A detailed breakdown of Utah Division of Waste Management and Radiation Control Forms. Note that some offer a choice between PDF or Word Doc versions.
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Radiation
- DWMRC-01 Radioactive Material License Application
- DWMRC-02A Series: Preceptor Attestations for Medical Use
- DWMRC-04 through DWMRC-26 Series
- Other Radiation
General
Solid Waste
Used Oil
Waste Tire
Radioactive Material License Application
DWMRC-02A Series: Preceptor Attestations for Medical Use
- Licensing Guidance for Preceptor Attestations for Medical Use Form
(02/20)—DWMRC-02A Series - DWMRC-02A (AMP)
(02/20)—Authorized Medical Physicist Training and Experience and Preceptor Attestation [10 CFR 35.51] - DWMRC-02A (ANP)
(02/20)—Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation [10 CFR 35.55] - DWMRC-02A (AUD)
(02/20)—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)
(02/20)—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)
(02/20)—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)
(02/20)—Radiation Safety Officer Training and Experience and Preceptor Attestation [10 CFR 35] - DWMRC-02A (AUD-RSL)
(02/20)—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
- DWMRC-04: Notice to Employees (08/18)
- DWMRC-04SP: Aviso a los Empleados (08/15)
- DWMRC-05: Cumulative Occupational Exposure History(01/16)
- DWMRC-06: Occupational Exposure Record (01/16)
- DWMRC-10: Instructions for Registering an X-ray Machine
- DWMRC-13: Instructions for Applying for a Radioactive Material General License for Certain Measuring, Gauging or Controlling Devices (01/16)
- DWMRC-14: Instructions for Terminating a Radioactive Material License (01/16)
- DWMRC-26: Generator Site Access Permit Application (01/15)
Other Radiation Forms
- Instructions for Registering X-ray Machines
- Model Delegation of Authority
- Instructions for Renewing or Making Changes to an Existing X-ray Machine Registration
- Request for Public Information and Fee Policy (10/05/12)
- X-Ray Assembler Notification
- X-Ray Program Forms
General Forms
- Contained-Out Determination Soil Fact Sheet
- Contained-Out Determination Application
- WMRC/Template for Environmental Covenants
- Episodic Event
- 30 Day Storage Extension Request for Hazardous Waste Generators
- Community Portal User Guide
- Application for Project Oversight for Hazardous Waste Sites Overseen by the Corrective Action Section with the DWMRC
- Drum-Top Lamp Crusher Registration Instructions
- Drum-Top Lamp Crusher Inspection
- Notification of Regulated Activities Form (EPA Form 8700-12)
- Records Request (GRAMA) Form
- Small Business Assistance Form (DWMRC)
- Template for Request for Comfort Letter
- Template for Application for an Enforceable Written Assurance Letter
Solid Waste Program Forms
Annual and Quarterly Reporting
Required reporting for solid waste facilities, including permitted recycling facilities and waste tire facilities, is now conducted through the Community Portal.
Community Portal Tutorials
- New User Registration (video)
- Facility Verification and Adding Users (video)
- Portal Overview (video)
Annual and Quarterly Report Tutorials by report type
Compost Facility Reporting
Incinerator Reporting
Landfill Reporting
Landtreatment Facility Reporting
Post-Closure Care Reporting
Recycling Facility Reporting
- Recycling Reporting – Permitted Facilities (video)
- Permitted Facilities PDF for review only
- Recycling Reporting – Non-Permitted Facilities (video)
- Non-Permitted Facilities PDF for review only
Tire Storage Facility Reporting
Transfer Station Reporting
Used Oil Forms
Used Oil Collection Centers (UOCCs) Inspections
Used Oil Collection Center Registration Application
Used Oil Annual Report Form
Applications and 10-Year Renewal Forms
- Used Oil Off-Spec Fuel Burner Application and 10-Year Renewal
- Used Oil PBR Transporter and Transfer Facility Notification
- Used Oil Processor-Re-Refiner Application & 10-Year Renewal
- Used Oil Transfer Facility Application & 10-Year Renewal
- Used Oil Transporter Application & 10-Year Renewal
- Used Oil Fuel Marketer Application & 10-Year Renewal
Financial Forms (R315-15-10 and R315-15-12)
- Form 17.2: Trust agreements.
- Form 17.3: Surety bond guaranteeing payment into a standby trust agreement trust fund.
- Form 17.4: Irrevocable standby letter of credit with standby trust agreement.
- Form 17.5: Insurance endorsement of clean-up and closure.
- Form 17.6: Used oil transporter pollution liability endorsement for sudden occurrence.
- Form 17.7: Used oil pollution liability endorsement for sudden occurrences.
- Form 17.8: Used oil pollution liability endorsement for non-sudden occurrences.
- Form 17.9: Used oil pollution liability endorsement for sudden and non-sudden occurrences.
- Form 17.10: 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: 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: 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: 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: 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.