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TRANSCRIPT
Step
1:
Chec
k Re
turn
Sou
rce:
Ch
eck
sour
ce fo
r dam
age
& re
mov
able
con
tam
inat
ion.
Wip
e so
urce
to c
onfir
m
rem
ovab
le a
ctiv
ity is
less
than
5nC
i (10
CFR
35.
67).
If re
sults
are
5nC
i or a
bove
, co
ntac
t you
r RSO
for a
dditi
onal
inst
ruct
ions
.
Step
2:
Pack
agin
g yo
ur R
etur
n:
Þ
Plac
e so
urce
in o
rigin
al c
onta
iner
and
ship
ping
box
, cen
ter a
nd se
cure
ly
pack
age
it to
redu
ce m
ovem
ent d
urin
g tr
ansit
. Se
al b
ox w
ith h
eavy
dut
y
tape
& k
eep
one
side
open
to in
sert
nec
essa
ry fo
rms.
If b
ox is
dam
aged
, pl
ease
requ
est a
new
one
.
Þ
Conf
irm ra
diat
ion
surf
ace
read
ing
(on-
cont
act)
on
all s
ides
of p
acka
ge is
gr
eate
r tha
n 0.
5 m
rem
/hr b
ut le
ss th
an 5
0 m
rem
/hr.
If ab
ove
50 m
rem
/hr,
cont
act y
our R
SO.
Step
3:
Com
plet
e Em
erge
ncy
Resp
onse
She
et B
, pag
e 1:
Þ
Ch
eck
box
C un
der i
tem
1 fo
r UN
2915
, Cla
ss 7
...Ty
pe A
”
Þ
Com
plet
e ite
m 2
with
You
r Shi
pper
’s 2
4 Ho
ur E
mer
genc
y Te
leph
one
Num
ber.
Step
4:
Com
plet
e Re
turn
Pac
king
Lis
t – S
heet
B, p
age
2:
Prov
ide
emai
l add
ress
and
fax
for R
etur
n Di
spos
al R
ecei
pt c
onfir
mat
ion.
Refe
r to
your
sour
ce c
ertif
icat
e fo
r inf
orm
atio
n ne
eded
on
the
Retu
rn P
acki
ng L
ist.
Þ
1 O
rigin
al &
2 c
opie
s of S
heet
B a
re n
eces
sary
¨
Plac
e or
igin
al E
mer
genc
y Re
spon
se/R
etur
n Pa
ckin
g Li
st S
heet
B
(p
ages
1-2
) in
smal
l pac
king
list
pou
ch.
¨
Plac
e 1
copy
of t
he R
etur
n Pa
ckin
g Li
st in
the
box
with
sour
ce.
¨
Keep
1 c
opy
of th
e Re
turn
Pac
king
List
for y
our r
ecor
ds.
Step
8:
Com
plet
e Fe
dEx
Air W
aybi
ll:
Þ
You
are
the
send
er a
nd re
spon
sible
for r
etur
n sh
ipm
ent c
osts
.
Þ
Ship
to:
Atte
ntio
n: R
ecei
ving
Ec
kert
& Z
iegl
er Is
otop
e Pr
oduc
ts
1800
N. K
eyst
one
Stre
et, B
urba
nk, C
A 91
504
Þ
Fi
eld
5 - P
acka
ging
che
ck b
ox “
Oth
er.”
Þ
Fiel
d 6
- Spe
cial
Han
dlin
g c
heck
box
“Ye
s, a
s per
att
ache
d Sh
ippe
r’s
Decl
arat
ion.
”
Step
5:
Dete
rmin
e so
urce
nuc
lide
activ
ity in
MBq
. Th
is in
form
atio
n w
ill b
e ne
eded
for t
he S
hipp
er’s
Decl
arat
ion.
F
or a
Dec
ay C
hart
and
Rad
ioac
tivity
Uni
t Con
vert
er, p
leas
e vi
sit:
htt
p://
ww
w.e
zag.
com
/ezi
p.su
ppor
t
Step
7:
Wip
e Te
st o
f Box
:
Perf
orm
a d
ry w
ipe
on th
e ou
tsid
e su
rfac
e of
the
box.
Rem
ovab
le a
ctiv
ity
cann
ot e
xcee
d 22
dpm
/cm
2 bet
a or
gam
ma
emitt
ers a
nd 2
.2 d
pm/c
m2 o
f al
pha
emitt
ing
nucl
ides
[49
CFR
173.
443(
a)(1
)]. C
onta
ct y
our R
SO if
wip
e te
st
is ab
ove
limits
.
Step
6:
Seal
& L
abel
Box
:
Þ
Seal
box
with
hea
vy d
uty
tape
. Writ
e “s
ecur
ity”
alon
g th
e le
ngth
of t
he ta
pe
or u
se p
re-p
rinte
d ta
mpe
r ind
icat
ing
tape
.
Þ
Do n
ot d
efac
e th
e fo
llow
ing
Type
A in
form
atio
n on
the
box:
UN
2915
RAD
IOAC
TIVE
MAT
ERIA
L, TY
PE A
PAC
KAGE
. US
A DO
T-7A
-TYP
E A.
Þ
Dete
rmin
e TI
[Tra
nspo
rtat
ion
Inde
x =
max
dos
e ra
te in
m
rem
/hr a
t 1 m
eter
(3 fe
et)]
from
pac
kage
surf
ace.
The
TI
mus
t be
<1.0
mre
m/h
r on
all s
ides
of t
he b
ox in
ord
er to
la
bel a
s Yel
low
II (4
9 CF
R 17
3.40
3). R
ound
up
to th
e fir
st d
ecim
al p
oint
. (H
int:
0.4
2 =>
roun
ds u
p to
0.5
).
Þ
Fill
in th
e nu
clid
e(s)
, tot
al a
ctiv
ity, a
nd T
I in
blan
k se
ctio
ns
on Y
ello
w II
labe
ls. A
dher
e 2
labe
ls, o
ne e
ach
on o
ppos
ite
sides
of t
he b
ox o
ver o
rigin
al o
r def
aced
Yel
low
II la
bels.
Þ
Appl
y Ca
rgo
Airc
raft
Onl
y la
bels
to o
ppos
ing
sides
of t
he b
ox.
UN29
15—
Yello
w II
Pac
kage
Ret
urn
Inst
ruct
ions
Yo
ur re
turn
mus
t shi
p as
a U
N29
15 –
Yel
low
II, i
f the
surf
ace
read
ing
of y
our p
acka
ge o
n an
y sid
e is
gre
ater
than
0.5
mre
m/h
r but
less
than
50
mre
m/h
r. A
qual
ified
Shi
pper
mus
t pre
pare
pac
kage
for s
hipm
ent i
n ac
cord
ance
with
Titl
e 49
CFR
172
.101
, 172
.204
, 172
.403
, 172
.704
, 173
.403
, 173
.425
, 173
.433
, & 1
73.4
43. O
ther
re
quire
men
ts m
ay a
lso a
pply
.
IPL
Form
329
Revi
sion
: G
Cont
inue
d ov
erle
af =
> D Page
1 o
f 2
A) Complete Shipper and Consignee boxes in upper left side.
You are the Shipper, and EZIP, 1800 N
Keystone Street, Burbank, CA 91504
is the Consignee.
B) Transportation Details:
1. Airport of Departure: Contact your local FedEx office for location code.
2. Airport of Destination: LAX
3. For disposals only: cross out “Passenger and Cargo Aircraft”.
4. Air Waybill #: this is a 12 digit tracking # from
your FedEx Air Waybill.
5. Shipper’s Reference No. : notate EZIP issued Return N
umber.
6. Shipment Type: cross out “N
on-Radioactive”.
C) N
ature & Q
uantity of Dangerous Goods:
1. UN
or ID #: UN
2915
2. Proper Shipping Nam
e: Radioactive material, Type A package
3. Class or Division: 7
4. Packaging Group: skip this field
5. Quantity and type of packaging: Isotope to be returned, Physical &
Chem
ical form (m
etallic salt solid for most m
edical returns), Activity in MBq,
and number of Type A Packages.
6. Packaging Instructions: II Yellow , TI , &
dimensions of box in centim
eters
7. Authorization: skip this field
D) Shipper’s 24 hour Emergency Telephone Phone N
umber
Under “Additional Handling Inform
ation”, record the Shipper’s 24 hour
Emergency phone #. This is your 24 hour telephone num
ber should an
emergency arise w
ith your package during transit. This number is also
recorded on the Em
ergency Response / Return Packing List Sheet B.
Þ
Once all inform
ation is typed, the DG form is com
plete
Print 3 copies on candy striped paper. If using a black & w
hite printer,
put the provided candy striped paper in your printer. The typed DG
Form m
ust have the colored candy stripe or it will be rejected by the
carrier (i.e. FedEx).
Þ
Outer Box Labeling &
Pouches: 1.
Mark RA# on provided EZIP return label and adhere to box.
2. Place 3 DG copies and FedEx Air W
aybill in large FedEx pouch and adhere to package.
3. Adhere sm
all packing list pouch (containing the original Em
ergency Response / Return Packing List - Sheet B) to package.
Note: Shipper’s Declaration for DG
Form m
ust be completed and signed by
a qualified DO
T trained shipper.
Regulatory References: Title 49 CFR 172.101, 172.204, 172.403, 172.704, 173.403, 173.425, 173.433. O
ther requirements m
ay also apply.
Once you have carefully com
pleted Steps 1 through 9 for your UN
2915 return, your source is now
ready to ship to EZIP!!!
IPL Form329
Revision: G
Continued Step 9: The Shipper’s Dangerous G
oods (DG) tem
plate and a completed sam
ple Dangerous Goods (DG
) Form (w
ith steps A to D) can be found at: w
ww
.ezag.com/ezip.support .
A completed sam
ple (with steps A to D), has also been included w
ith your Return Kit. Please note that the DG
form m
ust be typed and signed by a qualified & trained shipper.
Page 2 of 2
D