|
|
| SAMPLE TRANSPORTATION INSTRUCTIONS | |
Radioactive material transport checklist |
|
| ||
Date |
| Operator |
| |
Destination |
|
| ||
|
|
|
|
|
|
|
|
|
|
Transport Container Model |
| Serial Number |
|
| ||||||||||||||||
Radionuclide |
| Activity |
|
| ||||||||||||||||
Type of Label Applied |
| Transport Index |
|
| ||||||||||||||||
Survey Meter Model |
| Serial Number |
|
| ||||||||||||||||
Calibration Date |
| Film Badge |
|
| ||||||||||||||||
Dosimeter Serial Number |
| Initial Reading |
|
| ||||||||||||||||
Final Reading |
|
|
|
|
|
|
|
|
|
| ||||||||||
Radiation Area Signs |
| Packing List |
|
| ||||||||||||||||
Rope |
| Bill of Lading |
|
| ||||||||||||||||
Radioactive Material Sign |
| Emergency Equipment |
| |||||||||||||||||
Radiation Survey |
| Driver’s Compartment | mRem/hr | |||||||||||||||||
(Record highest reading) Vehicle (18 in from surface) |
|
|
|
|
|
|
|
| mRem/hr | |||||||||||
Packages properly marked and labeled (including transport index) |
|
| ||||||||||||||||||
Packages secured in vehicle |
| Vehicle Placarded |
|
| ||||||||||||||||
Shipping papers properly completed |
|
|
|
|
|
|
|
|
|
| ||||||||||
Remarks: |
|
|
|
|
|
|
|
|
| |||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operator’s Signature
5.11