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Radiological Pickup Request Form | Center for Environmental Health and Safety | SIU
Center for Environmental Health and Safety
618-453-7180
asteen@siu.edu
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Center for Environmental Health & Safety
1325 Radio Drive - MC 6898
Carbondale, IL 62901-6898
618-453-7180 | F: 618-453-7192
asteen@siu.edu
Radiological Pickup Request Form
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Radiological Pickup Request Form
Main Navigation
Home
About CEHS
Environmental Compliance
Laboratory and Hazardous Waste
Occupational Health and Safety
Radiation Safety
Contact Us
Center for Environmental Health & Safety
1325 Radio Drive - MC 6898
Carbondale, IL 62901-6898
618-453-7180 | F: 618-453-7192
asteen@siu.edu
Main Content
Please provide the following information
Name
*
Rad Lab Supervisor
Department
*
Building/Room
Email
*
Phone
*
Date
Nuclide One
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Two
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Three
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Four
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Five
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Six
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Seven
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Nuclide Eight
Nuclide
Tritium H3
P-32
P-33
S-35
I-125
C-14
Assay Date
mCi Amount
State
Solid
Liquid
Inventory Number
Comments
Enter Quantity of Replacement Carboys Needed
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0
1
2
3
4
5
Type
S@luki
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