Form 252 3 intent work 2025

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4.9 out of 5

501 votes

The document outlines the requirements for submitting a Notice of Intent to work with radioactive materials or x-ray devices in Texas under reciprocity. It specifies that BRC Form 252-3 must be submitted at least three days prior to work, includes necessary notification information, and provides contact details for submission. Additionally, it emphasizes the need for a valid Agency letter recognizing the license and includes privacy notification rights.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your company name, mailing address, city, state, and zip code in the designated fields. Ensure accuracy for proper communication.
Provide the Radiation Safety Officer (RSO) phone number and email address. This information is crucial for any follow-up inquiries.
Fill in your materials license number and issuing agency/state, along with the X-ray registration number and its issuing agency/state.
Indicate whether you possess an Agency letter granting reciprocal recognition of your license/registration by checking 'Yes' or 'No'.
List the names and contact details of individuals who will use radioactive materials (RAM) or X-ray devices during the job.
Complete the job notification section by providing the date you were notified of this job, duration of work, customer name, and representative in charge.
Detail the location and directions to the job site, including road/street names and zip code.
Fill out the radioactive material and/or X-ray device information accurately, including radionuclide details and serial numbers.
Finally, certify that all information provided is true by signing and dating the form before submission.

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