RADIATION SAFETY CERTIFICATION CHECKLIST
IONISING RADIATION LABORATORY
Supervisor Name:
DRSO Name:
Inspection Team:
Department:
Building No:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Date:
Room No:
The maximum activity (MBq/mCi):
For laboratories using more than one (1) ionising radiation source additional information can be supplied on the last page.
CRITERIA
Y
N
N/A
ACTIONS REQUIRED/COMMENTS
DRSO Arrangements
Does the budget division/department have a DRSO?
Do personnel know where personal radiation exposure records are held?
Is there a register kept for all ionising equipment?
Does the department have a Radiation Inventory?
Are all sources on the department Radiation Inventory?
Management
Is access to the Laboratory limited to authorised personnel?
Are appropriate radiation warning signs displayed at the laboratory doors?
Have risk assessments been completed for all ionising radiation procedures?
Are standard operating procedures (SOP) in place for all ionising radiation activities?
Is an appropriate tag out system in place?
With regards to purchasing has approval been granted?
Do the laboratory practices comply with the conditions of the Management Licence?
safety.unimelb.edu.au
RADIATION SAFETY CERTIFICATION CHECKLIST: IONISING RADIATION LABORATORY 1 of 4
Date: 23 September 2013 Version: 1.4 Authorised by: Director, OHS and Injury Management Next Review: 23 September 2016
© The University of Melbourne – Uncontrolled when printed.
CRITERIA
Y
N
N/A
ACTIONS REQUIRED/COMMENTS
Laboratory Practices
Is suitable radiation/contamination monitoring equipment provided?
Is monitoring equipment calibrated at scheduled intervals?
Is there a book for recording maintenance of ionising equipment?
Are controls used in the laboratory to limit radiation exposure?
Is appropriate PPE worn whilst undertaking radioactive activities?
Are all sources of radiation maintained and stored appropriately?
Are all sources of radiation appropriately labelled?
Is there an authorised users list?
Is radioactive work segregated from all other work in the laboratory?
Are there disposal pathways for all sources?
Training
Have personnel completed a laboratory induction?
Have personnel completed Radiation Safety Practices – Ionising training?
Have personnel completed refresher Radiation Safety Practices – Ionising training?
Are there any additional training requirements? If “yes” have personnel completed
these?
Do personnel hold a suitable Use Licence?
Incident Reporting and Emergency Procedures
Are appropriate emergency procedures in place?
Are personnel aware of the required emergency procedures?
Are personnel aware of required incident reporting procedures?
Emitting Apparatus and Sealed Sources
Is the emitting apparatus/sealed source housed in an appropriate enclosure?
Are visible and audible signals provided on the enclosure and outside the laboratory?
Are "fail-to-safe" mechanisms on enclosures to prevent entry of the radiation
enclosure when the beam is on?
Are "fail-to-safe" mechanisms on enclosures regularly tested?
Are radiation “mapping” surveys conducted when required?
Does the design of the room include structural shielding requirements?
Has a plant risk assessment been conducted for radiation plant and associated
plant?
Does the emitting apparatus comply with the conditions of the Management Licence?
safety.unimelb.edu.au
RADIATION SAFETY CERTIFICATION CHECKLIST: IONISING RADIATION LABORATORY 2 of 4
Date: 23 September 2013 Version: 1.4 Authorised by: Director, OHS and Injury Management Next Review: 23 September 2016
© The University of Melbourne – Uncontrolled when printed.
FURTHER COMMENTS/OBSERVATIONS
IONISING RADIATION LABORATORY CERTIFICATION APPROVAL
Y
N
Further Requirements/Comments
Follow Up/Action Date
Certification approved
Certification approved
(where further action was required and completed)
Verified on Management Licence
Name of Certifier:
Signature:
This certification is valid for
safety.unimelb.edu.au
Date:
year(s) from the date of approval
RADIATION SAFETY CERTIFICATION CHECKLIST: IONISING RADIATION LABORATORY 3 of 4
Date: 23 September 2013 Version: 1.4 Authorised by: Director, OHS and Injury Management Next Review: 23 September 2016
© The University of Melbourne – Uncontrolled when printed.
ADDITIONAL IONISING RADIATION SOURCES
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
Ionising radiation is being used for the following purpose(s):
Type of isotopes (open sources):
Type of sealed sources:
Type of ionising emitting equipment:
safety.unimelb.edu.au
The maximum activity (MBq/mCi):
The maximum activity (MBq/mCi):
The maximum activity (MBq/mCi):
The maximum activity (MBq/mCi):
The maximum activity (MBq/mCi):
The maximum activity (MBq/mCi):
RADIATION SAFETY CERTIFICATION CHECKLIST: IONISING RADIATION LABORATORY 4 of 4
Date: 23 September 2013 Version: 1.4 Authorised by: Director, OHS and Injury Management Next Review: 23 September 2016
© The University of Melbourne – Uncontrolled when printed.