Location of Apparatus/ Laboratory: Room no.: Level: Building: School/Centre: Street number: Suburb: State: Postcode: Apparatus / Laboratory Custodian: Title: Given name: Family name: Position: Contact number: Email address: Proposed use of Apparatus/ Laboratory: Radiation activity: Where applicable, list all ionising radiation apparatus (4.1), sealed source devices (4.2) & unsealed radiation source (4.3) in the laboratory. Ionising Radiation Apparatus Description of apparatus (please tick one only): General X-Ray apparatus (radiography) XRF □ □ Radiography/Fluoroscopy Industrial X-Ray □ □ Mammography Security Screening □ □
Location of Apparatus/ Laboratory: Room no.: Level: Building: School/Centre: Street number: Suburb: State: Postcode: Apparatus / Laboratory Custodian: Title: Given name: Family name: Position: Contact number: Email address: Proposed use of Apparatus/ Laboratory: Radiation activity: Where applicable, list all ionising radiation apparatus (4.1), sealed source devices (4.2) & unsealed radiation source (4.3) in the laboratory. Ionising Radiation Apparatus Description of apparatus (please tick one only): □ General X-Ray apparatus (radiography) □ XRF □ Radiography/Fluoroscopy □ Industrial X-Ray □ Mammography □ Security Screening
registration_application_for_radiation_apparatus_or_laboratory_0.docx