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;. .LUDLUM 2241,2 Se1faU1Jo; ..,Z'6_2ZlZ_ Cal. oue Date* -~t1/JJ;..
Qetec;tor 1: M;ike/~ogel: LUQLJJM..M~\(,i ___ . ~erirll No.....BBJ;faf 21 Blcron MlcrgRem :!Vleter: Seti;; I No. ;82-24!)
- C<JE 04e.oate~ 8/411Q.
- 2. £hei;kiQurce -lnformatfon:'
smfr¢e- J. Js()tRP.if:lb-232 ~erlai.NQ.:.Jj 2, . . Aitlv!W: .1$!;>.,.L. unlil'):,..I!~.. t~ssav t>o1~.- :12/~10 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. 'initl~lsan_d ccirnrnents I "cht (B"OSs.cpm or ,source Cali.b. Check . Of Temp. fago:l.!tifo* lo~, Conditio'1. etc.t .;
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*
'Bicrori
---.-.*~--, ---~1
J
~,..i,i* 7'.~~C-~~.*~~~<<;~
*Rev.110/w/1s ln:StrJJtri~!e!dRespon~~.coe\:ktog*
1 1, Jos.tr~Dl!!l~!lm f3aten,wter; rv'ia,~e/Mpdel: _ *LVDl.UM;2241-2 . :seri8,f[fa, ~2fi27lJ .... ;i:.;:iL, Due Pai~~ :lillllft Pctector 1:; Mtike/N'!Pc!eJ: .LQDkUM44,fQ: ,.,,_.,... ~rli!l'Np~ _E:f(:(lllii_ llJi:fon *Mi~rot}em Met~r: .SEriaf~P:,.::bl.i.4]_._._ .cavou~:qate;; .SZ41li5 i:Z;. $:~k Source. tnforn:iJ!tlrul: Source 11~.ot~pe;:rh-z32. . Sertal/11¢,; 116. *.-..,.:~. . Ai;;tlv1ty'..,<O~!-'. unit&:JJ,ci;__. A,ssay Da~e; ]2~:10
- 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(~. :/..<x1 1/lr
~ ,"-~r:-'1-': r.*~\ ~- rimi::>~.tlfl~ti
~-" --:--
- 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 ~... .
...,.~~e-ma;ks -~~~,.,,-~.-...*
....-, . . . . . *o--;--~"'"'."'
siJurc!;'. ~e;o{J11:i(.;. * . +f-2,(jy,, ,fir *1ns1; i Battary, :i nma <4~bien1 *Initials and'Commems.
;gtosstprri'J)r soui:C:e. callb. *; Check" Of Ten)pi \add'i'lnfdi lnsL u.'.md.iti6n;eic;:
uf<ei1i/hrj' gross. '.<;Pin *current ! JY:!Nl ttieck, * (~F.) or .uRerri/hr
- JYfN) ' ..
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 1
- l. Instrument lnformation Ratemeter:
Detector 1: Make/Model; Make/Model: : Lv(tv,..., di.!!fbl.l-
"[;J/JJ>.;.. ~-
Serl.a! No. Serla1No.~-
.rZQ6vff Cal.Due Date: -
Bicron MicroRcm Meter: Seria1 No. t-' (it . 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 i i' 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} j I or uRem/hr {Y/N) (VJNJ !I Ratemeter I Mi"- qq3r,.~ ltuin: lf'ff~1 CPI+'\ v~ 1/ \/ /{)lf~ ~67 TI--232 f.!7 I 1 Ratemeter 'MtY\ ql{'?>\ (."""' I .,. :IA. //)1/1)_ "-~ I YI v -..!/ /!J-sg' s-i:;.-.; 1""<-/.~7 '?JC (/ ~ Rate meter I I I Rate meter l 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
Rev 1.10/18/15 1ostrument Field Response Che~k log
~rastrument lnformatlon 1
1. Ratemeter: ~al<e/Model: Lv-f£"'""' P"...7~~~ Serial No. ~,tqf_G C;il. Due Date: ~G Detector 1: Make}Model: 2~3;; f¥.:.?.1:= Serial No. 1!£.!!~ Blcron Microaem Meter: Serial
- No. . N t-A Cal. DtJe Date: f\Jf~
- 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'~--- GP5 Coordinates (when required}: Y-Coord; W 07~ "¥0~. I Instrument Field R~sponse 2 I J l Use Acceptance Crlteri~ Remarks i Meter Bkg Bkg counts Source So1Jrce Rel?ponse +/-20% inst. Battery Time Ambient Initials and Comments ! I
- j. Cnt (cpm) or Cnt {gross cpm or s.ource Calib. Check Of T~mp. (add'l Info: Inst. Condition, etc.} I Time uReni/hr) Time uRem/ht) gross cpm : current (V/N) check 11 FI II 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/? ~:z11. cp.- I . 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 Bicron NA NA j -
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
Rev 110/18/15 Instrument field Response Che.ck log
- 1. Instrument lnformatlon1 Ratemeter; Make/Model: lu/fvt- .?.).'fl~.2. Sefiul No. PJ.D6 <>'ff Cal. Due Date: ~/;;Uc Detector 1: Make/Model: **:zd!Lf~M @..r~. Serial.No. Pe//,,2 :t.o/..1:-
Bicron MictoRem Meter: serlal No.
- Jv i~-,- Cal. Due Date: ~J ( 4
- 2. Check.Source Information: __
Source! Isotope: D~/37 Serliil No.: //tl:;il.J{J, Activity: tJ_(J,)- unitsjJ!!.&' Assay Date: Afh_ 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 I 1i1strument Field Respon.se 2 Us<!Acceptance Criteria
. Remarks
...... - l I
- j Meter Jll:g .skg Counts
[cpm) or Source Cnt Source Response (gross cpm or
+/-20%
source Inst. Caiib. eattery Chct;k, Time Of Arnbtent Temp. Jnltlals and comments (add'l Info: inst. CGoditlon, ..etc.) I Cnt Time* uRem/hr) Ttme uRem/hr) gross cpm r;urrent (Y/N) check ("f) i 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 1'11i V\
Rate meter I
>t1~1 ,qi'\.._ i Lw...r1.1 --..-'l7ftr t!&11!t1 1
. ~I I
\!
I .
\/
I
/6_F_?2_ S':t;".1 -n. .,,;.:s-;i_ ,,£!£.
~
Rate meter
- Bicron NA NA Bicron NA NA Btcron NA NA Bicron r--** ..
NA
~**-
NA . *-** I
- l. Jnstrument 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
Instrument field Response Check.log fhstrument lnformatjon 1
~h 1.
Rat.emeter: Make/Mtldel: ~ICloiJ $,IL~Q gf)/\ Serial.No. ~)_). 'i Y. Cat Due Date: Detector 1: Make/Model: 7'&"71;,IZ/./A L . Serial No. ~.tV/A Det~ctor :i: lvlake/Modef;
- Serial.No.
- 2. Chei:k s~nm:e lqfo.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_..\_ _ __ oatft:Lot.~/J (Tim.e:. a_q_s:j_
~: Site or Location: .Site/Job: -":z-'--,_1...=------~-- location
Description:
.- _.6r-;..i!J.,_,*.....tJ:~.d/l.,. _ _,,\~----*-- 0 1 GPS Coordinates (1.vhen required): X-Coord: Al 1f}- :Z,g $'[) q" Y*Coord;M) i> "'l~ 0 yc * ~1.7.! 1 j
"'***** ,,,, ...... *---.~- ....- . . -*.=--.-...... - - - -........
Instrument ~leJd Response2 Use Ai::ceplance Criteria Remarks ! Det. aKg ekg Sour1::e .Source Inst. Battery j Time Ambient ~ Initials and Comments ~
*/-20%of l!
No. Cnt (~} Cnt Response sour<:e Net Cailb. Check or. Temp.. (add'! Info: tempecature, Inst. Ctmditfon, I (i/2) Time (~ ht_/l/11 fl Time (~'tl!:el cpm *Current , I (Y/N} (Y/N) i
.check (FJ 1
I etc.) i I ~~-
,JI iJ\~
< ...... rv!A J>re~*e~m
. r? 1,Jtl :1z. '1
{Y/N)
~
y v -* A'/£1 _'ftr. i. s~ rl"
-.,z
. ' . 2 --
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
lnstrrument Field Response Check log 1
- 1. Instrument lnformatlon Ratemeter: :Mal<e/Model: LUf)Lv;.'! :J'J'i/*) __ Serliil No. 2&'l- 1 } I Detector 1:: Make/Model: LV/)l11!'A* o/ l./~10 SeriaU~o. flt..UN il)
Detector 2: Make/Model: S.ertal No. _ _*_ __
'2., Check Source Information:
Source 1 Isotope: 1h Z1 Z... Serial No.: . [l_tp Activity: ~ 1.1riits: ~ Assay Date: tz{~t.> /1° Instrument Response Acceptance Range.(source cpm ~ bkg-t/-20%): 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* lnstrum~nt R~sponse Acceptance nange {source cpm - bkg +/-20%);
- oot cpm + 20% l :i -~'1 5 rret cpm -20% *?i 17
- 3. Technlclan/Worker Performing Checks:
Name: ) fl!vtt'° K,14}/,,..;g./
Title:
_~_,_c_T____ Date: 12}_1(4Jrt Time: /r> oo
- 4. Site or Location: :Slte/Job:_"3""'""""._,"Z-=--------- Location Descriptlon; _ _,_WJ..c;*'-'~""".
GPS Coordinates {wbetHequirnd); x~coor~: N L\2. L.S I ,~.=r 'l 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,
; (1/2) Time (cpm} Time (~ cpm current (lt'/N) I ci'cck {F) etc.)
j' [p*~~~-~~==~===-=o=:;~~=*==~~**='==*tjt.~.~~~(Y~/~N)~==="l'==l==--==~=""'"""""~=-=======~"""""'====~j 1-'-1J""~.2.......1-=~_,*..._J-""m=1fl./=..+--'-""fq_.2"-o_......,J'-"m.. ._"=-'
. J,. ,1q1 D>' -~ '{ - **
1 Y Y moo t./'5. 7- 5JC. - 1 _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
'==*j-,-~-~-t----J~~-_i~~~~-1-~-l----!----t-~......-. . ~~~---1 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
Rev 1 l(J/18/15
. Instrument Field Response Cllecl;< log
- 1. .Instrument Information)
Ratemeter: Detector 1:. Make/Model: Make/Model: Seria!No; Serial Np,
**~~
P(l.11 ~ cat ou.e Date: ?6'.tf" Blt:ron MlcroRem Meter: Ser!al No. iJ in . Cal. Out; Date: fJ (r\
- 2. Chetk Source Information: ,.
Source 1 Isotope: =th-.;2$2, 'Sertal No:: _f/( Activity: <!:.O) units: ,&*C~" Amy Date:l~;Jf: Response Acceptance Range {+/-20%): uRem/hr *f20% _ _ uRem/hr -20% __**--** !Scpm +20%. ~ Source 2 lsot9pe:(s-r:n Serial No.: //'fl?;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: Arb; ~. I ,I . ft Location Oescription:.~_ _
./
eo.-;_~-'-'-""'"£>l_..'/)_ _ _ __ Y-Coon:l: \1Jt>?B ~'1f.$."t.7 :_ 0 GPS Coordinates (when required): X*Coord: fl:I "-P.f',;i.g !f!f./i ... ! I --- Instrument field Responsez Use Acceptance Criteria Remarks i l Meter Bkg Bkg Counts Source Source Response t/-20% Inst. Battery Time Ambient Initials and ):omments I I Cnt Time (cpm) or uRem/hr) Cnt lime {gross cpm or uRem/hr) source gross cpm oruRem/hr Co lib. current (Y/N) Check (Y/N} Of check Temp. (°F} (add'IJnfo: inst. Condition, etc.) iI I
.. (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~ C?l'VI \~ 'J \I 1-CJ/0 51. ,::J_ /'"s .. ('5? ~LJC Ratemeter I f
/ v I Ratemeter -*****-.
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*
- Rev 110/18/15 Instrument Field Response Check log
.1. Instrument lnformatlon 1 Ratemeter: Make/Model: ~(/k._~'1/-;?. Serial No. ~£.Off, Cal. Due Data: ~
Detector 1: Make/Model: ~bl ¥~-;-i.@ *-- Serial No; 17/!l(MY-f-Bicron MicroRem Meter: Sena I No. f\J i IL\-' ca1. Due Date: fif {Ii.
- 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% _ 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; Date: Jtjlt/5" Time: /$a 't _
- 4. Site or Location: Site/Job:_ _ _ d.*"-l.., A""* ..t:."-*..,.,,,..3'........;..../~-.. ~ ... _ _,_ .11: location Descriptlon:_ _-=~=c..;.* . .,;;.'3'1-'A*"'*"""~'-"'jJ'-------
1 GPS Coordinates (when required): X-Coord; N :1'.:~~8 S". '1 . Y-Coord: kV o 7'S 0 vo J1. 7 '" I I Instrument Field Response~ Use Acceptance ei*lterl.a Rem.arks ; ! Meter Bkg . Bkg "counts Source source .Response +/-20% Inst. Battery Time Ambient Initials and Coft)rnents f I Cnt Time (cpm)or Cnt (gross i;:pm or source gross cpm Ca lib. Check Of Temp. (°F) {add' I Info; Inst. Condition,. etc.) I I uRem/hr} Time uRem/hr} current *(YIN) check or uRem/hr {Y/N) I I
........,,.,., (Y/N} . I Rate meter ., ,,..,h ZffrC i:.?w { C1A,.,. lfS-f10 C...1:>f."" v \! ~*v* 136~ *~.D -n,.,,,p).;3;L ~- I Rate meter !Mir. 'tt1l.. <:,,.,. I wi.ifA. I 1-f Lf<; r*l'h \/
I vI '1/ l>IJ ~1.o /"' A,/37 ~Oir;; Rate meter I Rate meter 1 Bicron NA NA I 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
Instrument Field Response Check log 1 1, Instrument lnformatlon Ralemeter; Make/Model: ~ Serial No. A?... ?--i.f I.A Cal.Due Date: r{-1/l't:J Dete$:'.torl: Make/Model:. J;iV-rC.4:1£,A '--*---* Serial No._AA~*-- Qetector 2: Make/Model: - - - - - - - - - - Serlal No. _ _ _ __
- 2. CheckSource Information:
Source.1 Isotope: 'Tb 2J t. Serial No.: I I (p m Ac!lvity; ~ units:~ Assay Date: I 7. £~? o /1 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________ _ Date: fb}u.:.{r<nme:.[L/O 1>
- 4. Site or Location: Site/Job:_._J_.,_i... __________ Location De?cription:.fi'-~'""'""~,:,;,..:.-.** - - - - - - - - -
GPS Coordina~es (when required): X-Coord! Y-Coor.d:
~---~---
_,_. ...... ---* ....... *-*---*----- ...... ---*-*..-~*------** .... *-**--*-*---*--~* ~-~- Instrument Field Respqnse 2 Use Acceptance Criteria
*. ~
Remarks l r Det. No.
- p. /:2).
BKg
.cnt Time
(~) Bkg
~~
SoiJri::e Cnt Tims Source
Response
(r~*
+/* 20% of source Net
.cpm I :-
Inst. Callb . lt current BaHery Check (Y/N) I Time
.Of ched~
Ambient Temp. {f) Initials and Comments (<Jdd'l lnfi:i: temperature, tni;t. COncll!ton, etc.) I l I J~/t.hlr . . .. (Y/NI t iY/N) i
' =
l ~- 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
Instrument Fiel.d Response Check Log
- l. Jhstrument lnformatlon1 Ratemeter: Make/Model: /.JdJ.W*V\ JJ.VI, 2..- serlul No.:a_.l... h].11. Cal. Due Date:.~ i...
Detector 1: Make/Model: lv{Ll..vM- r.f'l*t"tJ Serial No. !.lltw e, '") Detector 2: Maka/Model: - - - - - - - - - Serial No. _ _ _ __
- 2. Check Source loformutlon:
Source lJ5otopei11;iJ??. Seria.1 No.: tL~--*---** Activity:~ unlts:~i' Assa\1 Date:~/ Q lnstrum.ent Response Acceptance Ran&e {source cpm-bkg +/-W%): oot cpm.+ 20% 2:2'.i z:..r,, flat cpm -20% 1'S' z~':{ Source 21sotope:G:.L.ll_serlal No,;&' }t/J- 'fl Activity: - D '2.. units~ Assay .Date: ~ Instrument Response Acceptance Range (source cpm - bkg +/-20%): i:uttcpm + 20% 1-y~,<; ~cpm -20% mi "i 11
$. Jec!lnlcian/Workcr Performing Checks:
Name:51t.Ve K1,i.IJ '"'A <!L
Title:
r:.cr ___ oa~e: /i/b/1<
µ 1 Tlm~:Ffro ..._.__ __
- 4. Site or Location: Site/Job:_~_..._'- _ _ _ _ _ _ _ _ __ 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 I
~.
No. BKg Cnt Bkg (avg of3) Source Cnt Source
Response
+/- 20% of source Net Inst.
Calib. Battery Check I Time Of
! Ambient Temp.
! Initials and Comments
(<>dd'l Info: temperature, in.>t, Condition, i {1/2) Time (cpm) Time (~* cpm 'i current (Y/N) check* 1 (f) eti::.) i
~)Wl- (Y/N) ('l/N) I fJ; J 3'1. lmu-.i 7 '-77. I I ffl?W i J{'"fj-,,; ~
~ 'fl y-** y..* 1i.11 ~
<;; 1- Ip st I '-{
11
.: rn )JfJJ!_ ,__:_14. l. / /._fl4N' r ti I{;, I t'..l"' ""f v v /<(/{ (J.1.c> Sit-
- 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 .
Instrument Fietd R~~ponse (:heck' log 1 Du~ Date: qf*i.l 1<.p
- 1. Instrument lnformatlon Ratemeter: Make/Moc;lel: j.V])l.11AA 'J-?'11 .. 4- Serlai.No. 2¥-L] 3 J Caf.
0etector 1: Make/ModeJ: l V RI.. VM- Wt o
- Serial No.{R. WI Z. "i .
Detector 2:
- 2. Cpeck Source 'nformation:
Make/Model: Serial No. Source 1 Isotope: "fl, 27'2 Serial No.: J/i,p Activity: Lo. t. uni~s:~ Assay Date; 1'fl--s~/*..:;. Instrument Respoi{se Acceptam:e Range (so~rce cpm - bkg +/-20~): - - *-. . 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\~-~- Date; Lo/u:) li{ Time: Ji; I <
- 4. Site or Location: ....* _o_.~_-""-3_..*,-"-2-~~~~--
SHe/Job :._,._fi Location Description :_:.t~.~~r.l.!+-----------~- GPS Coor.dln11tes (when require\']}: X-Cootd; _ _ _ _ _ _ _~ Y-Coorcl:._ _~----- t;f;7' _____ ---*- --U-se~A-c-c-~-p-ta_n_c*e--C*-rlteria-*--***-~----,,,.------R-e_m_.a._r_k_s_____ . ---] d)et: BKg Bkg Source Source +/- 20%of Inst. Battery I lime I Ambient Initials and comments 1 No. Cnt (avg of'3) Cnt Response source Net ! C<ilib. Chetk Of ., Temp. (adp'l lnfo: temperature,. inst. Condition, j (1 /2) Time (cpm), Time {~) cpm *, current [Y/N) check {F} . etc.) . .1
~ [V/N) 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
~t.t/{'-'
- 1. Instrument lnformatlon Ratemeter: Make/Model: ~, 1 g~tJ ,/11 U R.-0 K01\ Serial No. ~l/ 4 Cal. Due Date:
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:* -* 1 Zlk- serial No.: /Lk. Activity: ~C?:_I_ units;~ Assay Date; / z..hi) /1° Instrument Response Acceptance Range (source cpm - bl<g +/-20%): aet cp~ + 20% -Li.'! 2.<. ~cpm-20% l)Z.Y~
,o;.\i'.;.v,,\\~dt.v1i 0 2£_ *h.(l~M I~r ~ '2bfio Jj__
Source 2 ls(";tope: Serial No.: Activity: _ _ _ . _u_nlts: _ _ Assay Date: _ _ Instrument RcsponseAcceptance Rcmge (sourc.e cprn - bkg -i/-20%); ~ cpm + 20%_ __ nm; cpm -20%~--
- 3. JQ.cfillkiao/Worl<er Performing Che<:ks:
Name::.SlE.v'.f' /( 1/l':ir<AAAJ Title; R.c.T Dllte: J32/L~ Time: Lil'f.
- 4. Slteorj;_oi:atloo; Site/Job:.__,'3~,..... 7-.*""'".- - - - - - - - LocationDescription:__,_ft__._~_,,_11..""p_1..___ _ _ _ _ _ _ __
GPS Coordinates [when.required): X-Coord:__________ Y-Coor.d: _________
*-1 I
-**~u-------*-*
r lnstrumentfleld Response 2 Use Acceptance. Criteria Remarks Det. BKg Bkg Source . Source. +/-20%of lhst. Cattery ) Time j I lnllia!s snd Comment> i I T~~** I Amblerot I Cnt (~ Cnt sourc£Net Chi:d( jadd'l Info; temperaturn;inst. Condition, I (f No. Response Ca lib. Of I (1 /2) l f\/ (~
*=
Time fJ \1\- de I lime /~kB)_ _,,.. . . K. ~J.... ~'
'{\
tJ fn I /7 cpm (Y/Nj i
*: *cuuent (V/N) y ~
(Y/NJ chec~
.1.£15.' ,c;&, 3 *~
S: I::. Tl, z:i,z._ etc.) ! I j l ~-- t I -~ *---*~-~
- 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
Rev 110/18/15 ln$trument Held Response Check log 1
- 1. lnstrumenttoform(;Jtion Ratemeter:
- Mako/Model: Serial No. ~6tJqt[ ca1. Due oate: -rq~
Detector l: .Make/Model: !;eilal No. 'f'E//U'f,2-Blcroo MlcroRem Meter: Serlal No. !II i,_A'_*_ _ _Jal, Due Date: (V i-4_
\.
- 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 _ _ 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" I Time: li.P. $
- 4. Site or Location: Site/Job: Al"'fq1 1. [ Al . Location
Description:
___ ~-'?'M~..s.l!.,,.A""'~"'*,...'/!_""-----'--~- GPS Coordlnates (when required): x.coord: ~ 'tJ.."'#l'ii. / GY.' 'f Y*Coord: Wo? ~"' V.i:'l '3q.? * J I Instrument Fi.aid Response 2 U.se Acceptance Cr.iteria Remar~s l
*----~*--'-* *- ~
Meter Bkg Bkg Counts Source Source Response +/* 20% Inst. Battery Time Ambient lnitials and Comments j 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) I or uRem/hr
.(Y/NJ (Y/l'J}
f Ratemeter
~..lXI
.f JIA1J'\ 1;.1$ (:,.w J/111;'1 tfMS? ,. -""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_
- Rev 110/,13/15 Instrument Field Response Check log
- 1. Instrument tnformatlon1 Ratemeter: Make/Model: Serial No.~~47<<" Cal. Due Pat~: '1f/!1P Detector l: Makl'.!/Moclel: SerialN~. ~/Uf{J..
Bicron MkroRem Meter: Serial No.. tJ M Cal. Due Date:. ..JYJJj_
- 2. Check Source lnformatlon:
Source 1.lsotope: :IA.;J.)... Serial No.: r/ I Activity: .?b. I units:fLC/ As.say Date:l..;2..~td Response Acceptance Range (+/-20%): uRem/hr+20% _**-*.~ uRem/hr-20W ~*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.. !t>/P1/1s-R:,y,~
.... ~'------~
""'*)<>* e..c.:r* Date:-~ Tinw: tJf,z.~
- 4. Site or Location: Site/Jpb: tfra.!\ J. f . . . ,r location Descrlplion:_ __;C.a=.'-r~__,_,;e""t"""lj)_* _ _ _ _ _~
r~ "" . GPS Coordinates (when required): X-Coord: N .<!);6'rlfl..Ff'lt 9 '. I: . o Y-Coord:..JllLQL'.{E Yti ..> 1,l I Instrument Field ~ Use Acceptance Criteria Remarks J I Meter Bkg Bkg C01,.mts Scio re Source Response* +/-20% .Inst. Battery Time Ambient !ni~ials and Comments *1 Cnt (cpm) or Cnt (gross q:im or source Ca lib. Check, Of Temp. (<id.~'l lofo; inst. condition, etc.) Time uRem/hr) Time uRem/hr} gross cpm current (V/N) check (°F) I l or uHem/hr (Y/N) (Y/N) . Ratemeter I fl4irt V/t.60 Q11v,
. I.
*p,yi,r.,. '{6/.f;l.{,
t:Jprv.
- v. y y 1
!J1f.t ft,'> :....rh iJ';l... () £.
Rate meter i IY\ iA 'j'(..cc "'un I tMir. 1{~'1 LAl~
*I
\f v,
........... v lJ!~'f(} 1L I /""-~ f"J7 PO ~
v. Ratemeter ' ... I .. l Ratemeter Bicron NA NA i Blcron NA NA Bicron NA :NA B1cron NA NA i
- 1. lnstrumcnt 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
Rev 110/18/15 lnstrumenHieJd Response Check Lo~ 1
- 1.
- instrqment !nforroatl2n
~/i/1c.;,.
Ratemeter" Make/Mod et: )... v0LUN\ .'J ') '1 f* ,,_.. SerialNo*. 2(,;,J/~I Cal. Due*9ate; Detec:tor 1: Make/Mode!: l;Jl/Jli/10. 'i.Y~ Cr> serial Nci,ll111' z, I
!llcron M!croRem Meter'. Seiial No. fl 1.1..-~ lA. 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 Response Acceptance Range {+/,20%): uRem/hr +20% __,__ u.Rern/hr *20% _ _. net cpm + 20% :iJ*:,15 ~ cpm.~20% _'¥"r__,, '"t*__
- 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..rt7 '-/17" Y-Coord: tf 2 ; '181)'70' 2
. - Ll!>:l: t'*ID~Q m~
I I Instrument Field*Response Use Acceptance Criteria Remarks r Meter Bkg Bkg Counts Source Source Response +/-20% Inst. Battery Time **Ambient tnitlals rind Comments I Cnt (cpm) or cnt {gross cpm or source callb. Check Of Temp. {add'I info: lnst. Condition, etc.} II l1me uRem/l1r) Trme uRern/hrJ gross cpm current (Y/N) check ("Fl I
* .oruRem/hr (Y/N} i 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 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 '( '( I~ *z.<; ft.;. s '11. 1-s'l.. ~ft.. l 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?..
I/) tlJ.lf{_ NA -
)r _M.,fl..fN. 'i
'f y Dql0 1'f>,"( . 'fl.. 'J'>."l s~
Bicron NA NA 11 ,.,Jt./Jf,,., '{ y J s'211 *~v.< 7y,, 2."\7-. St. Blcron NA v j_ .** J.11.Je. NA
*- I I ~ ,~./-/IL.
I
'I v y t32s- <;.y. (;p . l"{.1 2.?>Z. SJ!;.. !
- Bicron NA NA
- 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
Rev 110/18/15 Instrument field Response Cheek log d~ 1
- 1. Instrument lnformation Ratemeter: Make/Model: Lv~WJY.~~ Serlal No.d!:,t,, (!;f'/ 5?' Cal. Due Date; 1'/1;/Jfo Detector 1: Make/Model: z:",di ~-J Serial No. 1'f.~
alcron MlcroRem Meter: Serial No. H r1 iA Cal. Due Date: tJ tA
- 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 .) .\ Location
Description:
C .. r~e.fJ GPS Coordinates (when required): X-Coord: Nt.fd-. d-! ,if.q 1 Y-Coord: ltJ (2 76_:¥0 ', 'iq, 7
- r - I ln~t;~men't Field Response 2 .Use Acceptance Criteria - Remarks i 1* M.eter Bl(g Skg Counts Source Source Response +/* 20% Inst. Battery Time Ambient lnltials and Comments I Cnt Time (cpm) or uRem/hr)
Cnt Tlme (gross cpm or uHem/hr) source gros~ cpm Ca lib. current Check (Y/N) Of check Temp. {°F) {add'! Info; inst. condition, etc.) oruRem/hr (Y/N) (Y/N} I 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 ?" I Rate meter . l f Bicrnn NA NA * - --- I Bicron Bicron ! Bicron NA NA NA NA NA NA
- -- - l 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
rs
~~ 'TJE~I.. SEll"V#C~ Re11110/18/15 Instrument Field Response Check tog
- 1. Instrument Information~ ,
'Ratemeter: Make/Model: Li..t\\.\i.,'\! 22<.fl-2.. Serial No . .Z(,z..7:i7 Cal. Due Date: 7 /2 (,. ,,
Detector 1: Make/Model: Lu.cl(.;,"' '-lt\ *ID Serial No. p'2. I l 11 2. 7 Sfcron 'MlcroRam M@ter: .serial No.. N (tA: 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%): uRem/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 i' Meter Bkg Bkg Counts Source* Source Response +/* 20% lnst. Battery Time '*Ambient Initials ;;ind Comments il i I Cnt 11me {cpmJ or uRem/hr} Cnt Time (gross cpm or uRem/hr) source gross cpm or uRem/hr Ca!i!J. current (Y/N) Check (Y/Nj Of check Temp., (oF) {<tdd'l Info: Inst. Condition, etc.) I l i (Y/N} I Rateineter IM( iJ ffS'f l,PM / li\1 tJ Jf/5llc£.fl...__ y ~ y /{L{o $'t.c.. '"1"k7.3<... w l y j Ratemeter Ratemeter f\atemeter I Mtp.) . rff~"( cf,..,.: /MIM l z I.fl 7_. ((M, :..1 'i I' {t,~l/tf' '(tf'~ {,., *tt!Jl sic:- Ii
- Bicron NA NA I
-Bicron Bicron NA NA NA NA
----~-
~ I BIC:ron NA NA
- I 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
- Rev 110/lSJ/15 lnstrumen~ Field R~s:ponse Check l.og
- 1. Instrument Information*
Ratemeter: Make/Model: Cal. Due Date: Y1{£'- Detector l: Make/Model: Blcron MicroRemMet~r: Cat..Que,Date:/¢7//C
/*
.2. CheckSoun:e Information:
Source 1Isotope:1"&?3;... Serial No.: .. _JL f. . . Activity: .C()} units:;{?~* Assay Oate:, 1~;,t; Response Acceptance Range ,(+/;.2q%): .uRem/f1r+20% (<,,4 uRem/hr -20% JJSL. 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*nse2 Use Acceptance "criteria Remarks I I Meter Bkg Bkg Counts Source Source Response +FW% In5t, B;ittei:y Time Ambient. Initials <intl Comments t I
- ~
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 Rate meter t:.'.r 1*.:, { Mil'\ ltCQ'I !..,~- I.
\}, VJ
(
'11 I
~:e-> .'S7_ {,, 6--1~7
-rbZ Rate meter
*-=- --~.--
-~-~-
Bicron NA *6..it/!l,.,,,.//..,r NA .** ! "Sr Ll'AL, *:....- 1' \,/ I
\f I
\l hl/51 .* c;-'(j). fJ-19. r?.. -..J..~ :2-I '
..Blcron NA NA ()
Bfcron NA NA __ ... ___ Bkrori NA :NA i
- 1. Instn1me11t 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
Rev 110/18/15 Instrument field Response Che1;k Log
- 1. 'fu!trument loforrnatloni. ~
Ratemeter: Make/Mod{!J: /;,~~~ Serial.No. Detector l: Make/Modeli _______ _ Seria1:No. Sicrari:MlcroRem M~t-er: serial No.
- 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:f3 2- o L'of""A/}e//l r -' .. I lnstrument Field Responsel Use Acceptance Criteria
. R~marks
'CSl!~~l!lili'll
. """" ...I 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 or uRern/hr current JY/N) check C'F> I l (Y/N} :;,.*.
(Y/N) I
,">,;,A,
*== l Rate meter f '11';-d\. ~"t J.'1dJU\ /:Mir\- ir1t;_.r1 -
- R9temeter f-mi .... i qz. 't c:*,...., ,~..,,.,_; /It>/(,,. cJ,,.,._ Tl I
'\
r'
/
'-/'
{/ I :S..z >'" f~~z__ a' LC..
--23:/
_~ :rs "'I v*"JI. Jf9 i r
*- I 2 . Raterneter I ( f Ratemeter !
Sicron .NA '1* R~ IL;;.. .NA /"3C)11~R~- ll. ~. -;:,[ \{ r'!>si* '.L.(;,,Pj ~-).').._ . .ld9 I Bicr<m NA T ! NA I J I .,,,.,._ 11-**"'"*'
. _, **r 'U-fi:: I .Blcron
,______ NA NA v I Simm NA NA ________ .....__, I 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
'JTS'i' M~ 7f"dYCPl~.<:O.IL .$'S'll:~
Rev 110/'l8/15 instrument Field Response Check log
- 1. Instrument !nformation1 Ratemeter: Make/Model: l11J/vf{' s?J:'(( . Serial No. 11t."6':J_ Cal. oue DiJte; /tJjtf/!t:.
Ltl.Jtlf<t' '{.if-LtJ Serial No. i!K, :bt,.4142. Oetector l: Blcran Mlcn>Rem Meter: Make/Model: Serial No. 8613 6 Cal. Due Date: W'"
- 2. Check Source Information:
.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 Locatlon.9escription:_ _ _c.,,...a-:""*...-dJ:""""'".:~
. . . . .""'.~-.----~-
GPS Coordinates !when.required); X..Coord; /Y_Y2;;£rt 'f>i;"'l Y*Coord: W tJ Ii" l..fO $41: 7 ,,. I I Instrument Field Response' Use Acceptance Criteria Remarks 1 l Meter Bkg Cnt Bkg Counts
!cpm) or Source Cnt Source Response (gross cpm or
+/-20%
source Inst. Callb. current Battery Check. TI me Of Ambient Temp. (oF) Initial~ and Comments (add'! Info: inst. Condition, etc.) I I* I Time uRern/hr) Time uRem/hrJ ,gross cpm or uilem/hr (Y/N) (Y/N) check I I (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:'...;;- {/{)£,_
-* p
/_$ ~!?7 I ! I I Ratemeter Ratemeter Bicron 'NA Gvll111/~r NA I ;i_r_,/p,,,_k . '\./ IJ c...f f t,63 t;'-S: ~ /).<_ -rz. .-.).'$ )_ I I /' I I -
Bicron NA I fll.A J I/ Bicron *NA NA
~ ------- ***********-
Bieron 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 . .
Rev 110/18/15 Instrument Field Response.Check Log
- 1. Jnstrument lnformatlon 1 Date:*~
Ratemeter: Make/Model: Ll.ID~vM. ') J.:-n- Z.. Serial *No. J.(g 2 J :n Cal. Due Detector l: Malm/Model: lu/)j.-vlf"I. Lf.'L-1.E....___** Seri<.11 l\lo. tR. JIt I J J
- Bicron MlcroRemMeter: Serial No, A:-.:7 ;:>. Y (;{ Cal. Due Date: ~ *
- 2. Check Source Information:
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___
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 \ "tl l'i'
)
- 3. Tgcbnlcianl\~orker Perfoi:.mJ!J.lt~!!edc..~:
N~me: S1ff..Vt .KJtJLJ~AA/ mil:!; __t._rr'-.-~~- . Date: 14~t{rr Tim.;.: Ofoo 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 1 y;eoord: i!d 0']&:'.'~ '(9 -r~ J
----~l--~~--~~.~~.~~-.,,-2~~.._.~~~~~~~~~~~~--~~....-~~~~--~~----..,.._~"""""""-
i Instrument Field Response Use Acceptance Criteri;;i Remarks i Meter Ratemeter Ratemeter I 1111}) ?'~ o :S t *v j m1p/. llflwtl, f<f/ D h v..... I m11J 19f Dif c,""' JI q 7 7 - v*Yl,,
~
'i Y
--y Y
Y
.tJ 9oo
() ()f) o ( 5. I
. .f'S- "1
.17t.. Z>z.. 'S"li.. ...,.,,,,,,,,,,,::'
. <!J' /J 7 <.>IC.. -
------.i:1 Ratemeter / ,.,.,,,.; f 9?<w*IJ\r. *P I 'l ¥<!~ c. .. ,..,.. '- '/ y' IZ-1o
- 65, { LJ.._,.IJ,.,,,,_,i,.2---'),,_i:_.- - - - - - - - - - - ; /
Ratemeter 1f11f!V Ratemeter l111tfl/ q no I ~,..,A ) qr)o") n> '!ml/./
/ ,11!
P1JJ'L. _ __f___11XL_s..e!:ti_ -- '-/ ll. Yi5 (.?(tt \. y7 +/- *y I b () {)
/iooo
&b .1..
.&&. l..
ft. z r 7 st
. / , / f l st:
l 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 17 ?. 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 Instrument U:ield Response Check Log Instrument lnformation 1
*1.
Ratemeter: Detector 1: Make/Model: LiJ~WtY\ ~)<{/~ Make/Model: .lvtJ t-tt ,!Y'\. 1'.i-1 D
- 2. Serlal No.c20:l 1 3 7 Serial No. f/11 l 11 .l\
Ca!. Due Date: qtip iP t:hJ &
- n Bicrc;in MlcroRem Meter: SerJal. No. /I JJ 7' vi Cal. Due Date:
- 2. Chee So r 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% ~ Source 2 Isotope; C.s (} J Serial No.: ft.71! I J* 8" r 0
.ActlvJty: .. l,. units:~ Assay D<ite: i 'l. G f, I {1 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.*
-~~~~~~~~~~~- Location Descript!on:._...C.._o...g,,..A1..._.._6_..1_t:._c...=tJ------
GPS Coordinates (when required): X-Coord: ,111 lf..J, 'tf'I Cf/ Y-Coord :.JA) 018'_,_{41 71'1 2...
! r Instrument Field Response 2
- Use Acceptance Criteria Remarks I Meter Bkg Bkg Counts Source Source Response -t'/*20% Inst. Battery Time Ambient initial~ and Comments i Cnt . {gross cpm or source Ca lib. Of Temp. (add'! Info: inst. Condition, etc.)
I Cnt (cpm) or Check I Time uRem/hr) Time uRem/br} . gross cpm oruRem/hr current (Y/l'J) {Y/N) check (°F} I Ratl:!meter f /fl I!l) Kf'f\ d.J m1t/ ,Jo '3 I ~ C,*l'h (Y/N)
.,, y L_ &11( S't: if l/J...ZJZ
~
~**-""""~""'"'"-""*"""~"'-""'*"""'*~""~~I 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 ' f 1'1/!fi/ l11 .;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 t.,'i~ ' y y v t Jvo lk} Cs 111 S£. I Ratemeter '/r111r.I C'o Z t/ (. ,,,, .J (il/t./ _i).c.> *1 '?' 4 c.r ,;.., '-( I '( 1:CTJD 1 i.. 3 f /.. :;i_:. -l.... 'Sf: Ratemeter Jm1rJ *CJD.Pf '*'I' / !¥_!/;./ . n.SYlf i."'1-.....,, y I
'I s {.~ 131 "0K.
-'1,, /~D J 1..
Bicron *NA -7 .\l..ilt*>1 I! NA IX' ;,L"" WI y 'I oq1(" \.(, '1 -7'1 2:rl s~ j Bicron NA } ,/lt-t ! NA (-7 1-lh."4 !,.- ;
.... y liQg_ __r;,c 1 11_ Z.1?... 'S~
Blcron r:-**...,........... NA______]....J.J4-.I~ ,_!:!~*-*-*- I K' !J~"-M p.. ..., .:.; .'1 ;t,;7Jo /'2., 3 f11 .l~L s.t. i
- 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 .
zrs MJ~ TC~AL .s'liSM~~ Rev 1. 10/18/'lS Instrument Field Response Che<:k Log
*1. Instrument 1!\fowa!IWl Ratemeter: Make/Modef; Cal. Due.Date: If~
'Detector 1: Make/Model:
Bleron MlcroRem Meter: Cal. Due Date: tJtz:_6ff.C
- 2. Check Source Information:
source1 Isotope::~& Serial No.: !r/ . Activlty;<b{_ unlts:,&G Response Acceptance Range (+/-20%): uRem/hr +20% ~ uRem/hr-20% ,.13-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: Wb7r_* .:tf> />?.. Z I l instrument field Response 2 Use Acceptanc~ Criteria Remarks I Meter 61\g Bkg counts Source ** source Resp0nse +/~20% Inst Battery Time Ambient** !tlltials ;mci Comments II Cnt Tirp(!
(cprn)or uRem/hr) Cnt
- rime (grosscpm or uRem/hr)
$OUrce gross cpm
*or uRem/hr Ca lib.
current (Y/N) Check (Y/N) check Of Temp. ("F) {add'l lnfo: lmt. Conctttlon, etc.) (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'/ (.?l'h 1 I w-Tr-1.. /lYJLf,ft' r.A,.._
, v I"/ -**
w *~1
. :;-G. 'S /"_:; .. ( '37 v-ac;.
£/
~atemeter.
J i I Rate meter
*Bicron 1 NA 1'7b J./J'Jld.tfty NA
' I 12c..,"", .... tC..v *wI (/
-*** T
~(/
{)t~'( <t~ fTh-2~) u ZJc: Bicron I NA NA ' J
~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
Rev 110/1s/1s Instrument Field Resp.onsa Check l..og
~nstrument lnformatlcm ' ~
1 L1,1, o;; 1. Ratemeter: Make/Model.: Serial No. ~iC,.f(,~ . Cal. Due Date: r¢s;f/b D~tector 1: Make/Model: : : l"it."'V. : Serial No. . 'g;z_t;h{l£1.. 6icron Mlc;roflern Meter: serial No .. :&'J$G.. Cal.-Oue Pate: O'f/.off-'
. 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% ~ 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..."1J ne.~cpm -20% ~-
- 3. Technlti;m/Worlser Perfor!Jllng Che.::ks:
Name: X EJ""s~.f!s.
Title:
-~"fl~c_r ___ Date:!¢t/1S- *Time~~ 4 Site or location: Site/Job: A:t:.~fi '1 ( AfJ_J) ti> f~c;I
, . *AJ 1 Location
Description:
"".,.;- o'; ~,
~....,4/,.R_
---'===~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 I Meter Bkg Bkg Counts Source Source Response* +/-20% Inst. Battery Time Ambient lnltials ai:id Comments 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) v Rate meter {;If.~ r , Raterneter I (\I\ If\ 1J,'fJ.~nM / i.1A~
<;* 2 cl L. ', r*'I'.. 1;,,.~
lf'J7'n / i'l"-
//(/Oil }~~~
'F i&-- . VI
\/
~'.!
("fo'i l~f> tG.7
~~.
rrh-)'$2. ~
' [/" <:;' ~ { 3 "7 V"f15"
. Ratemeter f I V' Rate meter I I Bicron NA "I.v11,.../~~ NA ~ 30/l/rlAIA. //1111' \/ I \/ f----.. L313~ ~.~ -rrt...-:1-5 ~ ......Dr Blcron NA
' *r NA I I f I Bicron NA NA :
Bkron NA 'NA 1.
- f 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
Rev 1 10/18/1S Instrument Flcgld Response Check log 1
- 1. tnsilrument lnformatlon Ratemeter: Make/Model: Serlal No. /fC.£,Clf Cal. Due Date:~
Detector 1; Make/Model: Serie! No. ,"P~t""ib/f(L Blcron Mlc:roRem Meter: Serial No; .pc.q 5~ Cal. Due Date: ~~k-'*
. 7.
- 2. Check Source lnformet!on:
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 I 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 "~ Rate meter !'"" .; .....
,. *-.I I ~-:"v\ llJ!IY7c'1,,.,.. -!./ Y./ VI /~J,./ -~7.l/ /'~ .. /-c;./ a~
~l.iifii.tfl~ ~'1 ~ i g .
I f f {/ Rate meter G">fk. Ratemet~r Blcrori Bicron NA NA
~IV/Pf/Ar I
NA NA _j_'j')_p1~!£..r I*
\f J
\/
I.
~---
-¥--~- (er-,(/() 61,q ..rn-.:.i~1-fJ>
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
Rev 110/18/15 Instrument.Field Response Checkl.og 1
- 1. Instrument lnformatlon Ratemeter: Make/Model: Cal. Due Date: JJ/p3{15,..,,
Oa1ector 1: Make/Model: Blcron MlcroRetn Meter: car. Oue Date: c;(../!Wto 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 3.- 1:: 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 . Location Descrlptlon:-O~:;v ~1'" Ct.Fr 7
GPS*Coordinates (when required): X-Coord: tf2 ').@ IZ. ~ Y*Coord; &Jf3'"' 'II~&£.~ . I Instrument field Response 2 Use Aeceptance Criteria Remarks ! 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 Rate meter 1.0 7 31/tl s*** I .r:.J 9~.,;..97 (.>y"' y .v I y 11 >fO kV. q" /)/?.I ~..J _...~ u......., '-IF . 0 1')1 Rate meter Ratemeter ~--~ Bicron NA 1. r.:i ..,e"".\, NA </@~<-1 y y v Goe. er~ \ti. z.s i.
,!). (...,,, l (;?&;-.'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 Instrument Field Response Check log 1, Instrument lnformil~ionl .
Ratemeter: Make/Model: tv!k~.tfl\ ).') ¥! * ,";/, Serial No. 1 W).. ~ Tl Cal. Due D~te:. q It./ 1 ~ No. ?k1 u 121 Detector l: Blcron Mi~roRem Meter: Make/Model; lvOLv'\I\ '11./*1 o Serial S~rtal No. .t) .24 '1 l1.. Cat Due Date; !/!t£t.?
- 2. Check Source lnforrnai:ion:
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 Date; J..Qf?ij6. Time: 01.Ci.t"
- 4. Site or.Location; Site/Job:_.2.,,,...,,.,,.""'/.._*- - - - - - - - - - Location Description;_S_,_:_!>b_c~1-0""o..,'.~h-=-i.~-~--
GPS Coordinates (when required}: X-Coord: A/qz:..1.1.r J / (,.,, Y-Coord:_!c'~].f. 101~ <... I Instrument Field Response 2 Use Acceptance Criteria Remarks ! I Meter Elkg Bkg Counts Source Source Response +/-20% Inst. BElttery Time Arnbient Initials and Comments l Cnt Time {cpm) or uRem/hr) Cnt Tl me (gross cpm or. uRem/hr) source gross i;pm Calib. current Check (Y/N) Of check Temp. (of) (add'! Info: inst. Condition, etc.} I l I or uRcm/hr (Y/N) i I I
.. (Y/N) I Raternet~r ii /fiiN 'l"lOl*c. lj rl1trJ lg 5z.r;--, (. ,*~"'- "(
y' y
... v y
O(..ico 1*1. '1 Tl-P2... ~k. i
- l. Ratemeter ,) ft'!lfll It.to l .. : I Wl 1;.J fo!\tq{° ~s10 t~*\ * 'i -***-
t\f*1... ... 11."l (.~ l"fl 'St j i Ratemeter I/ 1111// 9i. (;}{....,~ J!Mt ti JC/ I / (o -i;,..r1JV\ 'f v y' I l3CJ I{'{ '( fJ\ 21t 'Sk I i Ratemeter hr1utf fr(,, i:i (,vm ).'AJA/ )']; I t1 "'L (.**"' '( y* 'f' {-Z. >.;. ~q. '{ (, 1n ':)le:. i Rate meter } tY!I V } '12 7 .:*" J fVlttJ ff I ; I '-'"V\
\j I 'I y , (10 fi-? *~/<./{7 *SI(
. "I y y Ratemeter lm.rrJ l(Z.l,.,,, j (II/A/ ;.c;sfl'Z- , .. ,.~ 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. / Bicron NA /;., 1.;.(b<1!1 NA J 'l J 11.,,,., "" 'I Ll5)o I t;"z.:Y Ii-\ 2~:~ *') V- I l.
"-{
i 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
~
M..Jl'l}-V TC~IL J>eft~ Rev,110/18}15 instrument Field Response Chee!< Log
~~
1
- 1. Instrument lnformatlon J.-,!ff,,
,1~y0 I
/.
R~temeter: Make/Model: f.d/t~W . 'r , } Serial No. c9cr:a*c1~* Cal. Due Date: ,hb, Detector!; lYlake/Model: L.(t'k**-1 ft/-16 Serial No. f"RJl).6"fJ _) Bicrop ll/licroRem Meter: Serlal No. N /J~ 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:. Location
Description:
____.g,,,,;,c>j,..;;,,,. _,_:;;;:dJ._~_:.>"1~----
. "Y..1.
GPS coordinates (when requlr~): X-Coord:_N_!/g, 'ft2./?- Y*Coord;lf/ 07!. Z6l12~ T 1
' Instrument Field Response 2 -* ==-
U?e Acceptance Criteria
~~
Remarks l l Meter 6kg Bkg Counts* Source Source Response +/-20% Inst Battery. Time Arnbleot lnillals and.Comments (gross q::im or source C;lib. Check {add'! Info: Inst. Condition, etc.) Cnt (cpm) or Cn{ Time Of check Temp. l TI me uRi:m/hr) uRem/hr) ,;..WIWS cpm
- current {Y/N} ("Fl i 1
'.or uRem/hr (Y/N} i 1
(Y/N) I
~ w:*4 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-'fo/C..t/!W' '{,(
- f--,- V/ /J112
-*?:</,q l/'..:;.*i?I v~-
Ratemeter I t .( Ratemeter ***-- Bicron NA NA ~---- I 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
Rev 110/13/1'.i Instrument field Response Check Log 1
- 1. Instrument lnformatlon Rat<?mcter:
Detector 1: Make/Mode!: Make/Model; Cal. Due Date: ¢1.k-Bicrcm MlcroR~m Meter: 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:
___* f_ Y_ /_._
- _
Data:tpP.J/lJ Tlrne:/...2-~ Tl
- 4. Slte*or Locati91!: Sjte/Job:_ _...,.A~~""'"~-"~~,2.__._f_.,..- ___ Location
Description:
. ~.k.L(- Jk~~IYI _____
GPS Coorqlnates (when required): )(.Coord: /:L Q. ml~ v,coord; !t),ozs., 7ofl?/1° l!l!ll't~~ Jr ~
~*a ,.
i
-1 i Instrument Fiefd Responsez Use Acceptance Criteria -Remarks i I
j Meter Bl<g Bkg Counts Source* source Response : +/>20%, lnst. j Battery Tlm.e .ll.mbierit Initials and Cornments j Cnt Time (cpm)or uRem/hr) Cnt Time
' (gross cpm-or uRem/hr) source gross cpm Ca lib.
cuuent Check (Y/N) Of check Temp. ("f} (add'i lnfQ:'lnst*. Conditiori, etc;/ l
-~
-DN!Rem/hr (Y/N} 1
, (Y/N) Rate meter . l'M*f1 'fg1'( <:.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. 1 1
*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
~~~-~~--
**-~i!JfYT:!E
..:Z.-'i.-i.*~ TBCHNIC..:.~t. 'SEN '\.,7iff?s. '~ev 110/18/l.5 lnstrument:f-leld Response Check,Lo8
- 1. lns!r..,umi!nt Information1
'Ratemiiter:
- Make/Mod.el: LUDLUM 2241,2 Serial No:~ *cal Due Daro:; .'9/2/l:g.
Detector .1: Mak~/Moileb _:,;t.l;!.Ql,,.lJ.~i'J..O. :~:. .seria!No; A.B.i1UZ7.....
*BlcronMli:roRem.Meter: Sei'ial No, *. A:214lL__ Cat'Due Date: ._8/4/16 2.. Check Source lnfotm;ttion:.
*sour~31s~top~:,ib=z32 .serJaJ.No*. It!? . ActMtv: £1,l._ .. -units: -l!CL. As~av:Dat~; J:.2/30/10
~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;
. 7 v ..
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, _____ u .
.** Q Joc.3tbn .Oescription: Dor .......~.,*
GRS'.;:1J(lrd1r>dtl>:>.(\\0 tJ~o r~quired); x:.cor:nd:;Af.*::/2.f_*_?."["?:i...: ...... Y*Cuord:J,;.Y_J.'.DK b'/572.
.* ;r* 0 .*-**,*** ""*"'* ~.-....~*(*, .. ~,,, .** ~ ..... *,}r ... *"~~* ~- .... ***~****.t--:*'"-* 1******.~:-- .* ........ .**..*. - . *~**"11~*~*;-***
1
.. ,............*,,1*****"r"i'..}**;:\~ -.. .. * - ~-, .. = 1..-s.:- * *a *rJ"5'7'1,.,_._,.., ..
. : lnstru.met:ir Field Respiln~* a. _ . U5e'Acceptance Criteria . Remarks * *
... -M~;;,---T'.'tikK~;*ai-itc~~-~,,;-~ 5;~~~;' '"s~u*r~~*~p-ons;* .,r. 20;;, ln~t. eattP.ry** r Tir:l'e .* Ambi\i!rf' lmt1als and Comments
~. ; Cnt
. Time ; uRem/hr)
I jcpm} or en~ Time (3ros.~ cpm 'or uRem/hr)
-so1,.1rce grc:;s .cpm '.
Callb;
.r.µrra.m cn,ecJ;.
(Y/N) 1** bf
.. i;heck T~m{.I, cfF) u:1c1::1'<into. :mt:;<;or'oiucm. etc;
- ! or uRem/hr {YIN) * \
- J.:~:~t~.~i:l.~~I.~~h'<-'!riil~~l:ff,;. /J/Jl. "\"\ * ..* X." .. .;... { ... ;J.17~~ ...... YS"~\11.*.rn.,.. .bli.:7.. ,~.f-, . ......-..~~.,.,.......... -~
r::~~:i;~*-.~,LJnl~ t-"ii!f~-ij. it!* i_,.:._ ........ ,...... :..:l:_.01(.+ . .,,.9,.A .:CZ!' :':1}1J&'. + i
,.1t~zoz c~~
I: .... :-;~:r' .. ,..
- Y..
y i........ .~. i. tj:i;5.. Jf'J*--
. 1 ..... *./*" *+**"
i
+; .
?:~~ ~
~"L~>..-p..,.,"'. .i: ...... ~. -'--- .. -.:.:.,___
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, tror ...... L~A . ___ .,J . ~~/ .
1 ___ , . 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 * ,
~
Ml..i~*rEC4'£PoHC-..,,.,_ $airVA1C.er Rev 110/18/15 Instrument Field Response Check Log 1
- 1. instrument lnformatlon Ratemeter: Make/Model: Cal. :Que Date: _ Of°y/I(
Detector l: Make/Model; Blcron MlaoRem Meter; Cal.. Due Date: N*M
- 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% _ _* 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; {)J 671f.~ (:,'f>f ;L"' H
- M"Mr$);
I
¥J'
! Instrument Field Response* Use Acceptance Crfteria Remarks f
Meter Bkg Cnt B~g Counts (cpm)or Source Gnt Source Response {gross cpm or
+/~20%
source Inst. Callb. Battery Chee~ T!me Of Ambient Temp. Jnitlafs and comments (add'l Jnfo:*inst. Condition, etc.) I I Tln~e uRem/hr) Time uRem/l'lr} gross cpm-or uRem/hr current (Y/N) (Y/N} check ("F) !
. (Y/N} I Rateineter I vv,1P... *.ig 1 (7e; '1M- I **A,\,\ . Lf')It'? t-#fr>: ..:.1 v ..J ()1j} '-?1* 5. "'fh-;;. f? IJF I Rateme.t~r Rate meter IN.I ..... li':-/<;"J (*;~ "f M*""r lb?o'i ,,)..,..
I tJ I
~I l
*./J l
tL'l.:f..P ~7.~ /,, -tz-7--&£.* I I 1 Rate meter . Bicron Sicron NA NA l NA NA I I 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 -
- Rev 110/18/15 Instrument Field Response Check log
- 1. lns~rumertt lnformatlon 1
L ti! Ratemeter: Detector 1: Make/Model: Make/Model;
-::r-£C::-rilf=""ff:-;j-
~--- __
Seria!No. d10G0'7& Serial No. &l-11.2k.c..f,7... Cal. Due Date~e>~'tf' Blcron MlcroRem Meter: ~erial No.. N (~ Ca!. Due Date: M i-A-_
- 2. Check Source lnformatjon:
'Source 1 lsQtQpe::z'6:~ Serial No.: //I Activity:<'?_~/ unlls: tvC/ Assay Date:ld{.Jt/tl!>
ResponseAe<;eptance Rango {-t/*2D°Ai}; uRem/hr ~20%__ uRem/hr *40% _ _.~ .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: /IfA Response Acceptance Range (+/*20%}: uRem/h r+W% _ _ uR.ern/hr -20% _ _*~-- :~ cpm + 20% t 3;l.7J 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. b._.*--*__
Site or location: Site/Job:_ __.._A-r-"-..._t....__.;?-,__*..... 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 ~ IOI'"!
--*- ~""~9.J~!;l;;l!;:
I i' Instrument Field Respi::mse 1 Use Acceptance Criteria Remarks I I i Meter Bkg Bkg Counts
- Source (cpmJ or Cnt Source Response +/-20% Inst.
calib. Battery Time Amqlent Initials and Comments {add'! info: inst. condition, etc,) I I Cnt Time uRem/hr} Time (gross cpm or uRem/hr) source gross cpm c:urrer:it Check (Y/N) Of check
.Temp.
(QF) Il
-0rvRem/hr (Y/N} iI J
(Y/NJ Ratemeter I Mfr g-bt. I A~A- L/'S"'1isr:m,.... y v v V3;u.;; S-<T.6 -r,;(-,2_,'.g .2 07 J *-*""' Ratemeter (I\';" ~t..Gl c.-f1~"' f ,,.,,~ IO. ..h)--'f _.;.,.,,. 4f A/ I
!\/ 'I"'{ "5 -:( sq fl
/.:s.-/37 P'/lt:;;
~atemeter ( If/' __J
- Ratemeter l
- Bicn.>n NA NA I *- ..
Blcron NA NA
- Bicron NA NA Bieron 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
- Rev 110/18/15 Instrument field Response Check Log
- 1. *instrument information 1 Ratemeter: Make/Model: l. vDt-v1n 2?-'ft~ 2 Serial No. 202. l r7 Cal. Due Date: 11( 7. f1 lt' Detectorl: Make/ModeJ: Lv;'.kd.!11.. ~Y'-1.0 serial.No. fif. m J J. I Bicron MlcroRem Meter: $erial No. A l .1 o.f iA. ~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_ _ _ _ _ _ __ Location Oescription:__.4::'.' ........Y
....'J'""c*""'f....""",:=..)"'"'fl'---------
GPS Coordinates {when required): X-Coord: A['/2 ° .':11! I 7: l ** . Y*Coord:. tdvlX" 7"t'J{L5" l I Instrument Field Responsei Use Acceptance Criteria Remarks ! I I Meter Bl<g Cnt
. Bkg Counts
{cpm) or Source Cnt Source Response (grnss.cpm or
+/*20%
sou rte lnsL Calib. Battery Check I* TimeOf Ambient Temp. Initials and Comments. (add'llnfo: jnst. condition, etc.) II Tlme uRem/hr) Time uRem/hr) gross cpm current {Y/N) ctieck (QF} Il
.or uRem/hr (V/N)
I (Y/N)
~
.. l l Ratemeter I n1~v f!Jts(~1' I m11o.1 /1M7 (.~N\
y }' y {,* 'l'/.{ Y,t!l 'fh ZJl. ~f( l J Ratemeter . Jm11J l(:'f f<( """ ) m.1..I JI i:L< ,._~*,,, y y v D\*!f*x" if/ . ..., (( /J')* ~f:. I 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. 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
~icron NA NA t~ )* '~* NA
~ uK~ NA I Jr )*:i:+/-i
,. f( ,,,.._/&.
'j y
y y 1 y' 1 *it.,... 0"15
,,, ~9.1 r;t.*(
Th 2.?.2. 1l-i 2.:,-.z..
~!(
~K i
I I
- 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
Appendix E-lnstrument Check Sheets November
Rev '.!. 10/18/15
*Instrument Field Response Checklog
- l. Jnstrument lnfQrmation 1
- Ratemeter; *Make/Moder;
- WDLUfY,l 2241-2 Serial No .* 292737 Detei::tor 1; M<ike/Model.:' ~!J.L~44::..10 * - .. -Serial No * .J:1Ull1;?.L Biaot1 'MkroRem Meter: 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,- -*.--~~---~'"."'"-ini..-=~1--:.-*,..-:_--~"l<*ll.'.............,.! * ., *~<?"'.---::-.>~,;- 'r'._ ... ..,. .* ....,.* -v.~~'!?'"~**-"*"f"'""...-.'-*_..,.__._..,_~.,_.--~-~---=~=-~-_,,,.~----~--*~----~.---*
* *~ lnstrumentfield Iles onse* . Use *Arceptance*Criteria Remarks
-------**-* Sour.Ce *Response Meter 6kg Sourc.e +/-20% Inst. aanerv Time Ambient .. lni,tlal~and Comments Cnt: .Cnt {gross epm or sour<:e Calib. *Ctied; Of Tl'!mp. (~dd'I Info: ins1. CondiliOll, et:c:.}
lime Time uRern/hr) i;:vrrent iY/N) th\'!ck r"n {Y/N} Ratemeter 1
~~~eter _::::::_+/-:::.=' *. _w r~-*- --H~i)Z s;- -----~
Bicron Bicron __ NA NA NA
. . = I: *
~ ...v:
t,. . . 1 {]ilV ..., J:f_ ____ J1'.}}*_g .. :~.r,___.. __________
-rl 1 i.~-? St..
1
.. - ... _............ __ _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 ln~trum~nt lnfortnat!Qn 1 1. f.!~temeter:
- Mak~/Model: LUDLUM 2241-2 Serial Na. 2fi2!37. Cal; Due Date: 9/Ulfi Detector 1: Mak1,;/Model: _lUDLUM 44-10 Serif!! No. ER.11112Z Bicron Mh:roRem Meti?r: S~rlatNo . ...h2;1.4U . Cat, Due Oate: 8/4/16
- 2. Check.Source Information:
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 .
~~ ......~~--~ .......,-,__ ~~,.,,....~..----~-..~~--....,..,....~~~,_.-
Us c Acceptam:e Criteria
- Remarks 1
Bk{l Bkg Counts
- Souri;;e Source Response +/-20% Inst. J .Battery Time Ambient lnitiGJls and Comments
-Cnt [cpm}br Cnt (gross .:pm or source Cal!b.
- Check. Of {add'l tnfo:Jnst. Conditiol'I, eti:.}
Time uRem/hr) Time ur.em/hr) ~toss cpm current [ (Y/N)
- check ciruRem/hr (Y/N) "
___ (Y/N) i Bicron Bicron
R~v.110/lB/lS Instrument Field Res;ionse Check Log
- l. . fnstrum~nt lofor.mi!tipg 1
Rat!>meter: Mafie{Moditi: LUDLUM2241-2 s~riai No._2627~7
- Cal. Due Date~ 9/2llfi Detector 1: Make/Model: !JJPL~1.Q___, .)erlalNo * ...£1:! in*12z BlcronMlcroRem IVJet~r: Serial No .* ~2H~
z_ Cbeck ~puree Information: Source J Isotope: Tb-232 Serie! No.: '.l:J.6 Activity: .<O.L lfnlts: ~!CL Assay Dat~: .UL3QJ:!.O Nespo11~e Acr.eptance Range {*1/-20%); uflem/hr.*~20% .'?o~* uRem/hr "20% ~J..i_ 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
~~"'~__,-* * *>** '"'"",11'"'1r"IT"'art~~i'G.£.."l'tl<t"l*~~T"I".'~~ ~-,,...,._-~-#!am, *~"' ... -= ,,,_ .
~---~....,.,.h-m:t_..,,..._ ~- . '"!
. I Instrument Field Response 1
use Acceptance. Criteria- Remarks
-Meter
* - Bkg
- ,..._........,--*Sour~e Bi;g Counts
- Source Respon$e ti* 20% Inst. . Battery Time f\mbieAl Initials an.tl'Commr;;nts :
Cnt {cpm) or ! Cnt (gfOS5 tpm Of source Calib. .Check Of Temp. {add'l lofo: lrut.. Collditlor., etc.) ; {Y/N~ {~F) Time uRem/hr) ' Time uRem/hr)
.8l'OSS. cpm cwrnnt check
!l I or uRem/hr (Y/N.)
........,.,......,""'*,..,..._,._<"'=""""""""""~"""".tU'.f~~""""""""'""""""""""""n=,;~....;."""""""'°'"'"",.,,,.,.,~..-
(Y/N) 1
., -r.:mm~~iSVQ~~*.rnMJ'XY,t?'Su>:Mr.l:t*imA°f i
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 m11J &"'$ 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 1 f'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
_f .<.<.l;;.,J NA.. 11no1,p ""' l '"1 <i:fl,_.J u£
,*r Y
___y_H __ _i._ t_ :1cvo ** to.2__ ..£tl!J.... _.J....t. -------------; ri:in_ _ . NA Y /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
! Ambient
~-.-~
Det; 8Kg aim Sour¢¢ Source- +/>ip%of:
- lnst. Battery Tbne 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' to e,va!V-\1~' i11~~f!JJ1)e~t'.st<1blil\y 0
~.~~ *~-~ ,~ ......
- ..w..i..+~*T~ll. S6lR.'9.-~~E$*
Rev 110/18/15 l~s.ttum~ntF:leld1tesporiseChecls tog. 1
- 1. .lns\rument, lnfcrmatiofi *
* '.Ra.temeu!r: *Makc>/M9del: L.UDLU.M 2241~2 S~rial*No *. 21j2 231 Detector1: Mal<eJIVlodel: . kUDLOM.44*lO., Serlaf~9, .Jt.liliH27 .
Blcron:MlcroRem Mete~: Serlal. J~o. Y.,.2,.,.2.,_.4""U..._...,.... CaLDue:Oate: 8/4l16
- 2. Check Source -Information:
,Scii:irce.ti~~tope: Tb-232 . :Se~!~I No.; _i>>.6 . AttlvitY: ':SQ*..'L*. .units;. _UQ~ .. Assay Dal1F.W3o/10
~e~pon..se. Acceptance RangeJ-t /,,40%): 1.1Flf!m/h(t 20%,~:!_. -,*:* u~eii1/hr *20%.-d- 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. ~ **
Initials and Comments {ad!l'Unto:*lrist..Coriditmn,etc,) 2/.
1.. murnmentinformatlon1 ,, 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.5cfa 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,2 5 CfJil. . .. . .. - - * *-* .. me
- Oet No.
* - {1 t2)
- Sj{g ..-.
Ci:i:R TJme;
~~g
.(a\!g'.of3)
(~pm)
. Soll.re~
Cnt Jlme
*~pure!!
Sesponse
'. *(:G~)' :
+/"-2Q%*of
* *source Net cpm
*. Battery Ch~ck
. {Y/N}
TI Of check* Alnbientc tnitiafs and '.C-0mments Temp*. [ (ac.!cl'l Info: temperature, lns.t. Conditlon, lf! Qtt0} l I
\
. ~cpm '(Y/N) i.
.'-......-~~................:~""""'""""'""""'"'*""...._._,._:_~""""'~-. ~~"""""'-.,._,,,..,,__..,""""'.._,,,.,_""'I
,I'.
i. 2,
R~V 110/18/15 tostrum~nt:Field Resppnse Check log 1
- l. lilstru!l)got tnforlj'latloil Ratemet{!r~ *
- iMake{Model: LUDl::UM-2241-2 *S~i?.LNP._l~?TI7 Detector 1: Malr.e/Mbdel: *. tUDLUi.\ll 44~1.Q. ~~~ *s:erialNo;, __~
-Blr:ton Microllem;Mfiter: serial ~~o,. A22~4~U_ _ (;al. Due Date:. 8/4/l5 .
2~ PJe:kSyurce lnforrriatiou:
.sour.eel 1sptope:I.D:i32_s~rlal No~; .1.l.Q.....---.-;... 'Activity: .s.QJ,;.._ units: .~i.... .~sav Date: .12l30/10*
Re~ponse Accepta1\~ ~ange*(i/;203): µRem/hr +2Q'¥> .!~"'~ ~Rem/hr *20% ...J..tL. .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 *-----**- .. lnt<ltion.Dt!r.cr'1Pti.:in~* i;J.!~,""0""5""',---~--M--*--
.GPS:Coorl.iinafe:; {i\ihen 1equired}; x,coord: .,f r:t Z,4(....J._'"___ ---- Y-Coord:Jd£1:.~'-~-~.]_ ...
..~ ... --:.~--"""'V'*'i*~*.. -...,...,._~ .,,,.rr: ...... <";r";*.**'--""" .. .,,qi*.-~ .. _. *t:rooi.'.!"'°"****," **~**-ru~~,.....,.~ ~ n-==-..~----~.-----------.....,,~~-- Mei,; 1 *rrme i uRem/hr}
- Instrument .Field.Ae!>ponse.i
*~.~,~*:*s~:P~:'~ ~s~~~~.-:**....s~~~~~sR:;!o~:e Time
- uRen:i/hr}
+:~~~:
.gross cpm Use Acceptance Criteria
~~-
wueot
- BJ~=~
(Y/N) T~f ch{?<:k Air){li~rit Temp. (:f} Remar~.s
- _1riit1a1s arid'tomment~.
. :{apd'I Info: tnsr. Cotidition; etc.)
- o/ uRemi!)r *('f/~). !
(V/N) Ratemeter Ratemeter* Ra tei'neft:!r .** Bicron Bit:toh
-*-.-~.1 '
.. --"*------~
_.. ****--*** __ _. J
{z-7~~~~'*'-i.:.;.,...~.. .
""*""L*~-*'J.~7f[S v'"--*":.-~* .:;_.->
P.><;J"f.rV T~AIL §"~~E;S"
- 1. Instrument lnforroatioo 1 "I .
f~*//t. Ra!emeter: Make/Model: -~~/.£<.:::-~"'- .z~"'~{} St>rial No. dWlC/f Cal. Due Date:t°J D_etector 1: IYJake/Model: ..Ld f v;:12 iflf,,,.L') Serial.. No. Pkil)1**4;t Detect~r2.: Make/Motje!: _ Serial No.~----~ Z.
- Check Source Information: . * ,
Source llsotope:. -tf1*\)J;) Serial No.: 1f I. . . Activity:~. unlts: pt./J. Instrument Re.~potlse A~eptance Range-{ sou re~ cpm- bkg +/-20%}: ('f£d3.*IJ- [l_ C~ [j_*, Source*2;1sotope: (USerlal No.: l Activity: units:~ Assay.Date: -._ _ Instrument Response Acceptance Range (source cpm
- bkg +/-2o%): * *rel: cpm + 20% 13'271 ~t cpm -20% 2:8'{'1
. 3.
4. J ( ! i f I i l -- - : I ;l'i.),'l i...j..{JZ;Cj/ V 1'l fV frtt;*? LJI/, 7 a .~ft,. .. ;;z.;:2 /*i < l * -- -* 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 Instrument Field Response Check Log 1 Instrument lnformation 1 ~
' Ratemeter; Detector l; I I Mal;e Mpdel: t/:;,[ft.r r-*c-rL-,c..
Make/Model:
!fl .
i/,,,,,,.
., -, ,., I '
;/21 ~/I
. . I Sena No. ~<.!:.'.!:-'"' ~' : ..
Serial No. fj? ilU'$L6:
"")..,,..-...:c.z: Cat.:oue Date; o1jet.JI.<
Bicron MlcroRem Meter: Serial No. l'iy.:J.. __ 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% _ . _ * -* - uRem/hr -20% =......_ - -~ q;m +20%('.5,,;Zf n.~ q;)m -20% -S".81'-f
- 3. 17*/
Title:
1<. ( *
- 4. Site or location: Site/Job:_ ,4(<?v, L/, ~ _ Location Descrlption:,_ _ _w_()_1.__;:<..-_,*}""'-
GPS Coordinates (when required): X-Coon:j: IV xf-'..r.f... 1_.;i.-? Y*Coord: j,J 7~ ¢ l.~ ;;,, %..? ~* i r i lnstn.unent Field Response 2 Use Acceptance Criteria Remarks i i j Meter Bkg 8kg Counts Source Source Response +/-20% Inst. Battery Time Ambient Initials and Comments II 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) ! ~ '""""' Rate meter 1 mr r . f D l 1 2cti. [Jll{iY- '/'--<"17 <p}"' or uRem/hr (Y/N)
>./
(Y/N) v ~-
\j I /tJl'--1 37. (,/ - *n ---
¢> 7 .L'L-7.J.. r c..*
Rate meter I mi 1, *tj.q7 , o n z. <**t: .* ,.,.,. '"**
. i/'17<1 .::#...,, \,./ I. . .} {; /n1< :;*7~ T 0
~<: *1?'7 !2~
I ~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' / I ~* 13yr- ':z/~-v Cs. \~7 .?/£. Bfcron NA ..;-;,t(!J.,11 NA lJIJ.- -//;_ I.,
--.u 0~{~\J y YI l/U.l6 ;?7_,;)_ "'t-k- "J ~ 2v .. l:) ~-
Bicron NA 11' 1 rl " NA '?£} (11./~ 1 J.,.l./ {I '1 /5'10 ~2.c.r- .-Hi . . ..??2 ,ij>' 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
R~v 110/18/15 Instrument Field Response Check Log 1
- 1. Instrument lnforma1ion flatemerer: Make/Model: lUBlUM 2241-2 Serial NCI.. 2fi2137 ,, Cil!. Due oat.a: *.5Il:Ulf;.
Qei(:!t:tor l: Make/Model: _!..J,rn,LUM M.::.l!l.-...:..... .Serial No._ PR 1l 1J2L Bimm MJr;roRam-Meter: Serial No . .A224u__,,._. ~al. Due Date: 8/4/16
- 2. _9hecl< Sou~£!;.}ofQrmatlon; Source llsotope: Ib-232 Serl<Jl No.; J,1Ei ActMty: .59.:r.L. units: -IJ.f.:L.. As!i<lY Date; 12f%l/10 Respon~~ Acceptance Range (-1-/-20%): uRem/hr *t20% .l:::3. .._ uRem/tir ,20% .J:L.. 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,~'.-~_"_,,-
-* * * *use Ac:cep~ance Criteria
~~"V"T"!'*~ -~ .......,..~~-..,,...-_..,.. ....,..,..~ -...~
Meter akg Count>
.. -~--
Sourrn 5ourcr._Re.sponse 'f'/-20% Inst Battery '1 Time Ambii.>rit Remarks rnitlals and Comments {cp_rn} or Cnt {~ross cpm or source Calil~. Check Of Temp. (add"l liifo: Inst, r.ondition. etc.) j uRem/hrl nme tiRf!m/hr) *gross cpm current {Y/N) check*. {"F) j or'!Rem/hr (Y/N) i (V/N)
*=i<,,....._..--=4>=~=*~*""""'~*-~*:"""'""""'I~
2.QJe? I 'f C",;"' . 3-.i"". "'ai"""'~:"i11=-::;;7""'-'!.""'-z""*""."";""r=""""*"'... ~ "..,_.,,,,......,.,,,..,,*.*n,.,,,,,l
-.. . __t .. ID<><'.*
~--*---
37;Q-- (_ ?)7
~~--_I~--J)J,----------i 7..7 )(..
l _j'
,,...,...................,,........_1.)/___ , .:r~.\*~-L_,;;____ -- I
~~~~~~~~~~~~~~~~~~~~~~~~~~*/~~~ ~-- ~-II7~~~---*-
--1-----!---'-"*i)
J?1s;.. '17. Z; *
"1.i * *7
~* ...._Jj;_
i: _] I'
-, l,o Jh--i.~"l: )/: __ .
_;_.;...;.;...--+---+--"!'---+i------t--.;.......;.......,-,,---cr--i:t---'~--r--:---- - _ _,J___ .!J.L':' --; l!f . -.~1.Ll_ ... i.l_L ______ _J .icton ~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.
- 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
- Rev 110/18/15 fnstrum4llnt field Response Check log
!0$1.~ment lnformiJtion 1
- 1. fl .
Ratemeter: Make/Model*:
/
idi, .1 l C-;n {<:?,;;f_ /...,)., '-'jzkt//t:, w6* m Qll. Due Date: Detector l: Make/Model: ~lt.*,,.r ¥'{-('(} _ Bicnm Micr&~em Meter: Cal. Due Date: 2~ Chei::kSource Information: . *( .... Source 1 lsotope::t':P-)32 Serial No.: 11 . Act!vity:-C'D* 1 units: JL:l. Response Acceptance Ra1_1ge(+/*20%}: uRern/hr+20% .:!l_ vRem/hr ~20% 1-i Source 2lsotope:Gs-.--13) Serial No.: 111J.J.,.!:2 .Actlvl~:- ~ .. 6~ units:/! C: Assay Date; Nk Response .Acceptarice Range (+/-20%};
- uRem/hr +20%.__ 1JRem1hr -20% ___-_ * ~ :c;pm + 20% r<;,?.J 3 mttcpm -20%* Z'?"f.j
- 3. Technli:ian[Worker Performing Checks:
T2c:T I!ff:.;:£~s-Name: .:::J"* ~/11.r'-'c* '($° Title; oate: * . f ----- Time: l ~'f S-
,;?j!/,;$//5""
- 4. Site or Location: Site/Job: A Y?_.r. '!. .3 Locat'f6n Descriptlon:_ _ _ _t---->.___*'"""'~"". "-S---~--
GPS Coordinates (when ~equired): X-Coord: /.!/ t;J c-U. 1./-.;;.7 . Y-Coord: ),/.f 71 ° O).;, "1..J~ I i Instrument Field Response 2 UseAcceptanceCrlteria Remarks '
- i Meter Bkg Bkg Counts Source Source Response +/-20% Inst Battery Time Ambient tnltlais and Comments Cnt Time (cpm) or uRem/hr)
Cnt Time (gross cpm or uRem/hr) source gross cpm eallb. current
.Check
{Y/N) Of chec~ Te!llP* {oF) (add'! Info: inst. Condition, etc.) I oruRem/hr (Y/N) I I I (Y/N) I v
~
...a.
~
Ratemeter /i.71, lf8~!'~. /;;,'it J 'le,/,} v .cffe';,. v v I~
;~.., /"' 7A-.;2.32' Rate meter Jlivlin '\5 ~ S' ~'>YI-. l12*i11 I f ¥5'-! ii.a.yr I'
-4 <; lv* /<:};;°'1 37.S*~ c'!>..,.,,./ -,'"'!>
Ratemeter. l ' I V' Rate meter l Bicron NA ;.('~/,,.;r11 jfl( NA "'.) J"L
~ '
/ .L!l.*l<;.v,N*I y-
*1"' *. / v v 1911? 37.>"" "'Th- -1.J>.'.L .....t/"E-Bicron NA I NA 11l;7s/1r at.. 1 f / I .I' *f--*
f v 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 *
- Rev 110/18/15 Instrument Field Response Check log
- 1. ln:!trument lnformation 1 Ratemetet; Make/Model: LvJfv~n ;J>lf;-:2_ Serial No; ~.o.2.l_ . Cal. Due.Date; D'l/t>l/;6 r1
- Detector 1: Make/Model: (_.._,tffrtd! lt:l{.-l4 Serial No.f!:@:./J.:?4*'f*::i.
Bicron MkroRem Meter: Serial No. N !f-'"rr~*_ _ Cal. Due Date: J'J [+\
- 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% _ _ Source 2 lsotop~: Cr 41!Z Seria.1 N9.: r( E;j:f ~1 2.. Activity: Jl .c..),. unirs: ff.t{ Assay Date:.
'1 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 Response 2 Use Acceptm1ce Criteria Remarks !
i l 81:~ .i
! Met<?r Bkg Counts Source *S0t1rce Response +/* 20% .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,.}
ll I i Time uRem/hr} Time uRem/hr) gross cpm or uRe.m/hr current (Y/N) (Y/f'J) check (~F) I I L {Y/NI i 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 l
! 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 I* Ratemeter- I IN! )'\ q7J...L~a.,. I/£\;IA vl.~.r~~ ,A o!,,f v ' ..::; .fl I I./ 4iJ ;;t..,r> 71-1-.)?,2_ q:;;z; i I Ratemeter I li1i.-. "n26. c..-;,..,,,. I w..:~ -*-- * \ /,r-7 /' ~"""'
l! y ;I l.k:;. ¥0. [,*,,;; /'JJ j "3? ""j;"~: I I Ratemetet I }tftltl !qcz.::i._ ,,, I,,-!A,}'\ 14~?.~~ ~. ,/,>., !..J ....I \/
- ll./fV u'l 11*., -rh - J.. f:J, t)~ I Ratemeter i \'\1i,.., r; '5'iv ?, Ctn,, /v1l..*h
- .T.
I I 57Jl , _h,,. .J v flF' lif)J* "1*~~ ~
.. . LJ.,,.,{ ? / f7? i Bicron NA NA I I
-**-*- ' { f l l
,__ Bicron NA NA
- Bicro11 NA f\lA I
- 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
~....-,._ ,.,......,...,,,
...~'~..:.D~*=
**~ ~***.
MU'"l.!V T~L'l<d.. Z>t!E'{R ......,fC~* Rev 110/18/15 Instrument Field,Respons~ CheckLog 1
- 1. !nstrume!11lo.fu.rmjllon Ratemeter: Make/Model: l\!DbUM 2241"2__ Seri~J Np. -1fill.ll Cal.Oue*Dat~: .52J2jl.Q Detei;tor l: Make/Model: WDLi!M 44-lP_. Serial No . .-.E.a.l1U2L 8Jcron MkwRem Jl/leter: Seria!No. ~ Cal. OuffDa~e: Jd!J./J.§
- 2. .ch~k Saurc-e .informatloq:
source l Isotope: !h.:432._Serlal N(l.: ..l).Ji._ ~ Activity: .$9. J .._ units:*J.tci._ *. kisay Pate: W30/10 Respon~e Acceptilm;;e Range .(;/-20%}: uflem/hr-+20% _;:-::_,_.. uRem/hr
- 20% A~. a<10t cpm.+ 20%.12.91IL ~tcpm ~20% l5284 Soµrc<-:.2 Isotope: .!:=;;.:ill_,Serial No.: ....8.1E1&.4&_~ Activity: ..Q.Q.2..._unlts:_µ.cL,Assay 011te: JLZ.QL.;10
*-Respon.s~ Acceptani;e Range.(~.f.-20%); uRem/hr-+20% ~ * - .. uR(!m/hr -20% ___:_:: ** mrl ~pm -;-*W%-.J.3-3.l£
- i:iei cpm -20%:..'.39.1$ ... :*
. 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.>'~
_.,S~S"'i . 2..~ '.$""- 1 GPS Coordinates (when r<iqulred): X-Coord:\.rl7 ..... S-o. i..1*
--.----- Y-Coord'. 1...:i '-fl' '.'iL.'
- ~*.-~-~-*-**r~~1ri;;;:~~~l'"Fi;!d'R;;r;~~;;~* --
I'"'*
..,.,'w:'-"fT"',:;-.:=i?:;~*t.....1:"~*2*::1:'Hltlt.P"°~lO ..,...... WM 1:1 e- "'11 *~ p : J U -.... AAb;i:: ~~ ..
I o*** < Use Acceptance Criterii'I Remarks Mete;~ T Bkg !!kg CouotS , souroo "'"""' """"'" *I* 20% I ll>ttery Time Ambient lnitfals and Comments
'! Cot (cpm) or ,. Cni (gross cpm.or sol.Ir~ . Callb. ; Check Of Temp. (add'l Info: Inst. Condition. etc)
Time uRem/hr) ;. Time uRe111/hr) ,gross q:im
- current .~ (Y/N) cheL:k ,~n i ' ' .
or 1.1Rem/hr \ ('f/lll)
~,,,,,.,, .,.*+,,...,,,,,,_._._.~
(Y/NJ
'"~
~aterneter }ZIO Ratemeter Ratemeter Ratemcter t! 11urv 1 *
- np
- 1 ( ,,..._ - * *
- Ra1emeter
,.. **-** _...._'!""~-,..-.J.,~<>----i ~at.emeter 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~
Rev 110/18/15 lnstrument Field. Response Check 1.0g 1 l* Instrument ln.forrnatjon Ra.temeter; Make/Model: LUDLUM 2241~2 5.erlal No . ..2.62232_ cat Due Date~ ~ Oetectqr 1: Make/Model: .,_J,_lJill,..~lll_-*. Serial tJc; . .--ER.l..l.1.U.L. Bicron MkroRem Meter: St<rial No. A2J.4...LL-.,.. Cal. Due Date: 8{4/16
- 2. ~he<<;:k Sour~ Information:
Source I Isotope: Ib-232 Serial No,: J.l.6 m , Activity: <0,..J.__ units: .JJ.i;J.. _ Assay Dat_e: ill30/10 Re>pome Accept;mc.C:' 'R1lnge {*/*20%): uRem/hr +20%. 20- __ *ulltrm/hr *20% J.:i_ ~ cpm,. 20% 22iU.Q_ ne:*cpm *20% 12284 5(lurce 2 Isotope: _c;s:t~J___ ,, Seda! No.: . 87 EJ3-48,... .. _ 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 $' <:x.-.
- z-i
..,..~.~,1""1-.~*~~r...,****--.""~;~:-.-=;:r~l"l';'..*1*111~**- * ******~'. - """r'"'*'**~.-,.,..<;.1,** ***~.-~ ...,..r~*
- _:"t"f,-'t"A....,.n.":"'**~~-'!1"'1'?"~ . . ~~..
1 lnstn.iment Field Responsr; n Use.Acceptance Criteria ft Remarks r I Time Meter Bkg Cnt Jlme Bkg"'couni~ So~~*c,e fcprn) or uRem/hr)
- Cot Time Source. f!espon;;e (gross cpm or unem}hr}
'l'i io%'
soma:! groS!i c:pm Inst Calib. current
; Battery Chee~
(Y/N)
! Of diP.d:
l I Ambient Temp. (:-!=} g ft tniti<JiS and Comments {atld'! Info: !nst.<:oruJitlon. etc.)
- . ) I( . \ oruRem/hr {Y/N) ;
, 1m..n 1- 1"'-1"1 * *
* . . lY/NJ * '
~~~**~;'":~~ .... 2.o -~ "q8 c.* ,,,, y 'f .._, . y"-*** *.:i=::o-;;*C' '3°7, a ~~- 7:37.. s~- ~"""'"'""""' ""' *~
*-- -~,,_._, ___7,J ..... - _c.*. ~-:~- ... - .... *----.--\*-- *-~*---*- ---..----.. --,....-*-----**+ - - - - i - - --~u-"'-'--='------=-,,,_-,..-------__,
,_._ll ~atemeter I /-1 '1 i" **h ~ *. *- *. I;I .?_"- ~ . crt*1 ......Y., -** .. ,. . *--~- ... _____ -1...... _, £*500 __ _2f. ~- -" ~~::_µL f;. t._ __ . :
f,la1emeterc t t;°il/L{ "" I rJPJ1'1 (**11'> Y ¥ . Y tfHo .f'iJ:.!? ____ . .:fk.1E~: .. J1L *- ***-*---*---*-~ Rat~meter f __ _; ___{J_kf~ --'--~.C[~ I) .-51'.!'<L~ ...}{_.__ , ~--.L__ 1 'l}o fiL (l W*ff1 fl:- .. . -~
-~~~(3~~~~! .. **-**- -**---~- .. l:':t,/!I:. . .**--------.*-*--.'-"" ,.., ..... , ____ *-*-**. ___,,. *-*-- :k}¢ ' ---- -- --*~~-* ;
Ratemeter #'A- . ,YVIA - 1 **---... ... ______ . ,,,_.__________ *----1
-~%~~~- . .
Blcro:ri ~NA_____ .. ~/A
' --- ____ _]____
z~ .. -****q*~t1 1
~z~*--*--
NA
- ~ ~J~~ t~ --1
*.v/A l
1 _ _ ...... Yy. . ~~;~ -~~~~
"-f"**--* ;i/;--*-*****-*--*-;-**-* ~~i1~ r/c
.......... '$....--.. .J-K----**--*------*-*-*1 j
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 Instrument Field Response Check Log 1
- 1. Instrument lnformaiion Ratemeter:
Detector 1: Make/Model: Make/Model: Serial No. CJCf:.'O'i 'i Serial No. -P"f?:1 i.tZ:,£.'4';}_ tal. Due Date: tJ"l_fa rf t, 13icron MictQRem Meter: Serial No. ---AL.\,....'i~_.____ Cal. Due Date: . N { V4
- 2. Check Source In ormation: . .
l ["{ Activity:CC ,.I units; p...(_-: Assay D~te:f.;1/f.r:~ 1 Source 1 lsotope: 'Ir.) :2. Serial No.: 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 Name: J* t.:;.,;~v.* .*i S
') .
Title;
. _/*~f
'.f?'
IS.:="- Date: (J . /J.t"' {./.?~Time_: 6 <lfl *7
- 4. Sot* o<l.ooatlon:
GPS Coordinates(when sne,IJob: required): fiju, . 7'>'4,,,..,t.,f v,,z r/rtr'" tt '( X-Coord:J./ <f ;?°'3 I t':f7~ Y-Coord:-1£'LB71 C>Cr
~.':.uon ""'"'*"'?"'
1 f;.'3,.'
?.:,,?, ':Ji (,.,,I waoJs I l Instrument Field Response2 Use Acceptance Criteria Remarks I Meter 8kg Bkg Counts Source source Response +/- ~0% Inst. Battery Time Amblent Initials and Comment::; i I
Cnt II Time (cpm)or uRem/hr) Cnt Time (gross cpm or uRem/hd source gross <;pm qlib. current Check (YIN) Of check Temp. (oF) (add'! Info: inst. Condition, etc.} i I / Ratemeter J.11,.';/Lh°' I Wlt \I\ lf~/10 <;,,.....
*or uRem/hr (Y/N)
\../
{Y/N)
...,4 lj
- Otf tP/ . Ii.- .) J;.. ;;.~
"' ' .. .,_, ,. . '1I
.~
l...\~/r. **II I " I *Ratemeter VVHi,. l l ~ i '1..,n, I w-:t"'* I tCi.5 ~fi-~1 :J \J I ....j Ni:t( 1f ~.,; /~--1"?1'7 ~i?. '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 S\ff'ls 6:,,,,.. '(/ y y /.-:J.~5" .5]>.~
.. Q*
r'"*<. \'3 f .(/{i!f;,_~
- 1 Raterneter i...i\:"' , I I I
*a
';?- li Ratemeter **-*-*****
__j Bicron NA -*---~ NA '* ! ~icron NA NA I 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
Rev 110/18/lS Instrument Field Response Check Log
- 1. lnstr!./ment lt.lis!cmation' Ratemeter: MakeiModel: LUDLUM 2241-,2 Serial No. 2G.:U37 De~ector 1: Make/Model: .......tUDLU!YI :44-10 Serial No. _efLU1:!2L Bir;ron MlcroRem Meter: u_~
se,.ial N(l. _bll,_._g.... Coit Due Date; Bl4lJ,§
- 2. Ch~~.!!mi 1ntormatlon: .
sovrce I Isotope; Jo-232 serial No.: 116 Activity: <0.1__ units: .JJ£L. Assav Pilte* .1Z/..3Q/10 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 Remark$
- Ambieni Initials and Coinments Temp. (add'l*lnlo:.inst. Ci::lndition. etc.) *'
f'f.)
Rev 110/18/15 Instrument Flel.d Response Check log 1
- 1. Instrument lnformatlon Ratemeter: Make/Model: Serial No. :J,d(..o4 ~* Cal. Due Date: ~6 Detector l: Make/Model: Serial No. '?IRt I ;LC:,.cf,;;i Bitron MicroRem M~ter: Serial No. l (,: -~ 2 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~ i71 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
- 4. Site or Location: Site/Jo~: A-,.,,~. . .L/.~./i, ;A I S (~ I . I
, locatjon C:.'
D~scr.lptlon: Whe>P'>. 1 GPS Coordinates (when required): X*Coord: '/V ~:.?: ~{ >"lf6'l- Y-Coord; W 7£ "'1:5' Ll~CN'J'"' j Instrument Field Response~ Use Acceptf,!nce Criteria Remarks ! ij Meter *skg Cnt Time. Bkg Counts (cpm).or uRern/hr) Sol.lrce Cnt Time Source Response (gross cpm or uRem/hr) 7/* 20%
- so11rce gross cpm Inst.
Ca lib. current Battery Check {Y/N) Time Of check Ambient Temp. efJ
!nltials*and Comments
(<idc.l'l tnlo;lnst; Condltlon, etc.) I l I
.or uRem/hr. (Y/NJ I (Y/N) l I -* 1 v
Rate meter
'"""' ?_;. i k:. '?( '""" I J<JI ~--.... Lf.J_ 7l/tf C#IJA \/ v D'1$ 7 37 <.;. "' *lb** ..? ~.z. (/£..
I 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..jrfl-.1'1/ S--,;;h'IVI '# V/ 4 r. 11<:-c;. '£5;. <) .'f7* - 7 .,. .} ~--.cJc;- 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 IV ~¥60 iµ7 I" Ill - 'J 3~J.. _:n7* tJ' Ratemeter f t~;h L;l~°\ c'., 1,c.y. *,,_... '1;"q ~<( r"~"'**A if {, ~.,, ....... rNS'if fq_?~t:> * ._; .* 1-S I '-;::t),7 . Bieron NA 5,, .~ ..If'.,.. NA '""'U"" 1i 01
*"g..,.pr-1/'**v 11/ ~l t
/v #')~0 '-1'1 {)CJ In -.;i.-sr a~ i Blcron NA '- ,i!/f~1..'fh,,r NA f,, :<n 11..i---
., *, ../. . ...J I *Lt 1.'-j '-{ 4- r-f 'L /'" Ti,,...;,) J .2 ,..q-~ i Bicron NA I NA .. I: )i"!t'-/k oz:- I ! \...../ I
]. 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
- 1. Instrument lnformation 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 *----- II Lnc<ition Of.isr:ription* D .,
&r:-ctf)
-"----'----------~-
GPS Coordinate~ (when required): X-oord:,.}./_!f.l_"J (£'(.~-- Y*Coord: W D/'l Oo 1 S:r(J..__
**----~- ~--*--~-*--
Mete! Bkg Bkg Counts : Spurce Source Respons<* +/- .20% Inst. Battery nrne Ambient Joilials end Comments Cnl (cpm) or Cnt (gross cpm or ~ourc~ C;ilib. Check Of Temp. .(add'!l11fo:,lnst. t:onditio*.'. etc.) Time uRem/hrJ Time uRem/hr) gross cpm current * {Y/N} check {°FJ
!(/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 instrument Fi~ld Response Ch eek Log 1 Cl
- 1. ln$trument lnformation Ratemeter:
Detector 1: Make/Model: Make/Model: Li.-.dwii .J.)t//""').. r:;;Jl;fl" Yf~(tf. Cal. Due Date: 6*'ivJ.'1. Bicron MlcroRem-Meter: Cal. oueoate: Ot~fl/1'
- z. Check Source Information: /
source l isotoper!1--J..J2. Serial No.:_ {I Activity:: CO. 1 units:~** Assay Date: l>fa)16 Response Acceptance Range (+/-20%): u.Rem/hr +20% _.:u_ vRem/hr -20%~ * ~.cpm + 20%G7"1! *o!m'tcpm *20%3.5)',;;;c;;. source 2 Jsotope:(s-!TI Serial No.: H1£?~- J2 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______
X~Coord: JV.t../,) Sf ff'/. {'t>)' kl/ ~cg 'qf.Ci'/1. 11 6 GPS'Coordlnates(wlieMequired): Y-COord: Meter Skg Cnt Bkg Counls fcpm) or Sourc:e Cnt Source Response (gross.~pm or*
+/-20%
source Inst. Ca lib. Battery Check Time Of _Ambient Temp. Initials and Comments {add'I Info: inst. Condition, etc.) i' l. nme uRem/hr} .Time uRem/hr} gross cpm current. (Y/N) check ('f) i I or uRem/hr (Y/N} l (Y/N) !' Ratemeter \. Ratemeter Ratemeter 1 Ratemeter
. Ratemeter Ratemeter 1 Bicron Bkron l Bicron 1.
2.
Rev 110/18/15 Instrument: Field Resp~mse Check log
- ., Instrument Information~ j Ratemeter
- Make/Model: ~l1.1w-.. {)J Yf- 'f.). ?erlal No. _;)~G-Gj? Cal. Due Date; o~;!-1/!c.
Detector l: Make/Model: { r jz;;;;:Y?/"io Serial No. 'Pfet 1.;;G~:;>, 8i<:ron Mh:roRem Meter: Serial No, lGf'if 7
< * ' .. Cal. Due Date: 6l")rUjb.e:.
- 2. CheckSource Jnformatlon:
ActM1y: -<c. units:~ 1 Source 1 lsotope: *Tb:J.3). . Serial No.: ..JI ( . .
. 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 Response 2 Use Acceptance Criteri.J Remarks Meter Bkg Bkg Counts Source Source Response +/20% Inst. Battery Time Ambient Initials and Comments C::nt (cpm) or Cnt (gross cpm or source Ca lib. Check Of Temp. (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 L Bicron NA lnstru:~t rati;~~r. {n~t Bicron
- 1. designated check source i!l llstad o . call Record chec:k source response cpmJ :prlono field deployment for alt theeY. sources being-u-se-d-._______.
- 2. 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
- 1. }.rlstrument lnformatlon Ratemeier: Malce/Model: LUDLUM 224]...:.L....__ SerlJJINo -2.,62237 Cal. Oue Di!te: . 9/2[1fi Detector 1: Make/Model: blJDLQ!YJ 44-10___ , 5erlill No. ~.E.B.. ll 1.l 27 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. A.ssav Date: ..12[.3.Q/10 Re~poni.t: AcccPLanCB Range (..;h1.0%): uRem/hr +20% __ -!:--_~)-*- uRem/hr -?0% _I_~-._ 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_=------*---*-*---.-- loc(ltion Der.criptlon:~¥. -------*--- GPS Coordinates {\'"{h\:n requirr.d): Y-CnouJ: ~ .._,,.& -z.' 2. ~ ,"1" tJ @ ~..n.v 1rr,;> 1....... ,,i.- cL~~ ~-. tcl".,...) .*-:~.~-~~::IT*:=-"'1, ..~,~.:'=<'"2"'."'7~~_,...,..,~~l~~,~--=f:.-."J.;-::--
* - 1 lnstn~mt!(:t Field Response*
*.,;:";"..I_.,,,,... **-~-- ......~~_...,.,.
Use Acreptance Criteria
~"'"""--*~---*~-~, ...~ ... .
Remarks ~- Meter
- Bkg
- - * ...--,--*--r**-----...... .
Bkg* Counts ; Sourc.e Source Response t/* W% lmt. !3atterv Time Ambient initials and Comment~ Cnt (cpm) or Cnt. {groi;:s <,:pm qr source Caltb. Check Of .Temp. {ac:f.d'I tnfo: Inst. ConditiOfl, m.j Time uRern/hr) Time uRern/hr) current (Y/N) check . (~F) 1 {yuv) (Jl'l1"1\ (Y/N) iii'~~~ Rateme!~--1,.- ..J.. ..
- flatsmeter. I Ratemeter I R.atemeter I
~~~l'.f).~~-=: z._~.~-~ Ratemter Blcrorl !)ic:ron NA 3icr_£!!_ ____ ~A '1 Mk-:2: * ""*--* _ . ~--~ --:-::~::~---=~:j
- l. *1 11strument 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 Instrument field Respon$e Check Log
- 1. lnr;trum(!nt Information~
- f/
/{atemeter:* Make/Model: Lr.JfhY1 fV/.-.L Serial No. ;u.t..-&1 Y cat oue Date: 01Jo frt Detector 1: Make/IYlodi;:l: ] ul/vN\ y:::z;- Serial No.. f?tLt lk{Jf_ )...
Bicron MlcroRem Meter: Serial No. N {*fr Cal. Oue Date: Jv+/-IJ
- 2. Check Source Information: _
I f'( .,::: 1 *- Source l lsotope:-ro.:.22.z... Serial No.:_____ Activity: .A.:._ unlts:-tU(.; Assay Dete:Jii-11.,.o1i Response Acceptance Range (+/-20%): uRem/hr +20% * - - uRem/hr. -20% ---~ ~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 lf 1 ;;L.. . .* "-' LocatlonDescrlptlm1:,__ ___ ~.**-~_/_-_~s______
~fS Coordinates fwhen required}: X-Coord: Al :..rt::.":V. L{;,:i... 't'*Coord: Wo 71.aW.
1 V7 , ,. t' ! Instrument Field Response 2 Use Acceptance Criteria - Remarks 1 i 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.) Il Time uRem/hr) TI me uRem/hr} gross i:pm or.uRem/hr (Y/N)
~urrent (Y/NJ
{Y/N) I check {"F) I Ratemeter l~ q.qu.1 I' ;/t,. / ,..,,_r'V\ t/°'71). ,;J ~.a~ .
~~-
'V \.} l/ C43'1 275.t.. -n:- ,;;..-:: ;:;_ ..It j I Ratemeter I "';..,, '1'1 l\ ~ 1.'I'..,,, .1 ~ ti 6i f /m,.,,,,. /...,, 0.1 ..f/* i,(Jt'-('$ ~,~-<:: t.. ...~ '?7 'o~~ I l Ratemter jMih. I !JLI~ ff..'""" i ""'*~ 4 (. 't:. 'l."J ":~*..,... *JI ...{_/ .J.J iii 'fl; 9*,;i.,;..,o -n*f'>,..--2 :SJ ?_c_>:;" II L~;iA Jf 1~
1 Ratemeter ; '='"'-'*' IC t..\ TI .J'?Y, '-ii \1 ....!/ i(J!;:"~ ii/.'J. () e /<"*~/"57 ~~- l
/ l:llwi
. I ,:?" -
Ratemeter f I 1 Ratemeter .. i Bicron NA NA I I Bicron NA N.£\ l i Bicron NA NA I
- 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
R.ev 110/18./15 lnstrume~Field Response Check tog
;L .!W>J:rnro11nt tnformation 1 Ratemeter: Make/Model; LUDLUM 2241-2 Serial No. -1fil.]_32_
Detector l: Make/Moctcl: _(t;;Dl~J..&L4!:l:liL~- Serl<11 No. _£fl. llil22 B1cton Micronem Meter; Serial No,..;..822....:.11.-U_ _ Cal. Out> Date: 814/16
- i. ~heck Squrce lnfonnatlon:
source l isotope: Iii-Hi: serial No.: llG Activity: s.Q.,l __ units: iu:.L A5o.ay Dute: .W.3.Q/10 Re~pons.e Acr:t!UtolKP. Range V/-20%): uRemihr +20% :~.:!.... ,_ uRem/hr *<10% -1.:.L_ !!!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. .$1.t~ pJ,l.o_c_atlQr'.1' S'!e/lob*_....,_':£,.f:_ .. _... *- ... *---- ... --..* * - -
GPS Cocn.liMW~ (wht-11 req~iretl); X*Coord:_.~ :!1,~}~'....:.lfi!~.---
?TS'
~*-._,,, T~L SG"<<'.V~
. Rev 110/18/lS Instrument Field RespQnse Check log
- l. Instrument IJJformatlonl di ci i:;a 1 ~ P'1,/0rf.c.,
z, Ratemeter: Detector 1: Bkron MictoRem Meter: Check Source Information: Make/Model: Make/Model: Serial No. Serial No. "7-ffllf:~/ 'I~ Serial No. /tf'i *
~
Cal. Due Date: Cai. Due Date: w 4
*Source. l lsotope:"'t/1\-.;>p *Serial No;: ff l ActiVity: ~. 1 units:~ Assay Date; -!lf'/r_~o Response Acceptance Range (-r/-20%): uRern/hr +20% _!.J_(_ uRem/hr -20% 2=f ~cpm + 209' q ~ cpm-20% ~~C Source 2 !sotopel5- ( 51 ~Serial No.: {f'1£,)7{./ J Activity: 6. c..2 units:f.Ll.- Assay Date: .J::!A. .
- Response Acceptance Range (+/-20%); uRem/hr +20% _ _ uRem/hr -20% ...:.._ ~ cpm.,. 20%15.)7?' am_cpm -20% ff) 4 f f?(**-r_ _ __
Title;_!_'--.__ Date!)/!:J/J. 7 I S- Time: 0[~$'"'
~* . 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 ~0...:i,.t\,2 1 --~---.....,,.-~~----~-~-.,._~~=---....,.---=-=-~==~ lnstrumentField Re.sponse 2
.... ~.~---~-*-.,
Use Acceptance Criteriti
. ,__ ~-~=--------~~----""""1 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 i Ratemeter j ~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
*fl!~"'--"*~
*-.....~/'lJ"'!!j£ MJ.,,_~' T~.'f../S. !f'51C'V'¥CES Rev'.!. lfJ/lB/15 Jnstrurn~ield Response thei;:k Log l.
Instrument lnformotion
- Ratemet-er:
1 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 . As-;,ay Date: .J.i/fil)}lO Ret,.pon~c Accc~Lance Range !-1/:20%): uR<?m/hr +20% .* ~~-... ul1em/hr *20o/.. .__tl_,. 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 1X~ -,--_.-.-. uR_crn/hr_-;:.9~!_.,...-=---'.':" ~c.:pni -t.iO%~.Jl~.,-.- ~{lL9*:!1_1 *W% ,~$!.?}.....
3.. B?.~JlQ!ci~n/Worker Performing Checks: N;m1c::.F._(.£1(f-:.J9t1..fJy.LJ-pJ
Title:
.,C/-. r_ -------
- 4. ~,!;~_?LL9.\:.i!~icm: S,te/Job:_tf*_*.-*--*--*---- *--*--* . Location,Df?r,<:riptio11*...Jt!J.m)__s./.fi.LIJ1]J:__ _____ ...... __
.GPS (.oordin<i!~5 (whim re'luiredl: X*Coord:~J2,~.1-J.' J,f',H__"_ Y*Cuord: ...,J ()") 'r".{'/' .o,.1, \ '
- --..* ...:- ... ~ *: ....-.-'!:'!'""*'T"'!'"'!" i.<n-."'°r-'* ""*'1"'-Nl"IT!:"U"l'~"'.;oo"~ **~r.;rr*.*r.-r---*, ,..,.-. -* _.,.#, .......,.. **. L"'"f<r "*** * **,"'\o** ,.. .. ~ *.,.,.-;e-. ... *.-*..,-.-.,,.. ...~....,._-... .,.,...~.-..__.....,, - ... sa~1~,,.,._
- 1nsrrumeritr:ield Respcms1i Ust! Acceptance Criteria Remarks Initials and Comment:.
Rev 110/1~;
- Instrument Field Response Check Log 1
. 1. Instrument lnformat!on *' !/ 1 ,
Ratemeter: Make/Model: l v// (,.*µ. J,?{r**1 2 serial No. '2,at.:..01 S- Cal. Due Date: 1 P"V ~:,ftt. Detl:!ctor 1: Make/Model: LJ.)fG-.m '/f/.~i() Serial No. t?J\'(f l::C.t/ ;z.. Bicron MkroRem Me'ter; Serial No . ...J.!LD_ Cal. Due Date: z>}#J,£6
- 2. Check Sourcg Jn formation:
Source llsotope;T/,.,?jJ serial No.: IC ( Activity: 4.0- 1 units:-~* Response Acceptance Range (+/-20%): uReni/hr +20% _4_1__ uRem/hr -20% _lJ._ Source 2!sotope:C~*137 Serial No.: l (C, t;-t~* r i.. Activity: 6 *l)2 unitsyLC Assay Date: µ.e:_,. Response Acceptance Range (+/-20%): uRern/hr +20%_*_. uRem/hr-20%~- ~ cpm + 20%1:5 .,:l 7 % -1_cpm -203 ix"f 1-3. TH!e; (Z(..T Date: t:.jf¢f Time: D~:S""~
- 4. site or Location: Site/Job: ~rf?, il, / / .'5Et2 . Lo~tion
Description:
~oc.62> f{1t:,;f:.Ji.-1 /g1-GPS Coordinates (when required;: X*Coord: //vJ-V.$//7.n~' Y-coorc!:W7'6'f""1 }!.,:S>.2 t' I ./
! i Instrument Field Response 2 Use Acceptance Criteria I Meter Bkg Bkg Counts Source Source Response +/-.20% Inst. Battery Time Ambient Initials and Comments C11t {cpm) or Cnt. {gross cpm or source Calib. Chetk (add'Llnfo: Inst. Condltio~. etc.) I Of Temp. Time uflem/hr) Ti.me uRem/hr) woss cpm current (Y/NJ. check (oF) oruRem/hr {Y/N) I (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------ Rev 110/18/15 lnstnunentField Response Check L~
- 1. Instrument lnforinatioril Ratemeter: 'Make/Model: Serial No. .....~c.c:~ Cat.Due Oate: e>.f<<//!tf, Oetector 1: Make/Model: Serial No . .ecJ(>l'f"2 ,
Serial No. /4Y'1 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 Meter e~.g Bkg Coun'\s Source Source Response +/-20% inst. 6attery Time Ambient lnitiills ;.md Comments .l l
Cnt Time (cpm)or vRem/hr) Cnt Time (gross cpm or uRem/hr} source
.gr.css cpm oruflem/hr Callb.
current (Y/N] Check {Y/flll Of check Temp. (of) (add'! Info; inst. Condition, eti;.) I
- 1. (Y/N)
'Ratemeter I Rate meter.
1* Ratemeter Ratemeter
!_Ratemeter
- Ratemeter Bicron 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 shoult.l be withln 20%. 'lf co um race diverges significantly, pf!rform additional counts to evaluate Instrument stability
~~
t..t~~/ T~fl.. $rd!!!R'¥M:ES> Rev 110/18/15 lnstrumerit Field Response Check tog
- 1. lnstrument-lnformation 1 L J Ratemeter: Make/Model; '~*' ,J,)'f/- ). Serial No. ~Ot:;:-Clllf.((" Cal. Du.e Date: trf6~
Detector!: Make/Model; l ,.d:le l/'r',/If Serial No. f [i:- I 1~5' r Bicron MiuoRem Meter: Serial No. {if$ 7 Cal. Due Date:_¥;&',c
~~~~r Source 1 lsotope;'i ~~~~Serial No.: _tl~I J
___ . *Activity: ,c..() 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""~~....,.,~-=~~--.,.,...~~~~~~-- ......~~~""""'~~ Instrument Field Response Use Acceptance Criteria ~ Remarks ""'! Meter Bkg Bkg Counts Source Source Response +/-20% Inst. Battery Time Ambient Initials and Comments i 1 Cnt *tcpm).or Cnt (gross cpm or source Ca lib. Check Of Temp. (add'l lnfo: inst. Condition, etc.) 1 nme uRem/hr) TI me uRem/hr) gross cpm current (Y/N) check (oFJ : i {Y/N) I I Ratcmeter or uRern/hr (Y/N) 1 Ratemeter Ratemeter Bicron Bkron NA Blcron NA 1. 2.
-~"_,.,.__
,.,""""'~***-**!l*..:W.
Rev i-'J..rJ/18/lS
- 1.. lnS:trum~!U !nform@tlpni Ratpmetf!~~
- Make/Mog~l~ lUDLl.:JM 224:1-2 SerJalNo. ...2fJ.21'fl.1 ~ cat Due Date: _W]JJ...6.
DcJei::tof 1: Make/Model: . LVDW)M !lfl:lQ.~=~: Seflal"No. _Eli il ll2Z f3.ic~Pn -Mic:roR~m Metll'r-: SP.flr1I No;~~--- cai: oueDate: .8j4fl6 l.. :fbeckSopretJ lnfo.rmatlon: Sour,<:e) lr.otope: Ih-232 serl"IJllo.;. iJ.L....m~* Acd11ity: .;Q,,1__ uni.ts;,p~L., ... Assay. Date: li/.3D/1D. Rf!'>µOni>e Ac~eP:taQc.~ riange{+(2(l'J";): *ufle rn/hr .;;2Q1i~ }:E, ...._ 1.1Rem/hr *20% ~4- 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:
.* . . ~, . t.,-.tL~... . . .......c.J.i:f(:~*\)
~-- __ _
,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~_ici_*.._.. - - .* ~.:....,,,,.~~--.._ ....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* Remarks M.'-ett.>t* : Bk~ 1*u1'&; .Co1,1n1£-~sc.iur.ce
- s_our.~e Resp_ori_i;q +/-J!O% Jrntta1s* andcC0111ment5
.
- Cnt (i:pm},or Cnt [gr.os:;cpm o.r (<Id~'\ Info: ln5t. Condition, etc,~
iime uRem/hr). *u~em/hr}
.~YS
~ Ttt:-c~.A11.. .~v~
Rev l 10/1B/15 Instrument Field Response Chat:k log
- 1. ln~trument lnformation 1 Raterneter: Make/Model: &JICl'wd..?f/.-j, Serial No.fi0Gb'1f? Cal. Due Date: 0 ~'> ~<:;
Detector 1: Make/Model; 1_..,71,,,~,.._ 11'/.*-'-I tJ Se~ia!.No. Pi:..!f;i.6'f2-Bicron MicroRem Mater: Serial No. (t.f F 7 Cal. Du~ Datil: f2C;/!1j/7.::o
- 2. Check Source Information:
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* Use Acceptance Criteria Remarks Meter Bkg 8kg .Counts Source Source Re.spons~ +/~20% Inst. Battery Tl me Ambient Initials a.nd Comments -:.- Cnt {cpm)or Cnt (gross cpm or sourc-e Calib. Check Of Temp. ladd'I Jnfo: inst. Condition, etc.) Time uRem/hr) Time uRem/hr} current (Y/N) check (oF) ! I (Y/N) I I
. Ratemeter
- Ratemeter 1
Ratemeter Ratemeter Ratemeter Ratemeter Bicron Bicron NA
- 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
~------ - -- - - -
Rev 1101'18/15 lnstn.mi~nt l.!!filrmatio,n 1
- 1.
- r~ateo*w1e.r: Mr*e/Mo.d?.l; LUDLUM 2241~2
- SerlalNo.~ Cal *. ()ueQatti: J!LUJ.§
[;r.:tecto,r l: ,.:fak~/Modal: L!iQt.UM 44,w:.. .=:_ Serl<il:No.,_,_£R1 ri12:t Bicr9n .f\/Jlc.rpRam Me.~~r: ~~rial No .. ...A42:~:4l:J~*__ C,<il. Du1;1 Dal~: §L4(1tj
.~. ~Jw:.1< Som.cc lnfor111,ation;
*~ov.rce i lsotop~~ Ih::l3..z._Serl~l N.r,;i *.: JJfr _ /l.ctivhy: j::OJ....... units: ~&:i .* it.ssavr.w 14!:- .12l'm/10 R.e~;icir1!f.:' Ar.:c'!~'t>>nq* H~riga i:i/;'20~): u.RP.m}hr+i0% :'!::.~~-- .uHNp/hr ;,?0% *.Ji_ ~ cp:m>~*:!O')li 2,?926 ~cpm *20"A 15284
$~;,:re~} lsornp;.1; ~Ckl31:... :serial Ne.: *...81..E1&9.1l.... -1\ctivlty: J102.,~--)*0ltS; J.ii:L*A~s;)~ Pa!>?'. .lLZ.Ol:lO Ri:spo~:.e/.,r'cept??c: ~an~eJ+/,20%) -~~P.~ri:Jh'. _+W'~ ~- _. .. 11.R~.rn/hr -~piv.* .*:"'.*"'.<* ,~~ ~p:;:"+.:::~~t, +.~~: .~*G.?~ :2'.~71,:.Jl~l'.9- ..
- 3. Teffif.llfl~.l:!LWP.,L'~~r*Perfarrolng Chee~:
Nar:-io:;f,-,Y{~;?':'?~
- 4 ~i~.9! W@t}RfJ:. S:te/Job;.'-,£"' J,,; ___ -~** ***-- ._,........,_,.~* JocnHon* D~':t:i'iptlru~*__;,0/()VQ...S"._______,,_____ ,.......
GP.S*CvOf,UllH:M' (v/h~n H!QtJjr,edl: XA:'.q910 .*.~~.z~~i:zo....,;.~-- Y-C{~or.d.* \N 7fi..'.:~~.J~-"--*
*_ _..,_..............,.......,....,....._,,..,..,...-..--....-":-' * .._;_,_'7 ___ ** >- *. __. *..,
fiem~rk:; Source r1~:.pG1tit~, 420% lfl~I. j*: 6arterv **nm!!! /.\mtiif!rit .lmtla1$,and Commi!nts {grosifcpf"l or. source: Qllib. Ghee.I\ Of Temp. *(adtft ri1to: ln§'t:CMoitio.);~tC~l uRem/li1) -gross~pm
- cl.immt* (Y/N) .cli~ci¢ {°fl pruRem/hr' (Y/N)
-""~T:GJ-r-m:W~~-~~*1.
---l~'---"--ll-{'-'J* l.[.?1:.~ -~.Ji_ -~,..J
*.hJ:lL}.~~*-------~d .........; . . : ......!.
],
Sitrpn
!f..1'"1""""-*...... '*~**rs W'i. '-*' Tt::iClli11""'6C;,.-i. L. Sl."t!:R 'I) ".M.."tX Rev l 1fJ/1S/l5 lll~~rumentlnforma1ion 1
1. Ratemetf'r'. Make/Mode!: lUDLUl\tt 2241~2 ser.isii 'r-.1:. * ~tiZ737 Cal. Due Date: .!UUJ& Dctettor 1: Make/Model: lWQkUMA4-lQ .... -- Serlan~c . ..ffU.U12£;,... Bicron i\llicroflem Meter: Serial No.
- Alli&~~ Ca:t. Oue Date: 8/4116
- 2. ~.11.g.f.k.~9.lJ!.q:! 1nfo.fill.~i.ruF So11rc*::- 1 lsorope:*J.tJ=2..'i2...._Serla1 No.: .11..fa___ . .Activity* .s.D~J.. _ uriits: .w;L_ Assay Dat\!; ill3.0/10 Re~;.;L*n!>t:: A(.ceptc111c~ Rangelt/*20%): 1Jflern/hr ~2()'1.;, c ?:-?.... unern/l1r -JO% _Ji_ net c;pm.; 20%_4]92..Q ms rpm *W'Jl. 15284 .
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 lnstn~mcnt Field Response Check log 1 l* Instrument lnformatlon Ratemeter: Make/Model: Serial No. JltC<Pr'i Cal. Due.Date: t)rf:.*tjlc.,. Detector l: Make/Model: .Serial No. FKlf,,2'~ )- Bicron MicroRem Meter: Serial No. I 4 'f1 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>/f0 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% '/$if 3.
iitle: .17(~ Date: 1~}/l:fftSTime; QY{ / 4, Site or locatiq.!!: .. location*Description:.,...._..,p._,IA_v._f.~""l.?,_*~A_6_.r-_.---~-- GPS Coordinates (when required): X*Coord: N tf)- "'-.,."~'.Jll 'l"ftf Y~(:oord: W 7feS2,'-;rJ.3:l.,C.. ,. i* "" lnstrnment Field Respoo$e2
- Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Source Response' +/-20% Inst. Battery Time Ambient lnitlals and Comments Cnt {<:pm) or Cnt {gross cpm or source Calib. Check Of Temp. (adc.l'l lnfo: inst. Conditlon, etc.)
lime uRe.m/hr) Time uRe!ll/hr~ gross cpm current (Y/N) check (oF) oruRem/hr *{YIN) r {Y/Nl
- Ratemeter f Ratemeter
- I* Ratemeter
! Ratemeter l Ratemeter I Ratemeter
- Bicron NA
)*Bicron NA 'Bicron. NA
- 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..,_ Cal. Due Date: _'JjJ.J..lfJ Detector l: Make/Model: __luv..W.M 44*.W .._. ***-* Seriill No. ~.B.1.11:12L BJc;ron MkroRem Meter: *Serial No. _A7.2fil.__ i::aLDuP. Dat<!: .t\f4/1§
- 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 Z0~<.13.3.15 ...
_1 ~-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 Time 1\mbient l!litlals and Comments Check Of Temp. (acid'.! Into: Inst. Co11clitioi1 *. l!tc.} (\'/N) check fFJ
I..** Rev 110/18/15
'Bnstrument Field Response Check l.og
- l. lnstryment lnformatlori?
Raterneter: Make/Model: Serlai No. ;;:)C-"CCJ1'i Cal. Due Date: ~C,. Detei::tor.1: Make/Model; Serial No. ?ill/.?-.<;,o/,;. Bkron MlcroRem Meter: Serial No. J<J:G 1 Cal. Due Date: '2( l"'i.>"{LG 2, Check Source Information; ,, Source 1 Isotope: -rf...::;;3J.-5erial No.: If ' ., Activity: 0 * \ units:f?:~*-i Response Acceptance Range (+/-20%): uRem/hr +20% _q_l_ uRem/hr -20% ...11....._ 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=*"-.- -
- Location Oescriptlori:, _____w"" "°"""<:.;:;,-cc::c:."'"O._s..__ _ _ _~
GPS Cpordinates {when reuuired): X-Coord: NW 0 3/ $.~SJ" Y-Cbord: W 2'$.:J<;Jl "'fl. I"? 7 '" 1 lnstrument Field Resporise Use Acceptance Criteria Remarks Meter Bkg Bkg .Counts Source Source Response +/-20% Inst. Battery. Time Amblent Initials and Comments Cnt {cpm) or Cnt {gross cpm or source Ca lib. Check Of Temp. (add'l Info: inst. Condition, etc.) Time vRem/hr) lim,e uRem/hr} gross cpm current .(Y/N) check ("F) or uRem/hr (V/N) (Y/N}
- Ratemeter Ratemeter
*Ratemeter Ratemeter
~-~~~-~~~~~~~~~-~~-1 Ratemeter Rate meter ~~~~~~~~
'Bimm
- 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
*Rev 1*10/18/15 fri5trµmE?.Ql!icld R~spon~,e Ch~(:~ Log
- 1. >nstryrnens inf2rma1ionJ
*Rate met.er: Ma~:e/Mrn;fel; LUDLUM i~fil. Se?:illl. No . ...2:n2:l~ Cal. Oue Oat~: 3-/Z/J,f!
Decector:.l! M!:lke/ti;1oge[: *. l!JQ.JJ.!M,.4.4:1.Q.. __ ~ f>ar\ill fJo; .J:.R.1.UUL Blcron ,Mil:roReorMeter~ ** &eria1 t-.i9; ..AZ.ZA.l,L_:..__ C~t Duf} Date~ S/4/1§ 2, &:heckSour"li! Information:
- so.urce.ll~otope:Jb*2*R serlall\IC..:J~15 ___ Activity: .$9..;J..... units:.µ~. .Assay Date: .121.3.0/10 Re*;pon~e Acnwwilc~ Ran&e *( -11~20%): uRem/hn2ow. . . ~ ..._,.. ii fl~m/hr "?01*.: J:L_ .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 A__,mbient 1p1tials aryd* corrim'entii Of
- r,emp, (ad~'.11ni:a: inst. r.o.ndi~io'I. et(.) '!
cheg~*
- 1 i"F) ;
*""""~**;r1*~*...,Jz-. --~~*N*""'""""'~"~""""""'"""""""""'"'"'"""""" '***'*~
R~temet~-~
"-~YS MJ'lYV *v-~~l/... .si>*Si?~e:lr Rev 1 10/18/15 Instrument Field Response Check Log
- l. Instrument lnformatlon 1 Ratemeter:
.Detector 1:
Make/Model: Make/Model: Serial No. ~r;:oq~* . Serjal No. t .,,.(£!IM../(;- Cal.DueDate: 61#, Blcron MlcroRem Meter: Serfa! No. .~J (A Cal. Due Date: /tJ (A
- 2. Check So r e Information: ~
Source l lso~ope:
- I "' ?;.2 Serlal No.:
Response Acceptance Range (+/*20%}: uRem/hr +W% _ _ f /{ Activity: 01'1 units:_µ.£..; uRem/hr -20% Assav oate: 1.>ifi{~ 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 / ,, Location Descriptlon:____~--~-~-"- '-/""'5_____ GPS*Coordinates*{when required); X"Coord:-1if_t.1.~.:. ..,, ~'.!tS:4~t Y*Coord: ~J ']1:> :ft ,I (J;fl i I Instrument Field Response' Use Acceptance Criter!e Remarks
.....JM'!l'IW,
- I I Meter 8kg Bkg Counts Source Source Response i-/-20% Inst. . eattery Time Ambient Initials and Comments Ij Cnt Time (cpm) or
*uRem/hr)
Cnt Time (gross cpm or uRem/hr) source gross cpm Calib. current Check (Y/N) Of check Temp. (of) (add'l lnfo: inst. Condition, etc.} I t* i Ratemeter /1-1-1 i]* - *S'Pli </<A f w.;)\ t/1/£l:'/.._ r tf1¥' or uRem/hr * {Y/N) y v (Y/N} v it/i.2£ 1Q *rif-~n 7lE.
- lQj , i :r~
I I 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 j i Ratemeter i !JI I)\. ')~S"i.. (.fl/', !IM.,°)'\ .q1f flio .f5~1VI --.:r \. .._/ if"~S- 1/6 :Lo "th.. y. ?:.L "9y i l Ratemeter r""'"- ii'll -;:°' (.1'111'1 Imel- {D°?t;~ /*~;AA -! ..J,1 ,J1 11"/C qt'..,;." rA,., f?7 ':# I r i/
*RatemetBr I Ratemeter
- 1. Bicron NA NA
.......--~~-
Bicron NA NA .. ---~~
-Bicron NA NA
- A _ _,.......,...
- J
- 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
~~y~
~*
~_:;~ TIC....r::l~lt..!'E~~~
Rev 110/18/15 Instrument Field-Response Chee!< Log
- 1. Instrument lnformatio1l Ratemeter: Make/Model: Serial No. t?c<..q B Cal. Due Date; D~t' Detector 1:
Blcron MkroRem Meter: Make/Model: Serial No. __l'tl __ serial No.~~l.l 1
._,__[* t//.ef. Cal. Due Date: b([..,,,(f (,
- 2. :cneck Soyrce *fnformatlon: ~
Source !Isotope: *(l..;;l);l Serial No::. I/( , A<:tivity:.r::'.'cJ, I. units:~* Assay Date:~ VP 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/'51 1!/
- 4. ~e nr Location: Site/Job: /!;,-.rt!"'- .£ <:_;" -"). (e- location
Description:
c..v vr:.*{)~ GPS Coordinates (when reql)ired}: X-Coord:_ _ _.....__ _ _ __ Y-Coord:__~-----~-
;-.~-.~,
ln.strument Field Responsei Use Acceptance Criteria Remarks i. Meter Bkg 8l<g Counts Soµrce Source Response t/-20% Inst. B~ttery Tl me Amblent lnltialsand Comments Cnt {cpm) or Cnt (gross cpm or source Calib. Check Of Temp. (add'! Info: inst. Condition, etc.) Time uRem/hr) TI me uRem/hr} . gros;_. cpm current (Y/N) check (of) or uRem/hr (Y/N} {Y/N) Ratemeter Ratemeter. Ratemeter Ratemeter Ratemeter I Ratemeter 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 deploymentfor 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
R~v 110/'J.8/15 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 serhil No. -2.limL-
*pctector 1: M<ike/Mod~I: _L!.,!R.!.J.L!'li 44-1Q. ____ _ ~orl<il No. _E.R.111127_ .
Blcron MicroRem. M~ter: .Serial Nti, .*i'i221.l!._____ _
- 2. ch~kSo_y~JtJf.l!.QJ'mation:
Source l Isotope: J_k2:3.2..._._:Serlal "lo.; J.1.,6 Acthii\y; -.sQ..._1..... units: .W~L. Assay Da.tr.; _.12J.3.Q/*10 Rewom.ii A~n:;itanc.f! Range (-i-/-20'f.,): ulh*mJhr +:20%,?:?... ___ uRem/nr *W~-:._i!;( __ .;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;~ _
~-~~ *~*-~~~- *. . ~---~,... * * **"'**-**---,-~-,~t;~;~*;~;~'j; i;.ldR~p~~:~:-~ ~* ** ..... "*~.,,._..,.,.. __ ""_G;;;~c;pt~~c;J*""'~~~*-**.,.....,.,,.... ----------~Re-rr~.~.i=rk=s.,,.......~--.-- ..-- *
- --M-ete_(_1 _Bkgls-~* oun:t~~~-;_1~ Sour.::~ Re:;pon~t! t/-.20% tnsl. Batter\' '! 1me Ambient * .
Crlt [~pm). or
- Cnl (gross cp_m or source Calib. Check Of Temp, Initials and Comments (ood'l Info: lnst. Condition.
"="'-:ttm ett.J 5= -~
Tim~ uRem/hr} : _Time u~~rn/hr) .grosr. cpm C.l.lrmnt (Y/N)
- ciiec!t [~f)
_jf\l/11) I ( 11\*.-.iJ 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 ~ J) '-: <' *'"" ___ .. .."/:. _7 --*-1i
...;.Ra:::.:t::..:e.,.;..rn_e::..:t...;..e_r __,_l_+-l,.:.......;\,__"l...__,"l.,..,~. . .-.r~
4-. . J___ CJ*'i k ¥ ~-u---..*---1-........---1-_,_--H...,., *- --* ---- *--- i Bicron Sicron}}