1 RADIOACTIVE material , Tracking Number _____. EXCEPTED PACKAGE. Date _____. Acceptance Checklist - 2013. The continued offering of non-compliant dangerous goods packages may result in the embargo of your dangerous goods shipments by FedEx Express. Directions: If RQ and UN2908, UN2909, UN2911, the following Check ( ) N/A, Y or N for each checklist item. additional information must be on the Declaration Y: Shipment complies. N: Shipment does not comply and is rejected. N/A Skip if N/A. N/A: Not Applicable Y N 22. Passenger and Cargo Aircraft or Cargo Aircraft RADIOACTIVE material , Excepted Package Only Only limitations correctly indicated. For Passenger (UN2908, UN2909, UN2910, UN2911) [ ; ]: and Cargo Aircraft, medical or research certification not required. [ ; ; USG-10]. N/A Yes No Y N 23. Name or symbol of radionuclide(s) ( , Ir-192, Y N 1.)
2 Package is in good condition and free of leakage, Iridium 192). [ , Step 6 (a)]. odor, or external damage. [ ]. Y N 24. Description of the physical and chemical form Y N 2. Complies with all applicable government and FedEx ( , liquid sodium iodide, solid metal, etc.) or variations. [ ] Special Form [ , Step 6 (b)]. Y N 3. Destination serviced (including AK and HI). [SRG] Y N 25. Number of packages and type of packaging N/A Y N 4. If 023 AWB (IP1, IXF, or ATA), correct statement(s) ( , 1 Excepted Package or 1 fibreboard box, etc.). in the Handling Information box. [ ] [ , Step 7]. Y N 5. Shipper and consignee name and address marked If RQ, the following must be on the Package on the package. [ ] N/A Skip if N/A. Y N 6. RADIOACTIVE material , Excepted Package label on the package. [ ] Y N 26. RQ marked on the package. [USG-04]. Y N 7. UN Number marked on the label.
3 [ ]. N/A Y N 27. OVERPACK is marked on the package if all markings and labels are not visible. [ ]. N/A Y N 8. Gross weight (in metric units) marked if the package exceeds 50 kg (110 lb). [ ]. N/A Y N 9. All dry ice marking, labeling, and documentation entries complied with. [Packing Instruction 954; (d); ; FX-19]. If RQ, the following must be on the Declaration N/A. Tracking Number may be completed by the shipper or the Dangerous Goods Specialist. Y N 10. Shipper and consignee name and address on the Shipment does not comply and has been Declaration. For 023 shipments, shipper's address rejected. Due to the regulatory discrepancies includes country name. [ ; ] indicated, your shipment cannot be transported by FedEx. Y N 11. Page of Pages. [ ]. Returned to shipper using DOT-SP 14691. Y N 12. Typewritten or computer generated. Some fields may be handwritten.
4 [FX-12] Shipper Contact Name: Y N 13. RADIOACTIVE indicated. [ ]. _____. Y N 14. RQ before or after the basic description. ( : RQ, UN Number , RADIOACTIVE material , Excepted Shipper Contact Phone Number : Package, 7; or RADIOACTIVE material , Excepted Package, 7, RQ. [USG-04] _____. Y N 15. UN Number , preceded by prefix.[ , Step 1]. Y N 16. Proper shipping name. [ , Step 2]. Inspected Y N 17. Class Number 7. [ ; , Step 3] By _____. Y N 18. Activity of radionuclide(s) in Becquerels ( , Bq, MBq, GBq, TBq, etc). [ , Step 7] Emp # _____. N/A Y N 19. OVERPACK USED [ , Step 8]. Y N 20. 24-hour emergency response telephone Number . [USG-12]. Y N 21. Name, title, place, date, and shipper's signature (may be typewritten for US domestic shipments, including US Territories). [ ; ] For further assistance, call 1-800-Go-FedEx (1-800-463-3339), then press 81 to be connected to the DG.)
5 Hotline. EFFECTIVE: 01/01/13 2013 FedEx Express - All rights reserved. This document is an uncontrolled, EFFECTIVE: 01/01/2013_v2 Page 1 of 1 reference-only, copy. Dangerous Goods Acceptance Checklist Page 1 of 1. Sample Package- 2013. The highlighted numbers correspond to those found on the 2013 FedEx Express RADIOACTIVE material , Excepted Package Acceptance Checklist. A Shipper's Declaration and additional markings are required if the shipment is a Reportable Quantity (RQ). 1 5 6, 7. FedEx Express offers IATA-endorsed seminars to help you understand dangerous goods regulations and avoid costly fines. Refer to our seminar schedule at Need to monitor the status of your shipment? for more information. Ask your account executive for information about FedEx Insight . Want immediate notification of status? Ask about FedEx Priority Alert . service.
6 EFFECTIVE: 01/01/2013 This document is an uncontrolled, reference-only, copy