Information

  • Document No.

  • Inspection Title

  • Permit Holder

  • Permit Number

  • Location
  • Room Number

  • Conducted on

  • Prepared by

  • Signature of Person Conducting the Assessment

  • Personnel present

  • Signature of Personnel Present

General Inspection Items

  • Is the current permit posted on the door?

  • Are all users listed on the permit?

  • Is a 24 hour emergency contact name & telephone posted?

  • Have yellow "Danger Radiation" warning signs been posted?

  • Were any food or drinks observed in the lab?

Specific Inspection Items

  • Does the lab have open sources?

Signage

  • Are there "In Use" signs in the work area?

  • Is all equipment / glassware / samples used for radioactive work labeled as "Radioactive"?

  • Is high level waste labeled as "Radioactive"

  • Is high level waste labeled with the name of the isotope?

  • Are any non-radioactive items labeled as "Radioactive"?

  • Is there a Lab Rules poster in the work area?

Lab Practice

  • Are hot benches covered with bench paper?

  • Are emergency clean up supplies available?

  • Location of clean up kit

  • Is there a low level radioactive waste can? (Note: Does it need to be emptied?)

  • Is excess liquid and/or solid waste transferred to the Hot Lab (B7249)?

  • Are radioisotopes secured with a combination lock on the storage container?

  • Are any small (bar) refrigerators secured? (bolted to floor or wall)

  • Are radioactive items decontaminated prior to returning equipment / glassware to general use?

  • Is decontamination of equipment / glassware verified with wipe tests before returning to general use?

  • Are hard Beta or Gamma isotopes used?

  • Is there a monitor or Geiger counter available?

  • Is the monitor or Geiger counter functioning?

  • Do users monitor their hands and clothes after radioactive work?

  • Do users know where they can obtain their badge results?

  • Are seats suitably covered with a non-porous material?

  • Is I-125 or I-131 in use?

  • Are bioassays done as required?

Documentation

  • Is there an inventory of isotopes on the door to all storage equipment (refrigerators, storage cabinets)?

  • Are weekly wipe tests being conducted?

  • Is usage being tracked?

  • Is waste path being documented?

  • Is the waste that is transferred to the Hot Lab (B7249) given an identifying label that is noted on the inventory sheet?

Contamination

  • Sketch of lab layout desired?

  • Sketch lab layout, indicating locations of wipe tests

  • Wipe test results
  • Does the lab have sealed sources?

Lab Practice

  • Is access to radioisotopes restricted?

  • Is the sealed source that is not in a device stored in a locked container that is secured to the floor or wall?

  • Is the dose rate less than 2.5 microSieverts per hour?

  • Is there a monitor or Geiger counter available?

  • Location of nearest calibrated monitor?

  • Are hard Beta or Gamma isotopes used?

  • Do users know where they can obtain their badge results?

Documentation

  • Is there an inventory of radioisotopes in storage enclosures listed on the enclosure door?

  • Is the sealed source in a gas chromatograph?

  • Is the GC labeled with the name of the radioisotope?

  • Is the GC labeled with the level of source activity?

  • Is the GC labeled with "Radioactive" signs?

  • Is the GC labeled with 24 hour emergency contact name and phone number?

  • Does the GC contain a tritium source?

  • Is the GC vented through a fume hood?

  • Is the sealed source in a nuclear gauge?

  • Is the gauge affixed with a steel tag bearing the radioactive Trefoil symbol, name of radionuclide, and level of activity?

  • Is the case affixed with a steel tag bearing the radioactive Trefoil symbol, name of radionuclide, and level of activity?

  • Are the following available in the case?

  • Dangerous goods shipping manifest

  • Exemption permit for transport in BC

  • Type A package certificate

  • Special Form certificate

  • Leak Test certificate

  • Log Book (to record use)

  • "Radioactive" signs (in case of emergency)

  • SFU radionuclide license

  • CNSC Emergency Procedures poster (INFO 0483)

  • Fire and water resistant "Radioactive" placard

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.