ML20148H037

Power Insp,Inc QA Program

ML20148H037
Person / Time
Site:	07100654
Issue date:	03/07/1988
From:	POWER INSPECTION, INC.
To:
Shared Package
ML20148G005	List: ML20148H037
References
NUDOCS 8803290297
Download: ML20148H037 (26)

Text

{{#Wiki_filter:__ POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM 1.0 ORGANIZATION 1.1 The Radiation Safety Organizational Chart outlines the structure of Power Inspection, Inc.'s Radiation Safety Program with reference to Management, Radi-ographers and Radiographer's Assistants. (See ) 2.0 RESPONSIBILITIES 2.1 Corporate Radiation Safety Officer (a) The Corporate Radiation Safety Officer is responsible for the overall Radiation Safety Program as required by Federal, State, and Local Regualtions. 2.2 Radiation Safety Officer (a) Serves as Liaison Officer with the NRC. (b) Maintain all radiographic equipment including exposure devices, survey meters, and associated equipment. -(c) Maintain the personnel monitoring program including all required records and forms. (d) Provide for training and determine competence of Radiographer's Assistants and Radiographers. (e) Maintain the record keeping system. Review and ensure the maintenance of those records kept by others. (f) Assume control and institute corrective action in emergency situations. (g) Investigate the cause of incidents and determine necessary corrective action. (h) Maintain control of procurement and disposal of licensed material. (i) Conduct quarterly inventories of all licensed k material. (Form 5) .e (ff 8803290297OOjgQ{,, [\\ - PDR ADOCK PDR C .z- -.,.,-,.. -. -. - _ -. -. - -.... -

I POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM 1

2.0 RESPONSIBILITIES

continued Part 2.2 (j) Evaluate radiographic personnel on a quarterly basis and conduct on-the-job inspections of radiographic personnel a't intervals not to exceed 3 months. (k) Assure that all leak tests are performed on schedule and maintain appropriate records of results. (1) Maintain records of survey meter calibrations. (m) Maintain records of dosimeter calibrations. 2.3 Radiation Safety Consultant (a) Act in an advisory capacity to the licensee's management personnel. (b) Review NRC communications with the RSO, as requested. (c) Update Operating and Emergency Procedures as requested by the Radiation Safety Officer. (d) Upon request of the Radiation Safety Officer, conduct training programs. (e) Assist the Radiation Safety Officer in conducting audits and reviews or other internal inspections as required. (f) Assume control of radiographic operations and institute corrective action in an emergency situations should the Radiation Safety Officer be unavailable or request assistance. 2.4 NDE Manager (a) The NDE Manager is responsible for examinations performed by Power Inspection, Inc.'s personnel and reports to the President.

o 6 POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM ATTACHMENT 3 \\ i

O P0WER INSPECTION, INC. 4' INCIDENT DATA REPORT This Report is to be completed within 24 hours and immmdiately forwarded to the Radiation Safety Officer in the event that: A. Any emergency situation defined (but not limited to those listed) in Paragraph A, B, C, D, E may have occured. B. Your film badge becomes wet, mutilated, or lost. C. You have reason to believe that your film badge may indicate an excessive exposure that you may not have received. Section 1 (To be completed in the event A. B. or C occurs) 1. NAME: SIGNATURE: 2. WORK LOCATION: (lab-customer-site-city-state) 3. TYPE OF INCIDENT / EMERGENCY DATE TIME 4. DID YOU S10P RADIOGRAPilIC OPERATIONS IMMEDIATELY? YES NO 5. ATTDil' FED TO CONTACT R.S.O. TIME CONTACTED.. R.,S.O. 6. EQUIPMElf: PROJECTOR - HAKE AND HODEL S/N r' SOURCE S/N ACTIVITY CURIES SURVEY METER: MODEL S/N 7. IF POSSIBLE OVER-EXPOSURE OCCURRED, AT WilAT DISTANCE WERE YOU FROM Tile SOURCE? FOR WilAT LENGTl! 0F TIME 8. EXPLAIN IN DETAIL EXACTLY EVERYTilING TilAT OCCURED. (use reverse side of sheet) Section 2 (To be completed in the event that "C" aboveoccured) 1. EXPLAIN _IN DETAIL IIOW YOUR Fill! BADGE BECAME WET, HUTILATED OR LOST. (use reverse side of sheet) Section 3 (To be completed in the event that "C" above occured) l l 1. WilERE WAS YOUR FIIJi BADGE LOCATED UllEN YOU BELIEVE IT UAS EXPOSED TO RADIATION 2. Il0W HUCil RADIATION Do YOU BELIEVE YOUR Fill! BADGE RECEIVED? 20-100HR 100-300 MR 300-600 HR Above 600 HR Unknown 3. WlIY WERE YOU NOT WEARING YOUR Fill! BADGE l 4 EXPLAIN EXACTLY EVERYTilING TilAT OCCURED. (use reverse side of sheet) 5. ON Tile REVERSE SIDE INCLUDE ANY OTilER INFORMATION UllICII YOU FEEL IS PERTINENT. 1

= J' i s FORMS RECORDS 1. Utilization Log 2. Film Badge Transmittal and Desimeter Log 3. Quarterly Audits 4. Quarterly Maintenance Checklist 5. Quarterly Inventory Report 6. Leak Test Records A,B,C SAMPLE RECORDS 1. Incident Data Report 2. Radioactive Material Receiving Report 3. Radioactive Material Shipping / Certification Report 4. PI's Vehicle Accident Notice 5. Annual Dosage Report 6. Radiographer's Periodic Training 7. Employee Termination Notice ..,---..r.- -re .., - - -.~., -.

FORM 1 P0WER INSPECTION, INC. UTILIZATION LOG ames Part A: WarNng: Intentonal Fadure to Record informabon Accurately on thss Form May Result in a Fino and/or Disciphnery Acton. LOCATION of Source Use: Csty State De*= Dietrict/Brance CUSTOMER PRCUECT: Job No Part 5: "Sourse of Rameson* "Protector" "Survey instrument" Ir Co X. Ray Model No. S/N ModelNo. S/N Model C/N in Storage Cal Due-Acevity curies Secup Deh Backup Meter S/N: (1 wk rrwurnum) Part C: Trenoport Te (Lesetion from Per1 A): Truck /VeNede No. (Complete appecetdo column (s) 1&2, or 2&3, or 4)

1) PlacJng Protector ist veNele:

2) VeNele Placarded Yes No 3) Propector remmenmgin 4)Not tansportedM mr/hr eurisco Strage contamer mr/hr @ 18*,from vehtcle veNcle trorn provtoue Transport indez (CL1-10.0) mr/hr @ dnver vansport Label claae: 1 I

IN Transport Index ! eel Class i I u Masonei prepared for tenaport in ac.-ne-,c4 we wneen procedures by to P#Aographer egned beiow (Part Hk l RESULTS OF PHYS 4 CAL SURVEY rnr Part D: RadograpNe Operatione. (8 Dasy Equipment W Check Ust h, M OK (NA) Not e f*=Na (') See Remarks r A Surwy Propocer tar Excenerve Par' aman Lavoie ^ t a Protoctr mW lor damage to Range, locks, and labode mr ent e Convol Cable and F'senge checked for cute, brenh.e, or loosenese n Crank lnaW lor loosenese 8 Contal checked lor treedom of cable movement (l . ou.de - io, - and b,o.en o, -.ange ft, a Collimmer (If used) checked tor escure aanchment g, 4 Plpe possooner (lf used) char

• art tot damage and secure anactiement V

Maint inspeceon pertormed or unenessed by he Radiographer signed below (Part H) mr ft. Personned iniormed Sagne Rope _Fvpnm we RDorn Constant Surveiaance Part E: Securing RadograpNo Opereth ne: Lange of Exposurs Record of physiced outwy made to determos ocurce is in ehme6ded pontoon when Nurter of E.xposura escunng exposure doncet mr/hr @ surisce or et 6* trom device se requerei Total Exsneure Trnet hr trwt Survey pertormed or weessed by Fediographer signed below (Part 4 Part F: Transport Fren@eturn: Desenadort: City T? Loceeon Truck /VeNele No. (X) If same se Part C (Complete the applicable column (s) 1&2, or 3, or 4)

1) Placing Protector in vehsde

2) Venscle Ptscarded vee No 3) Protocer not used or

4) Not tanspor'a+

'Y) rnr/hr eurisco dorage contamer rnr/hr @ 18* frorn vehicle removed trorn vehsc6c transport index at 10.o) mr/hr @ dnver M Labed Ciasc I s _m Material prepared for teneport in accordence we wnnen procedures by the Radiographer esgned be6ow (Part Hk Pirt G: Storage Surver mr/hr when the protector se placed m storage, as performed m accordance wm 10 CFR 34.43 (dk Surwy Performed or weessed by Radiogrogner esgned boiow (Part Hk (Surwy when the protector is p6 aced in the storage vault, or other approved storage locatort) (When he protector is serad in the vehsde this survey shaa be the same as Part F Colorno 1 kne 1) Part H: The Bo6ow esonedjndividua)(s) herem_vtthaj the above kseed informabon (Part A thru Part G) is accurate and has been completed in accordence we PCWER INSPcCTI(W, Dr..ucense procedures, State, and Federal RegutabondL in addtbon,the above named metonale have been property closer 6ed, descreed, packaged, marked, and labe6ed, and are in proper condition for transport accordmg 2 the apphcatie regulaeone of the Department of Transportatiott RADIOGRAFNER RADIOGRAPHERS ASSISTANT: Romerks

._.m FORM 3 POWER INSPECTION, INC. QUARTERLY AUDIT CWO(LIST CUSTOMER DATE LOCATION USNRC Region: I II III IV V State RS0 or Job Radiographer Asst.' Radiographer Projector SNf Radioactive content "SURVEY COMMENT 5" 1.) Dosimeters charged daily and readings recorded. SNi SNi Coment: 2.) Radiation survey meter (s) in proper working order; including calibration date. CAL Comment: SNi 0ATl: 3.) Film badges properly worn and stored. Comment: 4.) Copy of radiographic operations manual (RSM ) available and copy of USNRC or applic-able state license. Coment: 5.) Copy of the applicable USNRC or STATE RULES AND REGULATIONS available. Coment: 6.) Copies of USNRC form #3 or applicable STATE FORM properly posted. Coment: 7.) Projectors posted to indicate contents. Coment: 8.) Radioisotope storage building or mobile lab properly posted to indicate Radioactive Material. Comment: 9.) Records of source storage, equipment maintenance and utilization. Coment: 10.) Records of vehicle survey (when appl.) Coment: 11.) Radiation area posting. Coment: Remarks: , Signatures; Radiographer Asst. Radiographer POWER INSPECTION RSO

POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM i

2.0 RESPOtSIBILITIES

continued 2.5 Radiographers and Radiographer's Assistants (a) Report all deficiencies and/or discrepancies to the Radiation Safety Officer or Radiation Safety Consultant. (b) Maintain the following records: 1. Utilization Log--includes the date, location number of exposures, type, and serial number of the source used. (Form 1) 2. Model and Serial numbers of survey meters used on each job. (Form 1) 3. Results of all surveys taken at the start and termination of exposures, including the location, and time of survey. (Form 1) 4. Daily dosimeter readings. (Form 2) 5. Source activity (calculated from age of source since its receipt. (Form 1) 6. Daily equipment checks, repairs, and/or replacements. (Form 1) 3.0 DOCUMENT CONTROL 3.1 The Radiation Safety Officer shall be directly responsi-ble for all documents pertaining to Radiation Safety. 4.0 EQUIPMENT CONTROL 4.1 The Radiation Safety Officer shall be directly responsi-ble for control of all radiographic equipment. 5.0 INTERNAL INSPECTION SYSTEM 5.1 The Radiation Safety Officer or the Radiation Safety Safety Consultant shall audit Radiographers and Radi-ographer's Assistants at intervals not to exceed 3 months to assure compliance with Power Inspection, Inc.'s Operating and Emergency Procedures, and applicable USNRC and/or State Rules and Regulations.

POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM 5.0 INTERNAL INSPECTION SYSTEM: continued 5.2 Audits shall be conducted on an announced and unannounced at the discretion of the Auditor. 5.3 hecords of Radiographers and Radiographer's Assistants shall be retained by Power Inspection, Inc.'s Radiation Safety Officer. 6.0 SHIPPING, RECEIVING,'AND TRANSPORTATION OF RADIOACTIVE MATERIALS 6.1 Transportation of Exposure Devices and Storage Con-tainers (Reference Attachment 2) 7.0 RECORDS 7.1 The Radiation Safety Officer is responsible for all Radiation Safety Records. 7.2 Reference Power Inspection, Inc.'s Record Forms (Attachment 3) . -. ~. -..

POWER INSPECTION, INC.'S QUALITY ASSURANCE PROGRAM ATTACHMENT NO. 1 RADIATION SAFETY ORGANIZATIONAL CHART PRESIDENT

• Corporate Radiation Safety Officer * * *
• Radiation Safety

. Radiation Safety. NDE Manager Officer Consultant Radiographer l Radiographer's Assistant i ( l Lines of Responsibiliy

• l Lines of Communication i

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POWER INSPECTION, INC. QUALITY ASSURANCE PROGRAM ATTACHMENT 2 1

f 10. TRANSPORTATION OF EXPOSURE DEVICES AND STORAGE CONTAINERS i A. The vehicle used to transport exposure devices and storage containers must be in good operating condition and carry the<following equipment: 1. Two calibrated survey meters in good working order. 2. Radiation warning signs - at least 4"CAUTION-RADIATION AREA", and at least 2 "CAUTION - HIGH RADIATION AREA". 3. Warning rope or tape - 50 ft. minimum. 4. Pocket dosimeter charger in good working order. 5. Length of utility rope. 6. Flashlight. 7. Spare "D" batteries. 8. Copy of Operating & Emergency Procedures. 9. Copy of NRC License. B. The vehicle must be accompanied by a qualified Radiographer or Radiographer's Assistant. C. Insure that the shipping container is properly packaged, with all shipping plugs, locks, and padding material in D. Label the container according to the radiation levels as listed below: SURFACE _3_FEET "RADIOACTIVE - WHITE I" 0.5 MR/HR NONE "RADIOACTIVE - YELLOU II" 50 MR/HR 1.0 MR/HR "RADIOACTIVE YELLOW III" 200 MR/HR 10 MR/HR The label shall be marked with the following information: 1. Contents (source material) 2. Total # of curies 3. Transport Index (radiation level at 3 feet) E. Place the container / exposure device in the vehicle and secure against movement within the vehicle. F. Perform radiation surveys to insure that the radiation level inside the driver's compartment does not exceed 2 mr/hr and that the radiation level outside the vehicle does not exceed 1 mr/hr. l l

10. TRAwSPORTATION OF EXPOSURE DEVICES AND STORAGE CONTAINERS: continued G. In the event that the transporting vehicle is required to stay in an "unrestricted" area, the container must be secured within the vehicle and the vehicle locked to prevent theft or unauthorized removal. H. All keys to the vehicle and the exposure device and/or shipping container must be in the possession of the Radiographer. I. If the vehicle is transporting a package bearing a "Radioactive Yellow III" label, the vehicle 1must be placarded on all four sides with a "RADIOACTIVE" placard. J. If the vehicle becomes disabled on the road, or if any other emergency situation arises, see Section 9, "EMERGENCY PROCEDURES". K. A Radiographer and/or Radiographer's Assistant shall be in constant attendance during transportation of devices. L. In case of an accident of any kind, make an immediate radiation survey to see where, if at all, the radiation levels are higher than permissable levels. Maximum permissable leakage on shipping co. tainers or exposure devices is 10 mr/hr, 3 feet from any surface, and 200 mr/hr at the surface. If necessary, rope off the area at the-2 mr/hr level and post warning signs. Have someone con-tact the home office. Do not leave the scene without the local police being there. Refer to Section 9 for detailed Emergency Procedures. M. In-plant transportation of devices shall be accomplished using hand-carts or similar means. Hand carrying of exposure devices for long distcnces is expressly prohibited because of the relatively high radiation levels which exist at the surfaces of these devices.

10. TRANSPORTATION OF EXPOSURE DEVICES AND STORAGE CONTAINERS: continued N. Before tranporting byproduct material, you shall notify appropriate personnel at the destination of the starting time, route to be followed, and the estimated time of arrival. You shall instruct them to notify civil authorities and Power Inspection, Inc's Radiation Safety Officer if you do not arrive within two hours of the estimated time of arrival. If you encounter any un-expected delays, be sure to notify these personnel of your revised estimated time of arrival. i h l J

~. FORM 4 P0WER INSPECTION, INC. t)UARTERLY MAINTENANCE CHECKLIST Camera Model No. Date / / Camera Serial No. ~ ANY PARTS FOUND DEFECI1*.'d SHALL BE REPLACED RETURN (WORN OR DEFECTIVE) PARTS TO RSO ACCEPTABLE WORN OR DEFECTIVE 'ock box protector cap Pigtail connector Lock operacion Source safety plug Source outlet nipple u Source tube disconnect Source tube Source tube end or collimator S3urce identification tag "CAUTION-RADIOACTIVE MATERIAL" label Drive cable connector Drive cable Drive cable conduit or hoursing Control assembly REMARKS: QUARTERLY MAINTENANCE PERFORMED BY: l l l l l l l

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n,-... h CERTIFICATE OF RADICACTIVITY LEAK TEST ? 0~^ n d ( gA j HEALTH PHYSI,CS. ASSO,CI ATES LTD. CONSULTANTS IN RADIAllON SAFETY "EXAMPLE" l 2356 S M OKf E VALLEY ROAO / HIGHLAND PAMM. ILL. Soo35 / PHONE 0 (312) 433 3330 I Test Due, on/or Before _ 5-l b 8 8 l Name POWER INSPECTION, INC. Address License No., I N _S E_R T _ N R C L I C E N S_E Cityt State _ Zip Expiration Date 10-20-K Equiprnent blanufacturer T/0 660 hiodel No. 8955 " serial No. 66-3292 dhotope IRIDIUM 192 _ Curinge 47 Date 5/12/86 Source Serial No. 34-8955 Individual performing test _ INSERT NAME Date 10-20-87 ] This test was' performed in accordance with H.P. Associatre instructions included in this kit, No. 286 l ,j INSERT SIGNATURE ,( (Signature of Individual Performing Tett) l (To be filled out by llealth Physics Associates) DATE SAh!PLE RECEIVED DATE SAhlPLE PROCESSED - l TEST DATA CPhi-Counts Per blinute l Sampre CPhi (Net) DPhi hiicrocuries Detected ( .f DPht-Disintegrations Per 2 hiinute 3 hi -Less than 0.0001 Standard hiicrocuries 1 1 l: CONCLUSION: Results of this test indicate the presence of less theo 0.005 microcuries of removable contamination and n>ect presently necepted standards of radiation safety. In accordance with prevai:ing regulations, this source should again l be leak tested on or before i l

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40 NORTH AVENUE BURUNGTON, MA. 01803 MyW[518EMNp i 4.' L..EA.K. {.TE.S.T.M.a-(617) 272 2000 c Power Inspection, Inc. P.O. No. MM-27-58 Co.Name 12330 Perry Highway NRC orINSERT NRC LICENSE Street State License No. Wexford, PA 15090 city, State Projector Model No. T/o 660 Serial No 3292 Source Model No. A-424-1 Serial No. 66-3292 Curies 27 i l IR 192 X ' CO-60 CS 137 Other Wipe Performed By INSERT SIGNATURE Date 1/3/86 C The United States Nuclear Regulatory Com., e ron Tscwoes vst omtv mission requires that radiog raphic sources be tested for evidence of leaking at the time of y manufacture and thereaf ter at not_more than -{ six. month intervals. The amount of removable contamination must not exceed 0.005 microcuries.lf the test shows more than 0.005 microcurie of remova-ble contamination, the source and equipment must be immediately taken out of service and be repaired or be disposed of. Please note that this source must be tested again on or before J w w - J w ORIGIN A1 l

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9 ~ POWER INSPECTION, INC. ~ "RADIOACTIVE MATERIAL RECEIVING REPORT" I. RECEIVING DATE TIl!E RECEIVED II. LOCATION (District or Project Location) III. MATERIAL RECEIVED FROM IV. CARRIER V. RADIOACTIVE llATERIAL TYPE Iridium 192 Cobalt 60 Other SOURCE SERIAL NO. ACTIVITY REMARKS UI. CONTAINER TYPE: 1. SOURCE CllANCER MODEL NO. SERIAL NO. 2. EXPOSURE DEVICE MODEL NO. SERIAL NO. VII. PHYSICAL RADIATION SURVEY OF CONTAINER 1. Radiation Level @ External Surface MR/IIR 2. Radiation Level @ Three (3) Feet from External Survace MR/IIR 3. RADI0 ACTIVE YELLOW IABEL TRANSPORT INDEX .37 VIII. IS SOURCE ACCOMPANIED BY: 1. Decay Curve YES NO (optional) 2. Evidence of Leak Test YES NO IX. If Source is Received in Source Changer, what Device is Source to be installed in? 1. EXPOSURE DEVICE: MODEL NO. SERIAL NO. X.

• NOTES:

1. The container shall be surveyed within three (3) hourc after receipt during regular working hours, or within eighteen (18) hours if received after regular working hours. 2. Radiation levels should not exceed the following: l A. 200 HR at the surface of the container. B. 10 l!R at three (3) f eet f rom the surf ace of the container. I C. IIDIEDIATELY NOTIFY Tile RADIATION SAFETY OFFICER IF Tile RADIATION LEVEL EXCEEDS Tile LEVELS SPECIFIED IN NOTE 2a or 2b. SICNED DATE Radiation Safety Officer or Radiographer +,F i

/ ~ P0WER INSPECTION, INC. "SHIPPING / CERTIFICATION DOCUMENT FOR RADI0 ACTIVE MATERIAL" SHIPPED TO: CARRIER: WEIGHT: QOPER SHIPPING NAME RADIOACTIVE MATERIAL RADIOACTIVE MATERIAL SPECIAL FORM N.O.S. L.S.A., N.O.S. "EXPOSURE DEVICE AND MATERIAL IDENTIFICATION" EXPOSURE DEVICE SERIAL NO SOURCE NO NRC CERT. OF CONP TYPE OF PACKACE TYPE OF PACKAGE SOURCE CHANCES SERIAL NO SOURCE NO NRC CERT. OF COMP LABELING NATURE AND OUANTITY OF CONTENTS RADIONUCLIDE FDFM ALnVITY IN CURIES SHIPPING IABEL TPANSIORP INDEX l RADIOACTIVE kHITE I IRIDIUM 192 SPECIAL FOPM RADIOACTIVE YELIDW II COBALT 60 SPECIAL FOP 3 RADIOACTIVE YELIDW III CESIUM 137 SPECIAL FOP 3 DEPL M D 0239 NOPMAL FOPM LB. AT.15 MCI /LB. SHIPPERS CERTIFICATTON the above named materials are properly classified, described, packaged, This is to certify that in proper condition for transporta' tion according to the applicable marked, and labeled; and are regulations of the DEPARTMENT OF TRANSPORTATION (D.O.T.) TRANSPOPTATION BY AIR is within the limitations prescribed for cargo - only aircraf t. This shipment ' DATE SIGNATURE

NOTI.CE In case of asi accident involving tiils vehicle IMMEDIATELY NOTIFY: POWER INSPECTION, INC. ~ ~~T P.O. E0X 186 12330 PERRY HIGHWAY WFXFORD, PA 15090 om TELEPHONE COLLECT (412)935-7111 i ~ ~ " nts 3[. g,[,....T............. KRIS KUMAR (412) 935-0999 3 i ino u o A v s _i_ JERRY LINT (412) 847-3095 MIKE MEDAL (216) 877-9403 e- -e

P0WER INSPECTI0N, INC. WHOLE 800Y (IPOSURES FOR CALEbOAR TE AR 19_ ti e.see soportine (sa.e s Address) mRCticensene(s). I Annual Whele Sedy Dese Busber of Individuals Ranges * (Rees) In Each Range be Reasurable Exposure usasurable Essesure Less than 0.100 0.100 -- 0.250 0.250 - 0.500 0.500 - 0.750 0.750 - 1.000 1.000 -- 2.000 2.000 - 3.000 3.000 - 4.000 4.000 - 5.000 5.000 - 6.000 6.000 - 7.000 7.000 - 8.000 0.000 - 9.000 9.000 - 10.000 10.000--11.000 11.000--12.000 12.000 Total Number of Individuals Reported the above information is subsitted for the total number of individuals for whos personnel sanitoringwas(checkene): () required under 10 CFR 20.202(a) of 10 CFR 34.33(a) during the calendar year. () provided during the calendar year. ' Individual values enactly equal to the values seperating esposure ranges shall be reported in the higher range. .e w ..-w ,g.- 1,-,..-- ,.p.,,-p.w7,,w % g.,mm ,g,7g ,w ,%%wm, ,,fy .m

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M POWER INSPECTION, INC. RADIOG RAPHER ' S PERIODIC TRAINING AS REQUIRED BY USNRC TITLE 10 CFR PART 34, PARA. 34.11, SUB-PARI.. (b) (2) AND POWER INSPECTION,.INC.'S NRC LICENSE CONDITION AS CONTAINED IN THE RADIATION SAFETY MANUAL PART 1 SECTION 8 PARA. D. NAME: SSI r CERTIFICATION DATE: Y SUBJECTS REVIEWED: ORAL: WRITTEN: 1. REVIEW AND CRITIQUE OF INTERNAL RADIOGRAPHERS EXPERIENCE. 2. DISCUSSING OF AVAILABLE RADIOGRAPHERS EXPERIENCE. 3. REVIEW AND DISCUSS PERSONNEL DOSES AND REDUCTION PRACTICES. 4. NEW PROCEDURES AND REGULATIONS. 5. REVI,EW AT LEAST ONE FUNDAMENTAL RADIATION TOPIC. 6. REVIEW CRITICAL OPERATING AND EMERGENCY PROCEDURES. I 7. REVIEW RADIOGRAPHERS PERFORMANCE REVIEWS. l TIME SPENT ON EACH

SUBJECT:

i 1. 2. 3. 4. 5. 6. 7. RSO'S COMMENTS: DATE: kADIOGRAPilERS SIGNATURE DATE: ' RADIATION SAFETY OFFICER

,a P0WER INSPECTION, INC. TERMINATION' NOTICE i SOCIAL SECURITY N0. NAME DATE LAST WORKED REHIRE YES NO REASON FOR DISCHARGE LAY OFF DISCHARGE JOB CORPLETED REFUSAL TO FOLLOW IkSTRUCTIOES REDUCTIDE II FORCE 100 SLOW OTHER (EIPLA!B) ABSENTEE VOLUNTARY QUIT ORunn OR Onlulas On Jos DISSAi!SFIED OTHER (EIPLAll) TO SEta OTHER JOB MRSotAL RE ASOBS EXPLAMATION: h BY COMPANY REPRESEu1AllVE DATE_

n FORM 2 s,. P0WER INSPECTION, INC. FIIM BADGE 'IRANEMITIAL MO DOSIMEITR IDG TO: LOCATION ENCLOSED IS YOUR FILM BAOCE NO. FOR THE MONTH OF AT THE END OF EACH MONTH-IF YOU ARE AWAY FROM THE MAIN OFFICE OR DISTRICT OFFICE, YOU ARE REQUIRED TO RETURN THIS DOSIMETER LOG AND USED FILM BADGE "VIA FIRST CLASS MAIk" TO POWER INSPECTION, INC. PERSONNEL CATAGORY (PLACE AN "X" IN THE APPROPRIATE BOX) A. ( ) RADIATION WORKER......... RADIOGRAPHER AND RAul0GRAPHER'S ASSISTANTS 8. [ ] NON-RADIATION WORKER AND OFFICER PERSONNEL POWER INSPECTION, INC. PROVIDES FILM BADGE MONITORING TO ALL PERSONNEL IN CATEGORY "A" AND "B" AS INDICATED ABOVE. 00SIMETERS ARE NOT ASSIGNED TO NCN. RADIATION WORKERS, THEREFORE, RECORDING OF 00SIMETER RdADINGS IS NOT REQUIRED FOR CATEGORY "B" PERSONNEL. ! DOSIMETER READINGS ARE TO BE. RECORDED DAILY DATE.....MR DATE.....MR

• NOTE:

1. THERE MUST BE AN ENTRY FOR EACH OAY OF THE WEEK FOR RADIOGRAPHERS ANO RADIOGRAPHER'S ASSISTANTS AS REQUIRED BY POWER INSPECTION, INC.'S P R O C E DUR E.S.(PERSONNEL MONITORING EQUIPMENT AND US AGE) 2. ENTER NOT IN USE IN THE APPROPRIATE SPACE FOR EACH LAY TH#' YOU: A. OID NOT USE RADIATION PRODUCING DEVICES 8. WERE NOT REQUIRED TO WEAR YONITORING OEVICES, BECAUSE YOU WERE NOT IN-VOLVED IN ANY ACTIVITY OR AREA THAT WOULO REQUIRE PERSONNEL MONITORING SIGNATURE DATE 4 ...}}