AERB/RSD/IR-CR/U-1

UNDERTAKING FORM

DUTIES & FUNCTIONS OF CERTIFIED INDUSTRIAL RADIOGRAPHERS

1. To assist the Site-in-charge in carrying out the radiography job at the site in a safe manner. To start the
work with the permission of the site-in-charge and to carry out radiographic job under the general
supervision of the site-in-charge.

2. To always wear the chest badge on the shirt near the chest & wrist badge to the wrist while working in
the radiation field.

3. To regularly maintain the up-to-date record of the personnel dose received by him.

4. To inform the Site-in-charge/ management in the event of any suspected over exposure to radiation for
himself or any incident causing damage to the source/ device while handling or any other alarming
situation involving the radiation source.

5. To promptly inform the site-in-charge in the event of any accidental exposure to the film badge or any
misuse of the source/film badge.

6. To make sure that all the materials such as radiation survey meters, radiation warning sign boards etc.
are available for radiation protection before starting the exposure.

7. To ensure that the radiography exposure devices are duly brought back to the storage room after use
and stored safely inside the storage room.

8. To make relevant entries in the log book after completion of the day’s work.

9. To carry the radiographer’s certificate issued by the RP&AD with himself while handling radiography
sources.

10. To maintain cordial relations with other workers of the company at the site and to follow any specific
instruction issued by the site-in-charge or R.S.O. scrupulously in respect of safe handling of radiography
source at the site and not to leave the site without obtaining prior permission from the site-in-charge.

11. To promptly inform, Head, RSD, AERB in the event of leaving the institution.

I have fully understood the above duties and functions and I hereby undertake that I shall scrupulously
follow the same while discharging my duties as a certified radiographer. I also undertake that I shall
scrupulously observe the safe handling procedures stipulated by the Radiological Safety Division (RSD),
AERB while handling industrial radiography sources and that I am liable for appropriate action by the RSD,
AERB in the event of any violation of the above duties & responsibilities and safe handling procedure.

( )
Sign. Of Certified Radiographer
Date :
Name :

Cert. No.:
Endorsed by : Signature of Head of Institution
with date and seal