Radiation Source Disposal Notification
About this form
This form is used to notify the Health Protection Service of the permanent disposal, or transfer into another jurisdiction, of a registered radiation source.
When a source is disposed, this form must be completed by the source owner and the certificate of registration must be returned to the Health Protection Service.
For all decommissioned apparatus, a licenced technician must complete the ‘Decommission’ section of this form.
Your personal information
Access Canberra uses this form to collect information which is necessary to allow the ACT Government to provide services to you. Personal Information may be used or disclosed in accordance with the Information Privacy Act 2014.