TV Rheinland Philippines, Inc.

Ground Floor La Fuerza Building 1, 2241 Don Chino

Roces Avenue, 1231 Makati City, Philippines
Page 1 of 2

Report Ref. No.: OSLBR01WB0013343-01

TV Rheinland Philippines
ANSI/HPS N13.11-2009
Personnel Dosimetry Service Dose Report
Report
Report Reference No. ........................ : OSLBR01WB0013343-01
Approved by (+ signature)..: Jonathan Jerome A. Acuna, RRT
Date of issue ...................................... : November 2, 2015

Digitally signed by
Jonathan Jerome A.
Acua
Date: 2015.11.02 09:28:38
+08'00'

Number of pages ............................... : 2 pages

Laboratory
Name .................................................. : TV Rheinland Philippines, Inc. - Philippine Laboratory
Address .............................................. : Ground Floor La Fuerza Building 1, 2241 Don Chino Roces
Avenue, corner Sabio St., Makati City, 1231 Philippines
Subscriber/Customer
Name .................................................. : Luis Tirso M. Rivilla General Hospital
Address .............................................. : Km. 144, National Highway, Brgy. Samput, Paniqui, Tarlac
Department...: Imaging Department
Standard:
Standard ............................................. : ANSI/HPS N13.11-2009
Measuring procedure ........................ : Dose Assessment of Optically Stimulated Luminescence (OSL)
Dosimeters
Dose Report Form:
Dose Report Form No........................ : Dosimetry2015rev14
DRF Originator ................................... : TVRP
Particulars:
Quantity of Badge Retrieved against Delivered..: 3/3 Badges
Monitoring Period........: April to July 2015
Type of monitoring......: Bi-Monthly
General remarks:
The information indicated in this dose report is intended only for the use of the subscriber or customer.
This information indicated in this dose report must be kept confidential.
This dose report shall not be reproduced except in full without the written approval of the laboratory.
This dose report shall not be used for advertisement or litigation purposes without the written approval of the
laboratory.
Summary of Dose Report:
Doses from the dosimeters tested were below the investigatory level and dose limits for radiation
workers. Dosimeters issued were for the monitoring period of April to June 2015 but were used by
customer from April to July 2015.

DRF No.: Dosimetry2015rev14

DRF originator: TVRP

TV Rheinland Philippines, Inc.

Ground Floor La Fuerza Building 1, 2241 Don Chino
Roces Avenue, 1231 Makati City, Philippines
Page 2 of 2

Report Ref. No.: OSLBR01WB0013343-01

RADIATION DOSE MEASUREMENT

OSLD Serial No.

OSLD Type

HP (10)
(mSv)

HP (3)
(mSv)

HP (0.07)
(mSv)

Beta
(mSv)

Ferrer, Marites Arizabal

XA02827034L

Whole Body

BLD

BLD

BLD

Ibay, Mark Anthony Intal

XA025792364

Whole Body

BLD

BLD

BLD

Background Badge

XA02740889U

Background Badge

0.080

0.080

0.080

Name of User

Notes:
-Lowest Level of Detection (LLD) = 0.05 mSv
-Investigatory Level = 0.5 mSv/month, 1 mSv/2 months
-Action Level = 1.7 mSv/month, 3.4 mSv/ 2 months
-Dose limit to abdomen of woman of reproductive capacity = 13mSv
in 3 months
-Dose constraint for fetus during pregnancy = 1mSv

Effective Dose for Occupational Exposure

20 mSv in a year averaged over defined
periods of 5 years, with no single year
exceeding 50 mSv (IAEA BSS No. 115 of 1996)

Equivalent Dose
Hp(3)
Hp(0.07)
Hp(10)

20 mSv in a year averaged over defined periods of 5 years, with no single year exceeding 50 mSv (ICRP Statement, April 21, 2011)
500 mSv (IAEA BSS No. 115 of 1996)
20 mSv in a year averaged over defined periods of 5 years, with no single year exceeding 50 mSv (IAEA BSS No. 115 of 1996)

Legends:
DB: Damaged Badge
BLD: Below Lowest Limit of Detection (LLD)

MNU: Meter not used

ML: Meter Lost

ER: Estimated Reading Given

MNA: Meter Not Available

Calibration is traceable to the National Institute of Standards and Technology, USA

End of Report

DRF No.: Dosimetry2015rev14

DRF originator: TVRP