NRC Form 541A - Uniform Low-Level Radioactive Waste Manifest Container and Waster Description (Continuation)| ML13083A183 |
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01/31/2017 |
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NRC/OCIO/GEMSD/IMSB |
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| Download: ML13083A183 (1) |
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Category:NRC Forms (Blank)
MONTHYEARML22192A1972022-07-11011 July 2022
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ML12164A7412020-01-31031 January 2020
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ML12164A7422020-01-31031 January 2020
NRC Form 313A (Rso), Radiation Safety Officer or Associate Radiation Safety Officer Training, Experience, and Preceptor Attestation (10 CFR 35.57, 35.50). (01-2020)
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NRC Form 361N - Non-Power Reactor (NPR) Event Notification Worksheet
ML13083A0722019-09-30030 September 2019
NRC Form 313 - Application for Materials License
ML13083A0192019-07-31031 July 2019
NRC Form 7 - Application for NRC Export or Import License, Amendment, Renewal, or Consent Request(S)
ML13083A1232019-07-31031 July 2019
NRC Form 396 - Certification of Medical Examination by Facility Licensee
ML13083A1272019-07-31031 July 2019
NRC Form 398 - Personal Qualification Statement -- Licensee
ML13083A1742019-07-31031 July 2019
NRC Form 526 - Certification of Small Entity Status for the Purposes of Annual Fees Imposed Under 10 CFR Part 171 (Effective July 16, 2019)
ML13083A1762019-05-31031 May 2019
NRC Form 531 - Request for Taxpayer Identification Number
ML13083A2502019-04-30030 April 2019
NRC Form 664 - General Licensee Registration
ML19231A2062019-01-31031 January 2019
NRC Form 527 - Request for Information Related to Contractor Charges -- in Accordance with 10 CFR 170.51
ML16025A0332018-12-31031 December 2018
NRC Form 405F - List All Owners, Officers, Directors, and Executive Personnel (Oodep'S)
ML13083A1372018-10-31031 October 2018
NRC Form 426 - Authorization to Publish a Manuscript in the NUREG Series
ML13083A0942018-06-30030 June 2018
NRC Form 354 - Data Report on Spouse
ML13083A1422018-05-31031 May 2018
NRC Form 445 - Request for Approval of Official Foreign Travel
ML13083A1522018-04-30030 April 2018
NRC Form 483 - Registration Certificate -- in Vitro Testing with Byproduct Material Under General License
ML13083A1072018-04-30030 April 2018
NRC Form 366A - Licensee Event Report (LER) Continuation Sheet
ML13083A1062018-04-30030 April 2018
NRC Form 366 - Licensee Event Report (LER)
ML13083A2952018-04-30030 April 2018
NRC Form 740M - Concise Note
ML13083A2972018-04-30030 April 2018
NRC Form 742 - Material Balance Report
ML13083A2982018-04-30030 April 2018
NRC Form 742C - Physical Inventory Listing
ML13083A2962018-04-30030 April 2018
NRC Form 741 - Nuclear Material Transaction Report
ML13083A2442018-02-28028 February 2018
NRC Form 653 - Transfers of Industrial Devices Report (to General Licensees)
ML13083A1082018-02-28028 February 2018
NRC Form 366B - Licensee Event Report (LER)
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NRC Form 782 - Complaint Form
ML13083A3292017-12-31031 December 2017
NRC Form 781 - Sbcr Compliance Review Part a
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NRC Form 536 - Operator Licensing Examination Data
ML13083A0172017-10-31031 October 2017
NRC Form 5 - Occupational Dose Record for Monitoring Period
ML13083A0052017-10-31031 October 2017
NRC Form 4 - Cumulative Occupational Dose History
ML13083A0182017-10-31031 October 2017
NRC Form 64 - Travel Voucher
ML13083A0592017-10-31031 October 2017
NRC Form 241 - Report of Proposed Activities in Non-Agreement States, Areas of Exclusive Federal Jurisdiction, or Offshore Waters
ML14211A1652017-09-30030 September 2017
NRC Form 749 - Manual License Verification Report
ML13083A0022017-08-31031 August 2017
NRC Form 3 - Notice to Employees
ML13083A2372017-07-31031 July 2017
NRC Form 629 - Authorization for Payment by Credit Card
ML13083A0502017-05-31031 May 2017
NRC Form 212 - Qualifications Investigation Professional, Technical, and Administrative Positions
ML13083A0852017-03-31031 March 2017
NRC Form 327 - Special Nuclear Material (SNM) and Source Material (SM) Physical Inventory Summary Report
ML19231A1992017-03-31031 March 2017
NRC Form 787 - Freedom of Information Act - User Survey
ML13083A0792017-02-28028 February 2017
NRC Form 314 - Certificate of Disposition of Materials
ML13083A1802017-01-31031 January 2017
NRC Form 540 - NRC Uniform Low-Level Radioactive Waste Manifest Shipping Paper
ML13083A1812017-01-31031 January 2017
NRC Form 540A - Uniform Low-Level Radioactive Waste Manifest Shipping Paper (Continuation)
ML13083A1822017-01-31031 January 2017
NRC Form 541 - Uniform Low-Level Radioactive Waste Manifest Container and Waste Description
ML13083A0282017-01-31031 January 2017
NRC Form 136 - Security Termination Statement
ML13083A1832017-01-31031 January 2017
NRC Form 541A - Uniform Low-Level Radioactive Waste Manifest Container and Waster Description (Continuation)
2022-07-11
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APPROVED BY OMB: NO. 3150-0166 Estimated burden per response to comply with this information collection request: 3.3 hours3.472222e-5 days <br />8.333333e-4 hours <br />4.960317e-6 weeks <br />1.1415e-6 months <br />. This uniform manifest is required by NRC to meet reporting requirements of Federal and State Agencies for the safe transportation and disposal of low-level waste. Send comments regarding burden estimate to the FOIA, Privacy and Information Collections Branch (T-5 F53), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0166), Office of Management and EXPIRES: 12/31/2019 Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.
NRC FORM 541A U.S. NUCLEAR REGULATORY COMMISSION 2. MANIFEST NUMBER (01-2017)
UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST CONTAINER AND WASTE DESCRIPTION (CONTINUATION)
Instructions: See NUREG/BR-0204 for detailed instructions for completing this form: http://www.nrc.gov/reading-rm/doc-collections/nuregs/brochures/br0204/ 3.
PAGE PAGE(S)
OF DISPOSAL CONTAINER DESCRIPTION WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER 16.
WASTE
- 5. 6. 7. 8. 9. 10. SURFACE PHYSICAL DESCRIPTION 14. CHEMICAL DESCRIPTION 15. RADIOLOGICAL DESCRIPTION CLASSIFI-CONTAMINATION CATION SURFACE 11. 12. 13.
CONTAINER CONTAINER WASTE RADIATION MBq/100cm 2 WASTE SORBENT WEIGHT AS-Class A IDENTIFICATION DESCRIP- VOLUME AND APPROXIMATE SOLIDIFICATION, Stable LEVEL DESCRIP- % INDIVIDUAL RADIONUCLIDES AND ACTIVITY (MBq) AND NUMBER/ TION CONTAINER WASTE STABILIZATION, CHEMICAL FORM/ AU-Class A GENERATOR (m 3) WEIGHT TOR CHELATING CONTAINER TOTAL; OR CONTAINER TOTAL ACTIVITY Unstable
(µSv/hr) BETA- VOLUME(S) IN MEDIA CHELATING AGENT ID NUMBER(S) (See Note 1) (kg) ALPHA AGENT AND RADIONUCLIDE PERCENT B-Class B GAMMA CONTAINER C-Class C (mSv/hr) (See Note 2) IF > 0.1%
(See Note 3)
NRC FORM 541A (01-2017)