JEFFERSON LAB Radiological Work Permit

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1 Form : HPF-OSP-002 Revision: 6 : 12/1/2009 Radiological Work Permit Page 1 of Serial Number: 2011-S011 Start : 1/1/2011 Expiration :12/31/2011 Work Area/Description of Work: Any location within JLab complex, to include Accelerator tunnel, Hall-A, Hall-B, Hall-C, Hall D, Free Electron Laser, CHL. This RWP applies to all operations that involve contractor services to perform non-destructive testing(ndt), such as soil density measurements(sdm), or any other jobs that involve bringing radiation generating devices(rgd s) or radioactive materials on to Jlab property. Task Description: Under conditions defined above and the attached Memo Of Understanding(MOU), this RWP is applicable to the following activities, contingent on RadCon Review: 1) Contractor to perform NDT, on Jefferson Lab property. 2) RadCon RCT s to perform contractual service agreement verification and intermittent job coverage. 3) Contractor, SOTR, or COTR or other JLab trained personnel to serve as escort to untrained. Work Area Radiological Conditions: _*_Radiation Levels * Contamination Levels n/a Airborne Maximum Maximum Maximum Contact Location Location Whole Body Other *To be assessed by RCT or verified by contractor license for source to be used. ALARA Estimate: (whole body dose rate is an estimate of average conditions) (Total Man-hours) X (Whole Body Exposure Rate) = Man-mrem Expected cumulative dose less than 100mrem to any contracting individual. Training Requirements for Entry on this RWP: _ Radiation Worker I Radiation Worker II Respirator Qualified GERT Training required for non-jlab employees prior to performing NDT Dosimetry Requirements for Entry: * Dosimeter SRPD _Multiple Dosimetry (as specified below): Extremity Dosimetry( as specified below):

2 Form : HPF-OSP-002 Revision: 6 : 12/1/2009 Protective Clothing Requirements: N/A Radiological Work Permit RWP # 2011-S011 Page 2 of Full Protective Clothing (coveralls, booties, overshoes, cotton liners, rubber gloves, hood) Partial protective clothing (as specified below): Special protective clothing (as specified below): Respiratory equipment (as specified below): Radiological Controls Coverage Requirements: * Continuous * Intermittent None * To be determined by RCT or RadCon Coordinator at the time of work Special Instructions/ Consideration /Stay-time Controls: Dose Tracking required * Pre-job briefing required Other (as specified below) Pre-Work Package and Notifications: 1. A copy of applicable licenses for the materials expected to be brought to the JLab site. 2. Identification by model and serial number of the specific sources expected to be used, and the isotope and activit for each source 3. Copies of the results of the most recent leak tests on the applicable sources. 4. The names of the operators who may conduct the testing. 5. For radiographers, copies of certifications and evidence of current annual refresher training. 6. A signed statement containing an estimate of the current radiation dose for each operator. 7. Documents indicating device-specific training for the operators listed. Normally, this information should be provided at least ten business days prior to the expected date of arrival on site 8. When NDT is scheduled, the subcontractor or his/her representative (SOTR, JLab supervisor, etc.) will notify RadCon approximately hours in advance of the work with an estimate of the arrival date/time. *See continuation form for RadCon Checklist *RCM approval required for any worker with an incomplete current year s dose record. Waste Production and Disposal: Routine Y / N Description N/A Approx. amount expected lbs cu. ft. Characteristics: N/A Oily Bulk liquids Lead *Requires RCM notification > 1 M dpm H 3 Metal > 250 mr/hr Mixed * Radiological Conditions that may void this RWP Individual/Contractor dose greater than 100 mrem Approvals: Submitted by: Work Supervisor N/A RCD Approved by RCD Manager (or designee) Cancellation: This RWP is cancelled as of by RCD Manager(or designee)

3 Revision: 3 : 4/06/2006 Page 3 0f 5 RWP Number: 2011-S011 Issued: 1/1/2011 RadCon Pre-work Checklist(24-48hrs prior to arrival on-site) 1. Upon notification of impending work(step 8 of Pre-work package) - Verify training in accordance with MOU - Verify dosimeter issuance - Gather pertinent information on test, and make arrangements for job coverage as necessary RadCon Checklist(upon arrival on-site) 1. Review available contractor s information on file - Personnel status(current on all required on-site and contractor excepted training) - Dosimetry status(jlab & subcontractor) - Source verification(model, serial number, leak test) - Portable instrument verification(calibration dates, physical integrity) - Posting and signage integrity( are posting materials adequate for conveying radiological conditions) 2. RadCon Job coverage: - Ensure proper dosimetry prior to commencement of work. - RCT to have survey instrumentation adequate for type of radiation hazard (i.e. NG-2 for gamma and neutron survey) - Perform pre-job survey of source holder/instrument. - Provide job coverage as required by MOU or RadCon Manager or his designee. - Ensure area is adequately cleared of unnecessary personnel, and if necessary provide postings, guard and access control. - Update information on continuation form. - Perform post-job survey.

4 Revision: 4 : 12/1/09 Page: of RWP Number: 2011-S011 Issued: 1/1/2011

5 Revision: 4 : 12/1/09 Page: of RWP Number: 2011-S011 Issued: 1/1/2011

6 Revision: 4 : 12/1/09 Page: of RWP Number: 2011-S011 Issued: 1/1/2011

7 Revision: 4 : 12/1/09 Page: of RWP Number: 2011-S011 Issued: 1/1/2011

8 Form : HPF-OSP-006 Revision: 6 : 12/1/09 Briefing Sheet Page of NOTE: RCT should sign verifying that all attendees of the brief have signed the briefing sheet. RWP Number: 2011-S011 Issued: 1/1/2011 Name (Please print) Signature Task #

9 Form: HPF-OSP-009 Revision: 6 : 12/1/09 Name (please print) Pre-Work dose estimate (mrem) TJNAF Radiation Control Group Radiological Work Permit Closeout Analysis RWP No S011 Total Net Dosimeter (mrem) Individual (e.g., type of work) Page: of Lessons Learned/Suggested Improvements/Comparison of totals from previous job (if applicable): After some initial glitches with respect to the SOTR and contractor communication with actual NDT Subcontractor, the performance of soil density measurements were carried out with few problems. Most of the NDT subs were given the Field Operations Coordinator number after being briefed on RWP, and were ask to provide an additional layer of pre-planning by calling upon request for services. Continuous coverage by RCT s was provided to contractors who were on-site for the first time to assess their level of professionalism and safety consciousness, while performing measurements. After determining their work methods were acceptable, intermittent coverage was provided after verifying dosimetry, current leak test, and instrument requirements. To complete this training click here to certify.

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