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   The Division of Environmental Health licenses, certifications, and permits

Learn more about the Division of Environmental Health

Medical Licensing

The application is for all medical use of radioactive material used by hospitals, clinics or private physicians.  Adapt the application to fit the proposed use and/or facility.  Few applicants will need to complete the entire application.

Manufacturers and Distributors

 

For manufacturers and distributors who want to make and ship nuclides for medical use, there is no application form on this site.  If you wish to apply for a license for accelerator-produced medical nuclides contact the department and we will work directly with you.  We use the nationally recognized standards when preparing these applications and licenses, NUREG-1556, Vol. 21.

 

Nuclear Pharmacy

There is no application form on this site.  If you wish to apply for a license for a nuclear pharmacy contact the department and we will work directly with you.  We use the nationally recognized standards when preparing nuclear pharmacy applications and licenses, NUREG 1556, Vol 13.

For further information contact Curt DeMaris, 360-236-3223

For files which require a viewer go to http://www.doh.wa.gov/viewer.htm to download a viewer. If the type of package you are interested in is not available on-line, please contact us to receive a printed copy.

New Licenses
 

• Application DOH 322-016 (PDF, 1.37 MB)  Instructions  DOH  322-026 (PDF, 245.54KB)
• Application  (MS Word, 955KB) Instructions (MS Word, 645KB)
• Appropriate fees - Current Fees
• Completed city-county notification form
• Small business discount certification (if applicable)

Send completed application packet to:

Washington State Department of Health

Radioactive Materials Section - New License

P.O. Box 47827                                                                                   

Olympia, Washington 98504-7827    

  Be sure to:

• Complete the entire form.

• Make a check made payable to the Department of Health

• Enclose original, signed copy of your radioactive materials license application with supporting information.

• Keep a copy for your records

Renewal Licenses

Renewal applications must be received 30 days prior to expiration of the current license.  This qualifies your license for timely renewal which allows your current license to remain in effect until the Department has processed your application.  Information contained in previous applications regarding only initial training and qualifying experience, such as training certificates and medical preceptor statements, may be incorporated by reference.

A renewal package consists of:

• Signed application
  • Application DOH 322-016  (PDF, 1.37 MB)  Instructions DOH  322-026 (PDF, 245.54KB)
  • Application (MS Word, 955KB) Instructions (MS Word, 645KB)
• Completed city-county notification form (for changes in location)

Annual fees are billed separately.  Renewal applications are sent to:

Washington State Department of Health

Radioactive Materials Section - License Renewal

P.O. Box 47827                                                                                   

Olympia, Washington 98504-7827    

Contact Information
 

For more information call or email the appropriate person.  Send written correspondence to the address below or fax to 360-236-2255.

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Washington State Department of Health

Office of Radiation Protection                                       Physical Address:
P.O. Box 47827                                                            111 Israel Road SE, TC2
Olympia, Washington 98504-7827                                  Tumwater, Washington 98501
(360) 236-3300

Send inquires about DOH and its programs to the Health Consumer Assistance Office
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Last Update : 08/13/2009 05:12 PM