SDRW PWS Section J Attachment 1.pdf
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- Solicitation number
- N0040626QS246
About this file
This document is a Radiography Operations Planning Work Sheet template for contractors conducting radiography work on federal installations, specifically designed for use at Japanese defense facilities (SRF-JRMC).
The worksheet requires contractors to provide comprehensive planning documentation in seven sections. Section A requests general information including prime and sub-contractor names and proposed radiography dates. Section B requires transportation and vehicle details including manufacturer, model, license plate, vehicle signage, driver name, passenger information, work site location, and the route to be taken on base. Sections C and D address equipment specifications depending on radiography type: gamma radiography requires radioisotope serial number, activity level, collimator serial number, and half-value thickness; x-ray radiography requires machine manufacturer, serial number, maximum kVp and mA ratings, total number of exposures, and beam direction. Section E mandates a detailed site diagram illustrating radiography location, structural features that provide shielding, equipment placement, and the 2 mr/hr (0.02 mSv/hr) controlled boundary. Section F requires calculations establishing the controlled boundary distance from the radiation source. Section G provides signature blocks for approval by both the contractor's radiographer and the SRF-JRMC Radiation Safety Officer (RSO), with corresponding dates. The document references compliance with Japanese Ministry of Labor Ordinance No. 41 and Ministry of Health, Labor, and Welfare Ordinance No. 172 regarding ionizing radiation hazard prevention.
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Text version
Attachment I
RADIOGRAPHY OPERATIONS PLANNING WORK SHEET
A. General Information
1. Prime Contractor Name:
2. Sub-Contractor Name (if applicable):
3. Proposed Date(s) of Planned Radiography:
B. Transportation and vehicle Information
1. Manufacturer:
2. Model:
3. License Plate Number:
4. Sign on Vehicle:
5. Driver’s Name:
6. Passengers:
7. Location of Radiography site (ship, building, pier):
8. Transportation Route to be taken to and from work site while on base:
C. If conducting gamma radiography complete the following:
1. Radioisotope: Serial Number:
2. Activity: Date of Determination of Activity:
3. Collimator Serial Number:
4. Half Value Thickness:
D. If conducting x-ray radiography complete the following:
1. Machine Manufacturer:
2. Serial Number:
3. Maximum kVp:
4. Maximum mA:
5. Total Number of Exposures:
6. Direction of Beam:
E. Provide a diagram of the work site that illustrates:
1. The location of the radiography, including major features such as walls, bulkheads, tanks, walkways or passageways that may provide shielding or difficulty in controlling the area.
2. The location of the exposure device drive cable, guide tube, and end stop if using gamma radiography equipment, or the location of the tube head and control panel if conducting x-ray radiography.
3. The location of the 2 mr/hr (0.02 mSv/hr) controlled boundary.
Attachment I
4. The closest distance that workers are allowed to the x-ray tube head or gamma radiography source as specified in “Ordnance on Prevention of Ionizing Radiation Hazards, Ministry of Labor Ordinance No. 41 of 30 September 1972 and as amended by the Ministry of Health, Labor, and Welfare Ordinance No. 172 of 16 July 2001.
F. Provide the calculations for the 2 mr/hr (0.02 mSv/hr) controlled boundary from the distance from the gamma radiography source, or the x-ray machine tube head, to the location where the boundary shall be established.
G. Review/Approval:
Contractor’s Radiographer:
Name
Signature
Date:
SRF-JRMC RSO (the SRF's RSO) Approval:
Name
Signature
Date:
File details come from the government source that posted it. Updated .