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 EXPIRES: (MM/DD/YYYY)

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 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 UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST CONTAINER AND WASTE DESCRIPTION See NUREG/BR-0204 for detailed instructions for completing this form:

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

NRC FORM 541 (MM-YYYY)

Additional Nuclear Regulatory Commission (NRC) Requirements for Control, Transfer and Disposal of Radioactive Waste

1. Manifest Totals

2. Manifest Number No. of Pkgs/

Disposal Containers Net Waste Volume (m )

3 Special Nuclear Material (grams)

Net Waste Weight (kg)

U-233 U-235 Pu Total Activity (MBq)

All Nuclides Tritium C-14 Tc-99 I-129 Source (kg)

Page(s)

3. Page of

4. Shipper Name Shipper ID Number Disposal Container Description

5. Container Identification Number/Generator ID Number(s)

6. Container Description (See Note 1)

7. Volume (m )

3

8. Waste and Container Weight (kg)

9. Waste Weight (kg)

10. Surface Radiation Level

(µSv/hr)

(mSv/hr)

11. Surface Contamination MBq/100 cm 2

Alpha Beta-Gamma

12. Waste Descriptor (See Note 2)

13. Approximate Waste Volume(s) in Container

14. Sorbent Solidification, Stabilization, Media (See Note 3)

Physical Description

15. Chemical Description Chemical Form/

Chelating Agent Weight

% Chelating Agent if > 0.1%

16. Radiological Description Individual Radionuclides and Activity (MBq) and Container Total; or Container Total Activity and Radionuclide Percent

17. Waste Class AS-Class A Stable AU-Class A Unstable B-Class B C-Class C

1. Wooden Box or Crate

2. Metal Box

3. Plastic Drum or Pail

4. Metal Drum or Pail

5. Metal Tank or Liner

6. Concrete Tank or Liner

7. Polyethylene Tank or Liner

20. Charcoal

21. Incinerator Ash

22. Soil

23. Gas

25. Aqueous Liquid

28. EPA or State Hazardous Sorption NOTE 1: Container Description Codes. For containers/ waste requiring disposal in approved structural overpacks, the numerical code should be followed by "-OP."

10. Gas Cylinder

11. Bulk Unpackaged Waste

12. Unpackaged Components

13. High Integrity Container

19. Other. Describe in item 6, or additional page

31. Anion Ion-exchange Media

32. Mixed Bed Ion-exchange Media

37. Paint or Plating

26. Filter Media

33. Contaminated Equipment

34. Organic Liquid (except oil)

35. Glassware or Labware

36. Sealed Source/Device

68. Solid A Sorb

41. Animal Carcass

42. Biological Material (except animal carcass)

43. Activated Material NOTE 2: Waste Descriptor Codes. (Choose up to three which predominate by volume.)

59. Other.

Describe in item 12, or additional page

67. Florco X

69. Chemsil 30

70. Chemsil 50

71. Chemsil 3030

72. Dicaperl HP200

73. Dicaperl HP500

74. Petroset

91. Concrete (encapsulation)

92. Bitumen

93. Vinyl Chloride

94. Vinyl Ester Styrene

99. Other. Describe in item 14, or additional page 100. None Required

60. Speed Dri

61. Celetom

62. Floor Dry/

Superfine

63. High Dri

64. Safe T Sorb

65. Safe N Dri

66. Florco

90. Cement Solidification

8. Fiberglass Tank or Liner

9. Demineralizer

29. Demolition Rubble

24. Oil

27. Mechanical Filter

75. Petroset II

76. Aquaset

77. Aquaset II

89. Other. Describe in item 14, or additional page NOTE 3: For solidification media that meet disposal site structural stability requirements, the numerical code should be followed by "-S."

For all solidification media, the vendor (manufacturer) and brand name should also be identified in item 14. Code 100=NONE REQUIRED.

30. Cation Ion-exchange Media

40. Noncompactible Trash

39. Compactible Trash

38. Evaporator Bottoms/

Sludges/Concentrates Waste Description for Each Waste Type in Container (MM-YYYY) 1