Irradiating Apparatus Licence and Application Procedures

Form required
DH 1271(S) & IA-P2	Sample

Guidance notes for IA-P2 form

General

• You need licence for possession of each irradiating apparatus in a functional state.
• Submit separate application for each irradiating apparatus.
• Submit with this application form a floor plan of the premises showing
  1. the location of the irradiating apparatus within the room,
  2. the dimensions of the room,
  3. the type and thickness of the construction material of the door(s), walls, floor and ceiling of the room,
  4. direction of the primary radiation beams, and
  5. utilization of the adjacent areas, e.g. office, reception, corridor, darkroom, store room, etc. (Sample of floor plan drawings)

Part A

Complete either A1 or A2 and rest of the questions in Part A :

For Section A1, please submit

1. A copy of Identity Card / Document of the applicant.
2. 2 recent photos of size 45 x 60 (mm).

For Section A2, please submit

1. A copy of the business registration certificate.
2. A copy of Identity Card / Document of the authorized person.

Part B

1. Fill in detailed information of the irradiating apparatus in the table.
2. Tick the box for relocation within the original premises in your application.
3. Submit technical specifications of the irradiating apparatus with your application.

Part C

1. Tick the appropriate box related to shielding of the irradiating apparatus.
2. Fill in shielding information for floor, ceiling, walls and doors as required.

Part D

Tick the boxes on personal protective measures available in the premises. You may tick more than one box.

Part E

1. Specify at least one person who is qualified, and is holding a valid licence, to use the concerned type of irradiating apparatus.
2. Tick the appropriate box if contrast media is intended to be used.

Part F

Sign the declaration.

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