Spare Dosimeter Form

Spare Dosimeter Form

Dosimeter Information


Series code is a 2 or 3 character code next to the 7 digit account number
Under Apron (Waist) Dosimeter Record the 7 digit binary number located above barcode on back of dosimeter
Wear Period Record the date range printed on the front of the dosimeter
Over Apron (Collar) Dosimeter Record the 7 digit binary number located above barcode on back of dosimeter
Wear Period Record the date range printed on the front of the dosimeter
Whole Body (Chest)) Dosimeter Record the 7 digit binary number located above barcode on back of dosimeter
Wear Period Record the date range printed on the front of the dosimeter

Department Authorization

Form must only be completed by the dosimeter contact or supervisor


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