Special Form Certificates

Radiation Safety» Special Form Certificates

Source Code

Nuclide

Activity mCi

Special Form Certificate

View

CC*

Cs-137

8

USA/0673/S
replaces GB/140/S

view

CA*

Am-241

40

USA/0632/S
replaces GB/7/S

view

CAA*

Am-241

40

USA/0632/S
replaces GB/7/S

view

40*

Cs-137

8

USA/0673/S
replaces GB/140/S

view

45*

Am-241

10

USA/0659/S
replaces GB/029/S

view

46

Am-241

40

USA/0263/S-96
replaces USA/0263/S

view

47*

Am-241

40

USA/0632/S
replaces GB/7/S

view

50

Cs-137

8

USA/0673/S
replaces GB/140/S

view

52

Cs-137

5

USA/0670/S
replaces GB/113/S

view

54

Am-241

100

USA/0043/S
replaces GB/0043/S -85

view

55*

Am-241

100

USA/0620/S
replaces GB/149/S

view

57

Am-241

10

USA/0632/S
replaces GB/7/S

view

74

Cf-252

0.1

USA/0356/S

view

75*

Cs-137

8

USA/0614/S
replaces GB/353/S

view

76

Cf-252

0.06

USA/0356/S

view

77

Cs-137

8

USA/0356/S

view

78

Am-241

40

CZ/1009/S

view

82

Co-60

0.06

USA/0502/S
replaces GB/193/S

view

98

Am-241

10

USA/0733/S-96
replaces GB/145/S-96

view

470

Am-241

40

USA/462/S

view

570

Am-241

10

CZ/1009/S

view

750

Cs-137

8

USA/0614/S
replaces GB/353/S

view

751

Cs-137

8

USA/0614/S
replaces GB/353/S

view

752

Cs-137

8

USA/0614/S
replaces GB/353/S

view

* The certificate places restrictions on source manufacture dates. Sources with serial numbers below those shown in the table below are no longer certified as special form:

Source Code

Affected Serial Numbers

Nuclide

Activity, mCi

Sources Manufactured Before

Used on Gauge Models

33

All S/N

Cs/AmBe

10/50

4/1/81

257,1403

34

All S/N

Cs/AmBe

10/50

4/1/81

1403, 2376, 2401

47

<740

Am-241:Be

40

5/17/77

3401, 3411

48

All S/N

Am-241:Be

40

5/17/77

3401, 3411

55

<8132;
17978 to 18080

Am-241:Be

100

2/23/88

1255, 1257, 3241

60

All S/N

Am-241:Be

300

2/23/88

2226, 3241

63

All S/N

Cs/AmBe

10/50

4/1/81

1403, 2401, 2402, 2451

64

All S/N

Cs/AmBe

8/50

4/1/81

2401, 2402, 2452

65

All S/N

Cs/AmBe

10/50

4/1/81

2401

70

All S/N

Cs/AmBe

8/125

4/1/81

2401

Please refer to the Special Gauge Shipping Instructions for further details regarding transport of gauges with sources that are not certified as special form.

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The serial number for each source has a two or three digit prefix, which is related to the applicable special form certificate as shown in the table below. For example, a source with serial number 75-2345 (prefix 75) would use special form certificate USA/0614/S. The certificates are in Adobe Acrobat 3.0 format.