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Application for Possession and Use of Radioactive Materials
University of Maryland
Radiation Safety Office
College Park, Maryland
Application for Possession and Use of Radioactive Materials
1. Name of Individual User: | 2. Telephone: | 3. Date:
4. Department: |
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5. Building where you will be using Radioactive Material: List Room(s) in which you will:
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6. Isotopes to be used: | 7. Chemical/Physical Form | 8. Possession Limit by Nuclide:
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9. Chemical, biological and radiation hazards involved:
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10. Type of hood(s), air flow, filters, and ventilation in laboratory by room No.:
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11. Make and model of all radiation detection instruments available for your use and method and frequency of calibration:
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12. Method and frequency of monitoring your work are for possible contamination:
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13. Type of security to avoid loss or theft of radioactive material:
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RSO C-1 Rev. 3/93 |
14. Type of containers to be used for radioactive waste: ( Will be supplied by Environmental Safety, Hazardous Waste Opns based on your needs as reflected in Item 14. above and as requested to HWO):
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15. Attach complete protocol(s) of your investigation (include amount of activity to be used per experiment or procedure):
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16. Detail how you plan to control each hazard listed in Item 9. above:
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17. Type and approximate volume of radioactive waste generated per month: (be specific)
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For Use by the Radiation Safety Office
Date Received: Conditional Approval: Committee Approval: |
Signature Principal Investigator
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Signature of Department Chair
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RSO C-1 Rev. 3/93