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NRC Form 5 – Occupational Dose Record for a Monitoring Period
| Form Number: | NRC
Form 5  |
|---|---|
| Form Title: | Occupational Dose Record for a Monitoring Period |
| Current Edition: | 10-2017 |
| Authority Directive or Regulation: | 10 CFR Part 20 |
| Form Status: | Approved by OMB: 3150-0006, Expires: 10/31/2020 |
| Special Instructions: | Instructions and additional information pertinent to the completion of this form are on Page 2 of the form. For Questions: E-mail: Minh-Thuy.Nguyen@nrc.gov RES/DSA/RPB Telephone Number: (301) 415-5163 |
Page Last Reviewed/Updated Wednesday, October 25, 2017
