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The application must consist of: A request that a registration permit be issued by filing the appropriate, official application form (ORC-R1). Complete information, including: applicant's full company name, owner/operator name (with IRS Employer Identification or Social Security number), individual responsible for radiation protection (Radiation Safety Officer), name of licensed practitioner (for healing arts radiation use only), radiation service companies used, radiation procedures performed at the facility, radiation machine registration fee category and modalities used, radiation machine equipment inventory and status, signature of owner/operator. Applicants are instructed to mail a copy of the completed official application form to the address specified on the application form, and retain a copy of the application for their records. 2. Application to open a new radiation machine facility (renovation or new construction) must include: A request that a registration permit be issued by filing the appropriate, official application form (ORC-R1). Prior to construction, the floor plans, shielding specifications and equipment arrangement of all new installations, or modifications of existing installations utilizing ionizing radiation sources with maximum energy greater than 70 kVP (kilovolts peak) shall be submitted to the Division of Public Health Office of Engineering for review, see contact information below: Division of Public Health Office of Engineering Edgehill Shopping Center 43 South DuPont Hwy. Dover, Delaware 19901 Phone: (302) 741-8640 Fax: (302) 741-8641 Submission of a Shielding Plan to the Division of Public Health Office of Engineering for all facilities planning to use radiation machines for modalities below, which may have maximum energy exceeding 70 kVP, by filing the appropriate, official Minimum Shielding Requirements Report form (ORC-R15A), completed by a registered Radiation Service Provider. Radiation Machine Facilities or rooms that require a shielding plan include: • Dental panoramic or cephalometric x-ray • Dental Cone Beam Computed Tomography (CT) • Stationary radiographic or fluoroscopic x-ray • Mobile x-ray machine used routinely in one location • Computed Tomography (CT) scanner 3PDF Image | Radiation Machine Registration Permit Manual
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