Radionuclide Utilization Form
P. O.# _________________________________________
Investigator: ________________________________
Laboratory Room #___________________________
Radionuclide: ___________________________________
Activity: ________________________________________
Chemical Form: _________________________________
| Date | Amount Used | Amount Remaining | Disposal Method |
| (uCi) | (uCi) | (uCi) |
Drain/ Sewer |
Liquid Waste |
Solid Waste |
|||
Return to the Radiation Safety Officer when remaining balance is "O".
Use one form for each stock vial.
______________________________________ _______________________________
Signature of Researcher Date
| University of the Sciences in Philadelphia • 600 South Forty-third Street • Philadelphia, PA 19104-4495 • phone: 215-596-8800 • email: safety@usip.edu |