Académique Documents
Professionnel Documents
Culture Documents
3.
4.
5.
6.
7.
8.
9.
10.
11.
CLASSIFICATION OF LICENCES
Classification of licences.
Class A licence.
Class B licence.
Class C licence.
Class D licence.
Class E licence.
Class F licence.
Class G licence.
Class H licence.
PART III
13.
14.
15.
16.
17.
18.
742
PART V
INFORMATION
Chapter 1- Information Required for Class F Licences
Regulation
19.
20.
21.
22.
743
Act 304.
PART I
PRELIMINARY
1. (1) These Regulations may be cited as the Radiation Protection
(Licensing) Regulations 1986.
Citation and
commencement.
(2) These Regulations, except regulations 12, 13, 14, 17, the
whole of Part V and the whole of Part VI, shall be deemed to have
come into force on the 1st February 1985.
2. In these Regulations, unless the context otherwise requiresamendment of a licence means amendment of any of the
particulars contained in a licence, but does not include an
amendment which amounts to a transfer of the licence;
application fee means an administrative fee imposed by the
appropriate authority upon the submission of an application to
obtain, amend or renew any licence;
approved registered medical practitioner means a registered
medical practitioner who is approved by the appropriate authority
to be responsible for the medical surveillance of workers;
construction licence means a licence to start work on the
building of a nuclear installation;
full operation stage means the stage where full operation of
any nuclear installation, milling installation or waste treatment
facility is allowed;
irradiating apparatus means an apparatus capable of
producing ionizing radiation but does not include a sealed source
apparatus;
letter of intent means a letter written to the Board informing
it of the intention to site, construct and operate a nuclear
installation, a milling installation or a waste treatment facility;
licence fee means a fee imposed on an applicant upon
notification by the appropriate authority that his application to
obtain, amend or renew any licence is successful;
milling means any activity involved in the concentration and
beneficiation of any material containing or associated with
radioactive materials, nuclear materials or prescribed substances;
milling installation means any installation built to undertake
milling;
register means a book or a file kept by the appropriate
authority in which all the particulars of licensees are recorded;
Interpretation.
744
sealed source means a radiation source consisting of
radioactive materials, nuclear material or prescribed substances
firmly incorporated in solid and effectively inactive material, or
sealed in an inactive container of sufficient strength to prevent,
under normal conditions of use, any dispersion of its contents;
sealed source apparatus means any apparatus containing or
using one or more sealed sources;
sitting licence means a licence to site any nuclear installation;
temporary operation stage means the stage where restricted
operation of any nuclear installation, milling installation or waste
treatment facility is allowed for the purpose of confirming their
expected normal operating characteristics predicted by the design
information;
waste treatment facility means any facility which is used for
processing, treating or storing, prior to disposal, radioactive
materials, nuclear materials or prescribed substances;
worker means any person working under the instruction of
the licensee, whether or not employed by the licensee, in the
handling or use of, or in any activity that will bring him into
contact with, any radioactive material, nuclear material,
prescribed substance or irradiating apparatus.
PART II
CLASSIFICATION OF LICENCES
Classification
of licences.
Class A
licence.
745
Class B
licence.
Class C
licence.
Class D
licence.
Class E
licence.
Class F
licence.
746
(2) A licence under Class F for operating a nuclear installation
shall be issued in two stages, namely(a) the temporary operation stage; and
(b) the full operation stage.
Class G
licence.
Class H
Licence.
General
Conditions.
Application
for licence
747
Amendment
or renewal
of licences.
Application
fee and
licence
fee.
748
(b) Class F; and
(c) Class H,
shall be fifteen ringgit for each application, amendment or renewal
and shall not be refundable.
(2) There is no application fee for a licence classified under(a) Class A and Class B in respect of the milling of materials
containing or associated with radioactive material or
nuclear materials or in respect of a waste treatment
facility;
(b) Class F; and
(c) Class H,
(3) The licence fee for all classes of licence shall be as
prescribed in the Fifth Schedule.
Waiver of
fees.
16. The appropriate authority shall waive the application fee and
the licence fee in respect of(a) the transfer or radioactive materials, nuclear materials,
prescribed substances or irradiating apparatus for charitable or non-profit purposes;
(b) an amendment which does not relate to(i) the class of the licence; or
(ii) the details of any apparatus, material or
installation.
Register of
licensees.
Form of
licence.
Information
required for
a siting licence.
749
Information
required for
a construction
licence.
Information
required for the
temporary
operation
stage.
750
(b) a description of the proposed measures to control
radiation exposures, including the operational radiation
monitoring programme designed for the workers,
members of the public and the environment, together
with a complete list of the supporting services and
facilities;
(c) a detailed medical surveillance programme;
(d) a programme for the initial and periodic training of
workers on general safety and radiation protection;
(e) the facilities and equipment designed to contain spillage
and the procedures to followed in handling spillage of
radioactive materials, nuclear materials or prescribed
substances;
(f) the proposed plan and procedures to prevent loss, theft or
unauthorized use of radioactive materials, nuclear
materials or prescribed substances;
(g) the plan for operational monitoring of the quality and
quantity of effluents to be discharged and emissions from
the facility, including(i) the frequency and points of sampling;
(ii) the types of equipment and analytical methods to
be used;
(iii) the contingency plan in the event of abnormal
results; and
(h) a description of the proposed procedures to prevent
accidents and the proposed contingency plan in the event
of an accident.
Information
required for the
full operation
stage.
Information
required for
application
to site,
construct and
operate a
milling
installation.
751
Information
required for
application
to site,
construct
and operate
a waste
treatment
facility.
Chapter 3 General
25. The appropriate authority may, at any time during the
construction and development of the facility, require, in writing,
the applicant to furnish such information as it may consider
reasonably necessary in order to evaluate the health and safety of
workers and members of the public, the security of the country
and the environmental aspects of the development and future
operation of the facility.
Additional
information.
752
26. Prior to the construction and development of any part of the
facility, all principal plans and drawings shall be submitted to the
appropriate authority for approval, and the approved plans,
drawings and materials shall not be changed during the
construction and development of the facility unless prior approval
from the appropriate authority is obtained.
PART VI
MISCELLANEOUS
Notification
form.
Form of
returns.
Form of
register.
PART VII
REVOCATION
Revocation.
P.U. (A)
297/75.
FIRST SCHEDULE
CATEGORIES OF SEALED SOURCES
(Regulation 4)
Category
A
1
2
3
753
SECOND SCHEDULE
CATEGORIES OF UNSEALED SOURCES
(Regulation 4)
Category
A
1
(Low
radiotoxicity)
H1
15
37
53
56
58m
60m
61
62m
59
69
71
76
79
81
83m
85m
85
80
81
85m
87m
91m
88
89 (66m)
O8
Mn25
Co27
Kr36
Sr38
Nb41
97
Nb41
99m
Ar18
Mn25
Ni28
Co27
Zn30
Kr36
Kr36
Sr38
Sr38
Nb41
93m
Mo42
52m
Mn25
Mn25
Co27
Ge32
Co27
Kr36
Kr36
Sr38
89 (122m)
*Nb41
98
51
Kr36
Y39
*Nb41
101
96m
123
Mo42
Tc43
103m
113m
116
127
129
133
120m
121
128
129
134
131m
133
125
127
129
130
131
135
135m
138
137
Tc43
Te52
I53
Cs55
134m
Cs55
Rh45
Te52
I53
Cs55
Cs55
In49
Te52
I53
Cs55
Cs55
Te52
I53
Xe54
Cs55
Cs55
Te52
I53
Xe54
Cs55
Ce58
191m
193m
197m
203
205
207
227
235
238
239
U92nat
235
243
237
239
246
249
Os76
Po84
245
Am95
Pt78
Ra88
Pu94
246m
Am95
Pt78
U92
Pu94
Am95
Po84
U92
Am95
Cm96
Po84
U92
Am95
754
Category
A
2
(Moderate
radiotoxicity)
14
18
24
31
32
33
35
38
41
42
43
47
47
48
48
51
52
54
52
Be4
P15
K19
V23
C6
P15
K19
Cr24
F9
S16
Ca20
Mn25
Na11
C117
Sc21
Mn25
Si14
Ar18
Sc21
Fe26
55
Fe26
59
55
56
57
58
Co27
63
65
64
65
69m
72
73
74
76
77
75
82
74
77
88
86
83
85
89
91
92
90
92
93
86
88
89
95
97
90
93m
95
95m
96
90
93
99
96
97m
Tc43
97
99
97
103
105
Ru44
105
111
109
Zn30
As33
87
Kr36
Sr38
Y39
Zr40
Nb41
Ag47
Fe26
Ni28
Ga31
Se34
Kr36
Sr38
Zr40
Nb41
Mo42
Tc43
Rh45
Cd48
Co27
Ni28
As33
Br35
Rb37
Sr38
Zr40
Nb41
Mo42
Tc43
Co27
Cu29
As33
Kr36
Sr38
Y39
Zr40
Nb41
Mo42
Ru44
103
109
115
115m
Pd46
Cd48
Pd46
In49
Co27
Zn30
As33
Kr36
Sr38
Y39
Zr40
Nb41
Tc43
Ru44
105
Ag47
113
Sn50
755
Category
A
Sn50
122
Sb51
121
Te52
121m
123m
Te52
Te52
125m
127m
129m
131
131m
132
133m
134
120
123
130
132
132m
I53
133
135
135
132
136
Cs55
137
131
140
134
135
137m
139
141
143
142
143
147
149
147
149
151
153
155
153
159
Te52
Te52
I53
Xe54
La57
Ce58
Nd60
Te52
Te52
I53
Cs55
Ce36
Ce58
Pm61
152m
Eu63(9h)*
Te52
Te52
Ce58
Pr59
Pm61
Eu63
Te52
I53
I53
Cs55
Ce58
Pr59
Sm62
Gd64
Te52
I53
I53
Be56
Ce58
Nd60
Sm62
Gd64
165
166
166
169
171
171
175
177
181
185
187
183
186
188
185
191
193
190
194
191
193
197
196
198
199
197
197m
203
200
201
202
203
206
212
220
Dy66
Tm69
W74
Os76
Pt78
Hg80
T181
Dy66
Yb70
Re75
Os76
Pt78
Hg80
Pb82
Ho67
Lu71
Re75
Ir77
Au79
Hg80
Bi83
Er68
W74
Re75
Ir77
Au79
T181
Bi83
Er68
W74
Os76
Pt78
Au79
T181
Rn86
756
Category
A
226
231
234
233
231
237
240
240
240
239
234
237
245
238
240
244m
244
238
250
244
245
Rn86
U92
Np93
Am95
Cf98
3
(High
radiotoxicity)
Th90
U92
Pu94
Am95
Th90
U92
Pu94
Am95
Th90
U+92
Pu94
Cm96
Pa91
Np93
Am95
Bk97
Fm100
Na11
36
45
46
60
90
Sr38
91
93
94
106
CI17
Y39
Ca20
Zr40
Sc21
Nb41
Co27
Ru44
110m
115m
114m
124
125
124
125
126
131
134
144
152
160
170
181
182
192
204
212
207
210
211
224
228
232
Th90nat
230
236
244
242
241
249
249
253
253
254m
255
256
Ag47
I53
140
Be56
Tb65
Ti81
Ra88
Pa91
Bk97
Fm100
Cd48
I53
Ce58
Tm69
Pb82
Ac89
U92
Cf98
In49
I53
Sb51
I53
Bi83
Th90
Pu94
Cf98
Fm100
Cs55
154
Eu(13a)63
Hf72
Sb51
Eu63
Ta73
Bi59
Am95
Es99
Ir77
At85
Cm96
Es99
757
--------------------------------------------------------------------------------------------------------------------------------Category
Type of Irradiating Apparatus
A
B
--------------------------------------------------------------------------------------------------------------------------------4
Radionuclides in the category shall be as follow:
(Very high
210
210
223
255
226
Pb82
Po84
Ra88
Ra88
Ra88
radiotoxicity
228
227
227
228
229
230
231
230
232
233
234
237
236
238
239
240
241
242
241
242m
243
Am95
240
242
243
244
245
Cm96
246
247
248
248
249
250
251
252
254
Ra88
Th90
U92
Pu94
Cf98
Ac89
Pa91
Np93
Pu94
Cm96
Cm96
Cf98
Th90
U92
Pu94
Pu94
Cm96
Cm96
Cf98
Th90
U92
Pu94
Am95
Cm96
Cm96
Cf98
Th90
U92
Pu94
Am95
Cm96
Cf98
Cf98
254
255
Es99
Es99
--------------------------------------------------------------------------------------------------------------------------------* referring to the half-life on the radionuclide.
THIRD SCHEDULE
CATEGORIES OF IRRADIATING APPARATUS
(Regulation 6)
--------------------------------------------------------------------------------------------------------------------------------Category
Type of Irradiating Apparatus
A
B
--------------------------------------------------------------------------------------------------------------------------------1
Dental X-ray units, mobile and fixed medical X-ray units,
mobile veterinary X-ray units, X-ray gauges, other irradiating
apparatus not specified in this Schedule.
--------------------------------------------------------------------------------------------------------------------------------2
Industrial radiography X-ray units, X-ray analysis units
chiropractic X-ray units, X-ray therapy units not operable above
500 peak kilovolt.
--------------------------------------------------------------------------------------------------------------------------------3
Computerised tomography units, accelerators, neutron
generators, X-ray therapy units operable above 500 peak
kilovolt
---------------------------------------------------------------------------------------------------------------------------------
758
FOURTH SCHEDULE
manufacturing
transferring
trading
handling
producing
selling
Licence number ..
processing
storing
purchasing
using
Amendment.
Licence number
Renewal
owning
others
(specify)
.
759
--------------------------------------------------------------------------------------------------------------------------------6. PARTICULARS OF PERSONS(S) WHO WILL SUPERVISE THE USE OF RADIOACTIVE MATERIAL
------------------------------------------------------------------------------------------------------------------------------------------------
Name
Designation
Date of birth
Identity
card/passport
number
A
B
C
D
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
760
---------------------------------------------------------------------------------------------------------------------------------
761
-----------------------------------------------------------------------------------------------------------9. DESCRIPTION AND THE INTENDED USE OF THE RADIOACTIVE MATERIAL TO BE LICENSED
------------------------------------------------------------------------------------------------------------------------------------------------
Element
and mass
number
Chemical
and/or
physical
form
Name of
Activity
Intended
manufactuuse (use
rer and
sealed
unsealed
relevant
model
source
source
code
number (if
(per
given
available)
source)
below)
A
B
C
D
E
F
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
762
Type of
Supplier
Model
Number
Radiation
Range
instrument
number
available
detectable
A
B
C
D
E
F
---------------------------------------------------------------------------------------------------------------------------------
Attach a resume describing the method and frequency of calibration, date of last calibration and
standards used for instrument calibration.
--------------------------------------------------------------------------------------------------------------------------------14. PERSONNEL MONITORING
--------------------------------------------------------------------------------------------------------------------------------Type
Supplier
Evaluating
Frequency
(tick where appropriate)
agency
of evaluation
A
B
C
D
--------------------------------------------------------------------------------------------------------------------------------Film badge
Thermoluminescence dosimeter
(TLD)
Others (specify)
-------------------------------------------------------------------------------------------------------------------------------15. STORAGE AND HANDLING FACILITIES FOR THE RADIOACTIVE MATERIAL
(tick where appropriate)
Laboratory facilities, plant facilities, including those equipped with fume hoods, etc.
Storage facilities, containers, special shielding (fixed or temporary), etc.
Remote handling tools or equipment, etc.
763
--------------------------------------------------------------------------------------------------------------------------------(b) State the experience of the Supervisor, Radiation Protection Officer and operator and
attach the appropriate resume if available.
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Organization
Duration
Year
A
B
C
D
E
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
764
-----------------------------------------------------------------------------------------------------------19. DECLARATION
I.,
(full name)
identity card/passport number
hereby declare(a) that this application is made on my own behalf/on behalf of
...
(b) that the particulars given in this form, including all supplements attached hereto,
are true and correct.
Signature
Name (capital letters)
Designation
Official Stamp
Date
--------------------------------------------------------------------------------------------------------------------------------ATOMIC ENERGY LICENSING ACT 1984
RADIATION PROTECTION (LICENSING) REGULATIONS 1986
APPLICATION FROM TO OBTAIN, RENEW OR AMEND LICENCE
(Regulations 13 and 14)
--------------------------------------------------------------------------------------------------------------------------------Form LPTA/BP/2
NUCLEAR MATERIAL
--------------------------------------------------------------------------------------------------------------------------------This application form shall be completed in duplicate and submitted together with an application
fee of $15.00 to:
Executive Secretary,
Atomic Energy Licensing Board,
12th and 13th Floor,
Plaza Pekeliling,
No. 2 Jalan Tun Razak,
50400 Kuala Lumpur.
or (for renewal or amendment of a licence for a medical purpose):
Ketua Pengarah Kesihatan,
Kementerian Kesihatan,
Jalan Cenderasari,
50480 Kuala Lumpur.
--------------------------------------------------------------------------------------------------------------------------------Note: If more space is needed, use additional pages
--------------------------------------------------------------------------------------------------------------------------------FOR OFFICIAL USE ONLY
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
765
2. PURPOSE OF ACTIVITY
(tick where appropriate)
New licence.
manufacturing
transferring
Amendment.
trading
handling
Licence number.
producing
selling
Renewal.
processing
storing
Licence number
purchasing
using
owing
others
(specify)
--------------------------------------------------------------------------------------------------------------------------------3a. APPLICANTS NAME
3b. APPLICANTS MAILING ADDRESS
--------------------------------------------------------------------------------------------------------------------------------4 PARTICULARS OF PERSON RESPONSIBLE FOR THE APPLICATION
(a) Name (capital letters)
(b) Identity card/passport number
(c) Designation
(d) Telephone number
--------------------------------------------------------------------------------------------------------------------------------5. ADDRESS WHERE NUCLEAR MATERIAL IS TO BE USED OR STORED OR PROCESSED
--------------------------------------------------------------------------------------------------------------------------------6. PARTICULARS OF PERSON(S) WHO WILL SUPERVISE THE USE OF THE NUCLEAR MATERIAL
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Date of birth
Identity card/
passport number
A
B
C
D
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
766
--------------------------------------------------------------------------------------------------------------------------------8. DESCRIPTION AND THE INTENDED USE OF THE NUCLEAR MATERIAL TO BE LICENSED
--------------------------------------------------------------------------------------------------------------------------------Element and
Chemical and/or
Maximum
Intended use
mass number
physical form
quantity
A
B
C
D
---------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------
767
Attach a resume describing the method and frequency of calibration, date of last calibration and
standards used for instrument calibration.
--------------------------------------------------------------------------------------------------------------------------------11. PERSONNEL MONITORING
--------------------------------------------------------------------------------------------------------------------------------Type
Supplier
Evaluating
Frequency
(tick where
agency
of
appropriate)
evaluation
A
B
C
--------------------------------------------------------------------------------------------------------------------------------Film badge
Thermoluminescense
dosimeter
(TLD)
Others (specify)
--------------------------------------------------------------------------------------------------------------------------------12. STORAGE AND HANDLING FACILITIES FOR THE NUCLEAR MATERIAL
(tick where appropriate)
Laboratory facilities, plant facilities, including those equipped with fume hoods, etc
Storage facilities, containers, special shielding (fixed or temporary), etc.
768
--------------------------------------------------------------------------------------------------------------------------------(b) State the experience of the Supervisor, Radiation Protection Officer and operator and
attach the appropriate resume if available.
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Organization
Duration
Year
A
B
C
D
E
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
769
-----------------------------------------------------------------------------------------------------------16. DECLARATION
I...
(full name)
identity card/passport number.
hereby declare(a) that this application is made on my own behalf/on behalf of.
(b) that the particulars given in this form, including all supplements attached hereto, are
true and correct.
Signature
Name (capital letters)
Official stamp
Date
---------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------FORM LPTA/BP/3
IRRADIATING APPARATUS
--------------------------------------------------------------------------------------------------------------------------------This application form shall be completed in duplicate and submitted together with an application fee
of $15.00 to:
Executive Secretary,
Atomic Energy Licensing Board,
12th and 13th Floor,
Plaza Pekeliling,
No. 2 Jalan Tun Razak,
50400 Kuala Lumpur.
or (for renewal or amendment or a licence for a medical purpose):
Ketua Pengarah Kesihatan,
Kementerian Kesihatan,
Jalan Cenderasari,
50480 Kuala Lumpur.
---------------------------------------------------------------------------------------------------------------------------------
770
manufacturing
transferring
Amendment.
trading
handling
Licence number.
producing
selling
Renewal.
processing
storing
Licence number
purchasing
using
owning
others
(specify)
--------------------------------------------------------------------------------------------------------------------------------3a. APPLICANTS NAME
------------------------------------------------------------------------------------------------------------------------------------------------
771
-----------------------------------------------------------------------------------------------------------6. PARTICULARS OF PERSON(S) WHO WILL SUPERVISE THE USE OF IRRADIATING APPARATUS
------------------------------------------------------------------------------------------------------------------------------------------------
Name
Designation
Date of birth
Identity card/
passport number
D
------------------------------------------------------------------------------------------------------------------------------------------------
Name
Date of birth
Identity card/
passport number
A
B
C
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
Maximum
milliampere
Serial
number of
control
panel
E
7. X-RAY analysis
8. X-RAY gauge
9. Research with human subject
10. Research
11. Others (specify)
Maximum
power
level
kilowatt
D
1. Dental
2. Medical diagnosis
3. Medical therapy
4. Chiropractic
5. Veterinary
6. Industrial radiography
Maximum
peak
kilovolt
Type and
Model
Serial
number of
tube
head
F
G
Supplier
Intended use
(use relevant
code given)
773
Attach a resume describing the method and frequency of calibration, date of last calibration and
standards used for instrument calibration.
-----------------------------------------------------------------------------------------------------------------------------------------------13. PERSONNEL MONITORING
-----------------------------------------------------------------------------------------------------------------------------------------------Type
Supplier
Evaluating
Frequency
(tick where appropriate)
agency
of
evaluation
A
B
C
D
-----------------------------------------------------------------------------------------------------------------------------------------------Film badge
Thermoluminescence
dosimeter
(TLD)
Others (specify)
------------------------------------------------------------------------------------------------------------------------------------------------
774
--------------------------------------------------------------------------------------------------------------------------------(b) State the experience of the Supervisor, Radiation Protection Officer and operator.
and attach the appropriate resume if available.
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Organization
Duration
Year
A
B
C
D
E
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
775
-----------------------------------------------------------------------------------------------------------17. DECLARATION
I...
(full name)
identity card/passport number.
hereby declare(a) that this application is made on my own behalf/on behalf of.
(b) that the particulars given in this form, including all supplements attached hereto,
are true and correct.
Signature
Name (capital letters)
Position
Official stamp
Date
--------------------------------------------------------------------------------------------------------------------------------ATOMIC ENERGY LICENSING ACT 1984
RADIATION PROTECTION (LICENSING) REGULATIONS 1986
APPLICATION FORM TO OBTAIN, RENEW OR AMEND LICENCE
(Regulation 13 and 14)
--------------------------------------------------------------------------------------------------------------------------------FORM LPTA/BP/4
TRANSPORTATION
--------------------------------------------------------------------------------------------------------------------------------This application form shall be completed in duplicate and submitted together with an application
fee of $15.00 to:
Executive Secretary,
Atomic Energy Licensing Board,
12th and 13th Floor,
Plaza Pekeliling,
No. 2 Jalan Tun Razak,
50400 Kuala Lumpur.
or (for renewal or amendment of a licence for a medical purpose):
Ketua Pengarah Kesihatan,
Kementerian Kesihatan,
Jalan Cenderasari,
50480 Kuala Lumpur.
--------------------------------------------------------------------------------------------------------------------------------Note: If more space is needed, use additional pages
-------------------------------------------------------------------------------------------------------------------------------FOR OFFICIAL USE ONLY
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
776
2. TRANSPORTATION OF
(tick where appropriate)
New licence.
Radioactive material
Amendment.
Licence number.
Radioactive waste
Renewal.
Nuclear material
Licence number
Nuclear waste
1b. PERIOD NEEDED.
(minimum 1 year,
Others (specify)
maximum 3 years)
--------------------------------------------------------------------------------------------------------------------------------3. TRANSPORTATION MODE
(tick where appropriate)
Sea
Road
Others (specify)
Air
Rail
--------------------------------------------------------------------------------------------------------------------------------4a. APPLICANTS NAME
--------------------------------------------------------------------------------------------------------------------------------7. IF USING TRANSPORTATION SERVICE COMPANY, STATE THE NAME, ADDRESS AND TELEPHONE
NUMBER OF THE COMPANY
------------------------------------------------------------------------------------------------------------------------------------------------
777
---------------------------------------------------------------------------------------------------------------------------------
778
Attach a resume describing the method and frequency of calibration, date of last calibration and
standards used for instrument calibration.
--------------------------------------------------------------------------------------------------------------------------------13. PERSONNEL MONITORING
--------------------------------------------------------------------------------------------------------------------------------Type
Supplier
Evaluating
Frequency
(tick where appropriate)
agency
of
evaluation
A
B
C
D
--------------------------------------------------------------------------------------------------------------------------------Film badge
Thermoluminescence
dosimeter
(TLD)
Others (specify)
--------------------------------------------------------------------------------------------------------------------------------14. RADIATION PROTECTION PROGRAMME
Describe the radiation protection programme to be adopted including the contingency plan.
(a) State the qualifications of the Supervisor and Radiation Protection Officer. List
relevant courses attended and attach certified copies of certificate(s) obtained.
------------------------------------------------------------------------------------------------------------------------------------------------
Name
Designation
Qualification/Courses attended
A
B
C
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
779
-----------------------------------------------------------------------------------------------------------(b) State the experience of the Supervisor and Radiation Protection Officer and attach the
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Organization
Duration
Year
A
B
C
D
E
---------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------16. DECLARATION
I...
(full name)
identity card/passport number.
hereby declare(a) that this application is made on my own behalf/on behalf of.
(b) that the particulars given in this form, including all supplements attached hereto, are
true and correct.
Signature
Name (capital letters)
Designation
Official stamp
Date
---------------------------------------------------------------------------------------------------------------------------------
780
ATOMIC ENERGY LICENSING ACT 1984
Amendment.
Licence number.
Disposal
3. TYPE OF WASTE (tick where appropriate)
Renewal.
Licence number
Radioactive waste
781
782
------------------------------------------------------------------------------------------------------------------------------------------------
783
By applicant
Attach a resume describing the method and frequency of calibration, date of last calibration and
standards used for instrument calibration.
--------------------------------------------------------------------------------------------------------------------------------13. PERSONNEL MONITORING
--------------------------------------------------------------------------------------------------------------------------------Type
Supplier
Evaluating
Frequency of
(tick where appropriate)
agency
evaluation
A
B
C
C
--------------------------------------------------------------------------------------------------------------------------------Film badge
Thermoluminescence
dosimeter (TLD)
Others (specify)
--------------------------------------------------------------------------------------------------------------------------------14. RADIATION PROTECTION PROGRAMME
Describe the radiation protection programme to be adopted.
--------------------------------------------------------------------------------------------------------------------------------15. QUALIFICATION AND EXPERIENCE OF SUPERVISOR AND RADIATION PROTECTION OFFICER
(a) State the qualifications of the Supervisor and Radiation Protection Officer. List
relevant courses attended and attach certified copies of certificate(s) obtained.
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Qualification/Courses attended
A
B
C
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
784
-----------------------------------------------------------------------------------------------------------(b) State the experience of the Supervisor and Radiation Protection Officer and attach the
appropriate resume if available
--------------------------------------------------------------------------------------------------------------------------------Name
Designation
Organization
Duration
Year
A
B
C
D
E
---------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------16. DECLARATION
I...
(Full Name)
identity card/passport number.
hereby declare(a) that this application is made on my own behalf/on behalf of.
(b) that the particulars given in this form, including all supplements attached hereto, are
true and correct.
Signature
Name (capital letters)
Designation
Official stamp
Date
------------------------------------------------------------------------------------------------------------
785
Import
3. ITEM
(tick where appropriate)
Renewal.
Radioactive material
Licence number
Nuclear material
Export
Irradiating apparatus
Others (specify)
---------------------------------------------------------------------------------------------------------------------------------
786
---------------------------------------------------------------------------------------------------------------------------------
787
--------------------------------------------------------------------------------------------------------------------------------11. Additional information required for the import or export of prescribed substance
--------------------------------------------------------------------------------------------------------------------------------12. DECLARATION
I...
(full name)
identity card/passport number hereby declare(a) that this application is made on my own behalf/on behalf of.
(b) that the particulars given in this form, including all supplements attached hereto, are
true and correct.
Signature
Name (capital letters)
Designation
Official stamp
Date
------------------------------------------------------------------------------------------------------------
788
FIFTH SCHEDULE
LICENCE FEES
(Regulation 15)
3. Licence fee for Class A, Class B or Class C in respect of the sale of, trading in or transfer of
radioactive materials, nuclear materials or irradiating apparatus shall be two hundred ringgit per year
for each licence irrespective of the number or category of materials or apparatus to be sold, traded in or
transferred.
TABLE I: Licence fee per year for radioactive material (sealed source) according to the categories listed
in the First Schedule.
--------------------------------------------------------------------------------------------------------------------------------Category
Licence fee per year in ringgit
A
B
--------------------------------------------------------------------------------------------------------------------------------1
$100 for the first source.
$20 for every additional source.
2
$200 for the first source or gauge.
$40 for every additional source or gauge.
3
$300 for the first source.
$60 for every additional source.
4
$1,000 for the first source or cell.
$200 for every additional source or cell.
--------------------------------------------------------------------------------------------------------------------------------If the sealed sources fall under several categories, the licence fee shall be the sum of the fees for all
the categories.
---------------------------------------------------------------------------------------------------------------------------------
789
TABLE II: Licence fee per year for radioactive material (unsealed source) according to the categories
listed in the Second Schedule.
--------------------------------------------------------------------------------------------------------------------------------Category
Licence fee per year in ringgit
A
B
--------------------------------------------------------------------------------------------------------------------------------1
$100
2
$200
3
$300
4
$1,000
--------------------------------------------------------------------------------------------------------------------------------If the unsealed sources fall under several categories, the fee for the category which carries the
highest fee shall be the licence fee.
---------------------------------------------------------------------------------------------------------------------------------
TABLE III: Licence fee per year for irradiating apparatus according to the categories listed in the
Third Schedule.
--------------------------------------------------------------------------------------------------------------------------------Category
Licence fee per year in ringgit
A
B
--------------------------------------------------------------------------------------------------------------------------------1
$100 for the first apparatus.
$20 for every additional apparatus.
2
$300 for the first apparatus.
$60 for every additional apparatus.
3
$1,000 for the first apparatus.
$200 for every additional apparatus.
--------------------------------------------------------------------------------------------------------------------------------If the apparatus fall under several categories, the licence fee shall be the sum of the fees for all
the categories.
---------------------------------------------------------------------------------------------------------------------------------
TABLE IV: Licence fee per year for transportation, storage prior to disposal/disposal and
import/export.
--------------------------------------------------------------------------------------------------------------------------------Purpose
Licence fee per year in ringgit
A
B
--------------------------------------------------------------------------------------------------------------------------------Transportation .. ..
$100
Storage prior to disposal/
disposal .. ..
..
$100
Import/export .. ..
$100
---------------------------------------------------------------------------------------------------------------------------------
790
SIXTH SCHEDULE
ATOMIC ENERGY LICENSING ACT 1984
(Signature)
(SEAL)
Executive Secretary/
Director General of Health
---------------------------------------------------------------------------------------------------------------------------------
791
SEVENTH SCHEDULE
ATOMIC ENERGY LICENSING ACT 1984
RADIATION PROTECTION (LICENSING) REGULATIONS 1986
FORM FOR NOTIFICATION BY APPROVED REGISTERED MEDICAL PRACTITIONER
(Regulation 27)
--------------------------------------------------------------------------------------------------------------------------------FORM LPTA/BM/1
WORKER
--------------------------------------------------------------------------------------------------------------------------------This form shall be completed in duplicate and submitted to:
Executive Secretary,
Atomic Energy Licensing Board,
12th and 13th Floor,
Plaza Pekeliling,
No. 2 Jalan Tun Razak,
50400 Kuala Lumpur.
or (in respect of an activity for medical purpose):
Ketua Pengarah Kesihatan,
Kementerian Kesihatan,
Jalan Cenderasari,
50480 Kuala Lumpur.
------------------------------------------------------------------------------------------------------------
792
-----------------------------------------------------------------------------------------------------------In accordance with section 25 (4) of the Atomic Energy Licensing Act 1984, I/we hereby report the
following:
--------------------------------------------------------------------------------------------------------------------------------A. PARTICULARS OF THE PERSON WHOSE HEALTH IS OR IS REASONABLY SUSPECTED TO BE AFFECTED BY
IONIZING RADIATION
------------------------------------------------------------------------------------------------------------------------------------------------------------------
1. Name
--------------------------------------------------------------------------------------------------------------------------------2. Address
--------------------------------------------------------------------------------------------------------------------------------3. Identity card number
4. Date of birth
5. Sex
--------------------------------------------------------------------------------------------------------------------------------6. Normal work
--------------------------------------------------------------------------------------------------------------------------------7. Circumstances of exposure
--------------------------------------------------------------------------------------------------------------------------------8. Estimate of does received
--------------------------------------------------------------------------------------------------------------------------------9. Type of injury
--------------------------------------------------------------------------------------------------------------------------------10. Treatment given (if any)
--------------------------------------------------------------------------------------------------------------------------------11. Observation following treatment
--------------------------------------------------------------------------------------------------------------------------------12. Name, address and telephone number of the employer
793
EIGHTH SCHEDULE
ATOMIC ENERGY LICENSING ACT 1984
RADIATION PROTECTION (LICENSING) REGULATIONS 1986
FORM OF RETURN OF SALE OF RADIOACTIVE MATERIAL, NUCLEAR
MATERIAL, PRESCRIBED SUBSTANCE OR IRRADIATING APPARATUS
(Regulation 28)
--------------------------------------------------------------------------------------------------------------------------------FORM LPTA/BM/2
RETURN OF SALE
--------------------------------------------------------------------------------------------------------------------------------This return shall be completed in duplicate and submitted to:
Executive Secretary,
Atomic Energy Licensing Board,
12th and 13th Floor,
Plaza Pekeliling,
No. 2 Jalan Tun Razak,
50400 Kuala Lumpur.
Nuclear material
Irradiating apparatus
Prescribed substance
Others (specify)
794
(c) Name, designation, identity card number, telephone number of person responsible to the
seller
--------------------------------------------------------------------------------------------------------------------------------4. DESCRIPTION OF MATERIAL OR APPARATUS SOLD
(Fill in where necessary only)
(a) Radioactive material
--------------------------------------------------------------------------------------------------------------------------------Element
Chemical
Name of
Activity
Date of
and mass
and/or
manufacturer
Sale
number
physical
and model
Sealed
Unsealed
form
number (if
source
source
sealed
(per
source
source)
A
B
C
D
E
F
---------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------
795
------------------------------------------------------------------------------------------------------------
796
ATOMIC ENERGY LICENSING ACT 1984
Nuclear material
Irradiating apparatus
Others (specify)
Prescribed substance
---------------------------------------------------------------------------------------------------------------------------------
797
-----------------------------------------------------------------------------------------------------------4. NAME, DESIGNATION, IDENTITY CARD NUMBER, TELEPHONE NUMBER OF PERSON RESPONSIBLE
-----------------------------------------------------------------------------------------------------------------------------------------------5. PARTICULARS OF MATERIAL, APPARATUS AND SUBSTANCE POSSESSED (fill in where applicable)
---------------------------------------------------------------------------------------------------------------------------------
798
------------------------------------------------------------------------------------------------------------
799
NINTH SCHEDULE
ATOMIC ENERGY LICENSING ACT 1984
RADIATION PROTECTION (LICENSING) REGULATIONS 1986
FORM OF REGISTER
(Regulation 29)
--------------------------------------------------------------------------------------------------------------------------------LPTA/BM/4
REGISTRATION
--------------------------------------------------------------------------------------------------------------------------------Licence Number
REGISTER FOR
File Number
REGISTRATION NUMBER
Effective date
Expiry date
--------------------------------------------------------------------------------------------------------------------------------Name of Licensee
Mailing Address
Telephone Number
Address of Facility/Premises
--------------------------------------------------------------------------------------------------------------------------------Name of Supervisor
Identity Card/Passport Number
Name of Radiation Protection Officer
Identity Card/Passport Number
--------------------------------------------------------------------------------------------------------------------------------Purpose
--------------------------------------------------------------------------------------------------------------------------------Details of Apparatus/Material/Installation
--------------------------------------------------------------------------------------------------------------------------------Remarks (if any)
Registered by
Signature
Date
Seal of registrar
---------------------------------------------------------------------------------------------------------------------------------