ML18313A148

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OMB 3150-0165, NRC Form 542
ML18313A148
Person / Time
Issue date: 06/26/2019
From:
Division of Decommissioning, Uranium Recovery and Waste Programs
To:
L DESOTEL DUWP
Shared Package
ML18313A143 List:
References
OMB 3150-0165
Download: ML18313A148 (1)


Text

UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST MANIFEST INDEX AND REGIONAL COMPACT TABULATION NRC FORM 542 (MM-YYYY)

U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 542 (MM-YYYY)

APPROVED BY OMB: NO. 3150-0165 EXPIRES: (MM/DD/YYYY)

2. MANIFEST NUMBER List all original "PROCESSED WASTE" generators (if any) before "COLLECTED WASTE" generators.

PAGE(S)

PAGE OF 3.

Estimated burden per response to comply with this information collection request: 45 minutes. 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 Information Services Branch (T-6 A10M), 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 Budget, Washington, DC 20503. If a means used to imp ose an information collection does not display a currently vaild OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

10. ORIGINATING COMPACT REGION OR STATE AS PROCESSED/COLLECTED TOTAL 11.

WASTE COLLECTOR/PROCESSOR 1.

NAME IDENTIFICATION NUMBER SHIPPING DATE SHIPPER USE ONLY D. VOLUME (m )

3 C. ACTIVITY (MBq)

B. SNM (g)

A. SOURCE MATERIAL (kg) 9.

WASTE CODE P = PROCESSED C = COLLECTED 8.

MANIFEST NUMBER(S) UNDER WHICH WASTE (OR MATERIAL)

RECEIVED AND DATE OF RECEIPT 7.

PREPROCESSED WASTE (OR MATERIAL)

VOLUME (m )

3 GENERATOR FACILITY ADDRESS 6.

GENERATOR NAME PERMIT NUMBER (IF APPLICABLE)

AND TELEPHONE NUMBER 5.

GENERATOR IDENTIFICATION NUMBER 4.

TOTALS OF ALL PAGES (NRC FORMS 542 AND 542A)

Instructions: See NUREG/BR-0204 for detailed instructions for completing this form:

http://www.nrc.gov/reading-rm/doc-collections/nuregs/brochures/br0204/