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Form Number: NRC Form 5 PDF Icon
Form Title: Occupational Dose Record for a Monitoring Period
Current Edition: 1-2008
Authority Directive or Regulation: 10 CFR Part 20
Form Status: Approved by OMB: 3150-0006, Expires: 11/30/2008
Special Instructions: Instructions and additional information pertinent to the completion of this form are on Page 2 of the form.

 



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Thursday, January 31, 2008