Notes
A. The pertinent paragraphs regarding this form are in Administrative Code
DHS
157.88, Subchapter X, #7, and are:
-
DHS 157.88 Posting, notification and reporting
requirements. (1) POSTING OF NOTICES TO WORKERS. (a) Except as
provided in par. (b), a licensee or registrant shall post current
copies of all the following documents in a conspicuous location that
is accessible to workers on the way to or from the worker’s work
station or job location:
7. A "Notice to
Employees" form that details the types of information that
employers must give to their employees and department contact
information.
Note: The
"Notice to Employees" form may be obtained from the Department
by writing: Department of Health Services, Radiation
Protection Section, P.O. Box 2659, Madison WI 53701-2659.
This is a required form. See DHS 157
(pdf, 717 kb, pg 415) or the
unofficial version at Subchapter X
(pdf, 10.5 kb) which can be printed
separately from the complete DHS 157 with this pdf file.
B. The pertinent paragraphs regarding this form are in Administrative Code
DHS
157.88, Subchapter X, #6, and are:
-
DHS 157.88 Posting, notification and reporting
requirements. (1) POSTING OF NOTICES TO WORKERS. (a) Except as
provided in par. (b), a licensee or registrant shall post current
copies of all the following documents in a conspicuous location that
is accessible to workers on the way to or from the worker’s work
station or job location:
-
6. Emergency procedures that apply to
activities conducted under the license or registration.
This is a required form. See DHS 157
(pdf, 717 kb, pg 415) or the
unofficial version at Subchapter X
(pdf, 10.5 kb) which can be printed
separately from the complete DHS 157 with this pdf file.
C. The pertinent paragraphs regarding this form are in Administrative Code
DHS 157.88, Subchapter X(3), and are:
-
(3) NOTIFICATIONS AND REPORTS TO INDIVIDUALS. (a) Radiation
exposure reports. Every 12 months, a licensee or registrant shall
provide a written report of radiation exposure to each employee who is
required to be monitored for radiation exposure under s. DHS 157.25
(2). The report shall include all of the following:
-
1. Name of the licensee or registrant, the name of the
individual and the individual’s identification number.
-
2. Results of any measurements, analyses and
calculations of radioactive material deposited or retained in the body
of the individual being monitored.
-
3. Any order issued under this chapter.
-
4. Any condition of the license or registration as
shown in records maintained by the licensee or registrant under s. DHS
157.31 (7) that relates to radiation exposure of employees.
-
5. Each calendar quarter in which the worker's
activities involved exposure to sources of radiation and the dates and
locations of work. If a report under this paragraph is being provided
to employees under par. (b) or (c), the report shall include the
calendar quarter within which the employee terminates employment or
requests a report under this subsection.
-
6. The radiation exposure report for each year the
worker was required to be monitored under s. DHS 157.25 (2).
-
7. The statement: "This report is furnished to
you under the provisions of Wisconsin Administrative Code, Chapter DHS
157, Radiation Protection. You should retain this report for future
reference."
-
(b) Reports to employees upon termination. A
licensee or registrant shall provide the report required under par.
(a) to each employee within 30 days of the employee’s termination.
-
(c) Reports to employees upon request. A
licensee or registrant shall provide an employee with the report
required under par. (a) within 30 days of receiving a written request
from the employee, or within 30 days after the dose of the individual
has been determined by the licensee or registrant, whichever is later.
-
(d) Reports to the department. A licensee or
registrant required to provide a report under s. DHS 157.32 (2) to (4)
shall, on the same day, provide a copy of the report to the subject of
the report.
-
(e) Exposure request at time of termination. At
the request of a licensee’s or registrant’s employee or of a
worker employed by another person but working in a licensee’s or
registrant’s facility, a licensee or registrant shall, upon a worker’s
termination, provide to the worker, or to the worker’s designee, a
written report of the radiation dose received by that worker from
operations of the licensee or registrant during the current calendar
quarter or fraction thereof. If the most recent individual monitoring
results are not available at that time, a licensee or registrant shall
provide a written estimate of the dose, clearly indicating that it is
an estimate.
-
(f) Documentation required to be maintained. Documentation
that a report was provided as required under this subsection shall be
maintained by the licensee or registrant for 3 years after generation
of the documentation.
This is a required form. See DHS
157
(pdf, 717 kb, pg 415) or the
unofficial version at Subchapter X
(pdf, 10.5 kb) which can be printed
separately from the complete DHS 157 with this pdf file.
PDF: The Free Adobe Acrobat Reader software is needed to view print
portable document format (PDF) files. Learn
more.
Last Revised: May 19, 2009 |
