Because regulatory forms and procedures can vary from state to state we have listed the majority of these attachments as “examples”, although many may in fact be valid for your use. Always check with your state regulatory agency for their version. Go to the “View My State” section on the APNGA home page to access your state.
Attachments / Forms / Checklists / Links
- ALARA Philosophy and Commitment Example
- Annual Audit Checklist Example
- Bill of Lading – Common Carrier Example
- Bill of Lading – Private Carrier Example
- Bill of Lading – R&L Carriers
- Company Individual Authorized to Sign Example
- Daily Utilization Log Example
- Disposal Procedure Example
- Decommissioning Form Example
- Emergency Procedures Example
- Emergency Responder Info Sheet
- Emergency Response Sheet Example
- Emergency Response Wallet Cards
- FEDEX Dangerous Goods Form Link
- Gauge Operating Procedures Example
- Gauge Service Record Example
- IAEA Certificate of Competent Authority Example
- Inventory Instructions Example
- Inventory Sheet Example
- Leak Test Instructions Example
- License Application Checklist Example
- License Application for Gauge – Go to “View My State” & Select your State. An example/worksheet is provided as an attachment.
- License Application Worksheet Example
- Media/Reporter Info Sheet
- Member of Public (MOP) Dose Calculation Sheet Example
- New RSO Article
- Notice to Employees Poster – NRC – Spanish Version
- Notice to Employees Poster – NRC – English Version
- Notice to Employees – Agreement State Version – Go to “View My State”
- NRC Service Personnel Background Clearance Notice
- NRC License Application Form 313
- NRC Gauge Security Requirements
- NRC Inspection Procedures
- NRC Reciprocity Form 241
- NRC 2 Independent Tangible Barriers Notice
- Operating Procedures Example
- Periodic Table
- Personnel Dosimetry Cumulative History Form Example
- Personnel Monitoring Declaration of Pregnancy Form Example
- Personnel Monitoring Declaration of Pregnancy Acknowledgement Example
- Personnel Monitoring Individual Exposure Record Example
- Personnel Monitoring Instructions Example
- Poster and Notice Requirements Example
- Radiation Safety Program Example
- Radioactive Scrap Info Poster
- Reciprocity Contacts
- RSO Responsibilities Example
- Service Providers and Quantities of Concern
- Shipping and Receiving Procedures Example
- SI Unit Conversion
- SSD – Sealed Source and Device Info/Numbers – Go to the manufacturer website.
- Storage Area Drawing
- Table of Contents (Full Version) for APNGA Training Manual
- The CFR’s – Code of Federal Regulations
- Training Requirements (NRC
- Transfer Procedures Example
- Transfer or Disposal Form
- When to Notify the Agency Example