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{{#Wiki_filter:ADVANCED NOTIFICATION OF SHIPMENT OF CATEGORY 1 AND/OR 2 RADIOACTIVE SOURCES In accordance with 10 CFR Part 110.50(c)(3)(i) of the U.S. NRC Regulations NRC Form 831 (MM-YYYY)
{{#Wiki_filter:NRC FORM 831                U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0036                                      EXPIRES: (MM/DD/YYYY)
SEND COMPLETED FORM TO:
(MM-YYYY)
U.S. Nuclear Regulatory Commission ATTN: Headquarters Operation Center Email: hoo.hoc@nrc.gov (Preferred Reporting Method)
Estimated burden per response to comply with this mandatory collection request: 30 minutes. This form 10 CFR 110.50(c)(3)(i) allows the NRC to request additional information from licensees to determine whether a license should be revoked, suspended, or modified. Send comments regarding burden estimate to the Information Services Branch, (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-001, or by REPORT OF EXPORT                e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, 3150-0036, Office of Management and 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.
Fax: (301) 816-5151 (Alternative Reporting Method)
ADVANCED NOTIFICATION OF                                          SEND COMPLETED FORM TO:
A Part 110 license number:
SHIPMENT OF CATEGORY 1 AND/OR 2 RADIOACTIVE SOURCES                                        U.S. Nuclear Regulatory Commission In accordance with 10 CFR Part 110.50(c)(3)(i)                          ATTN: Headquarters Operation Center of the U.S. NRC Regulations                  Email: hoo.hoc@nrc.gov (Preferred Reporting Method)
B Name of the individual and licensee making the notification: (address, city, state, zip code and  
Reference Number:                                                      Fax: (301) 816-5151 (Alternative Reporting Method)
 
Part 110 license number:
telephone number)
A Expiration date:
U. S. exporting facility:
Name of the individual and licensee making the notification: (address, city, state, zip code and telephone number)
(company name, address, city, state, zip  
B U. S. exporting facility:
 
(company name, address, city, state, zip code and telephone number)
code and telephone number)
Foreign recipient name, address and end use C
C Foreign recipient name, address and end use  
 
location(s) if different than recipient's address:
location(s) if different than recipient's address:
D Radionuclide(s) and activity level in TBq, both  
Radionuclide(s) and activity level in TBq, both D      for single and aggregate shipments:
 
for single and aggregate shipments:
Total Activity Level (TBq):
Total Activity Level (TBq):
E Make, model and serial number, for any  
Make, model and serial number, for any E
 
category 1 and 2 sealed sources, if available:
category 1 and 2 sealed sources, if available:
F End-use in the importing country, if known:
F     End-use in the importing country, if known:
G Shipment date: (MM/DD/YYYY)
G     Shipment date: (MM/DD/YYYY)
H REPORT  OF EXPORT NRC FORM 831 (MM-YYYY)10 CFR 110.50(c)(3)(i)
This notification should be accompanied by a copy of the foreign recipient's authorization or confirmation H
U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB:  NO. 3150-0036 EXPIRES:  (MM/DD/YYYY)
of that authorization from the government of the importing country, as required by 110.32(g).
Estimated burden per response to comply with this mandatory collection request: 30 minutes. This form allows the NRC to request additional information from licensees to determine whether a license should be revoked, suspended, or modified.
Comments:
Send comments regarding burden estimate to the Information Services Branch, (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC  20555-001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, 3150-0036, Office of Management and 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 831 (MM-YYYY)}}
This notification should be accompanied by a copy of the foreign recipient's authorization or confirmation of that authorization from the government of the importing country, as required by 110.32(g).
Reference Number:
Comments: Expiration date:}}

Latest revision as of 20:20, 19 October 2019

NRC 831 (OMB Copy)
ML19127A378
Person / Time
Issue date: 05/29/2019
From:
NRC/OCIO
To:
References
Download: ML19127A378 (1)
v • d • e


Text

NRC FORM 831 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0036 EXPIRES: (MM/DD/YYYY)

(MM-YYYY)

Estimated burden per response to comply with this mandatory collection request: 30 minutes. This form 10 CFR 110.50(c)(3)(i) allows the NRC to request additional information from licensees to determine whether a license should be revoked, suspended, or modified. Send comments regarding burden estimate to the Information Services Branch, (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-001, or by REPORT OF EXPORT e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, 3150-0036, Office of Management and 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.

ADVANCED NOTIFICATION OF SEND COMPLETED FORM TO:

SHIPMENT OF CATEGORY 1 AND/OR 2 RADIOACTIVE SOURCES U.S. Nuclear Regulatory Commission In accordance with 10 CFR Part 110.50(c)(3)(i) ATTN: Headquarters Operation Center of the U.S. NRC Regulations Email: hoo.hoc@nrc.gov (Preferred Reporting Method)

Reference Number: Fax: (301) 816-5151 (Alternative Reporting Method)

Part 110 license number:

A Expiration date:

Name of the individual and licensee making the notification: (address, city, state, zip code and telephone number)

B U. S. exporting facility:

(company name, address, city, state, zip code and telephone number)

Foreign recipient name, address and end use C

location(s) if different than recipient's address:

Radionuclide(s) and activity level in TBq, both D for single and aggregate shipments:

Total Activity Level (TBq):

Make, model and serial number, for any E

category 1 and 2 sealed sources, if available:

F End-use in the importing country, if known:

G Shipment date: (MM/DD/YYYY)

This notification should be accompanied by a copy of the foreign recipient's authorization or confirmation H

of that authorization from the government of the importing country, as required by 110.32(g).

Comments:

NRC Form 831 (MM-YYYY)

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