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Webserver Date: 26-April-2017

Application for obtaining the certificate of approval for an irradiation facility (Form III)

 
 
FORM – III
{See rule 5(1)}
APPLICATION FOR OBTAINING THE CERTIFICATE OF APPROVAL
FOR AN IRRADIATION FACILITY

 

  1. Name of the applicant:
  2. Address of the applicant:
  3. Installation for which approval is applied for:
  4. Name and Designation of the Head of Installation:
  5. Names, qualifications and experience of Personnel:

     

    Category of Personnel Name Academic Qualification Type of training experience When and where trained Duration of training
    Operator          
    Radiological Safety Officer          
    Quality Control Officer          

     

  6. Proposed date of starting the Irradiation Facility:
  7. Are the personnel provided with facilities for:
    1. Personnel dose monitoring
    2. Medical Surveillance
  8. Details about the Irradiation Facility:
    1. Identification number of the facility:
    2. Location and its address:
    3. Source details:

      Name of radio-nuclides

       

      Activity
      Energy Output
         

       

      Radiation generating plant

      X-ray unit

      Electron Accelerator

    4. Name of the supplier and its address:
    5. Purpose for which the irradiation facility will be used:
  9. Please furnish the following:
    1. A site plan (1:500 scale or as appropriate) of the installation indicating the location of buildings including residential complexes. Occupancy within 5 meters radius of the facility.
    2. Architectural blue prints (appropriate scale) showing layout of equipments.
    3. Details on geology of the location, water table, soil characteristics, seismicity.
    4. Complete design drawing of the facility including details of shielding surrounding of source, wall thickness and labyrinth access if applicable, openings voids, reinforcements, mechanical and electrical safety systems, ventilation, fire protection systems.
    5. Source movement system (where appropriate).
    6. Safety analysis report to demonstrate the adequacy of radiation safety under normal and anticipated accident conditions as detailed in rules 20 and 21.
    7. Operating and emergency procedures.
    8. List of calibrated radiation monitoring equipment in working conditions.
    9. Description of the organizational structure including delegation of authority and responsibility for operation of the facility.
  10. Any other information which the Competent Authority may deem necessary to access the safety status of the irradiation facility.
  11. Please indicate as appropriate:
    1. The irradiation facility is yet to be built.
    2. The irradiation facility is already built and equipped.
    3. Existing irradiation facility is to be modified as per enclosed.
  12. I hereby certify that:
    1. All the statements made above are correct to the best of my knowledge and belief.
    2. No operations will be carried out for purposes other than those specified under item 7(5) of this form.
    3. All provisions of the Atomic Energy (Control of Irradiation of Food) Rules, 1996 shall be strictly complied with.
    4. The irradiation facility shall not be transferred/sold/rented by me/us to another without the prior permission of the Competent Authority.
    5. No radiation source for the irradiation unit will be transported without the prior permission of the Competent Authority.
    6. Full facilities will be accorded by me/us to any authorized representatives of the Competent Authority or the licensing authority to inspect the installation at any time.
    7. Radiation surveillance and medical surveillance of all persons engaged in radiation work as required by the Competent Authority will be duly carried out at my/our expenses.
    8. All recommendations that may be made from time to time by the Competent Authority in respect of radiation safety measures will be duly implemented.
    9. Duly qualified/experienced radiological safety officers/quality officers will be appointed before the commencement of the operation of the facility.
    10. Any changes in the personnel listed in this application will be intimated forthwith to the licensing authority and the Competent Authority.
    11. The rules regarding decommissioning, disposal of decayed sources and reuse of the site of the decommissioned facility shall be strictly complied with.

Date: Signature of the applicant

 

Seal of the Institution

 

 

This form may be sent to Chairman, Atomic Energy Regulatory Board, Niyamak Bhavan, V. N. Purav marg, Anushakti Nagar, Mumbai - 400 094.

 

This Form is provided by External Relations Section, DAE, Mumbai- 400001.