The following are the six questions that the General Licensee will be asked to complete on the self-inspection form F-45021 (PDF, 52 KB) when it is mailed with the annual bill.
- Has the contact person changed?
- Has the number of devices containing radioactive material changed in the past year?
- If device has been transferred to another licensee, was the Department of Health Services been notified within 30 days? Wis. Adm. Code, DHS 157.12(4)
- Are all radiation warning signs and labels visible and in good condition on the device?
- Are all Devices containing Radioactive Material in working order (For example damage to shielding, On/off mechanism or indicator failure, leak test exceeds 0.005mCi)?
- Has the device been leak tested within the last six months or as required by the Sealed Source Device Registry?