ML20151Z053

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Instructions for Completing Nrc'S Uniform LOW-LEVEL Radioactive Waste Manifest
ML20151Z053
Person / Time
Issue date: 07/31/1998
From:
NRC
To:
References
NUREG-BR-0204, NUREG-BR-0204-R02, NUREG-BR-204, NUREG-BR-204-R2, NUDOCS 9809210115
Download: ML20151Z053 (32)
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INSTRUCTIONS FOR COMPLETING NRC'S LOW-LEVEL RADIOACTIVE WASTE MANIFEST LISTED IN THESE INSTRUCTIONS ARE THE ITEMS OF INFORMATION THAT ARE FEDERALLY REQUIRED OR OTHERWISE NEEDED FOR THE COMPLETION OF THE UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST -

(NRC FORMS 540,541, AND 542). AN EXPLANATION OR REFERENCE FOR EACH l TEM IS INCLUDED TO ASSIST YOU IN PROPERLY COMPLETING EACH FORM. PLEASE CALL THE DESIGNATED CONSIGNEE, THE U.S. NUCLEAR REGUt.ATORY COMMISSION (301-415-6196), OR THE U.S.

DEPARTMENT OF TRANSPORTATION (202-366-4488) IF YOU SHOULD NEED CLARIFICATION OF ANY OF THE ITEMS.

r OBTAIN COPIES OF NRC'S UNIFORM low-LEVEL

! RADIOACTIVE WASTE MANIFEST FORMS AND THE GENERAL ' 4 INSTRUCTIONS FROM THE GRAPHICS AND ELECTRONIC COMPOSITION SECTION OF THE PUBLISHING SERVICES BRANCH, MAIL STOP T-4 E16, U. S. NUCLEAR REGULATORY COMMISSION, WASHINGTON, DC 20555-0001 OR TELEPHONE 301-415-5877 OR E-Mall ADDRESS

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SAMPLE NRC FORMS 540,541, AND 542 ARE SHOWN AS EXHIBITS AT THE END OF THESE INSTRUCTIONS. ,,

.< THE ONLY CHANGES BEMEENSEv. 2 AND REV.1 OF THESE INSTRUCTIONS ARE (1) UPDATED INFORMATION FOR REQUESTING FORMS AND INSTRUCTIONS, (2) UPDATED

  • SAMPLE FORMS THAT SHOW THE CURRENT OFFICE OF MANAGEMENT AND BUDGET CLEARANCE NUMBER AND (3) A MINOR CLARIFICATION TD THE CERTIFICATION STATEMENT ON NRC FORM 540.

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NUREG/BR-0204, Reg 2.

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l The Uniform Low-Level Radioactive Waste Manifest . .i consists of the following forms: )

4 (1) NRC Form 540 and 540A': Uniform Low- ,

li . Level Radioactive Waste Manifest (Shipping  ! );

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Paper) and continuation page-  ! I NilC Form 541 and 541 A: Uniform Low-Level (2) ,

Radioactive Waste Manifest (Container and

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Waste Description) and continuation page; and 1

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]O (3) NRC Form 542 and 542A: Uniform Low-Level Radioactive Waste Man:fest (Manifest Index &

d Regional Compact Tabulation) and  !

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( The entities who must comply with manifesting regulations

, are defined in Appendix G, Section 1, to 10 CFR Part 20.

, Typically, all shipments oflow-level radioactive waste for '

L which the consignee is a licensed low-level radioactive I waste disposal facility are subject to NRC manifesting

n. requirements.

T I With exceptions as defined in the regulations, shipments of low-level radioactive waste (as determined by the consignor j within the defmitions in the regulation) to waste processors or waste collectors, prior to ultimate disposal of the ~

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j radioactivity at a licensed disysal facility, are also subject l y_. to these' manifesting requirements. Note that State or b

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' Forms 540 and 540A and their respective ,

.=;' .y instructions are based on Department of Transportation j

." regulations, including changes issued on September 28,

. . ]". 1995 (60 FR 50292).

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1 l E Compact manifesting requirements may encompass shipments beyond those defined by the NRC.

NRCForm 540 is to be completed by specified shippers of low-level radioactive waste intended for ultimate disposal at 1 a licensed land disposal facility.

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y( NRC Form 541 is to be completed by specified shippers of

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low-level radioactive waste intended for ultimate disposal at l a licensed land disposr.1 facility, unless agreement has been l7

+i reached between appropriate parties to transmit the required information electronically.

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} NRC Form 542 should be completed by processors and i s

collectors oflow-level radioactive waste who are shipping R

low-level radioactive waste attributed to others for ultimate ni disposal at a licensed land disposal facility, unless agreement has been reached between appropriate parties to transmit the required information electronically.

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{ Note: The NRC requires all users of the Uniform Manifest 4 forms to report information in metric units, and all the forms 4

have been developed for the use of metric units. Metric j units are used in NRC Form 540 as pennitted by DOT uq_, ~

~ 2 regulations, and required after April 1,1997, with the -

) exception ofitem 18 (Total Wqight or, Volume) in which I~ DOT allows the shipper to specify appropriate units. DOT

'l allows reporting of English units following the International

System of Units (SI). NRC Forms 541 and 542 are

'! i designed for metric reporting. However, if the consignor, consignee, and others having authority over reporting

~- requirements agree, metric and English units may be used.

_ '. In this case, the shipper may need to add the English units to the forms in a manner that prevents misinterpretation.  !

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Note: Information in these instructions that is typediff t

Italics is not required by Federal law or regulation. ,

Radioactive shipments that are not manifested under NP.C i:. regulations must continue to comply with Department of l

)! i Transportation (DOT) regulations.

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NRC FORM 540: UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST l (Shipping Paper) l 4  !

NRC Form 540 must be completed for shipments oflow-i level radioactive waste intended for ultimate disposal at a l

licensed land disposal facility. The majority of the information on NRC Form 540 is needed to meet DOT 4 shipping paper requirements for radioactive material

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shipments. The,following are generalinstructions. Details regarding DOT requirements can be found in 49 CFR Part 172.

[ 1. Emergency Telephone Number - The shipper is to

{ provide an emergency response telephone number or

[ numbers for use in the event of an emergency. If a J single number applies to every entry on the shipping j papers, enter this number in the space provided. If H there are multiple numbers, each individual number

? must be entered in item 11 immediately following the applicable description of the radioactive material.

9 Enter the name ofthe organization responsiblefor J providing the emergency response information.

5 1 Note that additional emergency response information 1 must be available and presented in accordance with 49

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CFR 172.602. -

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2. Is This an " Exclusive Use" Shipment? - The shipper answers by checking "yes" or "no." See 49 4  ! CFR 172.203. If"yes," then specific instructions for j  !

maintenance of exclusive use shipment controls must j be provided by the shipper to the carrier and must be

gl included with the shipping paper as required at 49

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CFR 173.403.

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TotalNumberofPackagesIdentsfiedOn This Manifest - Indicate the total number ofpackages

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Does EPA Regulated Waste Requiring a Manifest !

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" Accompany This Shipment? - If the answer to this f ,,

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question is "Yes," the shipper completes the applicable EPA manifest and attaches it to the NRC

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y Form 540. The shipper shouldalso identify the EP mamfest number in the spaceproyided(ifacceptable ff to the consignee, the mamfest number appearing in Y ltem 8 ofNRC Form 540 may be identical to the EPA tj mamfest number).

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ti Shipper - Indicate the cornpany or facility name, facility address, contactperson, and telephone number. Ifapplicable, Indicate the permit or other similar number assigned to the shipper by the appropriate host State in which the designated licenseddisposalfacilityislocated. Indicate whethen p

( the shipper is a waste generator, collector, or processor, as defined in the regulation, by checking

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the appropriate box. Ifyou are a generator, enter om Q[ ofthefollowing letter codes (Government - G, Fuel

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- -.  ; " ' ~.~ J Cycle industry - FC, Nuclear Power - NP, University

% (Academic) - A,-Medical- M Industrial-I, Other - O, ;

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M in the " GENERATOR TYPE" space. The spacefor a l shipper identification number isprovidedfor the \

[ shipper to recordthe number, ifany, assignedto the y^ shipper by the consignee or the designateddisposal \

facilityoperator. A spaceprovidedunderthe m

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heading, " SHIPMENT NUMBER,"isfor any use deemedappropriate by the shipper.

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6. Carrier - Indicate either the carrier's name, address, contactperson, and telephone number, or the carrier's , ,

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name and EPA identification number. Also include m.

the shipping date. Upon receipt ofthe shipment, an .

q_ :e 1 authorized carrier representative will acknowledge *B"

^shipment receipt by signing and dating in the space provided

7. Enter the total number of pages for EACH set of L NRC Forms (*ae., Fesms 540 and 540A, Forms 541 . . .,

- and $41 A, and Forms $42 and 542A). In addition,

. Ident!fy the number ofpages ofadditional information ~

. (e.g., host State) that requires a separate page or pages and is a part ofthis manifest. Ifan EPA .

manifest accompanies the NRC Forms, do not include itspages in item 7.

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IfNRC Form 542 or additionalpages are not part of .

' this mam'fest, enter "None"in the appropriate blank.

if only NRC Form 540 (and 540A, if necessary) is g <

- intended to physically accompany the shipment (e.g.,

t the shipper is electronically or otherwise providing NRC Forms 541 and 542 and any additional n= information separately to the consignee), then this must be indicated by placing parentheses around the ,

number of pages entered for NRC Forms 541,542," ,

andadditionalinformation. a -

8.. Manifest Number - A traceable manifesi number of '

- at least four number / letter characters must be entered by the shipper. This number may be dictated by the  !

consignee of the low-level radioactive waste (e.g., the  ; '

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waste processor, waste collector, or licensed disposal 2 i

site operator) prior to the shipment.

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9. Consignee - Indicate the company or facility name, l address, contact person, and telephone number. Upon T- wg-receipt of the shipment, an authorized person at the T '

l facility will acknowledge receipt of the shipment by signing and dating in the space provided. I 10.

Certification - The certification on the manifest must be signed and dated by the person responsible for the . .

packaginiandlibeling operations. The person must also be authorized to sign on the behalfof the ~

shipping company or facility.

11. U.S. Department of Transp artation Desc:iption (Including Proper Shipping Name, Hazard Class, j UN ID Number, and Any AdditionalInformation) '

- The requirement for providing this information is contained within DOT regulations at 49 CFR 172.202.

n For purposes of transportation in commerce, DOT L regulations at 49 CFR 172.101 provide a listing of I

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hazardous materials. If this information is required, .

the shipper must use the exact descriptors, in the order specified,in the DOT regulations. Additional

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i description requirements (e.g., indication of I Reportable Quantity and NRC Certificate of f

Compliance, if applicable) are specified at 49 CFR ,

172.203.

12. DOT " Radioactive" Label - See DOT regulations at O .

49 CFR 172.203 and 49 CFR 172.403. Indicate the 4

type of radioactive label that appears on the package  !

(White - I, Yellow II, or Yellov'III). The shipper . -

does not need to repeat the word " RADIOACTIVE." j

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i If no label is required by DOT, place "NA" in this I  !

column.

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13. Transport Iudex - See DOT regulations at 49 CFR 173.403. This is a dimensioniers number, which, for  !- '

nonfissile material packsges, is equivalent to the ,

radiation dose rate in millirem per hour at one meter h from the surface of the package. The Transport Index ll is placed on the label of a package to designate the degree of control n ~ ecessary during transportation. If l

reporting of_the_Tjansport Index is not required, place  :. , .

l "NA"in this column. L.- m -A . ~ T T .. '4hJi- l

14. Physical and Chemical Form - See DOT regulations i at 49 CFR 172.203. Describe the physical form of the contents of the package as " Solid," " Liquid," or

" Gas." List the most prevalent chemical form, e.g., '

cellulose, cement, metallic oxides. Additional generic information on material description may be 4

included, as needed, to satisfy requirements of shipment consignee. Further information on the physical and chemical description of the waste is [k 2

required on NRC k  ;

Form 541.

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15. Individual Radionuclides - See DOT regulations at ky l
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" 49 CFR 172.203 and official abbreviations at 49 CFR i 173.435. List the radionuclides (as detennined in DOT regulations at 173.433(f)) that are present in the f.

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transport package. The element symbol may be .

,' I immediately followed by the nuclide's mass number, i

i.e., a dash is not needed. A semicolon and space i 1 should separate the listing of multiple nuclides.

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16. Total Package Activity in SI Units - Report the total {

l activity in the transport package in SI units (e.g., j ,

' megabecquerels). If desired, this activity may also be n .

reported in units of millicuries, in parentheses below ,

s .. g the listing in SI units. c -

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17. LSA/SCO Class - See DOT Regulations at 49 CFR p 172.203. For a shipment oflow spe;ific activity e material or surface contaminated c'ajects, provide the appropriate group notation. .

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18. Total Weight or Volume - See DOT regulations at m _.J' - > --

49 CFR 172.202. Using the most appropriate units, -

identify the total weight or total volume (net or gross as appropriate) of the material identified in Item 11. p ,

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19. Identification Number ofPackage - For each j package, apackage identifcation number, unique };

among the individualpackage identification numbers  ?

a within the shipment, should beprovided. Both numbers andletters may be used.

DO NOT WRITE IN THE AREA LABELED "FOR i I CONSIGNEE USE ONLY." THIS AREA HAS BEEN LEFT f BLANK INTENTIONALLY TO ALLOW EACH DISPOSAL j FACILITY TO RECORD DISCREPANCIES, BURIAL INFORMATION, ETc. (THE INFORMATION IN THIS SPACE IS TO BE DETERMINED BY THE INDIVIDUAL I CONSIGNEES.) L. .

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Use NRC Form 540A if additional space is needed to Y

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i describe this shipment. Indicate the page number, total Form 540 and 540A pages, and the manifest number reported in Item 8.' j .

r NUREG/BR-0204, Rev. 2 10 -

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l NRC FORM 541: UNIFORM l

LOW-LEVEL RADIOACTIVE WASTE MANIFEST 1 (Container and Waste Description)

This form must be completed by shippers oflow-level radioactive waste as defined on pages 2 and 3, unless the information is being transmitted electronically, as noted on page 3 of these instructions.

If waste shipments are to a consignee other than the disposal '

facility operator or are uncontainerized, not all the information is required by NRC regulations. For shipments of containerized waste to a consignee other than the disposal facility operator, the information requested under Items 5 through 10 of " DISPOSAL CONTAINER

  • DESCRIPTION" and Item 16, " Waste Classification,"is not required by NRC regulations. (Note that container information, however, may be required by the consignee.)

For all shipments of uncontainerized waste, Items 5, 6, and 10 are not applicable; the volume of the waste would be reported in Item 7, the weight of the waste in Item 8, and surface radiation levels in Item ( br those uncontainerized wastes shipped to a consignee other than the disposal facility operator, the information requested in Items 9 and 16 is also not required by NRC regulations.

1. l Manifest Totals - Indicate the total number oflow-level waste disposal containers described on tids  !

manifest (the total number ofpackages may be listed, ifthe consignee is not a licensedlow-level waste

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disposalfacility), the total net waste volume (cubic l

meters), and the total net weight (kilograms).  ;

Appendix G of 10 CFR Part 20 requires separate i 11 NUREG/BR-0204, Rev. 2 l

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.j l s y manifest totals for tritium (H-3), C-14, Tc-99, I-129

{ U-235, plutonium, and uranium and thorium in source

!. material. For the first four nuclides, enter the totals in h

"; megabecquerels (MBq) in the appropriate boxes. If the radionuclides are not present, place "NP" in the ap j;" space. If the radionuclides are present in any of the containers within a shipment, but are identified in item

quantities no greater than the lower limit ofdetection ,

l; (LLD), the quantities of these nuclides must be record  !

il the sum of the respective LLD values (with the summe

[ value included in parentheses). (Note that Item 15, I beginning on page 18, would also be expanded to re reporting of tritium (H-3), C-14, Tc-99, and I-129 below l

p LLDs). If both detectable and quantities based on LLD i values of radionuclides exist in containers making up y shipment, the sum of the detectable and "LLD-based

! must be reported separately, the latter in parentheses. T total activity for all nuclides on the manifest (excludi

[y LLD values) column. must be indicated in the "ALL NU

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p Also indicate the total manifested quantity of uranium an

} thorium in source material (kilograms) and special nucle i material (grams), including uranium and thorium in

[ unimportant quantities defined in 10 CFR 40.13. Note: T mass being requested is not the weight of the waste h

ip containing these nuclides. Ensure that the totals in gram dj for U-233, U-235, and plutonium equal the grand total Q weight of these nuclides in Special Nuclear Material.

(1 Indicate the total number ofdisposal containers con h i I

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4 NUREG/BR-0204, Rev. 2 12 r

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each type ofSpecial Nuclear Material inparenthesis y

1 after the quantitylisting.

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Manifest Number - Transfer the manifest number i i from NRC Form 540, Item 8. I

l 1 3. Page1of page(s)-Include the total number of i Form 541 and 541 A pages.
4. Shipper Name andID Number - Same as reported in i

Item 5 of NRC Fonn 540.

NOTE: SEE PREVIOUS DISCUSSION  !

4 REGARDING THE COMPLETION OFITEMS 5 THRCUGH 10 ON FORM 541.

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5. '

Container Identification Number / Generator ID Number (s) - Provide a disposal container !i identification number unique among the individual

?l container identification numbers within the shipment  !

l (both numbers and letters may be used). Also indicate I ID number (s) of the generator (s) contributing waste to

' the disposal container. If more than one disposal container is assigned to a single generator, the

! generator ID number need not be repeated. Note that

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the definition of" generator" identified in this item includes (a) " waste generators" as defined in k'

' Appendix G of 10 CFR Part 20 and (b) those licensees to which waste can be reasonably attributed, in the context of the Low-Level Radioactive Waste Policy Amendments Act of 1985, as a result of processing, decontamination, or transfers of radioactive materials.

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l 13 NUREG/BR-0204, Rev. 2

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! ' The spacing between the vertical listings of generator L

ID numbers in this column (if more than one generator contributes waste to a single disposal l .;

container) allows for the recording, on an individual j

generator basis, of all information required under the j

J heading, " Waste Description for Each Waste Type in

' i! Container." Note that information on discrete waste L

types (i.e., activated material, contaminated equipment, mechanical filter, or scaled source / devic wastes or individual disposal container wastes jl

contained in different solidification / stabilization j media) is requested. No more than one generator should be listedper outlined row. Individual

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)^ consignees (e.g., disposalfacility operators) may require more extensive breakdowns ofradiological l- descriptions (e.g.,for Class *AS or A U waste).

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i Container Description - Using the codes found in j 6.

Note 1 at the bottom of NRC Form 541, describe the j

disposal container. When Code 13 (High Integrity

!l Container) is used, also identify the manufacturer anc 9

the model number. NRC and/or host State Cert

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of Compliance Number (s) should be identified, as appropriate. If Code 19, "Other," is used, describe th

l container in Item 6. If the explanation is not entered j in Item 6 (the preferred method), enter "see additiont

$j page" and provide the description on that page. The additional page must be included in the " additional information" total pages called for in Item 7 of NRC jl} Form 540. If the container and waste require dispos; ll in an approved structural overpack, the letters "-OP" 9

M must be entered following the appropriate code number.

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7. Volume (Cubic Meters) - As a minimum, indicate the volume of the outside dimensions of each container to the nearest hundredth of a cubic meter.

Consignees (e.g., disposalfacility operators) may require a greater sensitivity ofmeasurement. For volumes ofless than I cubic meter, always include a zero in front of the decimal. For bulk unpackaged waste or unpackaged components or equipment, enter the estimated volume of the waste.

( 8. Waste and Container Weight (Kilograms) - List the

' combined weight, in kilograms, of the container plus the contents. For uncontainerized waste, provide the welght af the waste. Consignees may require specific

sensitivities ofmeasurement.

} 9.

! Surface Radiation Level ( Sv/hr or mSv/hr)-

Indicate the radiation level on contact with the disposal container or uncontainerized waste. If this level does not represent the highest radiation level on the disposal container, provide additional descriptive information. Select appropriate units for the entire page. Do not use "BKG" for background levels unless the background level is indicated in this column.

10. Surface Contamination (MBq/100 cm'):

Alpha, Beta-Gamma - Record the results of contamination surveys performed on the disposal container. Do not use "BKG"for backgroundlevels i

imless the backgroundlevelis indicated in this f column. Estimated values are acceptable ifpotential

) occupational exposures limit sun'ey data collection.

15 NUREG/BR-0204, Rev. 2 L_.... .

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' Waste Descriptor - Using the codes found in Note 2 at the bottom of NRC Form 541, indicate the codes

! that most specifically describe the type of waste in the -

container. For discrete waste types (i.e., activated

[ material, contaminated equipment, mechanical filter, E

L sealed source / device or for wastes contained in l

different solidification / stabilization media), the

! spacing between these vertical listings of waste j descriptors or medias (ifmore than one waste type or d media is included in a single disposal container) allows for the provision of radiological descriptions

.i on an individual waste descriptor and individual

[j solidification / stabilization media basis. Individual i consignees (e.g., disposalfacility operators) may y

require more extensive breakdowns ofradiological t

i  !

descriptions. If Code 59, "Other," is used, a written explanation is required. The preferred option is to d

include the explanation in item i 1, but if additional  ;

j space is required, enter "see additional page" in Item

11. The additional page must be included in the y

j " additional information" total pages called for in Item 7 ofNRC Form 540, 9

12. Approximate Waste Volume (s) in Container -

Indicate the approximate volume in cubic meters of 4[

containerized waste, as applicable, by generator, l

{

waste descriptor (if activated material, contaminated b equipment, mechanical filter, or scaled source / device

$' waste or waste contained in different L

M solidification / stabilization media). ">85%" may be L

" entered if(l) the' disposal container " fill volume"

{

l exceeds 85%; (2) the disposal container does not contain the aforementioned discrete wastes, together  !

or mixed with other waste types, and does not contain NUREG/BR-0204, Rev. 2 16 e,

t-l l

f l

~- - -

_34aa _ - - _ - --

ML: po+y; , x ,

' h 5' l . . , , ,

t ate 2 les more than one solidification / stabilization media; and in the (3) the external volume reported in Item 7 is d approximately equal to the internal disposal container Iter, volume.

13.

Sorbent, Solidification, Stabilizatien Media - All t

shipments must use the codes found in Note 3 at the

>e or bottom of NRC Form 541. Indicate the co identifies the material used to solidify or absorb was

>ns material. The spacing between the vertical listings of media descriptors (ifmore than one media descripto al is included in a single disposal container) allows for the provision of radiological descriptions on an al individual " media-descriptor" basis. Individual ten consignees may require more extensive breakdowns a radiologicaldescriptions. Similarly, individual el disposalfacilities may require solidification ofcertain em wastes (e.g., oil) in speca) led media and may require identsfication ofmedia vendor (manufacture brand name. If Code 89 or 99, "Other," is used, a written explanation is required. The preferred option is to include the explanation in Item 13, but if additional space is required, enter "see additional af page" in Item 13. The additional page must be included in the " additional information" total pages ed called forin Item 7 ofNRC Form 540.

1ce If the solidification process is intended to stabilize the e waste in accordance with applicable NRC regulations at 10 CFR 6 L56(b) and disposal site requirements, a letter, "-S", must be entered following the appropriate ,

ter code number. Note that all Class B and C wastes '

i tain must meet stability requirements. For all wastes s

I claimed to meet the aforementioned stability 17 NUREG/BR-0204, Rev. 2 l

- . ,c- ,

L

~

i j

requirements, the vendor (manufacturer) and the brand

.I j

{ name column. of the solidification media must be i  ;

.g:

l p 14.

Chemical Description - List the most prevalent y

!. chemical forms of the waste. Information in ite should expand upon the chemical form description

{'

ltem 14 of NRC Form 540. If animal carcasses w coded in Item 11, the chemical form should includ l j the word " LIME," if applicable, in addition to any l other significant chemicals.' Also indicate the nam y the chelating agents that are present in amounts k greater than 0.1% by weight of waste. Specify the jj percent in the column under the heading " Weight 9 Chelating Agent if>0.1%." If chelating agents are 6

not present indicate "NP." If chelating agents

. represent less than 0.1% by weight, indicate "0." If d(

l wastes were generated from large decontamination !

  1. l processes (e.g., LOMI, Can-Decon, Citrox, etc.),

indicate the process in this column. If an additional H

sheet describing the content of these wastes is needi 3

2 note this in Item 7 ofNRC Form 540.'

', 15.

j Radiological Description - This information may b '

. presented in either of two ways. First, list all f'

significant radionuclides followed by their respectiv l

[l activities in megabequerels that are present in the 1 l j waste in each container and for each waste generatoi (e.g., if waste from more than one generator is '

M contained in a single container). Daughter products i

' ) must be either individually reported or, if within a factor of 2 of being in equilibrium with its (their) f parent, reported as the parent with its activity listed, '

y but with the symbol "D" or "NAT" indicating I

NUREG/BR-0204, Rev. 2 18

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4, A dN w , sq g' g g ,

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2 #1 '

daughter products in equilibrium (e.g., Cs-137D or 3

ThNAT). For waste included within a single l- container, the significant radionuclides and their respective activities must be separately reported for discrete waste types (i.e., activated materials, 4

contaminated equipment, mechanical filters, and in sealed source / devices and wastes in solidification / stabilization media). Other wastes may be described by a combination of waste descriptor codes and, as a result, the radionuclides and activities or may be reported as a combined total. When the radionuclides tritium (H-3), C-14, Tc-99, or I-129 are present, but the quantities are below the LLD, note the radionuclide and report the LLD value in parentheses.

After listing the individual radionuclides as described above, enter the word " Total" on a new line and enter the total activity contained in the container. However, if any LLD values were included in the container, i

these values should not be included in the container sum because they will be totaled separately under Item 1.

OR, alternatively, for containers containing a single waste type, enter the total megabequerels in the '

container (for each waste generator, if waste from more than one generator is included in a single conimer) and enter the percent of each radionuclide.

Always include the "% sign when using this option.

Individual consignees may require more extensive breakdowns ofradiological descriptions or may not i'

allow the alternative method ofreporting described above.

19 NUREG/BR-0204, Rev. 2 k '

u

1 i m . 1

,a -

+ . \

Is 1

' Note: The activity for uranium and thorium in sourc material and U-233, U-235, and plutonium in Speci 1 Nuclear Material must be reported in megabecquere.

The quantity of these isotopes must be reported, in kilograms for source material-including the -  !

1 abbreviation "kg", and in grams for Special Nuclear l Material-including the abbreviation "g." The weight quantities must be reported in brackets, eithe adjacent to the activity listing or below the

] radionuclide listing.

l I A radionuclide is "significant" ifit is contained in th waste in concentrations greater than 0.01 times the concentration of that nuclide listed in Table 1 of 10 1

j CFR 61.55 or 0.01 times the smallest concentration that nuclide listed in Table 2 of 10 CFR 61.55. A 1

radionuclide other than one listed in the tables is d considered significant ifit is contained in the waste i s concentrations greater than 0.26 megabecquerels/cm' f Furthermore, any radionuclide whose activity represents a Reportable Quantity under DOT p}-

regulations or is 0.01 or'more of the total activity j! within the disposal container should be listed even if i

f the above concentration criteria are not exceeded.

7 Listing only the most abundant radionuclidea or the

@ category " mixed fission products" is not acceptable.

W Use official abbreviations only.

'1 i

) To save space, two nuclides andtheir respective 1

activities may be entered on each line in this bisected i

column. Additionalnuclidesandtheirrespective l 1

activities may be entered on subsequent lines that ma.

l be includedin each " outlined" row; that is, the lines j separating rows are not intended to limit the vertical o

i

, NUREG/BR-0204, Rev. 2 20

i

' Mf4..

. : g ,. . . ..

Sm _ _ . - -

reporting ofnuclides and activities, but are provided to aid the transcription and readability ofthe providedinformation.

16. Waste Classification - Using the following codes, I indicate waste classification and the structural stability of the waste in accordance with applicable NRC requirements or the radioactive material license j applicable at the disposal facility to which the waste

{ will be consigned. Waste generators shipping to processors need not complete this item.

AS - Class A Stable AU - Class A Unstable B - Class B j C - Class C BU or CU (unstable class B or C) may be used to classify waste requiring appropriate handling i or processing at a disposal facility to achieve l

required stability. If Greater-than-Class C wastes are shipped, use "GTCC" (see 10 CFR  ;

61.7(b)(5)).

Use NRC Form 541 A if additional space is needed to describe this shipment. Indicate the page number, total number of Form 541 and 541 A pages, and the manifest i ,

number from NRC Form 540, Item 8. I i

1 l

a

! i I

1 21 NUREG/BR-0204, Rev. 2

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1 i NRC FORM 542: UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST (Manifest Index and Regional Compact Tabulation) 1.

Waste Collector / Processor - Complete the collector orprocessor's'name, ID number, and the shipping date. Space has also beenprovidedfor any use deemedappropriate bythe shipper.

A waste collector orprocessor is an entity, operating under a Commission or Agreement State license, whose principalpurposeforpossessing the i

radioactive material or waste is asfollows:

( A collector collects andconsolidates waste generated by others and transfers this waste, withoutprocessing or. repackaging, to another waste collector, processor, or licensedland disposalfacility.

A processorprocesses, repackages, or otherwise treats low-level radioactive material or waste generated by others before the eventualtransfer ofthe waste, or waste residue, to a licensedland disposalfacility.

2.

Manifest Number - Transfer the mamfest number from NRCForm 540, Item 8.

3. Page1of Page(s)-Include the totalnumber of Form 542 and542Apages.

4.

Generator Identification Number - Each row should include one ofthe generator ID numbersfrom NRC Form 541, Jtem 5. i 'Igenerator numbers associated 23 NUREG/BR-0204, Rev. 2 i

~ -

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I

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- . . - ~ , . - ._ _ _._.._._._ __ ___

. ' " ~

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x_J h with generators to whom low-level radioactive wa

[

is being attributed should appear in this column. l

5. Generator Name, Permit Number (Vapplicable) and Telephone Number - SpecVy the information requested about the generator to whom waste is bt i attributed. List one and only one generator, and 1 accompanying information, in each block. Ifthe
- permit number is reported in item 4, it need not be s

repeated here. Provide the generator information ,

j requested in items 6 through 11 in the same row.

t'

6. Generator Facility Address - List the complete address ofthe generator'sfacility that has i contributedlow-level waste to the shipment. List <

and only one generator address in the block

' consistent with the generator information providet l '

Item 5.

, 7. Preprocessed Waste (or Material) Volume - Indics l 1] the approximate volume in cubic meters (not l l

including the container) ofthepreprocessed waste ;

material. This is the volume ofwaste or material \

J; receivedfrom the consignor'sfacility. This f :

information may be that indicated on the consigno. ,

NRC Form 541, Jtem 12, or the shippingpaper us< l tofacilitate the transfer ofradioactive material. l

8. ManifestNumber(s) Under Which Waste (or Material) Received and Date ofReceipt - List the '

previous mamfest number (s) applicable to the low-level waste that has been attributed to the generatc ,

listed in item 5, and date(s) ofwaste or material i

a  :

n <l NUREG/BR-0204, Rev. 2 24 l i,j i

1 hj i!

u~ % q,;y m , r a,y gMn}T \

receipt by the shipper identifiedin item 5 ofNRC Form 540.

' ~

9.

sg Waste Code: Processedor Collected-Indicate proper waste code, "P"or "C,"usingIhe definitions ofwaste processor and waste collector in Appendix G l of10 CFR Part 20. Do not mixprocessedand  ;

collected waste on the same line, list separately.

10.

Originating Compact Region or State - Identify the originating compact region, or unaffiliatedstate. The information to be providedisfor the original generator ofthe waste, as definedin Appendix G ,

e Section I, of10 CFR Part 20. For each generator listedin item 5, provide the information in the same

-n row. State abbreviations may be used. Compact  ;

abbreviations may be used when it cannot be confused with a State abbreviation (do not use 2 letter Compact abbreviations).

e 11.

>r As Processed / Collected Total- For each original generator in Item 5, list the totalSource Afaterial(in kilograms), Special Nuclear Afaterial(in grams),

, activity (in megabequerels) contained in the waste,

! andthe volume (in cubic meters) attributedto that generator. SpecialNuclear AfaterialandSource Afaterialare definedin 10 CFR 70.4 and 40.4, respectively.

j Total ofAll Pages (NRC Form 542 and 542A) - At

). the bottom ofthe page, indicate the totalsfor items IIA through 11D that are reportedon allpages of the NRC Form 542 and 542A. Do not include subtotals.

25 NUREG/BR-0204, Rev. 2 i_

m. .worwermv + '

Y_. .~ ~

u. s i i l'

l.

Use NRC Form 542A ifadditional space is needt ,

describe this shipment. Indicate the page numbe number ofForm 542 and 542A pages, and the m<

i numberfrom NRC Form 540, Jtem 8.

l:

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. i tt ii NUREG/BR-0204, Rev, 2 26

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  • % P APPROVED SV OMB: NO. 31604164 Estimated burden por response to comply with this information conection request: 1.17 hours1.967593e-4 days <br />0.00472 hours <br />2.810847e-5 weeks <br />6.4685e-6 months <br />. This uniform m -

EXPlRES. 05/31/2001 Forward comments regarding burden estimate to the Records Managernerg Branch (T4 F33), U.S. Nuclear Washinoton, DC 20503. R en information collection does not display a currentty valid OMO control number, the N__ T..

NRC FORM 540 U. S. NUCLE.AR REGULATORY COMMISSION 5 SHEMR . NAME AND F ACILITY S 1998)

UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST SHIPPING PAPER USER PERMIT' NUMBER SHIPMENT .

1 EMERGENCY TELEPHONE NUMBER pnclude Arve Code)

CONTACT ORGANIZATION _.

O CARRIER- Name and Address

2. IS THl3 AN UCLUSIVE USE" SHIPMENTT 3 FOT AL NUMBER OF

- PACKAGES DEPmFIED YES ON THis MANIFEST NO 2"""">

UOU WASTEREQUIRING A

~W M

MANIFEST ACCOMPANY

~

SIGNATURE - Autharred cena ecAnowbdgeg wesso r-j THIS SHIPMENT 7 N"Yes? prende Mansfest Number ... s>

12 14 11 U S DEPARTMENT OF TRANSPORTATION DESCRFTION PHYSICAL AND (includmg proper shippmg name, hazard class UN O number, DOT LABEL TRANSPORT and any addeonal mformation) "RADCACTIVE" INDEX CHEMICAL FORM

+

I is required by NRC to meet reportsnp requirernents of Federal and State Agencies for the sarne transportation and disposal of low-level waste.

eletory Corntnission, Washington, w 2055M001, and to the Paperwalk Reduction Project (315H16d). Office of Management and Budget. -

ny not conduct or sponsor, and a person is not required to respond to, the informaton collection.

M'EH I O WMBER 6M E 7 NRC FORM 540 AND 504A PAGE 1 OF PAGE(S) y s umber on all conbnuabon NRC FORM 541 AND 541 A PAGE(S) P89)

COLLECTOR NRC FORM 542 AND 542A PAGE(S)

PROCESSOR ADDIflONAL INFORMAflON PAGE(S)

IER GENERATOR TYPE 9 CONSIGNEE - Name and Faceity Address Cor(TACT (Spec &)

TELEMIONE NUMBER (include Area Code) TELEPHONE NUMBER (ketude Area Code) -

L EPAID NUMBER SIGNATURE - Aumcreed consynee acknowhdgeg weste rscorpt DATE SHIPPING DATE 10. CERTIFICATION The a b cettry that the herern-named matanais are property classmed, desenbed, packaged. marked. and labeesd and are TELEPHONE WM8;R In proper Condebon for transportation according to 94 apphcable regulabons of the Departmerit of Iransportstron The also

@nch Area M) certMes that the matenals are classmed, packaged, rnarked and labeled and are m proper condibon for transportaban and desposal as desenbod m accordance with the apphcab'e requeroments of 10 CFR Parts 20 and 61, or equsvakrnt state regulabons OATE AUTHORIZED SIGNATURF TTTLE DATE 15 16 17 18 TOTAL WEIGHT NOlVIDUAL 19 IDENTIFICATION TOTAL PACKAGE LSA/SCO OR VOLUME NUMBER OF RADIONUCUDES ACTMTV N SI UNITS CLASS (I,/se apprtymehr unrfs) PACKAGE A t% se m .. __m

' MrCMlUHb onnn m .w a . -

O$ b f 0%vic CLid y

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4% (je NRC FORM $40A p *51 UNIFORM LOW-LEVEL RAD WASTE MANIFES SHIPPING PAPER (CONTINU nc N ng haz rd UN O nu. DOT BEL TRAN T PHY L AND and any ackkbonal enformabon) " RADIOACTIVE" INDEX CHEMICAL FORM

-mens 6

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U. S. NUCLEAR REGULATORY COMMISSION IgST NUMB _ER _

iCTIVE <

N) PAGE OF PAGE(S) _

NDEIDUAL TOTE CKAGE ACTMTY N SI UNITS LS CO CLASS

'C UE (Use opsvapnele wwts)

NU B PACKAGE CF "

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  • COLLECTED WASTE" penerators.

s

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PRE PERMrf R (IF APPLNE), p

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2. Nucieer Reputetcry Commission. Washington DC 2055W1. and to the Peperwork Reduction Project Q1504165). OfUos of Maragement and us contrat member. the NRC may not conduct er *nonw, end a penon h nd required to rwpond to, the infonw4 ion ocWien. ""#

WASTE COLLECTOR / PROCESSOR SHPPER USE ONLY~~

3.

PAGE 1 OF PAGE(S)

8. 9 10 11 AS PROCESSEDCOLLECTED TOTAL STE MANIFEST NUMBER (S) UNDER WASTE CODE OR M N A SOURCE TER N WHICH WASTE (OR MATERIAL) P = PROCESSED COMPACT q B. SNM C ACTMfY D. VOLUME UME RECENED AND DATE REGION C e COLLECTED 3 OF RECEPT OR STATE (m ) 3 l

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UNIFORNi low-LEVEL RADIOACTP WASTE MANIFEST CONTAINER ANDWASTE DESCRIPTION (CONTINUAT~

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U.S. NUCLEAR REGULATORY COMMISSION

[E f PAGE OF PAGE(S) to

! WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER l'

14. 15 RADOLOGICAL DESCRIPTION O CHEMICAL DESCRIPTION ASonse A I WDGHT DN

% INDMDUAL RADONUCUDES AND ACTMTV(MBq) AND

% ^ ** #

4 CHELATING CONTAINER TOTAL; OR CONTAINER TOTAL ACTMTV g AGENT AND RADIONUCLCE PERCENT go,,, g IF = 01% CCass C a n sa Mer e e pg {pu N7CNlVOC CARD 1

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poss) U.S. NUCLEAR REGULATORY COMMISSloN L UNIFORM LOW-LEVEL RADIOACTIVE "

t WASTE MANIFEST . m r ,vo, MANIFEST INDEX AND REGIONAL COMPACT TABULATION

~

Ust all orlDinni

  • PROCESSED WASTE" generators (if any) " " "

" COLLECTED WASTE" generators.

GmEMM CENERATOR NAME. OENERA M NUMBER ELE NUM R ' ggs ut

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Hes. The uniform manifest is required by NRC to meet report requirements of Federal and State Apencies for the asis 0. .%i J-, am maposal cf kw les (T4 F33), U.S. Nucieer Reguletory Commission, Washington, DC 205550001, and to the Peporwort Reduction Project (3150-0163), ofrxm of Management at kl Oh8 contml number. the NRC may not conduct or spenaar, and a person is not required to re+ pond to, the information erflection WASTE COLLECTOR / PROCESSOR SHIPPER USE ONLY 3

PAGE 1 OF PAGE(S) 8 9 10. 11-AS PROCESSEDrCOLLECTED TOTAL WASTE MANIFEST NUMBER {S) UNDER #

WASTE CODE A. SOURCE CR MATERIAL) WHCH WASTE (OR MATERIAL) P a PROCESSED MATERM B SNM C. ACTMTY D. VOLUME VOLUME RECElvED AND DATE REGION C s NN 8

(m ) (kg) (g) (MBq) 3 (m )

APER"URE

, CARD A!co Avn! eble on Aperturn (;ard J Oo aD 6 -C BTALS OF ALL PAGES (NRC FORMS 542 AND 542A) i -

o r k,'[.

G M2A UNIFORM LOW-LEVEL RADIOACTIVE i

KANIFEST INDEX AND REGIONAL COMPACT T a 7 x

. 'i/ GENERATOR GENERATOR NAME, ceggAfoR a ,,n,cAroN ncRun NuueER c ApeccAatE) ,Aca;ry g, , NUMBER ANDTELEPtCNE NUMBER ADDRESS f.i b; .

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