ࡱ>    y xbjbj 7{{]88888LLL8$L`Af\4****+@-T+/[@]@]@]@]@]@]@$BxEP@8/++//@88**Ag3g3g3/F8*8*[@g3/[@g3g3>h?*,ОK's0F>G@0A0`A>Ec0E ?E8?//g3/////@@g3///`A////E///////// : Radioactive Contamination Monitoring Record Form Date:   FORMTEXT          Name:  FORMTEXT       Location:  FORMTEXT      Radioisotope(s) used:  FORMTEXT       Record the type of contamination survey (direct or indirect) and the make/model of the counting instrument used in the appropriate section below (i.e. contamination meter, liquid scintillation counter etc.), and if this is a post-procedure or weekly survey. FORMCHECKBOX  No radioactive work done  FORMCHECKBOX  No contamination found  FORMCHECKBOX  Contamination found and removedDirect Survey: Contamination Meter:  FORMTEXT       Detector:  FORMTEXT      Check one:  FORMCHECKBOX  Post-procedure  FORMCHECKBOX  WeeklyIndirect Survey: Liquid Scintillation Counter:  FORMTEXT       Gamma Counter:  FORMTEXT      Check one:  FORMCHECKBOX  Post-procedure  FORMCHECKBOX  Weekly Record the background, measure and net counts per minute for each surveyed location. Compare the net CPM with the appropriate contamination limit chart. If contamination is found, decontaminate immediately, re-swipe and record the result.Sample #DescriptionCPM (Measured)CPM (Net)Contamination Found (Yes/No)Decontamination ResultsCommentsBKG FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       Radioactive Contamination Monitoring Record Form Record the background, measure and net counts per minute for each surveyed location. Compare the net CPM with the appropriate contamination limit chart. 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