Title Page

  • • Measuring distance from the sources: 1m, i.e. appr. 60 cm from the surface of the radiation unit.

  • • The measurement is performed in accordance with NCRP 102

  • • Use drawing 43824 for the LGK 23016, 43834 for LGK 23004 and LGK model C and 1002511 for LGK Perfexion as instruction for where to measure.

  • • The result to be in accordance with NCRP 102 (average below 20 μSv/h, maximum 100 μSv/h).

  • • If the measurement is done on LGK 23004, the plastic hood must be removed.

  • • A calibrated instrument shall always be used for the measurement.

  • Conducted on

  • Prepared by

  • Location

Site and Instrument data.

  • LGK Serial number

  • Total Activity (TBq)

  • Reference Date

  • Picture of activity sign on LGK

  • Instrument type

  • Instrument serial number

  • Instrument calibration date

  • Picture of calibration label

Measurements

  • Point 1

  • Point 3

  • Point 4

  • Point 5

  • Point 6

  • Point 7

  • Point 8

  • Point 9

  • Point 10

  • Point 11

  • Point 12

  • Point 13

  • Point 14

  • Point 15

  • Point 16

  • Point 17

  • Point 18

  • Point 19

  • Point 20

  • Point 21

  • Point 22

  • Point 23

  • Point 24

  • Point 25

  • Point 26

Results

  • Average of measurements (μSv/h)

  • Average below 20 μSv/h

  • All measurements lower than 100 μSv/h

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.