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Warning Text %XTableStyleMedium2PivotStyleLight16`=Sheet1 [Sheet2\Sheet3886Isotope efficiencydpm/ml cpmsamplereleaselimit (dpm/ml)limitfractionCi/mltotalCicountingH-3C-14P-32P-33S-35!Volume of liquid in carboy (ml) =Limit fraction total = Total Ci/ml =activitybkgVolume of sample counted (ml) =' a waste pick-up with Radiation Safety.#Part 3: Summary Data for Container,Total Radioactivity of Container Contents = mCi<Radiation dose rate at contact with exterior of container = ,Wipe test results on outside of container = dpm/100cm2 eNote: Wipe test results must be <1000 dpm/100cm2, if the results exceed this level decontaminate and / 0 Print NameDate&Part 1: Liquid Radioactivity AnalysisName of Authorized User: &Radioactive Materials Permit Number: &Part 2: Disposal Method Determination5Is the liquid in this container suitable for release?iexterior of the container. Document the results in the space provided below (part 3). Complete the name, nsignature, and date section (part 4) at the bottom of this form. Attach this form to the carboy and schedule apIF NO, the liquid in this container is NOT suitable for release. Perform a radiation/contamination survey of thefIF YES, skip part 3 and complete part 4 (name, signature, date) of this form. Dispose of the liquid as Part 4: This Form Completed By:Date of Analysis: happropriate for it's chemical and physical properties. Send this form to Radiation Safety as a record of the disposal.1 re-wipe the exterior of the container. SignatureI of the dose rate on the container when you request the pick-up.LIQUID RELEASE EVALUATIONUIF no answer, a required field in part 1 has been omitted or not completed correctly. wNote: If the contact dose rate is >0.5 mr/hr special labeling is required for transportation. Notify Radiation Safety mR/hr:|5 5_6608l9;=ccB g2ɀ 1BB=SW  dMbP?_*+%^[&L&8The University of Georgia Radiation Safety Manual&R&8Liquid Release Evaluation 8/21/03 &?'?(?)?M\\esdfile\HP LaserJet 4050 Seri4C odXXLetter DINU"4qWI "dXX??&U} } t} }  } t}  } }  }  1              > >                        g2hhhhhhhhh #yzzz{ $|}}}~ v,wwwx " _ _J PGGGGGGGGJ Q D A A A A A \ A  R  S E B B B B B ] B  R ^ ``~ CA@R X <D D  D D D D B~ X{@! C D D % Y D  A! Y  DD  e iD D  MD D D  (D D D  ""B ^ aa~ C@U@R X <D D  D D D D B~ X*@! C D D % YD  A! Y  DD  e iD D  MD D D  (D D D  ""B ^ aa~ CX@R X <D D  D D D D B~ X@! C  D D % Y D  A! Y DD  e iD D  MD D D  (D D D  ""B ^ aa~ C@U@RX <DD DDDD B~ XA@!C  DD%YD A!Y DD e iDD MDDD (DDD ""B ^ aa~ C@U@RX<DD DDDD B~ XF@!C DD%YD A!Y  DD eiDD MDDD (DDD ""BPGGGGGGGG# e %    u#@ %  GG #Z %  JPGGGGGGGGJ %[DD i jKKKL?KKKM % NOOGGGGGGJ &uuuuu@ % s  %    fD   ID  ,D  YES NO""""B GGJ NOOGGGGGGJ * q-rrrrrrrrs . PGGGGGGGGJ )p q'rrrrrrrrs q(rrrrrrrrs DSl*****@Ce****** ! 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