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