180 Neb. Admin. Code, ch. 6, Attachment 1
Current through September 17, 2024
1. | Yes | No | Has your registration of radiation generating equipment expired? (180 NAC 2) | |
2. | Yes | No | Is all operable dental radiation generating equipment at this facility properly registered? (180 NAC 2) | |
3. | Yes | No | Has your service provider performed equipment performance evaluations on all dental radiation equipment at the facility at the required five year interval? (180 NAC 6-004.07) |
Comments:
Form Completed by: _____________________________________________ Date
* Please retain a copy of this completed inspection form for your records
180 Neb. Admin. Code, ch. 6, Attachment 1