Jump to:
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
- Used Oil Annual Report
- Used Oil Forms
- Annual Report
- Application
- 10-Year Renewal Forms
- Financial
- PBR Transporter and Transfer Facility Notification
Waste Tire
DWMRC-01 Radioactive Material License Application
DWMRC-02A Series: Preceptor Attestations for Medical Use
- Licensing Guidance for Using the 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-07: In Vitro Testing under General License—Registration Form (01/16)
- DWMRC-10: Instructions for Registering an X-ray Machine
- DWMRC-12: Use of Depleted Uranium—Registration Form (01/16)
- DWMRC-13: Certain Measuring, Gauging or Controlling Devices Under General License—Registration Form (01/16)
- DWMRC-14: Radioactive Material License Termination (01/16)
- DWMRC-26: Generator Site Access Permit Application (01/15)
Other Radiation Forms
- 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
- Community Portal User Guide
- Application for Project Oversight for Hazardous Waste Sites Overseen by the Corrective Action Section with the DWMRC
- Guidance on Contained-In/Contained-Out Determinations for Management of Hazardous Waste Remedial Projects in Utah
- Drum-Top Lamp Crusher Registration Application
- Drum-Top Lamp Crusher Inspection
- Notification of Regulated Activities Form (EPA Form 8700-12)
- Records Request (GRAMA) Form
- Small Business Assistance Form (DWMRC)
- WMRC/Template for Environmental Covenants
- 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 Annual Report Form
Application Forms
- Application for Used Oil Collection Center
- Used Oil Collection Center Log Sheets
- Application for Used Oil Fuel Marketer
- Application for Used Oil Processors/Re-refiners
- Application for Used Oil Transporter
- Application for Used Oil Transfer Facility
- Application for Used Oil Off-Specification Burner
- Used Oil Grant Package and Application
10-Year Renewal Forms
- 10-Year Renewal Application for Transporters
- 10-Year Renewal for Used Oil Fuel Marketer
- 10-Year Renewal for Used Oil Fuel Processor/Re-refiner
- 10-Year Renewal for Used Oil Fuel Transfer Facility
- 10-Year Renewal for Off-Specification Used Oil Fuel Burner
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.