Fillable UNIVERSITY RADIATION SAFETY OFFICE INDIVIDUAL USER APPLICATION To:WrightStateUniversityRadiationSafetyOfice (Wright State University)

Fill Online, Printable, Fillable, Blank UNIVERSITY RADIATION SAFETY OFFICE INDIVIDUAL USER APPLICATION To:WrightStateUniversityRadiationSafetyOfice (Wright State University) Form

Use Fill to complete blank online WRIGHT STATE UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

UNIVERSITY RADIATION SAFETY OFFICE INDIVIDUAL USER APPLICATION To:WrightStateUniversityRadiationSafetyOfice (Wright State University)

On average this form takes 2 minutes to complete

The UNIVERSITY RADIATION SAFETY OFFICE INDIVIDUAL USER APPLICATION To:WrightStateUniversityRadiationSafetyOfice (Wright State University) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 9 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Wright State University

BROWSE WRIGHT STATE UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
In
dividual User Version:2015.1 Revised:01Mar2015 Univ ersi t y Radiaon SafetyOffice 1
UNIVERSITY RADIATION SAFETY OFFICE
INDIVIDUAL USER APPLICATION
Date:
To:WrightStateUniversityRadiationSafetyOfice
From(AuthorizedUser):Dept:
Re:AmendmentRequesttoAddIndividualUsertoUseAutho rization
Pleaseapprovethefollowingindividual(s)asanIndividualUser(s)undermyUseAuthorization.
Training
Aguideonthetopicsforlaboratory‐speciictrainingcanbefoundonpage2ofthisdocument.Eachap‐
plicantmustalsocompletetheSafeUs e ofRadioactiveMaterials training,offeredbytheRadiationSafe‐
tyOficeviaPilotorcanbelecture‐based,uponrequest.
Laboratory‐SpeciicTraining:Ihavetrainedeachapplicantonlaboratoryprocedures,radiation
hazards,useofpersonalprotectiveequipment,rulesandregulations(e.g.wheretoindtheRadiation
SafetyManual,security,nottoeat,drink,smoke,applycosmetics,andtouchcontactlensesinthelab),
userresponsibilities,emergencyprocedures,andotheritemsfromtheRadiationSafetyManualasthe
topicsrelatespeciicallytomylaboratory.
RadiationSafetyTraining:AttachformRSO1(RadioactiveMaterials)foreachapplicant.
For RSOffice Use, Only:
Comments/Condions:_____________________________________________________________________
________________________________________________________________________________________
RadiationSafetyOficer: Date:
Dosimetry
Dosimetrywillnotbeneeded.
Pleaseissuedosimetry.AttachedisaDosimetry Issuanceform.
In
dividual User Version:2015.1 Revised:01Mar2015 Univ ersi t y Radiaon SafetyOffice 2
Topics for Laboratory Training
 Laboratory procedures for use and storage of radioactive materials.
 Individual User responsibilities.
 Ordering procedures.
 Security of radioactive materials.
 Restrictions on eating, drinking, smoking, applying make-up, and touching contact lenses
while in the lab.
 Disposal of radioactive waste.
 Radiation hazards and health protection problems
 Personal protective equipment
 ALARA practices.
 Lab coat, gloves, proper attire (e.g. pants or skirt that covers legs completely and close-
toed shoes) are required when using unsealed sources of radiation.
 Operation and use of the survey meter, as applicable.
 Surveys for removable contamination.
 Rules and policies (e.g. review the Radiation Safety Manual).
 Relevant Ohio rules and license available from RSO, 104 Health Sciences Bldg.
 Location and review of the Radiation Safety Manual.
 Worker must comply with provisions of Ohio rules and Radiation Safety Manual.
 Worker must report violations or unsafe conditions.
 Response to unusual occurrences that may involve radiation exposure.
 The worker can obtain radiation exposure information at any time from the Radiation Safety
Office.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

UNIVERSITY RADIATION SAFETY OFFICE INDIVIDUAL USER APPLICATION To:WrightStateUniversityRadiationSafetyOfice (Wright State University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 December 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document