ML16293A848
Text
{{#Wiki_filter:? I.' Appendix E Instrument Check Sheets
Appendix E-lnstrument Check Sheets October
I'. Rev 1 lQ/'lS/15
- 1.. lnstrym1mt i!lformatiqn~.
~~temet1!r: Ma~e/Mq?eJ;. Qetec;tor 1: M;ike/~ogel: Blcron MlcrgRem :!Vleter:
- 2.
£hei;kiQurce -lnformatfon:' .LUDLUM 2241,2 LUQLJJM..M~\\(,i ___. Se1faU1Jo;..,Z'6_2ZlZ_ ~erirll No.....BBJ;faf 21 Seti;; I No. ;82-24!)
- Cal. oue Date* -~t1/JJ;..
C<JE 04e.oate~ 8/411Q. t~ssav t>o1~.- :12/~10 smfr¢e-J. Js()tRP.if:lb-232 ~erlai.NQ.:.Jj 2,. . Aitlv!W:.1$!;>.,.L. unlil'):,.. I!~.. Re.sptm!>l':A<;c:el.'tanc;e:Range (:*V~t1i'5)_: u!ter:n/fir +20'>(:.:~.9-.__ 1,1~eii'/hr~20%_ L.. -~pr:n-1*W~f. 2'29?.§....... ~<=Rm~;o~ !52B4*.
- Sour:ce,2 isotomi:~C.s:.U7.... _Seria!-Nc::~Jl2£13=4.8.......-.
Activity: *Q*02 ._unfts:J.lt.L* f\\S$ayDat~* J.aal~O
- ** Response_,\\:;.::eptQ_ncc*Rarige:t+/~2~); -uRem/f:ir:;~:/.o~;. _______ -
)l~ierri/hr~.zo~i- __ __ __ . ~cpm i.10%_..lm!:i::.. ~cDrn*Z0]{*-.*.89.;J,!,} --* 4 S!~~:p..rJ~_c_at_ipn: i*leiJot)*-~ Z,:..;._ ____ ~.--.. --""' -*-----* t:ocation riesJ':riptiow~W.::;.0.-0;._JJ_..*:;;_;:1"--. ---.:..--'-'-- GPS coordmatl~~ (wlwn r¢qvir:ed): l<*Ctmru:; :S '12.~}*_~Z-.':t-:-i~. -Y-Coorrl: w 7~~iS'~J..!.""' __ _
- *-K~¢"t~pkg :
- . ~ource R~sponi.e: *, 4 W.%
- l$l, i Ba(for\\i.
Time*
- Ambient.
I "cht (B"OSs.cpm or ,source Cali.b. Check . Of Temp. Jfirn~, .uRem/hrl gross cpm current ; (Y/foJ} fF}* l1Y11U)
- p_rl.iRemfht
{Y/N~ ~ {Y/N) ,._,,_,...~.i.... --.i.....-..-.... Ratemeter
- f Ratemeter
-~~~'!.'et~c Ratemeter. Bier.on* 'initl~lsan_d ccirnrnents fago:l.!tifo* lo~, Conditio'1. etc.t 'Bicrori ~--, ---~1 L__ _____________ ----
J ~,..i,i* 7'.~~C-~~.*~~~<<;~ 1, Jos.tr~Dl!!l~!lm 1 f3aten,wter; rv'ia,~e/Mpdel: _ Pctector 1:; Mtike/N'!Pc!eJ: llJi:fon *Mi~rot}em Met~r: i:Z;. $:~k Source. tnforn:iJ!tlrul: ln:StrJJtri~!e!dRespon~~.coe\\:ktog*
- LVDl.UM;2241-2.
- seri8,f[fa, ~2fi27lJ....
.LQDkUM44,fQ:,.,,_.,... ~rli!l'Np~ _E:f(:(lllii_ .SEriaf~P:,.::bl.i.4]_. _. _
- i
- .;:iL, Due Pai~~ :lillllft
.cavou~:qate;;.SZ41li5 A,ssay Da~e; ]2~:10
- Rev.110/w/1s Source 11~.ot~pe;:rh-z32.. Sertal/11¢,; 116. *.-..,.:~..
Ai;;tlv1ty'..,<O~!-'. unit&:JJ,ci;__.
- Re~~oni.t:.Acc~::>ttinte~ang~'{,1~21)%): ul,teni/!Jr*t,W~~.::.4):L __,
u'Rt!m/!lr... ;>.o.r..JL: ~Pfl1'1-.. 20%i~~36.. *~-i~Prri'.'2.0%. 15234_ So\\.i(c:f li!:Qtope: *-~::.t:r£..,_.s~:o;I Nr;i; ::.::az.E..t:t:A!L...-
- 4.c;ti~Jty;, Jt.QL_:*unlts:*~;f\\"sav D.~tf.:...xJ.1JJJJO R<>spci'l:;P.)~c:q;*ptant(l*g.;i(Jfl!?J+A20~): µReml~r*~ip%*_
uRdm/l.fc.~O.?~ **-..... ~ ~.tµm-*i.'20~lJ.3Jl!L ~pcn,:ii)*t. _$:-H.~L.. __. __,,,_*--*** *~-- __._,. *-*.,_,..:.. ~.--~-----*--*-**- --'-'--*~-'-*.. --.*~-
**-~
3~.. T~eh~i.YMtwfl" !~11or~1ng che~ts! f\\lame~
- .,,i(l&l.trJ!!P mi~:.. l;.t.1:.... -
JJa(~. :/..<x11/lr rimi::> tlfl~ti ~,"-~r:-'1-': r.*~\\ ~- ~. ~-" --:--
- 4.
$1.tc((,)t ~q¢~tjP.!'):
- tefJqb;",,_f.l
- J._..,.;_ -
C' "'-- *~. M<'atjoii tlfil:' r,ipt i.Orv.:fa'b.\\'l\\d r GP$.~t!or.a1ncit~sf11;hf>1l*feqL(1feq)! x~c<)Qrg: :iJ_'.'tc",'.~;z..*.*.-z~:i:::_. -.-. *' v;c;,;?"Y' W"7~"S'l'il:io*:(4 ~... siJurc!;'. ~e;o{J11:i(.;. *
- gtosstprri'J)r uf<ei1i/hrj'
. +f-2,(jy,, ,fir soui:C:e. gross. '.<;Pin or.uRerri/hr *
- 1ns1; callb.
o--;--~"'"'."' i Battary, :i
- Check"
- current ! JY:!Nl JYfN) nma Of ttieck, *
<4~bien1 Ten)pi (~F.) ~ --~-*-*:-.~- ...,.~~e-ma;ks -~~~,.,,-~.-...*
- Initials and'Commems.
\\add'i'lnfdi lnsL u.'.md.iti6n;eic;: Bicfon j..:~...... f:,...~ 31crt.in j NA *.,.* - ~-~ ... ~f.strume~tiie~1go11l'.e~.ch~i:wurr;:.
- i
- .
Sourt1' and Sar.\\it;r.ollrid.tpuntcrl'Jie-.51'llltilrJ b~'dl!lerrril!lf'l1*fr0rn :rlle\\:a~1agi. cf th re(! $tatlc c:rumts.afrhr.>'samiHoc.. HJOii *. Repeat:cowits ~J\\QUld. be. within ~tl'.!'~.. If (j:lvrit* rate di\\l~rGe~ s'£lnJiirai1lly,,p~t{qrm:itiidt~Pn111 ~.:iurJt:1:t~*c:yi;ilv11te *i:i?tnJll)~.~t ~1;.!l:;ilJfY *
- 7!TS A<U-W ~.&.Ii-,51;.en~<E!r.
Rev 110/18/15 Instrument F.ie_ld Response Check Log
- l. Instrument lnformation1 Ratemeter:
Make/Model; Lv(tv,..., di.!!fbl.l-Detector 1: Make/Model: : "[;J/JJ>.;.. ~- Bicron MicroRcm Meter: Serl.a! No..rZQ6vff Serla1No.~- Seria1 No. t-' (it Cal.Due Date: - . Cal. Due Date: N (A
- 2.
Check Source Information: Sour~e 1 Isotope: ~Seri<il No.: /L[..
- Activity:<:O~ I units:#?-'
Response Acceptance Rang~ (+/.ZO%}: uRem/hr-i-20% ~ uRem/hr *20% fK-- Source 2 !sqtope: C§~f!? Serial Np,; L{Cf~..-{ :2-Activity: O.o;z. unltsjflt;* Assay Oate: JJLli. Response Acceptance Range. (+/*20%): uRern/hr +20% -*=* uRem/hr -20% __ fl~ cpm -l-20% 13 ',P.,73' ooM:pm *-20%) f('1'
- 3.
Checks:
Title:
ec-r
- 4.
Site or Locatign: Site/Job: Location
Description:
- C;-'~"'"'""'""°'"""*-------
GPS Coon;linates (when required): V-Coord: __ ~Af-/l-'_* *--- r--- I Instrument Field Responst?' Us9 Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Sour('.e Response* +/-20% Inst. Battery Time Ambient 1!1itials anti comments Cnt (cpm) or Cnt .(gn:iss cpm qr source Ca lib. Check Of Temp. tadd'J Info: lnst. Condition, etc.) Time uRem/hr) 11me uRem/hr) gross <:pm current (Y/f\\I) eheck {of} or uRem/hr (VJNJ I {Y/N) Ratemeter I Mi"- qq3r,.~ ltuin: lf'ff~1 CPI+'\\ v~ 1/ \\/ /{)lf~ ~67 TI--232 f.!7 1 Ratemeter 'MtY\\ ql{'?>\\ (."""' I.,. :IA. //)1/1)_ "-~ YI v -..!/ /!J-sg' s-i:;.-.; 1""<-/.~7 '?JC Rate meter I I I I (/ ~ Rate meter Bicron NA NA Blcron NA l NA Bicron NA NA i.Bicron NA NA *----* 1, Instrument deslgn~ted*checksource Is llsted on ca!lbrntjon sticker. Record check source rnsponse (netcpm}.prlor to field deployment for.all.check sourc.es being used.
- 2.
Sour~e ;md aackground count rate.should be determined from the average_ ofthree statk.counts at the same locl!tlon. Repeat counts should be within 20%. If count rate diverges significantly, perform additional.counts to evaluate-instrument stabnity ' i j I I l i
Rev 1.10/18/15 I 1ostrument Field Response Che~k log
- 1.
~rastrument lnformatlon 1 Ratemeter: ~al<e/Model: Lv-f£"'""' P"...7~~~ C;il. Due Date: ~G Cal. DtJe Date: f\\Jf~ Detector 1: Make}Model: 2~3;; f¥.:.?.1:= Blcron Microaem Meter: Serial No. ~,tqf_G Serial No. 1!£.!!~ Serial No. N t-A
- 2. Check Sourte lnformatlon:
!!/ gJ(tc~ . Source 1 Isotope:. 7Ji,:4lJJ..: Serial No.: L.LL Actlvlty: ~ units:~ Assay Date:/~/~.? Response Acceptance Range (+/-20%): uRem/hr +20% __ uRem/hr -20%._. __ ~ cpm + 20%2lfL r.ist cpm -20% 3'f;{'Jib6 source 2 Isotope: (ff ~13'7 Serial No.; l/:/$<J~P,. Activity; t/.tJ,)... unitsi1C Assay Date: AlA_ Response Acceptance Range {+/-2-0%}: uRem/hr +20%_ uRem/hr *20% ___ ~ cpm + 20% /J'..t7:L r:i.stcpm -20% Ji-'~7'""~
- 3.
Checks: niie: -'-_;::._er_._-_____ Date: 1¢5'/l Time; /,J.S:'/ 4.. ~!ti;i or l..ocatlon; Site/Job: Location Oescription:.___~--'-C._P.....;'11'!....;./!;.:....:..*~;;.:..;;;.;(J'~--- Y-Coord; W 07~ "¥0~. I GP5 Coordinates (when required}: J Instrument Field R~sponse 2 l Use Acceptance Crlteri~ Remarks
- j.
+/-20% Meter Bkg Bkg counts Source So1Jrce Rel?ponse inst. Battery Time Ambient Initials and Comments Cnt (cpm) or Cnt {gross cpm or s.ource Calib. Check Of T~mp. (add'l Info: Inst. Condition, etc.} Time uReni/hr) Time uRem/ht) gross cpm : current (V/N) check ( 11FI I I orvRem/hr (Y/N} (Y/N} Rate meter {,,,. ;.... qFf 7,.,_ I Mi"". 11~1 £0111 1/ v \\f II/co
- 64{9
Cs~1.n L)ji:.' Ratemeter.rl'VI l\\f'\\. en "l ::, I I A4lf' L/? I ~:z11. cp.- v "1 v 1!¢t' fl 61/. I . '7J-,,,l,?,,t... v_p> Rate meter I /. P' Rate meter Bicron NA NA Bipron NA NA j Bicron NA NA Blcron NA NA I ~-~*--
- 1..Instrument deslgoilted check source ls listed 011 callbration stlcl:er. Record check source response (net cpmJ prior to field deployment for all checl: sources being used.
- 2.
Source'omd Background count rnte should be det<!rmined frnm the 11v~ra&e of three static count~ at the same location. Repeat counts sho.uld be within 20%. If count rate diverges s_ignlficantly, perform addltlonai counts tQ evak1atf! lnstrument*stabJHty I I I i
Rev 110/18/15 I
- j Instrument field Response Che.ck log
- 1.
Instrument lnformatlon1 Ratemeter; Make/Model: lu/fvt-.?.).'fl~.2. Detector 1: Make/Model: **:zd!Lf~M @..r~. Bicron MictoRem Meter:
- 2.
Check.Source Information: Sefiul No. PJ.D6 <>'ff Serial.No. Pe//,,2:t.o/..1:- serlal No.
- Jv i~-,-
Cal. Due Date: ~/;;Uc Cal. Due Date: ~J ( 4 Assay Date: Afh_ Source! Isotope: D~/37 Serliil No.: //tl:;il.J{J, Activity: tJ_(J,)- unitsjJ!!.&' Response Acceptance Range {t/*ZO%): uRem/hr +20% _~ uRem/hr*20'hi Ret cpm + 20"1$/S~'l! ~t cpm -20% 83'1.f "i. . Source 2 lsotope: Jb ~..;.J;...serlill No~: Ul. Actlvlly: <:_O.I l.lnltsf"'~** Assay Pate: ~P Response Acceptance Range (+/-20%):
- uR~m/hr +20% __
uRem/hr -20% __ ~ cpm.f.2o9I97f IT J".1$ cpm *20%..???!C.C.
- 3.
Technic/an/W~ker P~r~ing Che.cks: Name:_.J:, {:-!Jf<<.4.l;_ __
- 4.
Slte or location: Site/Job:.-~t'fu_,,_.-',~""'."--":f......,. (.__ ----,---- GPS Coordinates (when required): X-Coord: iljj4;t.<? ;;i.-<B 'Pl.'7 ~ I 1i1strument Field Respon.se2 Us<!Acceptance Criteria Remarks +/-20% Arnbtent Meter Jll:g .skg Counts Source Source Response Inst. eattery Time Jnltlals and comments Cnt [cpm) or Cnt (gross cpm or source Caiib. Chct;k, Of Temp. (add'l Info: inst. CGoditlon,..etc.) Time* uRem/hr) Ttme uRem/hr) gross cpm r;urrent (Y/N) check ("f) or uRcrn/hr (Y/N) (Y/N) Ratemeter
- I M~t. 1/1£ I CfE1 l lili1';'1 f(/}11! /'J-1
'/ \\/ v J£tls
- S-6.~ C,$-l'J)? (}£ Ratemeter I
1'11i V\\ >t1~1,qi'\\.._ i L w...r1.1 'l7ftr 1 t!&11!t1 ~I \\! \\/ /6_F_?2_ S':t;".1 -n...,,;.:s-;i_,, £!£. Rate meter I I. I ~ Rate meter
- Bicron NA NA Bicron NA NA Btcron NA NA r--**.. ~**-
Bicron NA NA
- l.
J nstrument designated check source Is listed on calibratlon sticker. Record check ~ource response (net.cpmj pylor to fiekl deployment:for all <:heel: sources ~eing used.
- 2.
Sour~e and Backgro.und count rate.shouio be determined from the aver.age cf three static coun~$ at the same,tocatlon. ~epea,t to.uots should be within 20%. If count rate diverges signlficantly, perform additlonaf :counts t<i evaivate lmtrum.er.t stabHity l I I i ! I
Instrument field Response Check.log
- 1. f hstrument lnformatjon 1
Rat.emeter: Make/Mtldel: ~ICloiJ $,IL~Q gf)/\\ Serial.No. ~)_). 'i Y. Detector 1: Make/Model: 7'&"71;,IZ/./A L Serial No. ~.tV/A Cat Due Date: ~ h Det~ctor :i: lvlake/Modef; Serial.No.
- 2.
Chei:k s~nm:e lqf o.rmatiom source 1 lsotope:jb Z:. 'J l... SarlalN<J:: 11 (&. Act_ivlty: *:<::__~ ~J units;~ lnstrumentResponse Acceptance Range {source ~pm-bkg +/*20%); Source 4 lsqtope: Serial No.: Activity; _____ units:. __ Assay Oate: -* __ Instrument Response Acceptance Range {~oun:e cpm ~*bkg +/~20%}: ~cpm + 20% __ -,.,- rre.tcpm -20% __
- 3.
T~chnlcianlWorkerPe.rforming Checks:. Name: S~'i/C K1&~ftl.At--' 11tle:._~_C_..\\ ___ ~: Site or Location: .Site/Job: -":z-'--,_1...=------~-- GPS Coordinates (1.vhen required): X-Coord: Al 1f}- 0 :Z,g 1 $'[) q" oatft:Lot.~/J (Tim.e:. a_q_s:j_ location
Description:
.. - _.6r-;..i!J.,_,*..... tJ:~. d/l.,. _ _,,\\~----*-- Y*Coord;M) i> "'l~ 0 yc * ~1.7.! 1 "'*****,,,,...... *---.~-.... -..-*. =--.-...... ----........ Instrument ~leJd Response2 Use Ai::ceplance Criteria Remarks I Det. a Kg ekg Sour1::e .Source
- /-20%of j Inst.
Battery j Time Ambient ~ Initials and Comments ~ No. Cnt (~} Cnt
Response
sour<:e Net Cailb. Check i or. Temp.. 1 (add'! Info: tempecature, Inst. Ctmditfon, (i/2) Time (~ Time (~'tl!:el cpm
- Current,
(Y/N) .check (FJ I etc.) ht_/l/11 fl J>re~*e~m {Y/N) I (Y/N} ~~- iJ\\~ <...... rv!A ....... ~....,... -..., v , JI . r? 1,Jtl :1z. '1 y A'/£1 _'ftr. i. s~ rl" 2 -.,z ii i I . -----*-*---~-- l
- 1.
lmtrument de$tgnated chedc so1m:e.is listed.on calibration sticker. Record.chack source resp.onse (net cpm) p~ior 1:q field deployment for all checkso11rc1?s being used.
- 2.
Source and Background count rate should tie.determh:ied from-the average of three ~ti!tir,; counts at the same locatlorl. Repeiltcounts ~hould be within 20%. If count rate dlverges*slgn!Ucantlv; perform;,idditlonal counts.to evaluate inwument stability l i I
lnstrrument Field Response Check log
- 1.
Instrument lnformatlon1 Ratemeter:
- Mal<e/Model: LUf)Lv;.'! :J'J'i/*) __
Detector 1:: Make/Model: LV/)l11!'A* o/ l./~10 Detector 2: Make/Model: '2., Check Source Information: Serliil No. 2&'l-1 }I SeriaU~o. flt..UN il) S.ertal No. __ Source 1 Isotope: 1h Z1 Z... Serial No.:. [l_tp Activity: ~ 1.1riits: ~ Instrument Response Acceptance Range.(source cpm ~ bkg-t/-20%): Assay Date: tz{~t.> /1° rim. cpm +. 20% 2.2. 'l?::L Mt cpm -20% I )"z. ogi_ Source 2 Isotope: Ufl1 serial No.. : R7E3 [l.. 't'.f. 1\\ctiVity: _.o Z
- u. nits:&.,_;_,. AsS!l'/ Date: 1/"/.£J/to*
oot cpm + 20% l :i -~ '1 5 rret cpm -20% *?i 17 lnstrum~nt R~sponse Acceptance nange {source cpm - bkg +/-20%);
- 3.
Technlclan/Worker Performing Checks: Name: ) fl!vtt'° K,14}/,,..;g./
Title:
_~_,_c_T ___ _
- 4.
Site or Location:
- Slte/Job:_"3""'""""._,"Z-=---------
GPS Coordinates {wbetHequirnd); x~coor~: N L\\2. L.S I ,~.=r 'l Date: 12}_1(4Jrt Time: /r> oo Location Descriptlon; _ _,_WJ..c;*'-'~""". Y-Coord.: w ~ -:r :; Yo ' ;;.:1*2. * .! ~: BKg Bkg Source ,Source
- ~ +/- 20% oJ Inst.
Batti:ry 1 Time Arn.blent Initials and Comments ---i i No. Cnt (avg of 3) Cnt Respvnse. source Net Ca lib. Check j Of Temp. (add~l lnfo: temperature,lnst. Condition, j'
- (1/2)
Time (cpm} Time (~ cpm current (lt'/N) I ci'cck {F) etc.) [p*~~~-~~==~===-=o=:;~~=*==~~**='==*tjt.~.~~~(Y~/~N)~==="l'==l==--==~=""'"""""~=-=======~"""""'====~j 1 1-'-1J""~.2....... 1-=~_,*..._J-""m=1fl./=.. +--'-""fq_.2"-o_......, 1 J'-"m...._. "=-'J,. ,1q1 D>' -~ '{ - Y Y moo t./'5. 7-5JC. _C~s/~]_._../~l,mµ~K.~~~v--'-!~tm='*~~---lll.!:/itz_ r--cr~-1--.....,.,--y-1-~y~~)-V_O_<~~-~~.~~lll-.L<~IL~~~~--~~--i I >-----+----.. **1-------i-----i.------l!\\------.. -*-- ----+----~----.. _ r- ----------------1 1 '==*j-,-~-~-t----J~~ .. -_i~~~~-1-~-l----!----t-~ ...... -.. ~~~---1
- 1.
Instrument deslgnated*check*sovcc.e ls llsted on calibrat!Dn sticker. Recorcl check source rn~ponse.(net.cpm) prior to Held deployment for all diei::I: sourc{!s bemg used,
- 2.
Source and Background cou111t rate should be di:termlned from the i!V~f2JIU ofthm1i static count!; auhe sam1rlccatlo11. Repeat counts should b~ within 20%. If count rate diverges significantly, perform adtlitlonc1I counts to evaluat~ instniment stablllly
l I Rev 1 l(J/18/15 . Instrument Field Response Cllecl;< log
- 1..Instrument Information)
Ratemeter: Make/Model: Detector 1:. Make/Model: Blt:ron MlcroRem Meter: Seria!No; **~~ Serial Np, P(l.11 ~ Ser!al No. iJ in
- 2. Chetk Source Information:
Source 1 Isotope: =th-.;2$2, 'Sertal No:: _f/( Activity: <!:.O) units:,&*C~" Response Acceptance Range {+/-20%): uRem/hr *f20% __ uRem/hr -20% __ cat ou.e Date: ?6'.tf" Cal. Out; Date: fJ (r\\ Amy Date:l~;Jf: !Scpm +20%. ~ Source 2 lsot9pe:(s-r:n Serial No.: //'f l?;l:?.. :i..2. ActJvity: 0,.d. units;.vC/ Assay Date: IJ!/t Response Acceptance Range (+/-20%}: uRem/hr +20% _. __ _ uRem/hr -20% _*_~.- ~ cpm +-20%11:2.:Z:I:.. ~ cpm -20% 75$f'J .9. Technlclao/,1Jorker Perlormli:tg Ch~dm Name: :::::t. awe.c.ko RC(
Title:
~ Date:/¥~/£ Time: /ac:>o _
- 4.
Site or Location; Site/Job: GPS Coordinates (when required): Arb; ~. I Location Oescription:.~ __ eo.-;_~-'-'-""'"£>l_..'/) ____ _ , I ft ./ X*Coord: fl:I "-P.f',;i.g !f!f./i... Y-Coon:l: \\1Jt>?B 0 ~'1f.$."t.7 :_ I Instrument field Responsez Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Source Response t/-20% Inst. Battery Time Ambient Initials and ):omments Cnt (cpm) or Cnt {gross cpm or source Co lib. Check Of Temp. (add'IJnfo: inst. Condition, etc.) Time uRem/hr) lime uRem/hr) gross cpm current (Y/N} check (°F} oruRem/hr (Y/N) (Y/NJ Ratemeter '/I'd>;,,. t'i~('!,... ~ Ii..~~.... - l/twt,,. - \\/ v v /005'" 57.o. n-,iez_ £)5. Rate meter f f>\\iY' °! ') (,,-.?:, c~ I JK;,. /If~, \\~ 'J \\I 1-CJ/0
- 51.,::J_ /'"s.. ('5?
~LJC C?l'VI Ratemeter I / v Ratemeter f Blcron NA NA Bicron NA NA Bicron NA I NA Bicron NA NA
- 1.
Jnstrument desi6nilted check source ls. listed on calibrat1on sticker. Record check sourc!l. response (!let cpm) prior.to field deployment for all check sources being used;
- 2.
Source and Background count rate should he deterrnined from the average of three static counls at thesame*loc;.ition. Repean:ounts should oe within 20%. If count ~re dlveTges significantly, perform addltlonalcounu to evalu<ite !nstrumentstabillty*
- I i I
I I i
L Rev 110/18/15 I ! I Instrument Field Response Check log .1. Instrument lnformatlon1 Ratemeter: Make/Model: ~(/k._~'1/-;?. Serial No. ~£.Off, Detector 1: Make/Model: ~bl ¥~-;-i.@ *-- Serial No; 17/!l(MY-f-Bicron MicroRem Meter: Sena I No. f\\J i IL\\-'
- 2.
Check Source Information: Source 1 Isotope; m-~Serla! No.:. Ii I Actlv!ty: ~.I unlts: ~* Response Acceptance Range (+/-20%): uRem/hr +20%__ uRem/hr *20% _ Cal. Due Data: ~ ca1. Due Date: fif {Ii. Source 2 Isotope:~ ~<37 Serial No.: /f1 ):!...-1;i.. Activity: CJ,6,)... unltsWC; Assay Date: JJli+/-._ Response Acceptarice Range (+/-20%); *uRem/hr +20%_* __ uRem/hr-20% _. _ l'l~ cpm + 7.0"loil...2-21 swt cpm -203 g/ '/.'!
- 3.
Title;
- 4.
Site or Location: Site/Job: ___ A""* d.*"-l..,.. t:."-*..,.,,,..3'........;..../ ~-.. ~ 1 .11: GPS Coordinates (when required): X-Coord; N :1'.:~ ~8 S". '1 I Instrument Field Response~ Meter Bkg. Bkg "counts Source source.Response +/-20% Cnt (cpm)or Cnt (gross i;:pm or source Date: Jtjlt/5" Time: /$a 't _ location Descriptlon: __ -=~=c..;.* ..,;;.'3'1-'A*"'* """~'-"'jJ'------- . Y-Coord: kV o 7'S 0vo J1. 7 '" Use Acceptance ei*lterl.a Rem.arks Inst. Battery Time Ambient Initials and Coft)rnents Ca lib. Check Of Temp. {add' I Info; Inst. Condition,. etc.) Time uRem/hr} Time uRem/hr} gross cpm current
- (YIN) check
(°F) or uRem/hr {Y/N) (Y/N} Rate meter.,,,..,h ZffrC i:.?w { C1A,.,. lfS-f10 C...1:>f."" v \\! ~*v* 136~ *~.D -n,.,,,p).;3;L ~- Rate meter !Mir. 'tt1l.. <:,,.,. I wi.ifA. I 1-f Lf<; r*l'h \\/ v '1/ l>IJ ~1.o /"' A,/37 ~Oir;; Rate meter I I I Rate meter 1 Bicron NA NA Bicron NA NA Bicron NA NA Bicron NA NA -.~-----
- l.
Instrument designate.:! check source rs listed.on calibration sticker. Record check source response (net cpm) prlorto field.deployment for all cheG!I soun;es being used.
- 2.
Source and Oackground count rate should.be determined from the a11erai.:t? of three $t<lti~ counts at the same location. Repeat*counts should be withln 20%. If.~ount rate cliverees
- slgnitlcantly, perform addjtional counts to evaluate instrument swblllty f
I I I I I I I
Instrument Field Response Check log 1, Instrument lnformatlon1 Ralemeter; Make/Model: ~ Dete$:'.torl: Make/Model:. J;iV-rC.4:1£,A '--*---* Qetector 2: Make/Model: ----------
- 2. CheckSource Information:
Serial No. A?... ?--i.f I.A Serial No._AA~*-- Serlal No. ____ _ Source.1 Isotope: 'Tb 2 J t. Serial No.: I I (p m Ac!lvity; ~ units:~ Cal.Due Date: r{-1/l't:J Assay Date: I 7. £~? /1 o lnstr.ument Response Acceptance Range (source cpm - bkg +/-20%): OOt_fpm t 20%_ p.. 'l?,lo_ ~ cpm -20% 1 $"2'irf >>K<:.1.'\\'\\ lk.- +20'1~ ~ 1.i.(t4'V'> /&1r.. zo r,*~ _.Ji__ Sourc;e 21satope: Serl al No.: Activity; ____ units: __ Assay Qate: __ Instrument Response Acceptance Range {source cprn**.bkg -t/-20%): net cpm +.20%. __ _ netcprn-20.% __ _
- 3.
Tethnlcian/Worl<er Performing Checks: Name.: f'17lv'~ {
Title:
.. Rc::r ________ _
- 4.
Site or Location: Site/Job:_. _J_.,_i... _________ _ Date: fb}u.:.{r<nme:.[L/O 1> Location De?cription:.fi'-~'""'""~,:,;,..:.-.* *--------- GPS Coordina~es (when required): X-Coord! Y-Coor.d: ~---~--- ....... *-*---*-----...... ---*-*..-~*------**.... *-**--*-*---*--~* ~-~- Instrument Field Respqnse 2 Use Acceptance Criteria Remarks +/* 20% of I I ~ Det. BKg Bkg SoiJri::e Source Inst. BaHery Time Ambient Initials and Comments No. .cnt (~) Cnt
Response
source Net Callb.. Check .Of Temp. (<Jdd'l lnfi:i: temperature, tni;t. COncll!ton, I
- p. /:2).
Time ~~ Tims (r~* .cpm l current (Y/N) ched~ {f) etc.) J~/t.hlr t i .. (Y/NI t iY/N) = ~- rv \\ f\\-. £ N (,!\\ 19 Phi: 1 y y JLf.oo 5"J.~ ~ ~~32. f I i
- 1.
ln.~trument designate ti check source is*listecl on !':alibr.otion sticker, Record chedi sourcll. response (net.1:pm) prior to.field deployment for all.thee!\\ sourc<is bei!18 used.
- 2.
Source ant! Backgroun<:f'count rate should be determine.cl from the average cf three static i:ounts at.the same lo cation. flepeat counts should be wlthln 20%. l f count rate dlverges*s!gnifkantly, perform additional cowm.10 evaluate Instrument stability l r I l l
Instrument Fiel.d Response Check Log
- l. Jhstrument lnformatlon 1
Ratemeter: Make/Model: /.JdJ.W*V\\ JJ.VI, 2..- Detector 1: Make/Model: lv{Ll..vM-r.f'l*t"tJ Detector 2: Maka/Model: ---------
- 2.
Check Source loformutlon: serlul No.:a_.l... h].11. Serial No. !.lltw e, '") Serial No. ____ _ Cal. Due Date:.~ i... Source lJ5otopei11;iJ??. Seria.1 No.: tL~--*---** Activity:~ unlts:~i' Assa\\1 Date:~/ Q oot cpm.+ 20% 2:2'.i z:..r,, flat cpm -20% 1 'S' z~':{ lnstrum.ent Response Acceptance Ran&e {source cpm-bkg +/-W%): Source 21sotope:G:.L.ll_serlal No,;&' }t/J- 'fl Activity: - D '2.. Instrument Response Acceptance Range (source cpm - bkg +/-20%): units~ Assay.Date: ~ i:uttcpm + 20% 1-y~,<; ~cpm -20% mi "i 11 $. Jec!lnlcian/Workcr Performing Checks: Name:51t.Ve K 1,i.IJ '"'A <!L
- 4. Site or Location:
Site/Job:_~_..._'-_________ _
Title:
r:.cr __ _ oa~e: /i/b/1< Tlm~:Ffro µ 1 Location Oescription:.,......:.f..:::e;;;.o.*t::..::."°'"---------- GPS Coordinates {when required): x~coord: ___ _ V~Coord: ____ _ ! (/\\,Jl.t:f:. Instrument Field Responsez
..... --*--*--~*_, ___ -~*---*-- ---- --*--- --~;--.--
. (-T<; Use Acceptance Criteria Remarks ~. BKg Bkg Source Source +/- 20% of Inst. Battery I Time ! Ambient ! Initials and Comments No. Cnt (avg of3) Cnt
Response
source Net Calib. Check Of Temp. (<>dd'l Info: temperature, in.>t, Condition, {1/2) (cpm) (~* (Y/N) check* 1 eti::.) Time Time cpm i current (f) ~)Wl-(Y/N) ('l/N) lmu-.i 7 '-77. I I ffl?W i J{'"fj-,,; ~ y-** y fJ; J 3'1. ~ 'f 1 i.11 ~ <;; 1-Ip st l I '-{ 11.: rn )JfJJ!_,__:_14. l. / /._fl4N' ti I{;, I t'..l"' ""f v v /<(/{ (J.1.c> Sit-r
- l.
Instrument designated check source is* iist!ld on callbr11tlon zticker. Record chec!! source.response (net cpmJ prior to fio;!ld 'cleployment.for all checlnources be111r; ucsed.
- 2.
source and Background count rate should be determined from the average of three static counts* at the same location. Repeat counts.shou Id *be within 20%. If count* fate diverges slgnlfli;antly, perform additional counts to evaluate Instrument stability. I i i I
Instrument Fietd R~~ponse (:heck' log
- 1.
Instrument lnformatlon 1 Ratemeter: Make/Moc;lel: j.V])l.11AA 'J-?'11.. 4-0etector 1: Make/ModeJ: l V RI.. VM-Wt o
- Detector 2:
Make/Model:
- 2.
Cpeck Source 'nformation: Serlai.No. 2¥-L] 3 J Serial No.{R. WI Z. "i. Serial No. Caf. Du~ Date: q f *i.l 1<.p Source 1 Isotope: "fl, 27'2 Serial No.: J/i,p Activity: Lo. t. uni~s:~ Instrument Respoi{se Acceptam:e Range (so~rce cpm - bkg +/-20~): --* -.. Assay Date; 1'fl--s~/*..:;. oo.tcpm + 20 o z:z.i?.<. r.ta: cpm-20% I) 2'i:'j source 2 tsotope: ( 5 l..?7 Serial No.:&'1 ell - 'IR Activity:
- v Z.
Instrument Respon.se Acceptance Range {source cpm - bkg +/-20%):
- 3.
Technlcian/Worl<er Performing Checks: Name: S~V<f K/,.v'f/-t.Ar-Jfl
Title:
--:...R,_C\\~-~-
- 4.
Site or Location: SHe/ Job :._,._fi ....
- _o_.~_-""-3_..*, -"-2-~~~~--
Date; L o/u:) li{ Time: Ji; I < Location Description :_:.t~.~~r.l.!+-----------~- GPS Coor.dln11tes (when require\\']}: X-Cootd; _______ ~ Y-Coorcl:. __ ~----- d)et: BKg Bkg Source No. Cnt (avg of'3) Cnt (1 /2) Time (cpm), Time t;f;7' _____ ---*- --U-se~A-c-c-~-p-ta_n_c*e--C*-rlteria-* --***-~----,,,.------R-e_m_.a._r_k_s _____. ---] Source
Response
{~) ~ . ~ +/- 20%of source Net cpm [V/N) ~- Inst. Battery I lime I Ambient Initials and comments 1 ! C<ilib. Chetk Of Temp. (adp'l lnfo: temperature,. inst. Condition, j
- , current
[Y/N) check {F} . etc.) ..1 IY/N} y /~15' '( I f'l,r.) $3-fo SV- "-----~---......... ----_,,,,.,..... __ ,_~...,...---~----~---_,__--__,_-_____ -*--*-****-**---'"--------,,------,-----:--...r
- 1.
Instrument designated check source ls*ilsted on calibration sticker, RE!<:ord {:hack sourccHcspons~ (net cpm) prior to field deployment for 11ll.check sourc;es belnu vsec!.
- 2.
Souri;e and l3[Jckgrou~Q cmmt rate should be determined from.the average of tlm'le static counts at the.same location. RepMt counts $hould Ile within 20%. Jfcount r11te dlverce~ slgnlflcaitUv, P.erfo1:m addltlonal counts to. eviiluateJnstrument stablllh'
Instrument Field Response Check log
- 1.
Instrument lnformatlon1 Ratemeter: Make/Model: ~, 1g~tJ,/11 U R.-0 K01\\ Serial No. ~l/ 4 Detector 1: Make/Mo.de!: J../.,r!f.rl;,/1J*k .Serial No. Detcctbr,2: Make/~v'lodel: ~-* ------- Serial No. _________ _
- 2.
C eek Source Jnfo matlon: Source l Isotope:* -* 1Zlk-serial No.: /Lk. Activity: ~C?:_I _ units;~ Instrument Response Acceptance Range (source cpm - bl<g +/-20%): Cal. Due Date: ~t.t/{'-' Assay Date; / z..hi) /1° aet cp~ + 20% -Li.'! 2.<. ,o;.\\i'.;.v,,\\\\~dt.v1i 0 2£_ Source 2 ls(";tope: Serial No.: Activity: ___ . _u_nlts: __ Assay Date: __ Instrument RcsponseAcceptance Rcmge (sourc.e cprn - bkg -i/-20%); ~ cpm + 20% __ _
- 3.
JQ.cfillkiao/Worl<er Performing Che<:ks: Name::.SlE.v'.f' /( 1/l':ir<AAAJ Title; R.c.T ~cpm-20% l)Z.Y~
- h.(l~M I
~r ~ '2bfio Jj__ nm; cpm -20%~--
- 4. Slteorj;_oi:atloo; Site/Job:.__,'3~,. 7-.
Dllte: J32/L~ Time: Lil'f. LocationDescription:__,_ft__._~_,,_11..""p_1..__ ________ _ GPS Coordinates [when.required): X-Coord: __________ Y-Coor.d: ________ _ r lnstrumentfleld Response2 -**~u-------*-* Use Acceptance. Criteria Remarks
- -1 I
Det. BKg Bkg Source Source. I +/-20%of lhst. Cattery ) Time j Amblerot I lnllia!s snd Comment> No. Cnt (~ Cnt
Response
sourc£Net Ca lib. Chi:d( Of jadd'l Info; temperaturn;inst. Condition, I T~~** I (1 /2) Time lime /~kB)_ cpm
- *cuuent (Y/NJ chec~
etc.)
- =
_,,....... K. ~J.... ~' (Y/Nj (V/N)
- ~
(f de ~ l f\\/ (~ fJ \\1\\- I '{\\ /7 i y .1.£15.' ,c;&, 3 S: I::. Tl, z :i,z._ tJ fn I I ~-- j l I t -~ *---*~-~
- l.
Instrument deslenatecJ ch.eek.source* is listed on irnlihratlo n :sti~ker. Recore; cheelqm1rce response (net cpmj prlot to*fie!d deployment for <ill check !IOU rces be mg used.
- 2.
Source and Ba~kground.~ount rate should. be determined f.rom the av~raga of thre-0 static counts at thes.~me location. Repeat counts should.be within 20%. If count r~te diverges slgnlficantly,.perform additional counts to evaluate lns~rument.stablHty i I I !
Rev 110/18/15 j I ln$trument Held Response Check log
- 1.
lnstrumenttoform(;Jtion1 Ratemeter:
- Mako/Model:
Detector l: .Make/Model: Blcroo MlcroRem Meter: Serial No. ~6tJqt[ !;eilal No. 'f'E//U'f,2-Serlal No. !II i,_A'_* __
- 2.
Check Source Information: Source! Isotope:.:IJ...;l~ Sedal No.:../!I Activity: C.6.( units:,µti. Response Acceptance Range {+/.:20%): µRem/hr +20% __ uRem/hr -20o/o __ ca1. Due oate: -rq~ _Jal, Due Date: (V i-4_ \\. Source 2 Isotope: U*}37 Serial No1:1f'iE,;:J-f,;J_
- Activity: 0.C>A unitsJlfi-Assay Date: /!/..tf:_
Response.Acee ptance Range (+/-20%);. 11Rem/hr.+20% -* _* _. * .uRem/hr. *20%_~
- o.e;; cpm + 20%.{3 p."J ~ ~
- cpm -20% _..!_'iWcf:,.
- 3.
J~£hnician/Vliorker Peliorming Checks: Name:.;f e:~
Title:
-~JZ~c::r~* __ Date: /o/!t/!5" Time: li.P. $ I
- 4.
Site or Location: Site/Job: Al"'fq1 1. [ Location
Description:
___ ~-'?'M~..s.l!.,,.A""'~"'* ,...'/!_""-----'--~- Al / 'f J GPS Coordlnates (when required): x.coord: ~ 'tJ.."' #l'ii GY.' Y*Coord: Wo? ~"' V.i:'l '3q.? * I Instrument Fi.aid Response2 U.se Acceptance Cr.iteria Remar~s
- ----~*--'-*
~ Meter Bkg Bkg Counts Source Source Response +/* 20% Inst. Battery Time Ambient lnitials and Comments Cnt (cpm) or Cnt .(gross cpm or so1.1rce Co lib. Check Of Temp. (add'! Info: ill$t, Condition, etc.) lime uRem/hr) Time uRem/hr.l gf0£S (;pm current (Y/N} check (°f) or uRem/hr (Y/l'J} .(Y/NJ ~..lXI Ratemeter. f JIA1J'\\ 1;.1$ (:,.w J /111;'1 tf MS?,.. -""W.. v
- v v
16~).. s3. 7 -rz...-2$2-. ~}9__ .Ratemeter j IYI'* V"\\ rrz. I '(<fl" I*:¥.. ./l!'i7 /'-h~ \\j v \\J Jt.f 7 S-3.~ /:_.e_,/,?7 £:.//X' Rate meter I I I p-- 1 Rat~_s_neter -*--* Blcron NA NA Blcron NA NA
- Bicron NA NA Bicron NA NA
- 1.
Instrument designated check source.ls listed 9n calibrati-on sticke~ *. Aecord check source.response (net:cpm) prfor to fleld deployment for all check smirces being used.
- 2.
Source and Background count rate should.be *determined from the av1m1ge oHhree.stetic counts at:the same location. Repeat counts shovid be within :20%, If counNate.dlverges slgnlficantly,.perform adpitlonal counts to-.e11aluate instrument.stability_ f l
Rev 110/,13/15
- 1.
Instrument tnformatlon1 Ratemeter: Make/Model: Detector l: Makl'.!/Moclel: Bicron MkroRem Meter:
- 2.
Check Source lnformatlon: Instrument Field Response Check log Serial No.~~47<<" SerialN~. ~/Uf{J.. Serial No.. tJ M Cal. Due Pat~: '1f /!1P Cal. Due Date:...JYJJj_ Source 1.lsotope: :IA.;J.)... Serial No.: r/ I Activity:.?b. I units:fLC/ Response Acceptance Range (+/-20%): uRem/hr+20% _**-*.~ uRem/hr-20W As.say Date:l..;2..~td ~*cpm + 20%!'57 f' *r.mt cpm -20%~~C Source.2 Isotope: 4-l17 Serial N.o.: I (4t:'.:2~'1.2. Activity: 'D.6?-_unlts/LC.i" AssayO<ite: f\\JA Response Acceptance Range (+/-20%): uRem/hr +20% _~*** uRem/hr.-10%_.__ nel: cpm + 20%;,,/~~7? ru:,t cpm.-20% l§&Y'f 3.. ""'*)<>* e..c.:r* .... ~'------~
- 4.
Site or Location: Site/Jpb: tfra.!\\ J. f 6 ,r GPS Coordinates (when required): X-Coord: N.<!); 'rlfl..Ff'lt 9 I Instrument Field ~ Meter Bkg Bkg C01,.mts Scio re Source Response* +/-20% Cnt (cpm) or Cnt (gross q:im or source Time uRem/hr) Time uRem/hr} gross cpm or uHem/hr (Y/N) Ratemeter I fl4irt V/t.60 Q11v,. I.
- p,yi,r.,.
'{6/.f;l.{, t:Jprv.
- v i IY\\ iA
'j'(..cc "'un I tMir. 1{~'1.. \\f. Rate meter LAl~ Ratemeter . *I Ratemeter Bicron NA NA Blcron NA NA Bicron NA
- NA B1cron NA NA
!t>/P1/1s-R:,y,~ Date:-~ Tinw: tJf,z.~ location Descrlplion: __ _;C.a=. '-r~__,_,;e""t"""lj)_* _____ ~ '. I:. o r~ "". Y-Coord:..JllLQL'.{E Yti..> 1,l Use Acceptance Criteria Remarks .Inst. Battery Time Ambient !ni~ials and Comments Ca lib.
- Check, Of Temp.
(<id.~'l lofo; inst. condition, etc.) current (V/N) check (°F) (Y/N) y y 1!J1f.t ft,'>
- ....rh iJ';l...
() £. v v lJ!~'f(} 1L I /""-~ f"J7 PO ~ I
- v.
- 1.
l nstrumcnt designated t:heck source ls listed on callbration sticker. Record check sovrce response (net cpm} prior to field deployment for al! check sourt~ *being used. 2, Source ancl Background count rate.'ihould be determined from the average of three !itatfc count$ at the same location. RepP.at counts should oo within 20%. If count rate dive re as .significantly, perform additional counts to-evaluate io5trumentstablllty
- 1 I
l l i i I J
Rev 110/18/15 r
- 1.
- instrqment !nforroatl2n 1
Ratemeter" Make/Mod et: )... v0LUN\\.'J ') '1 f *,,_.. Detec:tor 1: Make/Mode!: l;Jl/Jli/10. 'i.Y~ Cr> !llcron M!croRem Meter'. lnstrumenHieJd Response Check Lo~ SerialNo *. 2(,;,J/~I serial Nci,ll111' z, I Seiial No. fl 1.1..-~ lA. Cal. Due*9ate; ~/i/1c.;,. Cal. Due Date: ~
- 2.
Chei;;k Source lnforniatipn: .~ f ~. f Sc.urce '.l lsotope::zJi l:z ~. Serial No.: /[ (g
- Actlvity1.{,Q_J__.units:~
Assay Date; 1'!ii.EJ Io Response Ac~eptance Range (+/-20%): uRem/hn*20% *;_v uRem/hr -20% ~ mit cpm + ~0% *1;2 <"(?.. \\. mt cpm -20% ! "l2?'{, Source 2 Isotope:(~ HJ Serial No.: (ir1EU:Lff! Activity:
- 07...
units:.4!4f Assay Date: 1{iojro '¥"r '"t* Response Acceptance Range {+/,20%): uRem/hr +20% __,__ u.Rern/hr *20% __ net cpm + 20% : iJ*:,15 ~ cpm.~20% _ __,, __
- 3. Technician/Work.er Pe~formlngChecks:
Name: ;):<Tl::ve" /(i:rflJfaAtvl Tltle: fZ.cr
- 4.
Site or LQCatlon: Site/Job:._~_. ~z.. _. -------~- . Location Descrlptlon:~fA-*~~~.it/\\ _________ _ GPS Coordinates {when required): x-coord: 7'8' f..rt 7 '-/17" Y-Coord: tf 2 ; '181)'70' Ll!>:l: t'*ID~Q I Instrument Field*Response 2 Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Source Response +/-20% Inst. Battery Time
- Ambient tnitlals rind Comments Cnt (cpm) or cnt
{gross cpm or source callb. Check Of Temp. {add'I info: lnst. Condition, etc.} l1me uRem/l1r) Trme uRern/hrJ gross cpm current (Y/N) check ("Fl
- .oruRem/hr (Y/N}
I .(Y/N) y= *y ~_temeter l/t!Jtf./ 'l ff~~ C\\l '-/1urJ \\ Cf(.1 Y Cf.Mo. '{ o~JS-..,_31,_!.( .. '11. l."?Z.- ')'( i Ra~emeter lj'}i,µ
- 1rqi'-1" IMtN.
11 2-tJ'a!J'). '{ y oq,r: j'J_.Cf t, o*:i ~IL l Ratemeter L~1tJ 'lS(i..-<.~" *l Jl\\I rJ I 61 >s I c.ff" '( '( I~ *z.<; ft.;. s '11. 1-s'l.. ~ft.. I Rate meter I fl'\\11J 1 SC7~'""" l MllJ io Ip qi. u~ y y 11 iS' I ':>V.s
- r... ) 1")
${L Bicron NA !:">>.f{/111?.. NA ) r _M.,fl..f N. 'i 'f y Dql0 1'f>,"( . 'fl.. 'J'>."l s~ . I/) tlJ.lf{_ NA 11,.,Jt./Jf,,., Bicron NA '{ y J s'211
- ~v.<
7y,, 2. "\\7-. St. Blcron NA j_.** J.11.Je. NA I ~,~./-/IL. 'I v y t32s- <;.y. (;p . l"{.1 2.?>Z. SJ!;..
- Bicron NA v
I NA I
- 1.
Instrument designated check sour~ is !i>ted.on caUbrat1on sticker. Record check squrce response (net cpm) *prior to flelcl deployment for a!I check sources being used.
- i.
Source and Backgro1rnd c;o1.mt rate.should be oetermined frqm the averilge of three static count:; at the same location. Repeat cotm~s"should bti within.20%. It count rate diverges ~ignlflc11ntly, perform additional counts to.ev;,;lu01te Instrument stabmw m~ I I I I I i ! I l
Rev 110/18/15 Instrument field Response Cheek log
- 1.
Instrument lnformation 1 d~ Ratemeter: Make/Model: Lv~WJY.~~ Detector 1: Make/Model: z:",di ~-J Serlal No.d!:,t,, (!;f'/ 5?' Serial No. 1'f.~ Serial No. H r1 iA Cal. Due Date; 1'/1;/J fo Cal. Due Date: tJ tA alcron MlcroRem Meter:
- i. Check Source Information:
. Sour~ llsotoP:e:::ZZ.m..serial No.: fl{ 1'\\ctlvity: ~ units:~* Response Acceptance Range (+/-20%); uRem/hr+2-0% _.__ uRem/hr-20% Source 2 lsotope:Cs..{J? Seri<il No.: (/1E:J:kl2. 1\\ctivlty: f?.t;..?-. units~ Assay Date: /JlJ1:... Response Acceptance Range (+/~20%): uRem/hr+40% __
- uRem/hr -20% *--*
net cprn + 2030.;275 ~ cpm -20% ?..r09 3.
Title:
iZC~ Date:~.tf" Time: @.C
- 4.
Site or location: Site/Job: A-ilA.). \\ GPS Coordinates (when required): X-Coord: Nt.fd-. d-! 1,if.q Location
Description:
C.. r~e.fJ Y-Coord: ltJ (2 76_: ¥0 ', 'iq, 7
- r -
ln~t;~men't Field Response2 I .Use Acceptance Criteria Remarks 1* M.eter Bl(g Skg Counts Source Source Response +/* 20% Inst. Battery Time Ambient lnltials and Comments I Cnt (cpm) or Cnt (gross cpm or source Ca lib. Check Of Temp. {add'! Info; inst. condition, etc.) Time uRem/hr) Tlme uHem/hr) gros~ cpm current (Y/N) check {°F) oruRem/hr (Y/N) (Y/N} Rate meter /w.ii' 'tJf;J.,t,lf,,i!JtA 'l*A"'* t/'/):1('1 u?.".-1 v i v 113..2..
- t;/,t.5' Tk.2~
D. Rate meter I 11~i \\'"\\ ~l. ~L\\ C.fY"\\ i....,~ u "'f <.f c.u{W'- ...J 'Y -v J n<t t/2 'if r's -15? £///_:!i_ Ratemeter I ?" Rate meter f Bicrnn NA NA Bicron NA NA Bicron NA NA ! Bicron NA NA l, Instrument designated checksource Is listed on calibratiornticker. Record check source response {netcpm) prior. lo field deployment for all check sources being used.
- 2.
Source cmd Backg(ound count rate.should ~e determined from the i!Verage of three static counts at the same location. flepeat counts should be within 20%. If count.rate diverges signiflcantfy. perform addltronal counts to evaluate instrument stability I I l I l i
rs ~~ 'TJE~I.. SEll"V#C~ Re11110/18/15 i' i l i I i
- 1. Instrument Information~
'Ratemeter: Make/Model: Li..t\\\\.\\i.,'\\! 22<.fl-2.. Detector 1: Make/Model: Lu.cl(.;,"' '-lt\\ *ID Sfcron 'MlcroRam M@ter: Instrument Field Response Check tog Serial No..Z(,z.. 7:i7 Serial No. p '2. I l 11 2. 7 .serial No.. N ( tA: Cal. Due Date: 7 /2 (,.,, Cal. Due Date: Ai {ft
- i. CheckSource Information:
Sol.!rce*11sotope; ~h 7_Y-Serial No.: 11 l.o ActiVity: ~ vnits:.~ C Assay Date: l'2..{~o/1~ Response Acceptance Range { +/-20%): u Rem/hr +20% ___ uRem/hr -,20% ___ net cpm + 20%2:2.'J<. I. ~ cpm* *20% t._,-z 'i:l/ source2.lsotope;C-sl::,7 S~rlaJNo.: <r;IE.(5-'IS' Activity:.c.2.. unfts;..uC{ Ass11vDate: 1/z.,,/1° Response Acceptance Range {*~/.20%}: 11.Rem/hr +20% ~ 1.1~em/~ -20% ~
- m;;{c:pm + 20~ rs-:, 7 <;'
net cpm-20% ~?I~
- 3.
Technician/Worker Performing Checks: N,ame: ~:~ t"l'"l'.::.*Vvr,"l ntle:. (C, (T Date: l!Jd/rs: Time: /~'i. D
- 4.
Site or*Locatfon: Site/Joh: __ ~-*~2~----~~---- Location
Description:
_~_*i:v-_ _.___~-------- GPS C:oordlnates (when required): XrCQord: ___ ~----- Y-Coord: ___ ~----- ~tr'J~ent Field:ReSPQnse2 "~~ Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source* Source Response +/* 20% lnst. Battery Time '*Ambient Initials ;;ind Comments Cnt {cpmJ or Cnt (gross cpm or source Ca!i!J. Check Of Temp., {<tdd'l Info: Inst. Condition, etc.) 11me uRem/hr} Time uRem/hr) gross cpm current (Y/Nj check (oF) or uRem/hr (Y/N) (Y/N} Rateineter IM( iJ ffS'f l,PM / li\\1 tJ Jf/5llc£.fl... __ y ~ y /{L{o $'t.c.. '"1"k7.3<... w j Ratemeter I Mtp.). rff~"( cf,..,.: /MIM l z I.fl 7_. ((M, y
- ..1
'i {t,~l/tf' '(tf'~ {,.,
- tt!Jl sic:-
Ratemeter I' f\\atemeter
- Bicron NA NA Bicron NA NA
~-
Bicron NA NA BIC:ron NA NA l,. instrument designated check source is listed on calibration sticker. f\\ecord check source response (net cpm) prior, to field deployment for all check sources being used.
- 2.
- source and f;lackground coum rate sho.uld ce.determlned from th<! av~mige.of three static counts at the same location. Repeat counts sho.ufc!. be within 20%.*lf count rate diverges
-significantly, perform additional counts to evl!luate inst11.mient stability I l I l I i I ~ I I
I I
- ~
Rev 110/lSJ/15
- 1.
Instrument Information* Ratemeter: Make/Model: Detector l: Make/Model: Blcron MicroRemMet~r: lnstrumen~ Field R~s:ponse Check l.og Cal. Due Date: Y1{£'- Cat..Que,Date:/¢7//C /* .2. CheckSoun:e Information: Source 1Isotope:1"&?3;... Serial No.:.. _JL f.. Activity:.C()} units:;{?~* Response Acceptance Range,(+/;.2q%):.uRem/f1r+20% (<,,4 uRem/hr -20% JJSL. Assay Oate:, 1~;,t; flflk;cpm + 20% *. S" rretc:pm -20% J!:flf"
- source 2 tsotope: 6~137 Serial No.:.1(1~-12.
Activity: t').o.;i.. units)'¥.~* Assay Date: NA-Rei;ponse Ar;ceptarn:;e Range.(+/-20%):.. uRem/hr..:+20% _ u Re!Tl/hr -20% flf'J cpm + 20% rS ';.t.? 5) ~ cpm ~20% '31tJ':;i.
- 3.
- 4. Site or-t..ocation:
Site/Job.:. GPS Coordinates !when required): I lnstwme;~Respo*nse 2 Use Acceptance "criteria Remarks Meter Bkg Bkg Counts Source Source Response +FW%
- In5t, B;ittei:y Time Ambient.
Initials <intl Comments Cot {cpm}or Cnt (grnss cprn or source Callb. Check Of T.emp;
- (<tdd'l Info: inst. Condition, etc,)
1lme uRem/nr} Time uRem/hr} . gross cpm current {Y/Nj check
- {oFj oruRem/hr
{Y/N) IY'Nl Ratemeter I,...;,,.. q,t'{('~ r~;r.. IJ,l{;JL, ( en,_ \\ v v ()1.1,t./ S'JA ll.-:J.~;L lJ~ Rate meter j l\\1i>'\\ 'i' lo tJ t:.'.r 1*.:, { Mil'\\ ltCQ'I !..,~- \\}, VJ '11 ~:e-> .'S7_ {,, 6--1~7 rbZ Rate meter I. ( I Rate meter
- -=- --~.-- -~-~-
Bicron NA
- 6. it/!l,.,,,.//..,r NA
.** ! "Sr 1' Ll'AL, * :....- \\,/ \\f \\l hl/51.* c;-'(j). fJ-19. r?.. -..J..~ :2-t .. Blcron NA I NA I I () Bfcron NA NA Bkrori NA
- NA i
- 1.
I nstn1me11t designated check soµrce 1s U.st.ed on callbratton st!cl:er. Re,ord chec1< so\\irce resP,onsi: (net ;;pmJ pnor to field qeployment for ell d1ecksources being used.
- i.
Source and Bacl:grou1Jd countn11n !!>liould be deter.min~d fmm'the average of three stoti1,1 J,!Ql,mt~ ~t the $ame location. Repeat rounts>>hovltfbe witMn 2Q%.1f count rilte div:erges slgoifl(:antly, perform add!tlona! counts to svaluatelnstrw:nent stabllit'I I
Rev 110/18/15 r Instrument field Response Che1;k Log
- 1. 'fu!trument loforrnatloni.
~ Ratemeter: Make/Mod{!J: /;,~~~ Detector l: Make/Modeli _______ _ Serial.No. Seria1:No. serial No. Sicrari:MlcroRem M~t-er:
- 2.
Check Soam:e lnformMlon: Source 1 lsotop_et11'a*l..k-serial No.:.. J / / Actlvi~. / units:~ Response Acceptance. Range (+/-20%-): vRem/lir+20%l2.i_ uRem/hr ~'.20~ -net cpm-+ 20% ~ cpm ~20%~~ Source21sotope:($.. /J7$erl<il'No,: /li{fd;;J-1)- Activity: f>..42:-; m1its:~Assaypat~:.~ .Response.Ac:ceptani:e Range (+/-20%):.. uRem/hr-+20%-.... -... -.. *-**. uRem/ht,,2Q':'o,,:...__ .. *cr.im +.:;{0% *{ >.~1 !f -~.1;pm -20% 'f ff:.1'j,. oate; 1rf'5Time:f 3 2-o L'of""A/}e//l I lnstrument Field Responsel Use Acceptance Criteria R~marks 'CSl!~~l!lili'll ) M~ter Skg ek'g Counts* Source Source Response +/-20% lost. Batter:y i'lme Ambient .Initials and Comments Cnt (q>m)or Cnt (gross cpm or source Cal lb. Check Of Temp. .(add'!lnfo: inst. Condition,.etc.i. Time uRem/hri Tirrie uR~m/hrJ. gross cpm current JY/N) check C'F> or uRern/hr (Y/N) l (Y/N} I ~"t J. '1dJU\\ /:Mir\\- ir1t;_.r1 - I r' '-/' I :S..z >'" ,">,;,A, *== Jf9 Rate meter f '11';-d\\. '\\ a' --23:/
- R9temeter f-mi....
i q z. 't c:*,...., ,~..,,.,_; /It>/(,,. cJ,,.,._ Tl / {/ f~~z__ LC.. ~ : rs "'I
- "JI.
2 ( v . Raterneter I Ratemeter Sicron .NA '1* R~ IL;;...NA /"3C)11~R~- ll. ~. -;:,[ \\{ r'!>si* '.L.(;,,Pj ~-).').._..ld9 Bicr<m NA T NA I J I 11-**"'"*' 'U-fi:: . _, **r .Blcron NA NA v Simm NA NA l* Jnstrwrnent*desigm1ted check source is listed.on calib;cition sticker. Record check source re~por.se {net cpm),prior to fleld deployment fora II check sources being:usecl.
- 2.
Source and 8ackgrounctcountrat~ should be d~terrriined from the av1m1ge ofihrae siatic-,ounts ;it tfle.sarne:location. Repe<it covnt.Bhoulrl.be w!th1n 20%. Jf cou'nt t<ite dlverBes .significantly, :perform a'ddtt!onal.counts to evaluate instrument stability I l i r I f I I I I ... I
I l I* I I 'JTS'i' M~ 7f"dYCPl~.<:O.IL.$'S'll:~ Rev 110/'l8/15
- 1.
Instrument !nformation1 Ratemeter: Make/Model: l11J/vf{' s?J:'((. Oetector l: Make/Model: Ltl.Jtlf<t' '{.if-LtJ Blcran Mlcn>Rem Meter:
- 2.
Check Source Information: instrument Field Response Check log Serial No. 11t."6':J_ Serial No. i!K, :bt,.4142. Serial No. 8613 6 Cal. oue DiJte; /tJjtf/!t:. Cal. Due Date: W'" .Source 1 Isotope:.-P....-.:232 Serial No.. ; /I l Activity: ~OJ units:~ Assay Date):;/1a/tQ ResP,onse Acceptance Range (+F20%}: uRem/hr +20% fil__ uRem/hr -20%.J!E_ ~cpm t z~ a~ cpm -20% :;$~'-' Sour<;e21sotope: (6.-(3] Serial No.: /I ~;l3..-f;? Actlvity:*t$.6).... units:~4 ~s.ay Date:.M_ Response Accept'1ncc R;mge (+/*20%): uRem/hr +~0% __ uRem/h~ -20%_~* _ ~cprn + 2D% i~l.7-1. lmt cpm -20% 4:>?'4?7
- 3.
Checks:
Title:
RCT Oate.:lof?pC:- Time: ls-'S-0
- 4.
Site or Location: Site/Job: k~"' 3.J 0 ,1 GPS Coordinates !when.required); X..Coord; /Y_Y2;;£rt 'f>i;"'l Locatlon.9escription: ___ c.,,... a-:""*... -dJ:""""'".:~ ......... ""'.~-. ----~- Y*Coord: W tJ Ii" l..fO $41: 7,,. I Instrument Field Response' Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Source Response +/-20% Inst. Battery TI me Ambient Initial~ and Comments Cnt !cpm) or Cnt (gross cpm or source Callb. Check. Of Temp. (add'! Info: inst. Condition, etc.) Time uRern/hr) Time uRem/hrJ ,gross cpm current (Y/N) check (oF) or uilem/hr (Y/N) (Y/N) Ratemeter.lw-.1' tf <'{l,{ttlffl., Mi>\\ *. ' qg~33, /'. ~;,.. v \\{ y 1~1"~ K.$"' CJC -n.. -.1."9 .Ratemeter IM1.--.
- l'<G (,I c.t I\\-,
l wi,')\\ 11 ~4g-e..h~ \\f.J (] \\./ /<;,of:;, hf:'...;;- {/{)£,_ /_$ ~!?7 I I I -* p Ratemeter Ratemeter Bicron 'NA Gvll111/~r NA I ;i_r_,/p,,,_k. '\\./ IJ c...f f t,63 t;'-S: ~ /).<_ -rz..-.).'$ )_ Bicron NA I fll.A I /' I I J I/ Bicron
- NA NA
~ ------- Bier on NA NA
- 1.
Instrument des.lgnated theck source ls lis~eq on calibrat19n sticker. Record check squrce resp<111se (net cpm) prlor to flelo*-Oeploymeot for all ctu~ck sources being; used. 2~ Source ;ind Background count rate.should be determined from the ;3verage of three static wunts Pt the same locatlon. Repeat ~ounts should be wlthln W%. If <:ount rate diverges sfgriiflcantly. perform additional counts ti;) evaluate.instrumen.t st<ibHlty 1 I I I
Instrument Field Response.Check Log
- 1. Jnstrument lnformatlon 1
Ratemeter: Make/Model: Ll.ID~vM. ') J.:-n-Z.. Detector l: Malm/Model: lu/)j.-vlf"I. Lf.'L-1.E.... ___ ** Bicron MlcroRemMeter:
- 2.
Check Source Information: Serial *No. J.(g 2 J :n Seri<.11 l\\lo. tR. J It I J J
- Serial No, A:-.:7 ;:>. Y (;{
Source 1 lsotope: 71'1.2)2. Serial No.: JI k Activity: '£2..J_ units;~ .Respom;e Acceptance Range (7/n20%); uR~m/hr +20% 1.D uRem/hr -20% Ji___ Cal. Due Date:*~ Cal. Due Date: ~ Source 2 Isotope: WlZ.Lserlal No.: &'.'.7lf11 *)!,fr Activity; * () '- l.lnits:~ Assay Date; Pbt1/, (,? Response Acceptance Range (+/-20%}:. uRem/hr +20% ___ uRem/hr-20% __ ~ cpm + 20% 17:i~ 1 \\
- 3.
Tgcbnlcianl\\~orker Perfoi:.mJ!J.lt~!!edc..~: mil:!; __ t._rr'-. -~~- . Date: 14~t{rr Tim.;.: Ofoo "tl l'i' ) N~me: S1ff..Vt.KJtJLJ~AA/ A(v--
- 4.
Site or Lotation.: Slte/Job:_3_._/___________ Location D.escrlption:~l~i>-'""'_?_it_fo_l ______ ~~~ GPS Coordinates {when required): X-Coord; r1( Ye" J.1 1 Y f': O 11 y;eoord: i!d 0']&:'.'~ '(9 1 -r~ J Rev 110/18/15
~l--~~--~~.~~.~~-.,,-2~~.._.~~~~~~~~~~~~--~~....-~~~~--~~----..,.._~"""""""-
i Instrument Field Response Use Acceptance Criteri;;i Remarks i Meter Ratemeter I 1111}) ?'~ o :S t *v j m 1p/. 19 f D if c,""' ~ Y Y . tJ 9 oo ( 5. I .17t.. Z > z.. 'S"li.....,.,,,,,,,,,,,::' ------.i:1 Ratemeter llflwtl, f<f/ D h v..... I m11J JI q 7 7 - v*Yl,, 'i --y Y () ()f) o.. f'S- "1 . <!J' /J 7 <.>IC.. Ratemeter /,.,.,,,.; f 9?< w*IJ\\r. /,11! *P I 'l ¥<!~ c...,..,.. '/ y' IZ-1o
- 65, {
LJ.._,.IJ,.,,,,_,i,.2---'),,_i:_. -----------;/ Ratemeter 1 f11f!V q no I ~,..,A ) P1JJ'L. _ __f___11XL_s..e!:ti_ -- '-/ y
- y I b () {)
& b.1.. ft. z r 7 st l Ratemeter l111tfl/ qr)o") n> '!ml/./ ll. Yi5 (.?(tt \\. 7 +/- /iooo.&&. l.../,/fl st: I Bicron fllA "1,.1-il..v." "1 NA 11 ,.{f,J/,,,,. V n9o o. <<.1 -rk i~z. S(: l Sicron NA ~;.u.l/,M,,, n NA i _ 41.Jl:wv, i.-.- ~ "/ y 1 7 ?. D b $~. f
- 'T/,i 7...3 Z ':: K
~ I Bicron NA '"l 1.J~.., ~ NA I g'.{)..((~.'\\ ;._,- " 'I -- ___t_ ___ *~--.~.Y i I. 00 - l,t,_ 7~ -fi.17.)"2 sr....
- 1.
Instrument designated check source ls listed on ca!lbration sticker, Record checksourl+/-e response {net cpm) prior to field deployment fur all check sources being used.
- 2.
Source and Background count rate should be determined from toe average of three !itilt!c counts atthe same locatlon. Repeat co1.1nts should b~ within 20%. If count rate diveq::es signjflcantly, perform additional counts to evaluate;inmument stability
Rev 110/18/15 I Instrument U:ield Response Check Log
- 1.
Instrument lnformation1 Ratemeter: Make/Model: LiJ~WtY\\ ~)<{/~ 2. Detector 1: Make/Model:.lvtJ t-tt,!Y'\\. n 1'.i-1 D Bicrc;in MlcroRem Meter:
- 2.
Chee So r Serlal No.c20:l 1 3 7 Serial No. f/11 l 11.l \\ SerJal. No. /I JJ 7' vi Source 1 Isotope:_. 'Z.'.J 1-:.. Serial No,; }/ /,,. Activity: L 0.1 units:~ Response Acceptance Range {+/-ZO%): uRem/hr +20% :2.0 uRem/hr -20% ~ Ca!. Due Date: qtip iP Cal. Due Date: t:hJ &
- Source 2 Isotope; C.s (} J Serial No.: ft.71! I J* r 8"
.ActlvJty:.. 0 l,. units:~ Assay D<ite: i I 'l. G {1 f, Response Acceptance Range (+/-20%): uRem/hr +20% _. _ uRem/hr -20% __ net. cpm+ 20% 11,*.i. I}" lletcprn -20% '?;? {I?
- 3.
Technician/Worker Performing Checks: Name:_~(!" KT/.J!mnJ!/* Tltle:_~_-_<_1 ___
- 4. *Site or location:
Site/Job: '.'5.* -~~~~~~~~~~~- GPS Coordinates (when required): X-Coord:,111 lf..J, 'tf'I Cf/ r Instrument Field Response2
- Meter Bkg Bkg Counts Source Source Response
-t'/*20% Cnt (cpm) or Cnt . {gross cpm or source Time uRem/hr) Time uRem/br} . gross cpm oruRem/hr Location Descript!on:._...C.._o... g,,..A1..._.._6_..1_t:._c...=tJ------ Y-Coord :.JA) 018'_,_{41 71'1 2... Use Acceptance Criteria Remarks Inst. Battery Time Ambient initial~ and Comments Ca lib. Check Of Temp. (add'! Info: inst. Condition, etc.) current {Y/N) check (°F} (Y/l'J) i I I (Y/N) ... """'"' ~**-""""~""'"'"-""*"""~"'-""'*"""'*~""~~ Ratl:!meter f /fl I !l) Kf'f\\ d.J m1t/ y L_ &11( S't: if l/J...ZJZ ~ I ,Jo '3 I ~ C,*l'h i Ratemeter /M1N ('fl q I.,_, ol m11J 1.1--~'l>< '-"'"" '\\. y y iJql < <f'lf. L( c( 111 SI( Ratemeter I fr'lr/J t {) 1'1 l11 ' f 1'1/!fi/ .;211'1"1 .l.*'"1\\."*, \\f y 'f /3b p
- .c,r,,_;
11zJ7- ~r.. I Ratemeter iJ,11,,.; L 0 I q(*I lm1AI /2 ("YI y v t Jvo lk} Cs 111 S£. t.,'i~ I Ratemeter '/r111r.I C'o Z t/ (..,,,,. J (il/t./ _i).c.> *1 '?' 4 c.r,;.., '-( y I '( 1:CTJD 1 i.. 3 f /.. :;i_:. -l.... 'Sf: Ratemeter Jm1rJ
- CJD.Pf '*'I' / !¥_!/;./
. n.SYlf '1 y I 'I /~D J 1.. s {.~ 131 "0K. i."'1-.....,, Bicron
- NA
-7 I! NA IX' ;,L"" y 'I oq1(" \\.(, '1 -7'1 2:rl s~ .\\l..ilt*>1 WI j Bicron NA },/lt-t ! NA (-7 1-lh."4 !,.- y liQg_ __ r;,c 1 11_ Z.1?... 'S~ Blcron NA ______ ]....J.J4-.I~,_!:!~*-*-*- I K' !J~"-M p.. '1
- t,;7Jo /'2., 3 f11.l~L s.t.
i r:-**...,...........
- 1.
Instrument designated che,ck source u 11.'lted on cal1brat1on sticker. Record check source respQnse {net*cpm} prior to fteltl deployment for all check sources oelng used.
- ?..
Source and Background count r.ite-should be determined from the aver.ige of three st;itfc: c9unts at the ~ame location. R!!peat t01Jnt~ should be within 20%. If count rate diverges sigoificsntly, perform addit!Mal counts to evaluate instrumentstabl!l.tv I
I I I zrs MJ~ TC~AL .s'liSM~~ Instrument Field Response Che<:k Log
- 1.
Instrument 1!\\fowa!IWl Ratemeter: Make/Modef; 'Detector 1: Make/Model: Bleron MlcroRem Meter:
- 2.
Check Source Information: source1 Isotope::~& Serial No.: !r/ . Activlty;<b{_ unlts:,&G Response Acceptance Range (+/-20%): uRem/hr +20% ~ uRem/hr-20%,.13-Cal. Due.Date: If~ Cal. Due Date: tJtz:_6ff.C Source 2 lsotope:b-/17 ~ial Noc: 1/61 /E';>xf,j.2 Activity: 0.M units:~**.Assay Date:.Litt: Response Acceptance Range (+/-20%): uRem/hr *1*2.0% __ uRetn/hr -20% _ ~ c;pm.+ 20%l:f.2?$ ra~ cpm -20% p(ff
- 3.
Techni~la~orker Performing Checks: Name;
- tl,(dd _
Title:
gel
- 4.
Site or tocatlon:
- Site/Job!._4-A--'-"-y;-"'-~-'f'i'-. _3,,_,<..:{,_____, ____ __,_
Location
Description:
" i
- o*
. f U I . GPS.Coordinates (wheo required): X-Coord: OL ~;;.. Jl 1!(.-f Y*Coord: Wb7 r_*. :tf> />?.. Z l instrument field Response2 Use Acceptanc~ Criteria Remarks Rev 1. 10/18/'lS Meter 61\\g Bkg counts Source *
- source Resp0nse
+/~20% Inst Battery Time Ambient** !tlltials ;mci Comments Cnt (cprn)or Cnt (grosscpm or $OUrce Ca lib. Check Of Temp. {add'l lnfo: lmt. Conctttlon, etc.) Tirp(! uRem/hr)
- rime uRem/hr) gross cpm current (Y/N) check
("F)
- or uRem/hr (Y/N)
(Y/N) Rateme.ter 'fM,'""- Pf 117 htlfu. /~"'Ir-.. Ii? t I.fl di>'; 'f v \\.(
- ()4!fo 5"6.'{
~~2$2. ~ Rate meter J fl'\\,,...... 91'i'/ 1 (.?l'h I w-Tr-1.. /lYJLf,ft' r.A,.._ v I"/ w
- ~1. :;-G. 'S
/"_:;.. ( '37 v-ac;. J i -** I £/ ~atemeter. Rate meter
- Bicron 1 NA 1'7b J./J'Jld.tfty NA 12c..,"".... tC..v
- w
(/ ~(/ {)t~'( <t~ fTh-2~) ZJc: Bicron I NA I NA I -*** T J u ~icron NA
- NA l*
Bicron NA NA .... -....A
- 1.
Instrument deslgn<Jte<i chei:I< source,ls listed on cahbrat.1on sticker. Record checli source re~ponsf! (riet cprnJ *prior to field deployment for an c!i~ck sources he Ing used.
- 2.
Source arid Background count rate should be determined from.the average of three static-coonts at the so>me location,. Repeat counts.should be within 20%. If co1,1nt rllte diverges signlflcantly, perform additional counts to evaluate lnstrumentstahlllty I
Instrument Field Resp.onsa Check l..og
- 1.
~nstrument lnformatlcm 1 ~ Ratemeter: Make/Model.: L1,1, o;; D~tector 1: Make/Model: : : l"it."'V. : 6icron Mlc;roflern Meter: Serial No. ~iC,.f(,~ Serial No.. 'g;z_t;h{l£1.. serial No.. :&'J$G.. . 2.J Check Source lnfor~on:. Source 1 !sotope:~ -J:>;l Serial No.: /If Activity:<:£)./ unit~:~ Response Acceptance Range (-t/-20%): uRern/ht +20% ~ uRem/hr *20% ~ . Cal. Due Date: r¢s;f/b Cal.-Oue Pate: O'f/.off-' Source 2 Isotope: C:;~IJ? Serial-No.: IJf0~-1;& Activity: CJ Qr unlts:µ~*Assay Dcit~: &A::_ F\\sponse Acceptance.Range {>1-/.:20%):. uRem/hr.+20%.,.,,.,,,,.,,.. ufll:!mftlr -20% __ na~ cpm + 20%/"S;:J..."1 J ne.~cpm -20% ~-
- 3.
Technlti;m/Worlser Perfor!Jllng Che.::ks: Name: X EJ""s~.f!s. Date:!¢t/1S- *Time~~
Title:
-~"fl~c_r __ _ 4 Site or location: Site/Job: A:t:.~fi '1 ( Location
Description:
~....,4/,.R_ AfJ_J) ti> f~c;I
- AJ 1
o'; ~, ---'===~t:;...,_~---- GPS Coordinates (when required): x~coord: 1v 71?" ~S ££.l Y-Coord: vv o 8" 1t? 3'[. '7 I Instrument Field Responsei Use Acceptanc~ Criteria Remarl~s Rev 110/1s/1s +/-20% Ambient lnltials ai:id Comments Meter Bkg Bkg Counts Source Source Response* Inst. Battery Time Cnt (cpm)or Cnt (gross cprn or source Carib. Check Of Temp. {<Jdd'l Info: Inst. Condition, et<:.) 1lme uRem/hr) Tl me u~em/hrj gross cprn current (Y/NJ ,;:heck ("F) .or uRem/hr (Y/N} (Y/N) / i.1A~ lf'J7'n / i'l"- i&-- \\/ v ("fo'i rrh-)'$2. ~ Rate meter {;If.~ 1J,'fJ.~nM tG.7 Raterneter r <;* 2 cl L. ', r*'I'.. 1;,,.~ //(/Oil }~~~ . VI ~'.! l~f> ~~. ' [/" <:;' ~ { 3 "7 V"f15" I (\\I\\ If\\ . Ratemeter 'F f I V' Rate meter I I Bicron NA "I v11,.../~~ NA ~ 30/l/ rl AIA. //1111' \\/ I \\/ f----.. L313~ ~.~ -rrt...-:1-5 ~ Dr Blcron NA
- r NA I
I f I Bicron NA NA Bkron NA 'NA f
- 1.
111strument designated check source.ls listed on t:ahl?r~tlon.stld:er. Record check soui:ce response (net cpm) prior to fleld deployment tor au check 50un:es being used *
- 2.
Source and S;ickground count.rat~ ~hould be determined from the avcroge.of three static wt.mu at the same location. Repent counts sho4ld b<: wlthin 20%. If count rate dlvel'.'ges significantly, perform add]tional counts to evaluate' Instrument stablllty I
Rev 1 10/18/1S
- 1.
tnsilrument lnformatlon 1 Ratemeter: Make/Model: Detector 1; Make/Model: Blcron Mlc:roRem Meter:
- 2.
Check Source lnformet!on: Instrument Flcgld Response Check log Serlal No. /fC.£,Clf Serie! No.,"P~t""ib/f(L Serial No;.pc.q 5 ~ Cal. Due Date:~ Cal. Due Date: ~~ k-'*
- 7.
Soutci;: 1 Isotope:. :Th~;.?e Serial No.: /l( _ Aetivlty: <::O.f *Units:~* Assay Date:/.?..~<<? Response Acceptance Range (+/-20%): uRem/hr t20%.fil_ uRern/hr -20%.:...ill::L ~ cpm + 20%
- . tr oo cpm *20% S?IT"<=C 5ource.2 lsotope:C:S... fJ7 Serial No.:.//7f:J3.. tL ActiYity: d.L:fl.... unlts:/1(C::; Assay Date:.&'.'A_
ResponseAcceptanceRange(+/-20%): llRem/llr+20%___ uRem/hr-20%__ im.tcpm+20% 1?,"2.7<, ~cpm-20% ~Y5
- 3.
Checks: ntle:. __ ~_-
- ~'! __ _
Date: &;k)/tr lime: !'?:Si
- 4.
Site or Location; Site/Job:_f}.re.u 3, J
- Location Oescrlptlon;c...* ---~--
.,;._.._ ""'-'-*""1d"""----= GP$ Coordinates (when required): x~coord: 1!J.. *~ 0 ;!'i' Slf.5 ~* Y*Coord:.IAh:llX<>'f/J: ft. 2,,,. I Instrument Field Response' Use Acceptance Criteria Remarl<s Meter Bkg Bkg Counts Source Source Response +J-20%
- inst.
Battery. Time Ambient Initials and Comments Cnt (cpm) or Cnt (gross cpm or source Callb. Check Of Temp. (<1dd'l Info: Inst. Condition, etc.) Time uRem/hr) Time 1.1Rem/hr) gross cpm current {Y/N) check ('F} oruRem/hr (Y/N) (YjN) Ratemeter I A..'l.. tfo/,,..m... Ii-.--..... 'f'l'lf ~-cP-, v '{ y _i9:L. 6S.f r-n-;2.1>..2 "~
- -.I I ~-:"v\\
llJ!IY7c'1,,.,.. -!./ Y./ VI -~7.l/ /'~.. /-c;./ a~ Rate meter ! '"".;.....,. /~J,./ Rate meter ~l.iifii.tfl~ ~'1 ~ i G">fk. g I f f {/ Ratemet~r ~IV/Pf/Ar NA _j_'j')_p1~!£..r \\f \\/ -¥--~- 61,q rn-.:.i~1 fJ> Blcrori NA (er-,(/() ~--- Bicron NA I NA I* J I. Bicron NA NA Bicron NA NA
- 1.
Instrument deslgn~ted cher:k source Is lined on. calibration stmker. Reoord cheek soureQ response (netcpm) prior to field deployment for al! check sources.balng used. 2., *Source 11nd Background count rate ~hculd*be determined frcmnheaverage of thr.ee '5tBtic cu1.1nts* at the sameJocatton. Repe<it coun~s snoul!fbe.wlthtn 20%, sf count rate dlven_tes significantly, perform add)tional r.:otmts: to ev{l!u,ate Jruln.1ment*3tablllty I
Instrument.Field Response Checkl.og
- 1.
Instrument lnformatlon1 Cal. Due Date: JJ/p3{15,..,, car. Oue Date: c;(../!Wto Ratemeter: Make/Model: Oa1ector 1: Make/Model: Blcron MlcroRetn Meter: 1~~~~ / $puree 11sotope:7Zzt:'l serial No.: I I I ActiVlty4 &:'*I units:....44 u As.say Date; I ?/J(.'!'C).. Respon5e Acceptance Range (+/*20%): uRem/11r +20% _:LL uRem/hr-20%.13__ nm cpm + 20% SJ 7 7t>lf&cpm *20% 26 gt ? Source 2 Isotope:(';; /i7 Ser:lal No.: II q e 1:: 3.-I J, ActivitY; tn? l.- unit~~~Assay Date: ~ ResponseAcceptrince Rangi::{t/*20%}: uRem/hr+20%-~ uRem/hr-20%_. __ ~cpm + 20% 13 ?-- 73 !lifl!cpm -20% t;~</'j
- 3.
mie:.£""'"c,;..__T __ _ Date: k.J.htPr Time: CJ?.'! I
- 4.
SJte or.Location: Site/Job: I* I f" /. Z.,.. u . 7 GPS*Coordinates (when required): X-Coord: tf2 ').@ IZ. ~ Location Descrlptlon:-O~:;v ~1'" Ct.Fr Y*Coord; &Jf3'"' 'II~&£.~ I Instrument field Response2 Use Aeceptance Criteria Remarks Rev 110/18/15 Meter Bkg Bkg Counts Source Sourc-r:diesponse +/*20% Inst. Battery Time Ambient Initials and Comments Cnt (cpm) or Cnt (gross cpm or source Callb. Check Of Temp. J~dd'l Info: lost. Conqitfon,.etc:.J TI me uRem/hr) TI me uRem/hr}
- gross cpm current (YJNJ check C:'F}
or uRern/hr (Y/N) (Y/N) Ratemeti;r 1. tJ 7t lf7 r..rlh-. /. {.) t./.< ;rJ C'rl'h v v y 07:*z..;> ~v.7"' G.c. ~lc""-H (?1-; c..i:Jyj i:.r* ** J:;. C.s 1:>. 7 7 31/tl s*** 9~.,;..97 (.>y"' I Rate meter 1.0 I.r:.J y .v y 11 >fO kV. q" /)/?.I ~..J _...~ u......., '-IF . 0 1')1 Rate meter Ratemeter ~--~
- 1. r.:i..,e"".\\, NA
</ @~<-1,!). (...,,, l y y v Goe. er~ \\ti. z.s i. Bicron NA (;?&;-.'I/ Bicron NA '7-0.1d~.~(~ NA ~~o~\\1 y v ../ 111!0'1 (, 0. 'I * ~ -Th 2. 32.
- Sicron NA NA Bicron NA NA
- 1.
Instrument design a tecl check source is'listed on c;dlbrotlon sticker. Recore 1:hi:ck sowce response (net cpm) prior to fleld deplciymenUor all check sources being used.
- 2.
Source and Backgrou rid courit rate >hould be determined from-the average of thni~ st;nic*cQLmts at the same location. Repeat counts should be within wro. If count rate diverges significantly, perform aoditionalcaunts to evaluat11 lnstrum~nt5tabllity
~~ ~ TfJ:~C4.il..*SSWWN:'ES Rev l 10/18/15 I l I I I 1, Instrument lnformil~ionl Ratemeter: Make/Model: tv!k~.tfl\\ ).') ¥! *,";/, Detector l: Make/Model; lvOLv'\\I\\ '11./*1 o Blcron Mi~roRem Meter:
- 2.
Check Source lnforrnai:ion: Instrument Field Response Check log Serial No. 1 W).. ~ Tl Serial No. ?k1 u 121 S~rtal No..t).24 '1 l1.. Cal. Due D~te:. q It./ 1 ~ Cat Due Date; !/!t£t.? Source 1 Isotope: fA i J "Z.. Serial No.: LI tr Activity: £e...J_ units: u.M.:. Assay D;ite: 1i(7:./1~ Response Acceptance Range {:i-/*20%}: uRem/hr +20%.]!:___ uRem/hr -20% _tl_ net cpm + 20% ).2'\\ 2Cp i:ret cpm -20% 1 -:;-2*.;-1 Source 2lsotope:{s /11 Serial No;; f1 f"t!i** lt % Activity:.D.!..- units:.1.....U: ASS'QY Date; 1/t"h..c Response Atceptance Range {+/-20%}: uRern/hr -!*20%__ uRem/hr-20% _. *-- ~ cpm -~ 20% i"\\~7 ~ QQt cpm -20% "? 'r ti
- 3.
Techniciao/Worker Performing Ch<<:ck~: Name: ~ 1lf;1/{. *1(1/v 511~/tl
Title:
.fi..<..T
- 4.
Site or.Location; Site/Job:_.2.,,,...,,.,,.""'/.._* ---------- GPS Coordinates (when required}: X-Coord: A/ qz:..1.1.r J / (,.,, I Instrument Field Response2 Meter Elkg Bkg Counts Source Source Response +/-20% Cnt {cpm) or Cnt (gross cpm or. source Time uRem/hr) Tl me uRem/hr) gross i;pm or uRcm/hr (Y/N) lg 5z.r;--, Raternet~r ii /fiiN 'l"lOl*c. lj rl1trJ (.,*~"'- "( Date; J..Qf?ij6. Time: 01.Ci.t" Location Description;_S_,_: _!>b_c~1-0""o..,'.~h-=-i.~-~-- Y-Coord:_!c'~].f. 101~ <... Use Acceptance Criteria Remarks Inst. BElttery Time Arnbient Initials and Comments Calib. Check Of Temp. (add'! Info: inst. Condition, etc.} current (Y/N) check (of) (Y/N) y' v O(..ico 1*1. '1 Tl-P2... ~k.
- l. Ratemeter,) ft'!lfll It.to l.. : I Wl 1;.J fo!\\tq{°
~s10 t~*\\ * 'i y y t\\f*1...... 11."l (.~ l"fl 'St i Ratemeter I/ 1111// 9i. (;}{....,~ J !Mt ti JC/ I/ (o -i;,..r1JV\\ 'f v y' I l3CJ I{'{ '( fJ\\ 21t 'Sk i Ratemeter hr1utf fr(,, i:i (,vm ).'AJA/ )']; I t1 "'L (.**"' '( y* 'f' {-Z. >.;. ~q. '{ (, 1n ':)le:. Rate meter } tY!I V } '12 7.:*" J fVlttJ ff I; I \\j 'I y , (10 fi-?
- ~/<./{7 *SI(
'-'"V\\ I Ratemeter lm.rrJ l(Z.l,.,,, j (II/A/
- .c;sfl'Z-,..,.~
.. "I y y J >.10 j (.2... % l~) //,... ?-VI- 'St:. Blcron NA (o, rk.,, \\.NA _Lln,,,7.,,,,J,.... 1 y v lfOO
- n.'7
-rtr.z.7,:z. '.:ii::: i Bicron NA
- 7,_,.(UJl,of NA
} 'fr 4(l1..~\\,,.. './ y v l'Z.. 'S..J 'i 'i.>f Ti: 2- ~ 2. "::>k. J 11.,,,., "" -~~-...... Ll5)o I t;"z.:Y Ii-\\ 2~:~ *') V- / Bicron NA /;., 1.;.(b<1!1 NA J 'l "-{ 'I i
- l.
Instrument designated check source is*fist~d on caJlbration $til:ker. Record check source rt:spo11se* (net i:pm} prior to field deployment for all check sourct!S b~ing used,
- 2.
Source and Bacl<ground countra.te should*be determined frorn the average ofthree static counts atthe $<lm~.loc<ition. Repeat counrs should be within 20%. If count rate diverges signitlcantly, per('on:n addltlo11al couo15:to evaluate.ins.trument stabllily I l i I i j I i I
~ M..Jl'l}-V TC~IL J>eft~ Rev,110/18}15
- 1.
Instrument lnformatlon 1 /. ~~ J.-,!ff,, R~temeter: Make/Model: f.d/t~W. 'r ,} Detector!; lYlake/Model: L.(t'k**-1 ft/-16 Bicrop ll/licroRem Meter: instrument Field Response Chee!< Log Serial No. c9cr:a*c1~* Serial No.. f"RJl).6"fJ _) Serlal No. N /J~ Cal. Due Date:,1~y0 I,hb, cat Due Datri: tJ(tA\\
- z.
Che~ Source Information: Sovrce:. Isotope; 16-di.2 Serial No;; f (.{ Activity:~ units: pC..*1 Assay Oate:t?.J./tJt:/ b Response Acceptance R<J,nge (+/-20~): uRem/hr +20% __ uRem/hr -203 __ Aet cpm + 20~.) ~-z"J t' fWl: cprn -20%%'J'i:;; C: Source21sotope:Ct;'*67.seri;i1No.: {/f@:J-1?- Acti\\1ity:6.02 units~AssayDate: /lJ/ __ ~ Response Acceptance Ran~e (+/-.20%}: uRem/hr +20%__ uRem/hr-20% -* -* -*** ~cpm + 20%1.:.)1 /"::;. ~J:prn -2D¥o _,£',,.,,~.t2* 3.
Title:
.e:.r;;."f Date: 1.pf_fr Time:QjO 2 4~ Site or location: Site/Job:.. !/rt?.171.. ;L, I _ ___ z:. GPS coordinates (when requlr~): X-Coord:_N_!/g, 'ft2./?- Location
Description:
____.g,,,,;,c>j,..;;,,,. .. "Y..1. .. _,_:;;;:dJ._~_:.>"1~---- Y*Coord;lf/ 07!. Z6l12~ T Instrument Field Response2
==- ~~ 1 U?e Acceptance Criteria Remarks Meter 6kg Bkg Counts* Source Source Response +/-20% Inst Battery. Time Arnbleot lnillals and.Comments Cnt (cpm) or Cn{ (gross q::im or source C;lib. Check Of Temp. {add'! Info: Inst. Condition, etc.) TI me uRi:m/hr) Time uRem/hr) ,;..WIWS cpm
- current
{Y/N} check ("Fl '.or uRem/hr (Y/N} (Y/N) ~ Rate meter {,;"*'1\\ ~' 1.2$,. £'.A l ii.Ai....... '(ff.I.( ( r;.!duf.. v y y t71o1 Xt./. 7. TA* JI/. ifr-. Ratemeter i rt-1i (\\ '{72'( &,,... t *v..r,:1' /IJ 5-'f o/ C..t/!W' '{,(
- f--,-
V/ /J112
- ?:</,q l/'..:;.*i?I ~-
Ratemeter I t .( v Ratemeter Bicron NA NA ~---- Bicrcn NA NA Bicron NA NA Blcron NA NA
- 1.
Instrument qesignated check source* ls listed.on.callbrntion sticker. Record i;hecksource response (net cpm) prior to field*deployment for all check soun;es being used. . 2. Source and Bacf:grou nd count rate shpuld be deterrriined'frnm the avnrage of thl'\\!:?1.! static count5 ar th~ same location. Repe;;1t counts stiout<J,be wlthln.20%. If t:o1mt rate diverges 5ignlflcantly, perform additional counts to evaluate instruQJents~abllity l l i 1 i 1 I w:*4 I l
Instrument field Response Check Log
- 1.
Instrument lnformatlon1 Rat<?mcter: Make/Mode!: Detector 1: Make/Model; Bicrcm MlcroR~m Meter: Cal. Due Date: ¢1.k-C::ai.Oue Da~e: r~1 II}
- 2. Check Source Information;
/_{:{* J , /~ Source 1Jsotope: :zh..-2?2 Serial No.: Activlty: ~..!.-....units:~ Assay Date: !.1 '5a'(Q Response Acceptan<;e Range (-t/~.20%): uRem/hr +20% __ uRem/hr ~20% rn;rt. cpm + 2090 T'f tr rxe:t:tpm -20%...im~ Source.2 Jsotope: Cs.~(51 Serial No.: i~...t?- Activity: {l())- 11riits~C: Assay Date: A/k RespooseAcq!ptanceRange{-+/*20%): uRem/nr+20%~. _ uRem/hr-20% ____ ~cprn+20"/o/S.,?7~ netcpm-20%- $f'-/7
- 3.
Technician/Worker Performing Checks: Name:.~.,..,-,#5
Title:
- fY/_*
- 4.
Slte*or Locati91!: Sjte/Job: __ ...,.A~~""'"~-"~~,2.__._f_.,..-__ _ GPS Coorqlnates (when required): )(.Coord: /:L Q. ml~ Data:tpP.J/lJ Tlrne:/...2-~ Tl Location
Description:
. ~.k.L(-... Jk~~IYI ____ _ v,coord; !t),ozs., 7ofl?/1° Rev 110/13/1'.i ~*a l!l!ll't~~ Jr ~ Instrument Fiefd Responsez Use Acceptance Criteria -Remarks i -1 i I Meter Bl<g Bkg Counts Source* source Response : +/>20%, lnst. j Battery Tlm.e .ll.mbierit Initials and Cornments j j Cnt (cpm)or Cnt ' (gross cpm-or source Ca lib. 1 Check Of Temp. (add'i lnfQ:'lnst *. Conditiori, etc;/ l Time uRem/hr) Time uRem/hr) gross cpm cuuent (Y/N) check ("f} -~ -DN!Rem/hr (Y/N} (Y/N) Rate meter. l'M*f1 'f g1'( <:.GA,, I P~f">> - LIM!~ C?JM v v \\{ J;J.Jlf -~.{ 7l.. -:J.~_:i. A ;;i;; Rate meter 11'1.'lin 1'W! c~:... I tk//A //rr;...z._;~ ,.,// (/ ... r /,,). 3"1 - SZJ,'5' ' /"__<._/?. 7 ~ I Rate meter r I I I P' - I I
- Rate meter i
I Bicron NA NA 1: \\ Bicron NA NA Bicrpi:i. NA .NA.
- Bicron NA NA
- 1.
Instrument des1cnated check source ls listed on c<ilibrat1on st1cker *. Record check source response {net cpm) prlor. to field deployment for all check source~ t~ing used,
- 2.
Source anrJ-Backgroum:i count mte.should be determlned from the avarage of Uue1i statfc*count$ at the same _loeation. Repeat.counts should be within 20%. lf count rate divsrges significantly,_perfqnn a.ddltlonal counts to ~valuate lnstrumeni:stabllity 1 1 i
~~~-~~--
- -~i!JfYT:!E
.:Z.-'i.-i.*~ TBCHNIC..:.~t. 'SEN '\\.,7iff?s. lnstrument:f-leld Response Check,Lo8
- 1. lns!r..,umi!nt Information 1
'Ratemiiter:
- Make/Mod.el:
LUDLUM 2241,2 Detector.1: Mak~/Moileb _:,;t.l;!.Ql,,.lJ.~i'J..O. :~:. Serial No:~ .seria!No; A.B.i1UZ7..... Sei'ial No, *. A:214lL__
- cal Due Daro:;.'9/2/l:g.
- BlcronMli:roRem.Meter:
Cat'Due Date:._8/4/16 2.. Check Source lnfotm;ttion:. As~av:Dat~; J:.2/30/10 '~ev 110/18/l.5
- sour~31s~top~:,ib=z32
.serJaJ.No *. It!?. ActMtv: £1,l._.. -units: -l!CL. ~espqn~e Acceptsflce R.a~ge ( -t/-7(1~.): ~flem/l1r +20%_,:;!:,~_ ~.. uRem/hr *20%.J'.:L_ .~rpm.+-20%..,:~~~R- ~.c:pm *io% 1528.4. Soun;e *2 l~otopP.:.. C.s-:13.l~... Senai '11,!Q.:.*.81E.13::t:l.8:.** -- . A_ctlvity: J)ilL,.,_,;unlts: ;..j.l&i._ A-;s_ay* Da tP
- UiQ.tl.O Respo'l~e A<:ceprance Range {.i-/:2p~:,y uf:(<?m/.J:lr +20%__
uR~m/hr -20%. __ /re!(pm + 20%.. l3325.... ~ cpm ~:ZQ%.JJ9.J.9......
- 3.
Technician/Worker performing Checks; . 7v f'4!lme_:o§.1'f~....::::/.&~~-;V' Title. f("Ct:T _.;.. -*....,,.... .oatE>:/i~~}f.rime:.:Cl/Je.:~?~.**- 4 ~~~:c>rJ,t1~i;9.n~ Site/Job*.. ;)?.. J, Joc.3tbn.Oescription: Dor ....... ~.,* u Q GRS'.;:1J(lrd1r>dtl>:>.(\\\\ 0tJ~o r~quired); x:.cor:nd:;Af.*::/2.f_*_?."["?:i...:...... Y*Cuord:J,;.Y_J.'.DK b'/572. .* ;r* 0.*-**,*** ""*"'* ~.-.... ~*(*,.. ~,,,.** ~..... *,}r... *"~~* ~-.... ***~****.t--:*'"-* 1******.~:-- .*........ 1.**..*. -.* ~**"11~*~*;-***..,............ *,,1*****"r"i'.. }**;:\\~ - ~-, = 1..-s.:- lnstru.met:ir Field Respiln~*
- a.
. U5e'Acceptance Criteria.
- a
- rJ"5'7'1,.,_._,..,..
Remarks u:1c1::1'<into. :mt:;<;or'oiucm. etc; ... -M~;;,---T'.'tikK~;*ai-itc~~-~,,;-~ 5;~~~;' '"s~u*r~~*~p-ons;*.,r. 20;;, ln~t. eattP.ry** r Tir:l'e .** Ambi\\i!rf' ~.
- Cnt I jcpm} or en~
(3ros.~ cpm 'or -so1,.1rce Callb; cn,ecJ;. 1** bf T~m{.I, . Time ; uRem/hr) Time uRem/hr) grc:;s.cpm '. .r.µrra.m (Y/N) .. i;heck cfF) or uRem/hr {YIN) * \\
- lmt1als and Comments J.:~:~t~.~i:l.~~I.~~h'<-'!riil~~l:ff,;. /J/Jl. "\\"\\ *
- Y..
..* X."... ;... {... ;J.17~~...... YS"~\\11.*.rn.,... bli.:7..,~.f-,....... -.. ~~.,.,.......... -~ r::~~:i;~*-.~,LJnl~ t-"ii!f~-ij. it!* i 1t~zoz c~~ y i i.... ~.. i.. tj:i;5.. Jf'J*-- ?:~~ ~................,... "...... i i_,.:._........,...... :..:l:_.01(.+..,,.9,.A.:CZ!'
- ':1}1J&'. +,
.. I:.... :-;~:r'..,.. ..1..... *./*" *+**"....... +; ~"L~>..-p..,.,"'....i:...... ~. -'---.. -.:.:.,___ J:c~~~~m_?t.~r :l~~,l~~;I-.. JJ:.~~l'. /:fl'!~#:. ,dv.t"'.l 1-.,.; ~r,r~. - Y:.
- .'/.. 1l
- f'Ji?...,.. fl,_.l.2.
1)1. 2:l.J:.. ~~.............. -~ ~ R~t.emet~r.lJ.."irn,(
- ).:.f~Dcr I.'5"*
- c.*;,.~:
1 V.s'~P.-...;.,S.l.... ¥?,. ($1:.n ?~...
- .* B,1tror...... L~A.. ___.,J.. ~~/.
___,,.. t.. ".J:~.. 14.~ *. ~<.,. *>...... ;... }(.... ),....l'..... l p<('? £_.... i :l~: ~~-.,.. rll:£3:t,.* ~~-K:__,, *.*. " ~
- ~~cron J NA.
~,,gt.-. J~IA .2* ~\\\\ hr,
- i... ~--+*.. l'f *--, ; ':(.... JJ:3 Y5.... ~ £1'* '{..
- ~.7
- -'!>"2._ ?.~-..................... _............ J
- ..*~
1 ~-~'? 1\\ ..... J}~Ao..... >.... :t.£~11, ':~~.. ---~*"~fl... ~lL.e.?i. l.r ~......:.\\/... **--*'----'t--.. J.~_.;f . I
- o. :.:>*Z
...-r.1 2 ~i..... ~~ ....i
- 1.
1 *1~f:.ilT'.Mt OO:\\i;J.,~a*c:ihef:~: ~o.irr.'.'*i~ -ist.~<f<jn ~<1'it1.:it!or:.~tii'.li:!r.. Recorrl.-!ie~~.s1~~1':.:!*.<~~~0!~.ie*{t1.it *~pw-i:w1a,::o fii:~d ~::p;oyn>i.:O::f:.r ai: c.hei:k so1':C.\\!~ b~.r:t \\.!~d; (. *s:owtii,anri IMd*i!:fO*!i:':~ <:.::J*illr 1 ~-**nhc11l,:i.~1?:'~"'ti>1rnio,.r1,ficir.:tlle. a.wm1gl! ohticoe !itatlc *counts at:t~~ 5~'71i>::;:;::,a'!'cor. l'.1r-111>"'t r..:-~~r'*s th.;>ti'.d *~'\\'!. "'**r~!'i*; <0%.. 1r ~~~*n: *r;.it1i;ci"*:ri;:,:) s.*&mkan~ly, pi!rfor!lu~<J*ti,or.a,itqunt~ !p.~v-?,'~.alt;? iry~trunv.:flt~taki:icv
r------ ~ Ml..i~*rEC4'£PoHC-..,,.,_ $airVA1C.er Rev 110/18/15 f Instrument Field Response Check Log
- 1.
instrument lnformatlon 1 Ratemeter: Make/Model: Detector l: Make/Model; Blcron MlaoRem Meter;
- 2.
~.l:t~Source l!)form!Jtlon: Source 1 isotqpe: -77.-;;J-8.J. Seri al No.: . [ f J Activity: ~~*units;~'. Response Acceptance Range (+/-20%): uRem/hr +20% ___ _ uRem/hr -20% __ Cal. :Que Date: _ Of°y/I ( Cal.. Due Date: N*M Source21sotope;{s~/J'Z SerialNo.:.Jl[.W..-/2. Activity; c::'..~.~,,.;- unlts:~AssayDate: tJlA. Respons_e Acceptance Range (-:+/*20%): uRam/hr +20% __ uRem/hr -20% __ A"et cpm + 20% j'?'....2.73 n:e.tcpm *20% ~'l 'f.e:J
- 3.
Checks:
Title:
E;=c_:rr_* __ Date; /CJ~"jf Time; C>"l/"3 ~I
- 4.
Site or location: Site/Job: & ~..2. 2:--:. b Location Descriptlon:~----'W ..... * '""o._o.._J.~s......_==-- EiPS Coordinates {when required): X-Coord: N'-I J.,l..f 7lf7!:1. Y*Coord; H {)J 671f.~ (:,'f>f ;L"' Use Acceptance Crfteria
- M"Mr$);
¥J' Instrument Field Response* Remarks Meter Bkg B~g Counts Source Source Response +/~20% Inst. Battery T!me Ambient Jnitlafs and comments Cnt (cpm)or Gnt {gross cpm or source Callb. Chee~ Of Temp. (add'l Jnfo:*inst. Condition, etc.) Tln~e uRem/hr) Time uRem/l'lr} gross cpm-current (Y/N} check ("F) or uRem/hr (Y/N) (Y/N} . Lf ')It'? t-#fr>: Rateineter I vv,1P... *.ig 1 (7e; '1M-I **A,\\,\\ ..:.1 v ..J ()1j} '-?1* 5. "'fh-;;. f? IJF Rateme.t~r IN.I..... li':-/<;"J (*;~ "f M*""r lb?o'i,,)..,.. tJ ~I
- ./J tL'l.:f..P
~7.~ /,, -tz-7--&£. Rate meter I I l l I Rate meter Sicron NA l NA I Bicron NA NA Bicron NA NA Bit;:ron NA NA i -~ "'"' .1. Instrument designated check sou11;e ls Jlsted on cahbratlon sticker. Record.check source response (net cpm} prior to field deployment {or all chad; sources being used.
- 2.
Source and Background count rate should be determined from the a11er.ige ofthree static oounts at the same iocetion. Ri:!peat coun!.$.i;nould b11 within 20%. If wunt rate diverges significantly, perform add1tion;1l counts to eYaiullte instrument stabllitv I I ! I I I 1 I I
Rev 110/18/15 I I i I J Instrument Field Response Check log
- 1.
lns~rumertt lnformatlon 1 L ti! Ratemeter: Make/Model: -::r-£C::-rilf=""ff:-;j-Seria!No. d10G0'7& Detector 1: Make/Model; ~--- Serial No. &l-11.2k.c..f,7... Blcron MlcroRem Meter: ~erial No.. N (~
- 2.
Check Source lnformatjon: 'Source 1 lsQtQpe::z'6:~ Serial No.: //I Activity:<'?_~/ unlls: tvC/ Cal. Due Date~e>~'tf' Ca!. Due Date: M i-A-_ ResponseAe<;eptance Rango {-t/*2D°Ai}; uRem/hr ~20%__ uRem/hr *40% __ .~ Assay Date:ld{.Jt/tl!> .flet cpm + 20%~?f&' ~ cpm -20% J'~~6 Source 2 Isotope:~ ~M, 2 Serial No.: l/'7D3-f:Z. Activity: &?..o;- _units:µ:~~ Assay Date: /If A Response Acceptance Range (+/*20%}: uRem/h r +W% __ uR.ern/hr -20% __
- ~--
- ~ cpm + 20% t 3;l.7 J w.t cpm.-20% 2'811
- 3.
Technician/Worker Performing Checks: Name: j"'f; 1Jw,,..,.-JJLi Tltle: _..... £,_'C_.r __ _ Date:l.t:ik.t//C" Time: 13...;2<_ 7 7
- 4.
Site or location: Site/Job: __ _.._A-r-"-..._t....__.;?-,__*..... b._.*--* __ Location
Description:
W.._tt:>""t:VJ.""*"'"'""s,~------ GPS Coordinates (when required): X-Coord: N ~/.2... 't7'f7 'f" Y-Coord: w D7'{. Gfl!['j 2 ~ ~""~9.J~!;l;;l!;: Instrument Field Respi::mse1 Use Acceptance Criteria Remarks i Meter Bkg Bkg Counts
- Source Source Response
+/-20% Inst. Battery Time Amqlent Initials and Comments Cnt (cpmJ or Cnt (gross cpm or source calib. Check Of .Temp. {add'! info: inst. condition, etc,) Time uRem/hr} Time uRem/hr) gross cpm c:urrer:it (Y/N) check (QF) -0rvRem/hr (Y/N} (Y/NJ Ratemeter I Mfr g-bt. I A~A-J *-*""' L/'S"'1isr:m,.... y v v V3;u.;; S-<T.6 -r,;(-,2_,'.g.2 07 Ratemeter (I\\';" ~t..Gl c.-f1~"' f,,.,,~ IO... h)--'f _.;.,.,,. - 4 A/ !\\/ 'I"'{ "5 -:( sq fl /.:s.-/37 P'/lt:;; ~atemeter f I ( If/'
- Ratemeter I
- Bicn.>n NA NA Blcron NA NA
- Bicron NA NA Bier on NA h!A
- 1.
Instrument designated check source Is fisted on cahbratlon sticker. Record check source response jnet cpm} prlor to field.deployment for all check sources being used.
- 2.
Source and Sackground.countr;;te shov)d be.determined from the average oUhrec st<itk: count~ at the same lo.cstlon. Repeat counts should be within 20"/.. If count raU! diverges slgnificantiy, perform additional counts.to evaluate instrument stability IOI'"! I I I l i I _ _J l
Rev 110/18/15 l .! I I I
- 1. *instrument information1 Ratemeter:
Make/Model: l. vDt-v1n 2?-'ft~ 2 Detectorl: Make/ModeJ: Lv;'.kd.!11.. ~Y'-1.0 Bicron MlcroRem Meter: Instrument field Response Check Log Serial No. 202. l r7 serial.No. fif. m J J. I $erial No. A l.1 o.f iA. Cal. Due Date: 11( 7. f 1 lt' ~al. Due Date: ~
- 2.
CheckSource Information: . Source 1Isotope:1) 1 r 'Z.. Serial No.. : J /(,,;, Activity: ~units:~ Assay Oate:fl:/.:zd1o Response Acceptance Range{+/-20%): uRem/hr +20%.J6!__ uRem/hr-20%..J:l_ ~cpm + 20%*11 '} Z I.I t-mt cprn -20% ti{' 2 61 Source 21sotope: Cs /"PI Serial No.:£1 lFU-.'f'i' Activity:. t)J... units:.v/~ Assay Date: / ['J.r),Lio ResponseAcceptanc~Range{+/-20%j: uRem/hr+20%_~ uRem/hr-20%__ oo!cpm+20%_J_L; !.'!: Aet<:pm-20% i?.:U 'l
- 3.
Technician/Worker Performing Checks: Name: SflNtf,1(1.v!.A1A.V 1ltle:. gc.1
- 4..Site or location;
.Site/Job:._* _A~* ~~1".f.\\_*~I _______ _ GPS Coordinates {when required): X-Coord: A['/2 °.':11! I 7: l ** I Instrument Field Responsei Meter Bl<g. Bkg Counts Source Source Response +/*20% Cnt {cpm) or Cnt (grnss.cpm or sou rte Location Oescription:__.4::'.' ........ Y 'J'""c*""'f.... """,:=..)"'"'fl'--------- . Y*Coord:. tdvlX" 7"t'J{L5" Use Acceptance Criteria Remarks lnsL Battery I* Time Ambient Initials and Comments. Calib. Check Of Temp. (add'llnfo: jnst. condition, etc.) Tlme uRem/hr) Time uRem/hr) gross cpm current {Y/N) ctieck (QF} .or uRem/hr (V/N) (Y/N) ~ l Ratemeter I n1~v f!Jts(~1' I m11o.1 /1M7 (.~N\\ y }' y {,* 'l'/.{ Y,t!l 'fh ZJl. ~f( J Ratemeter.. Jm11J l(:'f f<( """ ) m.1..I JI i:L<,._~*,,, y y v D\\*!f*x" if/...., (( /J')* ~f:. l Ratemeter /rn1(1) 7 C.L t. <..*i*l l*m;,v /i/IJJ '1 (.1*1\\1\\' y: y '{ jltJ< (9.1 1'"i. l i?.. ':,I( i *Ratemeter / 11111\\/ _ It.'-" b '*'h l.ill:w _:_,_JJ_Q_)..1.__q;.i ;'. t -I JV/{ 5'1 I t, Jn ~i. l Ratemeter 1..... 1.r/ 1 J,f '1.;,.,;, ) ;I'll /l/ I 150 '( '-""" v y '/ 1~1< or.t. ~ 1.7,t.. ~K i Ratemeter j WI :1.J 1 U':f '"" J IY/11;/ /0 f(f!f (.. ',i~ y y y I<; 1{ !)t'. g. f's* n "\\ '::Ir.'.. 1 Bicron NA < d7tx NA I 'I d~I~, v y y [)£* t';i"' I.JI. it ,..th 7_-.,z. ~(-. Bicroo NA t~ )* '~* NA I Jr )*:i:+/-i 'j y 1 1 *it.,... ~9.1 Th 2.?.2. ~!( ~icron NA ~ uK~ NA ,. f(,,,.._/&. y y y' 0"15,,, r;t.*( 1l-i 2. :,-.z.. ~K
- 1.
Instrument-designated check source 1s listed on calibration sticker. Re<:ord check source response {net cpm) prior to tleld deployment for:.all chetk sources being used.
- 2.
Source and Background *~ount :ate should be deten'liined from the average.of three static counts at the same location. Repeat counts should be within 20%. If count rate diverges sfgn!fitantly, perform ad ditlonal.counts to evilluate instrument stablllty I I I l l l I i i I I
Appendix E-lnstrument Check Sheets November
- Instrument Field Response Checklog
- l. Jnstrument lnfQrmation 1
- Ratemeter;
- Make/Moder;
- WDLUfY,l 2241-2 Detei::tor 1; M<ike/Model.:' ~!J.L~44::..10 *-..
Biaot1 'MkroRem Meter: Serial No.* 292737 -Serial No *.J:1Ull1;?.L Serial No. A22tiU Cat Oue Oate: 8/4/16
- z.
check Sourc.r, Information: Source l lsotape: Tb-232 ,Serial No.;..1.l.£..__""*- Activity: <il.L. 1111it,s:.IJ.r.:L. Assay Date; J2L.3il/10 Re~pon:;.e Acceptance Range ! i {2CJVr,J: uRen1/hr "'20%.2::;>_,_ uRe.m/hr <l0%..l.'1.- ~ tpm + 20%,.;,,i;~926 .mrt.c'prn -20%.J:!illllL .Source 2 f5otope:.. G~U'.'L.. Senal No.:..JUE13:48__. Activity: _Q.Q2 w1its:.JJ.~LAssayDate; j;,i1SJJJ.O .. Respons.a Acceptance.Range.{.+/,20%}: A:i~emJfll:.. ~20~~----_-_. -* *
- 1.1Rem/hr--20%*,.;.:;.:,:.:_,. * *!¥*cpm~.20%:1.ill!l:.... * ~
cpm~20%*.:_~9.l:9.
- 3.
Date: /tj4/i/,01me:_(! 9:fi]
- 4.
~!!.~_m::!.. ().c.~t!oil: Srte/Job*-~---.--- . / ff location Dm;i;,rJptibn:.~ ""'9~l""*~""";l_iZ..., ___ ~~~~--- GPS toqrdinates {w11en reqµir~d); x~coord: __ /j/..:!f.,;:;::_;L_1/)_f;A...c.oord:.JJ[J2.2~t..:..Slf. 7.r,- Rev '.!. 10/18/15 -*.--~~---~'"."'"-ini..-=~1--:.-*,.. -:_--~"l<*ll.'.............,.! *., *~<?"'.---::-.>~,;- 'r'._.....,..*....,.* -v.~~'!?'"~**-"*"f"'""...-.'-*_..,.__._..,_~.,_.--~-~---=~=-~-_,,,.~----~--*~----~.---*
- ~
lnstrumentfield Iles onse* Use *Arceptance*Criteria Meter 6kg Sourc.e Sour.Ce *Response +/-20% Cnt: .Cnt {gross epm or sour<:e lime Time uRern/hr) Inst. aanerv Calib..
- Ctied; i;:vrrent iY/N)
{Y/N} Time Of th\\'!ck Ambient.. Tl'!mp. r"n Remarks lni,tlal~and Comments (~dd'I Info: ins1. CondiliOll, et:c:.} Ratemeter 1 ~~~eter NA _::::::_+/-:::.=' *.. _w r~-*- --H~i)Z s;-
~
Bicron NA
- --,- -.. t,...... {]ilV..., 1J:f_ ____ J1'.}}*_g.. :~.r, ___.. __________ 1 Bicron __
NA = I: * ~...v: -rl1 i.~-? St.. .. -... _............ __ _j
- 1.
Jrittrument deslcmrted chec!< ~oun:e i:.H!m.ld*p(} c,qlibratiqn t:.t!Cl<er; P.ecord check ?Poree. rl!tponse {n~ q>m) prior to fit!l<l d~ploy1mml for at! chect.. SPuJ<:es being: used; '1: Source and Bi!cl,gi:our'Jd co1im* r<ite *should bt>:ile;termined from-th!.".ave.r<1ge.ofthre!! static counts at 1he.same.lo~;:itiM. Rcpe;ittour.~-~houtd b<> w.iJ11io 20%. If tount r ate.di11t:rges s_*unificantlr, perform add1tionatc.ounls t1.1.evaluilli:: instrumcrit~tabil*t.j"
Rev 110/18/15 Instrument Field Response Check l;>g
- 1.
ln~trum~nt lnfortnat!Qn 1 f.!~temeter:
- Mak~/Model:
LUDLUM 2241-2 Detector 1: Mak1,;/Model: _lUDLUM 44-10 Bicron Mh:roRem Meti?r: Serial Na. 2fi2!37. Serif!! No. ER.11112Z S~rlatNo....h2;1.4U. Cal; Due Date: 9/Ulfi Cat, Due Oate: 8/4/16
- 2.
Check.Source Information: Bicron Bicron Source l.lsotope: Ib*232 Serl~1 No.: ll§ Actlvlty:,5:.,Q;J_., units: $L 11$.say Date:.12/.30/10 f:lesponse Acceptance Ra_rige ( +/-20%)! uRem/hr +20% -~ !JR em/hr -20% _t(_ .!let gm1 +. 20% 22926 it'<?! cpm -20%
- l521M Source 2 !solnpe; _c:;.zm__serialNo,~ 87E13-.118 Activlty: _O.Q2 units:$L A.ss.i*rDate:.1/2Qfj,0
~e.spo~st: A~c.eptanc13 Rat:is?J+/.~2{}1~):_ ug~n~lh.I' ~*.20%__ .. 1.iR.~mLh' -_:?Q% __. 1~u:pm t.ZO%_:.ll31!L.~tcpm*20%.* a~mL. Bk{l -Cnt Time Bkg Counts
- Souri;;e
[cpm}br Cnt uRem/hr) Time Source Response (gross.:pm or ur.em/hr) +/-20% source ~toss cpm ciruRem/hr ___ (Y/N) ~~ ...... ~~--~ .......,-, __ ~~,.,,....~..----~-..~~--....,..,....~~~,_.- Us c Acceptam:e Criteria
- Inst.
J1.Battery Time Cal!b.
- Check.
Of current [ (Y/N)
- check (Y/N)
" i Ambient Remarks lnitiGJls and Comments {add'l tnfo:Jnst. Conditiol'I, eti:.}
Instrument Field Res;ionse Check Log
- l.. fnstrum~nt lofor.mi!tipg 1
Rat!>meter: Mafie{Moditi: Detector 1: Make/Model: BlcronMlcroRem IVJet~r: z_ Cbeck ~puree Information: LUDLUM2241-2 s~riai No._2627~7 * !JJPL~1.Q_ __,.)erlalNo *...£1:! in*12z Serial No.* ~2H~ Source J Isotope: Tb-232 Serie! No.: '.l:J.6 Activity:.<O.L lfnlts: ~!CL Nespo11~e Acr.eptance Range {*1/-20%); uflem/hr.*~20%.'?o ~* uRem/hr "20% ~J..i_ Cal. Due Date~ 9/2llfi Assay Dat~:.UL3QJ:!.O nP.£ cpm + 20% 2'.;!92fL ~ 1,:pm~.20% 1'52_84
- Source 2 Isotope~ _QUL._.serial No.: -81.El ~.-<1.3
~ Activity: J),.Q2._._unlts;...jJ.d_ Assay Date!.l/J.f)j)O.... R.i:spon~e Acc~Rt:i:llJfe R~n@J4~W%):. uRem/hr:.-i.20%.____
- - *uRem/hr -20,,.-_._. _.
t cpm -1* 20%~.1L ne cpm *20%..fil!J...9 -*- .3. Te£lJOklan/Worker Perforr.ijng Chedts: Narne:.s:rr-'-v.. ~:J;~t-J ritlg:.JZ. c:r Date: H1~~b(. nme:_l.O Ou .4. $.!t~.QrJ.Q.~tJm1: Slte/Joh:'--_.tf-",_,3:;_.,. _____ ~---~- GPS Coordinates (when required); X-Conrd.:_j)[l(_ Z. v ) ~ "Y "/.. 5 R~v.110/lB/lS ~~"'~__,-* * *>** '"'"",11'"'1r"IT"'art~~i'G.£.."l'tl<t"l*~~T"I".'~~ I Instrument Field Response1 ~-,,...,._-~-#!am,
- ~"'
-= ~---~....,.,.h-m:t_..,,..._.. ~-.. '"! use Acceptance. Criteria-Remarks Meter Bkg Bi;g Counts
- Sour~e Cnt
{cpm) or ! Cnt ti* 20% Inst. . Battery Time f\\mbieAl Initials an.tl'Commr;;nts source Calib. .Check Of Temp. {add'l lofo: lrut.. Collditlor., etc.) Time uRem/hr) ' Time 8l'OSS. cpm cwrnnt {Y/N~ check {~F) l I or uRem/hr (Y/N) 1 (Y/N.) i ........,.,......,""'*,..,..._,._<"'=""""""""""~"""".tU'.f~~""""""""'""""""""""""n=,;~....;."""""""'°'"'"",.,,,.,.,~.. - -r.:mm~~iSVQ~~*.rnMJ'XY,t?'Su>:Mr.l:t*imA°f Source Respon$e (gfOS5 tpm Of uRem/hr) rtemeter I tnuJ f~fPcrw I M1/\\J ,;,h1 '? 14 <*"" '/ Y Y fi! co ~l.I if1\\ z.;.i.. :~t.... temeter { l"l lvJ r0rrv CPI~ J r!l.!..t!L.. -.1-.J;.. ?Stu. Si.<<L ~----1:*-"--~--y v. ~ < 1.) {'; \\ 31 S..IC- ~ temeter j m 11J &"'$ 33 c.,,.,./ (r\\ 1 fVI J e, \\ o '-{ <,. "\\ Y Y Y
- / ?J Ci
/,. /.j'..__ :1)... ~~---->-;-; I temeter i11l11J rsll <.'Jn; f/111/ll Jl'f":t_l~ \\..;"1\\1\\ y V Y i'J'3D t;f,8 1f'rJC'1 J((. ~~met~. /.£12:.'!'1. f:--(1,., '\\a.- U'J.:.J.:1_.~_LJ:;."i.-5d.&i. Y. '/ Y 1.<.t.Jo L.1 1-
- f"Au.1.
fr:, *---------i
- erneter J m1JJ 8"5'IP 3".,n ] 1Y..1,V 11no1,p ""'
,*r Y t_
- 1cvo ** to.2 __.. £tl!J.... _.J....t. -------------;
ri:in __. NA _f.<.<.l;;.,J NA.. l '"1 <i:fl,_.J u£ Y _ __y_H __ _i._ /i;lt) 0 fVL 1t\\ ?,tt.- 5 t.
- on NA
>?, r...... 1 NA l'J?' t~Mlh-. y y y n3., 1.1.r __ Jl.7.:.F-S/C.
- on NA -*--4z dwili NA
{ 1.U""1 k y y ... *<.*-v--* 7 ( 'i 0 b 'j). ). ~n,.:.:...21;...:2-;.__.,.--.lj;~. IC.~----*-_-,_-.. --~.~.. -.. _-_.. ~==..
- l.
1nmumenr da~lgn<>md c/Ji;cJpoutce ls fist.eel on calfbrat!on stlcker. *Record,etiedoowce*respop;e (n!'?t cpm)*prlDr to.field t.leploy111<?m for all chm:~ ~ourcs& being use ti.
- 2.
source <incl Backgro<ll'!d cocint r;ite shmlld be dt!termlned f1om tne avarag;i o1 tJ1rell s1:;itlc~u11t~ at Ill<' sarne location Repl!i!: courits should b<! within 20%. Jfcd1J11l r<1te diver~<!s slgnificantly, perform additional cou111s io ovalu_;.t(l.nst(U111ent stahilliy
$9urce!llsotop~;G_<J~;7~erial'No~:* tVit::;;2>'!b- -Activity:();()):.: units~t:,~ ~say:Date:,l\\£4,.~"... lns.tr1Jment:R~sp9n!!~:A<;c~ptJ1f!~e>'ft:aris:~ (sour~~wrn;-l:),Ks+/"'20%): ~.cpm:+ 2Q~,:z,,.z 5*..JS1:pm-20%. *zs: ~r?:
- r*~~;;tfu;t);rrt~dRi~~J;=n-;;~~-~,,w==,*~*-~~~~-~,,."'"~'ij~;,:At~;tM;;:ctif;;~-~~-----,,--~~fl;;;~rlZ;~~~~l
~-.-~ Det; 8Kg aim Sour¢¢ Source- +/>ip%of:
- lnst.
Battery Tbne ! Ambient ln!tlals and Comments i No, . Cfit-(avg~of3) -Ct;it Respon~if so1..m:e-Net Callh. Chett Of r Temp. (add'.1tru-u:ti:m1pero:\\1re;lnst;C<.mclltl<m, t (1/-2) lime.
- 1e::1nn)
Time*
- ~l Cflrn (YIN) ched:
.(fl
- l '-lti;;.)
1 I. -~ cpm (Y.N) ~--;l~._,: =--~-1 ..11'.'-_,_-..---.~~c-'--><'-""-...,..,,,,_..., __ -I'~-~~~
- ---~1-""'f-~-l--.f..--<1>1=~--1
_I
- 1
- 1 Instrument deslgnatechilie.ck*~OIJ_{Ce*ls llst1<d"on cam:>r~tiprf~tr.. er::Recor{fi:;ti' ck;~o)lr~e:r* sppn.~e (net*cpm1 p_r1_or-to f!eltl depk>v~ntJoraU:c eek sources bell)g used..
Source and Backgrouni:i.count~a~e,shoWd'be.detenni_nep.fr~rlr~he.. a~t:Jf.i!~e qf t~r~es_~,;itic co1:!n:t5 at'tM,same!l~tlon. ReP,eat counts should be wlthl.n 2()%;.1f count r{l~e.d!verge~:s!gilifJq1nt!y~,perform:ac:ldi!ion~I co1,1ntS' 0to e,va!V-\\1~' i11~~f!JJ1)e~t'.st<1blil\\y
~.~~
- ~-~
,~......
- ..w..i..+~*T~ll. S6lR.'9.-~~E$*
l~s.ttum~ntF:leld1tesporiseChecls tog.
- 1..lns\\rument, lnfcrmatiofi 1
- '.Ra.temeu!r:
- Makc>/M9del:
Detector1: Mal<eJIVlodel:. Blcron:MlcroRem Mete~: L.UDLU.M 2241~2 kUDLOM.44*lO., S~rial*No *. 21j2 231 Serlaf~9,.Jt.liliH27. Serlal.. J~o. Y.,.2,.,.2.,_.4""U..._...,....
- 2.
Check Source -Information: , Scii:irce.ti~~tope: Tb-232 . :Se~!~I No.; _i>>.6. AttlvitY: ':SQ*..'L *.. units;. _UQ~.. ~e~pon..se. Acceptance RangeJ-t /,,40%): 1.1Flf!m/h(t 20%,~:!_. -,*:* u~eii1/hr *20%.-d-CaLDue:Oate: 8/4l16 Assay Dal1F.W3o/10 Mt*cpm*~*.2b%.42n6 rnptc:P,m-20% !5284. Source,2 Jsotope: ~C.li:.131.~_,Ser.ial.No,:....31.E13:.:41L-Activity:..J1.04__unfr,s:.JJCL As~ay Data: 1/2Q/10 .. __ ~~?RQ~l!A.!;.fi?.l?tc:i.ni;e)ii'lr:J!I9..l+/-L-.~Q~).;~:YR~m/h.i:.:t?.O~~,.,..----.-....... ~iRe,m[hco~03 *~...:.;*_ "mi.~.\\;PnJ-+:iq%:,:13~ * *Jt£:t:cpm*c20%~*89l9.: :*: *
- 3.
Technici;:m/Worker Performing Chetks:*
- Na.me
- .. SJL:Yf.-~~\\Jllit::!t,£.J..:l * *
- 4.
$i.~~.9-r,Jo.~~iP.1J: !lite/Job**. ffi&l'l'Af; 7 --,-.-.---~-""' tnc;;iticn O~r,criptlan:~e&f!(,;J<<~ l.;, *c OPS Coo1dinotes {wheri:require~)'*
- X*Coprd
- 4(_t..~.f~~)J...'...!L ?.,~.- 'Y~Coord: l;J(F'.1f' i~( S t. ~
Rev 110/18/15 Initials and Comments {ad!l'Unto:*lrist.. Coriditmn,etc,) 2/.
1.. murnmentinformatlon 1 Ratenieter; M~~e/mP.d~I: /-vJ/% :/?P'fl"".?- . Detector 1: Malfe/M~del: 1.-v~"lk.Jri ttif I~.. OetectoF2:, Make/Model: ----~*~---.
- z..<::heck-Source Information:
' *saurce;tisotppe:.*--t"Zi;i'.$2 _s~rii!I No.:' *.., 'Jr( Ac~lvitv.:' '*.c.DJ' Ulilts:!f C:, Assav:o'aif!:,!if.5cf a ln_~run:ie_nt Re~p(lnseAcceptance:Raf)ge (source cpm ~ t:ikg i!F~O%):
- Mt;,f'.rm +.ioCJ{l~I*22s* _ ~.cpm -20%:~<7£6,
sou,rce2'1sotope:O;..:f.,_g'*"iseri\\1l'No*:* lf20:?4.2 Activity:*.. (};q)t.., uni~s:f6: Assa,yDate:rlA*. 10.~~r~ment (te_sp0,ilse:Ac.Ceptan*ce R~nge (s~urc~ *Cprn ~ bkg.+/~20%)t ~ cpn:i +:20%/a.2< l~ mi!'cpm~20% 1i g.:.11 ---~.;~,-- ~::::~j"~~!;t~J~{:formlgg Checks:~...,,,,:_ 'iftie:-*--~"@tf'*,,_,,.... -~--*-* -**** --- ***--h~*. -"tfi.fo:tf/t:fjief Tim({f.'"/O,tt(:>:*- **H:--. *-*~--- --- -*-* -~ -.. --*.. -- ---. ---- *-
- 4. Site.orJ.ocation; :site/Joo:
A:ve,i L(. $: ~pcatton-Descrip.tlom 1.(.,.1~ l'.*1~$'? GPS'Coordlh~tes'{wh~n.;equlredJ: x~co~rrJ.: fxh*l2"ti *~:2 'l27 V..COofd: W ~.b,25 CfJil..
- Oet Sj{g.. -.
~~g. Soll.re~
- ~pure!!
+/"-2Q%*of No. Ci:i:R .(a\\!g'.of3) Cnt
- - {1 t2)
- TJme;
(~pm) Jlme Sesponse
- *source Net
'. *(:G~)' : cpm ~cpm '(Y/N) .'-...... -~~ ................:~""""'""""'""""'"'*""...._._,._:_~""""'~-. ,I'.
- i.
2,
- . Battery Ch~ck
. {Y/N} TI me Of check* Alnbientc Temp *. [ lf ! tnitiafs and '.C-0mments I (ac.!cl'l Info: temperature, lns.t. Conditlon, l Qtt0} \\
- i.
~~"""""'-.,._,,,..,,__..,""""'.._,,,.,_""'I
tostrum~nt:Field Resppnse Check log
- l. lilstru!l)got tnforlj'latloil 1
Ratemet{!r~ *
- iMake{Model:
LUDl::UM-2241-2 Detector 1: Malr.e/Mbdel: *. tUDLUi.\\ll 44~1.Q. ~~~
- S~i?.LNP._l~?TI7
- s:erialNo;, __ ~
serial ~~o,. A22~4~U __ (;al. Due Date:. 8/4/l5. -Blr:ton Microllem;Mfiter: 2~ PJe:kSyurce lnforrriatiou: R~V 110/18/15 .sour.eel 1sptope:I.D:i32_s~rlal No~;.1.l.Q.....---.-;... 'Activity:.s.QJ,;.._ units:.~i.... Re~ponse Accepta1\\~ ~ange*(i/;203): µRem/hr +2Q'¥>.!~"'~ ~Rem/hr *20%...J..tL. .~sav Date:.12l30/10* .l:!flt i:priL-t 2ri%~ ~ cpnr~~[)% ;15284 .so4rc{! 2 l~otop~: J;.s.~:i,31__5'1rml No.:' *...81£13~... _Activ:1ty::.:Q.Q.2_.,..units: -Mci-Msay.012te:.JJWJO ___ ~~~f!s~!:li:E~ei<l.~.ce ~3lf16_~(+/-/.~?Q1~K.. l!R..f!!11/.hi. ?f.Q~--* -.... ~-...1JR.e.rtt/tir>20%._._. __...,.... ~ .tpm.:1~20%.~~25_:.. *. ~wm .* 20%.Jl.~.l!L.. * * -- ----........ *
- 3.
Technidan/Worner. Peri2rm!ng Check~: Nam~ ~~g_jf/fi."'{fifY! /i;f'/
- 4.
g~~.C?f.l~.Cl,Jtl!m: Sit~/Jqb:_~( J *-----**- . GPS:Coorl.iinafe:; {i\\ihen 1 equired}; x,coord:.,f r:t Z,4(....J._'" ___ ---- lnt<ltion.Dt!r.cr'1Pti.:in~* i;J.!~,""0""5""', ---~--M--*-- Y-Coord:Jd£1:.~'-~-~.]_ .. ~ ... --:.~--"""'V'*'i*~*.. -...,...,._~.,,,.rr:...... <";r";*.**'--"""...,,qi*.-~.. _. *t:rooi.'.!"'°"****," **~**-ru~~,.....,.~ ~ n-==-..~----~.-----------.....,,~~-- i Instrument.Field.Ae!>ponse.i Use Acceptance Criteria Mei,; 1
- ~.~,~*:*s~:P~:'~ ~s~~~~.-:**.... s~~~~~sR:;!o~:e
+:~~~: ~~- :; BJ~=~ T~f
- rrme uRem/hr}
- Time
- uRen:i/hr}
.gross cpm wueot (Y/N) ch{?<:k
- o/ uRemi!)r
- ('f/~).
Ratemeter Ratemeter* Ra tei'neft:!r.** Bicron Bit:toh (V/N) Air){li~rit Temp. (:f} Remar~.s
- _1riit1a1s arid'tomment~.
. :{apd'I Info: tnsr. Cotidition; etc.) .... ---,*-.. -*-.-~.1 .. --"*------~ .. ****--*** __ _. J
f i {z-7~~~~'*'-i.:.;.,...~.. ""*""L*~-*'J.~7f[S v'"--*":.-~*.:;_.-> P.><;J"f.rV T~AIL §"~~E;S"
- 1. Instrument lnforroatioo 1 "I
Ra!emeter: Make/Model: -~~/.£<.:::-~"'-.z~"'~{} St>rial No. dWlC/f D_etector 1: IYJake/Model:..Ld f v;:12 iflf,,,.L') Serial.. No. Pkil)1**4;t Cal. Due Date:t°J f~*//t. Detect~r2.: Make/Motje!: _ Serial No.~----~ Z.
- Check Source Information:
Source llsotope:. -tf1*\\)J;) Serial No.: 1 f I. .. Activity:~. unlts: pt./J. Instrument Re.~potlse A~eptance Range-{ sou re~ cpm-bkg +/-20%}: Source*2;1sotope: [j_*, (USerlal No.: l ('f£d3.*IJ-Activity: [l_ C~ Instrument Response Acceptance Range (source cpm
- bkg +/-2o%):
units:~ Assay.Date: -. __
- rel: cpm + 20% 13'271 ~t cpm -20% 2:8'{'1
. 3.
- 4.
J ( i I l l
- I ;l'i.),'l i...j..{JZ;Cj/
V 1'l fV frtt;*? LJI/, 7 a .~ft,... ;;z.;:2 /*i < lv"Y" 116/f1 \\1 J 1f;f t 4if. 'Ju: '/'~*--In @r
- 1.
Instrument designated ~he:ek sour"e !s.listed on,caliljration stli{ker. Record. cll~ck source r,e5ponse {net cpm) prlorio field deployment for.all c'ifec11 sourccs;belng.used.
- 2.
Source and *Background counHat'e should be determined frorrrthe a11.erage of three statkc:ounts at the same loc,atlon. Repeat counts should be within 20%. lf count rate dlyerg~s slgillficantly, perform additional counts to evaluat(i lnstr.1,1ment stability
- ---------------------------------------------------~ Rev 110/18/15 i r j ~ Instrument Field Response Check Log 1 Instrument lnformation1 ~ I I !fl. ., -,,., I Ratemeter; Mal;e Mpdel: t/:;,[ft.r r-*c-rL-,c.. Detector l; Make/Model: i/,,,,,,. ;/21 ~/I Bicron MlcroRem Meter: . I "")..,,..-...:c.z: Sena No. ~<.!:.'.!:-'"' ~' :... Serial No. fj? ilU'$L6: Serial No. l'iy.:J.. __ Cat.:oue Date; o1jet.JI.< Cal. Due Date: 6/19: I/ G
- z.
Chee So rce Information: ,..,/?./, Source l Isotope: ~ ""2-serial No.: I fl Activity.; C.C..~, I 1.mits: feh' Assay Date:~/a Response Acceptance Range (+/-ZO%): uRem/hr +20%...'.ii__ uRem/hr *20% 2. i- ~ cpm + 20%.:;::rz1if rre1 cpm -20%.3'S:'S(6 Source 2 lsotope:~Serlal No.: f/ '?/::?3-/d:, Activity: <.1..t.i,;J units: e'~* Assay Date: /.,0 Response Acceptance Range(+/ ~26%): iiReiri/nr +20% _._ * -* -u Rem/hr -20% =......_ - -~ q;m + 20%('.5,,; Zf n.~ q;)m -20% -S".8' '1'-f
- 3.
17*/
Title:
1<. (
- 4.
Site or location: Site/Job:_,4(<?v, L/, ~ _ GPS Coordinates (when required): X-Coon:j: IV xf-'..r.f... 1_.;i.-? Location Descrlption:, ___ w_()_1.__;:<..-_,*}""'* ------- Y*Coord: j,J 7~ ¢ l.~ ;;,, %..? ~* i lnstn.unent Field Response2 Use Acceptance Criteria Remarks Meter Bkg 8kg Counts Source Source Response +/-20% Inst. Battery Time Ambient Initials and Comments Cnt (cpm) or Cnt {gross cpm or sou.rce Ca lib. Check Of Temp. (;idd'l Info: Inst. Condition, etc.) Ttme ufl.em/hr) Time uRem/hr) gross cpm current (Y/N) che~k l°F) or uRem/hr (Y/N) I (Y/N) ~- Rate meter 1 mr r. f D l 1 2cti. [Jll{iY- '/'--<"17 <p}"' >./ v \\j /tJl'--1
- 37. (,/ ¢> *n ---7 7.J..
.L'L-r c..* Rate meter I mi 1,
- tj.q7, o n z. <**t:
i/'17<1.::#...,, \\,./ I. ...} {; /n1<
- 7~ T 0
~<: *1?'7 !2~ ~temeter I /.#I, }'I q 'l'-1 I"' h*ri i IA r.; t....... 7 /,~ ;,.... \\/ {j r.;,; { lt"f q zs-;1,Q
- Tt..~,7 '5 ;i
"""~ Riatemeter I l'V\\i~ ¢'f'Gtl{ c*tfl.... /1;1/,., ll 8 (;! i e ',;._,_..
- J v'
/ 13yr- ':z/~-v Cs. \\~7.?/£. I ~* Bfcron NA ..;-;,t(!J.,11 NA lJIJ.- -//;_ --.u I., ' 0~{~\\J y YI l/U.l6
- ?7_,;)_ "'t-k-
"J ~ 2v.. l:) ~- Bicron NA 11' NA '?£} (11./~ 1 J.,.l./ {I '1 /5'10 ~2.c.r-. -Hi......?? 2 ,ij>' 1 rl " Bicron NA I NA 11/;J!tr, 'a~~.: I I ( ~ B!cron NA ! NA I {/
- l.
1nstrum ent desi.{lnateri check source IS lined on.-:afibration sticker. Record check sourcvesponse {net cpm) prlor to field deployment for all check sources being used.
- 2.
Source and !lacl-:ground count rnte should be determined fr;:;m -rile average of ~hree statti: \\'.ounts at the ~;ime location. Repeat counts should be wfthln 20"4, If count rate diverges significantly; perform a~d.itional i:ount.s.to evaluate instn.1mentstabifity.. I cJ I i I I I i
R~v 110/18/15 Instrument Field Response Check Log
- 1.
Instrument lnforma1ion 1 flatemerer: Make/Model: lUBlUM 2241-2 Serial NCI.. 2fi2137 Qei(:!t:tor l: Make/Model: _!..J,rn,LUM M.::.l!l.-...:..... .Serial No._ PR 1l 1J2L Bimm MJr;roRam-Meter: Serial No..A224u__,,._.
- 2.
_9hecl< Sou~£!;.}ofQrmatlon; Source llsotope: Ib-232 Serl<Jl No.; J,1Ei ActMty:.59.:r.L. units: -IJ.f.:L.. Respon~~ Acceptance Range (-1-/-20%): uRem/hr *t20%.l:::3... _ uRem/tir,20%.J:L.. Cil!. Due oat.a: *.5Il:Ulf;. ~al. Due Date: 8/4/16 As!i<lY Date; 12f%l/10 Aet cµm + 20%.J~~ ma:l cpm *20% 152M_ Source 2 £1;otope: _C:~l.3] _,.Ser'ial.No.: _.8.7.W::4L-Activity; 0.02 .units: _IJ,C.L MS<!Y Dale:.lL2.Qll.O .Response.Ai;centance.aange l+f.;20%):.. uRem/l'.1/'.~.;zo% _~-~ uRem/hr..,20%.'--"-**-* JW cpm+20%.:133li,; * ~cpm -20% ::..89.l 9:.*.. -
- 3.
Techl)~lan/Worker P~rforming Checks: Nilme:_ 1 ~.c.'--~---- 1ltle: 12c:c.. ____ _
- 4.
~!!£:.. l?!'J'i!f.<r~ipn: S1le/Job: __ _!:_/. 3c.. Locatipn [lf1.scripti()n:_lAf2_ 1~~~~S----~--~*-*-.... GPS Coo1 ditlille{:; (when req\\JiH1dJ; X-C:rwrd:~_:_'1'i~.o Z.' 5-5::..v~--. _ Y*CoorcJ:.!\\!..; Z"iU' 1:s,~'.-~_"_,,- ~~"V"T"!'*~ .. -~ .......,..~~-..,,...-_..,.. ___________ ....,..,..~...... -...~ -* * * *use Ac:cep~ance Criteria Meter ...,... -~-- akg Count> Sourrn {cp_rn} or Cnt uRem/hrl nme 5ourcr._Re.sponse {~ross cpm or tiRf!m/hr) 'f'/-20% source
- gross cpm or'!Rem/hr (V/N)
Inst Calil~. current (Y/N) Battery '1 Time Check Of {Y/N) check*. Ambii.>rit Temp. {"F) Remarks rnitlals and Comments (add"l liifo: Inst, r.ondition. etc.) j j i
- =i<,,....._..--=4>=~=*~*""""'~*-~*:"""'""""'I~
2.QJe? I 'f C",;"' . 3-.i"".. "'ai"""'~:"i11=-::;;7""'-'!.""'-z""*"". "";""r=""""*"'... ~ "..,_.,,,,......,.,,,..,, *.* n,.,,,,,l ID<><'.* 37;Q-- (_ ?)7 l ~--*--- ~~--_I ~--J)J,----------i 7..7 )(.. _j' ,,...,...................,,........_1.)/ ___,.:r~.\\*~-L_,;;____ I --1-----!---'-"*i) "1.i
- 7 i:
-.... __ t.. J ?1s;.. '17. Z; ~*.... _Jj;_ I ~~~~~~~~~~~~~~~~~~~~~~~~~~*/~~~ ~-- ~-II7~~~---*- _] -, l,o Jh--i.~"l: )/: _;_.;...;.;...--+---+--"!'---+i------t--.;.......;.......,-,,---cr--i:t---'~--r--:---- - _ _,J ___.!J.L':' --; l!f. -. ~1.Ll_... i.l_L ______ _J ~A -.,.t;;w. NA j j 1 *,,;. (l"""" ~- .. ? I _ ~, {_' ' °11
- L._.1 "~ 111... _,jJS,. _____...,.... -
...... _. _: ___ -* J
- i.
ln~trument.deslg11ateP check source is l!m~d on <allbr~tion sticker, Record check source respom£- (net cprnJ prior to fidd.deplPym;ml for all checl\\ s~urce~ b~ing used. .icton
- i.
SoumHWd. Bi:lckgr()untl cmmna.te should be determlri?.d ft om th!\\ average oJ tlirei:n;tatk: counts at tlw i:ame loi:ation. lie peat Nunt~ shoo Id br* within.209-.;,,Ji rnunt 1.11~ di\\'t:l!le>
- ~~olfit<intly, perform add1tlorial Wllfl\\S to.evuluate* i(ls trumeril ~tab1!1ty
I
- i Rev 110/18/15 fnstrum4llnt field Response Check log
- 1.
!0$1.~ment lnformiJtion 1 / fl Ratemeter: Make/Model*: m idi,.1 l C-;n {<:?,;;f_ /...,)., Detector l: Make/Model: ~lt.*,,.r ¥'{-('(} _ Bicnm Micr&~em Meter: 2~ Chei::kSource Information:
- (
1 Source 1 lsotope::t':P-)32 Serial No.: 11 Act!vity:-C'D* units: JL:l. Response Acceptance Ra1_1ge(+/*20%}: uRern/hr+20%.:!l_ vRem/hr ~20% 1-i Qll. Due Date: '-'jzkt//t:, Cal. Due Date: w6* Source 2lsotope:Gs-.--13) Serial No.: 111 J.J.,.!:2 .Actlvl~:- ~ .. 6~ units:/! C: Assay Date; Nk Response.Acceptarice Range (+/-20%};
- uRem/hr +20%.__
1JRem1hr -20% ___ -_ * ~
- c;pm + 20% r<;,?.J 3 mttcpm -20%* Z'?"f.j
- 3.
Technli:ian[Worker Performing Checks: Name:.:::J"* ~/11.r'-'c* '($° I !ff:.;:£ ~s-oate: *. Time: l ~'f S-f ,;? j!/,;$//5"" Locat'f6n Descriptlon: ____ t---->.___*'"""'~"". "-S---~-- . Y-Coord: ),/.f 71 ° O).;, "1..J~ Title; T2c:T
- 4.
Site or Location: Site/Job: A Y?_.r. '!..3 GPS Coordinates (when ~equired): X-Coord: /.!/ t;J c-U. 1./-.;;.7 i Instrument Field Response2 UseAcceptanceCrlteria Remarks Meter Bkg Bkg Counts Source Source Response +/-20% Inst Battery Time Ambient tnltlais and Comments Cnt (cpm) or Cnt (gross cpm or source eallb. .Check Of Te!llP* (add'! Info: inst. Condition, etc.) Time uRem/hr) Time uRem/hr) gross cpm current {Y/N) chec~ {oF) oruRem/hr (Y/N) I (Y/N) I ~ 'le,/,} v.cffe';,. "". ~
- ~.., /"'
Ratemeter /i.71, lf8~!'~. /;;,'it J v v v I~ 7A-.;2.32'...a. Rate meter Jlivlin '\\5 ~ S' ~'>YI-. l12*i11 I f ¥5'-! ii.a.yr -4 lv* /<:};;°'1 37.S*~ c'!>..,.,,./ -,'"'!> Ratemeter. I' l I V' Rate meter " l Bicron NA
- .('~/,,.;r11 jfl( NA
"'.) J"L /.L!l.*l<;.v,N*I y- *.. / v v 1911? 37.>"" "'Th- -1.J>.'.L.t/"E- ~ '
- 1"'
Bicron NA I NA 11l;7s/1r1 at.. f / I .I f v
- f--*
Bkron NA NA Bicron NA NA
- l.
Instrument designated check source la listed on callbratlon stll:;ker; Record check sov,rce re5pon~e (net cpm) prior to field deployment for all r.heck sources being use cl.
- 2.
Source and Background count rate should be *determined fr:om the l.lVerage of three.s~.atic wunts <Jt the same location.* Repeat i;o1.1nts should bl!l within 20%. If count rate diYerges significantly, perform additional counts to evaluate instrument stability I I I
Rev 110/18/15 Instrument Field Response Check log
- 1. ln:!trument lnformation 1 Ratemetet; Make/Model:
- Detector 1:
Make/Model: Bicron MkroRem Meter: LvJf v~n ;J>lf;-:2_ Serial No; ~.o.2.l_. (_.._,tffrtd! lt:l{.-l4 Serial No.f!:@:./J.:?4*'f*::i. Serial No. N !f-'"rr~* __
- 2.
Chetk Source Information: { [ J Source 1 JsQtope: -rJ....;:J;p Serial No.;.... I *. Activity: <:.c*'
- units:~
Response Acceptance Range (1-/-20%}: uRem/hr +20% __ uR_em/hr -20% __ Cal. Due.Date; D'l/t>l/;6 r1 Cal. Due Date: J'J [+\\ Source 2 lsotop~: Cr 41!Z Seria.1 N9.: r( '1 E;j:f ~1 2.. Activity: Jl.c..),. unirs: ff.t{ Assay Date:. tiff. Response Acceptance Range (+/-20%): uRem/hr +20% __ uRem/hr *20%__ Get i::pm + 20%ru2z: >iet. cpm *20% '£8ft>t
Title:
i Instrument Field Response2 Use Acceptm1ce Criteria Remarks .i 81:~ +/* 20% Met<?r Bkg Counts Source
- S0t1rce Response
.Inst. Battery Time Ambient lriitlals and Comments I Cnt (cµm) or tnt (gross cpm or ~ource Ca lib. Check Of Temp. (add'l Jnfo: inst Con!iition, etc,.} Time uRem/hr} Time uRem/hr) gross cpm current (Y/f'J) check (~F) i or uRe.m/hr (Y/N) L {Y/NI i Ratemeter f IM l\\f\\ i1 J "i.f (;. cl'r-' I WI,( LI'\\ L/6 <<. 9 ("'J;"/;, \\./ y y OC/'!'7 4f, I '1. 7;,.. -~ ;:;.. f 2.. R "F ! Ratemeter lt'lli~ 1*JY(,, r,~n... I.;,i; ti. II 6 C7 ~ 1,*t.>" \\../ '-L i,.,i <J1'i7 t.{ /.{J t:/ C5. -l1'7 /i b I* Ratemeter-I IN! )'\\ q7J...L~a.,. I /£\\;IA vl.~.r~~,A o!,,f 71-1-.)?,2_ q:;;z; v .fl I I./ 4iJ ;;t..,r> I Ratemeter I li1i.-. "n26. c..-;,..,,,. I w..:~ -*-- * \\ /,r-7 /' ~"""' l! y
- I l.k
- ;.
¥0. [,*,,;; /'JJ j "3? ""j;"~: I Ratemetet I }tftltl !qcz.::i._,,, I,,-!A,}'\\ 14~?.~~ ~.,/,>., !..J ll./fV u'l 11*., -rh -J.. f:J, ....I \\/ t)~ Ratemeter i \\'\\1i,.., .T. r; '5'iv ?, Ctn,, /v1l..*h I I 57Jl, _h,,. .J v flF' lif)J* "1*~~ ~. LJ.,,.,{ ?/ f7? Bicron NA NA I I { f , __ Bicron NA NA
- Bicro11 NA f\\lA
- 1.
Instrument designated check source i~ !isti;d on calibratlon sticker. Record chei.:k so1.m:I! respo~e {net cpm} prior to:field deployment fQr :all cneck sources belni: used. 2.. Source and Background count rate should be determined from the avernge*of three static co1.mtsat the same locl)tion. Repeat counts should be within 20%; if count rate diverges significantly, perform additional counts t() evaluate instnm1eot stability l . I l l I I i l I i I I i l l ' I ! i
~ ~'~..:.D~*=
- ~... ~***.
MU'"l.!V T~L'l<d.. Z>t!E'{R......,fC~* Instrument Field,Respons~ CheckLog
- 1. !nstrume!11lo.fu.rmjllon 1 Ratemeter:
Make/Model: Detei;tor l: Make/Model: 8Jcron MkwRem Jl/leter:
- 2.
.ch~k Saurc-e.informatloq: l\\!DbUM 2241"2 __ WDLi!M 44-lP_. Seri~J Np. -1fill.ll Serial No..-.E.a.l1U2L Seria!No. ~ source l Isotope: !h.:432._Serlal N(l.:..l).Ji._ ~ Activity:.$9.. J.. _ units:*J.tci._ *. Respon~e Acceptilm;;e Range.(;/-20%}: uflem/hr-+20% _;:-::_,_.. uRem/hr
- 20% A~.
Cal.Oue*Dat~:.52J2jl.Q Cal. OuffDa~e: Jd!J./J.§ kisay Pate: W30/10 a<10t cpm.+ 20%.12.91IL ~tcpm ~20% l5284 Soµrc<-:.2 Isotope:.!:=;;.:ill_,Serial No.:....8.1E1&.4&_~ Activity:..Q.Q.2..._unlts:_µ.cL,Assay 011te: JLZ.QL.;10
- -Respon.s~ Acceptani;e Range.(~.f.-20%); uRem/hr-+20% ~
- -.. uR(!m/hr -20% ___:_::
- mrl ~pm -;-*W%-.J.3-3.l£
- i:iei cpm -20%:..'.39.1$... :*
. 3. '.[!tcf'lniclan/Wot~J?r.Pwf-Ormlng *checks: Niime:._1'£:LJi.~r,~.-- 11t1e:....fi.hT: *--*-** D;M. !L:?'t'.C. T1r:rw:,,,J,'2,f!L_ __
- 4.
~lt~.. qrJi:>_i;9tiQn' SitP/Joh:~01.:..tb1v..t.""\\x.,~ ~..........l.~J ~ ?::c.~1"~,~;,.~~ location Desrription:-fU\\lAn'J ( t.>'~ GPS Coordinates (when r<iqulred): X-Coord:\\.rl7 S~S"'i 1 S-o. i..1* Y-Coord'. 1...:i '-fl' '.'iL.' 2..~ '.$"" Rev 110/18/15
- ~*.-~-~-*-**r~~1ri;;;:~~~l'"Fi;!d'R;;r;~~;;~* -- o*** <
..,.,'w:'-"fT"',:;-.:=i?:;~*t..... 1:"~*2*::1:'Hltlt.P"°~lO ..,...... WM 1:1 e- "'11
- ~
p
- JU-....
AAb;i:: ~~ Mete;~ T Bkg I !!kg CouotS, souroo '! Cot (cpm) or Cni (gross cpm.or Time uRem/hr) ; Time uRe111/hr) i ~,,,,,.,, ..,.* +,,...,,,,,,_._._.~ ~aterneter Ratemeter Ratemeter Ratemcter t! 11urv 1
- np
- 1 (,,..._ -
Ra1emeter ,.. **-** _...._'!""~-,..-.J.,~<>----i ~at.emeter Use Acceptance Criterii'I
- I* 20% I '"* I ll>ttery Time sol.Ir~.
Callb.
- Check Of
,gross q:im
- current
.~ (Y/N) cheL:k or 1.1Rem/hr \\ ('f/lll) (Y/NJ '"~ }ZIO Ambient Temp. ,~n Remarks lnitfals and Comments (add'l Info: Inst. Condition. etc) t\\lcron _*~NA ~l~~~~-=1~h... ;,,~v-****1 NA: I ~lA**~*Hl"I I J qi'* L-
- i.
1mtru1N'll' deslgnatetl chec~ ~O\\ll'C!? islistedc;in callbri)tlbn ~ticker, R~rord chodr sourc2 respon5e {nti1 cpm) pflor to field ilepioyrn1111t for all r:hac~ so.ureas be:ng used.
- i.
Sourte ~11d fl;,ckgr<H*ncJ co1mt rate shoulo l.ie detcrmlne.dJrom the awm1ge oftlJree.stmitcou!lts iit the $arne ioc-0tion Repe~t covr.tr. ~i10!1id br, w1tnln /()%.If count rate dr1erg~~ S*tnifip1-.tly, p.;rfouo ;rdd11ionakow1l~,,,, C\\*<Jluate in~lrument st.. 6il1ly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~.~-
- -~7$
~~* T~41l. .5rei'it1V!C'<l'f~ lnstrument Field. Response Check 1.0g l* Instrument ln.forrnatjon 1 Ra.temeter; Make/Model: LUDLUM 2241~2 Oetectqr 1: Make/Model:.,_J,_lJill,..~lll_-*. Bicron MkroRem Meter:
- 2.
~he<<;:k Sour~ Information: 5.erlal No...2.62232_ Serial tJc;..--ER.l..l.1.U.L. St<rial No. A2J.4...LL-.,.. Source I Isotope: Ib-232 Serial No,: J.l.6 m Activity: <0,.. J. __ units:.JJ.i;J.. _ Re>pome Accept;mc.C:' 'R1lnge {*/*20%): uRem/hr +20%. 20- __
- ulltrm/hr *20% J.:i_
cat Due Date~ ~ Cal. Due Date: 8{4/16 Assay Dat_e: ill30/10 ~ cpm,. 20% 22iU.Q_ ne:*cpm *20% 12284 5(lurce 2 Isotope: _c;s:t~J ___,, Seda! No.:. 87 E J 3-48,..... _ ActiVlty: J.Ul2:__ '!nits:..JJ.r;L ~\\ss.ay Dtite:
- Ji2SUJ.O Response Acceptance.Range t+/~?~J_; uRe~/h,r +~_0%~
uHf!?m/lir_ }P~~----- __. ~.t:PITl. **.. 20%....U3.Z,5 __. ll:{'.t.cpm,,,20%...8~l.~......
- 3.
Tec:b[llcian/Wotker P.erformlng Checks; N~rne: ___ '(p-;..!?:?J~... -*-- Title. f.. t:T om.. : i1.~.zc.r.1.c. Tim!:":_<:**~*<::. _
- 4..
~l!l"..9~J,t:1s;~tio.11:. Site/Job*J)q_Jt;... &.~-~ <.-/- toe;; lion li~scription: J:lf**lL* 113 bt GPS Coordinate~. iv~heruc~qujred); X*Coord../\\l.+/-L.?,tJ;_'l.' 2;t,J.: ___._,_ Y*Coord:~"' S $' <:x.-.
- z-i
..,..~.~,1""1-.~*~~r...,****--.""~;~:-.-=;:r~l"l';'.. *1*111~**- * ******~'. - """r'"'*'**~.-,.,..<;.1,**
- ~.-~...,..r~*
- _:"t"f,-'t"A....,.n.":"'**~~-'!1"'1'?"~
. ~~ 1 lnstn.iment Field Responsr; n Use.Acceptance Criteria ft Remarks Rev 110/18/15 Meter r Bkg Bkg"'couni~ So~~*c,e Source. f!espon;;e 'l'i io%' Inst
- Battery I Time I Ambient g tniti<JiS and Comments Cnt fcprn) or Cot (gross cpm or soma
- !
Calib. Chee~ ! Of l Temp. ft {atld'! Info: !nst.<:oruJitlon. etc.) Jlme uRem/hr)
- Time unem}hr}
groS!i c:pm current. (Y/N) diP.d: (:-!=}
- 1. )
I (. \\ oruRem/hr {Y/N) , m..n 1-1"'-1"1 lY/NJ ~~~**~;'":~~ 2.o -~ "q8 c.*,,,, y 'f .. _,. y"-*** *.:i=::o-;;*C' '3°7, a,_._ll ~~- 7:37.. s~- ~"""'"'""""' ""' *~
*-- -~,,_._, ___ 7,J..... - _c. *. ~-:~-... -
.... *----. --\\*-- *-~*---*- ---..----... --,....-*-----** +----i-- --~u-"'-'--='------=-,,,_-,..-------__, ~atemeter I /-1 '1 i" * *h ~ *. *- *. I ;I. ? _"- ~. crt*1 ...... Y., -**..,.. *--~-... _____ -1...... _, £*500 __ _2f. ~--" ~~::_µL f;. t._ __. f,la1emeterc t t;°il/L{ "" I rJPJ1'1 (**11'> Y ¥. Y tfHo .f'iJ:.!? ____.. :f k.1E~:.. J1L *- ***-*---*---*-~ Rat~meter f __ _; ___{J_kf~ --'--~.C[~ I).-51'.!'<L~...}{_. __, ~--.L__ 1 'l}o fiL (l W*ff1 fl:-... -~ -~~~(3~~~~!.. **-**- -**---~-.. l:':t,/!I:.... **--------.*-*--.'-"",..,,.....,, ____ *-*-**. ___,,. *-*-- :k}¢ -- --*~~-* Ratemeter
- 'A-
,YVIA - 1 ... ______.,,,_. __________ *----1 -~%~~~-.... z~.... -****q*~t1 1 ~z~*--*--
- ~ ~J~~ t~ --1 l "-f"**--*
Yy.. ~~;~ -~~~~ ~~i1~ r/c j Blcro:ri ~NA ~/A NA
- .v/A 1
__...... ;i/;--*-*****-*--*-;-**-*.......... '$.... --....J-K----**--*------*-*-*1 ' --- ____ _]____ i.. rn~trurnem dc!sl.gnoted check ~ourcc is listed on rnlibrollon ~ticker *.Record d11?dc;p~1rc_e. refpMse {net !.'.Pml pnur to fiefd de:pJoyment for <!ll chedi soi.uce~ bt:ing vsed. S.Q1m::e a11d sacl\\grounil count ;at~ shot>ld be d&termined from tlla averag~*of thrne static count5 at rhe sarne.loca1ion.. Repeat r.our.t~ ~1*01.1.:0 bi:. wit'lin 20%.. rf count r.-ite diverge~ ~i8;\\if1rn~tly, perform add1tlon;ilw1.1nl; toev;ilflille in~trumenl ~tab1litY
Rev 110/18/15 I I I I I
- 1.
Instrument lnformaiion1 Ratemeter: Make/Model: Detector 1: Make/Model: 13icron MictQRem Meter: Instrument Field Response Check Log Serial No. CJCf:.'O'i 'i Serial No. -P"f?:1 i.tZ:,£.'4';}_ Serial No. ---AL.\\,....'i~_. ___ _ tal. Due Date: tJ"l_fa rf t, Cal. Due Date:. N { V4
- 2. Check Source In ormation:
Source 1 lsotope: 'Ir.) :2. Serial No.: l ["{ Activity:CC 1,.I units; p...(_-: Assay D~te:f.;1/f.r:~ Response Acceptance Range (+/-20%): uRem/hr +20% _ uRem/hr *20% 1iia1; cpm + 20% $ zzc;e-~tcpm -20% Y.55.ef:.,,c... Source21sotope:C~.()'7 SerlalNo.: {14~.?-IJ. Activity: C:~.o.2.units:/-!(;AssayDate: ----~ Response Acceptance Range (+/-20%): uRem/hr ~:20% ___ uRem/hr-20%___ .oot cpm + 20% ),;5:;.;iJ 5" ~ cpm -20% ~rJ?~f &:J
- 3.
Technidan[Worker Performing Checks: r\\' _, 'I '). '.f?' .. _/*~f ( J. /J.t"' <l *7 Name: J* t.:;.,;~v.*.*i S Title; IS.:="- Date: {./.?~Time_: 6 fl
- 4.
Sot* o<l.ooatlon: sne,IJob: fiju,.. 7'>'4,,,..,t.,f v,,z r/rt r'" tt '( ~.':.uon ""'"'*"'?"' ?.:,,?, ':Ji (,.,,I waoJs GPS Coordinates(when required): X-Coord:J./ <f ;?°'3 I t':f7~ Y-Coord:-1£'LB71 C>Cr 1 f;. '3,.' l Instrument Field Response2 Use Acceptance Criteria Remarks source Response Meter 8kg Bkg Counts Source +/- ~0% Inst. Battery Time Amblent Initials and Comment::; Cnt (cpm)or Cnt (gross cpm or source qlib. Check Of Temp. (add'! Info: inst. Condition, etc.} Time uRem/hr) Time uRem/hd gross <;pm current (YIN) check (oF)
- or uRem/hr
{Y/N) (Y/N) i I ! i I lf~/10 <;,,..... . Ii.-.) J;..
- .~
"' '.~.....,_,,,... '1 / Ratemeter
- l... \\~/r. J.11,.';/Lh°'
I Wlt \\I\\ \\../ ...,4 lj
- Otf tP/
- II I "
I *Ratemeter ll ~ i '1..,n, I w-:t"'* I tCi.5 ~fi-~1
- J
\\J I .... j Ni:t( 1f ~.,; /~--1"?1'7 ~i?. VVHi,. I l Ratemeter i,,,*... {c<:; £I ot'M t W\\;L>I l.ftf ()l/f,L.M i/" w -~J I :;.-;..o 'FO. Cf., T(,.. ~);3.l_.Vi~~ I ~l'!l~ter I W"1~ (ii\\*(ol C:.,""' i i...i\\:"' S\\ff'ls 6:,,,,.. '(/ y y /.-:J.~5" Q* r'"*<. *a \\'3 f.(/ {i!f;,_~
- l
.5]>.~ I I I ';?- 1 Raterneter i Ratemeter __j Bicron NA NA -*---~ ~icron NA NA l.8icron NA NA
- 1.
Instrument aesignated check source is listed on calibration sticker. Rei.:9rd*checl: source respons!! (net cpm) prior to*fleld deployment for.all check sources being u~ed.
- 2.
Source and Background count rate should '.be determined from the average ofthree*statlc counts at tile same location. Repeat counts should be within 20%. lf cou11t rate <ftvernes
- significantly, perform addttiqnal cqunl:; to ewluateinstrument.stilbility I
Instrument Field Response Check Log
- 1.
lnstr!./ment lt.lis!cmation' Ratemeter: MakeiModel: LUDLUM 2241-,2 De~ector 1: Make/Model:....... tUDLU!YI :44-10 Bir;ron MlcroRem Meter: Serial No. 2G.:U37 Serial No. _efLU1:!2L se,.ial N(l. _bll,_._g.... u_~
- 2.
Ch~~.!!mi 1ntormatlon: sovrce I Isotope; Jo-232 serial No.: 116 Activity: <0.1 __ units:.JJ£L. Coit Due Date; Bl4lJ,§ Assav Pilte *.1Z/..3Q/10 Rev 110/18/lS Respon!>e Acceptance Range ( i/*20%): 1.inem/hr -t7.0%.'.b~.... 11Rem/hr *20%-.J.L. .re-tcpm +20%..2i926 AJ!lttpm *20% 1:?284 ..Source 2 rsotopf::.Q:l~7... _senal No.: J.2E13;:.AfL._ Activity: Q.Q2 units: J.lCL At.say Date: J..ll!J/J.0 CRe~ponse A~ce_~~an~~ R~ng~_l*+/:~0%f' _u_Re.m/hr ~20% __. . -* u.8.~111/hr_ :2Q:i;, _____... .e:cpfT't.*:.20%~13.315_... ~,cpm*20%._823,S,_.. -":"'-***-.~...-.~...... ~.. *~*-*1*---.,....,,.-............... _<:">"'.-*-l':-*..-;:;;-','"'-,.-*l"l':"*"-""'"*'"'*'*1~'~:'.. ~***_...... \\'T"'t-" : *..,......,...~-~.~ .. """~ 42L-ft---~'---~...,.....,.., _________ ~-**'I... ~~ i Jnstrume11t field Re.sponse* Use Acceptance Criteria
- Ambieni Temp.
f'f.) Remark$ Initials and Coinments (add'l*lnlo:.inst. Ci::lndition. etc.)
i j I I Rev 110/18/15
- 1. Instrument lnformatlon1 Ratemeter:
Make/Model: Detector l: Make/Model: Bitron MicroRem M~ter: Instrument Flel.d Response Check log Serial No. :J,d(..o4 ~* Serial No. '?IRt I ;LC:,.cf,;;i Serial No. l (,: -~ 2 Cal. Due Date: ~6 Cal. Due Date.: 06/1.J!/f(
- 2.
Check Source information: Soµrce 1 !sotope:'Th-.2-~;.2-Serlal No.: -(I { Activity:..::~*. I units:~; Assay Date;Q/z/0 Response Ao;:eptance Range (*t/*20%): uRem/hr +20% _'-l_( _ uRern/hr -20% '21 rnrt ~m + 20% <:; ~7?...;'!i.nnt cpm *20%3St(*~ Sovrce 2 Isotope: c~.. i 71 se.rtai'.No.: ! I ~(J,2~1)- Activity: OJ*' ::r* un!ts:p: C:,: Assay Date: NA Response Acceptance* Range {+/-20%): uRem/hr +20%__ _ uRem/tir -20% _~ ~ cpm + 20%J,3'.%-7:? it5 cpm -20%,?f~1 3.. Technician/Worker.Performing Checks; Name: 1 f?.~Mh
Title:
-12..c .... *_*T __ _ oate:llj.J'fc rim~: cJ1c;; I Whe>P'>.
- 4.
Site or Location: Site/Jo~: A-,.,,~.... L/.~./i, S locatjon D~scr.lptlon:
- A I
(~ I I C:.' GPS Coordinates (when required): X*Coord: '/V ~:.?: ~{ >"lf6'l-Y-Coord; W 7£ "'1:5' Ll~CN'J'"' 1 j Instrument Field Response~ Use Acceptf,!nce Criteria Remarks Meter
- skg Bkg Counts Sol.lrce Source Response 7/* 20%
Inst. Battery Time Ambient !nltials*and Comments Cnt (cpm).or Cnt (gross cpm or
- so11rce Ca lib.
Check Of Temp. (<idc.l'l tnlo;lnst; Condltlon, etc.) Time. uRern/hr) Time uRem/hr) gross cpm current {Y/N) check efJ .or uRem/hr. (Y/NJ (Y/N) ?_;. i k:. '?( '""" v Rate meter '"""' I J<JI ~--.... Lf.J_ 7 l/ tf C#IJA \\/ v D'1$ 7 37 "' *lb**.. ? ~.z. (/£.. Rate meter I I"' tr.. ~ r c.1~~0~ J.,.... "V">. 5f '17 <; ;.. ""~ 11../ l...1 Iv 1i/i.o;;.... '?"1. :; (' '... f~*?l/./J~ Ratemeter hu,f"\\ b 'f.Jt ;!#It.,,..,.,,)A t..j rfl-.1'1/ S--,;; h'IVI V/ 4 11<:-c;. .'f7* - 7 .,..} ~--.cJc;- l I I l 1 I '£5;. r. <) l Ratemeter I mi.... !.4'2.u <~n-. I~ 1*1-- ?'i"~o ~,..... '\\/
- VI
-~ l/~r,c) Ills }"'.c.. **' -?- 7 :hi:?: Rate meter I #!A,)"' f. l 't 1../),YI *t *IA *;1-. Y t; 7 {. j°>: /}M tJ' IV \\}'.. ~¥60 iµ7 I" _:n7* Ill - 'J 3~J.. Ratemeter f t~;h L;l~°\\ c'., 1,c.y. *,,_... '1;"q ~<( r"~"'**A if {, ~.,, rNS'if fq_?~t:> *._;.* 1-S I '-;::t),7. Bier on NA 5,,.~..If'.,.. NA '""'U"" 01 11/ ~l /v
- ')~0
'-1'1 {)CJ In -.;i.-sr a~ i 1i *"g..,.pr-1/'**v Blcron NA '- i!/f~1..'fh,,r NA f,, :<n 11..i---
- ,../..
...J t *Lt 1.'-j '-{ 4-r-f 'L /'" Ti,,...;,) J.2,..q-~ i I I I \\...../ I Bicron NA NA .. I: )i"!t'-/k oz:- Instrument designated check source is !isteddn callbra'tfon sticker. Record check sourcere~ponse (net cpm) prior to field deployment for all check sourci!s being used. ].
- 2.
Source and Background count rate should be.determined from the aver~zc ohhree static counts at the same location. Repeat count~ should l;i.e within 20%. If count rate divergf!s significantly, perform additional counts to.evaluatt> lnstru rnent stability
~---
Appendix E-lnstrument Check Sheets December
q~-....... '*:-::..&.l~T$ MJl"<;-4'
- Tef!aiP>fill:~~ll-.Y:l6'il: U-'#CllE'.$'
Rev 110/18/15 lnstrument Field Resppnse Check log
- 1.
Instrument lnformation 1 Ratemeter: Make/Model: LUDI.UM 2241-2 serfalNo.....262237 Ca!. Due Date~ 9/.2./J.6 Detector 1: Make/Model: _LQQIJ.!MM.:...1Q __ Serial No, _£R..ll1122. Bicron MlcroRem Meter: Serial No. _[QJ.fill_-__ _ Cal. Oue Date: 8/4[l6
- l. CheckSOurce lnft:1rmatJ211:
source l Isotope: Jh-2~2 serlal No.:.11§ Activity:.5.QJ... _ units: __JJ._ci__ Assay Date: 12/.3{)/10 Respon~e Acceolance Range (-i/-20%): uRem/hr t20%.3:~---*- uRem/hr *7.0~(, L:L_ a.et:cpm + 20%--2._292_6 ~ cpm *20% 15284 5ou~ce 2 li.ntope:.C.s.:13Z __ 5ef,ial No;:....81.£13..::!l.a.......... Activity; Jl..Q2_Ul)its: _µ_Q_ Assay Date: J.L2.QLJ.,O Resporise Acceptance Range. {.,_/-20%}. uRern/hr +20% __ uHem/hr-20% ~- t!..et cpm *"' 20%~S-q~cpm~20%_~:;l.:1~.*. _
- 3.
Technician/Worker Performing.Checks: Nam:.,?.1~\\.fff. ~U:l6:.t1"' tJ ntle: r; c-r ,-~:-... :-..-------- 4, Sl~t:..:.o.LL9!;9.t.ion: Site/Job:~ S Lnc<ition Of.isr:ription* &r:-ctf) II D -"----'----------~- GPS Coordinate~ (when required): X-oord:,.}./_!f.l_"J (£'(.~-- Y*Coord: W D/'l Oo1 S:r(J.. __
- ----~-
~--*--~-*-- Mete! Bkg Bkg Counts : Spurce Source Respons<* +/-.20% Inst. Battery nrne Cnl (cpm) or Cnt (gross cpm or ~ourc~ C;ilib. Check Of Time uRem/hrJ Time uRem/hr) gross cpm current * {Y/N} check Ambient Temp. {°FJ Joilials end Comments .(add'!l11fo:,lnst. t:onditio*.'. etc.) ! (/111,v) I r [fi1µ) or ~~;:i/nr (Yif>J} 'Rate'~te;'tr~j~d~_:r~~.-.r:..=7"""_ -""'v ""'1"'-"1"""_~"-""Z!!:l"""_~-y_:_""" __ ""'_ --..... ~"""""......._.~..... 1\\>!'*~=;o-"""""'==i1=~"""""~=="""---,.._..,~..................... { Ratemeter [ (,,. '* .'fl.2-~.. '-('~'... ~....Y..... _ R~temeter I 11s* c-I C> g- < / Ratemeter L_. __J_}£.(v \\II. J_t_,.-LL15'~ _0:1_h..,..* -~-------- R..~~~.f!!e~~~-- *. L... _£_} '1 ),Y* ')_. _ (_ __,,_.. _.l...tlJfP... <.:c ~.t;~ Ratemeter I {' 11 c "' f z_ V 1.. *~
- ~~~~--*--*-~NA.
-~ __ 1__~:: i;~--- i_,,_ 11... ~J::k: I 7.10 Bicron ~ ~A _L}_~<<~ :-,, ....... \\C1RJ G J. lnmument d.;si.gn;ite_d check_sourc~ is li:aed on c;1fibr;:1tion.r.ticker. Record check sourr.e response.(n~t cpni) prlqf to (1efd*dep!oy1mmt -for all ch11ck souri:es betng us(id.
- 2.
Sovrct' and l.lacl.:grour>rJ count. rate sh1J1Jld be. delermltrnd fr err th~ average of thrn.e 5tatic i;ounts llf-the sameJncation. Fle:pi;-_at coun~ ~hould be within 20",t.,. If co11nt* rate diV1::1ges sit:nificao1ly, pi;rforrn adc.l1tlonaJ 'P*ll'lt5 lo ev<Jlv~te io~trument~~ability
---~_*\\,f.J.JT.$ ~ WW 7f"~IL ..l>a'il"l-/#Ce:s" Rev 110/18/15
- 1.
ln$trument lnformation 1 Cl Ratemeter: Make/Model: Li.-.dwii.J.)t//""').. Detector 1: Make/Model: r:;;Jl;fl" Yf ~(tf. Bicron MlcroRem-Meter:
- z.
Check Source Information: / instrument Fi~ld Response Ch eek Log Cal. Due Date: 6*'ivJ.'1. Cal. oueoate: Ot~fl/1' source l isotoper!1--J..J2. Serial No.:_ {I Activity:: CO. 1 units:~** Response Acceptance Range (+/-20%): u.Rem/hr +20% _.:u_ vRem/hr -20%~ Assay Date: l>fa)16
- ~.cpm + 20%G7"1!
- o!m'tcpm *20%3.5)',;;;c;;.
source 2 Jsotope:(s-!TI Serial No.: H1£?~-J 2 Activity: * ~ units:~ Ass;.iy Date; NJ'i Hespons~ Acceptance Range (+/-20%}: uRem/hr +20% ___ ~- uRem/hr -20%...____ -~cpm + 20% ;?,J7?: fl:at cprn <lO% ~ lf'-17
- 3. - -'Technidan/y.'~1,rt Perf~rminR Checks: -
Name:._T.E.., i<<wl-1_ r1t1e: __ R_-_c_*._1_,*-....,..__ Date:f?{Etjtf" T!me: O'PO
- 4.
Site or location: Site/Job: ;t-...... 1' '1 c.(_ <.. ---- I Location Dcscrlption: __ __,W"'-"'=o"-'o'-'-c-_,_s _____ _ GPS'Coordlnates(wlieMequired): X~Coord: JV.t../,) 6Sf ff'/. {'t>)' Y-COord: kl/ ~cg 'qf.Ci'/1. 11
- l.
Meter Initials and Comments {add'I Info: inst. Condition, etc.) Skg Bkg Counls Sourc:e Source Response +/-20% Inst. Battery Time _Ambient Cnt fcpm) or Cnt (gross.~pm or* source Ca lib. Check Of Temp. nme uRem/hr} .Time uRem/hr} gross cpm current. (Y/N) check ('f) Ratemeter Ratemeter Ratemeter 1 Ratemeter . Ratemeter Ratemeter 1 Bicron Bkron l Bicron
- 1.
- 2.
or uRem/hr (Y/N} (Y/N) \\. i ' i I l
Instrument: Field Resp~mse Check log Instrument Information~ j Ratemeter: Make/Model: ~l1.1w-.. {)J Y f- 'f.). ?erlal No. _;)~G-Gj? Detector l: Make/Model: { r jz;;;;:Y?/"i o Serial No. 'Pfet 1.;;G~:;>, 8i<:ron Mh:roRem Meter: Serial No, lGf'if 7
- 2.
CheckSource Jnformatlon: Cal. Due Date; o~;!-1/!c. Cal. Due Date: 6l")rUjb.e:. Source 1 lsotope: *Tb:J.3).. Serial No.:..JI (... ActM1y: -<c. 1 units:~ . Response Acceptance Range f +/-20%); uRem/hr +20% ~ uRem/hr -20% 21._ -flet_ cpm -20%.3.5&;.l:;c. Source 2 Isotope: (.~ ()'{ Serial No.: 1<:r£;;2..312. Activity:.6..0..2-unltsyL. Ass;:iy Dale: !Jlfs_ Response 1\\cceptance flange (+/-20%): uRem/hr +20% __ uRem/hr -20%.~- ~ cpm + 20%.t3.27S ~ cpm -20%.SS-¥7
- 3.
Technlcfan/Worker Performing Checks:.
- Name: :r E;.iua.cfls.
Title:
f:...Cf
- 4. Site or location:
Site/Job: Arer t../. 5"...
- 1 Location pescriptlon
- ___
vv. ~~"'....,,-().""5------~ GPS Coordinates (whf!n required): X-Coord: ti. i_:),Q ).(Q Io,?. Y-Coord: l.J 7 ~,.., C~'f'.'.f: CP,~*,. Instrument field Response2 Use Acceptance Criteri.J Remarks Rev 110/18/15 Meter Bkg Bkg Counts Source Source Response +/20% C::nt (cpm) or Cnt (gross cpm or source Inst. Battery Ca lib. Check Time Of Ambient Temp. Initials and Comments (aoin Info; inH. Condition, etc.) Time uRern/hr) Time uRem/hr}. current {Y/N) ch.eek {"f) (Y/N) 1 Ratemeter
- Ratemeter Ratemeter I Ratemet~r Ratemeter Ratemeter Blcron NA NA L
Bicron Bicron
- 1.
- 2.
lnstru:~t designated check source i!l llstad o. call rati;~~r. Record chec:k source response {n~t cpmJ :prlono field deployment for alt theeY. sources being-u-se-d-. ____ ___. Source and Background count rate should be determined from-the average of thr.ee statk count~ ilt the samri location. Repeat tounts should be within 20%, If wunt rate diverges signiflca11tly, perform additional counts to evalui;te*lnstrumeot stability
Rell 110/18/15 lnstrum~ield Response Ch~ck log
- 1. }.rlstrument lnformatlon 1
Ratemeier: Malce/Model: Detector 1: Make/Model: LUDLUM 224]...:.L....__ SerlJJINo -2.,62237 blJDLQ!YJ 44-10 ___, 5erlill No. ~.E.B.. ll 1.l 27 Cal. Oue Di!te:. 9/2[1fi Bic:ron Mli::roR£m Meter: Seri a! No. _A",.""'2.;:i.4'-"U"--- Cal. Due:Date: 8/4116
- 2.
c:hetk so.uffi\\Lfil.forril~.IJ.~n:
- source l lsotopt:: lb-232.
S.ilrlal No.: H fi Actlvlw: 51)..L. units:.IJCL. Re~poni.t: AcccPLanCB Range (..;h1.0%): uRem/hr +20% __ -!:--_~)-*- uRem/hr -?0% _I_~-._ A.ssav Date:..12[.3.Q/10 mat cpmt 20%_U,.~ -Aat-c:pm-20% 15284 501,11 c:e-2 tsotopf.':.C0JJ_)ierial No.: *..8J.E.13,;,4a__ ActiVitv: Q,02 . unit~: _µc.L A>say Data: J.LWLJ.o . R.e~ponse Acceptance.Range'.(:1:/02f.)%):.. uRem/hr..+20%.""-,--~---- .. uRem/hr.,.20%. __ ruu.cprn::+_20%_r~:Z!;..,,. ~.cprn.*-20~\\._,.S9l9...
- 3.
Technlcla.nfWorker Performing: Checks: Namc*..5?rE/_(1f.1Jf.~1ti/ .d*-.
Title:
_!:-._C:,J_ _____
- ____ -*
4 5lt!0.EtJo.~attQ.rr 'iitF./Job :.-Lf...::.* -=z_=------*---*-*---.-- GPS Coordinates {\\'"{h\\:n requirr.d): loc(ltion Der.criptlon:~¥. Y-CnouJ: ~.._,,.& -z.' 2. ~,"1" tJ ~..n.v 1rr,;>1.......,,i.- cL~~ ~-. tcl".,...) .*-:~.~-~~::IT*:=-"'1,.. ~,~.:'=<'"2"'."'7~~_,...,..,~~l~~,~--=f:.-."J.;-::-- *.,;:";".. I_.,,,,...
- -~--...... ~~_...,.,.
~"'"""--*~---*~-~, ... ~ 1 lnstn~mt!(:t Field Response* ~- -----..--- Meter
- Bkg Cnt Time 1 {yuv) iii'~~~
Rateme!~--1,.-..J....
- flatsmeter.
I Ratemeter I R.atemeter I ... --,--*--r**-----....... Bkg* Counts ; Sourc.e (cpm) or Cnt. uRern/hr) Time (Jl'l1"1\\ ~~~l'.f).~~-=:.. z._~.~-~ -"-- Ratemter Blcrorl Source Response {groi;:s <,:pm qr uRern/hr) t/* W% source Use Acreptance Criteria lmt. Caltb. current (Y/N) !3atterv Check (Y/N) Time Of check Ambient .Temp. . (~F) Remarks initials and Comment~ {ac:f.d'I tnfo: Inst. ConditiOfl, m.j !)ic:ron NA 3icr_£!!_ ____ ~A '1 Mk-:2: * ""*--* _ ~--~..... --:-::~::~---=~:j
- l.
- 111strument deslgn;'lted che.;k source b fisted on t:allb adon.~ticller..Record diec~*~ou ca.response (net cpm) Prior 1.v field ci~proym!::nt for i.'111 chec.lc sau1ce5 being usi?d.
- i.
so~rce and S.atkground c_ount rate should be detem1*n~d from thr ::iverac.e nf three ~tlltic counts.:it thi> ~<Jme )11(Jtion. He peat CO\\lnt~ ~houlr:! mi witi1in*tQ%,1r cou*1t ratf.'. :liv1;:r~,is ~ignfflcant!y, perlor1n add1tionaf-ro11nls to e\\lalu<ite-in~.ti:ument stability.
- ~rs Rev l 10/18/15
' t i I l Instrument field Respon$e Check Log
- 1. lnr;trum(!nt Information~
f/ /{atemeter:* Make/Model: Lr.JfhY1 fV/.-.L Detector 1: Make/IYlodi;:l: ] ul/vN\\ y:::z;- Bicron MlcroRem Meter: Serial No. ;u.t..-&1 Y Serial No.. f?tLt lk{Jf_ )... Serial No. N {*fr
- 2.
Check Source Information: I f'( 1 cat oue Date: 01Jo frt Cal. Oue Date: Jv+/-IJ Source l lsotope:-ro.:.22.z... Serial No.:_____ Activity:.A.:._ unlts:-tU(.; Response Acceptance Range (+/-20%): uRem/hr +20% *-- uRem/hr. -20% ---~ Assay Dete:Jii-11.,.o1i ~pm+ 20%';. "";'7 ff !@'!: cpm -20% ;rn:c;, Source 2 lsotopeL.S.*l'.?'I Serial No.; l t:J.Q~ Activity: D. O;t.... unlts: ~ Msa; Date:.:t::!.A:: Response Acceptance Range (+/-20%): uRem/hr +20% ~----_ uRem/hr ;20% _r~--- m¢cpm + 20% I}): 71 m;tt.cprn-20% 9Ki'7.
- 3.
- Tec:hnician/Wa~lcer Pep.orming Chetks:
Name: 1 rZjJ..,.;,:./ $
Title:
_ecr-=-*-_. __ _
- 4.
Siteorlo~tign: Site/Jobt Azee lf1 ;;L... LocatlonDescrlptlm1:,_ __ ~ .**-~_/_-_~s _____ _ ~fS Coordinates fwhen required}: X-Coord: Al :..rt::." :V. L{;,:i... 't'*Coord: Wo 71.aW. 1V7,,,. Instrument Field Response2 Use Acceptance Criteria Remarks Metet Bkg Bkg Counts Source Source Response +/-20%
- Inst, Battery Time Ambient*
Initials and Comments Cnt" (cpm)or Cnt (gross cpm.or source Callb. Check Of Temp. (add'l lnfo: inst. Condition, etc.) Time uRem/hr) TI me uRem/hr} gross i:pm ~urrent {Y/N) I check {"F) or.uRem/hr (Y/NJ (Y/N) ~~- 'V C43'1 Ratemeter l~ q.qu.1 I' ;/t,. /,..,,_r'V\\ t/°'71).,;J ~.a~. \\.} l/ 275.t.. -n:-,;;.. -:: ;:;_.. It I Ratemeter I "';..,, '1'1 l\\ ~ 1.'I'..,,, .1 ~ ti 6i f /m,.,,,,. /...,, 0.1 ..f/* i,(Jt'-('$ ~,~-<:: t..... ~ '?7 'o~~ -n* ?_c_>:;" l Ratemter jMih. I !JLI~ ff..'""" i ""'*~ 4 (. 't:. 'l."J ":~ *..,...
- JI
...{_/ .J.J iii 'fl; 9*,;i.,;..,o f'>,..--2 :SJ 1 Ratemeter ; '='"'-'*' IC t..\\ TI.J'?Y, L~;iA Jf 1~ / l:llwi '-ii \\1 ....!/ i(J!;:"~ ii/.'J. () e /<"*~/"57 ~~- Ratemeter . I f I ,:?" 1 Ratemeter Bicron NA NA I Bicron NA N.£\\ Bicron NA NA
- 1.
Instrument designated check source ls llst?d on calibration sticker. Record r;heck source response (net cpmJ prior to field deploynie.nt for all check sources being vse.:I.
- 2.
Source and Background count rate should be determini=d from the average of three stiltk count5 at the same location. R~peat counts should be within 20%. If ::aunt.rate dlYt'!rges
- igniflc<Jntiy, perform additional.c
- ounts to evaiuate lnstrument stability I
j I I I l i I i l I 1
lnstrume~Field Response Check tog
- L
.!W>J:rnro11nt tnformation 1 Ratemeter: Make/Model; LUDLUM 2241-2 Detector l: Make/Moctcl: _(t;;Dl~J.. &L4!:l:liL~- B1cton Micronem Meter;
- i.
~heck Squrce lnfonnatlon: Serial No. -1fil.]_32_ Serl<11 No. _£fl. llil22 Serial No,..;..822....:.11.-U __ source l isotope: Iii-Hi: serial No.: llG Activity: s.Q.,l __ units: iu:.L Re~pons.e Acr:t!UtolKP. Range V/-20%): uRemihr +20% :~.:!....,_ uRem/hr *<10% -1.:.L_ Cal. Out> Date: 814/16 A5o.ay Dute:.W.3.Q/10 !!!Scrim -1 20% 2292§ a:P.f.cpm.. -20% _li284 sourcB 2 l~otope:.C.S.:.3.~Z..... Sr-rial ~o.:... 81£.13~g.8....._ Ar.rivlty: J1..Ql._unlts: _JJtl_ Assay Date: J..LZQL;lO .Respo'lse.Ac.r.e.ptanr..e.R8r;ge.{+f* 20%):,, uRem/hr.t20% *---*'-**-.. oflcm/Jir *,:JO% *---*-* _.. ~1-1.:pm :t i0%.J3l.Zt.:.....~.cpm,.;(0%.~ Sn!L.*..
- 3.
Te£!mic:la11/Worker f'erl'orining Checks; Niime:,.::fci_ 'bo.'"O!..~-- ___ _ Title...... /Z~.I-*-**--.
- 4.
.$1.t~ pJ,l.o_c_atlQr'.1' S'!e/lob*_....,_':£,.f:_.. _... *-... *----... --.. **-- GPS Cocn.liMW~ (wht-11 req~iretl); X*Coord:_.~ :!1,~}~'....:.lfi!~.--- R.ev 110/18./15
?TS' ~*-._,,, T~L SG"<<'.V~ . Rev 110/18/lS Instrument Field RespQnse Check log
- l. Instrument IJJformatlonl Ratemeter:
Make/Model: Detector 1: Make/Model: Bkron MictoRem Meter: Serial No. di ci i:;a 1 ~ Serial No. "7-ffllf:~/ 'I~ Serial No. /tf'i
- z, Check Source Information:
~
- Source. l lsotope:"'t/1\\-.;>p *Serial No;:
ff l ActiVity: ~. 1 units:~ Response Acceptance Range (-r/-20%): uRern/hr +20% _!.J_(_ uRem/hr -20% 2=f Cal. Due Date: P'1,/0rf.c., Cai. Due Date: w 4 Assay Date; -!lf'/r_~o ~cpm + 209' q ~ cpm-20% ~~C Source 2 !sotopel5- ( 51 ~Serial No.: {f'1 £,)7{./ J Activity: 6. c..2 units:f.Ll.- Assay Date:.J::!A..
- Response Acceptance Range (+/-20%); uRem/hr +20% __
uRem/hr -20%...:.._ ~ cpm.,. 20%15.)7?' am_cpm -20% ff) 4 f Date!)/!:J/J. S-Time: 0[~$'"' 7 I f?(**-r Title;_!_'--.__ ___ _ ~* 0
- 4.
Site or Location: Site/Job: lf/'<?11 lf. / 11 Location Descrlptlon:
- vva(;d')
GPS Coordinates {when required}: X*Coord; A/ 7,)... :!:.-2 :27~{72 Y*Coord:W ?go SV 1 ~0...:i,.t\\,2 --~---.....,,.-~~----~-~-.,._~~=---....,.---=-=-~==~....... ~.~---~-*-.,... ___, __ ~-~=--------~~----""""1 lnstrumentField Re.sponse2 Use Acceptance Criteriti Remarks Meter Bkg 8kg Counts
- Source Source Response
+/* 20% Inst. Battery Time Ambient lnltlals and Comments Cnt (cpm) or Cnl (gross cpm or .source
- Calib, Check Of Temp.
(add'I Info: inst. Condition, ~tc.) Time uRem/hr} Time uRem/hr) gross cpm current (Y/lll} chec\\i ("F) j * ' or uRem/hr (Y/N} 1~""*9=""""~==:="'*°"""'""""'"""""*""~'!""';>==="""4i=mi(.ieY/""iN....,,). ~=""""'=~="""""=>-!: Ratemeter Ratemeter i Ratemeter ~atemeter Ratemeter Ratemeter
- . Bicron NA Bicron NA Bicron NA
- 1.
lristrurnent designated check source is list on caObra ion sticker. Record chei:k source response (net cpm) prior to field rleplovment for all cheek sources being used.
- 2.
Source and Background co~1nt rate shotJld be determlrycd frorn the,averege ofthree statlt: couuts at the same*locatlon. Hepeat counts should be within 20%, If cmmt rate diverges s1gnlf1C<!ntly, perform additional counts to evaluate instrument stabllity i j
- fl!~"'--"*~
- -.....~/'lJ"'!!j£ MJ.,,_~' T~.'f../S. !f'51C'V'¥CES Rev'.!. lfJ/lB/15 Jnstrurn~ield Response thei;:k Log
- l. Instrument lnformotion 1
- Ratemet-er:
Make/Model:. LUDLUM 2241~2 S~rlal No. Z627iF Oct!?(. tor 1: Muke/Model: _wp~!JM 44-.10_ *.* -~... Seriiil No.....E.B llll2L. Blcron:Mi,rcRem Meter: SerM No.~ Cal. Due Date:.BL4l16 '2. Check Soo..n;e lnfi;:rtnatlon: Source 1 Isotope: Il.l=llL_Scrlal No.: _116.,.___ Actlvhy:.s..QJ-.~.- units:.i.u;L. Ret,.pon~c Accc~Lance Range !-1/:20%): uR<?m/hr +20%.* ~~-... ul1em/hr *20o/...__tl_,. As-;,ay Date:.J.i/fil)}lO f.$ cpm -t 20% 22926 _ ~ cpm -20%.15284 Sourr.!~ 2 Jso!()pe: _C.0;l7~_5f'rial No,; 8lEl3-~8-...
- Acthrity;..Q..,Ql__unlt~:..JM:L A~S'Jy l'l~te: J./JS)jjO
~r;i~pcn:.~_A_c_ei?ptanc~ R~~W-' _1+1-:~PJ:): uR13m/~r.-1-20 1 X~ -,--_.-.-. uR_crn/hr_-;:.9~!_.,...-=---'.':" ~c.:pni -t.iO%~.Jl~.,-.- ~{lL9*:!1_1 *W%,~$!.?}..... 3.. B?.~JlQ!ci~n/Worker Performing Checks: N;m1c::.F._(.£1(f-:.J9t1..fJy.LJ-pJ
Title:
.,C/-. r_ -------
- 4.
~,!;~_?LL9.\\:.i!~icm: S,te/Job:_tf*_*. -*--* --*---- *--*--*. Location,Df?r,<:riptio11*...Jt!J.m)__s./.fi.LIJ1]J:__ _____...... __ .GPS (.oordin<i!~5 (whim re'luiredl: X*Coord:~J2,~.1-J.' J,f',H__"_ Y*Cuord:...,J ()") 'r".{'/'.o,.1, \\'
- --..*... :-... ~ *:.... -.-'!:'!'""*'T"'!'"'!" i.<n-."'°r-'* ""*'1"'-Nl"IT!:"U"l'~"'.;oo"~ **~r.;rr*.*r.-r---*,,..,.-. -* _.,.#,.......,.. **. L"'"f<r "*** *
- ,"'\\o**,.... ~
- .,.,.-;e-.... *.-*..,-.-.,,.....
~....,._-....,.,...~.-..__.....,, sa~1~,,.,._ 1nsrrumeritr:ield Respcms1i Ust! Acceptance Criteria Remarks Initials and Comment:.
I I I . 1. Instrument Field Response Check Log Instrument lnformat!on 1 !/ 1 ,1 Ratemeter: Make/Model: l v// (,.*µ. J,?{r** 2 serial No. '2,at.:..01 S-Detl:!ctor 1: Make/Model: LJ.)f G-.m '/f/.~i() Serial No. t?J\\'(f l::C.t/ ;z.. Bicron MkroRem Me'ter; Serial No....J.!LD_ Cal. Due Date: P"V 1 ~:,ftt. Cal. Due Date: z>}#J,£6
- 2.
Check Sourcg Jn formation: Source llsotope;T/,.,?jJ serial No.: IC ( Activity: 4.0- 1 units:-~* Response Acceptance Range (+/-20%): uReni/hr +20% _4_1__ uRem/hr -20% _lJ._ Source 2!sotope:C~*137 Serial No.: l (C, t;-t~* r i.. Activity: 6 *l)2 unitsyLC Assay Date: µ.e:_,. Response Acceptance Range (+/-20%): uRern/hr +20%_*_. uRem/hr-20%~- ~ cpm + 20%1:5.,:l 7 % -1_cpm -203 ix"f 1-
- 3.
TH!e; (Z(..T Date: t:.jf¢f Time: D~:S""~
- 4.
site or Location: Site/Job: ~rf?, il, / /.'5Et2. Lo~tion
Description:
~oc.62> f{1t:,;f:.Ji.-1 /g1-GPS Coordinates (when required;: X*Coord: //vJ-V.$//7.n~' Y-coorc!:W7'6'f""1 }!.,:S>.2 t' I ./ Instrument Field Response2 i Use Acceptance Criteria Rev 110/1~;
- Meter Bkg Bkg Counts Source Source Response
+/-.20% C11t {cpm) or Cnt. {gross cpm or source Inst. Battery Calib. Chetk Time Of Ambient Temp. Initials and Comments (add'Llnfo: Inst. Condltio~. etc.) Time uflem/hr) Ti.me uRem/hr) woss cpm current (Y/NJ. check (oF) oruRem/hr {Y/N) (Y/N) Bicron NA I NA 1f!.;l.ia1.li(' 1 1 f I -}'..
- ---...,..-*_j
- 1.
h\\strumentdeslgoated check source.is lisJ ed on /;;iii :iratton sticker.'!1ecord chec:k sour~e response (net cpml priorto field deployment for all che~k sources being used.
- 2.
Source and Background count rate.should be determined from the a11ernge oHhrei:.s~tic cou11t5 at the same location. Repeat counts should be1withln 20%. If co1,1nt rate diverges significantly, P?rform additional counts to evaluate instrument stabiH_ty
1------
- 1.
Instrument lnforinatioril Ratemeter: 'Make/Model: Oetector 1: Make/Model: Bicron MlcroRem Meter:
- 2. Check Source Information:
lnstnunentField Response Check L~ Serial No...... ~c.c:~ Serial No..ecJ(>l'f "2, Serial No. /4Y'1 Cat.Due Oate: e>.f<<//!tf, Cal. Due Date: o.C../1.",f £.C Source 2 lsotope:{s.... 13'7 Serial No.: / j~tj;r-O .Actlvlty: y.. o~.:_units~Assay Date: Li.//t. Re~ponse Ac.ceptance Rang (+/-20%): uRem/hr +20%__ uRem/hr~20% ~ .~ cpm + 20% /:?22?'..fli! cpm.-20% ~Z'.:-, Instrument Field Response2 Use Acceptance Criteria Remarks Rev 110/18/15 . l Meter e~.g Bkg Coun'\\s Cnt (cpm)or Source Cnt Time Source Response (gross cpm or uRem/hr} +/-20% source .gr.css cpm oruflem/hr (Y/N) inst. Callb. current (Y/N] 6attery Check {Y/flll Time Of check Ambient Temp. (of) lnitiills ;.md Comments (add'! Info; inst. Condition, eti;.) l I
- 1.
'Ratemeter I Rate meter. 1
- Ratemeter Ratemeter
!_Ratemeter
- Ratemeter Bicron Time vRem/hr)
Bicron NA
- l.
Instrument deslgnated check so.1Jri;e is.list i:l.on ta_li ration sticker. Record cileck source respomie (net cpm) prior to'field deploymem for all chll~ sources being used.
- 2.
Soun;e 1md llackground co1.mt rate should be cleterminecl from the a11erage of three sti.1tlc count!i,a~ the sa'me location. Repeat counts s hoult.l be withln 20%. 'lf co um race diverges significantly, pf!rform additional counts to evaluate Instrument stability
~~ t..t~~/ T~fl.. $rd!!!R'¥M:ES> Rev 110/18/15 lnstrumerit Field Response Check tog
- 1. lnstrument-lnformation1 L J Ratemeter:
Make/Model; '~*',J,)'f /- ). Detector!: Make/Model; l,.d:le l/'r ',/If Bicron MiuoRem Meter: Serial No. ~Ot:;:-Clllf.((" Serial No. f [i:- I 1~5' r Serial No. {if$ 7 Cal. Du.e Date: trf6~ Cal. Due Date:_¥;&',c ~~~~r Source 1 lsotope;'i ~~~~Serial No.: _tl~I ___.
- Activity:,c..() J units; /efd_
Assay Date: t.:i/Jr:./fc. Response Acceptance Range (+/-20%): uRem/hr +20% _W_I _ uRcm/tir-20% ~ £Sa cpm + 20% <i!:"l'!Y -e:m cpm -20%.:?S")'GC Source z lsotope:Cs. ~/?1 Serial No.: 1110~ 1*;i.. Activity: Q,c.:i.. units:p('LAssay Date: AJA-Response Acceptance-Range {+/*20%): uRem/hr +20% __ __ uRem/llr -20% ~- ~ cpm -t 20% f ~.2 7"~ mg c:pm -20% Sq 4.C, r-~--~~~~~,__,_,.....,,,,._,~~~~~~~"ll""~~....,.,~-=~~--.,.,...~~~~~~--...... ~~~""""'~~ Use Acceptance Criteria ~ Remarks Instrument Field Response i Meter Bkg Bkg Counts Source Source Response 1 Cnt
- tcpm).or Cnt (gross cpm or 1
nme uRem/hr) TI me uRem/hr) i I I Ratcmeter 1 Ratemeter Ratemeter Bicron Bkron NA Blcron NA
- 1.
- 2.
+/-20% Inst. source Ca lib. gross cpm current or uRern/hr {Y/N) (Y/N) Battery Check (Y/N) Time Of check Ambient Temp. (oFJ : Initials and Comments (add'l lnfo: inst. Condition, etc.)
-~"_,.,.__ ,.,""""'~***-**!l*..:W.
- 1..
lnS:trum~!U !nform@tlpni Ratpmetf!~~
- Make/Mog~l~
DcJei::tof 1: Make/Model: f3.ic~Pn -Mic:roR~m Metll'r-: l.. :fbeckSopretJ lnfo.rmatlon: lUDLl.:JM 224:1-2 SerJalNo....2fJ.21'fl.1 ~ . LVDW)M !lfl:lQ.~=~: Seflal"No. _Eli il ll2Z SP.flr1I No;~~--- cat Due Date: _W]JJ... 6. cai: oueDate:.8j4fl6 Sour,<:e) lr.otope: Ih-232 serl"IJllo.;. iJ.L....m~* Acd11ity:.;Q,,1__ uni.ts;,p~L.,... Rf!'>µOni>e Ac~eP:taQc.~ riange{+(2(l'J";):
- ufle rn/hr.;;2Q 1i~ }:E,.... _
1.1Rem/hr *20% ~4-Assay. Date: li/.3D/1D. i:.wtcpm.+.?.b%_~~ * -@!!': cpm.:zo~i..'l,2,2E4. sm.:rc~.2 lso\\op~... C.s:.W7..,S.eria! No.* ~...81.E.lliL-l;,l.tivity: JUll......_unlts:..w.;L_.Msay Date* Ji.:2sJb.o ~Clspo_n~r. Ace¢ptan.c?*~nge ( ~/-20%): *.uRerr1/hr+20~'.~.'---. uRem/br,_2o<i~ -*--"'-* ~ ,cpm.~**°20%.,.1.UlS,.. ~ q;ru -:.:ov;.JWl9....
- 3.
Technicla.1Jj,Wg.!ls@r e~ri'ormlng Checks:*. Name:::;\\@.:V.(.:b;.:'.~~.:i.!~ Date*. t:Jr.;. 1t*tJ1me: c.J.i:f(:~*\\) .*... ~,.. t.,-.tL~............. ~-- __ _ ,1' ~~~.Pf:l~c;ttjqn: Site/Jo'i-r __ /*/J. _ _, ______.,.. ~--.*... *~.,~~-~ locat!qn De~~ripUcin: t-... 1Q cc...*. '-J?_.$:::;._ __ _,,_,_~.-~.- -*** GPS <:oordinaW1. {wl1e11*r1?quire:d); X"Ccord:~~~)r I~:-.-. - v~c1.Hud* w ;"]_,~SCl*'S~_i ci_*.. Rev i-'J..rJ/18/lS .* ~.:....,,,,.~~--.._.... 1"'..;,.,.,.11:!,,._,-,.,, ***,......,"'~-~*""t... *::.a..,-... _,1... *.,~*.i:--~*...,*;~x...... *"'Jl?!""'i'.,,,-~-* ,.*~~-~~':"::1i:*~~>r.-.l'l"tT~r11>f".,~.,..;...~=~--'--------* J lnstrumerit.Field l~esp.onse' Use Accept<lnt:e Criteria* M.'-ett.>t*
- Bk~ 1 *u1'&;.Co1,1n1£-~sc.iur.ce
- s_our.~e Resp_ori_i;q
.
- Cnt (i:pm},or Cnt
[gr.os:;cpm o.r iime uRem/hr).
- u~em/hr}
+/-J!O% Remarks Jrntta1s* andcC0111ment5 (<Id~'\\ Info: ln5t. Condition, etc,~
.~YS ~ Ttt:-c~.A11...~v~ Rev l 10/1B/15
- 1.
ln~trument lnformation1 Raterneter: Make/Model: Detector 1: Make/Model; Bicron MicroRem Mater:
- 2.
Check Source Information: Instrument Field Response Chat:k log &JICl'wd..?f /.-j, 1_..,71,,,~,.._ 11'/.*-'-I tJ Serial No.fi0Gb'1f? Se~ia!.No. Pi:..!f ;i.6'f2-Serial No. (t.f F 7 Cal. Due Date: 0 ~'> ~ Cal. Du~ Datil: f2C;/!1j/7.::o Source 1 lsotope:"lji *l.2. SerlaJ.r>Jo.: (( l Actlvity:..:::0- I units:. r._,,C[ Assay Date:l~/:so/<5 Response Acceptance Range (+/-20%): uRem/hr+20%~Lj-I_ uR.em/hr-20% i.+_ iu;tcpm*~.20 b921'? ~cpm -20% 3S"Y~ Source 2 lsotope(:5 )57 Seria.I No.; lJC/Vz-!:2-Activity; 0: °:;2. units{L:(:.* Af.say Date;.A/k Response Acceptance Range (+/-20%): uRem/hr +20% __ uRem/hr -20% __ ~cpm + 20% l"/27"~ *it cpm -20% ~'lr.r7
- 3.
Technician/Worker Performing Checks: Name:.7' EJJ....,..:..r.;f ~
Title:
- 4.
Slte or Location: Site/Job: GPS Coordinates (wh.en required): Instrument field Response* Meter Bkg 8kg.Counts Source Source Re.spons~ Cnt {cpm)or Cnt (gross cpm or Time uRem/hr) Time uRem/hr} . Ratemeter
- Ratemeter 1 Ratemeter Ratemeter Ratemeter Ratemeter Bicron Bicron NA Use Acceptance Criteria
+/~20% Inst. Battery Tl me sourc-e Calib. Check Of current (Y/N) check (Y/N) Ambient Temp. (oF) Remarks Initials a.nd Comments ladd'I Jnfo: inst. Condition, etc.)
- 1.
Instrument d gn.<ite check source is ll!;tftd on call rat!on.sticker.. Reyord check so. rce response t et cpm) prior to field deploymentfor all check so rces belng used.
- 2.
source and 13ackground count rate should be determined from the average ofthrue statit: counts at the same location. Repeat counts should-be within 20%. tf count rate diverges signlfkantly, perform additional counts to evalui;it!:dnstrum.ent stability ~------ - I I I
- 1.
lnstn.mi~nt l.!!filrmatio,n 1
- r~ateo*w1e.r:
Mr*e/Mo.d?.l; [;r.:tecto,r l: ,.:fak~/Modal: Bicr9n.f\\/Jlc.rpRam Me.~~r: .~. ~Jw:.1< Som.cc lnfor111,ation; LUDLUM 2241~2
- SerlalNo.~
L!iQt.UM 44,w:...=:_ Serl<il:No.,_,_£R1 ri12:t ~~rial No.....A42:~:4l:J~* __
- ~ov.rce i lsotop~~ Ih::l3..z._Serl~l N.r,;i *. : JJfr
/l.ctivhy: j::OJ....... units: ~&:i.* R.e~;icir1!f.:' Ar.:c'!~'t>>nq* H~riga i:i/;'20~): u.RP.m}hr+i0% :'!::.~~-- .uHNp/hr ;,?0% *.Ji_ Cal *. ()ueQatti: J!LUJ.§ C,<il. Du1;1 Dal~: §L4(1tj it.ssavr.w 14!:-.12l'm/10 ~ cp:m>~*:!O')li 2,?926 ~cpm *20"A 15284 Rev 1101'18/15 $~;,:re~} lsornp;.1; ~Ckl31:... :serial Ne.: *...81..E1&9.1l.... -1\\ctivlty: J102.,~--)*0ltS; J.ii:L*A~s;)~ Pa!>?'..lLZ.Ol:lO Ri:spo~:.e/.,r'cept??c: ~an~eJ+/,20%) -~~P.~ri:Jh'. _+W'~ ~- _... 11.R~.rn/hr -~piv.*.*:"'.*"'.<* ,~~ ~p:;:"+.:::~~t, +.~~:. ~*G.?~ :2'.~71,:.Jl~l'.9-..
- 3.
Teffif.llfl~.l:!LWP.,L'~~r*Perf arrolng Chee~: Nar:-io:;f,-,Y{~;?':'?~ 4 ~i~.9! W@t}RfJ:. S:te/Job;.'-,£"' J,,; ___ -~** ***--._,........,_,.~* JocnHon* D~':t:i'iptlru~*__;,0/()VQ... S".__ ___ __,,_ ____,....... Sitrpn GP.S*CvOf,UllH:M' (v/h~n H!QtJjr,edl: XA:'.q910.*. ~~.z~~i:zo....,;.~-- Y-C{~or.d.* \\N 7fi..'.:~~.J~-"--* Source r1~:.pG1tit~, 420% lfl~I. j*: 6arterv {grosifcpf"l or. source: Qllib. Ghee.I\\ uRem/li1) -gross~pm
- cl.immt*
(Y/N) pruRem/hr' (Y/N)
- nm!!!
Of .cli~ci¢ ..,_..............,.......,....,....._,,..,..,...-..--....-":-' *.._;_,_'7 ___ ** >- *. __. *.., /.\\mtiif!rit Temp. {°fl fiem~rk:;. .lmtla1$,and Commi!nts
- (adtft ri1to: ln§'t:CMoitio.);~tC~l
-""~T:GJ-r-m:W~~-~~*1. ---l~'---"--ll-{'-'J* l.[.?1:.~ -~.Ji_ -~,..J
- .hJ:lL}.~~*-------~d......... ;... :...... !.
],
!f..1'"1""""-*...... '*~**rs W'i. '-*' Tt::iClli11""'6C;,.-i. L. Sl."t!:R 'I) ".M.."tX
- 1.
lll~~rumentlnforma1ion 1 Ratemetf'r'. Make/Mode!: Dctettor 1: Make/Model: Bicron i\\llicroflem Meter:
- 2.
~.11.g.f.k.~9.lJ!.q:! 1nfo.fill.~i.ruF lUDLUl\\tt 2241~2 lWQkUMA4-lQ.... -- ser.isii 'r-.1:. * ~tiZ737 Serlan~c...ffU.U12£;,... Serial No.
- Alli&~~
So11rc*::- 1 lsorope:*J.tJ=2..'i2...._Serla1 No.:.11..fa ___. .Activity*.s.D~J.. _ uriits:.w;L_ Re~;.;L*n!>t:: A(.ceptc111c~ Rangelt/*20%): 1Jflern/hr ~2()'1.;, c ?:-?.... unern/l1r -JO% _Ji_ Cal. Due Date:.!UUJ& Ca:t. Oue Date: 8/4116 Assay Dat\\!; ill3.0/10 net c;pm.; 20%_4]92..Q ms rpm *W'Jl. 15284. Rev l 1fJ/1S/l5 5ource 2 l~owpr.;.CS..:.l37.. Serial Ne:
- _.,82£13.:>lS-.....
Actiw:y:..O...QL _1;nlt$:..m.LAssay D;ite: JD..Q/J.O ~e~por.;eJ\\c::F.:r.r:mr.:eB-ilfJCle [+/*20%); uRem/h' **:?On_--*- uReil'l/hr "20%... ----* ~ .. <:pm i :1.0!K...1:3..31.5... ~ cpri1 -;>m~. &n9....
- 3.
T..ec;hP.it;ljl.!JLWPJker Performing Chech§: Namt:.$i"11;Y.CK1~s~,.J
- -** -~,
!nitials,and Commt'!nts (alid'I into.: Inst. Co11dillon, etc.)
Rev 110/18/lS l* Instrument lnformatlon1 Ratemeter: Make/Model: Detector l: Make/Model: Bicron MicroRem Meter: lnstn~mcnt Field Response Check log Serial No. JltC<Pr'i .Serial No. FKlf,,2'~ )- Serial No. I 4 'f1 Cal. Due.Date: t)rf:.*tjlc.,. Cal. Due.Date: C>(/K'/if.p . 2. CheckSource Information: f J Source 11.sotope:P:~ Serial No;: J f. Activity: <d. units:~,. Assay*oate; l~{-9>/f 0 Response Acceptance Range (+/-20%): uRem/hr +20% _... _11 _ uRem/hr-20% ~ nat..cpm.+.20% f>l'1 "if _-nw c:pm -20% 'SSFtC Source21sotope:C.c:.i;r7 Serial.No.: i("(c,)':3'-/ ;! Activity:{) Q;l. units/:!_{/ Assay Date: JV/Jr Re.sponseAcceptance8ange(+/~20%): uRem/hr+20%_ uRem/hr-20%__ ~cpm+20% 1-;;i:r5 ~cpm-20% '/$if
- 3.
iitle: .17(~ Date: 1~}/l:fftSTime; QY{ / location*Description:.,...._..,p._,IA_v._f.~""l.?,_*~A_6_.r-_. ---~-- X*Coord: N tf)- "'-.,."~'.Jll 'l"ftf Y~(:oord: W 7feS2,'-;rJ.3:l.,C..,. i
- 4, Site or locatiq.!!:
GPS Coordinates (when required): lnstrnment Field Respoo$e2
- Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Cnt
{<:pm) or Cnt lime uRe.m/hr) Time r
- Ratemeter f Ratemeter
- I* Ratemeter
! Ratemeter l Ratemeter I Ratemeter
- Bicron NA
)*Bicron NA 'Bicron. NA Source Response' +/-20% Inst. {gross cpm or source Calib. uRe!ll/hr~ gross cpm current oruRem/hr
- {YIN)
{Y/Nl Battery Time Check Of (Y/N) check Ambient Temp. (oF) lnitlals and Comments (adc.l'l lnfo: inst. Conditlon, etc.)
- l.
Instrument desigriated*check s<iu<<:e:!Siisted on tal!bratlon m:tcker. Record check.source response (net cpm) prior to field deployment for all ched<.sources being used.
- 2.
Source and Background count rate should.be determined from theo;werage ohhree stfltic counts atthe s<ime locatlon.,.Repeat CO\\Jnts should be within 20%. If eount rate diverges. slgnificilntly,,perform.additional counts to evaluate l11strument.stabllitv
Rev 110/18/15 Jnstrumept Field Response Check Log ~
- l. !C!i.truruent l.Q.formatl..Qn1 Raterneter:
MtiKefModel: LUDLUM 2241.J_ Serlal.Nc._2£47..3.L..,_ Detector l: Make/Model: __ luv..W.M 44*.W.. _. ***-* Seriill No. ~.B.1.11:12L Cal. Due Date: _'JjJ.J..lfJ BJc;ron MkroRem Meter:
- Serial No. _A7.2fil. __
i::aLDuP. Dat<!:.t\\f 4/1§
- 2.
~h.~1.?.9!!.!J:.!! Information; Sovrc1?.1iso1ope: Jl.J:2.iZ,__Si:!rlal No.: J.1§ ___... ActM1y:.<OJ_ __ !..!nits: Jill.. As~ay Dtite: 12/~.Q/J.0 Resp0n:;r.; Ac<.t~otrinci,- Range.(; /-20%): uRttH/hr +20~!..?:u........ u R~rri/hr -20% _1~{--- r;wl;.q:ir~ WJ~.2~ oot.cpm *20% 157,&4 !iource-2ii.ol<l!J~:.C.s.:13.1'.. *. Serial No.* ** 81.El~.B-. Activity:..Q...02..__.unl!~: ~fil.. l\\ssay Dill-?' Ji.lSJ.../J.O Resp~*1se/\\w:ptanccfionge\\+l 20%}: uR.em/hr*~20%_ uR~m/!1r**<:O% ____,, ~_i,;prn _1 Z0~<.13.3.15... ~-q;m-20%.89.l'L..
- 1
.5lt?.J?r lo~atiQn: 'iitl':'/JOh *.* tfr..!"!{.QJ,,.,J.~~.. k?..£.l "':-...?_* _ u:irnlion Dl'r,c:ripti:;n-~,.2t! f~---7(.~11-_L __ ~.,.....- Gr*s C:oordin"l'J.\\ {when iequired): X*Coord...** ~........... -----.. -.. ~- Y-Coorc.i: ___ Remarks Battery Check (\\'/N) Time Of 1\\mbient Temp. fFJ l!litlals and Comments (acid'.! Into: Inst. Co11clitioi1 *. l!tc.} check
I..** 'Bnstrument Field Response Check l.og
- l. lnstryment lnformatlori?
Raterneter: Make/Model: Detei::tor.1: Make/Model; Bkron MlcroRem Meter: Serlai No. ;;:)C-"CCJ1'i Serial No. ?ill/.?-.<;,o/,;. Serial No. J<J:G 1 2, Check Source Information; Source 1 Isotope: -rf...::;;3J.-5erial No.: I f ' Activity: 0 * \\ units:f?:~*-i Response Acceptance Range (+/-20%): uRem/hr +20% _q_l _ uRem/hr -20%...11....._ Cal. Due Date: ~C,. Cal. Due Date: '2( l"'i.>"{ LG Source 2 Jsotope: Ls.t 3'? S<?ria! No.: 111(.?5:*-l::Z.. Activity:D-C~ unil~:jt/(; Assay Date: & Response Acceptance Range {+/-20%): uRem/hr +20%__ uRem/hr -20%._. __
- (Jet cpm + 20%!'.7) 7 ~ ~
cpm *20% "G[{ 1-l~
- 3.
- Checks:
rit1e: ~-ra=*"""c:-_*_.,_-__ Date;J°7-fs:f 2nme:fl_icl.1
- 4.
Site or location: Siti:/Job: __ _.Ac..=.r.,._p""ti--""5(.-'.C.C..l=*"-. --* GPS Cpordinates {when reuuired): X-Coord: NW 03/ $.~SJ" Location Oescriptlori:, _____ w"" "°"""<:.;:;,-cc::c:."'"O._s..__ ___ ~ Y-Cbord: W 2'$.:J<;Jl "'fl. I"? 7 '" lnstrument Field Resporise1 Use Acceptance Criteria Remarks Rev 110/18/15 Meter Bkg Bkg.Counts Source Source Response +/-20% Cnt {cpm) or Cnt {gross cpm or source Inst. Battery. Ca lib. Check Time Of Amblent Temp. Initials and Comments (add'l Info: inst. Condition, etc.)
- Ratemeter Ratemeter
- Ratemeter Ratemeter Ratemeter Rate meter
'Bimm Time vRem/hr) lim,e uRem/hr} gross cpm current .(Y/N) check ("F) or uRem/hr (V/N) (Y/N} ~-~~~-~~~~~~~~~-~~-1 ~~~~~~~~
- l.
lnstrument designated check source *1s listed on calibrati.on s~lcker; Record check source response (net cpm) prior ti.l:fleld deployment for au.;:he~k sources being used.
- 2.
Source and Background qJLmt rat!! should be determined from the aver.age of thre~ static count~ ~t the.s;ime locution. Rape<it counts should b.e within.20%. If count rate diverges slgnlficantly, perform additional counts to evaluate instrument stabllity
- d~...bi"..ii,...
~~Tjf; . ::,:~~~ r,11g:~..ffi..J! *. ~eht_yµ::es fri5trµmE?.Ql!icld R~spon~,e Ch~(:~ Log
- 1. >nstryrnens inf2rma1ionJ
- Rate met.er:
Ma~:e/Mrn;fel; LUDLUM i~fil. Decector:.l! M!:lke/ti;1oge[:
- . l!JQ.JJ.!M,.4.4:1.Q.. __ ~
Se?:illl. No....2:n2:l~ f>ar\\ill fJo;.J:.R.1.UUL &eria1 t-.i9;..AZ.ZA.l,L_:..__ Cal. Oue Oat~: 3-/Z/J,f! C~t Duf} Date~ S/4/1§ Blcron,Mil:roReorMeter~ 2, &:heckSour"li! Information:
- Rev 1*10/18/15
- so.urce.ll~otope:Jb*2*R serlall\\IC..:J~15 Activity:.$9.. ;J..... units:.µ~.
Re*;pon~e Acnwwilc~ Ran&e *( -11~20%): uRem/hn2ow.... ~ ii fl~m/hr "?01*.: J:L_ .Assay Date:.121.3.0/10 .am'cpm+20%_~292L ~.cpm-W% 152'f34 .source2 1.;1;lo1~i'~~ £.s.::l3]..... Ser.la! Ne.. * *. E:l.E13dlL... Acfi'li!y* ;.Q~t.nits: ~ A~say Date:..laOL:t.O
- Respc.
- ;:;e ;\\c:ci:!Ptarc:e R6niie:.t /;,W.%}:.. L1i.iemlhc~2.0c;; **--**.... Ji Hem/fit,::0%..*. -~-.. -., £Wt-c.pm.qo5(i3.lli;.,.~.cprn.~W~1i J~~l:£L...
3~ Teclfu!1:.l.!!.f'ilifll.Cl!k1?7f;eriorril.!ng' Checlis.: r~arnc.:i*~fu~\\i;l.c~.. : (.~}.§:,~ .. ~ --- ntle; _r;c~.1.:.-."***-**...... I, Dtt!t~. 'l.1~}.{:.!,!~t:.(' *; inlf:, 0,§:t6'_ 4
- Sltf!'.1.!?!;.IJ>;att0-n*
5:te/Job,_t_7.. --.. **---*-***-*-**......... _.-- .10~<1tion*oe~r:rlpH!ln: vvt**.tj:S.
- 3PS' C.001j1r\\iite~ (when:rc~quir~d):
X*CQO,rti* ___.. ___ *- ~--""-- ____ Y.:Cocird: ___ _ '-----~ ... ~~-~* Remc.irks l
- Time*.
1 1 A__,mbient Of r,emp, cheg~*
- i"F) 1p1tials aryd* corrim'entii (ad~'.11ni:a: inst. r.o.ndi~io'I. et(.)
- """"~**;r1*~*...,Jz-. --~~*N*""'""""'~"~""""""'"""""""""'"'"'"""""" '***'*~
R~temet~-~
"-~YS MJ'lYV *v-~~l/....si>*Si?~e:lr Rev 1 10/18/15 i I ! I j i
- l. Instrument lnformatlon 1
Ratemeter: Make/Model: .Detector 1: Make/Model: Blcron MlcroRem Meter: Instrument Field Response Check Log Serial No. ~r;:oq~*. Serjal No. t.,,.(£!IM../(;- Serfa! No. .~J (A Cal.DueDate: 61#, Cal. Due Date: /tJ (A
- 2.
Check So r e Information: ~ Source l lso~ope:
- I "' ?;.2 Serlal No.: f / {
Activity: 01'1 units:_µ.£..; Response Acceptance Range (+/*20%}: uRem/hr +W% __ uRem/hr -20% Assav oate: 1.>if i{~ SErt cpm + 20% *~:- 7:. ~cpm -20% ?$1'(~( Source 2 Isotope: b{?z. 7 Serial No.: JL1Q~* I ;t Activity: DP.J-units:~ Assay Date: __._ Response Acceptance Range (+/-20%): uRem/hr +2(?% __ uRem/hr *20% __..net-cpm + 20% H;?. 7?.m.u:-cpm *20% ES 9'1
- 3.
Tltl.e: f( c.. r Ot;.'-1* 4.. Site or Location: Site/Job: A-e.:-5 / GPS*Coordinates*{when required); X"Coord:-1if_t.1.~.:...,, ~'.!tS:4~t Location Descriptlon: ____ ~--~-~-"-'-/""'5 ____ _ ~J ']1 :> :ft, I (J;fl Y*Coord: I Instrument Field Response' ..... JM'!l'IW, Use Acceptance Criter!e Remarks Meter 8kg Bkg Counts Source Source Response i-/-20% Inst. . eattery Time Ambient Initials and Comments Cnt (cpm) or Cnt (gross cpm or source Calib. Check Of Temp. (add'l lnfo: inst. Condition, etc.} Time
- uRem/hr)
Time uRem/hr) gross cpm current (Y/N) check (of) or uRem/hr * (Y/N} {Y/N) I t* I
- rif-~n 7lE.
- lQj
, i
- r~
/1-1-1 i]* *S'Pli </<A t/1/£l:'/.._ r tf 1¥' v v 1Q Ratemeter f w.;)\\ y it/i.2£ Ratemeter f ffl.i v. 1W*ll c.,rv,. j 0\\1l\\ WM 1,,.ft:;.... v { I
- ../. O<;S/
~q yu ( <" -1 3:'1 '71~~ i Ratemeter i !JI I)\\. ')~S"i.. (.fl/', ! IM.,°)'\\. q1f flio.f5~1VI --.:r \\. .._/ if"~S-1/6 :Lo "th.. y. ?:.L "9 y l Ratemeter r ""'"- ii'll -;:°' (.1'111'1 Imel- {D°?t;~ /*~;AA ..J,1 ,J1 11"/C qt'..,;." rA,., f?7 ':#
- RatemetBr I
r I i/ Ratemeter
- 1. Bicron
.......--~~- - NA NA Bicron NA NA -Bicron NA NA
- A _ _,.......,...
- 1.
lnstrument*deslgnatecJ check sour~ i~ listed O!'l calibration sticker. Record,check source response {net cpml prior to field deployment for all check sourc~!i being used.
- 2.
Source and Background count r;ite should be determined from the <lverage of three statlc count~ at th same location. Repeat counts.should Ile within 20%. If u:iunt rate diverges slgnificantly; perform additlonnl counts to evaluate instrument stability I I j i ---~~ J I
~~y~ ~* ~_:;~ TIC....r::l~lt..!'E~~~
- 1.
Instrument lnformatio1l Ratemeter: Make/Model: Detector 1: Make/Model: Blcron MkroRem Meter: Instrument Field-Response Chee!< Log Serial No. t?c<..q B serial No.~~l.l .. [* t//.ef. Serial No. 1 l'tl Cal. Due Date; D~t' Cal. Due Date: b([..,,,( f (, Source !Isotope: *(l..;;l);l Serial No::. I/( , A<:tivity:.r::'.'cJ, I. units:~* Assay Date:~ VP
- 2. :cneck Soyrce *fnformatlon:
~ Response Acceptance Range {+/-20%}: uRem/hr.i.20% _t.\\_1_ uRern/hr -20% _ll__ ..!'lftt-c:pm + 213%' n~cpm -20% ?<:if"i).b Source 2 lsotope:Wfl Serial No.; l l'trf'.?-1-- \\ ;i... Activity: C,>...6,;J units: tY,(;Assay Date:. N.A Response Acceptance Range'{+/-7.0%): uRem/ilr +20% __ uRem/hr *20",f,,__,......,,,,, r.i:e!*cpm +.20%~.r~Hpm *20%. 'fY'/?
- 3.
recbOici.<JnlWorker Performlns Ch~c~: Name;;J:_ ~liJ,! *
Title:
77;,,...;c:[,,...*-'-. __ oate:LJ/-1~/('r Tlme: l/'511!/
- 4. ~e nr Location:
Site/Job: /!;,-.rt!"'-.£ <:_;" -"). (e-location
Description:
c..v vr:.*{)~ GPS Coordinates (when reql)ired}: X-Coord: ___....._ ____ _ Y-Coord: __ ~-----~- Rev 110/18/15 ln.strument Field Responsei Use Acceptance Criteria Remarks
- -.~-.~,
Meter Bkg 8l<g Counts Soµrce Source Response Cnt {cpm) or Cnt (gross cpm or Time uRem/hr) TI me uRem/hr} Ratemeter Ratemeter. Ratemeter Ratemeter Ratemeter Ratemeter t/-20% Inst. source Calib. . gros;_. cpm current or uRem/hr (Y/N} {Y/N) B~ttery Tl me Check Of (Y/N) check Amblent Temp. (of) lnltialsand Comments (add'! Info: inst. Condition, etc.) I Bicrof1~-+--'--+...!..>'-=l.-"':fJ'J<'>+--=""-'---l~-'----'-"4-r'-f-'--tt---+~--+--+~--+~--r--~-l-'--'-~-1-........,~-=-~1-.:.......:;'---'-"---'-...._,__,_~,,..--~ Bicron NA 'Blcron NA NA 1'10'.0 -13._!:
- ~....,,,,,;,_ f.-J.;,I.~-~-----:-~*
- 1.
Instrument designated.c eek source is listed on ali!m tlon sticker. Record thetk ~outce re~ponsiil (net,pro) prior to field deployment for all check sou mi$ belng used. .2. Source and 6ac~grounci count rate should be determined from the.average.af 1hr~ static counts et the sa.me location. Repe;it counts should be withln 20%. If c:ount rate diverges. signi(!cantly, perform additional counts to e*1a!uc>tl:' instrument stabllitv
- i.
-J
lnstrume.&t,tfie!d Res~onse Chedt l.og J I
- 1.
.!JlSt rumea.tJr.iJ!?fll.li!!..!m RatP.metnr.; Make/Model:-_ lUDWM 2241-2
- pctector 1:
M<ike/Mod~I: _L!.,!R.!.J.L!'li 44-1Q. ____ _ Blcron MicroRem. M~ter:
- 2.
ch~kSo_y~JtJf.l!.QJ'mation: serhil No. -2.limL- ~orl<il No. _E.R.111127_. .Serial Nti,.* i'i221.l!._ ____ _ Source l Isotope: J_k2:3.2..._._:Serlal "lo.; J.1.,6 Acthii\\y; -.sQ..._1..... units:.W~L. Rewom.ii A~n:;itanc.f! Range (-i-/-20'f.,): ulh*mJhr +:20%,?:?... ___ uRem/nr *W~-:._i!;( __ Assay Da.tr.; _.12J.3.Q/*10 .;m;: cpm +*20%...2-29~6 r.;wcpm *20% _15_4_6,4...,. Source :11sotope: _($::.1.3 7.... Sc*r ial Ne-.*.. J3.2E.13.:..48-. _ Activity: Jl.DL_ ;;.nit~: ~ Assay Datd:..lLZ.QL;J.O Re!;pon~e AccP.ptance Range,(+/-.~0%j. uR~Hrt/hr -1:20% ____ Li Rem/hr -20'.K.... ____ ~~pm.. 2tW-J3..lZ5... _ *~~;pm *ZW*. B!t.U!....
- 3.
T11chr!icl~i?~~-tfJti::.formlng Chec~s: Namc'S:'I(.Y..~.. Kl.'V~~ 4 ~l~~S~! !.P@.ti.Qf!: <;:te/)ob~(J_J _____.. ---**- *-T-... *--- l?r.;irion Derir.ripti(.l(l:~----- GPS Coordir.ili!:'~*(wht!*n required); /c'.*COotL'.A/J':.t... ~..f$Y1_ Y-C\\iord; c.J JY J.J' i 7 *.J;~ R~v 110/'J.8/15 ~-~~ *~*-~~~-*... ~---~,... *** **"'**-**---,-~-,~t;~;~*;~;~'j; i;.ldR~p~~:~:-~ ~* * *..... "*~.,,._..,.,.. __ ""_G;;;~c;pt~~c;J*""'~~~*-**.,.....,.,,.... ----------~Re-rr~.~.i=rk=s .,,.......~--.--.. --* "="'-:ttm 5= -~
- --M-ete_(_1 _Bkgls-~* <;. oun:t~~~-;_ 1~
Sour.::~ Re:;pon~t! t/-.20% tnsl. Batter\\' '! 1me Ambient *. Initials and Comments Crlt [~pm). or Cnl (gross cp_m or source Calib. Check Of
- Temp, (ood'l Info: lnst. Condition. ett.J Tim~
uRem/hr} : _Time u~~rn/hr) .grosr. cpm C.l.lrmnt (Y/N)
- ciiec!t
[~f) _ jf\\l/11) I ( 11\\*.-.i J or uRem/hr CY/N) -~ Y/N) ~~~~~-..,.......,,.....:.......,,.......,,..._,,,"'*'*~~ ~~1i6""""""--*-l.>t.'>""4'.~,,,.,,~~"""'i=<iP'==-"""""'"-'* _Ra_tem_e_te_r _...... 0b.JP,s.;;ub_J_ ____ -{f}l.1}.. _.~-Z!*r._ --X~ Ratem eter I .,_....~o _ _:. /!h.L... _. j ~ 7 J) '-: <' *'"" ___...."/:. _ ...;.Ra:::.:t::..:e.,.;..rn_e::..:t...;..e_r 4-. __,_l_+-l,.:.......;\\,__"l...__,"l.,..,~....... -.r~ J___ CJ*'i k ¥ ~-u---..*---1-........ ---1-_,_--H...,., i --*-1
- - --* ---- *--- i Bicron Sicron}}