Attachment A: Department of Energy Application fo Accreditation For Indirect Radiobioassay - Continued

DOE-STD-1112-98

By authorizing this application you affirm that you are aware that if accreditation is granted to your

organization, the accreditation applies to the indirect radiobioassay services using the specific measurement

systems and protocols in the categories requested and using the measurement techniques that were used to

demonstrate satisfactory performance in accordance with the ANSI N13.30. You will be expected to use

the same system(s) and techniques in the normal measurement(s) you perform.

The contractor or service laboratory has the responsibility to inform the PEPA prior to implementing

changes (e.g., in counting systems or analytical procedures) that could affect the system performance. The

contractor or service laboratory shall provide evidence supporting a conclusion that the proposed changes

are technically equivalent to the accredited system or procedure. The PEPA, with the Oversight Board'

approval, shall make a determination of technical equivalence. If the determination is that the proposed

changes are not technically equivalent, implementation of the proposed changes by the service laboratory

will void accreditation.

I hereby authorize this application and attest that all statements made are true, complete, and correct to the

best of my knowledge and belief and are made in good faith.

Authorized Representative:

Printed Name:

Title:

Signature:

Date:

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Operations / Field Office Review:

In authorizing this application you declare that you commit the DOE Contractor to:

C Be examined and audited, initially and on a continuing basis during the accreditation period.

C Permit the on-site assessors to review and examine records or other documents required by the DOE

Technical Standard.

C Participate in proficiency testing programs that will be required for maintaining accreditation.

Authorized Operations / Field Office Representative:

Printed Name:

Title:

Signature:

Date:

Telephone:

e-mail:

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