Radioactive Materials Purchase Approval Form

This form is used to request EH&S approval prior to placing a radioactive materials order with an outside vendor

As a result of Health and Safety operations taking place on both the 9 th and Colorado and the Anschutz Medical Campus, our administrative staff has moved to the Anschutz campus, and the 9/CO Cooling Tower will be locked during regular business hours. Beginning October 4 th, 2004, all Radioactive Materials Packages will be delivered directly to your lab by Health and Safety staff. Typically the commercial carriers arrive between the hours of 9 and 11:00 , after the packages are received they will be processed and delivered to your laboratory in the late morning or early afternoon. We will continue to contact your lab when the packages arrive to notify you that your material will be delivered shortly.

For all other matters that you may have visited the cooling tower for in the past you may contact our staff at 4-0345 to make an appointment ensuring that a staff member will be available to assist you.

Instructions:

1.     Complete ALL fields EXCEPT the SHADED areas

2.     Send the form to HSD by clicking on the submit button below

3.     HSD will review the Principal Investigator's authorization and the laboratory possession limits. HSD will provide a requisition (Reference) number for each isotope and compound requested by return email within two hours (next business day if form submitted after 3:00 PM). If you need a requisition (Reference) number immediately, please call 724-0345.

4.     Upon receiving a Requisition (Reference) Number from HSD, you create a Department Purchase Order (DPO) and place your order directly with the vendor of choice.

5.     Do not place the order with the vendor until HSD provides a requisition (Reference) number by return email. Please inform your vendors that isotope shipment must be identified by the Principal Investigator and the requisition (Reference) number on both the address label and the packing list.

6.    Please click here for a downloadable version of this form.

Note: If you have any questions regarding this form, please call HSD at 303/724-0345 .

All Radioactive materials used at the 9th and Colorado Blvd. campus must be delivered to the following address:

Cooling Tower HAZMAT

4405 E. Eighth Avenue

Denver, CO 80220

 

All Radioactive materials used at the Fitzsimons campus must be delivered to the following address:

Health & Safety Support Facility

13178 E. 19th Ave.

Aurora, CO 80045

Date:

Principal Investigator Name: 
Requestor Name:
Phone #:

Email:

Campus Box:

Bldg:

Room:

  Note: GE Healthcare (formerly Amersham) discontinued supplying short-lived isotopes at the end of November 2007.

User's Name Vendor Unit (# of Vials) Catalog Item # Compound Isotope Activity per Unit (mCi) Requisition (Reference) #
For HSD use only
For HSD use only
For HSD use only

For Standing Purchase Requests only:  

Vendor

Start Date

End Date

Activity per shipment (mCi)

Total Activity (mCi)

Compound

Isotope

Requisition (Reference) Number

For HSD use only

For HSD use only 

For HSD use only

 Please Click Only ONCE on the Submit Button Below

 

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