRAFT REGULATORY GUIDE "QUALIFICATIONS FOR

THE RADIATION SAFETY OFFICER IN A LARGE-SCALE NON-FUEL-CYCLE RADIONUCLIDE PROGRAM"

BY THE U.S. NUCLEAR REGULATORY COMMISSION.

ASRT # VADO021001

Lee S. Anthony, ph.D., Icnstructor

Certified Health Physicist Certified Radiologic Physicist Certified Medical Physicist

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ATTESTS THAT

Xmite A. Alrompattrl HAS MET THE REQUIREMENTS OF THIS BOARD AND IS HEREBY

CERTIFIED FOR THE PERIOD 1993 THROUGH 2003

AS A DIPLOMATE IN

INTERNAL MEDICINE

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ATTESTS THAT

5host Antnnti Alkmpzrtr t5HAS MET THE REQUIREMENTS OF THIS BOARD AND IS HEREBY

CERTIFIED FOR THE PERIOD 1998 THROUGH 2008 AS A DIPLOMATE IN

CARDIOVASCULAR DISEASE

6C11lk CHAIR~

AMERICAN BOARD OF IN-TERNAŽ MEDICINE

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CHAIR ELCEC,ýRE-TAR)* -TR EA SU R E R , l.6RkDET.lf1( AMERICAN BOARD OF IN IRNAL MEDICINE AMERICAN BOARD OF INTERNAL MEDICINE AMERICAN BOARD OF INTERNAL MEDICINE

SUBSPECIALTY BOARD ON CARDIOVASCUL4AR DISEASE

NUMBER 148070 1998

EXHIBIT 2

SUPPLEMENT A

SluFPEM197 U.&. NUCLEAR REGULA10AY CbMMiIS

TRAINING AND IXPERIENCE AUJTHORIZED USER OR RADIATION SAFETY OFFICER

1. NAIt OF PAOpOSKO AU'TIsORIZED USER OR RADIATION SAFETY QF~ICIR 7.FOR PHYSIC!ANS, STATE OR 7EARITORY MNIR! LICENSED

Tesf. A. A1dmovrri, /(.b. jJ

WOCIAI.Y WnARD CATI14ORY MONTH AND V9AR CERIEf *E

-1,0ICIAMAL C -5(;/f

CAllbi01,4.rI' 4'C hllF0E4f'

4. TRAININO RECEIVED IN BLASIC RAD104SOTGOE tiMNDLNG T(ECHNIOLICS

TWI AND 66N41M Of TRAINIG

CLOCK HOURS IN CLOCK HOURS OF VIRLD 00TRAINING L4CATION ^NO DATYMWIOf TRAINING8 LtCTUNC OR SUPERVISED

A LABORATORY Off-TilE-jO* EJLPRIO1CE

1ii#E LotAJ6 :rrtL44b CAv Cm, C "i.RAIATMIONPI4YICS AN ~ 4ps~iTAC . *1,04-0. F:?y 20o (00

10117RUMINTAYION RFAr"I4T 4kJ 09 C~S' &/rI ______

b. ADIA71ON PROT11IONP "Osir4t. -f' /?VF- (,/30/ 1?- (00

W, MAYNEMATIC~fNI91TA1NI1NGTO #I-+ T"I4 ./Y' THlE W" AND MSANUPIM60T a 4 A!iP 0 r-, A- 3 OFPA MOIACTIVtTY ,j x w v"l ,C

At4 i~a TA tO~L(

L. RAMPHtARMACUUITICAL1.5e .)IA ~ ?//f -q rof

6. EXPIRAI ENCIE wiY4 RADIATION. (Acne/ va of' RedAJo'rPa of fQuv~vpfft tohftp~p~v)

ISOTOPC haiC US E; Ar ONEg TIME LQCATION CLC c Hoc QUM TIP9 OF USE

cV-M/~dA

EXH-5

TOTAL P.01

A

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EMISIT 3 SUPPLEMENT B

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Pmma MUCHA USLIV I MW PM ýDACSI k-KVTo COLUMN

Pw LU ln^"% PS044RAL PAR'hOP*.TIQW VWVLD CCMUO aft

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JAN-18-2000 1G:31

R2 DNMSNUCLU)R PIED I C I NE

Fax:404-582-4 M718 760 2499 P-02/02

ij.& P(W-LIAM AIdULOYQAY

PRECE"Uri STATEMENT

Wiff a a A rd it mism pom f In" w4cm

X CUMCAC rotAINING ANO EXPEMENC4 OF ASOVA NAMED PHYSICIAN

M46"frApar fqf C, it" 0 am"Pofe's of

A- W&WAMOM Arp4ma, dF tvvaýw moolkieMalliva

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Kim ventilativik study

WHO vZotilett" Icon

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EXH-6

TOTAL P.02

EXHIBIT 3 (Continuýd)

PRECEPTOR STATEMENT (ConrinfiedJ

L CLINICAL IRAININO AND EXF9141ENCI Of ABOVE NAMED PHYSICIAN Monfinuildfi liumaw9w

CAUS INVOLVINC cmmtmys ISOTOPE CON1011IONS DJAGkOSfO 0A TREATED PERSONAL lAddiflooliviRton"efs" w sopvtowns mw jw

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A I C -0 -T= YARATOASNY OF POLVCYT146MIA WRA.

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lewbAfto 110PIACAVITANY TREA7MENT

TRIATMENT OF TMVJkOIO CARCINOMA

TRIAVANY OF MVPEFITHYROIDIS'

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INT1111019TITIAL 11%4ATM6MY

C0137 INYRACAVIlARY TAEATWNT

TtUl HE 14AFT TREATME14Y Cb-133 "o TFIVATM00 OF EYE Diuotsf

AADIOPHAAIAACC"CAL PREPAPIATION meAw 'tt4*m G&ONATOA set-mv "NIRAT" Irw 1 13M To4lik" REAGGHT KITS

DATES AND TOTAL NUM1111AR Or HOURS AECRIV90 IN CLINICAL RADIOISOTOPE TRAINING LOCATION DAYES CLOCK ROWS OF EXPER)ENCE

Tka. Lo-or, TAAAL '&Ue4c 41, 405f IT*L I AAwlerAl, ". Y.

4. THC TRAININd 7AD EXPERISCII INDICATib ASOVE -IL PRICEPYORl SIONATURN WAS 0411TAIN90 UWWR TM SUPERVISION Oll": a lq;kw4 of Fmrpvlisn I tULUA CUAII)bOrU AoVLY Al

k NAQ Of (14 ITVTION 7, PRI CEPYOR'S NAME Plosm tvoo ofAiNottl

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AL GOTT 6. VAT! 11 40OKt o2ol

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l'iU-L.LF+< PILVIUNE 718 780 2499 P.01/02

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EXH-7

Tm-IR-pm 15-148 540 556 0114 P-02

PROPOSED PhY31CIAK UM A.