Dewpointer Licensee Form
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DICKEY-john Corporation

Dewpointer General Licensee Record

Required for purchase of units containing Am-241






(Please provide your order number that was used to purchase product)



Contact person responsible for the safe installation and operation of the general licensee facility:







Check whether Americium 241 or Radium 226 is used.

Check One
Am-241 | Ra-226






Check One



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