D on all applications. Use supplemental sheets where necessary. Mail the original and one copy to: Department of Health, Bureau of Radiation Control, Radioactive Materials Section, 4052 Bald Cypress Way, Bin #C21, Tallahassee, FL 32399-1741. Regulatory Guidance Documents are available from the Bureau of Radiation Control to assist in completing this application. 1.a. LEGAL NAME, MAILING ADDRESS (Include ZIP code), FEI #, Phone & Fax Numbers: 1.b. STREET ADDRESS WHERE RADIOACTIVE MATERIALS WILL .
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How to fill out the FL DH 1322 online
This guide provides clear instructions on how to fill out the FL DH 1322, the application for a radioactive materials license for human use. It aims to support users in completing the form accurately and efficiently, ensuring compliance with Florida regulations.
Follow the steps to complete your application successfully.
- Click ‘Get Form’ button to access the FL DH 1322 application online and open it in the editing interface.
- In section 1.a, enter the legal name, mailing address (including ZIP code), FEI number, phone, and fax numbers. Ensure all details are accurate to avoid delays in processing.
- In section 1.b, fill in the street address where radioactive materials will be used or stored. If this address is the same as in section 1.a, indicate it accordingly.
- For section 3, select the type of application you are submitting: a new license, an amendment to an existing license number, or a renewal of a license number. Complete the corresponding license fee category field.
- In section 4, list all authorized users and authorized medical physicists who may receive, possess, prepare, use, or transfer radioactive materials. Attach a supplemental list if necessary.
- Provide the name and contact information of the radiation safety officer in section 5.a, and fill in the contact details for an alternate emergency contact in section 5.b.
- For section 6.a, indicate the radioactive materials for medical use and specify possession limits according to the applicable Florida Administrative Code. Fill out all relevant fields.
- In section 6.b, provide additional details regarding the radioactive materials not specified in section 6.a, including the chemical or isotope, physical form, and maximum activity.
- Continue filling out sections 7 through 34 as necessary, providing information related to facility diagrams, quality control, radiation safety committee details, and any other applicable requirements.
- Finally, in section 35, certify the application by having the applicant or an authorized official sign and date the form. Ensure that all information provided is accurate and complete.
- After completing all sections, review the form for any errors or missing information. You can then save changes, download, print, or share the completed FL DH 1322 application as needed.
Complete your application online today to ensure timely processing of your FL DH 1322.
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