Circular No. 08/2010/TT-BKHCN guiding the declaration and licensing of radiation

• Official number: 08/2010/TT-BKHCN
• Legislation Type: Circular
• Organization: The Ministry of Science and Technology
• Signer: Le Dinh Tien
• Issued Date: 22/07/2010

THE MINISTRY OF SCIENCE AND TECHNOLOGY -------	SOCIALIST REPUBLIC OF VIET NAM Independence - Freedom – Happiness ---------
No. 08/2010/TT-BKHCN	Hanoi, July 22, 2010

CIRCULAR

GUIDING THE DECLARATION AND LICENSING OF RADIATION JOBS, AND GRANT OF RADIATION EMPLOYEE'S CERTIFICATES

Pursuant to the June 3, 2008 Law on Atomic Energy;

Pursuant to the Government's Decree No. 07/ 2010/ND-CP of January 25, 2010, detailing and guiding a number of articles of the Law on Atomic Energy;

Pursuant to the Government s Decree No. 28/ 2008/ND-CP of March 14, 2008, defining the functions, tasks, powers and organizational structure of the Ministry of Science and Technology;

The Ministry of Science and Technology guides the declaration of, and grant of licenses for, radiation jobs, and grant of radiation employee's certificates as follows:

Chapter 1

GENERAL PROVISIONS

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1. The declaration of radioactive substances, radioactive waste, source nuclear materials, nuclear materials, radiation devices and nuclear devices.

2. The grant, extension, modification and re-grant of licenses for the following radiation jobs:

a/ Operating irradiation devices;

b/ Using radiation devices;

c/ Using radioactive substances;

d/ Producing radioactive substances;

e/ Processing radioactive substances;

f/ Storing radioactive substances;

g/ Treating and storing radioactive waste and spent radioactive sources;

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i/ Importing radioactive substances, source nuclear materials, nuclear materials and nuclear devices;

j/ Packing and transporting radioactive substances, source nuclear materials and nuclear materials;

k/ Transporting radioactive substances, source nuclear materials and nuclear materials in transit via the Vietnamese territory;

l/ Building radiation facilities;

m/ Changing the sizes and operation scopes of radiation facilities;

n/ Terminating the operation of radiation facilities.

3. The grant of certificates to radiation employees who perform the jobs specified in Clause 1. Article 28 of the Law on Atomic Energy.

Article 2. Subjects of application

This Circular applies to organizations and individuals involved in the jobs specified in Article 1 of this Circular.

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In this Circular, the terms below are construed as follows:

1. Use of radioactive substances means the use of an open radioactive source and discrete sealed radioactive sources not mounted in devices.

2. Operation of irradiation devices means the use of accelerators, radiotherapy devices or irradiation devices for sterilizing and treating materials.

3. Use of radiation devices means the use of radiation devices mounted with radioactive sources or X-ray emitting devices, excluding accelerators, radiotherapy devices or irradiation devices for sterilizing and treating materials.

4. Use of radiographic devices for medical diagnosis means the use of X-ray emitting devices for medical diagnosis, including integrated endoscopic devices, light intensifier X-ray image devices, devices for dental radiography, devices for breast radiography, mobile radiographic devices, computed tomography (CT) scanners, radiographic devices for bone densitometry, devices for intervention and angiography radiography, and veterinary radiographic devices,

5. Storage of radioactive substances means the temporary storage of radioactive substances from the time they exist to the time they are put into use or transferred to other organizations or individuals.

6. Change of the size and operation scope of a radiation facility means the relocation of a fixed radiation source or change of the operation limit against those indicated in the license, change of safety-affecting technical parameters of radiation devices, or restructuring of the radiation safety assurance system.

Article 4. Declaration

1. Within 7 working days after possessing radioactive substances, radioactive waste and radiation devices ineligible for declaration exemption or source nuclear materials, nuclear materials and nuclear devices, organizations and individuals shall declare them to competent agencies defined in Article 8 of this Circular.

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3. When receiving radioactive waste or spent radioactive sources, operators of national radioactive waste repositories or radioactive waste and spent radioactive source treatment and storage service establishments shall declare them to competent agencies under Clause 1 of this Article.

Article 5. Licensing of radiation jobs

1. Before performing radiation jobs specified in Clause 2. Article 1 of this Circular, organizations and individuals shall carry out procedures to apply for licenses.

2. If organizations and individuals fail to use radioactive substances or to transfer radioactive substances to other organizations or individuals, within one month after possessing them, they shall carry out procedures to apply for licenses to store radioactive substances.

3. After completing the construction or changing the sizes and operation scopes of radiation facilities, organizations and individuals shall, before putting such facilities into operation, carry out procedures to apply for licenses to perform radiation jobs.

4. Organizations and individuals that possess spent radioactive sources in licensed radiation jobs shall carry out procedures to apply for licenses to treat and store spent radioactive sources before doing so. This provision is not applicable to national radioactive substance repositories and radioactive waste and spent radioactive source treatment and storage service establishments.

5. An applicant for permission to simultaneously perform different radiation jobs or use different radiation sources may be granted a common license-

Article 6. General requirements on dossiers of application for licenses or radiation employee's certificates

1. Information provided in the dossiers must be accurate. Diplomas, certificates or other papers subject to the validity requirement must remain valid in the dossier processing time. Foreign-language documents must be translated into Vietnamese. Copies and translations must be notarized or certified by applicants.

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Article 7. Conditions for obtaining licenses or radiation employee's certificates

1. To obtain a license to perform radiation jobs, an organization or individual must fully meet the following conditions:

a/ Submitting a complete dossier under this Circular;

b/ Paying the radiation safety appraisal charge and licensing fee under law;

c/ Satisfying all the conditions specified in Article 75 of the Law on Atomic Energy;

d/ Radiation employees possess certificates of training in radiation safety.

2. To obtain a radiation employee's certificate, an individual must fully meet the following conditions:

a/ Submitting a complete dossier under this Circular;

b/ Paying the licensing fee under law; d Satisfying all the conditions specified in Clause 2, Article 28 of the Law on Atomic Energy.

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DECLARATION PROCEDURES

Article 8. Decentralization for declaration

1. Organizations and individuals that possess radioactive substances, radioactive waste, source nuclear materials, nuclear materials, nuclear devices or radiation devices, except those specified in Clauses 2 and 3 of this Article, shall declare them to the Radiation and Nuclear Safety Department.

2. Organizations and individuals that possess radiographic devices for medical diagnosis to be used in two or more provinces or centrally run cities (below referred to as provinces) shall declare them to the Science and Technology Departments of the provinces in which they are headquartered.

3. Organizations and individuals that possess radiographic devices for medical diagnosis other than those specified in Clause 2 of this Article shall declare them to the Science and Technology Departments of the provinces in which such devices are installed and used-

Article 9. Declaration procedures

1. Organizations and individuals shall declare each radioactive source, radiation device, source nuclear material, nuclear material and radioactive waste to a competent agency in relevant forms provided in Appendix I to this Circular.

2. Within 5 working days after receiving a slip of declaration, a competent agency shall issue a written certification of declaration, made according to the form provided in Appendix IV to this Circular.

Chapter III

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Article 10. Dossier of application for a license to operate irradiation devices or use radiation devices and radioactive substances

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of the radiation employee and person in charge of safety work, made according to form 01 -I/ATBXHN provided in Appendix I to this Circular;

3. A slip of declaration of sealed and open radiation sources, accelerators, X-ray emitting devices and neutron emitting devices, made according to the relevant form provided in Appendix I to this Circular;

4. A report on safety assessment of the operation of irradiation devices, use of radiation devices or radioactive substances, made according to form 01-III/ATBXHN provided in Appendix III to this Circular;

5. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required:

6. A copy of the producer's document providing information as declared in the slip of declaration of sealed and open radiation sources, accelerators. X-ray emitting devices and neutron emitting devices. When this document is unavailable, the applicant shall re-determine the activity rates and names of radioisotopes of sealed and open radioactive sources and technical parameters of accelerators. X-ray emitting devices and neutron emitting devices;

7. A copy of the service contract on individual irradiation dosimetry, for organizations and individuals that possess service registration papers for individual irradiation dosimetry;

8. Copies of radiation employee's certificates of the person in charge of safety work and employee performing the jobs specified in Clause 1, Article 28 of the Law on Atomic Energy. When this certificate is unavailable, a dossier of application for a radiation employee's certificate under Article 22 of this Circular shall be submitted together with a dossier of application for a license to perform radiation jobs;

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This Article is not applicable to applications for a license to use radiographic devices for medical diagnosis.

Article 11. Dossier of application for a license to use radiographic devices for medical diagnosis

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of the radiation employee and person in charge of safety work, made according to form 01-I/ATBXHN provided in Appendix I to this Circular;

3. A slip of declaration of radiographic devices for medical diagnosis, made according to form 06-I/ATBXHN provided in Appendix I to this Circular;

4. A report on safety assessment of the use of radiographic devices for medical diagnosis, made according to form 02-III/ATBXHN provided in Appendix III to this Circular;

5. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required;

6. A copy of the producer's document providing information as declared in the slip of declaration of radiographic devices for medical diagnosis. When this document is unavailable, the applicant shall re-determine technical parameters of such devices;

7. A copy of the service contract on individual irradiation dosimetry, for organizations and individuals that possess service registration papers for individual irradiation dosimetry;

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9. Translations of foreign-language documents.

Article 12. Dossier of application for a license to produce and process radioactive substances

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of the radiation employee and person in charge of safety work, made according to form 01-I/ATBXHN provided in Appendix I to this Circular;

3. A report on safety assessment of the production and processing of radioactive substances, made according to form 03-111/ ATBXHN provided in Appendix III to this Circular;

4. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required;

5. A copy of the service contract on individual irradiation dosimetry, for organizations and individuals that possess service registration papers for individual irradiation dosimetry;

 6. Copies of radiation employee's certificates of the person in charge of safety work and employee performing the jobs specified in Clause 1, Article 28 of the Law on Atomic Energy. When this certificate is unavailable, a dossier of application for a radiation employee's certificate under Article 22 of this Circular shall be submitted together with a dossier of application for a license to perform radiation jobs.

Article 13. Dossier of application for a license to store radioactive substances

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2. A slip of declaration of sealed or open radioactive sources, made according to the relevant form provided in Appendix I to this Circular;

3. A report on safety assessment of the storage of radioactive substances, made according to form 04-III/ATBXHN provided in Appendix III to this Circular.

Article 14. Dossier of application for a license to treat and store spent radioactive sources

1. All application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of sealed radioactive sources, made form 04-1/ATBXHN provided in Appendix 1 to this Circular;

3. A report on safety assessment of the storage of spent radioactive substances, made according to form 04-III/ATBXHN provided in Appendix III to this Circular.

Article 15.Dossier of application for a license to treat and store radioactive waste and spent radioactive sources in national radioactive waste repositories or radioactive waste and spent radioactive source treatment and storage service establishments

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of the radiation employee and person in charge of radiation safety work, made according to form 01-1/ATBXHN provided in Appendix I to this Circular;

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4. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required;

5. A copy of the service contract on individual irradiation dosimetry, for organizations and individuals that possess service registration papers for individual irradiation dosimetry;

6. Copies of radiation employee's certificates of the person in charge of safety work and employee performing the jobs specified in Clause 1, Article 28 of the Law on Atomic Energy. When this certificate is unavailable, a dossier of application for a radiation employee's certificate under Article 22 of this Circular shall be submitted together with a dossier of application for a license to perform radiation jobs.

Article 16. Dossier of application for a license to export radioactive substances, source nuclear materials, nuclear materials or nuclear devices

1. An application for a license to perform radiation jobs, made according to form 02-11/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of sealed and open radiation sources, source nuclear materials, nuclear materials or nuclear devices, made according to the relevant form provided in Appendix I to this Circular;

3. A report on safety assessment of the export of radioactive substances, source nuclear materials, nuclear materials or nuclear devices, made according to form 06-III/ATBXHN provided in Appendix HI to this Circular;

4. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required;

5. A copy of the producer's document providing information as declared in the slip of declaration of sealed and open radiation sources, radioactive substances, source nuclear materials, nuclear materials or nuclear devices. When this document is unavailable, the applicant shall re-determine the activity rates and names of radioisotopes of sealed and open radioactive sources, types and chemical composition of source nuclear materials and nuclear materials. and technical parameters of nuclear devices;

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7. A copy of the import license issued by a competent authority of the importing country to the importer, for nuclear materials and radioactive substances of a danger level above average;

8. Translations of foreign-language documents.

Article 17. Dossier of application for a license to import radioactive substances, source nuclear materials, nuclear materials or nuclear devices

1. An application for a license to perform radiation jobs, made according to form 02-11/ ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of sealed and open radiation sources, source nuclear materials, nuclear materials or nuclear devices, made according to the relevant form provided in Appendix I to this Circular;

3. A report on safety assessment of the import of radioactive substances, source nuclear materials, nuclear materials or nuclear devices, made according to form 06-III/ATBXHN provided in Appendix III to this Circular:

4. A copy of the organization's establishment decision, business registration certificate, investment certificate or professional practice registration paper. When this decision, certificate or paper is lost, certification of the agency that signs such decision or grants such certificate or paper is required;

5. A copy of the producer's document providing information as declared in the slip of declaration of sealed or open radiation sources, radioactive substances, source nuclear materials, nuclear materials or nuclear devices;

6. A copy of the purchase and sale contract or agreement on the transfer and receipt of radioactive sources, signed between the Vietnamese importer and foreign exporter;

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8. Translations of foreign-language documents.

Article 18. Dossier of application for a license to pack, transport and transit radioactive substances, radioactive waste, source nuclear materials and nuclear materials

1. An application for a license to perform radiation jobs, made according to form 03-II/ ATBXHN or 04-II/ATBXHN provided in Appendix II to this Circular;

2. A slip of declaration of sealed and open radioactive sources, radioactive waste, source nuclear materials and nuclear materials, made according to the relevant form provided in Appendix I to this Circular;

3. A slip of declaration of the goods escort, made according to form 02-1/ATBXHN provided in Appendix I to this Circular;

4. A report on safety assessment of the packing, transportation or transit of radioactive substances, radioactive waste, source nuclear materials and nuclear materials, made according to form 07-III/ATBXHN provided in Appendix III to this Circular;

5. The transportation contract, in case the consigner is not the transporter;

6. A copy of radiation employee's certificate of the person in charge of incident response. When this certificate is unavailable, a dossier of application for a radiation employee's certificate under Article 22 of this Circular shall be submitted together with a dossier of application for a license to perform radiation jobs.

Article 19. Dossier of application for a license to build radiation facilities

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2. A report on safety analysis of the construction of a radiation facility, made according to form 08-III/ATBXHN provided in Appendix III to this Circular.

Article 20. Dossier of application for a license to change the size and operation scope of a radiation facility

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A report on safety analysis of the change of the size and operation scope of a radiation facility, made according to form 09-III/ATBXHN provided in Appendix III to this Circular.

Article 21. Dossier of application for a license to terminate the operation of a radiation facility

1. An application for a license to perform radiation jobs, made according to form 01-II/ ATBXHN provided in Appendix II to this Circular;

2. A report on safety analysis of the termination of the operation of a radiation facility, made according to form 10-III/ATBXHN provided in Appendix III to this Circular.

Article 22. Dossier of application for a radiation employee's certificate

1. An application for the certificate, stuck with a photo and made according to form 05-II/ATBXHN provided in Appendix II to this Circular;

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3. Copies of diplomas and professional certificates relevant to the to-be-performed job;

4. A health certificate issued by a district- or higher-level health establishment within 6 months by the time of submission of the certificate application dossier;

5. Three 3 x 4 cm photos.

Chapter IV

GRANT OF LICENSES FOR RADIATION JOBS OR RADIATION EMPLOYEE'S CERTIFICATES

Article 23. Competence to grant licenses for radiation jobs and radiation employee's certificates

1. The Ministry of Science and Technology may grant the following licenses for radiation jobs and radiation employee's certificates:

a/ License for operating irradiation devices;

b/ License for producing radioactive substances;

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d/ License for transiting radioactive substances, source nuclear materials or nuclear materials;

e/ License for packing and transporting source nuclear materials or nuclear materials;

f/ License for exporting or importing source nuclear materials, nuclear materials and nuclear devices;

g/ Radiation employee's certificate to chief engineers of nuclear reactors, heads of operating shifts of nuclear reactors, managers of nuclear fuels, and operators of nuclear reactors.

2. The Radiation and Nuclear Safely Department may grant licenses for radiation jobs and radiation employee's certificates, except the cases specified in Clauses I and 3 of this Article;

3. Provincial Science and Technology Departments may grant licenses for using radiographic devices for medical diagnosis and radiation employee's certificates to persons in charge of safety work at medical-diagnosis radiographic institutions operating in provinces.

In case medical-diagnosis radiographic devices of an organization or individual headquartered in province A are installed and used in province B, the Science and Technology Department of province B may grant a license for using medical-diagnosis radiographic devices and a radiation employee's certificate to the person in charge of safety work.

In case mobile medical-diagnosis radiographic devices are used in different provinces, the Science and Technology Department of the province in which device owners are headquartered may grant a license for using medical diagnosis radiographic devices, and a radiation employee's certificate to the person in charge of safety work.

4. When a health establishment performs different radiation jobs involving the concurrent use of medical-diagnosis radiographic devices and radioactive substances (nuclear medicine) or operating irradiation (radiotherapy) devices, it may request the Radiation and Nuclear Safety Department or local Science and Technology Department to grant a radiation employee's certificate to the person in charge of safety work.

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1. Applicants for licenses to perform radiation jobs or radiation employee's certificates specified in Articles 1. 2 and 4. Article 23 of this Circular shall submit dossiers at the Radiation and Nuclear Safety Department and pay charges and fees under law.

Applicants for licenses to perform radiation jobs involving the use of medical-diagnosis radiographic devices or for radiation employee's certificates specified in Clauses 3 and 4, Article 23 of this Circular shall submit dossiers at provincial Science and Technology Departments and pay charges and fees under law.

2. Within the time limit specified at Point a or c, Clause 2, Article 77 of the Law on Atomic Energy, the Radiation and Nuclear Safety Department shall appraise dossiers and grant licenses for radiation jobs in the case specified in Clause 2, Article 23 of this Circular, made according to form 02-V/ATBXHN provided in Appendix V to this Circular, or submit dossiers to the Ministry of Science and Technology for the grant of licenses in the case specified in Clause 1. Article 23 of this Circular, made according to form 01-V/ATBXHN provided in Appendix V to this Circular.

Within the time limit specified at Point b. Clause 2. Article 77 of the Law on Atomic Energy, the provincial Science and Technology Department shall appraise dossiers and grant licenses for use of radiographic devices for medical diagnosis, made according to form 03-V/ATBXHN provided in Appendix V to this Circular.

3. Within 10 working days after receiving a complete and valid dossier, a competent agency shall appraise it and grant a radiation employee's certificate, made according to a form provided in Appendix VI to this Circular, except the case specified in Clause 4 of this Article.

4. When a dossier of application for a radiation employee's certificate is submitted together with a dossier of application for a license for radiation jobs, the time limit for appraisal of the dossier of application for, and grant of, a radiation employee's certificate will correspond to the time limit for processing the dossier of application for a license for radiation jobs.

5. If refusing to grant a license or certificate, within the time limit specified in Clause 2. 3 or 4 of this Article, a competent agency shall issue a written reply clearly stating the reason.

Article 25. Validity term of a license for radiation jobs and radiation employee's certificate

1. A license for exporting and importing open radioactive substances for use in nuclear medicine or application of radioisotope marking is valid for 12 months for many shipments. A license for exporting and importing source nuclear materials, nuclear materials, nuclear devices and other radioactive substances is valid for 6 months for each shipment.

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3. A license for operating irradiation devices is valid for 5 years.

4. A license for radiation jobs other than those specified in Clauses I, 2 and 3 of this Article is valid for 3 years.

5. A radiation employee's certificate is valid for 5 years.

Chapter V

EXTENSION. MODIFICATION AND RE-GRANT OF LICENSES AND RE-GRANT OF RADIATION EMPLOYEE'S CERTIFICATES

Article 26. Extension of licenses

1. If wishing to continue performing radiation jobs beyond the validity term indicated in their licenses, organizations or individuals shall carry out license extension procedures and submit dossiers to a competent agency at least 60 days before their licenses expire. After this time limit, they shall carry out procedures and pay charges and fees as for a new license.

2. A dossier of request for extension of a license comprises:

a/ A written request for extension of a license, made according to form 06-II/ATBXHN provided in Appendix II to this Circular;

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c/ A report on radiation safety assessment, made according to the relevant form provided in Appendix III to this Circular;

d/ A copy of the license.

3. Dossiers of request for extension of licenses shall be submitted at competent agencies defined in Clause 1. Article 24 of this Circular.

Within the time limit specified in Clause 2, Article 77 of the Law on Atomic Energy, a competent agency shall extend a license or issue a written refusal clearly stating the reason.

4. The term of an extended license will be counted from the date the old license expires.

Article 27. Modification of licenses

1. An organization or individual shall request modification of its/his/her license in the following cases:

a/ There is a change in its/his/her information indicated in the license, such as name, address. telephone number or fax number;

b/ There is a change in the information on the border gate of exportation or importation, for export, import or transit license, or on the route of transportation, for transportation or transit licenses;

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2. A dossier of request for modification of a license comprises:

a/ A written request for modification of a license, made according to form 07-11/ATBXHN provided in Appendix II to this Circular;

b/ The original license;

c/ A written certification of information details to be modified, in case of change in name, address, telephone number or fax number;

d/ A copy of the transfer contract, in case the quantity of radioactive sources or radiation devices decreases as a result of transfer; a copy of the export license enclosed with the customs declaration, in case the quantity of radioactive sources decreases as a result of export; a written certification of lost radioactive sources.

3. Dossiers of request for modification of licenses shall be submitted at competent agencies defined in Clause 1. Article 24 of this Circular.

4. Within 10 working days after receiving a complete and valid dossier, a competent agency shall grant a modified license or issue a written refusal clearly stating the reason.

5. A modified license has the same validity term as that of the old license.

Article 28. Re-grant of licenses

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When a license is lost, an organization or individual shall declare the loss to the police office of the locality in which the license is lost and announce such in the mass media. Past 30 days after such announcement, if the lost license cannot be found, the organization or individual may request a competent agency to re-grant it.

2. A dossier of application for a re-granted license comprises:

a/ An application for a re-granted license, made according to form 08-II/ATBXHN provided in Appendix II to this Circular;

b/ The police office's certification of declaration of the loss of the license and the press agency's receipt accepting to publish information on such loss;

c/ The original license, in case it is torn or rumpled.

3. Dossiers of application for re-granted licenses shall be submitted at competent agencies defined in Clause 1. Article 24 of this Circular.

4. Within 10 working days after receiving a complete and valid dossier, a competent agency shall re-grant a license or issue a written refusal clearly stating the reason.

5. A re-granted license has the same validity term as that of the old license. the dossiers and grant licenses under this Circular,

Article 29. Re-grant of radiation employee's certificates

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2. Dossiers and procedures for certificate re-grant and the term of a re-granted certificate are the same as those for a new certificate.

Chapter VI

ORGANIZATION OF IMPLEMENTATION

Article 30. Transitional handling

In case applicants have submitted dossiers of application for licenses for radiation jobs but not been licensed before the effective date of this Circular, they shall submit additional dossiers and documents under this Circular. Within 30 days after receiving adequate additional dossiers and documents, a competent agency shall appraise

Article 31. Effect

1. This Circular lakes effect 45 days from the date of its signing. This Circular replaces the Science and Technology Ministry's Circular No, 05/2006/TT-BKHCN of January 11. 2006, guiding procedures for declaration and grant of registration papers and licenses for radiation-related activities.

2. Any problems arising in the course of implementation should be promptly reported in writing to the Ministry of Science and Technology for consideration and settlement.-

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FOR THE MINISTER OF SCIENCE AND TECHNOLOGY
DEPUTY MINISTER




Le Dinh Tien

* Note: All the appendices mentioned in this Circular are not printed herein.

APPENDIX I

DECLARATION SLIP
(Issued together with Circular No.08/2010/TT-BKHCN dated July 22, 2010 of the Ministry of Science and Technology)

No.

Slip of declaration

Form

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Form 01-I/ATBXHN

2

Slip of declaration of goods escort 

Form 02-I/ATBXHN

3

Slip of declaration of sealed radiation source 

Form 03-I/ATBXHN

4

Slip of declaration of spent sealed radiation source  

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5

Slip of declaration of open radiation source 

Form 05-I/ATBXHN

6

Slip of declaration of radiographic device for medical diagnosis

Form 06-I/ATBXHN

7

Slip of declaration of X-ray generator (excluding radiographic devices for medical diagnosis)

Form 07-I/ATBXHN

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Slip of declaration of accelerator

Form 08-I/ATBXHN

9

Slip of declaration of neutron generator

Form 09-I/ATBXHN

10

Slip of declaration of nuclear source material

Form 10-I/ATBXHN

11

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Form 11-I/ATBXHN

12

Slip of declaration of nuclear device 

Form 12-I/ATBXHN

13

Slip of declaration of radioactive  waste

Form 13-I/ATBXHN

Form 01-I/ATBXHN

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SLIP OF DECLARATION OF RADIATION EMPLOYEES

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                         4. Fax:

5. Email:

II. SAFETY OFFICER

1. Full name:

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4. ID Card No./Passport No:                   Date of issuance:              Place of issuance:

5. Professional qualifications:

6. Workplace:

Tel:

8. Number of appointment decision of safety officer: ^1                     Sign date:

9. Certificate of radiation safety:

- Certificate No.

- Date of issuance:

- Issuance agency:

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Total: ……. employees

No.

Full name

Year of birth

Gender

Certificate of radiation safety

Radiation employee certificate^2

Professional qualifications

Job description 

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1

Certificate No.

Date of issuance:

Issuance agency:

Certificate No.

Date of issuance:

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2

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3

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PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

^1Not required if the appointment decision of safety officer is not available

^2 Only apply for employees performing tasks prescribed in Article 28 of the Law on Atomic Energy

Form 02-I/ATBXHN

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SLIP OF DECLARATION OF GOODS ESCORT 

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

II. GOODS ESCORT

1. Full name:

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3. Date of birth:

4. ID Card/Passport:

- ID Card No./Passport No.

- Date of issuance:

- Place of issuance:

5. Professional qualifications:

6. Workplace:

7. Tel:

8. Certificate of radiation safety:

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- Date of issuance:

- Issuance agency:

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

Form 03-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
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I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

II. CHARACTERISTICS OF THE SOURCE

1. Name of radioisotope:

2. Model:

3. Serial Number:

...

...

...

5. Activity rate (Bq or Ci):                                          Date of activity rate re-determination:

6. Purpose:

* Teletherapy                                                       * Brachytherapy

* Research and education                                      * Industrial meters ^1

* Geological exploration                                      * Radiography

* Industrial irradiation                                           * X-ray fluorescence analysis

* Device standard 

* Other applications (clearly specified):

7. Origin:

...

...

...

Number of import license                                      Date of issuance:

* Transfer from other organization or individual

Number of license for performing radiation jobs relating to the source of the transferor: …. Date of issuance:

8. Is there any written commitment on returning the source to the supplier made by the time importing such source?

* No                                                                     * Yes

III. ATTACHED EQUIPMENT

1. Model:

2. Serial Number:

3. Production country:

...

...

...

5. Movable or fixed equipment:    * Movable   * Fixed

6. Installation place (for fixed equipment):

7. Mass of depleted urani used to cover the source (if any):

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

^1 Industrial meters such as level and depth meters, etc

...

...

...

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF SPENT SEALED RADIOACTIVE SOURCE

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

II. CHARACTERISTICS OF THE SOURCE

...

...

...

2. Model:                                                                   3. Serial Number:

4. Production country:

5. Activity rate (Bq or Ci)                                            Date of activity rate determination:

6. Purpose:

* Teletherapy                                                       * Brachytherapy

* Research and education                                   * Industrial meters^1

* Geological exploration                                      * Radiography

* Industrial irradiation                                          * X-ray fluorescence analysis

* Equipment standard                                         * Other applications (clearly specified):

...

...

...

1. Model:

2. Serial Number:

3. Production country:

4. Production year:

5. Brief description of the status of equipment/container carrying the source:

IV. HANDLING BEFORE STORING

1. Handling method:

2. Storing location:

...

...

...

(Location and date)
DECLARANT
(Sign, full name and seal)

^1 Industrial meters such as level and depth meters, etc

Form 05-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF OPEN RADIOACTIVE SOURCE

I. DECLARANT INFORMATION

...

...

...

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

II. CHARACTERISTICS OF THE SOURCE

1. Name of radioisotope:

2. Production country:

3. Chemical formula:

4. State of matter:

5. Total rate of production/processing/import/export/use in a year or total activity rate in one transport (Bq or Ci):

...

...

...

* Medical diagnosis                                              * Medical treatment                     

* Research and education                                   * Radioisotope marking

* Other applications (clearly specified):

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

Form 06-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

...

...

...

SLIP OF DECLARATION OF RADIOGRAPHIC DEVICE FOR MEDICAL DIAGNOSIS

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

II. CHARACTERISTICS OF THE DEVICE

1. Name:

2. Model:

...

...

...

4. Production year:

5. Maximum voltage (kV):

6. Maximum amp (mA):

7. Purpose:

* Radiography for general diagnosis                   * Diagnostic fluoroscopy

* Intervention radiography                                   * Dental radiography

* Mammography                                                  *  CT scan

* Dual-energy X-ray absorptiometry                    * Veterinary radiology

* Other applications (clearly specified):

...

...

...

* Fixed                           * Movable

9. Place of fixed device (location of the room where the device is placed):

III. X-RAY TUBE

1. Model:

2. Serial Number:

3. Production country:

4. Production year:

IV. CONTROLLER

1. Model:

...

...

...

3. Production country:

IV. IMAGE INTENSIFIER (for fluoroscope)

1. Model:

2. Serial Number:

3. Production country:

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

...

...

...

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF X-RAY GENERATOR^1

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                      4. Fax:

5. Email:

II. CHARACTERISTICS OF THE DEVICE

...

...

...

2. Model:

3. Serial Number:

4. Production country:

5. Production year:

6. Maximum voltage (kV):

7. Maximum amp (mA):

8. Purpose:

* Industrial radiography                                        * Circuit board testing

* Security screening test                                      * X-ray fluorescence analysis

...

...

...

* Other applications (clearly specified):

9. Fixed or movable

* Fixed                          * Movable

10. Place of fixed device (location of the room where the device is placed):

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

^1 This part is only for the slip of declaration of X-ray generator, not radiographic devices for medical diagnosis or accelerator

...

...

...

Form 08-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF ACCELERATOR

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                        4. Fax:

...

...

...

II. CHARACTERISTICS OF THE DEVICE

1. Name:

2. Model:

3. Serial Number:

4. Production country:

5. Production year:

6. Ray emitted:      * Photon                                   Maximum energy:………………… MV

                            * Electron                                  Maximum energy: ......................... MV

                            * Other ray (clearly specified):           Maximum energy: …………. MV

...

...

...

8. Type:               * Linearity                                      * Cyclotron

9. Purpose:

* Medical treatment                                             * Research and education 

* Radioisotope production                                   * Sterilization by irradiation and material processing 

* Other applications (clearly specified):

10. Place of fixed device (location of the room where the device is placed):

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

...

...

...

Form 09-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF NEUTRON GENERATOR

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

...

...

...

1. Name:

2. Model:

3. Serial Number:

4. Production country:

5. Production year:

6. Maximum neutron energy: 

- Maximum accelerating voltage:

- Type of target

- Radioactivity of the target:

...

...

...

* Research and education 

* Geological exploration

* Analysis

* Other applications (clearly specified):

8. Fixed or movable

* Fixed                   * Movable

9. Place of fixed generator (location of the room where the generator is placed):

PREPARED BY
(Sign and full name)

...

...

...

Form 10-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF NUCLEAR SOURCE MATERIAL

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4. Fax:

...

...

...

II. CHARACTERISTICS OF MATERIAS

1. Type of nuclear source material:

2. Mass:

3. Chemical composition:

4. State of matter:

5. Place of storage or use: 

6. Purpose:

7. Characteristic of the container:

...

...

...

(Location and date)
DECLARANT
(Sign, full name and seal)

Form 11-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF NUCLEAR MATERIAL 

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

...

...

...

5. Email:

II. CHARACTERISTICS OF MATERIAL

II. 1. FORM OF NUCLEAR MATERIAL

* Fuel assembly^1                                                  * Not in form of fuel assembly^2

II. 2. NUCLEAR MATERIAL IN THE FORM OF FUEL ASSEMBLY

1. Model of each fuel assembly: 

2. Production country:

3. Mass of each fuel assembly:

4.  Mass of nuclear material in each fuel assembly:

...

...

...

6.  Mass of Uranium-235:

7. Average enrichment capacity of a fuel assembly:

8. Chemical composition or alloy composition of the fuel:

9. Material of the wrapping of the fuel assembly:

10. Purpose:

11. Place of use:

III. 3. NUCLEAR MATERIAL NOT IN THE FORM OF FUEL ASSEMBLY

1. Type of nuclear source material:

2.  Mass:

...

...

...

4. State of matter:

5.  Mass of isotope of fission:

6. Enrichment capacity of isotopic composition:

7. Number of section:

8. Purpose:

9. Place of use and storage:

10. Characteristic of the container:

PREPARED BY
(Sign and full name)

...

...

...

^1Fill in item II.2 if the nuclear material is in the form of fuel assembly

^2Fill in item II.3 if the nuclear material is not in the form of fuel assembly

Form 12-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

SLIP OF DECLARATION OF NUCLEAR DEVICE

I. DECLARANT INFORMATION

...

...

...

2. Address:

3. Tel:                                                                       4. Fax:

5. Email:

II. CHARACTERISTICS OF THE DEVICE

1. Name:

2. Model:

3. Serial Number:

4. Production country:

5. Production year:

...

...

...

7. Purpose:

8. Installation place:

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

Form 13-I/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

...

...

...

I. DECLARANT INFORMATION

1. Name of declarant:

2. Address:

3. Tel:                                                                       4.Fax:

5. Email:

II. CHARACTERISTICS OF RADIOACTIVE WASTE

1. Names of main radioisotopes:

2. Origin:

3. Activity rate (Bq/kg or Bq/I):  

...

...

...

* Solid                           * Liquid

5. Mass (for solid waste) or volume (for liquid waste):

III. WASTE TREATMENT BEFORE STORING

1. Treating method:

2. Storing location:

PREPARED BY
(Sign and full name)

(Location and date)
DECLARANT
(Sign, full name and seal)

...

...

...

APPLICATION FORM
(Issued together with Circular No.08/2010/TT-BKHCN dated July 22, 2010 of the Ministry of Science and Technology)

No.

APPLICATION

Form

1

Application form for a license to perform radiation jobs such as operating irradiation devices, using radioactive substances, using radioactive devices, producing and processing radioactive substances, storing radioactive substances, treating and storing radioactive waste and spent radioactive sources, building radioactive facilities; changing size and operation scopes of radioactive facilities and terminating the operation of radioactive facilities.

Form 01-II/ATBXHN

2

Application form for a license to perform radiation jobs such as exporting and importing radioactive substances, nuclear source materials, nuclear materials and nuclear devices

...

...

...

3

Application form for a license to perform radiation jobs such as packaging and transporting radioactive substances, radioactive waste, nuclear source materials and nuclear materials

Form 03-II/ATBXHN

4

Application form for a license to perform radiation jobs such as transporting radioactive substances, nuclear source materials and nuclear materials in transit through the territory of Vietnam

Form 04-II/ATBXHN

5

Application form for a radiation employee certificate

Form 05-II/ATBXHN

...

...

...

Application form for extension of the license for performing radiation job

Form 06-II/ATBXHN

7

Application form for amendments to the license for performing radiation job

Form 07-II/ATBXHN

8

Application form for re-issuance of the license for performing radiation job

Form 08-II/ATBXHN

...

...

...

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

APPLICATION FORM FOR A LICENSE TO PERFFORM RADIATION JOB(S)
(…….^1…….)

To: ……………… ^2 ……………….........................

1. Name of the applicant (organization^3/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^4:

...

...

...

- Job position:

- ID Card No./Passport No.

7. I respectively request for a license to perform the following radiation jobs:

No.

Name of radiation job

Place for job performance

1

...

...

...

…..

8. Enclosure:

(1)

(2)

…

...

...

...

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name(s) of radiation job(s) requiring the license

^2Name of the authority competent to issue the license as prescribed in Article 23 herein

^3Name of the organization applying for the license which receives the foundation decision or business registration certificate and has its own seal granted by competent police authority as well as directly performs radiation job(s)

^4Name of the legal representative of the organization
 If the applicant is an individual, only ID Card No./Passport No. is required.

...

...

...

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

APPLICATION FORM FOR A LICENSE TO PERFORM RADIATION JOB(S)
(Importing/exporting radioactive substances, nuclear source materials, nuclear materials and nuclear devices)

To: ……………… ^1………………........................

1. Name of the applicant (organization^2/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^3:

...

...

...

- Job position:

- ID Card No./Passport No.

7. I respectively request for a license to perform the following radiation job(s):

* Import:

                       * Radioactive substances

                       * Nuclear materials/nuclear source materials

                       * Nuclear devices

* Export

                       * Radioactive substances

...

...

...

                       * Nuclear devices

8. Information on domestic producer/use/receiver:

- Name of organization/individual:

- Address:

- Tel:                                                           Fax:

- Email:

9. Information on foreign receiver/supplier:

- Name of organization/individual:

- Address:

...

...

...

- Tel:                                                           Fax:

- Email:

10. Details of import/export of radioactive substances, nuclear source materials, nuclear materials and nuclear devices;

10.1. For import:

-  Date expected for import:

- Importing checkpoint:                                    Province/city:

- Date and place expected for discharging nuclear source materials/nuclear materials:

10.2. For export:

+ Date expected for export:

...

...

...

+ Date expected for arrival^4:

11. Enclosure:

(1)

(2)

(3)

…

I hereby commit that the above-mentioned information is correct and will strictly comply with provisions of the law on radiation safety as well as requirements specified in the license.

...

...

...

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

^2 Name of the organization applying for the license which receives the foundation decision or business registration certificate and has its own seal granted by competent police authority as well as directly performs the radiation job

^3Name of the legal representative of the organization
 If the applicant is an individual, only ID Card No./Passport No. is required.

^4For export of nuclear source materials or nuclear materials

Form 03-II/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

...

...

...

To: ……………… ^1………………............

1. Name of the applicant (organization^2/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^3:

- Full name:

- Job position:

- ID Card No./Passport No.

...

...

...

- Date expected for transport:

- Transporting route:

- Means of transport:

- Number of package of radioactive substances, radioactive waste, nuclear source materials and nuclear materials:

8. Carrier information:

- Name of organization/individual:

- Address:

- Tel:                                                          Fax:

- Email:

...

...

...

- Name of organization/individual:

- Address:

- Tel:                                                           Fax:

- Email:

10. Enclosure:

(1)

(2)

(3)

…

...

...

...

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

^2Name of the organization applying for the license which receives the foundation decision or business registration certificate and has its own seal granted by competent police authority as well as directly performs the radiation job

^3Name of the legal representative of the organization
 If the applicant is an individual, only ID Card No./Passport No. is required.

Form 04-II/ATBXHN

...

...

...

APPLICATION FORM FOR A LICENSE TO PERFORM RADIATION JOB(S)
(Transporting radioactive substances, nuclear source materials and nuclear materials in transit through the territory of Vietnam)

To: ……………… ^1……………….

1. Name of the applicant (organization^2/individual):

2. Address:                                                         3. Country:

4. Tel:                                                                5. Fax:

6. Email:

7. Head of the organization^3:

- Full name:

...

...

...

- ID Card No./Passport No.

8. I respectively request for the license with the following information:

- Date expected to enter Vietnam:

- Date expected to exit Vietnam:

- Transporting route through Vietnamese territory:

- Means of transport:

- Number of package of radioactive substances, radioactive waste, nuclear source materials and nuclear materials:

9. Receiver information:

- Name of organization/individual:

...

...

...

- Country:

- Tel:                                                           Fax:

- Email:

10. Carrier information:

- Name of organization/individual:

- Address:

- Tel:                                                           Fax:

- Email:

11. Enclosure:

...

...

...

(2)

(3)

…

I hereby commit that the above-mentioned information is correct and will strictly comply with provisions of the law on radiation safety as well as requirements specified in the license.

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

...

...

...

^3Name of the legal representative of the organization
Individual applicant is not required to fill in this item.

Form 05-II/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

Photo sized 3 x 4

APPLICATION FORM FOR A RADIATION EMPLOYEE CERTIFICATE

To: ………………… ^1 ……………………..

1. Name of the applicant:

...

...

...

3. Address:

4. Tel:                                                                5. Email:

6. Workplace:

7. I respectively request for a radiation employee certificate for:

* Chief engineer of nuclear reactor;

* Head of the operation shift of nuclear reactor;

* Safety officer;

* Person in charge of radioactive decontamination; 

* Person in charge of response to radiation and nuclear accidents;

...

...

...

* Operator of nuclear reactor;

* Operator of accelerator;

* Operator of irradiation device using radioactive sources;

* Producer of radioisotope;

* Industrial radiographer

8. Enclosure:

(1)

(2)

…………

...

...

...

(Location and date)
APPLICANT
(Sign and full name)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

Form 06-II/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

...

...

...

To: ………………… ^1 ……………………..

1. Name of the applicant (organization/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^2:

- Full name:

- Job position:

- ID Card No./Passport No.:

...

...

...

- License No.

- Date of issuance:

- Expiry date:

8. Enclosure:

(1)

(2)

(3)

I hereby commit that the above-mentioned information is correct and will strictly comply with provisions of the law on radiation safety as well as requirements specified in the license.

...

...

...

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

^2Name of the legal representative of the organization   Individual applicant is not required to fill in this item.

Form 07-II/ATBXHN

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

APPLICATION FORM FOR AMENDMENTS TO THE LICENSE FOR PERFORMING RADIATION JOB

...

...

...

1. Name of the applicant (organization/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^2:

- Full name:

- Job position:

- ID Card No./Passport No.

7. I respectively request for amendments to the license containing the following information:

...

...

...

- Date of issuance:

- Expiry date:

8. Contents to be amended:

(1)

(2)

…

9. Enclosure:

(1)

(2)

...

...

...

I hereby commit that the above-mentioned information is correct and will strictly comply with provisions of the law on radiation safety as well as requirements specified in the license.

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

^2Name of the legal representative of the organization   Individual applicant is not required to fill in this item.

Form 08-II/ATBXHN

...

...

...

APPLICATION FORM FOR RE-ISSUANCE OF THE LICENSE FOR PERFORMING RADIATION JOB

To: ………………… ^1 ……………………..

1. Name of the applicant (organization/individual):

2. Address:

3. Tel:                                                                4. Fax:

5. Email:

6. Head of the organization^2:

- Full name:

...

...

...

- ID Card No./Passport No.

7. I respectively request for re-issuance of the license containing the following information:

- License No.

- Date of issuance:

- Expiry date:

8. Re-issuance reason:

9. Enclosure:

(1)

(2)

...

...

...

I hereby commit that the above-mentioned information is correct and will strictly comply with provisions of the law on radiation safety as well as requirements specified in the license.

(Location and date)
APPLICANT
(Sign, full name and seal)

^1Name of the authority competent to issue the license as prescribed in Article 23 herein

^2Name of the legal representative of the organization   Individual applicant is not required to fill in this item.

APPENDIX IV

...

...

...

(NAME OF THE CERTIFICATION AUTHORITY)
-------

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

No….

(Location and date)

CERTIFICATION OF DECLARATION 

……….. (^1) …………

1. Name of declarant (organization/individual): 

2. Address:

...

...

...

5. Full name of the head of the organization:

6. Job position: 

7. ID Card No./Passport No.

8. Declaration of:…. ^1….with information attached to this certification 

DIRECTOR OF THE CERTIFICATION AUTHORITY
(Sign and seal) 

^1 Clearly specify whether the certification is made for radioactive substances, radioactive waste, radiation devices, nuclear source materials, nuclear materials or nuclear devices The following tables shall be attached to equivalent certifications of declaration

...

...

...

RADIATION DEVICE INFORMATION

(Issued together with Certification of Declaration No…. dated ….)

No.

Name  

Model, serial number

Production country: 

Purpose:

Installation location:

...

...

...

...

...

...

RADIOACTIVE SUBSTANCE INFORMATION

(Issued together with Certification of Declaration No…. dated ….)

No.

Name of radioisotope: 

Sealed or open source

Model, serial number (for sealed source)

Activity rate/Determination date

Storing location: 

...

...

...

...

...

...

RADIOACTIVE WASTE INFORMATION

(Issued together with Certification of Declaration No…. dated ….)

No.

Waste lot

Names of main radioisotopes in radioactive waste  

Activity rate (Bq/kg or Bq/I) 

State of matter (solid or liquid)

...

...

...

Storing location 

...

...

...

INFORMATION ON NUCLEAR SOURCE MATERIALS AND NUCLEAR MATERIALS NOT IN THE FORM OF FUEL ASSEMBLY 

(Issued together with Certification of Declaration No…. dated ….)

No.

...

...

...

Mass

Chemical composition

State of matter 

Origin

...

...

...

INFORMATION ON NUCLEAR MATERIALS IN THE FORM OF FUEL ASSEMBLY

(Issued together with Certification of Declaration No…. dated ….)

...

...

...

Model of  fuel assembly: 

Mass of fuel assembly

Mass of Uranium 235 in the fuel assembly

Average enrichment capacity 

Chemical composition

Material of the wrapping of the fuel assembly:

Production country

...

...

...

...

...

...

NUCLEAR DEVICE INFORMATION 

(Issued together with Certification of Declaration No…. dated ….)

No.

Name  

Model, serial number

...

...

...

Production year

Purpose

Installation place

...

...

...

APPENDIX V

...

...

...

No.

License 

Form

1

License issued by the Ministry of Science and Technology 

Form 01-I/ATBXHN

2

License issued by the Radiation and Nuclear Safety Department 

Form 02-I/ATBXHN

...

...

...

License issued by the Department of Science and Technology

Form 03-I/ATBXHN

Form 01-I/ATBXHN

MINISTRY OF SCIENCE AND TECHNOLOGY
-------

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

No.      /GP-BKHCN

Hanoi, on…/…/…

...

...

...

For performing radiation job 

(…. ^1….)

MINISTER OF SCIENCE AND TECHNOLOGY 

- Pursuant to the Law on Atomic Energy dated June 03, 2008;

- Consider the application for license of …^2…. on …/…/….;

- At the request of the Director of the Radiation and Nuclear Safety Department

HEREBY LICENSES 

…………………………….^3..................................................................................................

Address: ...........................................................................................................................

...

...

...

Be licensed for: ……………^4............................................................................................

...........................................................................................................................................

The licensed organization or individual must strictly comply with provisions of the Law on Radiation Safety and requirements specified in the License during the performance of radiation job.

This license will expire on.../.../...

MINISTER
(Sign, full name and seal)

...

...

...

^2Name of the organization or individual asking for the license  

^3Name of the licensed organization or individual in lower case and bold

^4Name of radiation job, radiation device or radioactive source to be used and purpose   For instance: Operation of the device containing gamma source for industrial radiography which has characteristics specified in the attachment of this license

^5 Name of the licensed organization or individual 

^6The Department of Science and Technology of the locality where the radiation job is performed

REQUIREMENTS OF THE LICENSE 

(Issued together with the License No.  /GP-BKHCN dated…. of the Ministry of Science and Technology)

1. Only perform radiation job using ….^1…. with characteristics specified in the attachment hereinafter

...

...

...

3. Notify the transfer of radioactive source to another organization or individual to the Radiation and Nuclear Safety Department in case of such transfer

4. Immediately notify radiation accidents to relevant agencies and 

RADIATION AND NUCLEAR SAFETY DEPARTMENT

Address:

Tel:

Fax:

Email: 

5. …….^2…….

...

...

...

^2Other requirements (if any) 

CHARACTERISTICS OF ….. ^1 ….. USED IN THE LICENSED RADIATION JOB

(Issued together with the License No.  /GP-BKHCN dated…. of the Ministry of Science and Technology)

RADIATION DEVICES 

No.

Name 

Model, serial number

Production country

...

...

...

Installation location

...

...

...

...

...

...

No.

Type

Mass

Chemical composition

State of matter 

Origin

...

...

...

...

...

...

NUCLEAR MATERIALS IN THE FORM OF FUEL ASSEMBLY 

No.

Model of  fuel assembly:  

Mass of fuel assembly

Mass of Uranium 235 in the fuel assembly

...

...

...

Chemical composition

Material of the wrapping of the fuel assembly: 

Production country

...

...

...

...

...

...

NUCLEAR DEVICES

No.

...

...

...

Model, serial number

Production country

Production year

Purpose

Installation place

...

...

...

...

...

...

^1 Clearly specify whether radioactive substances, radiation devices, nuclear source materials, nuclear materials or nuclear devices are used in the radiation job  Only attach the table corresponding to the radioactive substances, radiation devices, nuclear source materials, nuclear materials or nuclear devices used in the radiation job  For instance: with regard to the application for a license to perform radiation job with use of the sealed radioactive source then only the table of sealed radioactive source may be attached to such license.

Form 02-I/ATBXHN

...

...

...

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

No.      /GP-ATBXHN

Hanoi, on…/…/…

LICENSE 

For performing radiation job 

(…. ^1….)

DIRECTOR OF THE RADIATION AND NUCLEAR SAFETY DEPARTMENT

- Pursuant to the Law on Atomic Energy dated June 03, 2008;

...

...

...

- At the request of the Chief of Licensing Division

HEREBY LICENSES 

…………………………….^3..................................................................................................

Address: ...........................................................................................................................

Tell: ……………………………. Fax:..................................................................................

Be licensed for: ……………4...........................................................................................

...........................................................................................................................................

The licensed organization or individual must strictly comply with provisions of the Law on Radiation Safety and requirements specified in the License during the performance of radiation job.

This license will expire on.../.../...

...

...

...

.

MINISTER
(Sign, full name and seal)

^1Name of radiation job

^2Name of the organization or individual asking for the license  

^3Name of the licensed organization or individual  in slower case and bold

^4 Name of radiation job, radiation device or radioactive source to be used and purpose   For instance: Operation of the device containing gamma source for industrial irradiation that has characteristics specified in the attachment of this license

^5 Name of the licensed organization or individual 

...

...

...

REQUIREMENTS OF THE LICENSE 

(Issued together with the License No.  /GP-ATBXHN dated…. of the Radiation and Nuclear Safety Department)

1. Only perform radiation job using ….^1…. with characteristics specified in the attachment hereinafter

2. Ask for the extension of the license at least 60 days before its expiry date if the radiation job is performed after the expiry date specified in such license

3. Notify the transfer of radioactive source to another organization or individual to the Radiation and Nuclear Safety Department in case of such transfer

4. Immediately notify radiation accidents to relevant agencies and 

RADIATION AND NUCLEAR SAFETY DEPARTMENT

Address:

...

...

...

Fax:

Email: 

5. ……. ^2…….

^1 Clearly specify whether radioactive substances or radiation devices are used in the radiation job

^2Other requirements (if any) 

CHARACTERISTICS OF ….. 1 ….. USED IN THE LICENSED RADIATION JOB

(Issued together with the License No.  /GP-ATBXHN dated…. of the Radiation and Nuclear Safety Department)

...

...

...

No.

Name 

Model, serial number

Production country

Purpose

Installation location

...

...

...

RADIOACTIVE SUBSTANCES

...

...

...

Name of radioisotope: 

Sealed or open source

Model, serial number (for sealed source)

Production country

State of matter (for open source)

Activity rate/Determination date

Relevant radiation job 

Attached device/place of use

...

...

...

...

...

...

RADIOACTIVE WASTE

No.

Waste lot

...

...

...

Discharging place

Activity rate (Bq/kg or Bq/I) 

State of matter (solid or liquid)

Mass (for solid waste) or volume (for liquid waste):  

Storing location

...

...

...

...

...

...

...

...

...

Form 03-I/ATBXHN

PEOPLE’S COMMITTEE OF …
DEPARTMENT OF SCIENCE AND TECHNOLOGY
-------

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

No.  /

Hanoi, on…/…/…

LICENSE 

For performing radiation job
(Use of radiographic devices for medical diagnosis)

...

...

...

- Pursuant to the Law on Atomic Energy dated June 03, 2008;

- Consider the application for license of …^1…. on …/…/….;

- At the request of … 2…..,

HEREBY LICENSES 

…………………………….3...................................................................................................

Address: ............................................................................................................................

Tell: ……………………………. Fax:...................................................................................

Be licensed for: ……………4............................................................................................

............................................................................................................................................

...

...

...

This license will expire on.../.../...

DIRECTOR
(Sign, full name and seal)

^1Name of the organization or individual asking for the license  

^2Name of the entity affiliated to the Department assigned to process the application for the license

^3 Name of the licensed organization or individual  in slower case and bold

...

...

...

^5 Name of the licensed organization or individual 

REQUIREMENTS OF THE LICENSE 

(Issued together with the License No.   dated…. of the Department of Science and Technology)

1. Only use the radiographic device for medical purpose that has characteristics specified in the attachment hereinafter

2. Notify the transfer of radiographic device for medical diagnosis to another organization or individual to the Science and Technology Department in case of such transfer

3. Ask for the extension of the license at least 60 days before its expiry date if the radiation job is performed after the expiry date specified in such license

4. Notify the use of the device in another province or city to the Department of Science and Technology of such province or city before such use

5. ……. 2…….

...

...

...

^1For movable radiographic devices

^2Other requirements (if any) 

CHARACTERISTICS OF RADIOGRAPHIC DEVICE FOR MEDICAL DIAGNOSIS LICENSED FOR USE

(Issued together with the License No.   dated…. of the Department of Science and Technology)

No.

Name  

Model, serial number

Production country and production year

...

...

...

Purpose, Place of use/movable or fixed use

Components

Name

Producer

Model

Serial number

...

...

...

Controller

X-ray tube

...

...

...

Image intensifier^1

...

...

...

...

...

...

...

...

...

...

^1for fluoroscope only

APPENDIX VI

CERTIFICATE FORM
(Issued together with Circular No.08/2010/TT-BKHCN dated July 22, 2010 of the Ministry of Science and Technology)

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
----------------

...

...

...

RADIATION EMPLOYEE CERTIFICATE 

……1…..

Certify

Mr./Mrs. ………………^2..............................................

Date of birth:.............................................................

Place of birth:............................................................

ID Card No................................................................

...

...

...

Place of issuance:.....................................................

Workplace: ..............................................................

Address:...................................................................

Eligible to perform the job of a(n) :

…… 3…….

No.
Expiry date:

(Location and date)
DIRECTOR OF THE ISSUANCE AUTHORITY
(Sign, full name and seal)

...

...

...

^1Name of the authority competent to issue the radiation employee certificate written in bold and capital and 14 point font 

^2Full name in bold, italic and 14 point font