ML20203F781

Notice of Pending NRC Action to Submit Info Collection Request to OMB & Solicitation of Public Comment Re NRC Forms 540,540A,541,541A,542 & 542A,uniform LLW Manifest Forms

ML20203F781
Person / Time
Issue date:	12/05/1997
From:	Shelton B NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
To:
References
NUDOCS 9712170461
Download: ML20203F781 (20)

Text

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[7590-01-P)

U. S. NUCLEAR REGULATORY COMMISSION ,

Agency Information Collecuon Activities: Proposed Collection; Comment request AGENCY: U. S. Nuclear Regulatory Commission (NRC)

ACTIOit Notice of pending NRC actien to submit an information collection request to OMS and solicitation of public comment.

SUMICRY: The NRC is preparing a submittal to OMB for review of continued approval of Information collections urider the provialons of the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35).

Information pertaining to the requiroment to be submitted:

1. The 1:tle of the informatW collection:

NRC Forms 540, 540A, 541, 541 A, 542, and 542A, Uniform Low-Level Radioactive n'aste Manifest forms kFWh

2. Current OMB approval number ,

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NRC Forms 540, 540A: 3150-0164 ll, i ,OjO2 NRC Forms 541,541A: 3150-0166 lll NRC Forms 542,542A: 315C-0165 9712170461 971205 Y O PDR ORO EUSONI

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3. How often the co ;ec'.lon is required: Forms are used by shippers whenever radic, active waste is shipped. Quarterly reporting or less frequent is made to NRC depending on specific license conditions.

4. Who is required or asked tu report: All NRC licensed low-level waste facilities. All generators, collectors, ind processors of low-level waste intended for dispodal at a low-level waste facility must complete the appropriate forms.

B N 5. The number of annual respondents:

3 NRC Form 540: 8,000 NRC Form 541: 8,000 NRC Form 542: 600

6. The number of hou.s needed annually to complete the requirement or request:

NRC Form 540: 9,380 hours0.0044 days <br />0.106 hours <br />6.283069e-4 weeks <br />1.4459e-4 months <br /> (1.17 hours1.967593e-4 days <br />0.00472 hours <br />2.810847e-5 weeks <br />6.4685e-6 months <br /> per response)

NRC Form 541: 43.463 hours0.00536 days <br />0.129 hours <br />7.655423e-4 weeks <br />1.761715e-4 months <br /> (5.43 hours4.976852e-4 days <br />0.0119 hours <br />7.109788e-5 weeks <br />1.63615e-5 months <br /> per response)

NRC Form 542: 260 hours0.00301 days <br />0.0722 hours <br />4.298942e-4 weeks <br />9.893e-5 months <br /> (0.43 hours4.976852e-4 days <br />0.0119 hours <br />7.109788e-5 weeks <br />1.63615e-5 months <br /> per response)

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7. Abstract: NRC Forms 540, 541, and 542, together with their continuation pages, designated by the "A" suffix, provide a set of standardized krms to meet Department of Transportation (DOT), NRC, and State requirements.

The forms were developed by NRC at the request of low-Kval waste industry groups. The forms provide uniformity and efficient 'rt the collection of information contained in manifests which are required to control transfers of low-level radioactive waste intcaded for disposal at a land disposal facility. NRC Form 540 contains information needed to

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satisfy DOT shipping paper requirements in 49 CFR Part 172 and the waste tracking requirements of NRC in 10 CFR Part 20. NRC Form 541

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contains informatiori needed by disposal site facilities to safely dispose of low-level waste and information to meet NRC and State requirements regulating these actMties. NRC Form 342, completed by waste collectors or processors, contains inform 6f on which facilitates tracking the identity of the was,te generator. That tracking becomes more complicated wW1 the waste forms, dimensions, or packagings are changed by the waste processor. Each conta:ner of waste shipped from a waste processor may contain waste from several different generators. The information provided on NRC Form 542 permits the States and Compacts to know the original generators of low-level waste, as authorized by the Low-Level RaC~ active Waste Policy Amendments Act of 1985, so they can ensure that waste is disposed of in the appropriate Compaci.

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4 4o Submit, by (insert date 60 days after publication in the Eegeral ReakteJ, comments that address the following questions:

1. Is the propoced collection of information necessary for the NRC to .

properly perform its functions? Does the information have practical utility?

2. Is the burden estimate accurate?

3. Is there a way to enhance tlte quality, utility, and clarity of the information to be collected?

4. How can the burden of the information collection be minimized, including the use of automated collection techniques or other forms of information technology?

A copy of the draft supporting statement may be viewed free of charge at the NRC Public Document Room, 2120 L Street, NW (lower level), Wash ngton, DC. OMB clearance requests are avai;cble at the NRC worldwide web sito (http://www.nrc. gov) under the FedWorld col!ection link on the home page tool bar. The document will be available on the NRC home page site for 60 days after the signature date of this notice.

5-Comments and questions about the information collection requirements may be directed td the NRC Clearance Officer, Brenda Jc Shelton, U.S. Nuclear Regulatory Commission, T-6 F33, Washington, DC, 20555-0001, or by telephone at 301415-7233, or by Internet electronic mail at BJS1@NRC. GOV.

Dated at Rockville, Maryland, this 5 day of C /u 1997 For the Nuclear Regulatory Commission.

wf; ' , ( ' aj prenda Joy. helton,3RC-Clearance Officer Office of the Ehief Informhton'-Officer

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SUPPORTING STATEMENT FOR NRC FORMS 540 AND 540A UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST (SHIPPING PAPER)

AND NUREG.'BR-0204, " INSTRUCTIONS FOR COMPLETING NRC'S UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST" (3150-0164)

EXTENSION REQUEST Descriotion of the information Collection Current industry practice requires standardizeo forms to meet Department of Transportation (DOT), NRC, and State requirernents. NRC Forra 540 is specifically designed to meet DOT requirements. Although DOT already requires the information, it does not require that it be completed on a Federal form.

NRC Form 540 and continuation Form 540A were developed by NRC at the request of low-level waste industry groups. When completed, Fonn 540 contains information needed to satisfy DOT shipping paper requirements in 49 CFR Part 172 and the waste tracking requirements of the NRC's 10 CFR Part 20. NUREG/BR-0204, Rev.1, contains instructions for completing NRC Forms 540, 540A, 541, 541 A, 542, and 542A.

A. JUSTIFICATION

1. Need for and Practical Utility of the Collection of Information To meet existing regulations, each shipment of low-level waste (LLW) is currently accompanied by a manifest that describes the shipment contents as required in 10 CFR Part 20 and the DOT regulations l' 49 CFR Part 172. Presently there are three LLW disposal facilities in operation; however, more LLW disposal facilities are expected to be licensed in the future. Therefore the need for additional control and uniformity of data is foreseen. The detailed information requested on Form 540, and its electronic submittal to NRC, will enhance the ability of NRC and State regulatory agencies to control and safely regulate disposal of LLW. Licensees may currently use either a shipping manifest pursuant to Appendix F of 10 CFR Part 20, or NRC Form 540 and relcted forms pursuant to Appendix G to 10 CFR Part 20. The use of NRC Form 540 and related forms will become mandatory beginnh on March 1,1998.

2. Acency Use of InformaOn The agency and States will require the information on Forms 540 and 540A to meet DOT shipping paper requirements and NRC tracking requirements. ,

3. Reduction of Burden throuch Information Technolooy DOT requires that shipping papers physically accompany the shipment. Therefore, the data for Form 540 cannot be transmitted between waste generators, brokers, and waste disposal facilities solely electronically, as is permitted with NRC Forms 541 and 542.

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~4, Edort to identify Duolicaticn and Use Similar Information Duplication will be reduced by' requiring all LLW shipments undertaken by various agencies to use the uniform NRC shipment manifest forms. There is no reasonable and economic way to obtain the information other than through the use of shipment manifests. NRC Form 540 replaces previously-ust d manifests.

5. Effort to Reduce Small Business Burden The required information is necessary from all shippers of LLW. To the extent that small entities may make fewer waste shipments than larger entities, fewer manifests would be required of small entities and their burden would be proportionately less.

The Department of Energy (DOE) has developed free software for LLW shippers' use.

NRC is evaluating this software to ensure that all regulatory requirements will be met.

6. Cc.seauences to Federal Proaram or Policy Activities if the Collecti .m is Not Conducted or is Conducted Less Freouently if the collection is not conducted at all or is conducted less frequently, NRC and State regulatory agencies will not be able to obtain information needed to control and safely '

regulate disposal of LLW.

7. C!rcumstances Which Justifv Variation from OMB Guidelines There are no variations from OMB guidelines.

8. Consultations Outside the NRC An opportunity to comment on the information collection requirements in NRC Forms 540 and 540A was provided in the Federal Reair'er Notice published for this clearance extension. Based on public input from users, NUREG/BR-0204 was revised in November 1996 to clarify some of the instructions, No changes were made to NRC Forms 540 or 540A.

~ 9. Payment or G.;t to Respondents

- Not applicable.

10. Confidenticlity of the information Not applicable. No confidt.ntial information is requested.

11. Justification for Sensitive Questions This information collection does not involve sensitive questions.

12. Estimated Burden and Durden Hour Cost It is estimated that 8,000 NRC Forms 540 will be processect annustly. The total industry burden for completion of the form will be 9,380 hours0.0044 days <br />0.106 hours <br />6.283069e-4 weeks <br />1.4459e-4 months <br /> annually (7,770 hours0.00891 days <br />0.214 hours <br />0.00127 weeks <br />2.92985e-4 months <br /> from generators and 1,610 hours0.00706 days <br />0.169 hours <br />0.00101 weeks <br />2.32105e-4 months <br /> from coilsetors/ processors. The average burden to completo the form will be 1,17 hrs (9,380 hours0.0044 days <br />0.106 hours <br />6.283069e-4 weeks <br />1.4459e-4 months <br /> divided by 8,000 forms). Non-professional personnel will complete this information. Therefore, total cost is estimated to be $609,700 (9,380 hrs x $65/hr).

-13; Estimate of Othee Additional Costs There are nc, additional costs. For licensees required to complete Form 540, it is most likely that purchases of equipment and services were made (1) prior to October 1,1995, (2) to acnieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the govemment, or (4) as part of customary and usual business or private prectices.

14. Estimated Annualized Cost to the Federal Govemment The estimated annual cost to the Federal Govemment will be approximately $7,000 for manifest printing and distribution. This cost will be fully recovered through fee assessments to NRC licensees pursuant to 10 CFR Parts 170 and/or 171. The forms are not submitted to NRC.

15. Reasons for Chanoes in Burden or Cost There are no changes in burden. An increase in cost has been estimated based on an increase in the license fee recovery rate since the previous clearance.

16. Publication for Statistical Use None.

17. Reason for Not Displayino the Expiration Date

. Not applicable. The expiration date will be displayed.

18. Exceptions to the Certification Statement There are no exceptions.

B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS The collection of information does not employ statistica! methods,

L SUPPORTING STATEMENT FOR

~ NRC FORMS 541 AND 541 A UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST CONTAINER AND WASTE DESCRIPTION ,

(3150-0166)

EXTENSION REQUEST

-Qgleriotion of the information Collection Currert Industry practice requires standardized forms to meet Department of Transportation (DOT), NRC. and Shte requirements. Although DOT already requires the information, it does not require tha' t be completed on a Federal form.

NRC F6rm 541 and continuation Form 541 A were developed by NRC at the request of low-

' level waste industry groups. When completed, Form 541 contains information needed by disposal site facilities to safely dispose of low-level waste (LLW) and information to meet NRC and State requirements regulating these activities. NUREG/BR-0204, Rev.1, contains instructions for completing NRC Forms 540, 540A, 541, 541 A, 542, and 542A.

A. JUSTIFICATION

1. Need for and Practical Utility of the Collection of Info,rmation To meet existing regulations, each shipment of LLW is currently accompanied by a manifest that describes the shipment contents as required in 10 CFR Part 20 and the .

DOT regulations in 49 CFR Part 172. Presently there are three LLW disposal facilities in operation; however, more LLW disposal facilities are expected to be licensed in the future. Therefore, the need for additional control and uniformity of data is foreseen.

The detailed information requested on Form 541, and its electronic submittal to NRC, will snhance the ability of NRC and State regulatory agencies to control and safely regulate disposal of LLW. Licensees may currently use either a shipping manifest .

pursuant to Appendix F of 10 CFR Part 20, or specified NRC forms including NRC Form 541 pursuant to *ppendix G to 10 CFR Part 20. The use of NRC Form 541 and related forms will become mandatory beginning on March 1,1998.

2. Acency Use of Information The agency and States will require the information on Forms 541 and 541A to control and safely regulate disposal of LLW.

3. Reduction of Burden throuah Information Technoloav There'are no legal obstacles to the use of information technology, NRC has structured the forms so that LLW generators may transmit the information electronically to either waste brokers or the LLW disposal site facility on a voluntary basis for their convenience. The information is not transmitted to NRC. Since the requirement to.use NRC Form 541 has not yet become effective, NRC does not yet have a basis for estimating the number of electronic exchanges of information between shippers and receivers. NRC will attempt to obtain an estimate for the next renewal of the clearance, by which time some experience with the provision may have accrued.

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4. Effort to identify Duolication and Use Similar Information Duplication will be' reduced by requiring all LLW shipments undertaken by various agencies to use the uniform NRC shipment manifest forms. There is no reasonable and economic way to obtain the information other than through the use of shipment manifests. NRC Form 541 replaces previously-used manifests.

5. Effort to Reduct 3 mall Business Surden The required information is necessary from all shippers of LLW. To the extent that small entities may make fewer waste shipments than larger entities, fewer manifests would be required of small entities and their burden would be proportionately less.

The Department of Energy (DOE) has developed free software for LLW shippers' use.

NRC is evaluating this software to ensure that all regulatory requirements will be met.

6. Conseauences to Federal Proaram or Policy Activities if the Collection is Not Conducted or is Conducted Less Frequently if the collection is not conducted at all or is conducted less frequently, NRC and State regulatory agencies will not be able to obtain information needed to control and safely regulate disposal of LLW.

7. Circumstances Which Justify Variation from OMB Guidelines There are no vcriations from OMB guidelines.

8. Consultations Outside the NRC An opportunity to comment on the information collection requirements in NRC Forms 541 and 541A was provided in the Fed eral Reo it s er Notice published for this clearance extension. Based on public input from users, NURECwBR-0204 and NRC Form 541 were revised in November 1996 to clarify some of the instructions. No changes were made to NRC Form 541 A.

9. Payment or Gift to Respondents Not applicable.

10. Confidentiality of the Information Not applicable. No confidentialinformation is requested.

11. Justifiestion for Sensitive Questions This information collection does not involve sensitivo questions.

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12. EstimatSd Burden and Burden Hour Cost it is estimated that 8,000 NRC Forms 541 will be processed annually. The total;-

Industry burden for completion of.the form will be 43,463 hours0.00536 days <br />0.129 hours <br />7.655423e-4 weeks <br />1.761715e-4 months <br /> (27,130 hours0.0015 days <br />0.0361 hours <br />2.149471e-4 weeks <br />4.9465e-5 months <br /> for l surveying and weighing 232,000 containers and 16,333 hours0.00385 days <br />0.0925 hours <br />5.505952e-4 weeks <br />1.267065e-4 months <br /> for recording the -

information). Of tbjs, surveying and weighing will require an estimated 7,753 hours0.00872 days <br />0.209 hours <br />0.00125 weeks <br />2.865165e-4 months <br /> and 19,377 hours0.00436 days <br />0.105 hours <br />6.233466e-4 weeks <br />1.434485e-4 months <br />, respectively, and recording the information will require an

- estimated 12,703 hours0.00814 days <br />0.195 hours <br />0.00116 weeks <br />2.674915e-4 months <br /> from generators and 3,630 hours0.00729 days <br />0.175 hours <br />0.00104 weeks <br />2.39715e-4 months <br /> from collectors / processors.

The average burden to complete the form will be 5.43 hours4.976852e-4 days <br />0.0119 hours <br />7.109788e-5 weeks <br />1.63615e-5 months <br /> (43,463 hours0.00536 days <br />0.129 hours <br />7.655423e-4 weeks <br />1.761715e-4 months <br /> divided by 8,000 forms). Non professional personnel will complete this information. Therefore,

--total cost is estimated to be $2,825,095 (43,463 hrs x $65/hr).

113. Estimate of Other Additional Costs There are no additional costs. For licensees required to complete Form 541, it is most like!y that purchases of equipment and services wete made (1) prior to October 1,1995, (2) to achieve regulatory compliance with requirements not associated with-the information collection, (3) for reasons other than to provide information or keep records for the govemment, or (4) as part of customary and usual business or private -

)

practicos.

14. Estimated Annualized Cost to the Federal Govemment The estimated annual cost to the Federal Govemment will be approximately $7.000

, for manifest printing and distribution. This cost will be fully recovered through fee ,

assessments to NRC licensees pursuant to 10 CFR Parts 170 and/or 171. The forms -

are not submitted to NRC.-

15.- Reasons for Chanoes in Burden or Cost -

There are no changea in burden. An in rease in cost has been astimated based on an increase in the license fee recovery rate since the previous elecrance.

- 16. Publication for Statistical Use

. -None.

17. Reason for Not Displavino the Exoiration Date Not applicable. The expiration date will be displayed.

13. .Exceotions to the Certification Statement There are;no exceptions.=

l B.E COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS l

LThe collection of information does not employ ' statistical methods.

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-.. . -, , _. , , _ _ , . . . _ . ~ _ _ _ . . _ _ _ _ _ _ _ _ _ _ _ _ _ _

1 SUPPORTING STATEMENT FOR NRC FORMS 542 AND 542A UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST INDEX AND REGIONAL COMPACT TABULATION (3150-0165) 6 EXTENSION REQUEST Description of the Information Collection Current industry practice requires standardized forms to meet Department of Transportation (DOT), NRC, and State requirements. NRC Form 542 is specifically designed to provide the means to meet the authority of the Low-Level Radioactive Waste Policy Amendments Act of 1985. Although DOT already requires the information, it does not require that it be completed on a Federal form. NUREG/BR-0204, Rev.1, contains instructions for completing NRC Forms 540, 540A, 541, 541 A, 542, and 542A.

NRC Form 542 and continuation Form 542A were developed by NRC at the r. uest of low-level waste industry groups. These forms are completed by waste collectors or processors.

Tracking the identity of the waste generator becomes more complicated when the waste forms, dimensions, or packagings are changed by the waste processor. Each container of waste shipped from a waste processor may contain waste from several different generators.

This inforrnation is iis'.ed on NRC Forms 542 and 542A.

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A. JUSTIFICATION

1. Need for and Practical Utility of the Collection of Information To meet existing regulations, each shipment of low-level waste (LLW) is currently accomranled by a manifest that describes the shipment contents as required in 10 CFR Part 20 and the DOT regulations in 49 CFR Part 172. Presently there are three LLW disposal facilities in ope ation; however, more LLW disposal facilities are expected to be licensed in the future. Therefore, the need for additional control and uniformity of data is foreseen. The detailed information requested on Form 541, and its electronic submittal to NRC, will enhance the ability of NRC and State regulatory agencies to control and safely regulate disposal of LLW. Licensees may currently use either a shippng manifest pursuant to Appendix F of 10 CFR Part 20, or specified NRC forms including NRC Form 542 pursuant to Appendix G to 10 CFR Part 20. The use of NRC Form 542 and related forms will become mandatory beginning on March 1,1998.

2. Aaency Use of Information The agency will require the informr,'bn on Forms 542 and 542A to ensure that States and Compacts know the origina! generators of LLW, as cuthorized by the Low-Level Radioactive Waste Policy Amendments Act of 1985, so that the waste is disposed of in the appropriate Compact.

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3. Reduction of Burden throuch Information Technofoav There are no legal obstacles to the use of !nformation technology. NRC has structured the forms so that LLW generators may transmit the information electronically to either waste brokers or the LLW disposal site facility on a voluntary basis for their convenience. The information is not transmitted to NRC. Since the requirement to use NRC Form 542 has not yet become effective, NRC does not yet have a basis for estimating the number of electronic exchanges of information between shippers and receivers. NRC will attempt to obtain an estimate for the next renewal of the clearance, by which time some experience with the provision may have accrued.

4. Effort to iden,tify Duplication and Use Similar Information

. Duplication will be reduced by requiring all LLW shipments undertaken by various agencies to use the uniform NRC shipment manifest forms. There is no reasonable and economic way to obtain the information other than through the use of shipment marnfests. -NRC Fcrm 542 replaces previously-used manifests.

5. Effort to Reduce Small Business Burden

-The required information is necessary from all shippers of LLW. To the extent that small entities may make fewer waste shipments than larger entities, fewer manifests would be required of small entitles and their burden would be proportionately less.

The Department of Energy (DOE) has daveloped free eoftware for LLW shippers' use.

NRC is evaluating this software to ensure that all regulatory requirements will be met.

6. Conseauences to Federal Proaram or Policy Activities if the Collection is Not Conducted or is Conductqd Less Freauentiv If the collection is not conducted at all or is conducted less frequently, NRC and State regulatory agencies will not be able to obtain information needed to control and safely regulate disposal of 11W.

7. Circumstances Which Justifv Variation from OMB Guidelines _

There are no variations from OMB guidelines.

8. Consultaiions Outside the NRC An opportunity to comment on the information collection requirements in NRC Forms

542 and 542A was pr7 Ided in the Federal Reaister Notice published for this

! clearance extension. Based on public inpiit from users, NUREG/BR-0204 was revised in November 1990 to clarify some of the instructions. No changes were made to NRC Forms 542 or 542A.

l l 9. Payment.or Gift to Respondents Not applicable.

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10. Confidentiality of the information Not applicable. No confidentialinformation is requested.

11. Justification for Sensitive Questions This information collection does not involve sensitive questions.

12. Egimated Burden and Burden Hnur Cost it is estimated that 600 NRC Forms 542 will be processed annually. Only collectors / processors complete this form. The totalindustry burden for completion of the form will be 260 hours0.00301 days <br />0.0722 hours <br />4.298942e-4 weeks <br />9.893e-5 months <br /> annually. The average burden to complete the form will be 0.43 hrs (260 hours0.00301 days <br />0.0722 hours <br />4.298942e-4 weeks <br />9.893e-5 months <br /> divided by 600 forms). Nor'. professional personnel will complete this hiformation. Therefore, total cost is estimated to be $16,900 (260 hrs x S65/hr).

13. Estimate of Other Additional Costs There are no additional costs. For licensees required to complete Form 542, it is most likely that purchases of equipment and services were made (1) prior to October 1,1995, (2) to achieve regulatory compliance with requirements not associated with the information collectio ), (3) for reasons other than to provide information or keep records for the govemment, or (4) as part of customary and usual business or prFrate practices.

14. E_stimated Annualized Cost to the Federal Government The estimated annual cost to the Federal Govemment will be approximately $1,000 for manifest printing and distribution. This cost will be fully recovered through fee assessments to NRC licensees pursuant to 10 CFR Parts 170 and/or 171. The forms are not submitted to NRC.

15. B_easons for Chances in Burden or Co;;

There are no i hanges '.n burden. An increase in cost has been estimated based on an increase in the license fee recovery rate since the previous clearance.

16. Publication for Statistical Use_

None.

17. Reason for Not Disclavino the Exoiration Date Not applica The expiration date will be displayed.

18. Exceotion to the Certification Statement There are no emptions.

B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS The collection of information does not employ statistical methods.

& %o APPMWED SY OM8 NO. 31504164 Estanated burden por response to comply with the enformaton coGectai request.1.17 hours1.967593e-4 days <br />0.00472 hours <br />2.810847e-5 weeks <br />6.4685e-6 months <br />. Ttwo und evers MwoormrY rarward commente r d.no buroen estwnste to e e informaton and Recorde Monocement Branch (T4 F Or does ret display a currenth wahd Cami control NRC FORM 640 U. S. NUCLEAR REOutATORY CO** MISSION 6 sterect- NAME A o F Acur (mms m UNIFORM LOW 4.EVEL RADIOACTIVF.

WASTE MANIFEST SHIPPING PAPER USER PERMIT NUMBER SHIPM 1 1MLRGLfC1 f t1EPHONE PS MLN pr.Amo Aree Case)

CcPnAci ORGAPfJAllCPd 6 CARRIER - Name eN Accreet 2 IS iPSS AN 'LACLU9VE USE' 94PMENT1 3 TOTAL NUMBER OF YES PACKAGES DE. Y rFED

_ ON TMS MANtFEST NO asssa) 4 DUL$ EPA RLQULATED CONTACT WASTE REQuRING A -

MANIFFET ACCOMPANY ~

MS WNTT 68GNA11JRE - Aumanrod camer schnowsedgeg we f "Yes" provee mew W ur ber msass) 11 U S DEPARTMENT OF TRANSPORTATION DESCRIPTW,]N 12 13 14 (inc6ueeg pmper on poin0 came hazard class UN O number. DOT LABEL TRANSPORT PHY$8 CAL AND and say est$onel trWorneten) NACTNE" INDEX CHEMCAL FORM a

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host is required ty NRC to speel r requkemente of Federal .nd State Agences for the same tra. sportalon and desposal of km leve! warte.

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{the NRC may not conduct or sponars. and a person la not required to resprnd to, the information conecton I

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APPROVED BY OMB: NO. 31604186 Estemeied enerden par response to comp *v udth this information conecten request 5 43 hours4.976852e-4 days <br />0.0119 hours <br />7.109788e-5 weeks <br />1.63615e-5 months <br /> T EXPlHES: MM/DD/YYYY waste Forwerti comments sogarden0 turden estimate to tte informatori and Records Mar. age Managemette and Budget Wethmg m. DC 20503 If an informaton cohaction does not display a NRC F ORM M1 U.S. NUCLEAR REGULATORY COMMISSION -

tMM m o *511 deuw hs 64g*$im UNIFORM LOW LEVEL RADIOACTIVE WASTE MANIFEST __

CONTAINER AND WASTE DESCRIPTION ALL NUCUDES Additons' Nuclear Regulatory Commission (NRC) Reqwements for Control, Transfer and Disposat of Radioactive Waste D;3POSAL CONT AINER DESCRIPTION 6 0 7 4 s to $URFACE PHYSICAL DESCRIPTON CCN1MER WASTE SW ACE WoutR CONT AMINATON M 12 13

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Iv0f t 1, Conta aer Jeecnpuon Cooes. Por contamers Note 2. waste Desenpeor Cooes gcnoose up to three wnecn predominate Dy vetumaJ wesM requiring 6tsposalin approved structural overpects.

the numerical code muet be foilewed 14"CP? 20 Chexcel 29 De mmtion Rubbia 38 Evenerator 1 Wooden IW or Crate 0 Demmeratwer

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• 22 s d 31 Amon hmeichange Meden 40 kioncompac9be T 2

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• 6 Cowrote Tank er Liner

• is Other Desenbe m stem 6 1 PolyetPrens Tank or Linet or seditonal page 28 EPA or State Hararoove 37 Pomt or Plabeg 6FW W M w W auW%, e -

• NRC FORM $41 (MM YYYY)

undorm enendest to requered tv NRC to meet esportmg requ6toments in Federal and State cars for he s safe transportateon and dm 'sel cd km-leve4 l Wench (T S F33), U.S Nuc4 ear Reputatory Cornenessaan Washmgton, DC 20555-0001, to the Paperwork Reduction Protect (31 166), Offee of ervliy vshd OMB control numter, the NRC may not conduct ce sponsor, and a person la not required to respond to tha 6nformation collection E 1, IAANIFT&T TOTALS 2 uAw Es1HuwaLR WAETE &PECaAL NuCLL AR M Af t HiAL (grams)

U-233 U 735 Pu  ?OT AL PAGE 1 OF PAGE(S) 4 S. PPER KAME E acimry twaq) SOURCE Eerfauw c.14 Tc -99 4129 @9)

SHlPPER O NUMBER E WAST E DESCRIPTION FOR EACH WASTE TYPE IN COr.TAINER 16 sTE E 14 CHE MICAL DESCRefl0N 15 RADIOLOGICK DESCRIPTION CLAS$1FL CATON ABENT WEIGHT AS-Class A 4(CA110N  % INDMDUAL RADONUCLOES AND ACTMTY (MBq) AND bbs

^UD A IL12ATION' CHELAT1HQ CONT AINER TOTAL. OR CONT AINER TOT AL ACTMTV DIA

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Sorphon Solidificatiofi rest animal cercass) 60 SpeediDet 64 Safe T Sorb 69 Chomsd 30 74 Petmset 89 Other 90 Coment 94 Vmp Ester Styrere 61 Cm 65 Se4 N Dn 70 Diomed 50 75 Petmset u Desenbe in 91 Concrete 99 Other Describe

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'6 WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONT AINER 14 OONCAL DESCRPTON 15 RADQOGIC AL DESCRPTON CLAsserk A

P M NT NECHT h ICAT1rA  % POVIDUAL RADIONUCLIDES AND ALM (MBq) AND Au ss A CHELATING CONTAINER TOT AL, OR CONTA!NER TOTAL ACTMTV 2Al m g l DIA AC,ENT AND RADOA.lCLIDE PERCENT g,,,, g Nnes 3) F

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APPROVED BY OMB: NO. 31604165 Estnoted burden pa resonse to campsy wah tNs wormaton cotwton request: 26 minutes.

EXPtRES: MM/DO/YYYY wen 8e Forved comments regardmg burden estmate to the Horinaton and Recosde Manage, win enitectmn done ret des NR U.S. NUCLEAR REGULATORY COMMISSON

,FgW 64 UNIFORM LOW LEVEL RADIOACTIVE WASTE MANIFEST -IDLNTIFCAim NUME!ER MANIFEST INDEX AND REOlONAL COMPACT TABULATDN Ust an original

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1. Stanch (T4 F33), U.S. Nuctent RWatory Conesskm, WasNngon. DC 70555-0001, and to the Paperwork Reducten Protect (3150-0165). omco of prr% watut C2A6 ccmtr d numter, the tSC may nni crwfor1 or erre. end a r.orson 4 ned required to ro+ pond to, the irAwmatrm cohntton WASTE COLLECTOR / PROCESSOR We5'PER A ONLY 3

PAGE 1 OF PAGE(S) 8 9 10 11 AS PROCESSEDCOLLECTED TOT AL

,STE MANIFEST NUMBER (S) UNDER W ASTE CODE A SOURCE WHICH WASTE DR MATERIAL) COMPACT B $NM C ACTNW D VOLUME

,fERIAL) P e PRMED WE RECENED AND DATE CeCOLLECTED OR STATE 3 OF RECEPT

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UNIFORM LOW LEVEL RADIOACTIVE W MANIFEST INDEX AND REGIONAL COMPACT TABULA 4 6 6 T PRE OENERAfon CENERATOR NAME. GENERATOR KtNTFCATON PERMff NUMBER OF APPLCADLE). FACLffY @

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2 MAteFEUT NUMBER U.S. NUCLEAR REQULATORY COMMISSION iTE MANIFEST PAGE OF PAGE(S)

(CONTNUATION)

O 9 to 11 As PROCESSEDCOLLECTED TOT AL

[TE MANFEST NUM8ER(S) UNCER W ASTE CODE A SOURCE WHICH W ASTE (CA MATERIAQ COMPACT , g g sqq C ACTMTV D VOLUME

'ERLA4 P e NMD 0 ME RECEIVED AND DATE C e COLLECTED l EN M MA4 (vg) (g) (MBq) (m )

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