The University of Maryland Baltimore, Environmental Health and Safety, Inter-Departmental Billing

***EFFECTIVE:  IMMEDIATELY***

INSTRUCTIONS

Fill out the following:

Charge Department:

  • Contact Person
  • Department
  • Phone #
  • Work Address
  • Radiation Safety Authorized User – Printed or Typed
  • CHARGE Authorized Signature
  • Date – When the CHARGE Authorized Signature signed this form
  • UM CHARTSTRING (Project ID, Owner Department, Program, Fund, Account, and PCBU)

Description of GOODS / SERVICES provided:

  • Quantity for each line that is needed – How many?
  • The amount for each line that is needed
    • Get this information from the memo Radiation Safety sends you.
  • Parts – You can write a description in the space next to it.
  • Other – You can write a description in the space next to it.
BRING TO EHS – RADIATION SAFETY DEPARTMENT

Bring with you the following, for your Survey Instrument to be calibrated:

  • Survey Instrument
  • University of Maryland Baltimore Environmental Health and Safety Inter-Departmental Billing form (single sheet)
  • REMINDER – Make a COPY of the UM/EHS INTER-DEPARTMENTAL Billing form BEFORE bringing your Survey Instrument over to be calibrated.