Forms: Division of Waste Management and Radiation Control

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Radiation

General

Solid Waste

Used Oil

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

Other Radiation Forms

General Forms

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

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

Tire Storage Facility Reporting

Transfer Station Reporting

Used Oil Forms

Application Forms

10-Year Renewal Forms

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.

PBR Transporter and Transfer Facility Notification

Waste Tire Forms