ML19224B613
| ML19224B613 | |
| Person / Time | |
|---|---|
| Site: | Crane |
| Issue date: | 03/28/1979 |
| From: | Metropolitan Edison Co |
| To: | Mullinix W NRC/IE |
| References | |
| OLP-790328-32, TM-0252, TM-252, NUDOCS 7906150419 | |
| Download: ML19224B613 (52) | |
Text
=
?
TMI DOCUMENTS DOCID'ENT NO:
/ / ~[Ik ? -
[ 2,h 0F DOCUMENT PROVIDED BY COPY MADE ON E TROPOLITRi EDISON COMPMiY.
f Wilda R. Mullinix, NRC 7 9 0 615 0 dig L','
')
e 6
- ~ _ - -
+ - - -
- HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
- ) t-(2
,f %
o m
!NSTRUMENT SERI AL NO.
7 '~ d Co!umn No.1 Cclumn No. 2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATUS CALI BR ATION CA LI SR ATI ON In Service, Cut of -
CALIB A ATION PERFORMEO OUE REMARKS Semice, Repair or Cal'bration OATE SY CATE (Ind.cate Status Se'ow)
(Signature)
~'
C/- 7)
(T'
)
~' '
L
' l-f d /h h'* ? f N
~
.?
v.
l m
Form 1763-1 i.
\\;,
o
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
\\ " /~'
m INSTRUMENT TYPE
-m f
INSTRUMENT SERIAL NO.
7 '[O Column No.1 Column No. 2 Column No. 3 '
Column No. 4 Column No. 5 INSTRUVENT STATUS Call 8 R ATION CA LI D R ATION In Service Ou t. of.
CALIBR ATION PERFCRMED OUE REMARKS Service. Repair or CaGbration DATE SY CATE (Indicate Status Below)
(Signature)
.A
(_ )
{
(
.... ? c'
'/
9-7:~
t?c a 3 ?;
,1
(
I t
Fcim 1763-1
', ) ')
. ^'
I
~~
~
HEALTH PHYSICS PORTABLE INSTRUMENT
}
CAllBRATION/ STATUS LOG SHEET
' f.
a INSTRUMENT TYPE c-e
/
INSTRUMENT SERI AL NO.
? '/ O Column No. I Column No. 2 Column No. 3 -
Column No. 4 Column No. 5 INSTRUMENT STATUS CALI BR ATION Call 8 A ATI O N In-Service, Out. of.
C A t.!B R ATIC N PERFORMEO DUE REMARKS Service. Recair or Calibration DATE BY DATE (Indicate Strus Selcw)
(Signature)
C/
"?
E
~
-;~
Se A.
e
'/ ' 77
(
- i.,
$' Y bdh 5?
li
/
\\ s/
Form 17631
')
/
(i'i*
e
HEALTH PHYSICS P0.RTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET I
('
[
s i.
INSTRUMENT TYPE
<-r;
./
INSTRUMENT SERI AL NO.
Column No.1 Column No. 2 Column No. 3.
Column No.4 Column No. 5 INSTRUMENT STATUS CALI BR ATION CAllBRATICN i >% vice. Out - of -
Call 8 A ATICN PERFORMED LUE REYARKS Service, Repair er C4= rat.cn DATE SY CAT-c (Indicate 5tstus Setow)
($; nature) n:
.- ~
r * /
-l ~ / m d
e
/
'/
.cd Til.5EX O2' 9-75 h ze r b 3lW
%J Form 17631 e"
=
[
HEALTH PHYSICS PORTABLE INSTRUMENT CALIBRATION / STATUS LOC SHEET
?
[
~
I[,
INSTRUMENT TYPE F,i ^ c
/
INSTRUMENT SERI AL NO.
Y d
Cclumn No.1 Cclumn No. 2 Column No. 3 -
Column No. 4 Column No. 5 INSTRUMENT STATUS Call 8R ATICN Call 8R ATION In-Service, Cut of -
Call B R ATIC N PERFORMED OUE REMARKS Service, Repair or Cat.bration CATE 8Y CATE (Indicate Status Belo.9)
(Signature)
O-
- / AI
~ A
.:) ;
S' - / } -],
9- ?{
fc6 3-79 t'
C_
u Fcrm 17631 j ;: r-i.
2 O
o
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBR" Il0N/ STATUS LOG SHEET e
r, INSTRUMENT TYPE ////
Amp /e#
~
/
INSTRUMENT SERI AL NO.
/d ef /
Column No.1 Column No. 2 Column No. 3
- Column No.4 Column No. 5 INSTRUVENT STATUS CALI B R ATION CALIBRATION in-S... vic e. Out of -
Call 8 R A TI CN PER FOR MEO DUE REMARKS Sen, ice, Repair cr Cal traten DATE BY DATc lindicate Status Below)
(Signatu re)
/Af E A L c e.-
/.2d~7f 3.N 7-7 ?
?
\\
\\
9 v
Form 1763-1
~
.l..
I
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
'I 3 e' #I/ f INSTRUMENT SERI AL NO.
~ !' ~~ -
/ O5 Cotumn No.1 Column No. 2 Column No. 3.
Column No. 4 Co!umn No. 5 INSTRUMENT STATUS CALI BR ATION Call 8R ATION In-Service, Out of -
C.* LloR ATICN PERFORMED OUE REMARKS Service. Depair or Cal;bration DATE SY DATE (Indicate Status Beicw)
(Signa tu re) l.
_f:ei.,rt:
/- h* - ? )
TD 7 ~ Il Fcrm 1763-1
- t. I
~
i
=
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET n
r
(~
INSTRUMENT TYPE 4e/
C
- >,c/.
INSTRUMENT SERI AL NO.
/0 3 h Column No.1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 INSTRUVENT STATUS CALIBR ATICN Call 8 R A TIO N In-Qrvice Out. of -
Call 8 R ATI C N PERFORMEO CUE REMARKS
%rvice Peca r or Calibration CATE SY MATE tlndicate 5ts'us Below)
(Signature)
/,u 5 ; t i.. r. '.
/ -)L -79 7C
'l Is Form 1763-1
<y
\\ ;, r
(
i 6
~.
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET e
INSTRUMENT TYPE A/[
/7 m O /a R
~
/
INSTRUMENT SERI AL NO.
/# f /
Co!umn No.1 Column No. 2 Column No. 3-Column No. 4 Column No. 5 l
INSTRUMENT STATUS CALI BR ATICN CA LI B R ATICN in-Service. Out of -
CA LIB R ATICN PERFORMED OUE REMARKS Service. Reonir or Calicration DATE SY OATE (Indicate Status Ee;ow)
(Signatu e)
/A/ he < v l ' e c.
/.26 -7'1
- b. X'.
lf7 ?
/
(
(..
Form 1763-1
/
J I;
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET r
/ X'
,,$ z',., rf? // '6 m
INSTRUMENT TYPE Id v" b INSTRUMENT SERI AL NO.
Cotumn No.1 Column Nc. 2 Column No. 3 '
Column No.4 Column No. 5 Call 8R ATICN Call 8 RATION INSTRUMENT STATUS R EV AR G,,
in-Service, Out of.
Call 8 R ATION PERFORMED CUE Semce, Repa<r or Ca:<bratica OATE SY DATE (Signatu rel (Indicate Stams Below)
/.')
S)<ve4
/.2C 2 'i T L) 7-25 r-L ed r
/
Ferm 1763-1
. ' - ~
/
(.
e
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
/
INSTRUMENT SERI AL NO.
Column No.1 Cclumn No. 2 Column No. 3 '
Column No. 4 Column No. 5 INSTRUMENT STATUS Call BR ATION Call 8 R ATION In-Service. Out of -
Call 8 A ATICN PERFORMEO OUE REMARK 3 Service, Repair or Ca!ibration DATE oY OATE (Indicate Status Below)
(S;gnature) m s
y Form 1753_;
{:,.
J ')
9 I
3
~ ~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET r
INSTRUMENT TYPE 8/ /
[/7m O / e #
6 INSTRUMENT SERIAL NO.
/O52 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTPUMENT STATUS CALIBR ATION Call 8 ^ ' "
In-krvice. Ou t - o f -
CAllBR ATICN PERFORMED 0U REMARKS Service Recer or Cal.bration CATE BY OATE tincicate Satus Selcw)
(SignaNre) id Se n.ee-
/
2& -7 9 3 c.
7/79
/,. _
f e
Form 1763-1 i,
t
~
~ -~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CALIBRATION / STATUS LOG SHEET s
INSTRUMENT TYPE A _L) 6 6 0 INSTRUMENT SERIAL NO.
//k7 Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5 INSTRUMENT STATUS CALIBR ATION 8
in-Sec. ice. Out. cf.
CA LIB R ATION PERFORMED 0
REMARKS Service. Pepair or Calibration DATE SY DATE (Indicate Status Selow)
(Signa tu re)
D SEwcr 9 / ;r h2x Th 3 l,9 r
t
\\
Form 1763-1
HEALTH PHYSICS PORTABLE INSTR'1 MENT
~
cal!BRATION/ STATUS LOG SHEET m
/)EFn INSTRUMENT TYPE INSTRUMENT SERI AL NO.
Ilkb Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call B R ATION CAli3R ATION In Service. Out. of.
CAL BRATION PERFCPMEO CL'E REMARKS Service, Recaer or Cal;b stion DATE SY CATE (Indicate Strus Below)
(Signature)
.b "
t~ f I ??
!]3 J Z~
- k
(\\..
r
(
Form 1763-1
- i..
~
~
HEALTH PHYSICS PORTABLE INSTF:UMENT CALIBRATION / STATUS LOG SHEET O
\\.
INSTRUMENT TYPE b f x (> l < 4 3
INSTRUMENT SERIAL NO. / 9 f) GO L_
Column No.1 Column No. 2 Column No. 3 -
Cclumn No.4 Column No. 5 INSTRUDENT STATUS CA LI B R ATI ON CA In service, Out - of -
CA lib R ATIO N PERFCRMED U
REMARKS i rvice. Pepair or Calibratico CATE BY DATc
'ndicate Status Beical (S;;n atu re) bevo, e e i
AN00
, Y Q$
N 9i'"
C:
h a i c e.
?-1-TV t ir.
.e
,7 b IYr:/ ;&C 7-77 A 7_ e r A 5/79 F
t v
Form 1763-1 o,
'.)
t:-
1 f.
~
HE ALTH PHYSICS PORTABLE INSTRUMENT
~
CALIBRATION / STATUS LOG SHEET O
C k
INSTRUMENT TYPE D ha O e y l
/ lL[ h h L INSTRUMENT SERI AL NO.
Column No 1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 INSTRU'AENT S'.TUS Call B R A'l ON Call 8R ATION In-Oervice. Out - of -
CALIE R ATICN PER F O'.M E D OUE REMARKS Service, Repair or Cahbraticn DATE BY DATE (Indicate Status Below)
(Signatu re)
L
%~;u
I4 17 T G(2 4 (212, 9/4 l7Y
[S {e a t i s 3' 7 /
'D ;;.
- -7-7?
e_
TAI 5 Ovi f Q ~7 5 h 7 ci~h 3/79 C
(.,
Form 17631
(.
e
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET e
s.-
INSTRUMENT TYPE I)dec o A t o r,c c "- 530 INSTRUMiNT SERI AL NO.
314 /
Column No.1 Column No. 2 Column No. 3.
Cclumn No. 4 Column No. 5 INSTRUMENT STAT 1)S Call 3R ATION CA L! B R ATI O N In-Service. Ou t - of -
Call DR ATION PERFORMEO g
REMARKS Service. Pecair or Cahoration DATE BY DATc (Indicate Sntus Below)
(Sigr.atu re) fra 61a ;tc L 7 eDD-7 8
.M l~Y$
s L)
- 7..
ls_
1
'\\
Form 17631 s.
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATI']N/ STATUS LOG SHEET r
/
,i e
i? J? v. %n INSTRUMENT TYPE _ / /
4..
INSTRUMENT SERIAL NO.
126 Column No.1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R A TICN CA LIB 3 ATION In-Service, Cut of -
CAllDR ATICN PERFCRMEO DUE REYARKS Service, Repair or Cahbratio, DATE BY-CATE (Ind:cate Status ?elow)
(Signature) j '.f r s r s./ f ' !
?w Ycc N c?
($
Y?
m 5 % cc 5 h3 Tu vns shs
(
o Form 1763-1 9
f) l e
~
HEALTH PHYSICS PORTABLE INSTRUMENT
[
Call 8RATl0N/ STATUS LOG SHEET r
INSTRUMENT TYPE 1/, F.f e 4 e e d S' c V,e_,/<JrJ/
INSTRUMENT SERI AL NO. / 5.5 Cctumn No. 4 Column No. 5 Column No.1 Column No. 2 Column No. 3 INSTRUMENT STATUS CALF 8R ATICN Call 8 RATION In-Service, Out - of -
CALIBR ATICN PERFORMEO OUE REMARKS Serv;ce, Repair or Calibration DATE BY DATE (Indicate 5:3Ns Below)
(Signatu re)
L - / 7-7 7 m !?
9-i7 77 i io' seev e.
~ G m
-t.
/:' i/- 7 )
fwlC
/-//-D
_/ d Su;,, e
/0-25-7 7 b(L
/ - 29r - 7 Ts f15&)t x lT h I ~ ~l ]
k(LL H!I ' ill 7 % :.
Sl? Y Ce s1W 6 '73
'T D 1 tylc 3'N In cc n icq
,..k Form 17631
)
a
e 3
~
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET e
(
I'/ /
4 <' s W /. V-INSTRUMENT TYPE
- n a c u.
INSTRUMENT SERI AL NO.
M37 Column No.1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 INSTRUMENT STATUS Call 8 R ATION C A ll B R A TIO N in Service, Out - of -
CALIB R ATICN PERFORMED OUE REMARKS Service. Re;: air er Calibration DATE BY DATc (Indicate Sistus Belcw)
(S;gna tu re)
C u-l J = <
D. -~ 'C ~.t r,
G.,. :
%v
<t
%V 6 73
~T D + Ty k 3 ' /3 en s u 4,c c C
t Form 17631 e4 6
i.
t
'/.
~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET s
INSTRUMENT TYPE i I Y.:. \\ a.'
I INSTRUMENT SERIAL NO.
-L'U Column No.1 Cclumn No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R ATION CALI R CN In-Service. Out of -
CAL 18 A ATICN PERFORMED REVARKS Service. Repair or Ca!.bration CATE BY OAT-c (Indicate Status Celcw)
(Signature) n
/
)G I
'Al:D,
i Ji -r w, ( z w
, s
- d
=
Form 1763 '
)y r,
f
a
~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET r ~ \\
1.
INSTR MENT TYPE
/ E6f 7 EG TO R INSTRUMENT SERIAL NO.
$ 8' 73 8 Column No.1 Column No. 2 Column No. 3
- Cafumn No.4 Column No. 5 INSTRUMENT STAT'JS CALI BR ATION CMR TION In-Senoce, Out of -
CAllB R ATICN PERFORMEO gu REVARKS SeMce. Repair or CAbration DATE BY
" ATE (inoicate Status Belcw)
(Signature)
/a SuwcE 9-6-77
( /,caca
/-78
/ s S at,i ic e I s
'3 - 2 7 7 D. p D.s
/-77 IN
%,c e 3/OV GE 4 TO 67W
~
n.a, e,,,
wt JSu 7 - ; S~
' ?
7~ P S.c y1,,,
W~
wth 2k7/?V f
/J/?Y c
,' =,
C v-Form 17631
~
i' HEAL.TH PHYSICS PORTABLE INSTRUMENT Call 8 RATION / STATUS LOG SHEET f
INSTRUMENT TYPE Te le /c c k e INSTRUMENT SERI AL NO.
T 3G I Column No.1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 i
INSTRUMENT STATUS Call 88 ATION Call 8R ATICN In-Servica. Out of -
CAL!BR ATICN PERFORMED DUE REVARKS Service, Repair or Calibration DATE BY DATE (Incicate Status 9etcal (S;gnature)
L Su u, w
'/3i lr7
,90 (2
'/ 3 (/7 3 NEv INsachent IN S2du,cc 12-12-23 R
B.
.? - 2 2-7t' In
%<uico z-ae-78 M.G.-i(14.
MS - 7 F; N. dr ry-s a J LJ 7-579 ff
- - c ? ! -,
P/h
/0 l25'"
TM
&t s'iC <=
l/EffV s
/<.- )
,4 (
/0/3
/-)9
/
C v
')
Fcrm 1763-1 e
A
~
~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
\\
INSTRUMENT TYPE W /pNcIot INSTRUMENT SERI AL NO.
8.33 ?
Column No.1 Column No. 2 Column No. 3 -
Catumn 9c.4 Column No. 5 INSTRUMENT STATUS Call BR ATION Call BR ATION In Service, Out - of.
CALIBRATION PERFCPMED DUE REMARKS Service, Repair or Cat.bration DATe SY CATF (Indicate Statt.s Celcw)
(Signature) kE tz)
I]*1I'
?
k$
1 - A l -]:l y,it so r Gw DIlh[
/4l / s/ / DIJL
& Ok /9 h r* v.,: c $5.
/
3-i-74 Iq.o 5-N 2.
3n t. ca I
.n e / Metair a ~/. c
'7-27-77 r^ 9 T +C Tlor
'TN $."e:n ce lh7lT
'l~
/0 W
/
/
~
,s c)
~
L, Jr 3 -y 7 9 k/r J 6"79 Form 17631 e
e
1 HEALTH PHYSICS PORTABLE INSTRUMENT
./
CAllBRATION/ STATUS LOG SHEET g
g INSTRUMENT TYPE Gz#jdr 754 INSTRUMENT SERIAL NO.
83 7'> O Colu m n
- I Col u m n " ?.
d olumn #3 C of um n # 9 Cola e n * $
INSTRUMENT STATUS Call BR A TIO N CA LI BR ATI C N In-Semce. Out cP-PER FCR M E D CUE service, Repair or Calibrat:on CA LI B R A,TI O N BY CAT-CATE REMARKS (Indicate StaNs Se;cw)
(S;gnature) 2.l/l77 YW Jf//l7'9 p/-(M//cf
%2C on3 7-49'-7 )
m C-L Z#C 16
[,l
<,%~
,7 [
}
/
(cp'r,.ea
?
.A r$3" a
C W
=
oQ CH-)7Sa'-f
~
HEALTH PHYSICS PURTABLE INSTRUMENT
[,
~
~
CAllBRATION/ STATUS LOG SHEET m
INSTRUMENT TYPE
" / fc p sc-s &
s.
INSTRUMENT SERIAL NO.
E870I Column No.1 Column No. 2 Column Flo. 3 -
Column No. 4 Column No. 5 INSTRUMENT ST ATUS CAU 8R ATION Call 8R ATION In-krvice. Out - of -
CA L18 A ATICN F6RFORMED OUE REMARKS krvice, Repair or Caltration CATE SY DATE (Incicate Status Betow)
(Signa'urel
,m J-tJ - [c c s / c f
$/b/hY i.f
.?
^
O
):
,ld. D b
/- )?
x
/
%d Form 17631
- .s I
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET m
INSTRUMENT TYPE
/ 6t' p'/ # C' / d 7
INSTRUMENT SERIAL NO.
[Od Column No.1 Column No. 2 Column No. 3,
Cclumn No.4 Cofumn No. 5 INSTRUMENT STATUS Call 8 R ATION Call 8R ATION in-Service. Out - of -
CA LI B R ATION PERFCRMED OUE REMARKS Service. Repair or Cat;brition DATE SY DATE lind'.cate Status Below)
(Signatu re) h &
Y/
JN - 01' w ce (f3/2P A
//
/ n - { m o'ce
? - f cp
/h* / }jQn 6 = 79 w
O
,j Form 1763-1 f
a
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET f'
s t
INSTRUMENT TYPE /.
/-
.~
INSTRUMENT SERIAL NO.
i $' Y 7 4/
Co!umn No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 Call 8 R ATIOb INSTRUMENT STATUS CAL R^'
In-Snce Out of -
CA L'B R ATICN PERFCRMED U
REMARKS Service, Repair or Cahbration DATE BY CATE (In<1icate La us 3eicw)
(Signaturel
~~,s l
2-
[V l j) __ ? l.' /?
C' ~ ?$
e.,
N gfJ/2Y
/
h$,
shy O
<k 9
/
Fcrm 17631 mm meno m
-m==m-
,._w
1 lu HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET O
INSTRUMENT TYPE
/e e bri' INSTRUMENT SERI AL NO. O99h Column No.1 Column No. 2 Caiumn No. 3 -
Column No.4 Caiumn No. 5 INSTRUVENT STATUS CALI BR ATION CAliSRATICN In-Oe vita. Out of -
CAL 10 R ATION PERFCRMED OUE REMARKS r
Ce vice, Repair or Cai b stion
(, ATE SY CATE (Ind'cate Status Selcw) f Signatu re)
Ovh o4 bohe,
)!79 I
" * *
- Cd b' #L' T~
g.,
'li ? /7 7 GK 9//7/22 t/f il1 D :'
_P.
i,.i~
/) 92 Ut L '
b,l9?
D' 2 dr. f-Vf 7<?
/oh y a,nc /.98
/- ) 7
/
(__
L-Form 1763-1
ih I
"^
' ~
HEALTH PHYSICS FORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE O L 6 l' fr'd N u f i' g~ p
'1s -
INSTRUMENT SERI AL NO.
Column No.1 Column No. 2 Column No. 3 -
Column No.4 Column No. 5 INSTRUMENT STATUS CALIBR ATION CA LIBRATICN In-Service, Out of -
CAllDR ATION PERFORMED OUE REMARKS Service, Repair er Calibratien DATE BY DATE (Indicate Status Eetow)
(S;;na*ure) lN 5.6fl V! c 5 il-Y-l)
WY O! OM J'?-7f Ih Seoj[Os 2-28~'l8 M C.v @.b r
,E2 8' 76 1'r>.$;.1 Ji cl
[ 67(
kG-b&
O7V C
<'s.
Fcrm 17631
A
~ ' '
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE M /e /-c C e
~
INSTRUMENT SERIAL NO. ST S' / [
Column No.1 Column No. 2 Column No. 3
- Column No.4 Column No. 5 INSTRUMENT STATUS CA LI BR ATION Call BR ATION In-Service. Ou t of -
CALIBR ATION PERFCRMED OUE REMARKS Service. Repair or Calibration DATE SY DATE (Indicate Sts us Below)
(Signature)
S - /d - ] ]
C.C ar-P 9^77
/>>Seivar~
F0.5 ~7//6 77
/
ut _Sie,lc.,
aMV 32JJ0 5 ~ l' W l0 Schce Es - 7(
Dz G u f/77
,-L Farm 17631
~
"-~
~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
~
CAllBRATION/ STATUS LOG SHEET b/3/ /3 0 5'd
~
INSTRUMENT TYPE 7/3N INSTRUMENT SERIAL NO.
Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8 R ATION CAL 18 RATION tm Serwce. Out - of.
CAllBR ATICN PERFORMED OUE REMARKS Service Repair er Calibration DATE BY DATE (Indicate Status Below)
(SI;nsture) a jN 5t3 R L'it G ll - 1C - ] 'l
%,]~4 c c G s 2 ~IC ?f NIw t i'U t In Acvv!co 2-28-7 8 M,0. + G A 6 - 2 A -7 9; t w bu.
7b7l?P Ja/2Y
.i q.
1 Form 17631
(
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET S ' 5 c 'e
/
%,/d b!cR INSTRUMENT TYPE INSTRUMENT SERIAL NO.
f/ //2_
d.3Lu --s o
- 4 d.cla m n * 'T 03\\o e o
- l Co\\u m n *7.
0.e,1 v m., #3 INSTRUMENT STATUS CA ll B R ATIO N CA ll BR A TIC N In Service. Cu t -2/
PERFCRMED Call 8 R ATION OUE Service, Repair or Calit: ration BY DATE CATE REMARKS (Incicate Status Licw)
(Signature) 3~s2 bC[
2b/f77 E
! ^/
p vf t/
<~.o.,
l - 2 c: - 7 7 h /c.
? ~ 3-c - 7 /
e i' ~. i=,.= 2 v es (C '1 L - 7 7 R. S-
,N 6 O?t,d /5
//- /7-77
.,1.
2'l 7' ((
./.s
'D
'l e J. S y 'h yk,.
Iil Sene,c_..
3 - /- 7 Y b z. t.D. k-4 - I-7 Y
(}
c-<
y c) -, ;-
7; y
-. 7 S
h
(^
D e
e
1
.s
"~~ ~ ' -
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
% /s/cc/e4 INSTRUMENT SERIAL NO._
8286 Column No.1 Column No. 2 Column No. 3.
Column No.4 Column No. 5 INSTRUMENT STATUS CAllBR ATION IB" In-Service. Out. of.
CALIBR ATICN PERFCRMED DU REMARKS Service. Repsir er Calibration CATE BY U# -'
(Indicate Status Below)
(Signature)
A'sw 11-2I-7 2
- 8. 8 3-21-7j In Sevy;ee a-a 8 -78 0. R. + M.G.
5-29-72)
/d $fluicA
[- g - W DZ S c4-6'-& - f
. / / fu a c t_
2-C-79 h N C-f-G- 79 Il iL J-% 79 AWp C '/ '79 s
I Form 1763-1 I
HEALTH PHYSICS P0.RTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
.~
A
/
INSTRUMENT TYPE
/ e.[7Iec#de_
INSTRUMENT SERIAL NO.
$ 3.Cf Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R ATION CALIBR ATION In-Gervice. Out - of -
CALIBR ATION PERFORMED OUE REMARKS Service. Repair or Calibration CATc BY CATE (Indicate Sta.us Below)
(Signatu re)
/Oc cd l 'l-l l -7 7
/( 6-3 -2/ -7f Jn by vic e 2-26-78 G. R. t Pl.G.
S -2 A-7A ID Se2 ) t C &
!- b ' lf Db - S C s-EI ~ 7 V U
/O - ) ?
&/ f08
/- ) T K
't-t-i t
. :, : c
,) - /;
M
' l
]
- 4-7 9 k WO-6-79 v
Form 1763-1 4
1
2
~' ~~'
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
[6 /_ f crr.t INSTRUMENT SERIAL NO.
I 899 Column No.1 Column No. 2 Column No. 3.
Column No.4 Column No. 5 INSTRUMENT STATUS Calf 8R ATiON CALI BR^ '
In-Servica. Ou t. of.
CALIDR ATICN PERFORMED U
REMARKS Service. Repair or Cal;bration OATE SY DATE (Indicate S:2ms Below)
(Signatu re) nN (Se v ct*
?f
~
J N j
i et V.
~
N./
Form 1763-1 f
')
[
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET m
INSTRUMENT TYPE T2 O
'EI-~
- 17 f INSTRUMENT SERIAL NO.
Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R ATION Call 8 RAT 10N In-Service. Out of -
CS '.18 A ATI CN PERFORMED OUE REMARKS Service. Repair or Calibration DATE 8Y DATE (Indicate Status Below)
(Signature) f fic.164A rt o 7-2o-78 2&) f.
/O-Ja'78
/
Form 1763-1 4
a
- i. - -. -
FORM RS-23 o mo CALIBRATIOd
,t g
l-rra cru r=s a-s ma b]
Ib i
a Services Inc.
@=
N U
m "This Certificate will be accompanied by ;alibration Charts or Readings where applicable" CUSTOMER INFORMATION INSTRUMENT INFORMATION Customer Na=e: TMI Nuclear Station Instrument Manufacturer _,Eberline Custocer Address: P 0 3ox450,RteV441S Model R0-2 Set _al Nu=ber 271 Middletown, PA 17037 External Probe (s)
Serial 0 Custcuer P.O. #
54292 Calibration Method Gs 13/
Source #10/
Service W.O. #
78-02-667 Co 60 Source u012 INSTRtWJT CALI3 RATION INFOR. ATION V
Instrument Calibration T. 2 re e.,. per,e,se Range Standard Value 2.<,
. c,14w.
Ac or c,11s.
Cc==ent t
50 mR 10 =R/hr 10 =R /h r
, All calibrations + or - 15%
2 25 25 3
50 48 4
5 500 mR 100 mR/hr 100 mR/hr 6
250 250 500 480 A
9 5 R 1 F/hr i
D /k-10 7.5 2.5 11 4.8 4.7 12 13 50 R 10 F/br 10 D /b" 14 20 70 15 40
,a 16 17 18 19 20 ADDITIONAL TESTS Tvoe of Test Results Test Date
'd,*) tnjest 1
STAT WENT OF CERTIFICATION We Certify that the instrument listed above was calibrated and inspected prior to ship =ent and that it met all of the Manufacturers published cperating specifications.
'Je further certify that our Calibratien Mcasurements are traceable to the National Bureau of Standards ('Je are et responsible for da= age it. curred during shipment or use cf this instrument).
- )
Instrument Calibrated by:
!' h/
I certify that the abcVe infor=ation,is N (Signed) k correct:
,e,'/
Calibration Date:
4/17/78 Authorized Agent _
' ' ~ <
-- N Next Calibration Due:
7/17/78, Title Instru=ent Tech. _ Date. 4/19/78-x
-" ~~
HEALTH PHYSICS PORTABLE INSTRUMENT
}
CAllBRATION/ STATUS LCG SHEET C.J, i
-e g
,>n INSTRUMENT TYPE
/
INSTRUMENT SERIAL NO.
i 73 d olo m o# l Cda m n 1
Ce.b ~,., # 3 O t',, m n * "
Gi t. m a * $~
INSTRUMENT STATUS CALIBRATICN Call 8F ATION PERFCRMED in-Service Ou t -JJ -
CA LI BR ATICN CUE Service Repair or Cal;bration BY REMARKS CATE DATE (indicate Status Celow)
(Signature)
/
,3 - 7 ~/
7P J-r, '
w sepoce 6/77 7~ 2 9/77 "N
96d vic s
/2-W 77 F8 7-12-7f D So<vlc e 2.-2 R - 7 6
- 9. R.
5-EB - 7P>
lN 5 6.t v tcE
.5 4 -79 K G.
8-6-78 7v : a~ i:e e
~
q-Y
(
/su ne nn 2-6-79 nyG
& 79 H
e 4
v.
/'
}
f l'.
5~
n :, 3 - :
i
HEALTH PHYSICS PORTABLE INSTRUMENT Call 3 RAT 10N/ STATUS LOG SHEET g; e !
,r
?
INSTRUMENT TYPE
[d -I INSTRUMENT SERIAL NO.
27[
C 6 5 v m es *1 C,o k -.," ?.
C.o t o - o
- 3 c.Nmn'M C.s t o w
- S INSTRUMENT STATUS Call B R ATIO N CA LIBR ATION in-Service. Out - e,-
PER FC AMED Call B R A TICN DUE Service, Repair or Calibration O
OATE CATE REMARKS (Indicate Status Below)
(Signature)
//J' b^f O$
3,b/
7
'f S,7,,Gc!.)$c.l-
.7-
-y
<.2
?~ l-7 7 //h :
T-9-f 7 MA'G ? XO
//~ y - 7 7 is usnce r/r7 x^ R p /77
/
- ,0 $ k tv sc A
/J '3
>)
7D$M
/ ' 7e
//
19 '/ - 7'?.d?k T - 'I - 7 7
(_
lN S ER u t c E l2 -/ 7-7 7 fLb 5 ^ ^l S
'v e
t'oa - t 7:. : -t r
e
==
FORM RS-23
~
CA LIBRg THO N
_ ofmn 7
- s-c;smc.
CEFTIFICA E
"This Certificate will be accompanied by Calibration Charts or Readings where applicable" l
CUSTOMER INFORMATION INSTRUMENT INFORMATICN
~
f Custetser Name: TMI Nuclear Station Instrument Manufacturer Eberline Customer Address: P. O.
Box 480, Rte !!441 S Model R0-2 Serial Nu=ber 280 Middletown, PA 17057 External Probe (s)
Serial 0 i
Customer P.O. #
54292 Calibration Method Cs 137 Snurca 5107 I
Service W.O.
78-02-667 Cn 60 Sour a an12 f
procedure :i m 77 i
TNSTRt.'v
',7 CALI'iRATION INFORMATION Instrument Calibration I., a r r,-r e-r oe s c o., s e Range Standard Value n, c,,.. c o i o,.
M r.
c,3 n.
Coc=ent t
50 mR 10 mR/hr 10 mR/hr All calibrar'ans + or - 15:
2 25 25 3
50 50 4
5 500 mR 100 mR/hr 100 ra/hr 6
250 250 7
500 480 f
P
! 9 5 R 1
U/br 1
o /hr
? 10 2.5 2.5 11 4.8 4.7 12 13 ST) R 10 R/br 10 9/hr l 14 2n 20
' 15 40 40 16 17 18
' 19
~
' 20 ADDITIONAL TESTS Tvoe of Test Results Test Date k,*IEnk"8C STA-37 0F CERTIFICATION MarCertify that the instrument listed above was calibrated and inspected prior to shipeent and that it met all of the Manufacturers published operating specifications.
We further certify that our Calibration Measure =ents are traceable to the National Sureau of Standards (We are
-at responsible for damage incurred during shipment or use of this instrument).
,>p eq
/ '
u1I Instrument Calibrated by:
tt I certify that the above informatioc 'is (Signed) co me -
Cm/
Calibration Date:
4/17/78 Authorized Agent b M.,
,-r-
~
Next Calibration Due:
7/17/78 Title Instrunoht-Tech.
Date 4/19/78
HEALTH PHY51CS FORTABLE INSTRUMENT
}
CAllBRATION/ STATUS LOG SHEET Edc I
~
e
,- 3 INSTRUMENT TYPE MO 6
INSTRUMENT SERI AL NO.
'2 73
- 1
- \\ u m n ' 2.
h\\o m n
- 3*
Ca t
.w n 9
c 3 (._, m n 06 8
dolu m n
.o
~
INST 3UMENT STATUS Call 8R A TIC N Call 8 PERFCRMEO In-Etrvice, Out v -
CA U SR ATION 0U BY Service, Ecpair e Calibranon OATE DATE REMARKS (Indica e Sta:us Selow)
(Signature) la L,, - -
3 - 77
^
?,.. ?:
c,;
-i. e.
f
'7 7
'T G. D.
T/77
/
w Ser s/r e in 56, e.= t
/o 3-,,
7 7) s o+
/ - 78 I,v 9 u.
/e / s / 75-IM
//'Se/JG' lN St^il v a c s 2 72 7 t_. 8.
2 - 7.9 i
s.
,, / i ///*
I
's
( if,
~_~/*
l
. ) W /! o
. ?
'rl ~ ] N' h, f (
a I
,r,CEh A'<a 4
(')' ' ' f "p* *C L
,L. i6fr -a,/
v i
LM 3, vi c e 2
C-79 R G~
F-7 y me e
e
~
Geu - t i :. :.,.
~-~ --~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET
$d e,
[
INSTRUMENT TYPE
/), L,
//
.~
., W,'
INSTRUMENT SERIAL NO.
.A 0.ol u m o
\\
C o(emnS.
6t o m n%3*
d_olu m n
- S Gla m n ag t
INSTRUMENT STATUS CA LI BR A TIO N CA LI B3 A TIC N In-Service. Out *J
- PERFORMED CA LI BR A TI ON DUE Se-vice. Repair or Cahoration BY DATE DATE REMARKS (Incicate Status Eelow)
(Signa ture)
,s.
- 2. - !. ?, ' '
.s ~
7 (f
9' -) ?
, N $ 60 Vr'c f G -X- ) ?
/
_// Je-e
?-?- 7 7 hA c. 4 J/2 l/-7-77 oat'oF& W/m
.? u c, ; g; u..
? - y
,1 pc
/
nC
(*
~N
/h Nb
?~ ) f v
(
Ne e
e A
9 y,,y
~
e
~~ -'~
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET
~
INSTRUMENT TYPE kd 2--
INSTh'JMENT SERIAL NO.
9/3 Column No. I Column No. 2 Column No. 3.
Cclumn No.4 Column No. 5 INSTRUMENT STATUS CAllBR ATION Call 8 RATION In-service, Out - of -
CAllDR ATION PERFORMED OUE REMARKS S3rvice, Repair or Calibration DATE BY DATE (Indicate Status Below)
(Signature)
D % ce n/u/n brx2 s/n bs l
Form 17631 9,,
c.
_~
('
HEALTH PHYSICS PORTABLE INSTRUMENT 2
CAL!BRATION/ STATUS LOG SHEET a
o I I INSTRUMENT TYPE h - D,
' / k ')
INSTRUMENT SERIAL NO.
Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5
~
INSTRUMENT STATUS CAllBR ATION 8 '
In. Service. Out of -
CAllBR ATION PERFORMED 0UE REMARKS Service, Repair or Calibration DATE BY DATE (Indicate Status Below)
(S;gnature)
'l ' D In 3
- s.,e T l'73%
T'D %
n9 il 7Y 1N h-v 'ce, f-79 Xc}
x~
C
^
l Form 1763-1 o 'l f
e
~~ ---
HEALTH PHYSICS PORTABLE INSTRUMENT I
Call 8 RATION / STATUS LOG SHEF.T
^
r INSTRUMENT TYPE
- =/-
INSTRUMENT SERIAL N0'.
'/
Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 l
INSTRtJMENT STATUS CALiBR ATlON Call 8 RATION In-Service, Out - -
CAllBR ATION PERFCRMED DUE REMARKS Service. Repair or Calibration CATE SY DATE
!!ndicate Stvus Belcw)
(Signatu re)
</ ~ ?
->]
_oS
.p/.
g,,
L
'w Form 1763-1 n 't
? *!
HEALTH PHYSICS P0RTABLE INSTRUMENT CAllBRATION/ STATUS LOG 3HEET INSTRUMENT TYPE 884 d INSTRUMENT SERI AL NO.
/ff Column No.1 Column No. 2 Column No. 3,
Column No. 4 Column No. 5 INSTRUMENT STATUS CA LI BR ATION C S L! BR ATION In-Service. Ou t. of.
CA'. ' BR ATI CN PERFORMED OUE IEMARKS Service, Repair or Cal.bration DATE BY DATE (Indtate Status Below)
(Signature)
Y 7 7.T", 7 ] 7
/+7 /r c e r D U ~ 9
-))
rnu l N 5Fe :n c e II Cl-7 7 nh 2-9-7/
f & 96 s e._ (~ Esk
)I D T ^D.
1-2/,~7?fY.
/ - 2 4 ~7V D.X Y~ 2d ~lY f dn'v(c c
/N Gw 74
& G-,1 R. 6.
2-C-7r F* -?Y C.
g-3c. 7 y' pt?
y-W
- a 5 4t utc.?
2-7S
'T 9 6 - 73 O
Form 1763-1 i '/
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
,. s INSTRUMENT TYPE
- dMd
'5, ' "- -
--/2 /
INSTRUMENT SERIAL NO.
=~%.'
, d.2
- ?
.. !. _ ; 2.,
-.,.,.;~^.
INSTRUVENT ST ATUS Call 8R ATION CA ll BR A TIO N PERFORMED in ';ervice. Cu t -
CALIBR ATICN CUE BY Service. Pepair or Caiibration CATE CATE REMARKS (f ac:cre Status Si:w)
(Signature)
<//,/
? tsaL
/
f9f ' ?
'r-s 'b.? ?
l d
{ h)
- L Y,
'/
LO. (_ c: -..a i.v 3e.,ae 6 '.S-J'
< l-/ ',, }
~~'
l V Tc < v, i
5-dT TO'77 t'rd'C.- # 6 D
//
^7 )
"S d/-7'l h.tA 1.
/ I ~7 7 C cf S[r.,
$> /; A.
G..
,, - s ' '~^~
r l l
..,o. -17 n.e>?.,--
l 1 - 2 5 - - ?,i v;
c8
~
.'N 4 ( 1? o,1 C E I2-j7*77 2 L S.
3 - ? <5'
('..
.1
,, -. i:.q ; ' -
~
- z..,.
3.,
s
.~
_.a
'e
,, 3..>
sr c_,
lA) Se eu s c L.
6-25' jr?tf/c 9-) 2 tu 5Ea vie t 7-D o - 75
>A.EAJ.,
/ o-7 C
/0/? }
nW ! f) R
,1.- 39
.I N 5 %'! C 5 3 / 5 / 'I
!?5?,
(,
~~ 9 L
~
)
6% r M
/ ~a* *. :'. ~.
"fe)
{
. I-
~
' - ~ ~~~
HEALTH PHYSICS PORTABLE INSTRUMENT Call 8 RAT 10N/ STATUS LOG SHEET r~.
INSTRUMENT TYPE
. 'l " ' -.
Si$ a_
l n
'.. o INSTRUMENT SERIAL NO.
' '.2 53 s.'..n.:
' =. '
,.. /- ::
s.,'.,,. # !
-..,,,1
-;. <.)
INSTRUMENT STATUS CA LI BR A TIO N CAllBRATION PERFCRMED In-Service, Out -
CA U BR ATf CN CUE Serv.ce. Repair or Cahb
- .sn BY DATE OATE REMAR<S (Indicate Simi Jelow)
(Signature) f f' s- ?-
(.".~~i;
- )
L
,t1-
/
J
.. c v
1I JL v4-k t', - Y
^i 7 i
,t. ', 5'b e, c: 5e'
Cf e
n n - -W s
//-23-7)
/
s e) S Eiv. c (
'M T+. ;-
1-78
,m e
- )
)
)** -
') f c',r,
? /!
' f' W,
h
/
/
o 6
l I
r~~~
r j
e
. -^~
L G ;'s,
- n
___,_.L
8 $d b HEALTH PHYSICS PORTABLE INSTRUMENT M
~
CAllBRATION/ STATUS LOG SHEET O
w INSTRUMENT TYPE E-52e INSTRUMENT SERIAL NO.
423 Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5 INSTRUMENT STATUS CAL!BR ATION Call 8 In-Service, Cut of -
CA LIB R ATIO N PER FORMED 0U REMARKS Service, Repair or Calibration CATE BY OATE (Incicate Status Belowl (Signature)
L
% <v ic e 12 7 6
- p. z.
3-2-79 i..
c.
.c I - ) ~7 - Y, eo3t-
-l ' li 1m S Et a <c c_
d i 3 mq TD I-79
\\
u.
Form 1763-1
,,. ) <)
.l
( L :.
=
I
~~~ ~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE _ /r - C'e INSTRUMENT SERIAL NO.
//lft Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS CALt BR AT'ON Call 8 R ATI O N In-Service. Out - of -
CAltBR ATION PER FORM EC DUE REMARKS Serisce. Pecaer or Cahbration DATE BY DATE O ndicate Statu: Below)
(Signaturel M/ Sem 7- ?'- 7 7 rufC&yD
/ /- 7 7
/N G.,,a
/C/c ch 9 G/2
//9s/99
,g
%et) 4';I? V Gib
$&W
- - 2, y
,e d 9 n.e n ' u JU,b,. n 3
/
s.~. a 9-n fi s.,< d m a. -f 3-79
_T n
%-v~de e I 2 - 2 ~18 D. 2
/
/
/t U
C/
t' b L" lC rf
/Nl, %,$ %
a A sc f y [
o'
/
G Form 17631 i)
L L. L
'u y-
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
~~
2 6 INSTRUMENT SERIAL NO.
h Column No.1 Cciumn No. 2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATUS Call 8 RATION Call 8R^ ' "
In-Service, Out - of -
CAllBR ATION PERFCRMED U
REMARKS Service, Repair or Cal;bration F.TE SY CATE (Indicate Status Beicw)
(Signatu re)
/# Sc'A G' f-/P77 Y$me
{} - 7 7
/r
/*
n O fff JF c q),,'l '1 &,
_;?
tl t iv' s e n t,'
9 17 2 K.
/ 2 - 2 7-77 IN SER va E 12-17-77 L L-B 3
~7 0 5/W
/ 10 C <>C V M
3 bhW V
N qia- 't a 6 4-Te-w m,
,4'iff
.-c
/
V
- i. :,,,
0/'75 plu s'/
/2
^7f
!~
_/, !. *5se/c-z
, _ ; ; _,;,, L i ' ->i 7D s' - ? ?
L..,
Fcrm 17631 f
( L. N
]
J'[ '
HEALTH PHYSICS PORTABLE INSTRUMENT T
BATTERY CHECK LOG SHEET Column No.1 Cclumn No. 2 No.1 Cont.
No. 2 Cont.
No.1 Cont.
No. 2 Cont.
PERFCRMED PERFCRMED EM CATE CATE CATE y
8Y PERFCAMED ERFORMED PERFORMED
~
(Signature)
(Signature)
(S;gnaturs)
W/ shy J 4:- O M s=
.h 77
> //,, '
f /_-
/
~
/
)
f L -. L
4
~~ ~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET O
INSTRUMENT TYPE INSTRUMENT SERI AL NO.
f/9 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 l
~
INSTRUMENT STATUS Call 8R ATION Call 8RATICN '
In-Servke, Cut - of -
Call 8 A ATION PERFORMED CUE REMARKS Service. Repair or Calibration DATE SY CATE (Indicate Status Below)
(Signature) hgdp
<- Y ~79
/W $MV
/ D -'t'- 7 /'
(i. y c. % a.c.
l') 1' 0 7 ]
7 r*
t~'
- 2.;5 4 y-
. ~,..
~
n.
- i... r.
n yr 1;, :p.,,.
r
~
Se,:e 7 + ry D <'_
s.W T-ru SE t <> e t -
b*)2 Shk VN Y
'7 &
7-2;-
r.a
^'
i L
S e* vic s 12-2 '74 P 2.
3 /79
(~
/ A, 3 4 mc c
.9-G-M T c, f-75 Fcrm 1763-1
/,
l
(,
. l-n
~ -- -
HEALTH PHYSICS PORTABLE INSTRUMENT p
CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE k-$N 1
INSTRUMENT SERIAL NO.
JM)
Column No.1 Column No. 2 Colunin No. 3 Column No. 4 Column No. 5 Call 8R ATION CALI BR ATION
~
INSTRUMENT STATUS in-Service, Out of -
CAllB R ATiON PERFCRMEO QUE REMARKS Service, Repair or Calibration DATE BY DATc~
(Indicate Status Below)
(Signature) a v Elfrww.ts.3
" !' ?
s C.'l + 's 4 il 9 7
'0 5 d A.-fI h.-
/
$'~f-7 2 Mc e m r v
v r
=~
'.,,.; &l c s !ar a =2
.. /...., 3.5 1,,':, il = 1
.. :ma INSTRUMENT STATUS Call B R ATION CAllBRATION OMO In-Service, Cu t - :.* -
Call 8R ATION OUE Sarvice. Repair or Cale rsteen BY DATE CATE REMARKS
(:ndicate Status Below)
(S;gnature)
/
'fL s';i L 'I.'CE (7 4 1 ~ ~
L,. -<j "~,
9,
~
ft,) CGL'Oli L' ll:. 17
'Ribi <. -
7 i
i
/WSe v /
T 7 )
M/1'C~ nJ'D 5 //- } }
wwz s, ~ c, S,x,*w fo - El-71 62
//;tl?Y 7~
M.
-[
12l z< h 7 GC 3/31 /'7 7 b i n I ',
l'
?,'E
% l:: IT C bT-.&
(
01b h 0a Qc d ' -)9 /??/L'
$bY2erma
/
= a s.= l i' a t e%~. - $a C - n'. k p/n//
/.. ~
&7 W
_j L
S er vie e_
iz-2-78 P. 2.
'3-79 rO t,..
,c.
6 I
v g
J M e, >; / '. * ;. *
/ 1. i.
w m-y w
g
4 HEALTH PHYSICS P0.RTABLE INSTRUMENT
/
~~ '--
CAllBRATION/ STAT'JS LOG SMEET
~
b886 INSTRUMENT TYPE INSTRUMENT SERI AL NO.
[$2 M Column No.1 Calumn No. 2 Column No. 3.
Column No.4 Column No. 5 INSTRUMENT STATUS CA LI B R ATl 0i1 Call 8 A ATION In-Service. Out - of -
CALIBR ATION PERFORMEO QUE REMARF' Service. Repair or Calibration DATE BY DATE
' indicate Status Below)
(Signatu re)
$WV-S f
?w.-
b~$
44 F
f,!.
//f
?
C44;,E,
~
in 5 nica JA 9/77 (). ab-2-1l-7i kl 2:'J11h'i_.
IN ' D l T l1 i'
. D1 ~a.b U'
' -.,I.5 l 7 ?
9.';
',c 7'*/'
- +
In S evy n -
12 7 A D. Z.
'6 [78 L'
Fcrm 1763-1 iu g_
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET C_7JEx*c tNE INSTRUMENT TYPE N8-[
INSTRUMENT SERI AL NO.
/9 VT Column No.1 Cclumn No. 2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R A T1CN CA L! SR ATIC N In-Servic e. Cu t - of -
Call 8R ATICN PERFCRM'O OUE REMARKS Service. Recair or Cahbration CATE SY CATE (Indicate Status Setew)
(Signa tu re)
$$&ruiC [.
hfl2
///W 9/1g L
S evvie e l a 78 o. 2 : J. i=. u.
3/77 l
_.__ J Form 17631 Oe
I
"" ~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET t'BEKL IN E INSTRUMENT TYPE M//[- [
INSTRUMENT SERI AL NO.
.2.28 Column No.1 Column No. 2 Column No. 3, Column No. 4 Column No. 5 INSTRUMENT STATUS CALF 8A ATION CA L18R ATION In-Service. Out of -
CAL 0R ATICN PERFCRMEO DUE REMARKS Sarwce, Peper or Calibration CATE BY CATc (Indecate Status Below)
(Signatu re)
Y A) $&e w Le._
d /9 Aff 9b g?
/
I
'I h S e v,'e e 12 7 8 0.2. 4d.E d.
3[78 v
Fcrm 1763-1 2 d 2 l 'i r.'
HEALTH PHYSICS P0HTABLE INSTRUMENT f
CALIBRATION / STATUS LOG SHEET INSTRUMENT TYPE
.f r) C - # ;
INSTRUMENT SERI AL NO.
- 2. '7 >~ 2 Co!umn No.1 Column No. 2 Column No.3 Cc!umn No. 4 Column No. 5 INSTRUMENT STATUS Call BR ATION CALIBR AT!CN In. service, Out of -
CALID A ATICN
- ERFORMED CUE REMARKS Service, Repair or Calibration CATE SY OATE (Indicate Status Beloa)
(g;; nature)
> <<v,ce.
6-29-73 7(l 9-2 y-7 7 rn iJ
%2._, c e
' lu/T?
$C.
'&i?V 5 :e, r!
5/~/7' in <
. L j'.T
.%.- -~
T La kutc v h/0he h/r 9/dpa
/
4'
/
/-
Fcrm 17631 4
/
1
(,
. i..
n
HEALTH PHYSICS PORTABLE INSTRUMENT 3
CAL!BRATION/ STATUS LOG SHEET INSTRUMENT TYPE P, a - 4 INSTRUMENT SERI AL NO.
/3 P7 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS CAlt 8R ATION CAllDR ATION ImService. Out of -
CAlt89 ATICN PERFORMED DUE REMARKS Service. Reo sir or Calibration CATE BY DATE (Indicate Status Below)
(Signatu re)
ZW 3 e.e v c <-
/-;
-7 V
.D.K -
f 24-7Y ded/.Ji,,, - ::
~.
,t'
~ ~ ^
/
i t; SECa r [
'A - ?~ ? ?
f('
6 - 6' ' 7 ',l J
Form 1763-1
)
\\
t
.a 2
HEALTH PHYSICS PORTABLE INSTRUMENT
~
Call 8 RATION / STATUS LOG SHEET INSTRUMENT TYPE
//C-((
INSTRUMENT SERIAL NO.
/3/2-Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R ATION CALIBR ATICN In-Service. Out of -
CAL 18 R ATION PERFORMED DUE REMARKS Service. Repair or Calit:rnion DATE SY CATE
- (Indicate S:atus Belcw)
(S;gnatu re)
A
/
zw 2.:2nvcy
/
p/ p
/
m7"3 XO) 47/f-7/77 Y-fu 6./? 7 J~6D
/f??
.TVSea F9~7) n4-c+ro
// - y y 9 " 3 l - 7 ~)
h.hND l\\ -7 ')
!a n 7 7
,.,:. m,
- _7 3 In- %vme 2.-z c -7s M. g.
S-76-78 7~' '- : gr, r G /,
'- 7 27,2.73 0,. ,,- 17[
[H
$ ::'v! s
'l/Yl7!
S. 5
- 12. / 7 9
' ^ E '~
I:
'i
,?
'O 3 2m 3
,?
a,- a :.v i t.
- 1 ',,,
~
^
f '~' Tr 3 - ?9 Ae -'
C G %-
g.
3 f e
k, Form 1763-1 e
a l
4 T
4.
i
=
HEALTH PHYSICS PORTABLE INSTRUMENT
'- ~~'
I Call 8 RATION / STATUS LOG SHEET INSTRUMENT i /F:i
//C - 58 f
INSTRUF.i SERI AL NO.
/8/f Column No.1 Cclumn No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8 R ATION
~
CAllBR '
In-Service, Out - of.
CAllBR ATICN PERFORMEO U
REVARKS Service, Repair or Cantration DATE BY CATE (Indicate Status Below)
(S;gnature)
/
z.u ceiacsuc/
/
,eir
- 2-Y/JJ
//d
" 99 u
e
~.,w,% t <-e <!-
7-5/-77 h.ND, IL 77 i ^_ 2 3 7 ~7
(.,
~ ',
7 h' In - Semice a-29 -7 A m.G.
5-aA-76 L7x C Q',,'-?
[n
- n,,17
/
5,v E.< C.
V.
[~
IN iEGt c s V/'7 /7]
?% 0,
}2/??
f2 C
r ;,5
,c.,
e
> ~ ~ ~
r_
d '
.,,.s 3 1
/4:_, __ } c,et
'/U i
\\-
form 1763-1 b
e g
1
[ -
s-
a HEALTH PHYSICS PORTABLE INSTRUMENT
~ - ~
CAllBRATION/ STATUS LOG CHEET k..
INSTRUMENT TYPE
//C-M INCTRUMENT SERIAL NO.
/c?/[
Column No.1 Columr No. 2 Ccluma No. 3,
Cclumn No. 4 Column No. 5 INSTRUMENT STATUS Call 8 R ATION CAllB In %rvice, Out - of -
Call 8 R ATION PERFORMED OU REMARKS krvice, Repair or Calibration OATc SY
^-"
(Indicate St1tus Selcw)
(Signan.re)
//
z-c-o u -/
7 f}
b7_ */
V /)
.&/.
% ba t.e G 3 ! -7 7 3.
I
., -)
,3...
C.
_, S c,
- y s,
. +,
~r e
)
lN San *vic e
/- H - 7 7 h./c'.
1'- ?.C 7 P' 5^'
' L' n. u 6 b/h A//?(*
s/ )y
~
g,
q /;.
,9,(
(v, ~,,. -,
lN
.::^ u t < 7
'?/?/7!
S, S, l2 /7 f lu g;-
j -v.- ;
.s e-
/.
_ L r'
3 A
?
<-r-
/ ^> s L
Form 1763-1
_ -.7
~
. - - ~
HEALTH PHYSICS PORTABLE INSTRUMENT CALIBRATION / STATUS LOG SHEET
/
(-
INSTRUMENT TYPE P '. ". - ( :-
INSTRUMENT SERIAL NO.
9 i 73 4 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8R ATI O N CALIBR ATION In-Service. Cut - of -
CAL l8 R ATIC N PERFCRMEO CUE REMARKS Service. Repair or C.slibration CATE BY OATE (inwcate Status Below)
(Signatu,rel
'N-E (Lx11 C. 'd Q I'o ! 1
'/Y. A I 7! '77
.IE d Te 15 T I
c h 7/ 7 '7
' e v r l' 9'77 11 - S e ra e e e.
?~
i c M ht r.';. 5,
P///?7 MDc' /fM
///??
17 s... - -, s.
,3. N\\D.
// - 7 7
- -31-T7 d
iN WR I:ics 12 77 R. L 0 3 -78 9 -/7 '7' M~d/]i?.<)
/,2 - 7((
Gv1 ~ mis 2.
/
/
I:-<-,f 1,1
-t
/ r.
- c, A
\\-
Form 1763-1
\\~-
l
(
.L
~ ~ ~ ~ ~
HEALTH PHYSICS P0RTABLE INSTRUMENT
~
r al8 RATION / STATUS LOG SHEET
~
r
,f
' I C. - b INSTRUMENT TYPE INSTRUMENT SERIAL NO.
I107 Column No.1 Column No. 2 Column No. 3.
Column No.4 Column No. 5 INSTRUMENT STATUS CALI BR ATICN CALIBRATION In. Service. Cut. of.
CAllBR ATION PERFCRMED OUE REVARKS Serv ce. Repair or Calibration DATE BY DATE (inecate Status Below)
(S;gnature) 9 loll 1 N A -r 7/n h2 Ien.
/
T.4 6 6.N !c.E
$N Se v ut c e Y4-1) 6 8 C-P f f)
/f~ 7 7 7p' 5'z tu'ic e-
/ 7 y D.K.
'l 2 4 ~ 2I c'.: t c a,=
y e.o.- :i e_.
3-9-7Y h ic -
M. ?..' uV '-H -
-C,r.e v, ' c.
/ i.i- ;-
7~,.r!)
r./
f.- l 7
v
&is 5.G.
b^!,~
rM 5 E R:'tCR 9/?/7]
F. E l2 / f n
'n i.
s-s s 3
~
Form 1763-1 3
l
(.. L.
'-N
- m---
->.--e**-M-e
,w-um-gumpsim
-.emuse.g-m-
e 4
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE NI C - b
/
~
INSTRUMENT SERI AL NO.
IE-120. U Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5 INSTRUMENT STATUS Call 8 R A TION CALIBRATION In-Service. Out - of -
CAllBR ATION PER FC7MEO OUE REMARKS Servict, Repair or CJ!ibration DATi BY DATE (Indicate Status Below)
(Signs f rj) in - s efu :ce w!:0!n u mr 7'77 rjee r e s r.
If L 'i 7-t-7 1 exc c-n N-7;7 iN service 10-3V 77 G. R. s K B.
l 72 f a %'c e 1/?Tf M
6~/ ? R Scur
?*d f; /,' '
v,,,,,gg..,4 h
iN
/ A) blenep 7-2 0- n if
^7)c3 PUcj
$O - Do 75 O
.(.
2
!i
$ E.c; i %
-T a f ~0 2-
-/-77 0,0 S -
M.ru
!!il.d 01 A hi L
Fcrm 17631
[]
i';
i i
L
-?
HEALTH PHYSICS PORTABLE INSTRUMENT I
CAllBRATION/ STATUS LOG SHEET O~
INSTRUMENT TYPE
/
INSTRUMENT SERIAL NO.
- d7N Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STA TUS CAL 12R ATION Call 8R ATION in-Service. Out - of -
CAllBR ATICN PERFORMED OUE REMARKS Service. Pepair or C.shbration DATE BY CATE (Indicate Status 241cw)
(Signatu re) in-sexv
/p 77 s[%n 5 '!- W Needs Reo-d, sed
- 0. 0 ;
2-29-7c
)
I g o,-. >-
% dt; q e--
?-V-7?
TJ <
s
(_
L Form 1763-1 l fl
\\><
2 I
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET b
INSTRUMENT TYPE I/,
-40 R dd// 70 70 V/7#7 [
INSTRUMENT SERIAL NO.
. '. 9.1 Column No.1 Column No.2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATU3 Call BR AT!CN CA LI BR ATION In-Service. Out of -
CAllBR ATION PERFORMED OUE REMARKS Service, Repair or Calibration DATE SY CATE (Indicate S stus Below)
(Signature) g sz </c c &
i s.l T e p., r' e,_
A "/ 7-7 ^7 T~ P
-r De 9-/7-77 Ab( u oa2
(-
L' Form 1763-1
HEALTH PHYSICS PORTABLE INSTRUMENT I
T I
CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE
//
/2. r r,s Ced:/'/?:?/"
~
INSTRUMENT SERIAL NO.
/50 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS CAllBR ATIOr t CAL 188ATION In-Service. Ou t of -
CALIBR ATION PERFORMEO DUE REMARKS Service. Re:: air or Cai.bration DATE BY DATE (Indicate Status Setow)
(Signature) ht'.<
t' f' ))
2 C 5 c t' 5 d i,;i d / 2-1l -7 7
- wI LS,: T c:L, C
i
\\
Form 1763-1
/')-(_>.
l l) ~ '
T 7 -
_a
5 e
' ~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
~
r INSTRUMENT TYPE ccS/v-5 INSTRUMENT SERI AL NO.
/]d 7 Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5 l
INSTRUMENT STATUS CALI BR ATION CAL 18 R ATION In-Service, C'at - of -
CALIB A ATICN PER F CR M ED OUE REMARKS Service. Repair or Cal. brat an DATE SY CATE (Indicate Sta*us Below)
(Signature)
/ 4
//
/
z/v Sea <-'ncy
/
s Air #2 Y/J2 sd)/&
7/91 6/77 ff
/72
't/n h.O uln
-d
- 0. rts
/a /at[7 7 C
I t\\~
I Form 1763-1 L t. 7 i s,,
m
HEALTH PHYSICS PORTABLE INSTRUMENT I
CAllBRATION/ STATUS LOG SHEET
~
(~
INSTRUMENT TYPE 688-3 INSTRUMENT SERI AL NO. /327 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call 8P ATION CALIBR ATICN In-Service. Out of -
CAllDR ATICN PERFORMED DUE REYARKS Service, Repair or Calibration DATE BY DATE (Indicate Status Selow)
(Signaturej
~
_ru es ana cy
/
^^' f 5 /
+'k7
!kt 7
9
. f/,s /, ynJuslis.cf. a -/0- {}
a-Iz b) ~ l ~] l
(
3 7 7 YWb
\\\\ - ll is
~
0, O. 5, ia-e 3 -77 3
C r-
\\.
']
Form 1763-1
.) ;
(.i.
^
" ~~~
HEALTH PHYSICS PORTABLE INSTRUMENT CALIBRATION / STATUS LOG SHEET s
INSTAUMENT TYPE 9 5/7/- 8 INSTRUMENT SERIAL NO.
/d2'J d Column No.1 Column No. 2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATUS CALI BR ATION CA LIBRATION In-%rvice. Out - of -
CALIBRATICN PERFCRMEO DUE REMARKS Grvice, Reoair or Calibration CATE SY DATE (Indicate Status Selow)
(Signaturel
, /1 z u es :v w,/
c k/7 R" 9'
7
/
f_
y y
0c ii/,,
., - y-tj A.,ss
.er e 7 /, 7 41 C,"O. S.
l ~ ~W l "
~-
C Fcrm 1763-1 y
g' 1)
- f. i. i.
.,s.
~-
HEALTH PHYSICS PORTABLE INSTRUMENT
~
CAllBRATION/ STATUS LOG SHEET
(.
INSTRUMENT TYPE 6SM 6
~
INSTRUMENT SERI AL NO.
/J96 Column No.1 Column No. 2 Column No. 3 Column No. 4 Column No. 5
~
INSTRUMENT STATUS Call 8R ATION Call 8 RATION In-%rvice. Out of -
Call 8R ATION PERFCRMED DUE REMARKS Cervice. Pecair or Cahbration CATE BY DATE (Signature l)
(Indicate Status 9elow)
/
r" ewrx :-f&cy
/
/
2
?/ll '
ks7 0Y fff7 zo - s~ce 6h c/bv 9/r7 3 3I 11
- h. b D _
h !l ')
N
(
- 0,0,%.
I? - E h ~] 7
~
/
(
~
,~
b Form 1763-1 I /
,,g<y f
s. '
s
,e..
,w-
- +
e-+,-+ve~
~--,-=~--o
~
se -- w ww-
,,m m+
~~-., -
,,we-..
.--.-.--m
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET b
?
INSTRUMENT TYPE
'\\
INSTRUMENT SERIAL NO.
3>._
/
.i.~,...
- .2
,,, >; k, <
..'.,; >e
,,,,. :.:. =-
c.!.-., d !
INSTRUMENT STATUS CALIBRATICN
~
9 RATION IERFCRMED In-Semce, Cu t - g-CA tl BR ATICN DUE BY Serv.ce. Reoair or Calib stion DATE CATE REMARKS (Incicate Status 9eicw)
(S;gnature)
. - l 'i - 7 7
_((
- 5% 4 2__
7 b' 7 /1
=, -
t
+ i,..
/o r sf 'la e
i', - w e
' @th 7 C2
)/Wl7Y c cc,_
?
?,. 7: ~... ?.. r
?-9.7>
Y, q
('..
e ep f
f
- w t
n.
~
-!, o,e a
N e
e
-we e
1 HEALTH PHYSICS PORTABLE INSTRUMENT cal!3 RAT 10N/STA TUS LOG SHEE T r
e.,a
~
INSTRUMENT TYPE INSTRUMENT SERI AL NO.
- m
- .!,naf f
' e. v,.1 Z
e.'. i m.1 Y.3
' i.
- s /** *'. '
?'-
S
.a INSTRUMENT STATUS CA LIBR ATICN Call B R ATIO N In-Service. Cu t -
ERFCRMEO Call 8 R A TIO N OUE Serv,ce Repair or Calibration CATE DATE R E'.1 A R KS BY (Indicate Sta'us Balow)
(Signature)
//*r s
'^
u.
. =.
(sn.
}
a
. /
Summuuuu v
")
)
t e
-P ym/ J
)
i:m.. -,,,.
4
-+
e.
-.w---
e
,e-me ge nem
1 HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
_ iac I INSTRUMENT TYPE 80 / /~
~
INSTRUMENT SERIAL NO.
1 '7/
Colu m n " \\
c olo.-, n "
c..t v - n
- 5 coto m n*M u t.,, n * :5-INSTRUMENT STATUS CA lt 8 A ATIC N N
In-Servic e. Cut - ?,'-
EMCWED CALIBR ATION g
Service. Repair or Cat.bracon BY R E *.1 A R KS OATE DATE (Indicate Status Below)
($;gnature)
[ fr$ J 'W/ C C C
.m G
b i !
~
[ - -
inmu - n a - f m
e
.-..._.---,~....,.p
3 HEALTH P!iYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET gg (
INSTFiUMENT TYPE
[O.f.
INSTRUMENT SERIAL NO.
- 2. 7$
"3 ceta m Co' o m n
- f C.cl4 m n 1
OOl c m n 2 co t o,w a
INSTRUMENT STATUS Call 8 A ATIC N CRIBR ATION PERFCRMEO In-service. Ou t,'
Call 8R ATION QUE 0Y Semce, Repair or Cahbration CATE DATE REVARKS (Ind:cate Stams Below)
(S;gnature) 0A Cf r v,C 4
\\
\\
,f. o Y
& J,W
/ks72W Ed a~
s-
/
'~
f)
AE lb b f fi n9,nsk) c/ M P DJdfE O
/
O
\\
/ merabsb
,?
Kos7ti )
~
x k
\\
/ ), c o nv /\\
la KAb LU9&G
- ~
X i
i n 7
,m
/ U
/ MOV I
~/
/
/
/
'u
--L, t
Ee m ns?-
.e,
--w
.-yw,,%--%,.
,-.w-
- ~ - =.
.,e
]
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET 6*IC r
OF INSTRUMENT TYPE INSTRUMENT SERIAL NO.
2.7d n.clu
. ** 3 0I J m -v " Y O 3l J ~ n # $
000 Jm n # /
64/u n *
CALIBR ATION OUE Semce, Repair cr Cahbration BY REMARKS DATE OATE (Ind cate Status Below)
(signature) hs, fll Sc'/r/Cf g-e m
e r s 4'u. / 7 4 3 -f L.
~.
~r n=
=
,-%,-p.-
y e
1 HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET 5, d c l l'
80 E INSTRUMENT TYPE INSTRUMENT SERIAL NO.
1 2/
b u v, n %
% ', u m n *
- 1,1,,,, a ** ~3 C o n.
., "f
, a t.,w n
- 8 INSTRUN1ENT STATUS Call BR ATICN CA ll BR A TI O N In Service. Ou t <, -
PE AFCRMED Call 8 R ATION DUE Smice. Repair or Cat.cration BY REVARKS CATE CATE (Inc.cate Stams Beicw)
(S;gnature)
V?
/p $a 6#
ryn- #
aa1
. n 1 - 2 3
/
o i
CQ-
~
is) _repsic e
/
2* w'L
/
7/
r y' S e 4 yIC*t-9 ~'I5"77 N-
/ f77 e (-
, -y-gi m;
(
k<
m.
e W
4 m
HEALTH PHYSICS PORTABLE INSTRUf.1ENT CAllBRATION/ STATUS LOG SHEET
~
D
%hc \\
r I
INSTRUf1ENT TYPE
- O - 7 INSTRUf.1ENT SERIAL NO.
2E%
l
?_o t o.w ['i 0.d. u --
- 6 d c. u <w o * \\
0.o '. u.~s n " *.
C.sl u - n * ~2>
INSTRUMENT STA TUS CALI BR ATI CN
~
- 0 In-Serv ice. Ou t PER F CRMED CA LI B R ATION 0U wemce Repair or Cal orat!on BY REVARKS CATE CATE (Indicate SraNs Setoa)
(S egr.a tur e)
N/
J~f // f Lf//f77 sur oprene t',,
e, g-G;
) - '-?
3 ll e
/- - -
i..
F.R u-t1.3-f en e
m
3 4
'~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
?
t.,
INSTRUMENT TYPE, _, E l C..
fo INSTRUMENT SERIAL NO.
l J.9 5 Column No.1 Column No. 2 Colemn No. 3,
Catumn No.4 Column No. 5 INSTRUMENT STATUS CAL SR ATION Call 8 R ATION in-Service. Out of -
CAllBR ATION PERFCRMED DUE REMARKS Serv.ce, Pepair cr Cat.bration DATE BY CATE (Indicate Status Belowl (Signature)
M - b E DM L C a 4 ;O 7~3 N e -7
~7./7'7 NEQ T a > r T--
v 0,l du /e_
C/;s/p p
,bl /C 9/')9 in)
C.
C., c c_
fo-3-J?
TD l D -?
l~)
l N 5 2K v.cE 12-)7-77 R. L. 6-
~ '7f In byv ic e 2-E.g
~T 8 M.G.
2& '78
- 0) S E 6 e E*
L t. ;,;
T 7, =1 q/,/:7 s m E c c, r, t i-In iM ut ag i'/'? /??
R. 7, 6f ; 2 /- ?
= 3 b
.a__j 1u ;,
3_.-
/^, r.. ~ ~. ' 'r~. L 3 /; i <i
,.l,.. ). p.
r C
Form 1763-1 L,.. td I ' '
+. -
"6
e 3
4 HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET p
d '.5 M O INSTRUMENT TYPE INSTRUMENT SERIAL NO.
8 k4 Column No.1 Cclumn No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT ST ATUS CALIBR ATION j,., ON in Service. Out of.
CAU BR ATION PERFCRMEO Service. Repair or Cahbration DATE BY DATE (Inciecare Status Below)
(Signatu rel
$-/5b 7"? rYks:,-
/[-??
4/SM'
~
' v c e a v.
?,-29-?? kl?{),b ' ? -? p
/d5E4 9'/@ 77 ' E 7-3 la-71 ww g
- ~y -,9 cice to/ 5IO7 G 2.
1
'? 8'
/N vs ' <
.,m c, h % c
' 9 l'2 < I 7 7 61 3-77 c
.L ') T =X rE
^=..-]..*i',-
',-N,-
7 'z-.
dl7E
~
fiv' {s.e 1: c ;
3/E2f7)
L
$ 0-0- C'TS 1N 6BGvt&E 5 -(r-?]
.D.l.$ L l
&L fo... n J
/
i 1
I f
Form 17631 i ' ';
L I
a-
4 HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE d 5 'J d INSTRUMENT SERI AL NO. /M8 Column No.1 C !umn No. 2 C<lumn No. 3
- Cafumn No.4 Column No. 5 INSTRUMENT STAT'JS CALI B R ATION Call 0R ATION In-Service. Out of -
CALIBR ATION PERFCRMED OUE REYARKS Sen, ice, Repair or Calibration CATE BY CATE (Indicate Status Below)
(Signature)
Sv' s ex%,n
/ - y- ?7 lr$ $,mm.
v - 9'- 79' lN S&?wc z i2 77 R. L. 3 3 -74.
n i - w n.+: r.s a u na,i.:..~O,e; 4 I-1 11, I 'I L.~'? t. E 5_{ _l 7 '
D
~
y7 I a Se2 vice 3hh?
N 6/79 iH S Wic-E 5-f-9?
$ 0, S~6-7/
i b.cb lSrd b/d9 he ?D
- ADe~r e
/
L Fcrm 1763-1
/.
- = -
===vmag
=
w=
-=m
.w u==weem--=
6
427
"" ~~ ~
HEALTH PHYSICS PORTABl.E INSTRUMENT CAllBRATinN/ STATUS LOG SHEET
~
?
I-54C INSTRUMENT TYPE
~
/
INSTRUMENT SERIAL NO.
W.4' < ~
Column No.1 Column No. 2 Column No. 3.
Column No.4 Column No. 5 INSTPUMENT STATUS Call BR ATION Call 8R ATICN In SerAe. CNt - of -
C All B P ATION PERFCRMED DUE REMARKS Service. Repa:r or Cal:bration DATE SY CATE (Indicate StaNs Below)
(Signature)
// Se~ e f-f-77 Mc +,79 6'-77
/ d.$.3 2 v.c 2
.2
'l-77 7 h.3 v._5 C
'7 5
_ IN SERT'cs 5' f -78 L 0-8'G-75 i
,2cc
,7 i,,
u.,,.,
f f f
,$ 5 ?L (-f SC 65 0.10.N '
NsT RE&is,12 44 e.
=
O m
rd'8'h
/
Form l'/63-1
(=. l
!,,.b
. vp,
~
,..,,-me,.,
.,,m.
4 HEALTH PHYSICS P0f1 TABLE INSTRUMENT CAL!BRATION/ STATUS LOG SHEET
~
e INSTRUMENT TYPE INSTRUMENT SERIAL NO.
//3 62/
Column No.1 Column No. 2 Column No. 3.
Column No. 4 Column No. 5 INSTRUMENT STATUS Call 8R ATIOrJ CA L; BR ATION In-Service. Out - of -
CAllBR ATICN PERFCRMEO OUE REYARKS Service. Pecair or Lhbration CATE BY DATE (Indicate Status Below)
(Signature)
S....
- t 3 -9'- 7.?
G
'?
- 7 - 7.0
" N h
.(m.yl-
/f g ?.k (l,,, _/
Ci 1
L. -
t I
i C
Form 1763-1 9
d
(
[, L.
4 HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET
/
f_ x b h 2 oIf,e INSTRUMENT TYPE INSTRUMENT SERI AL NO.
i, ) 9 9 Q L 1
Column No.1 Column No. 2 Co!umn No. 3 Column No.4 Column No. 5 INSTRUVENT STATUS CAL!BR ATICN Call 8 ^'
In-Service. Cut - of -
Call 6 R ATICN PERFCRMED 0U REMARK 3 Service. Pe;: air or Calibr3 tion DATE BY CATE (Indicate Status Beicw)
(Signatu re) 3 rd b e.v v [c e
' I/ '-l f 7 ~7 C (2 Y 9 @
3 C-l - 7 3 TN Scar 3
- / - 7 'c D2 :/ DK
?-?-Y?
, 2 c.
Su :I 2:. c
~
A % / f ',..,. /
C
(~
L Fccm 17631
.sq
/
I
1 4
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE _
'P I.C. - l,,
INSTRUMENT SERIAL NO.
III-' l. <28 O Column No.1 Column No. 2 Column No. 3
- Column No.4 Column No. 5 INSTRUMENT STATUS Call B R ATIO N Call 8R '
In-Service. Cbt of -
Call B R ATIO N PERFORMEO U
REMARKS Service. Repair or Cabration DATE BY DATE (Indicate Status Below)
(Signa tu re) 1,4 S e q q : c_ g.
M lt o ln
'/A.4 7 1,/77 NM T J sT.
/ */
fe' a vi c e-9.2S77 D.V.
/.2 - 7 7 IN SERutce 10 7 7 G. R. 5 K. B.
J-3 l-78 IN 55R v t C s il'l7-7f d [. - &
]-?/
'In- %<v ic e E-U -7A tA, G.
5-26-76
_'ii c- :/n s'c-u.:, j i i
F,. -..
I :' >_
., ~ 2.' &
- W -3 A
., s.
C C'
Form 17631
.'t.
~'
=,
u.
4
~~~ ~~~
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET INSTRUMENT TYPE P! C - (,
INSTRUMENT SERI AL NO.
N
- 3. 3 0 2.
Column No.1 Column No. 2 Column No. 3,
Column No.4 Column No. 5 INSTRUMENT STATUS Calf SR ATION Call 8 ^
In-Service. Out - of -
CAllBR ATION PERFORMED 0U REMARKS Service. Repair or Calibration DATE SY DATE (Indicate Status Selow)
(Signature)
I,d - b Eft')!C E NI!O f 7 ~?
P/a A T l! 77 5 45
~f V S T.
o ll -S:.s ece 6 - l '7 ~ 7 7 n t _,~~ p
'l - 7 7 iN 5 GR vicE
[0-3 l-7 7
(,. g. f R. 9, I-31-7f IN SER vo c E (2-t7-77 k L B.
3-78 (iN f.-
A-
' '.\\
, Z f, - T','. >
(,
~~', )
g.
/
/
-j
~
_L'll.) m.xc S/ : / 's d'; - &,-
y'
,) c!
i
't "J 9 _j.
, f' j ~,
b o
r -
e-'
Fcrm 1703-1
+w e
6
a
"-~ ~~~
HEALTH PHYSICS P("lTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEET tm'_
INSTRUMENT TYPE
.P E C.
/,
INSTRUMENT SERI AL NO.
T '..O f_ p Column No.1 Column No. 2 Column No. 3.
Column No. 4 Column No. 5 INSTRUMENT STATUS CALI BR ATION CW8 In-Service, Cut - of -
CA LIB R ATIO N PERFCRME3 DU REMARKS Service. Repair or Calibration CATE SY DATE (Indicate Stan.s Se ow) *
(Signaturel s
fM b R.') \\ C. 'd 9 iO
'r'./k 4 3 3
BI ::.A
'f 3 ) S T.
/ f3 T 6.6 t <
<//?/7?
4 6 7')
-) ')
,,9 w :,vtiv.M
- )
0 317
^ ;'
3//,
~
G 7
3
\\
Neds Rectwed O, 0.6, 2-2 8 -7 F> -
/
6
> / T[79' OC
(,/n [
- ,, %%. -e
~)S:,8-h: Lk./ {1: a..:.
J i
f.n=ce c.c,,
C
',, i ')
j J,; _
Form 17631 4
a
~ ~ - - -
HEALTH PHYSICS PORTABLE INSTRUMENT CAllBHATION/ STATUS LOG SHEET
?
INSTRUMENT TYPE
//C- [
INSTRUMENT SERIAL NO.
/2/8 Column No.1 Column No. 2 Column No. 3,
Cctumn No.4 Column No. 5 INSTRUMEfJT STATUS Call 8R ATION I B R^ '
In-krvice. Ou t of -
CALIBR ATION P'ER F O R M E D UE REMARKS krvice, Repair or Calibration DATE SY DATE (Indicate Status Below)
(Signature)
/
G$55' Wl7
/4 %
//57
?
/Y f
4~' O sz,:Mes b3 I-H
- 3. m.h n/n w
i N 52 R vic E 10-3t - 7 7 G. R. s R. B.
I 7 ?
IN 5 :% i t. f 12-f7-77 S. L d.
3 ' 7$
jN Tra v t C c' 3 la';/Js'
'b 6h/Y
]a C r. -,.<,
e/
fx 3'/..
n
(,-
/k 4
$3
/. f.,
, s '
-/>-
-- - - ~
a Form 17631 I
e 6
-2
~
. p. --
.sm,
HEALTH PHYSICS PORTABLE INSTRUMENT d
I CAllBRATION/ STATUS LOG SHEET r
~'
~
D/6e
~
INSTRUMENT TYPE
/ ' 4,7 -
INSTRUMENT SERIAL NO.
,7.0 '-
- h"'
S' t~. '. w ?
s',,.,
b }.
.5
'* a r:..
'e' INSTRUMENT STATUS CA LI BR A TION CA ll 8R A TIO N in-Servece. Ou t. ?
PERFCRMED Call 8 A ATIC N DUE Service. Pecair or Capiration BY DATE CATE REMARKS (Indicate Status ceica)
(S;gna tu re)
/ /
'r N ?.-T[ \\'ic'$
5 % ]l (Q b.
5O^-~'
/
/ /
'/
'. ', ',s y
- f. _, l
/,
,a' s
dn w.e n/n f,. " c, 9 Q-a
/
/
e./-
A):.,. v
.s
/ '
h
%./
(M l Y 'a ~5 - l Yn S
=
per- - =.-
e.
-.,n
,a
1 4
HEALTH PHYSICS PORTABLE INSTRUMENT S'd
- I L%LIBRATION/ STATUS LOG SHEET c
D' INSTRUMENT TYPE 80
/7 INSTRUMENT SERIAL NO.
2'79 Colo ~ " * +
Siw~^* 6 colu m n
- i c_als, m n
- 2.
e_s'..e n
- 3 INSTRUMENT STATUS Call B R A TIO N CA L! B R ATIO N FERFCRMED in-Senice. Ou t - e t-CA LI Bl ATICN CUE BY Semice. Repair or Calibration DATE CATE REMARKS (Indicate Stams Betcw)
(Signature) 4 $2 ! ^/
5,/ _5 ( > s, c. ?
- 2. ~ 23'~ 7 7 79/f G, '. < >
J =.7 7 0 v T o f z g gqiA 929 Y" s aTLvic c-6 'T' ?)
r f C-
'.j (.
' ' '~~
?,,,,.n
- c/ - 7l 1,(
o O
m
')
t / ;i b
V* %* M s s'; ~,
HEALTH PHYSICS PORTABLE INSTRUMENT Call 8 RATION / STATUS LOG SHEET r
INSTRUMENT TYPE e'
//
INSTRUMENT SERI AL NO.
.7 7 '7 Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5 INSTRUMENT STATUS Call BR ATION All B In-Service. Out - of -
Call 8R ATICN PERFCRMED OU REMARKS Service, Repair or Cahbration DATE BY DATE (Indicate Status Belcw)
(Signaturel
- ,- r e-fu
. r, -
- a &."
r-V Fcrm 1763-t s
t t
+
~.
e HEALTH PHYSICS PORTABLE INSTRUMENT Call 8 RATION / STATUS LOG SHEET e
P 3
INSTRUMENT TYPE I,-
's v
/
INSTRUMENT SERIAL NO.
Column No.1 Column No. 2 Column No. 3 Column No.4 Column No. 5
^
INSTRUMENT STATUS Call 88 ATION Call BR AMN in-Service, Out. of -
Call 8R ATION PERFORMEO DUE REMAMS Service, Repair or Calibration DATE BY CATE (Indicate Status Belcw)
(Signature)
..., ?
-'F
'q
- }
,)
o, I' ' E.<
( fs C
/"C Fcrm 1763-1 l
a HEALTH PHYSICS PORTABLE INSTRUMENT CAllBRATION/ STATUS LOG SHEST m
INSTRUMENT TYPE INSTRUMENT SERI AL NO._
Column No.1 Column No. 2 Column No. 3 '
Column No.4 Column No. 5 CA LI B R AT r ON All8 RATION INSTRUMENT STATUS In-Service. Out - of -
Call 8R ATION PERFORMED REMARKS Service, Repair or Cai.bration DATE BY CATE (Indicate Statua Selowl (Signature) v e
v l
Fun 17631
(_ l l
\\l l e