OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

NRC Form 5, Occupational Dose Record for a Monitoring Period

OMB 3150-0006 · NRC.

OMB 3150-0006

Form 5 is used to record and report the results of individual monitoring for occupational radiation exposure during a monitoring period (one calendar year) to ensure regulatory compliance with annual radiation dose limits specified in 10 CFR 20.1201.

The latest form for NRC Form 5, Occupational Dose Record for a Monitoring Period expires 2027-11-30 and is listed under ICR 202311-3150-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form NRC Form 5 NRC Form 5, Occupational Dose Record for a Monitoring PeriodForm
2023 Final Supporting Statement for NRC Form 5.docxSupporting Statement A
NRC Form 5, Occupational Dose Record for a Monitoring Period Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202311-3150-006 Extension without change of a currently approved collection 2023-12-01
202008-3150-002 Extension without change of a currently approved collection 2020-08-19 Approved without change
201706-3150-008 Extension without change of a currently approved collection 2017-08-01 Approved without change
201405-3150-002 Revision of a currently approved collection 2014-05-29 Approved without change
201006-3150-009 Revision of a currently approved collection 2010-10-28 Approved without change
200903-3150-002 No material or nonsubstantive change to a currently approved collection 2009-03-04 Approved with change
200708-3150-002 Revision of a currently approved collection 2007-08-15 Approved without change
200408-3150-003 Revision of a currently approved collection 2004-08-13 Approved without change
200107-3150-006 Revision of a currently approved collection 2001-07-30 Approved without change
199807-3150-006 Revision of a currently approved collection 1998-07-15 Approved without change
199506-3150-004 Extension without change of a currently approved collection 1995-06-23 Approved without change
199207-3150-008 Revision of a currently approved collection 1992-07-16 Approved without change
199106-3150-004 Reinstatement with change of a previously approved collection 1991-06-26 Approved without change
198906-3150-004 Revision of a currently approved collection 1989-06-01 Approved without change
198605-3150-001 Reinstatement with change of a previously approved collection 1986-05-07 Approved without change
198512-3150-001 Revision of a currently approved collection 1985-12-12 Approved without change
198509-3150-002 Revision of a currently approved collection 1985-09-16 Withdrawn and continue
198304-3150-004 Revision of a currently approved collection 1983-04-08 Approved without change
198104-3150-006 Revision of a currently approved collection 1981-04-01 Approved without change