Ariz. Admin. Code § tit. 9, ch. 7, art. 3, exh. E
An applicant shall provide the following information in a specific license application before a license is issued to the applicant. The Department shall provide an application form to an applicant with a guide, when possible, to ensure that correct information is provided in the application:
Name and mailing address of applicant | Use location |
Contact person | Telephone number |
Users of RAM | Training of users |
Radiation Safety Officer identity (RSO) | Duties of RSO |
Description of RAM and uses | Description of radiation detection/ measurement instruments and their calibration |
Personnel monitoring | Bioassay program |
Facility description | Survey program |
Leak test program | Records management program |
Instruction to personnel | Waste disposal program |
Emergency procedures | Procedures for ordering, receiving, and opening packages |
Description of animal use | Licensing fee provided with application |
Copy of letter-of-intent | Description of ALARA and quality management to local governing body |
programs | |
Description of transportation procedures | Certifying signature |
Legal structure of licensee's operation |
Other licensing requirements listed in: R9-7-310, R9-7-311, R9-7-312, R9-7-511, R9-7-703, and R9-7-1721
An applicant shall provide the following information on a registration certificate. The certificate will be validated and returned to the applicant if the information provided is complete.
Name and address | Telephone number |
Where will the radioactive material be used | Address of use location |
Description of radioactive material use | Date |
Authorizing signature and printed name | Position of person signing the form |
Ariz. Admin. Code tit. 9, ch. 7, art. 3, exh. E