RUTGERS ENVIRONMENTAL HEALTH AND SAFETY

27 Road 1
Building 4086 Livingston Campus
Piscataway NJ 08854
732-454-2550 phone
732-445-3109 fax
http://rehs.rutgers.edu

Isotope Transfer Form

Research staff may transfer radioactive material to another authorized permit after obtaining  REHS approval. 

  • Research staff are prohibited from transporting radioactive material or offering radioactive material for transport.
  • Transfer requests must be submitted to REHS prior to the transfer.
  • Fax this form to REHS at 732-445-3109.

 

Transfer Date:


Radionuclide Information:
Isotope:


 Activity:


Chemical Form:


 

Transfer Information:

Transfer From:
Transfer To:
PI Name:


PI Name:


PI#:


PI#:


Bldg/Lab:


Bldg/Lab:


Phone:


Phone:


Alternate
Contact:

Alternate
Contact:

 

Last Updated:2/18/09
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