Report

Radiation Inspection Report

Document radiation levels and contamination at your facility with this comprehensive inspection report template. Record survey instruments, dose rates, contamination assessments, and safety recommendations.

Start with this template

View All Templates

Report

Document Preview

Review the structure, sections, and fields before proceeding to fill out the document.

Radiation Inspection Report

No.RIR-2026-0019

1. General Information

Inspection date7/14/2026 Time9:00 AM — 10:30 AM
AddressBuilding 7, Midwest Medical Center, Chicago, IL Basis for inspectionQuarterly radiation survey
Expert Dr. Emily White , Radiation Safety Officer

2. Object of Inspection

Object typenot filled in Object nameMidwest Medical Center
Technical conditionnot filled in

3. Main Parameters

Instrument TypeGeiger-Müller Counter Instrument Serial NumberGM-2022-4587
Calibration Date6/1/2026 Calibration Due Date12/1/2026

4. Inspection Conditions

Inspection conditions are not selected.

5. Radiation Survey Results

No.Damage descriptionPhotos
1- 0.18not filled in
2- 0.15not filled in
3-not filled in

6. Additional Information

Identification was carried outFacility: Midwest Medical Center, Radiology Department
There are remarksAll readings within acceptable limits. No contamination detected.

7. Inspection Participants

No.Full namePosition / statusComment
1Dr. Emily WhiteRadiation Safety OfficerLead inspector
2Mark JohnsonFacility ManagerAccompanying representative

Signatures

______________________________
Dr. Emily White, Radiation Safety Officer
______________________________
Dr. Emily White
______________________________
Mark Johnson

Report

Purpose and Procedure for Drafting the Document

What Is a Radiation Inspection Report?

A radiation inspection report is a formal document used to record radiation survey results, contamination levels, and safety observations at a facility. It helps ensure radiation safety and regulatory compliance by documenting measurements, instrument details, and recommended actions.

Why Use This Template?

This template provides a standardized format for radiation inspections, ensuring that all critical data such as dose rates, contamination levels, and instrument calibration are captured consistently.

Key Features

The report includes sections for report identification, inspection participants, survey instruments (repeatable), radiation survey results (repeatable), contamination assessment, defects and observations, conclusions, signatures, and attachments.

Periodic Radiation Surveys

Radiation safety officers use this report for routine periodic surveys to monitor radiation levels and ensure ongoing safety.

Post-Incident Inspections

After a radiation incident or spill, this report helps document the extent of contamination and the effectiveness of cleanup efforts.

Regulatory Compliance

Facilities subject to radiation safety regulations can use this report to demonstrate compliance with monitoring and documentation requirements.

Facility Audits

Internal or external auditors may use this report to verify that radiation safety practices are being followed.

Maintenance and Decommissioning

During maintenance or decommissioning of radiation equipment, this report helps document the radiation status of the area.

  1. 1

    Instrument Calibration Verification

    Before the survey, verify that all survey instruments are calibrated and within their calibration due dates.

  2. 2

    Area Survey

    Perform a radiation survey of the facility, measuring dose rates at designated survey points and recording background readings.

  3. 3

    Contamination Check

    If contamination is suspected or detected, assess the type, extent, and location of contamination.

  4. 4

    Data Recording and Reporting

    Record all survey results, instrument details, and observations in the report. Attach photos and supporting documents.

  5. 5

    Review and Sign

    Complete the report with overall assessment and recommendations. Obtain signatures from the radiation safety officer and facility manager.

Photo Report Generator

Attach photos of survey points, contamination, and instruments using the photo report generator to provide visual evidence for your radiation inspection report.

Create Photo Report

Mobile Photo Documentation App

Capture survey photos on-site with the mobile app and sync them directly to your radiation inspection report for a complete digital record.

Mobile App

Document Sections

Click a section to jump to it in the sample document.

General Information

Report number, inspection date, facility name, and location.

Object of Inspection

Details of the inspected facility including type and name.

Main Parameters

Survey instruments used, including type, serial number, and calibration dates.

Inspection Conditions

Background radiation readings and environmental conditions during survey.

Radiation Survey Results

Radiation survey results including dose rates, contamination levels, and locations.

Additional Information

Overall assessment, conclusions, and recommended actions.

Inspection Participants

List of personnel involved in the inspection, including radiation safety officer and facility representative.

Signatures

Signatures of the radiation safety officer and facility manager.

Document Fields and Columns

General Information

Inspection date
Date of the radiation inspection.
Time
Time of the inspection.
Address
Address of the facility.
Basis for inspection
Basis for the inspection (e.g., periodic, incident).
Expert
Name of the radiation safety officer.

Object of Inspection

Object type
Type of facility (e.g., nuclear, medical, industrial).
Object name
Name of the facility.
Technical condition
Overall condition of the facility.

Radiation Survey Results

No.
Sequential number for each survey point.
Element
Survey point location or component.
Defect
Type of finding (e.g., dose rate, contamination).
Volume
Measured value (e.g., dose rate in µSv/h).
Unit
Unit of measurement (e.g., µSv/h, Bq/cm²).
Damage description
Additional details about the finding.
Photos
Photographs of the survey point or contamination.

Inspection Participants

No.
Sequential number for each participant.
Full name
Name of the participant.
Position / status
Role or title of the participant.
Comment
Additional comments about the participant.

Frequently Asked Questions about Photo Reports and Photo Tables

What is included in a radiation inspection report?

The report includes report identification (title, number, date, facility), inspection participants, survey instruments (type, serial number, calibration dates), radiation survey results (survey point ID, location, dose rate, contamination level, background), contamination assessment (type, extent, location, measurement), defects and observations, conclusions and recommendations, signatures, and attachments.

How often should a radiation inspection be performed?

The frequency depends on regulatory requirements and the nature of the facility. Periodic surveys are typically conducted monthly, quarterly, or annually, and after any incident.

Can I add photos to the radiation inspection report?

Yes, the template supports attaching photos of survey points, contamination, and instruments. The photo report generator helps you include clear visual evidence.

Who should sign the radiation inspection report?

The report is signed by the radiation safety officer (inspector) and the facility manager to acknowledge the findings.

What instruments are typically used for radiation surveys?

Common instruments include Geiger-Müller counters, scintillation detectors, and ionization chambers. The report allows you to record instrument type, serial number, and calibration dates.

Create Your Document Online

Enter inspection details and generate a ready-to-download document.