FORM I

{See rule 4(1)}

APPLICATION FOR OBTAINING A LICENCE 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. Details about the Irradiation Facility :

(1) Identification number of the facility :

(2) Location and its address :

(3) Source details :

Name of radionuclides                             Activity

                                                  --------------------------------------------------------------

Radiation generating plant              Energy                       Output

X-ray unit

Electron Accelerator

(4) Name of the supplier and its address :

(5) Purpose for which the irradiation facility will be used

8. Please attach the following additional information to the application :

  1. A site plan (1:500 scale or as appropriate) of the installation indicating the location of building including residential complexes.
  1. Architectural blue prints (appropriate scale) showing layout of equipments.
  2. Complete design drawing of the facility including details of.
  3. Description of the organisational structure including delegation of authority and responsibility for operations at the facility.
9. 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.

 10. 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 authorised 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 Joint Secretary, Department of Atomic Energy, Anushakti Bhavan, CSM Marg, Mumbai- 400001



 
 
 
 

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