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Survey Meter:____________ S/N:_________ Cal. Due: ___/___/___ LS/Gamma Counter:___________________ S/N:________________ Efficiencies: H-3:_____%, C-14 / S-35:____%, P-32:____% Note: I-125 >H-3 , P-32 >C-14 for wide channel settings. . Action Levels: 2 mR/hr on GM survey, 200 dpm above bkg

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  1. Survey Meter:____________ S/N:_________ Cal. Due: ___/___/___ LS/Gamma Counter:___________________ S/N:________________ Efficiencies: H-3:_____%, C-14 / S-35:____%, P-32:____% Note: I-125 >H-3 , P-32 >C-14 for wide channel settings. Action Levels: 2 mR/hr on GM survey, 200 dpm above bkg on wipe test. dpm = (cpm – bkg) ÷ efficiency For an min. H-3 eff. of _____%, 200 dpm = ______cpm Record LS/Gamma results in cpm, GM results in mR/hr Date bkg 1 2 3 4 5 6 7 8 9 10 Initials LS GM LS GM LS GM LS GM LS GM LS GM LS GM LS GM Radiation Contamination Survey PI: Building name: Room # Isotope Room 3128A 10 1 2 3 4 5 6 7 8 9 Instructions • Enter PI name, Building, room # • Enter date used • Enter LS and GM results if applicable • Enter survey meter and LS serial # • Efficiency if reporting in CPM • Edit map to fit your lab • Drag and drop numbered circles at the sample site • Delete this box Refrig.

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