Radiation surveys confirm that this equipment is free of radioactive contamination in excess of regulatory limits specified in WAC 246-232-140 Schedule D.

No radioactive work is to be done while this notice is in place.

If there are any questions, please contact the RSO at 335-8916

Signature: _____________________ Date: ________________
(Radiation Safety Office)

Physical Plant: Upon completion of this work, the Physical Plant employee will sign and remove this notice and return it to the supervisor for filing.

Signature: __________________________ Date: _______________
(Physical Plant)