 |
Environmental Health,Safety & Risk |
|
||||
|
Radioactive
Contamination Survey Record
Form 105 |
| Instructions: (Refer to section 7.0 of CSUN Radiation Safety Manual for detailed instructions) |
|
1.
|
Use simple
drawing of area to be surveyed to identify locations where samples or
measurements are taken. Note: Existing laboratory diagram (part of IRUA application) can be used. |
||||||||
|
2.
|
Fill in all data fields, and record all survey results - including negative results (non detects). | ||||||||
|
3.
|
Decontamination must take place if measurements exceed the following limits: | ||||||||
|
|||||||||
|
Survey
Area Diagram
|
|||||||||
|
|
| Instrument Used: | Units recorded (e.g. CPM, mR/hr): |
|
Date
|
BKG
|
Area
1
|
Area
2
|
Area
3
|
Area
4
|
Area
5
|
Area
6
|
Area
7
|
Initials
|
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|