How to Fill Out Permit Application Forms

 

To download each form, click the Rad Forms link to the right. For additional instructions on filling out each form, click the form type below:

 

Application Initiation Page

An Application Initiation Page must be completed for all applications. All applications are tracked by RAM permit number and application date. Complete the RAM permit number and application date at the top. For new applicants, a RAM permit number will be assigned during the review process, so list "new". Indicate the application type, complete the personal data, and sign the PI statement to confirm acceptance of responsibilities.

 

Authority Page

All PIs must demonstrate administrative support for their RAM permit. The administrator responsible for the PI is based on the primary location of the PI's authorized work (typically the department chair). If the PI requests use of an area supervised by another administrator, then support for use of that area must also be obtained. For example, if the PI does not have a liquid scintillation counter (LSC) for monthly swipes and would like to use another PI's LSC in a separate building, the PI in charge of the LSC room must provide approval. The PI is responsible for completing the information on this page and obtaining the required signature(s).

Note to the Direct Supervisor: Signing of the Direct Supervisor Statement confirms acceptance by the Administrator of the responsibilities listed in Administrator Responsibilities.

Note to the Supervisor for the other area: These sections must be completed when the PI applicant is requesting additional rooms in areas not supervised by the Direct Supervisor. Signing of the “Supervisor for Other Area” statement confirms acceptance by the administrator of the responsibilities listed in Administrator Responsibilities.

 

Training and Experience Page

The Radiation Safety Committee (RSC) must review the training and experience of all individuals requesting a RAM permit. Criteria for acceptable training and experience are based on the proposed uses and amounts of radioactive materials.

Complete the personal data section. This is for the PI applicant only. Document the type, date, and the duration of classroom (formal) training received on the listed topics and indicate where the training was received. Document the type, date, location and duration of experience working with radioactive materials.

If the new potential PI does not meet the training and experience requirements, classroom training will be required. Reach out to your assigned HP for recommendations on additional training.

 

Isotope Page

PIs must list requested radionuclides and associated hazards. In addition to the Isotope Page, the PI must attach a Standard Operating Procedure describing the work being performed and addressing any radiation safety issues. All RAM permits should have a current SOP on file.

Make sure to list each radionuclide that is being requested and include what form of the radionuclide will be used. The most common forms are 'any,' 'generator,' or 'sealed source.' Additional forms that may be specified are activation byproduct, radionuclide kit, microsphere, seed, foil source, or slug. For each radionuclide requested, list a shipping and a possession limit in mCi. The shipping limit cannot exceed the possession limit. In general, shipping limits are approximately 80% of the possession limits.

If generic procedures are used, identify them on the Isotope Page. Generic procedures include Northern blot, Southern blot, Western blot, Hybridization, Soil moisture gauge, Iodinations, Soil density gauge, Gas chromatograph, electron capture foil use, etc. An SOP must still be attached if only generic procedures are being used, but the SOP does not need to be extensive.

If any special uses will be performed using the radionuclides requested, descriptions of the additional controls and procedures for each condition must be included in the SOP. Make sure to indicate which special uses may occur by checking the box next to each option on the Isotope Page.

For help on addressing the special conditions in the SOP or the setup in the lab, refer to Radiation Safety Special Uses and Controls of RAM. If you need additional assistance in addressing Personal Protective Equipment concerns, see the Personal Protective Equipment page.

 

Radioactive Material Location Page

Each room or area will be reviewed and approved on an individual basis. Rooms will be designated as restricted areas and the storage and use of radioactive materials is approved anywhere within the restricted area. Rooms may be categorized into the following types: radioactive work area, modified restricted area, common use area, storage only, transitory use only, or other.

Information concerning the surrounding areas is needed to assess safety concerns (e.g., radiation levels, contamination control, etc.). Information on the location of the radioactive work areas, storage areas, and other items on the identification key should be submitted with the application. Moving these locations within the restricted area does not require a permit amendment.

 
MODIFIED RESTRICTED AREA

To request a modification of a restricted area:

  • Explain the purpose for requesting the modification.
  • Provide a floor plan of the entire restricted area and surrounding areas. Identify all doors securing the area and mark which areas within the current restricted area will remain restricted and which will be non-restricted.
  • Describe how security to the modified restricted area will be maintained. 
  • If food and drink are to be allowed in the non-restricted area, explain how the food and drink will be brought into that area, and how the food and drink will be kept completely out of the proposed restricted area.
  • Explain how all individuals having access to the modified restricted area will be trained to know and understand their responsibilities with regard to compliance with the special conditions governing the area.
  • Before the application is forwarded to the RSC, it will be reviewed and approved for by all Environmental Health and Safety (EHS) groups (i.e., Radiation Safety, Industrial Hygiene/Biosafety, General Safety, etc.). If compliance issues are identified for any safety issue, the application for restricted area modification will not be supported. Once a restricted area modification has been granted, any deficiency identified with compliance of the special conditions governing that area could result in the withdrawal of the approval. 

When filling out the form, make sure to:

  • Complete separate forms for each room or area.
  • Provide a floor plan identifying the items listed in the Identification Key. Plan should be "to scale" and include room dimensions.
  • Provide information on how security of radioactive material will be maintained when authorized personnel are not present. 
  • Identify how the area will be used by checking the appropriate box(es) on the form (i.e. counting equipment only, transitory use only, etc.)

 

Radiation Survey Instrumentation Page

The purpose of this form is to ensure that the RAM permit has appropriate survey instrumentation available to detect both fixed and removable contamination. When filling out the form, make sure to provide the requested information for each radiation survey meter and counting system.

Most RAM permits will need a Geiger-Mueller survey meter. A NaI survey meter may be required if the permit includes radioisotopes of iodine. If alpha emitters will be used, a ZnS survey meter may be required. Counting systems, such as an LSC, will need to be used to identify removable contamination.

If you need to obtain a radiation survey meter, contact your assigned HP for ordering information. If you need assistance identifying a counting system available for your use, contact your assigned HP for the location of a nearby system or for purchasing information.

Note: Uncalibrated survey meters or counting systems will not be approved for use in radiation safety surveys. See Surveys and Instruments for additional information on the use and calibration maintenance of your detection equipment.

 

Page last updated on December 14, 2023.