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Click ‘Get Form’ to open the Contamination Survey Report form - uvm in the editor.
Begin by filling in the 'Room', 'Building', 'Investigator', and 'Phone No' fields at the top of the form. This information is crucial for identifying the survey location and responsible personnel.
Indicate the room status by checking either 'Radioactive Material Handling' or 'No Radioactive Materials were handled during this week'. Ensure you select the appropriate option based on your activities.
Enter your name as the surveyor, provide your signature, and date the survey in the designated fields. This adds accountability to your report.
For contamination tests, check all possible contaminants that were present during your survey. Fill in details about detector brand, model, and serial number along with calibration date.
Complete both area survey and wipe test sections by estimating detector efficiency for each contaminant. Record results in CPM (counts per minute) for both tests.
Finally, review all areas checked and indicate whether any exceeded three times the background levels by marking 'Y' or 'N'.

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