Form 206 Quiz
Form 206 Quiz
INSTRUCTIONS: Review the CSUN Radiation Safety Manual with special attention to the appendices: NRC Regulatory
Guides 8.13 and 8.29; and “Radiation Safety: A Worker’s Guide.” Each employee is to answer the questions on this
form, sign the certification on the last page and forward these materials to the CSUN Radiation Safety Officer (Mail Drop:
8284).
TRUE/FALSE QUESTIONS:
1. Exposure to ionizing radiation can cause cancer. T F
2. Cells that normally proliferate more rapidly are most sensitive to ionizing radiation. T F
3. Because alpha particles are slow moving, they are not an internal exposure hazard. T F
4. Low energy beta emitters (e.g., H-3) cannot be detected with survey instruments; therefore contamination of
laboratory equipment can be neglected. T F
5. Cleaning up a radioactive material spill should be put off until the end of the day since you may spill more
material, and it would be a waste of time to do it twice. T F
6. It is acceptable to keep your lunch in a refrigerator labeled “Caution - Radioactive Material,” as long as your
lunch is tightly sealed. T F
7. Radioactive material may be shipped from a vendor directly to the lab. T F
8. It is an acceptable practice to leave radioactive material unsecured if you know exactly where it is and will be
back WITHIN five minutes. T F
9. CSUN policy permits the disposal of liquid radioactive materials in sink drains. T F
10. Annual radiation refresher training is a mandatory requirement. T F
CERTIFICATION: I have read and understand the material contained within this manual and my responsibilities as a
user of radioactive materials and/or radiation-producing machines at CSUN.
Privacy Notification:
The State of California Information Practices Act of 1977 requires CSUN to provide the following information to individuals who are
asked to supply information about themselves:
The principal purpose for requesting the information on this form is to access radiation exposure history. CSUN policy, 17 C CR
30265.1, and 10 CFR 20.102 require maintenance of this information.
Furnishing all information requested on this form is mandatory - failure to provide such information will delay or even prevent
completion of the action for which the form is being filled out. Information furnished on this form may be used by various CSUN
departments for exposure records maintenance and will be transmitted to the state and federal governments as required by law.
The official responsible for maintaining the information contained on this form is the CSUN Radiation Safety Officer, EH&S,
Northridge, CA 91330.
Pursuant to the Federal Privacy Act of 1974, you are hereby notified that disclosure of your social security number is mandatory.
This record keeping system was established prior to January 1, 1975, pursuant to the authority of the trustees of the CSU under
Article IX, Section 9 of the California Constitution. The social security number is used to verify your identity.
12/2012