Form Limbah Sumber Bekas
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Transcript of Form Limbah Sumber Bekas
111
Lembar Isian Untuk Limbah Sumber Bekas
PUSAT TEKNOLOGI LIMBAH RADIOAKTIF
1. ASAL LIMBAH
a. Instansi
b. Alamat c. Telepon a. Email
d. Contact Person :
:
:
:
:...................................................................................................................................................................................................................................................................................................
..................................................................................................................................................................................................
2. Nomor Surat Persetujuan Pengiriman Zat Radioaktif : . (Dilampirkan)3. KARAKTERISTIK SUMBER BEKAS :
No.RadionuklidaNo. SeriAktivitas/Tgl.Dimensi/
BeratPenampung/
PembungkusPaparan (Sv/j, mRem/J)
Kontak1 m
Catatan :
Aktivitas : Ci Dimensi/Berat : panjang x lebar x tinggi / kg
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