1. (a) To be eligible for authorization as a TSP, an applicant shall submit to the Department an acceptable application, as described in section 30313.30(a), containing:

   1. (1) The applicant's legal name, mailing address and telephone number;
   2. (2) The applicant's social security number (SSN) or individual taxpayer identification number (ITIN) (pursuant to the authority found in sections 131050, 131051, and 131200 of the Health and Safety Code and as required by section 17520 of the Family Code, providing the SSN or ITIN is mandatory. The SSN or ITIN will be used for purposes of identification.);

   3. (3) Documentation that the applicant meets the requirements of section 30313.05. Except for applicants requesting authorization pursuant to section 30313.05(a)(1)(A), the applicant shall include at least three sample radiation protection survey reports of therapeutic X-ray equipment at a medical facility, one of which is a survey of therapeutic X-ray equipment with an energy greater than 500 kVp. Additionally, applicants requesting authorization pursuant to section 30313.05(a)(2) shall: for the required degree, submit a diploma or transcripts, or a copy or copies thereof; for training, submit completion documents, or copies thereof, showing what training was received or completed, the date(s) of the training, and that the training was approved, or obtained through a program accredited, by the Commission on Accreditation of Medical Physicists Educational Programs, Inc.; and, for work experience, submit a written letter from the applicant's supervisor, or multiple letters if multiple supervisors, containing:

      1. (A) The name, signature and date of signature of the supervising individual;
      2. (B) The name of the applicant;
      3. (C) The dates the supervisor supervised the work of the applicant;
      4. (D) The name of the facility where the applicant was supervised; and
      5. (E) A statement confirming that the applicant fulfilled the work experience requirement pursuant to section 30313.05(a)(2)(A) and is competent to function independently as a TSP. If work experience was completed under multiple supervisors, the statement shall state the amount of hours the individual was supervised and that the individual demonstrated competence in performing assigned duties during the time the individual was supervised; and
   4. (4) The application fee specified in section 30313.45.
2. (b) Authorization shall be valid for three years.

Note: Authority cited: Sections 114975, 115000 and 131200, Health and Safety Code. Reference: Sections 115060, 131050, 131051 and 131052, Health and Safety Code.

History

1. New section filed 5-13-2020; operative 10-1-2020 pursuant to Government Code section 11343.4(b)(2) (Register 2020, No. 20).