ML22132A252

OMB 3150-0166, OMB Copy NRC Form 541

ML22132A252
Person / Time
Issue date:	07/18/2022
From:	Priya Yadav NRC/NMSS/DDUWP/LLWPB
To:
Yadav P
Shared Package
ML22132A249	List: ML22132A250 ML22132A251 ML22132A252 ML22132A253
References
OMB 3150-0166
Download: ML22132A252 (1)

Text

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 or its equivalent is required by NRC to meet reporting requirements of Federal and State Agencies for the safe transportation and disposal of low-level waste (10 CFR EXPIRES: (MM/DD/YYYY) 20, App G). Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and regulatory Affairs, (3150-0166), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; e-mail: oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.

NRC FORM 541 U.S. NUCLEAR REGULATORY COMMISSION 1. Manifest Totals 2. Manifest Number (MM-YYYY) Net Waste Net Waste Special Nuclear Material (grams)

No. of Pkgs/

Volume Weight UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST Disposal CONTAINER AND WASTE DESCRIPTION Containers (m 3 ) (kg) U-233 U-235 Pu Total 3. Page 1 of Page(s)

4. Shipper Name Additional Nuclear Regulatory Commission (NRC) Requirements for Control, Transfer and Disposal of Radioactive Waste Activity (MBq) Source (kg)

All Nuclides Tritium C-14 Tc-99 I-129 Shipper ID Number See NUREG/BR-0204 for detailed instructions for completing this form:

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

Disposal Container Description Waste Description for Each Waste Type in Container

5. Container 6. Container 7. Volume 8. Waste 9. Waste 10. Surface 11. Surface Physical Description 15. Chemical Description 16. Radiological Description 17. Waste Class 3

Identification Description (m ) and Weight Radiation Level Contamination 12. Waste 13. Approximate 14. Sorbent AS-Class A Stable 2

Number/Generator (See Note 1) Container (kg) MBq/100 cm Descriptor Waste Solidification, Weight Individual Radionuclides and Activity AU-Class A Unstable

(µSv/hr) Chemical Form/ B-Class B ID Number(s) Weight (kg) (See Note 2) Volume(s) in Stabilization,  % Chelating (MBq) and Container Total; or Container Beta- Chelating Agent C-Class C Alpha Container Media (See Note 3)

Agent if > 0.1% Total Activity and Radionuclide Percent (mSv/hr) Gamma NOTE 1: Container Description Codes. For containers/ waste NOTE 2: Waste Descriptor Codes. (Choose up to three which predominate by volume.) NOTE 3: For solidification media that meet disposal site structural stability requirements, the numerical code requiring disposal in approved structural overpacks, the numerical should be followed by "-S."

code should be followed by "-OP." 20. Charcoal 31. Anion Ion-exchange Media 41. Animal For all solidification media, the vendor (manufacturer) and brand name should also be identified in item 14. Code

21. Incinerator Ash 32. Mixed Bed Ion-exchange Media Carcass 100=NONE REQUIRED.

1. Wooden Box or Crate 10. Gas Cylinder

22. Soil 33. Contaminated Equipment 42. Biological Sorption Solidification

2. Metal Box 11. Bulk Unpackaged Waste

23. Gas 34. Organic Liquid (except oil) Material (except 60. Speed Dri 67. Florco X 75. Petroset II 90. Cement

3. Plastic Drum or Pail 12. Unpackaged Components animal carcass)

24. Oil 35. Glassware or Labware 61. Celetom 68. Solid A Sorb 76. Aquaset 91. Concrete (encapsulation)

4. Metal Drum or Pail 13. High Integrity Container

25. Aqueous Liquid 36. Sealed Source/Device 43. Activated 62. Floor Dry/ 69. Chemsil 30 77. Aquaset II 92. Bitumen

5. Metal Tank or Liner 19. Other. Describe in item 6, Material Superfine

26. Filter Media 37. Paint or Plating 70. Chemsil 50 89. Other. Describe in item 14, 93. Vinyl Chloride

6. Concrete Tank or Liner or additional page

27. Mechanical Filter 38. Evaporator Bottoms/ 63. High Dri 71. Chemsil 3030 or additional page 94. Vinyl Ester Styrene

59. Other.

7. Polyethylene Tank or Liner Sludges/Concentrates

28. EPA or State Hazardous Describe in item 64. Safe T Sorb 72. Dicaperl HP200 99. Other. Describe in item 14,

8. Fiberglass Tank or Liner 12, or additional or additional page

29. Demolition Rubble 39. Compactible Trash 65. Safe N Dri 73. Dicaperl HP500

9. Demineralizer page

30. Cation Ion-exchange Media 40. Noncompactible Trash 66. Florco 74. Petroset 100. None Required NRC FORM 541 (MM-YYYY)