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   The Division of Environmental Health licenses, certifications, and permits


Learn more about the Division of Environmental Health

 

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Laboratory Licensing

The lab application is for all laboratory and manufacturing licenses who primarily use unsealed radioactive materials.  Forms and instructions are also listed for common amendments to laboratory licenses.

 

Forms and Information

 
 
  For further information contact Anine Grumbles , 360-236-3222

For files which require a viewer go to http://www.doh.wa.gov/viewer.htm to download a viewer. If the type of package you are interested in is not available on-line, please contact us to receive a printed copy.


New Licenses
 

To apply for a new license the applicant must submit:

Send completed application packet to:

Department of Health
Revenue Accounting
Post Office Box 1099
Olympia, Washington 98501-1099

  Be sure to:

  • Make a check made payable to the Department of Health

  • Enclose original, signed copy of your radioactive materials license application with supporting information.

  • Keep a copy for your records

Renewal Licenses

Renewal applications must be received 30 days prior to expiration of the current license.  This qualifies your license for timely renewal which allows your current license to remain in effect until the Department has processed your application.  Information contained in previous applications regarding only initial training and qualifying experience, such as training certificates and medical preceptor statements, may be incorporated by reference.

A renewal package consists of:

Annual fees are billed separately.  Renewal applications are sent to:

Attn: Radioactive Materials

Washington State Department of Health

Office of Radiation Protection

P.O. Box 47827                                                                                   

Olympia, Washington 98504-7827    


 

Decommissioning A Use Area

Certification-Disposition of Radioactive Material (PDF, 208 KB)

Decommissioning Funding Plan Template (MS Word, 85 KB)

Decommissioning Plan Cost Estimate Spreadsheet (MS Excel, 341 KB)

Intent to Decommission/Report of Closure (MS Word, 666 KB)

License Termination

Certification-Disposition of Radioactive Material (PDF, 208 KB)

Intent to Decommission/Report of Closure (MS Word, 666 KB)

New Radiation Safety Officer

Attachment A - Training and Experience Authorized User or Radiation Safety Officer (MS Word , 267 KB)

Attachment B - Duties of the Radiation Safety Officer (PDF, 41KB)

Attachment I - Emergency Procedures (MS Word, 118 KB)

New Authorized User

Attachment A - Training and Experience Authorized User or Radiation Safety Officer (MS Word , 267 KB)

New Use or New Nuclide

Adding a New Use or New Nuclide (PDF, 24 KB)

New Use Location

Adding a New Use Location Instructions (PDF, 27 KB)

Attachment H - Waste Disposal (MS Word, 162 KB)

Attachment I - Emergency Procedures (MS Word, 118 KB)

Attachment L - Air Emissions Questionnaire to Determine Exempt Status (MS Word, 129 KB)

Performing In-House Dose Rate Instrument Calibrations

    Attachment C - Calibration of Exposure Rate Instruments (MS Word, 117 KB)

Performing In-House Count Rate Instrument Calibrations

   Submit your own procedures


Contact Information
 

For more information call or email the appropriate person.  Send written correspondence to the address below or fax to 360-236-2255.

 

Arden Scroggs, Manager   360-236-3221
Joy Redman, Administrative Assistant   360-236-3220
   
General Licensing  

Billie Harvey, Health Physicist, General Licensing

  360-236-3266
   
Industrial Licensing  

Craig Lawrence, Health Physicist, Industrial Program Manager

  360-236-3229

Steve Matthews, Health Physicist

  360-236-3226

Pamela Walsh, Health Physicist

  360-236-3227
   
Laboratory Licensing  

Anine Grumbles, Health Physicist, Laboratory Program Manager

  360-236-3222

Jennifer Serne, Health Physicist

  360-236-3269
   
Medical Licensing  

Curt DeMaris, Health Physicist, Medical Program Manager

  360-236-3223

James Killingbeck, Health Physicist

  360-236-3224
 

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Washington State Department of Health

Office of Radiation Protection                                       Physical Address:
P.O. Box 47827                                                            111 Israel Road SE, TC2
Olympia, Washington 98504-7827                                  Tumwater, Washington 98501
(360) 236-3300

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Last Update : 09/16/2009 05:35 PM