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Radioactive Material Forms and Documents

Contact Radioactive Materials

  •  850-245-4545
  •  
  •  

    Fax

    850-921-6364
  •  

    Mailing Address

    Bureau of Radiation Control 

    4052 Bald Cypress Way Bin C21 

    Tallahassee, FL 32399-1741 

     

 

 24/7 Emergency                                  407-297-2095                            

• FLreciprocityRAM@FLHealth.gov   Reciprocity licensing

• Request a copy of a license            other than yours                   • FLHealth.gov/Records


Regulatory Guides

All files are 500 KB or less unless otherwise specified.


  • Fixed Gauge Guide (Individual documents)
    Regulatory Guide 1.20, Revision 2, February 2008 — For the preparation of applications for use of sealed sources in fixed gauges. also contains an application for non-human use of radioactive materials

    NOTE: Revision 1 should be used for new license applications, license renewals and amendments as applicable.

    NOTE: This regulatory guide is made up of multiple individual documents provided together as a single PDF file. The documents are also available individually.

  • Gamma Stereotactic Radiosurgery Regulatory Guide (DOC)
    Regulatory Guide 1.70, June 2012 — Guide for the preparation of applications for gamma stereotactic radiosurgery units including gamma knife devices

    NOTE: This regulatory guide is made up of multiple individual documents, provided together as a single file.

  • HDR Regulatory Guide(DOC)
    Regulatory Guide 1.60, October 2011 — Guide for the preparation of applications for high dose rate remote afterloaders

    NOTE: This regulatory guide is made up of multiple individual documents, provided together as a single file. An HDR application checklist is also available.

  • Industrial Radiography Regulatory Guide (DOC)
    Regulatory Guide 1.40, June 2013 — Guide for the preparation of applications for industrial radiography

    NOTE: This regulatory guide is made up of multiple individual documents, provided together as a single file.


  • Medical Use Guide(DOC)
    Regulatory Guide 1.30, Revision 5, August 2014 — For the preparation of applications for a medical use license. Includes license application form

    NOTE: This regulatory guide is made up of multiple individual documents, provided together as a single file.


  • Portable Gauge Guide (Individual documents)
    Regulatory Guide 1.10, Revision 6, December 2017 — For the preparation of applications for use of sealed sources in portable gauge devices

    NOTE: This regulatory guide is made up of multiple individual documents provided together as a single PDF file. The documents are also available individually.

  • Preceptor Attestation for Medical Authorized Users Guide  (DOC)
    Regulatory Guide 3.50, Revision 2, August 2014 — A required guide to document a physician's training and experience with radioactive materials to become an authorized user listed on a human-medical use radioactive materials license

    NOTE: This regulatory guide is made up of multiple individual documents provided together as a single PDF file. Some of the documents are available individually.



  • Unsealed or Sealed Sources Guide (non-human use) (Individual documents)
    Regulatory Guide 1.50, July 2013 — Instructions for preparing applications for radioactive materials licenses authorizing unsealed and/or sealed sources

    NOTE: This regulatory guide is made up of 30 individual documents, provided together as a single PDF file. The documents are also available individually.

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Forms and Checklists

All files are 500 KB or less unless otherwise specified.





  • Reciprocity License Notification
    Used by out of state licensees seeking reciprocal recognition of their license to be able to use radioactive materials in Florida.


  • Form DH 1322, December 2009(DOC) (Incorporated by reference in 64E-5.207, F.A.C.)
    Human use radioactive materials license application (for medical applicants only)

  • HDR Application Checklist(DOC) (Use with HDR Regulatory Guide 1.60 and DH Form 1322)
    Checklist for high dose-rate (HDR) remote afterloading license application



  • Form DH 361(DOC)
    Certificate — Medical Use Of Radioactive Material Under General License







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Information Notices

All files are 500 KB or less unless otherwise specified.

  • Information Notice 2014-1Information Notice 2014-1
    Revision 12 filing instructions: Changes to Chapter 64E-5, Florida Administrative Code (F.A.C.)

    NOTE: The first file contains only the information notice, while the second file contains the notice plus the actual replacement pages for revision 12



  • Information Notice 2010-3
    Industrial radiography reporting requirements (Clarification of the 24 hour notification requirement for an event in which the sealed source assembly did not return to the fully shielded position within the exposure device)


  • Information Notice 2010-1Information Notice 2010-1
    Revision 10 filing instructions: Changes to Chapter 64E-5, Florida Administrative Code (F.A.C.)

    NOTE: The first file contains only the information notice, while the second file contains the notice plus the actual replacement pages for revision 10

  • Information Notice 2009-2
    Notice of proposed changes in 64E-5, Florida Administrative Code — Majority of changes are regarding the medical use of radioactive materials

  • Information Notice 2009-1
    Varian Medical Systems Varisource high dose-rate remote afterloader events: Source retraction problems


  • Information Notice 2008-2Information Notice 2008-2
    Revision 8 filing instructions: Changes to chapter 64E-5, Florida Administrative Code (F.A.C.)

    NOTE: The first file contains only the information notice, while the second file contains the Notice plus the actual replacement pages for Revision 8



  • Information Notice 2007-5Information Notice 2007-5
    Revision 7 filing instructions: Changes to chapter 64E-5, Florida Administrative Code (F.A.C.)

    NOTE: The first file contains only the information notice, while the second file contains the notice plus the actual replacement pages for Revision 7



  • Information Notice 2007-2
    Additional requirements for licensees who possess or transfer certain generally licensed (GL) devices

  • Information Notice 2007-1Information Notice 2007-1
    Revision 6 filing instructions: Changes to chapter 64E-5, Florida Administrative Code (F.A.C.)

    NOTE: The first file contains only the information notice, while the second file contains the notice plus the actual replacement pages for revision 6





  • Information Notice 2003-1
    HAZMAT training requirements for radioactive material licensees (Replaces information notice 99-3). Includes new USDOT requirements for security awareness training and security plans (if applicable)

  • Information Notice 2002-9
    Am-241/Pu-238 disposal — Provides contact information for licensees who wish to dispose of unwanted or obsolete Am-241 or Pu-238 sources

  • Information Notice 2002-8
    Y-90 Zevalin human use radiopharmaceutical therapy — Contains information needed to amend licenses for medical use of Yttrium-90 (Y-90) as a radiopharmaceutical therapy procedure








  • Information Notice 99-5(DOC)
    Problems encountered when manually editing treatment data on the nucletron microselectron-HDR (new) model 105.999

  • Information Notice 99-4(DOC)
    Unplanned radiation exposures to radiographers resulting from failure to follow proper radiation safety procedures

  • Information Notice 99-2(DOC)
    Guidance on the use of a new dose-calculation formalism and revised air-kerma strength standard for Iodine-125 sealed sources










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Model Procedures

All files are 500 KB or less unless otherwise specified.



  • MOP Dose — Appendix A(DOC)
    MOP TEDE — Model procedures for conducting a member-of-public (MOP) dose compliance study — Appendix A (Use for all MOP studies)

  • MOP Dose — Appendix B(DOC)
    MOP DDE — Model procedures for conducting a member-of-public (MOP) dose compliance study — Appendix B (Use for all MOP studies)

  • MOP Dose — Appendix C(DOC)
    MOP CEDE non-medical facilities — Model procedures for conducting a member-of-public (MOP) dose compliance study — Appendix C (Use for all non-medical MOP studies with potential for internal exposure)

  • MOP Dose — Appendix D(DOC)
    MOP CEDE medical facilities — Model procedures for conducting a member-of-public (MOP) dose compliance study — Appendix D (Use for all medical MOP studies with potential for internal exposure)

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