State Agencies | Online Services
 

Agreement State Program

The Agreement State Program oversees the licensing, inspection and enforcement of all radioactive materials handlers regulated by the State of Ohio, for NORM (naturally-occurring) and TENORM (technologically enhanced naturally occurring) radioactive materials, and for certain byproduct, special nuclear and source material, under the agreement with the U.S. Nuclear Regulatory Commission (NRC).

The program applied to the U.S. Nuclear Regulatory Commission for Ohio to become an Agreement State with NRC. As an Agreement State, Ohio assumed responsibility for regulating most uses of byproduct material, special nuclear material and source material in Ohio on August 31, 1999.

The program licenses all handlers of radioactive materials not under the jurisdiction of the federal government and provides regulatory oversight throughout operation and license termination for radioactive materials users, facilities and organizations in Ohio other than nuclear power plants and certain government facilities, which are under federal jurisdiction.

Program staff members respond to incidents where lack of control of radioactive materials results in improper radiation exposure to workers or the public, personal or property contamination or damaged or missing sources or devices that contain radioactive material.

This section also oversees approval of sealed radiation sources and devices.

Forms

All files are in .PDF format. The free Adobe Acrobat Viewer is required to view them.

 Form #  Form Name Revision Date  
HEA0113       General License Inventory 12/12
HEA0122 Authorized Medical Physicist Training and Experience and Preceptor Attestation 6/13
HEA0123 Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation 6/13
HEA0124 Authorized User Training and Experience and Preceptor Attestation (for uses defined under OAC 3701:1-58-32, 3701:1-58-34, and 3701:1-58-53) 6/13
 HEA0125 Authorized User Training and Experience and Preceptor Attestation (Manual Brachytherapy, Ophthalmic Use of Strontium-90, Remote Afterloader, Teletherapy and Gamma stereotactic radiosurgery) 6/13
 HEA0126 Authorized User Training and Experience and Preceptor Attestation (for uses defined under OAC 3701:1-58-37) 6/13
 HEA0189 Sealed Source and Device Review Checklist  1/16
 HEA0190 Sealed Source and Device Transfer Review Checklist  4/16
 HEA0191

Sealed Source and Device Quality Assurance (QA) Checklist for Distributors Only  

 4/16
 HEA0192     Sealed Source and Device Quality Assurance (QA) Checklist for Manufacturer/Distributors  4/16
 HEA5101 Lifetime Occupational Exposure History (*Required 8 1/2 x 14 in. paper) 6/02
 HEA5102 Occupational Exposure Record for Monitoring Period 6/02
 HEA5115 Use of Depleted Uranium Under General License 3/11
 HEA5119 Certificate of Disposition of Materials 6/12
 HEA5133 Application for a License for Radioactive Material 3/11
 HEA5509 Radiation Safety Officer Training and Experience and Preceptor Attestation 4/12
 HEA5518 In-Vitro Testing With Radioactive Material Form 3/11
 HEA5522  Reciprocity Application and Reporting  2/11
     
 

 Mailing Address:
Ohio Department of Health
Bureau of Environmental Health and Radiation Protection
Agreement State Program
246 North High Street
Columbus, OH 43215

Telephone: (614) 644-2727
Emergency Telephone: (614) 722-7221
Fax: (614) 466-0381

E-mail: Bradiation@odh.ohio.gov

Last Updated: 4/12/2016