| Facility Name | |
|---|---|
| Location/Address | |
| Date | |
| Inspector(s) |
| Requirement | Compliant | Remarks |
|---|---|---|
| Up-to-date Radiation Safety Manual available | ||
| Warning signs and labels properly displayed | ||
| Personnel dosimetry in use | ||
| Access to restricted areas controlled | ||
| Radiation survey instruments available and calibrated | ||
| Shielding present as required | ||
| Records of training maintained | ||
| Incident and spill response procedures posted | ||
| Radioactive material inventory up-to-date | ||
| Waste storage and disposal procedures in place |