PI Last Name: PI First Name:
Environmental Release Summary for the period from 7/1/2017 to 12/31/2017
Please list above any isotopes released to the environment and their activity in millicuries. DO NOT INCLUDE WASTE TURNED OVER TO THE RSOF.
We require a response by Jan 15, 2018 as an enforcement policy item, resulting in rescinding of your isotope ordering privileges if we have not received your response by that date. If your lab has been in storage mode you are not required to fill out the form.
Please submit this form online. Alternately, fax it to Environmental Health and Safety, 368-2236.
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