Radioactive Materials License Supplement
License Conditions 11 through 13
Questionnaire
Please complete this questionnaire and submit with your
UAB Radioactive Materials License Application
Should you have any questions please contactRobert Heath, Jr.:
(205) 934-2487 (Safety office number), 934-2487 (fax), (email)
Your Name & Office Phone: / YES / NO11Release of Radioisotopes:
a. Do you expect any effluent release to any radioactive materials to the following?
1. Laboratory Air Space
2. Laboratory Drain
3. Fume Hood
Should you answer yes to any of the above, then, on a separate attachment, describe the nature and amount of release and explain how you intend to measure and mitigate such release.
12. Waste Management:
When radioactive material waste is generated, do you agree to the following terms:
1. Through vigilant recordkeeping, accurately determine the activity of all radioactive material in your waste stream
2. Segregate all liquid radioactive waste from all solid radioactive waste
3. Double bag and adequately seal all liquid radioactive waste from leakage. Then pack in a sturdy cardboard box for pick-up by the Hazardous Materials Facility personnel
4. Bag and adequately seal all solid radioactive waste. Then pack in a sturdy cardboard box for pick-up by the Hazardous Materials Facility personnel
5. Accurately complete the Radioactive Materials Waste Manifest , see link below:
6. Make sure that all radioactive material in your possession, including radioactive waste, is secure from unauthorized seizure of unnecessary exposure.
Briefly describe, on a separate attachment, how you will manage the handle, store and shielding of radioactive wastes.
Click onto or visit the link below to access and completethe Mandatory Radioactive Waste Minimization Program checklist by checking all that apply.
13. Receipt and Procurement of Radioactive Materials:
1. Upon the receipt of all radioactive material, will you log the stock material into the proper use log, and secure in properly labeled storage area?
2. Will you maintain all records, pertaining to UAB radioactive material licensure, for the time interval according to the UAB Radiation Safety Record Retention Schedule? Such records include, but are not limited to: use, survey, waste, receipt, inventory, transfer, calibration, etc.
Briefly describe how you will maintain said records.
Click link below to view Record Retention Schedule
1. Transfer of Radioactive Materials:
3. If you transfer radioactive materials to or from your radioactive materials license, whether within or without the UAB community,
a. Will you seek the prior approval from the UAB Radiation Safety Officer?
b. Will you contact the RSP to request instruction on completing the proper Radioactive Material TransferForms?
2. Disposal Procedures:
a. Upon the agreement of all items outlined in condition 12 above, will you agree to not dispose of anything bearing the radiation symbol (trefoil), the words “Radiation” or “Radioactive” into the non-radioactive waste stream?
(You should completely deface all radiation symbols and wording before discarding packages and documents into the non-radioactive waste stream.)
b. Will you dispose of all radioactive material waste according to guidelines outlined in the UAB Radiation Safety Procedures Manual? Furthermore, will you complete the proper Radioactive Materials Waste Manifest form to allow proper and timely radioactive materials waste pick-up by the UAB Hazardous and Regulated Waste Facility Personnel?
Briefly describe how you will ensure steps of proper disposal.
3. Training:
a. Will you promptly notify the UAB Radiation Safety Program of the arrival of new radiation workers to your license and provide direct supervision of their work with radioactive materials until all UAB Radiation Safety Training requirements have been met?
b. Will you ensure that all radiation workers successfully complete the UAB Radiation Safety Training Course, or its equivalent, within six months of joining your laboratory if documentation of prior or initial training has not yet been acquired or approved?
c. Will you ensure that all radiation workers, including you and your alternate licensee, satisfy all five year radiation safety refresher training requirements?
Briefly describe how you will ensure compliance in all training requirements.
4. Safe Handling Procedures
a. Will you require the use of laboratory coats and gloves during the use and handling of radioactive materials?
b. Will you employ the principles of A.L.A.R.A. within your laboratories?
c. Will you make use of a functional, calibrated, Geiger-Counter when applicable, and immediately decontaminate all contaminated areas and items under your possession and control?
d. Will you perform a weekly area wipe test during times/weeks of radioactive material use?
e. Do you, subsequently, agree to maintain and document all radiation-related records?
Briefly describe how you will promote safe use, handling and security of radioactive materials.
Describe the safety measures that you will employ in the handling of radioactive materials. Also include any special safety precautions involving a specific radiation related experiment or protocol.
If you respond “NO” to any of the questions above, then please provide a detailed explanation as to why your response was “NO”.
Please note that all “NO” or blank responses will greatly delay or jeopardize the approval of your UAB Radioactive Materials License Application.
RML Application Conditions 11 through 13UAB Department of Occupational Health & Safety Radiation Safety Program,
Revised December 28, 2010