Volume 3 - Atomic Energy Regulatory Board

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In case, it is found, at any stage, that the information provided by me/us is false and/or not authentic, then I/we hereby undertake to comply with the regulatory action(s) enforced against me/us and our institution, in accordance with the applicable Rules. Place: Date: Signature: Name of the applicant: Designation: Signature: Name of Head of the Institution: Designation: (Seal of the Head of the institution) 269
ANNEXURE-3 (Refer section 3.2.1.5) Form ID: AERB/RSD/GRAPF/LCO Government of India Atomic Energy Regulatory Board Niyamak Bhavan Anushaktinagar, Mumbai-400094 APPLICATION FOR LICENCE FOR COMMISSIONING/OPERATION OF LAND-BASED STATIONARY GAMMA RADIATION PROCESSING FACILITY (GRAPF) (a) (b) (c) (d) (e) This application would be considered by the competent authority for issuance of relevant consents, under the Atomic Energy (Radiation Protection) Rules, 2004 [AE(RP)R]. The duly filled-in form should be sent to Director/Head, Radiological Safety Division (RSD), AERB, Niyamak Bhavan, Anushaktinagar, Mumbai-400094 with the necessary documents Incomplete applications and those without all relevant documents are liable to be rejected All the forms pertaining to this facility can be downloaded from the website (www.aerb.gov.in) Attach extra sheets wherever required PART A GENERAL PARTICULARS A.1 Name and address of the institution: Telephone No. Fax No. E-mail (O): A.2 Name and address of the Head of the institution $ Telephone No. (O): (R) Fax No. Mobile No. E-mail 270
Page 1 and 2: GUIDE NO. AERB/RF/SG/G-3 (Vol. 3 of
Page 3 and 4: Price Order for this guide should b
Page 5 and 6: such as industrial safety and envir
Page 7 and 8: Betatron An electron accelerator in
Page 9 and 10: Handle Manufacture, possess, store,
Page 11 and 12: Radioactive Waste Material, whateve
Page 13 and 14: Tomography Radiography of one or mo
Page 15 and 16: CONTENTS FOREWORD .................
Page 17 and 18: 3.3.8 Lead Time for Submission/Avai
Page 19 and 20: 3.8.3 Construction ................
Page 21 and 22: 3.15.2 Procurement and Registration
Page 23 and 24: FUNCTIONAL PERFORMANCE OF SAFETY SY
Page 25 and 26: APPENDIX-5E (Refer section 3.4.1.4)
Page 27 and 28: GAMMA RADIATION PROCESSING FACILITY
Page 29 and 30: FACILITY FOR RADIATION TECHNOLOGY (
Page 31 and 32: ANNEXURE-33b APPLICATION FOR PROCUR
Page 33 and 34: BIOMEDICAL RESEARCH STUDIES ON HUMA
Page 35 and 36: ANNEXURE-59 APPLICATION FOR NO (3.1
Page 37 and 38: VOLUME - 3
Page 39 and 40: A.3 Name and designation of the app
Page 41 and 42: (v) (vi) (vii) (viii) (ix) (x) (xi)
Page 45: (vi) (vii) (viii) Layout and civil
Page 49 and 50: S.No. Designation of personnel Name
Page 51 and 52: (iii) (iv) (v) (vi) (vii) (viii) (i
Page 53 and 54: (a) (b) (c) Identification number o
Page 55 and 56: ANNEXURE-5 (Refer sections 3.2.2.2
Page 57 and 58: B.2.4 B.2.5 Distance of proposed si
Page 59 and 60: ANNEXURE-6 ( Refer sections 3.2.2.5
Page 61 and 62: S. No. 1 2 Designation of personnel
Page 63 and 64: (iv) (v) (vi) (vii) (viii) (ix) (x)
Page 67 and 68: (x) (xi) the procedures approved by
Page 71 and 72: (iii) (iv) (v) (vi) (vii) (viii) (i
Page 73 and 74: (a) (b) (c) certify that the indivi
Page 77 and 78: (xii) (xiii) (xiv) (xv) Emergency p
Page 79 and 80: ANNEXURE-11 (Refer section 3.3.5) G
Page 81 and 82: B.3 Details of commissioning Consen
Page 83 and 84: In case, it is found, at any stage,
Page 87 and 88: (x) (xi) the procedures approved by
Page 91 and 92: ANNEXURE-14 (Refer section 3.4.1.4)
Page 93 and 94: B.1 Medical Cyclotron PART B DETAIL
Page 95 and 96: (vii) (viii) Copy of appointment an
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ANNEXURE-15 (Refer section 3.4.2.2)
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(i) (j) Bone densitometer Others (s
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B.1.3 Type of unit: (a) (b) (c) (d)
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(xii) (xiii) (xiv) any incident/acc
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A.3 Name and designation of the app
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(iv) (v) (vi) (vii) (viii) (ix) (x)
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PART C UNDERTAKING I/we hereby cert
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PART B PARTICULARS OF THE PROPOSED
Page 119 and 120:
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A.2 Name and address of the Head of
Page 123 and 124:
D. ACCELERATOR (i) Number of accel
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III. In the Cross-sectional (elevat
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ANNEXURE-21 (Refer section 3.5.1.4,
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(ii) Gamma knife source(s) - attac
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(v) (vi) (vii) (viii) (ix) (x) (xi)
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(ii) 7. In case of a new unit (a) I
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(ii) (iii) (iv) (v) Copy of the AER
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If yes, permission for source trans
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(i) (ii) If yes, specify : A, the p
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(f) (g) (h) Water phantom for absol
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(b) whether, performance test repor
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3. Specify name and postal address
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3. Whether a copy of the undertakin
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3. Any other information: 4. Docume
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I hereby certify that the informati
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PART A GENERAL PARTICULARS A.1 Name
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B.3.4 For Simulator: (i) (ii) (iii)
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Available Not available Not appli
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B.7 Any unused radioactive sources/
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ANNEXURE-23 (Refer section 3.6.2) F
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(a) (b) Date and year of installati
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ANNEXURE-24 (Refer section 3.6.3) F
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PART B DETAILS OF THE EQUIPMENT B.1
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(ix) (x) (xi) (xii) (xiii) (xiv) fu
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Fax No. Mobile No. E-mail A.3 Name
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RSM* Make Model RSM S. No. Date of
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(h) (i) (j) (k) (l) (m) (n) (o) C.V
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(xx) AERB will be kept informed abo
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PART C UNDERTAKING I/we hereby cert
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ANNEXURE-27 (Refer section 3.7.4) G
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A.8 Contract awarding party for pro
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B.5.1 B.5.2 Particulars of source s
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(ix) (x) (xi) (xii) (xiii) the proc
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Radiation survey monitor* Make and
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(xi) (xii) (xiii) (xiv) (xv) (xvi)
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B.5 Documents to be available with
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ANNEXURE-31 (Refer section 3.9.2) G
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B.4.5 B.4.6 Sealed source classific
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B.14 Whether a radiation survey met
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(x) (xi) (xii) (xiii) (xiv) radiati
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Mobile No. E-mail A.3 Name and desi
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B.7 Particulars of the radiation su
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egulatory action(s) enforced agains
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A.3 Name and designation of the App
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(iii) (iv) (v) (vi) (vii) (viii) (i
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Page 226 and 227:
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ANNEXURE-34 (Refer section 3.10.1.4
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B.1.1 In-vivo diagnosis S. No. Radi
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B.8 Procedures for disposal of radi
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ANNEXURE-35 (Refer section 3.11.1)
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B.6 Particulars of emergency handli
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(ix) (x) (xi) (xii) (xiii) (xiv) ra
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Containing Radioactive Substances
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LIST OF PARTICIPANTS DRAFT DOCUMENT
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ADVISORY COMMITTEE ON PREPARATION O
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PROVISIONAL LIST OF CODES, GUIDES A
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Volume 3 - Atomic Energy Regulatory Board

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