Title Page

  • Site conducted

  • Radiographer/Trainee

  • Radiographer/Trainee

  • Conducted on

  • Inspector

  • Camera #

  • Source S/N:

  • Isotope:

  • Curies

  • Gbq:

  • Survey Meters #1:

  • Calibration Due:

  • Location:

  • Survey Meters #2:

  • Calibration Due:

  • Site Address

Checklist

Gamma Safety Check

  • 1. Were all personnel wearing all required monitoring equip?

  • 2. Were all personnel equipment currently calibrated and operational?

  • 3. Were all personnel wearing PPE? (Hard hats, etc….)

  • 4. Was the camera properly labeled (TI), including company address?

  • 5. Was the restricted area posted with proper warning signs?

  • 6. Was the high radiation area posted with proper warning signs?

  • 7. Was the restricted area properly controlled to prevent unauthorized entry?

  • 8. Was there a calibrated and properly operating survey meter present at the job-site?

  • 9. Was the Utilization Log properly completed before leaving for the job?

  • 10. Was a copy of the decay chart on the job site?

  • 11. Was a proper survey sheet filled out?

  • 12. Was all equipment functioning properly?

  • 13. Was a proper survey performed after each exposure?

  • 14. Did the radiographer survey the exposure device & guide tube properly?

  • 15. Were radioactive sources properly stored on the job-site when not in use?

  • 16. Were sources properly locked to prevent unauthorized removal?

  • 17. Were all storage areas posted with “CAUTION RADIOACTIVE MATERIALS” signs?

  • 18. Was a copy of the O&E procedures available at the job-site?

  • 19. Was a copy of the pertinent regulations available at the job-site?

  • 20. Was a copy of the company’s radioactive materials license available at the job-site?

  • 21. Were ropes, barricades, etc. properly erected around the restricted area?

  • 22. Was a collimator in use?

  • 23. Does Transport Vehicle have security system?

  • 24. Was a misconnect test completed?

  • 25. Did the camera and crank-out pass another misconnect test?

  • 26. Were shipping papers for Radioactive Materials completed?

Certification

  • 1. Are the NDT Technicians Level II certifications current?

  • 2. Does the technican have a copy if his/her certification?

  • 3. Is the technicians visual acuity current?

  • 4. Does the technician have a copy of his/her annual visual acuity?

  • 5. Does the technician have an approved and current radiographer card?

Quality

  • 1. Has the technician completed the report meeting applicable codes and standards?

  • 2. Does the reviewed film meet applicable codes and standards?

  • 3. Has the film been interpreted for acceptance or rejection in accordance with specified acceptance? standards

  • 4. Is the film free from mechanical , chemical or blemishes?

  • 5. Has the film been interpreted using for a density between 2.0 and 3.5?

  • 6. Has the densitometer been calibrated within the last 90 days?

  • 7. Does the technician have a step wedge companision film?

  • 8. Are the IQI's properly paced as per applicable codes and standards?

  • 9. Are the film markers and all required idnetification on the film and legible?

  • 10. Are the daily readiographic testing reports legible and correct?

Performance

  • 1. Does the technicain complete the work in a safe and timely manner?

  • 2. Does the technician properly mark the pipe correctly? (Including weld #, starting point, defects, etc)

Professional Integrity

  • 1. Does the technican adhere to complany policies and procdures including project policies?

  • 2. Are the technicians respectful to other coworkers?

  • 3. Does the technician take responsibility for his/he actions?

Sign Off

  • Completed by (Name, Signature & Sign Date)

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.