Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Section 1: Monitors
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Monitors in good condition
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Monitors within required calibration period
Section 2: Contamination
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Contamination in fume hood
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Contamination on benches
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Contamination on pipettors
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Contamination on floor
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Contamination on centrifuges
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Contamination on heat blocks / Incubators / other equipment
Section 3: PPE
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Lab coats being worn
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Safety Glasses being worn
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Gloves being worn
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Personal monitor badges being worn
Section 4: Shielding
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Appropriate shielding in place
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Perspex shielding
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Lead shielding
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Other Shielding present (if yes, specify)
Section 5: Housekeeping
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Room is kept tidy
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Benches are tidy
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Shelving is tidy / not overcrowded
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Fume hoods kept tidy / uncluttered
Section 6: Waste
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Adequate shielding around waste containers
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Level of waste in room acceptable
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Waste containers appropriate for the type of waste and labelled correctly
Section 7: Isotopes in use
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32-P
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35-S
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3-H
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Other (if yes, specify)
Section 8: Monitoring required
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Log book
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Swab test
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Results recorded & acceptable
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Other (if yes, specify)
Section 9: Signatures
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Name