Office Symbol - Download Now DOC

Document Sample
Office Symbol - Download Now DOC Powered By Docstoc
					 Office Symbol
 (                )                                            Date: 5 Sep 08_

 MEMORANDUM FOR Commander, I Corps and Fort Lewis, ATTN: IMNW-LEW-SO (Mr.
 Dougherty), MS 66, Bldg 2007A, Ft. Lewis, WA 98433-5000

 Subject: Military Movement of Radioactive Material

 1. Unit: __2/75 Ranger Battalion (Airborne)_____

 2. UIC: _AORG-SN____

 3. Purpose of movement: __Repair or Proper Disposal___

 4. Date of departure: __________________ 5. Date of Return:__________________

 6. Departing from: __Fort Lewis Washington_______________________

 7. Destination: ____________________________________________________________

 8. Military Personnel responsible for Items during movement:

 Name/Rank:___________________________Phone:_______________________________

 9. Visual inspection required of devices containing radioactive material. Inspect for
 cracks, deformity, leaks, or power. If found, contact RSO for assistance.

 a.   Prior to departure: _________________________________ Date:_____________
 b.   On arrival Location: ________________________________ Date:_____________
 c.   Prior to return: _____________________________________ Date:_____________
 d.   On arrival at Home Station:_________________________ Date:_____________

 10. Inventory of end Items containing radioactive material:

Item SN:                Cell SN:           Nomenclature          QTY    Radionuclide   Activity
                                               ACOG
005174                   N/A           NSN: 1240-01-412-6608     1 ea   H-3            100 mCI




 Printed Name: Thomas A. Dougherty////Signature:___________________________

 “THIS PACKAGE CONFORMS TO CONDITIONS AND LIMITATIONS SPECIFIED IN 49 CFR 173.424 FOR
 RADIOACTIVE MATERIAL, EXEPTED PACKAGE FOR ARTICLES AND INSTRUMENTS, Per Table 7,
 “declare that all of the applicable air transport requirements have been met.” UN2911


 Looking for more documents like this one?   AskTOP.net    Leader Development for Army Professionals

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:5
posted:11/4/2012
language:Unknown
pages:1