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Waste Management and Radiation Control Forms

DWMRC-01 Radioactive Material License Application


DWMRC-02A Series: Preceptor Attestations for Medical Use

  • Licensing Guidance for Using the Form (136 KB)
    (02/16)—DWMRC-02A Series
  • DWMRC-02A (AMP) (72 KB)
    (01/16)—Authorized Medical Physicist Training and Experience and Preceptor Attestation [10 CFR 35.51]
  • DWMRC-02A (ANP) (52 KB)
    (01/16)—Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation [10 CFR 35.55]
  • DWMRC-02A (AUD) (60 KB)
    (01/16)—Authorized User Training and Experience and Preceptor Attestation (for uses defined under 10 CFR 35.100, 35.200, and 35.500), [10 CFR 35.190, 35.290, and 35.590]
  • DWMRC-02A (AUS) (85 KB)
    (01/16)—Authorized User Training and Experience and Preceptor Attestation (for uses defined under 10 CFR 35.400 and 35.600), [10 CFR 35.490, 35.491, and 35.690]
  • DWMRC-02A (AUT) (94 KB)
    (01/16)—Authorized User Training and Experience and Preceptor Attestation (for uses defined under 10 CFR 35.300), [10 CFR 35.390, 35.392, 35.394, and 35.396]
  • DWMRC-02A (RSO) (94 KB)
    (01/16)—Radiation Safety Officer Training and Experience and Preceptor Attestation [10 CFR 35]
  • DWMRC-02A (AUD-RSL) (39 KB)
    (01/16)—Authorized User Training and Experience and Preceptor Attestation for uses defined under 10 CFR 35.1000 for Radioactive Seed Localization

DWMRC-04 through DWMRC-26 Series


Other Radiation Forms


General Forms


Solid Waste Program Forms

Annual Report Forms

  • Compost Facility Annual Report Form: DOC (28 KB) | PDF (128 KB)
  • Incinerator Annual Report Form: DOC (29 KB) | PDF (137 KB)
  • Landfill Annual Report Form: DOC (31 KB) | PDF (199 KB)
  • Landspreading Facility Annual Report Form: DOC (23 KB) | PDF (187 KB)
  • Post-Closure Care Annual Report Form: DOC (26 KB) | PDF (122 KB)
  • Recycling Facility Annual Report Form: DOC (31 KB) | PDF (136 KB)
  • Tire Storage Facility Annual Report Form: DOC (27 KB) | PDF (213 KB)
  • Transfer Station Annual Report Form: DOC (29 KB) | PDF (148 KB)

Quarterly Report Forms

  • Quarterly Fee Report Form: DOC (56 KB) | PDF (233 KB)

Used Oil Forms

Annual Report Forms

Application Forms

Financial Forms (R315-15-10 and R315-15-12)

  • Form 17.2: DOC (41 KB) | PDF (33 KB)
    Trust agreements.
  • Form 17.3: DOC (30 KB) | PDF (20 KB)
    Surety bond guaranteeing payment into a standby trust agreement trust fund.
  • Form 17.4: DOC (26 KB) | PDF (16 KB)
    Irrevocable standby letter of credit with standby trust agreement.
  • Form 17.5: DOC (29 KB) | PDF (19 KB)
    Insurance endorsement of clean-up and closure.
  • Form 17.6: DOC (29 KB) | PDF (19 KB)
    Used oil transporter pollution liability endorsement for sudden occurrence.
  • Form 17.7: DOC (22 KB) | PDF (19 KB)
    Used oil pollution liability endorsement for sudden occurrences.
  • Form 17.8: DOC (29 KB) | PDF (19 KB)
    Used oil pollution liability endorsement for non-sudden occurrences.
  • Form 17.9: DOC (29 KB) | PDF (19 KB)
    Used oil pollution liability endorsement for sudden and non-sudden occurrences.
  • Form 17.10: DOC (29 KB) | PDF (20 KB)
    Letter of Credit for third-party damages from environmental pollution liability with optional standby trust agreement to be used by transfer, processor, re-refiner, or off-specification burner facility.
  • Form 17.11: DOC (38 KB) | PDF (25 KB)
    Payment bond for third-party damages from environmental pollution liability to be used by transfer, processor, re-refiner, or off-specification burner facility.
  • Form 17.12: DOC (45 KB) | PDF (39 KB)
    Trust agreement for for third-party damages from environmental pollution liability to be used by transfer, processor, re-refiner, or off-specification burner facility.
  • Form 17.13: DOC (43 KB) | PDF (37 KB)
    Standby trust agreement, if and when applicable to certain financial mechanisms associated with third-party damages from environmental pollution liability requiring a standby trust agreement to be used by transfer, processor, re-refiner, or off-specification burner facility.
  • Form 17.14: DOC (47 KB) | PDF (47 KB)
    Standby trust agreement, if and when applicable to certain financial mechanisms requiring a standby trust agreement, other than liability, to be used by transfer, processor, re-refiner, or off-specification burner facility.

Waste Tire Forms