Guide for the Completion of a X-ray Permit Application

When completing the enclosed x-ray Permit Application, please use this guide when providing the information requested. The application form is provided below and should be completed accurately to facilitate the review of the application for approval. Incomplete application will result in unnecessary delays. The information provided will enable the University of Toronto Radiation Protection Authority (UTRPA) to provide a thorough X-Ray Safety Protection program for users of these X-Ray sources.

The following information is required in the appropriate section of the application.

Eligibility

In order to hold a UTRPA Permit, the applicant must be one of the following:

  1. Assistant Professor;
  2. Associate Professor;
  3. Full Professor

In addition, two years of relevant experience (industrial or academic) is required and should be detailed as outlined below.

If these conditions cannot be satisfied, then alternate arrangements can be made through the UTRPA. Contact the Radiation Protection Service (416-978-2028) for further information.

Experience

  1. Work experience with x-ray sources?
    i.e. when and where was work experience gained and the duration of the work?
  2. Type of work previously performed?
    i.e. diffraction, fluorescence, materials analysis, diagnostic, dentistry, etc.
  3. Formal radiation protection training. Please provide brief details.

X-Ray Sources

For each x-ray source please provide:

  1. The location (building and room number) where the x-ray source will normally be kept;
  2. The make, model and serial number of the x-ray source;
  3. The type of equipment;
  4. The maximum operating voltage and current of the x-ray source;
  5. The purpose for which the x-ray source will be used;
  6. The frequency of the equipment use.

For x-ray sources installed to be used in a permanent location, in addition to the above, please provide:

  1. Operation starting date;
  2. The name, position, telephone number and relevant qualifications of the person in charge of using of the permanent located x-ray source;
  3. The drawings and specifications completed as requested in Appendix 2;
  4. The anticipated maximum workload in mA x min/week;
  5. The composition of the boundaries of the room, including windows and doors, (include types of materials and thickness) for floor, ceiling and walls (North, East, South and West);
  6. For each direction (floor, ceiling, North, East, South and West walls) in adjacent rooms please provide the type of occupancy (e.g., office, classroom, laboratory, etc.), percentage of time the rooms are occupied while the machine is on, and usage factor (in %) of the machine in that direction.

Experimental Procedures

*No humans shall be irradiated other than for medical treatment purposes.

  1. Nature of work to be performed (e.g.: type of materials being analysed);
  2. mA x min/experiment and number of experiments per year (approximate).

Additional Information

  1. Will undergraduate and/or summer students be working with the x-ray source requested by this permit application?
  2. Is a radiation monitoring instrument located in your laboratory? If so, please provide the make and model number of the instrument.

Please return completed application to:

Radiation Protection Service
Environmental Health and Safety
Room 702, 215 Huron Street
University of Toronto
Toronto, ON, M5S 1A2
Or fax to: 416-971-1361
Or e-mail to: hector.rocca@utoronto.ca

X-Ray Permit Application Form (PDF)