National Radon Proficiency Program
PO Box 2109
Fletcher, NC 28732
angel@neha-nrpp.org
www.radongas.org

 

 

Chamber Application
 

Company Name:    
Street Address:      
City, State, Zip or Postal Code:    
Name of Responsible Party:   
Telephone Number:   (     )     
Fax Number:      (     )    
Email Address:    
Type of performance tests services to be provided:
Radon: ___                      Short-term: ___     Long-term: ___
Radon decay products: ___

The following information or affirmation is to be provided with the application prior to participation in the intercomparison.

Item

Reference Item in Chamber Protocols

Reference Item in Chamber App. Instructions

Initials
Quality Assurance Quality Control plan

1.2

    
Standard Operating Procedure

1.2

    
Commercial radium source
Supplier name: ____________________________

1.3

    
Chamber
Indicate size: __________________ cubic feet

1.4

    
Chamber continuous measurement device
Attach description and calibration information

1.4.6
and/or 2.4

    
Chamber grab measurement device
Attach description and calibration information

1.4.6, 1.5.2.1
and/ or 2.4.6

    
Copy of Responsible Party’s NEHA certification as a Residential Measurement Service Provider

1.6.4
and/or 2.6.4

    
Statement of potential conflicts of interest

1.6 and/or 2.6

    
Signature page  

7

  
Statement of agreement to follow chamber protocols or provision of proposed revisions  

2

  
Non-refundable application processing fee of $600  

6

  

The following materials must be provided prior to approval.

Item

Reference Item in Chamber Protocols

Reference Item in Chamber App. Instructions

Initials

Certificate(s) of insurance indicating additionally insured parties

  

4

  

Proof of passage of intercomparison

 

2.1

  

Sample form letter for notifying participants of need for performance testing

  

3.1

  

Sample failure letter of performance test

 

3.2

  

Sample passage letter of performance test

  

3.2

  

Sample database file (electronic and paper)

  

3.2

  

Performance test pricing schedule

 

6

  

Certification fee of $350

  

6

  

 

Signature of Responsible Party:                                                                             Date: