Get Department Of Health Services F 45006 Form 2018-2025

Completing the Department Of Health Services F 45006 Form online is essential for obtaining a radioactive material license. This guide will provide a step-by-step approach to effectively and accurately fill out each section of the form.

Follow the steps to complete the form with ease.

1. Press the ‘Get Form’ button to access the F 45006 Form and open it in an editor.
2. Select the type of application you are submitting by checking either 'New License' or 'Renewal License Number' in Item 1.
3. In Item 2, enter the applicant's full name and mailing address.
4. Provide the name and telephone number of the contact person in Item 3, including the area codes for both numbers.
5. In Item 4, list all addresses where radioactive materials will be used or stored, providing the corresponding telephone numbers.
6. Indicate whether portable gauge devices are used or stored at temporary job sites by answering the yes/no questions.
7. In Item 5, specify the name and telephone number of the Radiation Safety Officer and ensure to attach evidence of their training.
8. For Item 6, check the appropriate box pertaining to training for authorized users working with radioactive materials.
9. Complete Item 7 by providing details of the radioactive material, including the element and mass number, and intended use.
10. Item 8 requires you to attach a diagram of the radioactive material storage area.
11. As you proceed through Items 9.1 to 9.11, select the appropriate options and attach any necessary procedures or documentation as indicated.
12. In Item 10, confirm if the application fee is enclosed and specify the amount.
13. Finally, complete Item 11 by having an authorized individual sign and date the application, certifying the accuracy of the information provided. You may also fill out the optional correspondence authority section if applicable.

Complete the Department Of Health Services F 45006 Form online to secure your radioactive material license efficiently.