Forms: Fixed Gauge |  Industrial Radiography  | Medical | Portable Gauge

RAM Portable Gauge Application/Renewal Forms

All documents are in PDF format unless noted otherwise.

Radioactive Material License Application
License Guide-Portable Gauge
Portable Gauge Licensing Forms and Appendices Complete - ZIP File 
Appendix A - ALARA Program
Appendix B - Typical Duties and Responsibilities of the Radiation Safety Officer (RSO)
Appendix C - Radiation Safety Training Program
Appendix D - Leak Tests of Sealed Radioactive Sources
Appendix E - Calibration of Radiation Survey Instruments
Appendix F - Personnel Monitoring
Appendix F1 - Personnel Monitoring Form
Appendix G - Security of Portable Gauges
Appendix H - Radiation Survey Program
Appendix I - Dose Limit for Members of the Public (Annual Dose Determination Compliance Study)
Appendix J - Ordering, Receiving, Opening and Shipping Packages Containing Radioactive Material
Appendix K - Disposal or Transfer of Radioactive Material
Appendix L - Access Control and Security of Temporary Job Sites
Appendix M - Transportation of Portable Gauges
Appendix N - Operating Procedures
Appendix O - Emergency Procedures
Appendix P - Administrative Requirements    
Exhibit A - Example Facility Drawing
Exhibit B - Example Inventory Form
Exhibit C - Example Utilization Log
Exhibit D1 - Example Shipping Paper-Exclusive Use Shipments
Exhibit D2 - Example Shipping Paper Common Carrier Shipments
Exhibit E - Emergency Response Information
Exhibit F - Example Radiation Safety Program Annual Review

Radioactive Materials 4815 W. Markham Street, Slot 30
Little Rock, AR 72205