Radionuclide Shipment Checklist
| Preliminary Information | Shipper (RS or Lab Staff) | ||
| Training Verified (Within 2 years) | |||
| Shipping Address Verified | |||
| Recipient License on File | |||
| Billing Information | |||
| Nuclide | |||
| Activity (MBQ and(optionally) mCi) | |||
| Form (Normal/Special) | |||
| Quantity (Limited /Type A) | |||
| Wipe Test: | Background cpm | ||
| Wipe cpm | |||
| Exposure Rate: | Contact mR/hr | ||
| 3 Ft (TI) mR/hr | |||
| Label (W-I, Y-II,Y-III, n/a) | |||
| Marking: | Shipping Name & ID # | ||
| UWM Address | |||
| USDOT 7A Type A | |||
| This Side Up (liquid) | |||
| Dry Ice (on shipping papers) | |||
| Shipping Information | Shipping Papers & Certification | ||
| Disposal Form (copy to Radiation Safety) | |||
| Date Shipped | |||
| Initials of Shipper | |||
Updated February 27, 2008 by SAK