Dh 1322 - Application For Radioactive Materials License Page 3

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Florida Bureau of Radiation Control - Application For Radioactive Materials License
HUMAN USE
6.b. Radioactive Materials Details Not Provided In Item 6.a.
Chemical or
Isotope
Maximum number of sources, activity
Purpose for which radioactive
Physical Form
(curies) for each source and total activity
materials will be used:
Sealed source XYZ Corp.
Ex. Co-60
30 sources, 2 curies each for a total of 60 curies.
64E-634(1). 15 sources for
Model XYZ for use in XYZ Corp
possession for source exchanges.
Model AAA therapy device
See attached for procedure details
Item
Appendix
Title
Model Procedure
Equivalent
Attached Or NA
Procedure Attached
7
None
Facility Diagram
NA
8
A
Radiation Safety Committee
9
B
Instrumentation
10
C
Quality Control
D
Dose Calibrator
11
12
E
Personnel Monitoring
13
F
Training Program
14
G
Ordering And Receiving
15
H
Opening Packages
16
I
Use Records
17
J
Rules Of Use
18
K
Emergency Procedures
19
L
Area Surveys
20
M
Members Of Public Dose Study
21
N
Radiopharmaceutical Therapy
O
Implant Therapy
22
23
P
Radioactive Gases & Aerosols
24
Q
Quality Management Program
25
R
ALARA Program
(Radiation Safety Committee Required)
26
S
ALARA Program (No Radiation Safety Committee)
27
T
Leak Testing
28
U
Bioassay
29
V
Survey Meter Calibration
30
W
Waste
31
X
Inventory
32
Y
Diagnostic Radiopharmaceuticals
33
Z
Mobile Nuclear Medicine
34
Other
NA
DH 1322,12/09 (Rule 64E-5.207, F.A.C.)
Page 3 of 4

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