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: 07-01-2024
Authority Directive or Regulation: 10 CFR Part 20
Form Status: Approved by OMB: 3150-0006, Expires: 07/31/2024
Special Instructions:

Instructions and additional information pertinent to the completion of this form are on Page 2 of the form.

For Questions:

E-mail:  Terry.Brock@nrc.gov RES/DSA/RPB Senior Health Physicist

Telephone Number: (301) 415-1793

Page Last Reviewed/Updated Monday, July 01, 2024