ML003739482

Regulatory Guide 8.7,Rev 1(Draft Was Issued as DG-8007)Instructions for Recording and Reporting Occupational Radiation Exposure Data

ML003739482
Person / Time
Issue date:	06/30/1992
From:	Office of Nuclear Regulatory Research
To:
References
-RFPFR, DG-8007 RG-8.007, Rev 1
Download: ML003739482 (16)

Text

U.S. NUCLEAR REGULATORY COMMISSION Revision 1 June 1992 REGULATORY GUIDE OFFICE OF NUCLEAR REGULATORY RESEARCH REGULATORY GUIDE 8.7 (Draft was issued as DG-8007)

INSTRUCTIONS FOR RECORDING AND REPORTING OCCUPATIONAL RADIATION EXPOSURE DATA A. INTRODUCTION sis for this guide. The information collection require-ments in 10 CFR Part 20 have been cleared under Section 20.1502 of 10 CFR Part 20, "Standards OMB Clearance No. 3150-0014. The existing re-for Protection Against Radiation," requires licensees quirements for NRC Forms 4 and 5 were approved by to provide radiation monitoring for all occupationally the Office of Management under approval numbers exposed individuals who might receive a dose in ex- 3150-0005 and 3150-0006.' The amended informa-cess of 10 percent of the limits in 10 CFR 20.1201, tion collection requirements reflected in this guide 20.1207, or 20.1208. In 10 CFR 20.2106, licensees and contained on the revised NRC Forms 4 and 5 will are required to maintain records of the radiation ex- not become effective until after they are approved by posures of all individuals for whom personnel moni- the Office of Management and Budget. Notice of toring is required (pursuant to 10 CFR 20.1502). Ac- OMB approval will be published in the FederalRegis-cording to 10 CFR 20.2104, the dose in the current ter.

monitoring year must be determined for all persons who must be monitored, and this information must be B. DISCUSSION recorded on NRC Form 4 or equivalent. In addition, 10 CFR 20.2104 requires that, prior to allowing an This guide is structured to reflect the process a individual to participate in a planned special expo- licensee would go through in deciding whether or not sure, records of all prior exposures must be acquired. monitoring for occupational exposure to radiation is Records of prior dose must be maintained on NRC required under the revised 10 CFR Part 20. The Form 4 or its equivalent. Further, 10 CFR 20.2206 guide describes acceptable methods for determination requires certain licensees to submit an annual report of prior exposures, records of monitoring provided, to NRC of the results of individual monitoring. and reporting that are needed to comply with 10 CFR Part 20. NRC Forms 4 and 5 are provided. A format This guide describes an acceptable program for for electronically reporting exposure data to NRC is the preparation, retention, and reporting of records provided in Appendix A.

of occupational radiation exposures. It includes cop-ies of NRC Forms 4 and 5 and detailed instructions In order to avoid confusion with the acronym for on completing them. effective dose equivalent (EDE), the abbreviation LDE is used to represent the eye (lens) dose equiva-Any information collection activities mentioned lent, as defined in 10 CFR Part 20. The term total in this, regulatory guide are contained as requirements organ dose equivalent (TODE) has been added, and in 10 CFR Part 20, which provides the regulatory ba- it means the sum of the deep dose equivalent and the USNRC REGULATORY GUIDES The guides are issued in the following ten broad divisions:

Regulatory Guides are issued to describe and make available to the pub-lic methods acceptable to the NRC staff of implementing specific parts of the Commission's regulations, to delineate techniques used by the 1. Power Reactors 6. Products staff in evaluating specific problems or postulated accidents, or to pro- 2. Research and Test Reactors 7. Transportation vide guidance to applicants. Regulatory Guides are not substitutes for 3. Fuels and Materials Facilities 8. Occupational Health regulations, and compliance with them Is not required. Methods and 4. Environmental and Siting 9. Antitrust and Financial Review solutions different from those set out In the guides will be acceptable If 5. Materials and Plant Protection 10. General they provide a basis for the findings requisite to the issuance or continu-ance of a permit or license by the Commission.

Copies of issued guides may be purchased from the Government Printing This guide was issued after consideration of comments received from Office at the current GPO price. Information on current GPO prices may the public. Comments and suggestions for improvements In these be obtained by contacting the Superintendent of Documents, U.S.

guides are encouraged at all times, and guides will be revised, as ap- Government Printing Office, Post Office Box 37082, Washington, DC propriate, to accommodate comments and to reflect new information or 20013-7082, telephone (202)275-2060 or (202)275-2171.

experience.

Written comments may be submitted to the Regulatory Publications Issued guides may also be purchased from the National Technical Infor-Branch, DFIPS, ARM, U.S. Nuclear Regulatory Commission, Washing- mation Service on a standing order basis. Details on this service may be ton, DC 20555. obtained by writing NTIS, 5285 Port Royal Road, Springfield, VA 22161.

committed dose equivalent to the organ receiving the 1.3 Documentation of Prior Exposures highest dose as described in 10 CFR 20.2106(a)(6). For those individuals for whom monitoring is re-quired, determination of current year exposure at C. REGULATORY POSITION other facilities is required by 10 CFR 20.2104. To document the determination of current year expo-

1. DETERMINATION OF MONITORING sure, the individual to be monitored must provide an REQUIREMENTS NRC Form 4 signed by the individual or a written statement that includes the names of all facilities that According to 10 CFR 20.1502, if an adult is provided monitoring for occupational exposure to ra-likely to receive in 1 year a dose greater than 10 per- diation during the current year and an estimate of the cent of any applicable limit, monitoring is required. dose received. Although not required by the regula-The licensee should perform an evaluation of the tions, it is considered good health physics practice to dose the individual is likely to receive prior to allow- verify the information provided by the individual.

ing the individual to receive the dose. This evaluation Verification may be documented with:

need not be made for every individual; evaluations

• An NRC Form 5 for each listed monitoring pe-can be made for employees with similar job functions riod, or or work areas. Further guidance on evaluating the need to provide monitoring is provided in Regulatory

• Electronic, telephone, or facsimile transfer of Guide 8.34, "Monitoring Criteria and Methods To dose data provided by licensees listed on the Calculate Occupational Doses." written statement, or

• An NRC Form 4 countersigned by a licensee or 1.1 If Monitoring Is Not Required current employer.

If this prospective evaluation shows that the indi- In addition, 10 CFR 20.2104(a) (2) requires that vidual is not likely to exceed 10 percent of any appli- licensees attempt to obtain the records of lifetime cu-cable limit, there are no recordkeeping or reporting mulative occupational radiation dose. To demonstrate requirements in regard to the individual's exposure. compliance with this requirement, the individual to be For individuals who received exposure at other facili- monitored may provide a written estimate of the cu-ties in the current year, the previous dose need not be mulative lifetime dose or an up-to-date NRC Form 4 considered in this prospective evaluation. Only dose signed by the individual. This information need not that could be received at the facility performing the be verified so long as the individual does not partici-evaluation need be considered when determining the pate in a planned special exposure.

need for monitoring and, therefore, the record- NRC Forms 4 and 5 and termination letters or keeping and reporting requirements. If it is deter- reports, which report the results of monitoring prior mined that monitoring is not required and a subse- to implementation of the revised 10 CFR Part 20, quent evaluation shows that the 10 percent threshold may be used without recalculating dose according to has or will be exceeded, the dose received when the requirements of the revised 10 CFR Part 20. For monitoring was not provided should be estimated, re- the purpose of assessing prior dose, whole body dose corded, and reported. These estimates can be based in rem as reported on the old (1981 or earlier) NRC on any combination of work location radiation moni- Forms 4 and 5 can be considered equivalent to total toring or survey results, monitoring results of individu- effective dose equivalent (TEDE).

als in similar work situations, or other estimates to produce a "best estimate" of the actual dose re- 1.4 Records of Prior Exposure for Persons ceived. Participating in Planned Special Exposures If there are any periods of exposure during.the If monitoring is not required to demonstrate com- life of the monitored individual that have not been pliance with all limits but is required relative to one or determined and documented, participation in a more specific limits, the licensee should enter "NR" planned special exposure is not permitted. Accept-in the blocks on NRC Forms 4 and 5 to indicate the able documentation of prior exposure is similar to areas for which monitoring was not required (e.g., ex- that required for documenting current-year exposure.

tremity or skin doses). Where monitoring was pro- Alternatively, the licensee may request in writing that vided but not measurable, the licensee should enter a report of the monitored individual's exposure his-

"ND" for "Not Detectable." tory be provided by the NRC. To request an exposure history, the licensee may send a request signed by the 1.2 If Monitoring Is Required monitored individual to:

If the prospective evaluation shows that the indi- REIRS Project Manager vidual is likely to exceed 10 percent of an applicable Office of Nuclear Regulatory Research limit, monitoring is required (10 CFR 20.1502). Re- U. S. Nuclear Regulatory Commission cording and reporting of the results of monitoring per- Washington, DC 20555 formed, regardless of the actual dose received, is re-quired by 10 CFR 20.2106(a) and 20.2206(b) re- The request should contain the social security spectively. number (or other unique identifying number) of the 8.7-2

monitored individual authorizing release of the 2.2 Dose Calculations for CDE and TODE to information and the name and address of the person the Maximally Exposed Organ or licensee to whom the report should be sent. The REIRS database contains only reports submitted by Licensees are required by 10 CER 20.2106(a) (6) the seven classes of licensees required by 10 CFR Part to record the total organ dose equivalent (TODE),

20 to report occupational exposures. Any missing which is the sum of the deep dose equivalent (DDE) monitoring periods should be obtained directly from and the committed dose equivalent (CDE) to the or-licensees. gan receiving the highest dose. Organ doses need not be calculated if the committed effective dose equiva-1.5 Individuals with No Social Security Number lent (CEDE) does not exceed 1 rem and .there are no overexposures in any dose category within the moni-Doses to individuals who do not have a social se- toring year, including doses previously reported by curity number, such as citizens of foreign countries, other licensees. In this case, the licensee may record should be reported using another unique identi- "NC" for "Not Calculated" in items 16 and 18 on fication number. It is important to record the type of NRC Forms 4 and 5. If during the course of the year identification used in the data block labeled "ID the dose to date for the year exceeds 1 rem CEDE or type" that follows the "Identification Number" data the individual receives an overexposure in another block on NRC Form 4 and 5. The appropriate code dose category, the CDE to the maximally exposed or-listed below should be inserted in the blank labeled gan must be calculated, recorded, and reported.

ID Type. When CDE and TODE to the maximally exposed or-gan must be calculated, the licensee should refer to Regulatory Guide 8.34, "Monitoring Criteria and ID TYPE CODE Methods To Calculate Occupational Doses."

2.3 Dose to the Embryo/Fetus U. S. Social Security Number SSN A declared pregnant worker is a worker who has Passport Number PPN voluntarily informed her employer in writing of her Canadian Social Insurance Number CSI pregnancy and the estimated month and year of con-ception. The embryo/fetus' dose for the entire gesta-Work Permit Number WPN tion period must be recorded (10 CFR 20.2106(e)),

but need not be included on NRC Forms 4 and 5.

INDEX Identification Number IND Multiple records are not required in the case of twins, Other OTH triplets, etc. Any dose measured to demonstrate com-pliance with 10 CFR 20.1208 must be recorded.

The use of licensee-generated identification num- Licensees should be sensitive to the issue of per-bers should be avoided whenever possible. sonal privacy with regard to embryo/fetus dose. If re-quested by the monitored woman, a letter report may

2. RECORDS OF MONITORING RESULTS be provided to subsequent licensees to document FOR INDIVIDUALS FOR WHOM prior embryo/fetus dose. Further guidance on assess-MONITORING IS REQUIRED ing dose to the embryo/fetus is provided in Regulatory Guide 8.36, "Radiation Dose to the Embryo/Fetus."

The preparation of NRC Form 5 with the infor-mation clearly and legibly shown, or the collection of 2.4 Transmittal of Reports to the NRC all the information requested by NRC Form 5 using Certain licensees are required by 10 CFR paper or electronic media (see Appendix A), is re- 20.2206(c) to submit reports of monitoring for the quired by 10 CFR 20.2106. Such a record must be previous year to NRC on or before April 30. These maintained for each individual for whom personnel reports should be sent to:

monitoring, is required by 10 CFR 20.1502. In addi-tion, certain classes of licensees report the results of REIRS Project Manager this monitoring to NRC pursuant to 10 CFR 20.2206 Office of Nuclear Regulatory Research either by submitting copies of NRC Form 5 or by U.S. Nuclear Regulatory Commission transmitting the required information to NRC through Washington, DC 20555 electronic media. This report is filed annually. In-structions and additional information pertinent to According to 10 CFR 20.2206(b), "...The licen-each item are contained on Form 5. see shall use Form NRC 5 or electronic media con-taining all the information required by Form NRC 5."

2.1 Multiple Badges 2.5 Electronic Reporting of Exposure Data Further guidance on interpreting the results of Licensees are encouraged to record and report multiple dosimetric devices placed at different loca- these data electronically. The format for reporting tions within a single dose category is provided in radiation exposure data in an electronic, Regulatory Guide 8.34, "Monitoring Criteria and machine-readable format is provided in Appendix A Methods To Calculate Occupational Doses." of this guide.

8.7-3

D. IMPLEMENTATION with specified portions of the Commission's The purpose of this section is to provide informa- regulations, the methods described in this guide will tion to applicants and licensees regarding the NRC be used in the evaluation of applications for new staff's plan for using this regulatory guide. licenses, license renewals, and license amendments Except in those cases in which an applicant pro- and for evaluating compliance with 10 CFR poses an acceptable alternative method for complying 20.100 1-20.240 1.

8.7-4

PAGE OF NRC FORM 4 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB NO. 31504005 (6 921 EXPIRES:

10 CFR PART 20 ESTIMATED BURDEN PER RESPONSE TO COMPLY WITH THIS INFORMATION COLLECTION REQUEST: MINUTES. FORWARD CUMULATIVE OCCUPATIONAL EXPOSURE HISTORY COMMENTS REGARDING BURDEN ESTIMATE TO THE INFORMATION AND RECORDS MANAGEMENT BRANCH IMNBE 7714), U.S, NUCLEAR REGULATORY COMMISSION, WASHINGTON, DC 20555. AND TO THE PAPERWORK REDUCTION PROJECT 13150-00051. OFFICE OF MANAGEMENT AND BUDGET. WASHINGTON, DC 20503.

1. NAME tLAST. FIRST,MIDDLE INITIALI 2. IDENTIFICATION NUMBER 3. ID TYPE MALE 5. DATE OF BIRTH

4. SEX FEMALE S. MONITORING PERIOD 7. LICENSEENAME 8. LICENSENUMBER 9. RETOD 10. ROUTINE

11. DDE 12. LDE 13. SDE, WS 14. SDE. ME 1b. CEDE 18. CDE 17. TEDE ESTIMATE NO RECORD tSE18. TODE

6. MONITORING PERIOD -7. LCENSEENAME B. LICENSENUMBER 9. RECORD 10. ROUTINE ESTIMATE NO RECORD PSE 11 DDE 12. LDE 13. SDE,Wl 14. SDE,ME 16. CEDE 17. TEDE 18. TODE lO

6. MONITORING PERIOD 7.LICENSEE NAME 8. LICENSE NUMBER 9. RECORD 10. ROUTINE U'

ESTIMATE IDDE 12.LOE 13.SDE,W T 14. SDEME 16.CEDE 10.CDE 17 TEDE NO RECORD IB. TODE PSE 6.MONITORING PERIOD 7. LICENSEENAME 8. LICENSENUMBER 9. RECORD 10. ROUTINE ESTIMATE NO RECORD PSE 11.DDE 12. LDE 13. SDE,W8 14. SDE,ME 16. CEDE 17. TEDE 19. TODE

6. MONITORING PERIOD 7. LICENSEENAME 8. LICENSENUMBER 9. RECORD 10. ROUTINE ESTIMATE NO RECORD PSE

11. DOE 12. LDE 13. SDE.W8 14. SDE,ME 16. CEDE 16. C17. TEDE 18. TODE S. MONITORING PERIOD 7. LICENSEENAME U. LICENSENUMBER B. RECORD 10. ROUTINE ESTIMATE NO RECORD PSE Il.DODE 12. LDE 13. SDE, WB 14. SDE, ME 1ISCEDE is. COE 7.TEDE 1iBTODE

19. SIGNATURE OFMONITORED INDIVIDUAL 20. DATE SIGNED 21. CERTIFYING ORGANIZATION 22. SIGNATUREOF DESIGNEE 23. DATE SIGNED NRC FORM4 IG-921 . FR 4

INSTRUCTIONS AND ADDITIONAL INFORMATION PERTINENT TO THE PRIVACY ACT STATEMENT COMPLETION OF NRC FORM 4 (A# doses shotdd be stated in rams]

1 Type or print the full name of the monitored individual in exposures received during the monitoring period. If more Pursuant TO 5 U.S.C. 552a~e1)31. enected into law by Section 3 of the Privacy Act of the order of lost name linclude Jr. Sr. 'III, etc.). first then one PSE was received in a single year. the licensee 1974 IPublic Law 93-5791. the following statement is fumished to individuals who name, middle initial (if applicable). should sum them and report the total of all PSEs. supply information to the U.S. Nuclear Regulatory Commission on NRC Form 4. This information is maintained In a system of records designated as NRC-27 and described

2. Enter the individual's identification number. Including tI. Enter the deep dose equivalent IDDE) to the whole body. at 55 Federal Register 33984 lAugust 20, 19901. or the most recent Federal Register punctuation. This number should be the 9-dIgIt social publication of the Nuclear Regulatory Commission's Republication of Systems ol security number if at all possible. If the Individual has no 12. Enter the eye dose equivalent (LOEI recorded for the lens Records Notices' that is available at the NRC Public Document Room, Gelman social security number, enter the number from another of the eye. Building. Lower Level, 2120 L Street NW, Washington. D.C.

official identification such es a passport or work permit.

13. Enter the shallow dose equivalent recorded for the skin of 1. AUTHORITY: Sections 53. 63. 65. 81. 103. 104. 161 Ibl. and 1611nD of the

3. Enter the code for the type of Identification used as the whole body ISDEWBI. Atomic Energy Act of 1954. as amended 142 U. S. C. 2073. 2093. 2095, 2111.

shown below: 2133, 2134, 2201(b), and 22011o11. The authority for soliciting the social

14. Enter the shallow dose equivalent recorded for the skin of security number is 10 CFR Part 20.

CODE ID TYPE the extremity receiving the maximum dose ISDEMEI.

SSN U.S. Social Security Number 2. PRINCIPAL PURPOSEISI: The information is used by the NRC in its evaluation

-PPN Passport Number 15. Enter the committed effective dose equivalent ICEDEI. of the risk of radiation exposure associated with the licensed activity and in CSI Canadian Social Insurance Number exercising its statutory responsibility to monitor and regulate the safety and WPN Work Permit Number 16. Enter the committed dose equivalent ICDEI recorded for health practices of its licensees. The data permits a meaningful comparison of IND INDEX Identification Number the maximally exposed organ. both current and long-term exposure experience among types of licensees and oTH Other among licensees within each type. Data on your exposure to radiation ia

17. Enter the total effective dose equivalent ITEDEI. The available to you upon your request.

4. Check the box that denotes the sex of the individual TEDE l the sum of items 11 and 15.

being monitored. 3. ROUTINE USEISi: The information may be used to provide data to other

18. Enter the total organ dose equivalent ITODEI for the Federal and State agencles Involved in monitoring and/or evaluating radiation

5. Enter the date of birth of the Individual being monitored maximally exposed organ. The TODE is the sum of items exposure received by Individuals employed as radiation workers on a permanent in the format MMWDD/YY. 11 and 16. or temporary basis and exposure received by monitored visitors.The information may also be disclosed to an appropriate Federal, State, or local agency in the

6. Enter the monitoring period for which this report is filed. 19. Signature of the monitored individual. The signature of event the information indicates a violation or potential violation o law and in the The format should be MM/DD/YY - MM/DD/YY. the monitored Individual on this form indicates that the course of an administrative or judicial proceeding.

Information contained on the form is complete and correct

7. Enter the name of the licensee or facility not licensed by to the best of his or her knowledge. 4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON NRC that provided monitoring. INDIVIDUAL OF NOT PROVIDING INFORMATION: It is voluntary that you

20. Enter the date this form was signed by the monitored fumish the requested Information, including social security number; however.

0. Enter the NRC license number or numbers. Individual. the licensee must complete NRC Form 5 on each individual for whom personnel monitoring is required under 10 CFR 20.2106. Failure to do so may subject the

9. Place an X in Record. Estimate, or No Record. Choose 21. IOPTIONALI Enter the name of the licensee or facility not licensee to entorcement action in accordance with 10 CFR 20 2401. The social

'Record' if the dose data listed represent a final licensed by NRC. providing monitoring for exposure to security number is used to assure that NRC has an aeccurate identifier not deternination of the dose received to the best of the radiation (such as a DOE facilityl or the employer if the subject to the coincidence of similar names or birthdates among the large licensee's knowledge. Choose Estimate' only if the individual is not employed by the licensee and the number of persons on whom data is maintained.

fisted dose data are preliminary and will be superseded by employer chooses to maintain exposure records for its a final determination resulting in a subsequent report. An employees. 5. SYSTEM MANAGERISI AND ADDRESS:

example of such an instance would be dose data based REIRS Project Manager on sell-reading dosimeter results and the licenses intends 22. IOPTIONALI Signature of the person designated to Office of Nuclear Regulatory Research to assign the record dose on the basis of TLD results that represent the licensee or employer entered in item 21. U.S. Nuclear Regulatory Commission are not yet available. The licensee or employer who chooses to countersign the Washington, DC 20555 form should have on file documentation of all the

10. Place an "X in either Routine or PSE. Choose 'Routine' information on the NRC Form 4 being signed.

if the date represent the results of monitoring for routine exposures. Choose PSE if the listed dose data 23. IOPTIONALI Enter the date this form was signed by the represents the results of monitoring of planned special designated representative.

PAGE OF NRC FORM 6 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB NO. 3150-0006 (6-92) EXPIRES:

10 CFR PART 20 OCCUPATIONAL EXPOSURE SU E OCCPA IO ALEXP RECORD EC RDINFORMATION ESTIMATED BURDEN PER RESPONSE TO COMPLY COLLECTION REQUEST:

WITH THIS MINUTES.

FOR A MONITORING PERIOD HFORWARCOMMENTS REGARDING BURDEN ESTIMATE TO THE INFORMATION AND RECORDS MANAGEMENT BRANCH (MNBB 7714), U.S. NUCLEAR REGULATORY COMMISSION.

WASHINGTON, DC 20555, AND TO THE PAPERWORK REDUCTION PROJECT (3150-0006\, OFFICE OF MANAGEMENT AND BUDGET, WASHINGTON, DC 20503-2 IDENTIFICATION NUMBER 3. ID TYPE 4. SEX 6. DATE OF BIRTH

1. NAME (LAST. FIRST. MIDDLE INITIAL)

_ ___J.MALE FEM ALEE

7. NAME LICENSEE NSE NUMBERSA 9A. 98.

6. MONITORING PERIOD

_NE RECORD _ROUTINE ESTIMATEPSE INTA.KES DOSES (in rem) 10A. RADIONUCLIDE 1OB. CLASS IOC. MODE 1OD. INTAKE INjuCI 11.

DEEP DOSE EQUIVALENT (DDE) 12 EYE DOSE EQUIVALENT TO THE LENS OF THE EYE ILDE) 12.

13.

SHALLOW DOSE EQUIVALENT, WHOLE BODY (SDE,WB) 14.

SHALLOW DOSE EQUIVALENT, MAX EXTREMITY (SDEME) 15.

COMMITTED EFFECTIVE DOSE EQUIVALENT (CEDE)

COMMITTED DOSE EQUIVALENT, 16.

MAXIMALLY EXPOSED ORGAN (CDE)

TOTAL EFFECTIVE DOSE EQUIVALENT 17.

(BLOCKS 11 + 151 (TEDE)

TOTAL ORGAN DOSE EQUIVALENT, 18.

MAX ORGAN (BLOCKS I1+ 16) (TODE)

19. COMMENTS

21. DATE PREPARED

20. SIGNATURE -- LICENSEE NRCFORM5 (6-92)

'F INSTRUCTIONS AND ADDITIONAL INFORMATION PERTINENT TO THE COMPLETION OF NRC FORM 5 PRIVACY ACT STATEMENT (Al doses shoadd be stated in rems) 11 I

1 Type or print the full name of the monitored individual period. If more than one PSE was received in a single year, Pursuant TO 5 U.S.C. 552a/eli31, enacted into law by Section 3 of the Privacy h the order of lest name (include 'Jr.' 'Sr,' 'l1.' etc.). the licensee should sum them and report the total of all Act of 1974 (Public Law 93-579), the following statement is furnished to first name, middle initial (if applicable). PSEa. individuals who supply information to the U.S. Nuclear Regulatory Commission on NRC Form 5. This information is maintained in a system of records

2. Enter the individual's identification number, including 0A. Enter the symbol for each radionuclide that resulted in an designated asNRC-27 and described at 55 Federal Register 33984 (August 20.

punctuation. This number should be the 9-digit social internal exposure recorded for the individual, using the 1990), or the most recent Federal Register publication of the Nuclear Regulatory security number if at all possible. If the individual has format 'Xx- ##x,' for instsnce. Cs-137 or Tc-99m. Commission's 'Republication of Systems of Records Notices' that Is available at no social security number, snter the number from the NRC Public Document Room, Gelman Building, Lower Lv. 2120 L Street another official identification such a a passport or 10B. Enter the lung clearance class as listed in Appendix B to 10 NW, Washington, D.C.

work permit. CFR Part 20.1001-2401 ID, W. Y. V, or 0 for other) for all intakes by inhalation. 1. AUTHORITY: Sections 53. 63, 65, 81, 103. 104, 161(b), and 161101

3. Enter the code for the typo of identification used as of the Atomic Energy Act of 1954, as amended 142 U.S.C 2073, 2093.

shown below: IOC. Enter the mode of intake. For inhalation, enter 'H.' For 2095. 2111. 2133. 2134, 2201 lb), and 2201(o)). The authority for absorption through the skin, enter 'B.' For oral ingestion. soliciting the social security number is 10 CFR Part 20.

CODE iD TYPE enter 'G. ' For injection, enter 'J."

SSN U.S. Social Security Number 2. PRINCIPAL PURPOSEIS): The information is used by the NRC in its PPN Pasaport Number 1OD. Enter the Intake of each radionuclide in pCi. evaluation of the risk of radiation exposure associated with the licensed CSI Canadian Social insurance Number activity and in exercising its statutory responsibility to monitor and WPN Work Permit Number 11. Enter the deep dose squivalent (DDE) to the whole body. regulate the safety and health practices of its licensees. The dote permits IND INDEX Identification Number a meaningful comparison of both current end long-term exposure OTH Other 12. Enter the eye dose equivalent (LDE) recorded for the lens of experience among types of licensees and among licensees within each the aye. type. Data on your exposure to radietion is available to you upon your

4. Check the box that denotes the sex of the Individual request.

0o being monitored. 13. Enter the shallow dose equivalent recorded for the skin of the whole body (SDE.WB). 3. ROUTINE USE(S): The information may be used to provide data to other S. Enter the date of birth of the individual being monitored Federal nd State agencies involved in monitoring and/or evaluating in the format MM/DD/YY. 14. Enter the shallow dose equivalent recorded for the skin of radiation exposure received by individuals employed as radiation workers the extremity receiving the maximnum dose ISDEMEI. on a permanent or temporary basis and exposure received by monitored

6. Enter the monitoring period for which this report is visitors The information may also be disclosed to an appropriate Federal.

filed. The format should be MM/DD/YY - MM/DD/YY. 15. Enter the committed effective doss equivalent ICEDEI or State. or local agency in the event the information indicates a violation or

'NR' for 'Not Required' or 'NC' for 'Not Caiculated'. potential violation of lew and in the course of an administrative or judicial

7. Enter the name of the licensee. proceeding.

16. Enter the committed dose equivalent ICDEI recorded for the

8. Enter the NRC license number or numbers. msxsmally exposed organ or 'NR' for 'Not Required' or 4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT

'NC' for 'Not Cdlculated'. ON INDIVIDUAL OF NOT PROVIDINt INFORMATION: it is voluntary that 9A. Place an 'X' in Record or Estkmate. Choose 'Record, you furnish the requested information, including social tecurity number; if the does data listed represent a final determination of 17. Enter the total effective dose equivalent ITEDEI. The TEDE however, the licensee must complete NRC Form 5 on each individual for the dose received to the best of the licensees is the sum of items 11 and 15. whom personnel monitoring is required under 10 CFR 20.2106. Failure to knowledge. Choose 'Estimsta' only if the listed dose do so may subject the licensee to enforcement action in accordance with data re preliminary and wili be supersaded by a final 18. Enter the total organ dose equivalent (TODE) for the 10 CFR 20.2401. The social security number is used to assure that NRC determination resulting in a subsequent report. An maximally exposed organ. The TODE isthe sum of items 11 has an accurate identifier not subject to the coincidence of similar names example of such an instance would be dose data based and 16. or birthdates among the large number of persons on whom data is on self-reading dosimeter results and the licensaee maintained.

intends to assign the record dose on the basis of TLD is. Signature of the person designated to represent the licensee.

results that are not yet avaiable. 5. SYSTEM MANAGERIS) AND ADDRESS:

20. Enter the date this form was prepared. REIRS Project Manager

98. Plece an 'X' in either Routine or PSE. Choose Oflice of Nuclear Regulatory Research

'Routine-ifthedatarepresenttheresufteofmonitong 21.~ COMMENTS. U.S. Nuclear Regulatory Commission, for routine exposures. Choose 'PSE' if the Ibted dose In the space provided, enter additional information that Washington, DC 20555 data represents the results of monitoring of planned might be needed to determine compliance with limits. An special exposures received during the monitoring example might be to enter the note that the SDEME was the result of exposure from a discrete hot particle. Another possibility would be to indicate that an overexposed report has been sent to NRC in reference to the exposure report.

11

APPENDIX A FORMAT FOR ELECTRONIC TRANSMISSION OF EXPOSURE DATA Introduction 0 File name Descriptive name of the file or files contained on The following outlines a means by which licensees the disk.

may satisfy the requirements, of 10 CFR 20.2206,

• Date Created Date each file was cre-

"Reports of Individual Monitoring," in an electronic ated.

format by submitting magnetic disks, cartridges, or

• Operating system Operating system and tape with formatted radiation exposure data. version used to format the disk.

Media Requirements

• Contact Name and telephone number of the person The following data storage media are compatible with knowledgeable about the Radiation Exposure Information Reporting Sys- each file.

tem (REIRS). The electronic media listed below are

• Other instructions Comments or explana-preferred by NRC for these submissions and are pre- tion regarding the sub-sented in the order of preference. However, licensees mission, the actual date, are encouraged to submit data on whatever system is the data format, or the compatible with their existing systems. Other forms of other important infor-data submission may also be acceptable. NRC will mation.

provide additional guidance to licensees upon request

• Signature and date Dated signature of the to the REIRS Project Manager. licensee's authorized representative responsi-ble for the data.

PC Diskettes Expected Data 32" or 5%$" One routine Form 5 is expected for each monitored Double sided, high or double density individual at the facility for the monitoring year.

Standard IBM-DOS format There may also be a Form 5 for a planned special ASCII character format exposure for some individuals. Because there should be few repetitions of employee information, the em-Magnetic Tape ployee information is included in the Form 5. The primary license number is also included in each Form 8 mm tape cartridges 5 to ensure that the records are assigned to the Data quality proper facility.

ASCII or EBCDIC format File Structure The file structure consists of a Header Record, which Transmittal Letters provides information about the source of the data file, followed by Form 5 dose records and supporting With the submission of each disk, tape, or cartridge, Form 5 intake records. Each record contains only the licensee should also submit a transmittal letter ASCII or EBCDIC printable characters and is termi-nated with a Carriage Return (CR) and a Line Feed containing information that will minimize processing (LF). All empty space in a field is padded with time and help resolve possible discrepancies. Each spaces. Text strings are expected to be left justified in letter should contain the following information as a a field and numbers are expected to be right justified minimum: in a field.

8.7-9

Header Record The following record type occurs only once at the top of each data file to identify the source of the data.

Start End Field Width Col. Col. Description PrimaryLicense 13 1 13 Primary NRC license number.

PreparationDate 8 15 22 Date the record was written to the data file formatted as 'YYYYMMDD.'

LicenseeName 72 24 95 Name of NRC licensee.

Contact 72 97 168 Name of person to contact for further information about this data file.

PhoneNumber 14 170 183 Contact's phone number.

OtherLicense-1 13 185 197 Other related NRC license numbers.

OtherLicense 2 13 199 211 Other related NRC license numbers.

OtherLicense_3 13 213 225 Other related NRC license numbers.

OtherLicense_4 13 227 239 Other related NRC license numbers.

OtherLicense 5 13 241 253 Other related NRC license numbers.

OtherLicense_6 13 255 267 Other related NRC license numbers.

OtherLicense 7 13 269 281 Other related NRC license numbers.

OtherLicense 8 13 283 295 Other related NRC license numbers.

OtherLicense 9 13 297 309 Other related NRC license numbers.

OtherLicense_10 13 311 323 Other related NRC license numbers.

8.7-10

Form 5 Dose Record The following record type occurs once for each Form 5 being reported. It is followed by zero or more Form 5 Intake Records.

Start End Field Width Col. Col. Description Employee_ID 12 1 12 SSN, PPN, CSI, WPN, IND, or OTH.

IDs should have no punctuation.

ID Type 3 14 16 'SSN,' 'PPN,' 'CSI,' 'WPN,'

'IND,' or '0TH' PrimaryLicense 13 18 30 Primary NRC license number.

PreparationDate 8 32 39 Date the record was written to the data file formatted as 'YYYYMMDD.'

Record Type 1 41 41 'D' = DOSE FirstName 25 43 67 Employee's full first name (no nicknames).

Middle-Initial 1 69 69 Employee's middle initial.

LastName 25 71 95 Employee's last name. Titles such as "Jr" should be separated from the last name by a space. No punctuation should be used in the title.

Sex 1 97 97 Employee's sex.

'M' = Male and 'F' = Female BirthDate 8 99 '106 Employee's date of birth

('YYYYMMDD').

Monitoring Start 8 108 115 Date monitoring began

('YYYYMMDD'). This is typically January 1 of the monitoring year for everyone except new hires.

MonitoringEnd 8 117 124 Date monitoring ended

('YYYYMMDD'). This is typically December 31 of the monitoring year for everyone except terminations.

Report Type 1 126 126 'R' = Record, or 'E' = Estimate Exposure Type 1 128 128 'R' = Routine, or 'P' = PSE 8.7-11

Start End Field Width Col. Col. Description DDE 8 130 137 Deep dose equivalent in rems. This can be formatted as '999.999.'

LDE 8 139 146 Eye dose equivalent to the lens of the eye in rems. This can be formatted as

,999 999,1 SDEWB 8 148 155 Shallow dose equivalent, whole body in rems. This can be formatted as '999.999.'

SDEME 8 157 164 Shallow dose equivalent, max extremity in rems. This can be formatted as '999.999.'

CEDE 8 166 173 Committed effective dose equivalent in rems. This can be formatted as '999.999.'

CDE 8 175 182 Committed dose equivalent. This can be formatted as '999.999.'

TEDE 8 184 191 Total effective dose equivalent. This can be formatted as '999.999.'

TODE 8 193 200 Total organ dose equivalent, maximally exposed. This can be formatted as '999.999.'

8.7-12

Form 5 Intake Record The following record should be provided for each intake on the Form 5 being reported.

Start End Field Width Col. Col. Description EmployeeID 12 1 12 IDs should have no punctuation.

ID-Type 3 14 16 'SSN,' 'PPN,' 'CSI,' 'WPN,' 'IDL,' 'IND,' or

'OTH.'

PrimaryLicense 13 18 30 Primary NRC license number.

Preparation-Date 8 32 39 This is the date from the parent Form 5 Dose Record formatted as 'YYYYMMDD.'

Record-Type 1 41 41 'I' = Intake Radionuclide 9 43 51 Radionuclide abbreviation with the hyphen.

Class 1 53 53 'D,' 'Y,' 'W,' 'V,' or 'O' for other.

Mode 1 55 55 'H' = Inhalation, 'B' = Absorption, 'J'.=

Injection, 'G' = Ingestion Intake 10 57 66 The amount of gCi for the radionuclide.

This can be expressed in scientific notation using the format '+9.999E+99' or as a decimal number of less than 9 digits.

8.7-13

Form 5 Comment Record The following record type occurs only when comments are necessary to explain special exposure calculations or overexposures.

Start End Field Width Col. Col. Description Employee ID 12 1 12 IDs should have no punctuation.

ID-Type 3 14 16 'SSN,' 'PPN,' 'CSI,' 'WPN,' 'IDL,' 'IND,' or

'OTH.'

PrimaryLicense 13 18 30 Primary NRC license number.

PreparationDate 8 32 39 This is the date from the parent Form 5 Dose Record formatted as 'YYYYMMDD.'

Record-Type 1 41 41 'C' = Comment Comment 240 43 282 Explanatory comment when needed.

8.7-14

REGULATORY ANALYSIS A separate regulatory analysis was not prepared the guide. A copy of the "Regulatory Analysis for the for this regulatory guide. The regulatory analysis Revision of 10 CFR Part 20" (PNL-6712, November prepared for 10 CFR Part 20, "Standards for 1988), is available for inspection and copying for a Protection Against Radiation" (56 FR 23360), pro- fee at the NRC Public Document Room, 2120 vides the regulatory basis for this guide and examines L Street NW., Washington, DC, as an enclosure to the costs and benefits of the rule as implemented by Part 20.

8.7-15

UNITED STATES NUCLEAR REGULATORY COMMISSION FIRST CLASS MAIL WASHINGTON, D.C. 20555-0001 POSTAGE AND FEES PAID USNRC PERMIT NO. G-67 OFFICIAL BUSINESS PENALTY FOR PRIVATE USE, $300