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-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