Attachment 12 Radioactive Waste Pickup Receipt.pdf

PDF 703 KB Posted

Attached to
National Institutes of Health (NIH) Comprehensive Solid and Medical Pathological Waste and Recycling Management Services
Solicitation number
75N98023R00017
Issued by

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This document contains a radioactive waste pickup receipt template and information on a related federal contract opportunity for comprehensive solid and medical pathological waste and recycling management services. The template is for use by authorized investigators at the National Institutes of Health to indicate the type and amount of radioactive waste being transferred for disposal. It requests details on the waste such as whether it is dry waste, contained in carboys or sharps containers, and includes spaces to list various isotopes and their activities. The related solicitation is being conducted by the Department of Health and Human Services National Institutes of Health Office of Logistics and Acquisition Operations to provide waste and recycling management services across NIH facilities. It involves collection, treatment, and disposal of solid, medical, pathological, and low-level radioactive waste generated through biomedical research activities.

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Attachment 12

Page 1 Qf 1

NIH RADIOACTIVE WASTE RECEIPT

-t.- t.i.S.·GOVERNMENT .,..INTING OFFICE: 1111-1523s37Z

-- . · ··-· ... ,.. • -:-- • - - ·--4!' ...;..... - - - • - .• .,. - .. .,_. -· .. . ... , �- � ..-. ·-- � - • - �--:- • .. -

Radioactive . · .. aste

For Nuclear · edicine Use Only

Authorized lnves.tigator

Building / Room No.

2 Q 2-Gallon Cw:boy D 5-Gallon Carboy

D Sharps Container

· t:)DryWaste

0MPWBox

□ Other (Oesc::rlbe)

Isotopes. and A.ctivity

· 01-131 . · mCi D Tl-201 ---

□ I.-125 ____ mCi Oxe-133

0Tc-99m ___ .mCi OY-90 Oin-111 .. mCi Oaa-67 mCi

4 Laboratory Signature .. .

1.ab Phone#

Radioactive Waste ·· · Technician's Si2nature

Pickup Date

5 \Vaste Processing Information

NIH 88-36 (2191) •

mCi mCi mCi mCi mCi

1·

5 .

·oa.ctive · .··.·•··aste Pickup Receipt

Aµthorized Investigator

Building/ Room No.

D 2-Gallon Carboy □ 5-Gallon Carboy

0 DryWaste·· Dry Waste, H-3 or C-14 only

□ Ani n1a)1B1ological·Waste □ ]i.;tPWBox

D LSC Vials (Indjcate Number of Travs)

Other (Descxibe)

D

H-8

C--14

P-32

S-35

J,aboratory

Isotopes

. _.mCi c· m l

.mCi c·m 1 and Activity·

□ Cr-51

□ I-125

Lab

Sig11at111 e Phone#

Radioactive Waste Teclm.ician 's Signature

Pickup Date

Waste Processing Jr,for11,ation

NIH 88�5 (10/90)

mCi mCi mCi mCi

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