APPENDIX C: Instructions for Completing the Application for User Authorization

 

The following instructions are keyed to the data entry numbers on the form:

1a. The principal investigator is the person who will be responsible for the safe storage and use of radioactive material by his/herself or others. Upon approval of the application by the RSC, the principal investigator becomes the "Authorized User" referred to throughout the Radiation Safety Manual.

1b. Users are persons who will work with the material with or without the direct supervision of the Authorized User. If the material is to be used by students in a directly supervised and regularly scheduled laboratory course, so indicate. Such students need not be named in the application.

1c. Potentially exposed personnel shall include at least all persons authorized to work in the same room with the material. In the case of penetrating radiation (x-rays and gamma rays) indicate contiguous rooms (including those above and below) or areas which could be affected by unshielded sources, if authority for sources in excess of one millicurie is requested.

2. Indicate the building and room number(s).

3a. Each isotope shall be identified by name or symbol of the chemical element and the mass number of the isotope (e.g., cesium-137 or Cs-137).

3b. The activities listed shall be the maximum quantity desired to be on hand at any one time, including that temporarily stored as radwaste, and the maximum amount to be authorized for use in any one experiment or procedure. The quantity shall be expressed in curies.

3c. The "form" is the chemical or physical state of the material as it will be received from the supplier. If more than one form of an isotope is desired, the application must list the quantities for each form in curies.

5. Describe the purpose of the use of radioactive material in sufficient detail that the nature of the experiment or procedure can be readily understood. The information provided in sections 5 & 6 shall be sufficient to identify those procedures which entail a risk of airborne suspension of volatile or powdered radioactive materials and the anticipated maximum temperature to which each different form of the radioactive material is intended to be subjected. Identify potential accident scenarios which could result in unplanned exposure to ionizing radiation or ingestion/inhalation of radioactive material by users or the general public.

6. Prepare this section so that a complete evaluation of the radiation hazards can be made; include all anticipated changes in the chemical or physical form of each isotope listed in section 3 of the form.

8. All pertinent training and experience with radioactivity or related fields must be submitted on the first application from an investigator. Subsequent applications may refer to prior applications and need only list relevant changes.

1. List school or industrial or government facility where trained,
2. State duration of training in weeks, semester hours, etc.,
3. Indicate by check mark whether training was acquired on the job or in formal courses,
4. If this is the first application submitted by the investigator, list all radioactive isotopes with which experienced (on subsequent applications list at least those isotopes for which authorization is requested), the maximum amount (in curies) used at one time, and briefly indicate the nature of such use. If a supplemental page is required, so indicate and append.

9. Describe the instruments to be used for radiation exposure control and for experimentation. In the case of standard commercial instruments, provide a descriptive name for the instrument and list the name of the manufacturer, model number, and year of manufacture (or the approximate age of the instrument).

10. The application must be signed by the applicant and the immediate administrative supervisor (Department Chair, Laboratory Director, or Dean). The signature of the superior is necessary to signify administrative, if not technical, knowledge of the authorization sought.

Radiation-Producing Equipment

Proposals and requests concerning radiation-producing equipment and machines (as defined in Section 9.3.13) shall include a detailed description of each radiation-producing machine or piece of equipment. At a minimum, the information provided to the RSO by the proposed user shall include:

1. The manufacturer's name, address, telephone number and local representative, if any;
2. The name, model number and serial number of the unit;
3. The nature and intensity of the radiation emitted;
4. Whether the radiation field is confined within the equipment or extends outside the equipment during normal operation or when the equipment is accessed for maintenance;
5. In the case of equipment intended to produce an ionizing radiation field external to the equipment, the field shall be sufficiently characterized to permit assessment of the radiological health implications of its use;
6. Identification of safety devices incorporated to protect the operator and others from the harmful effects of such radiation.