Get Annex A Dot-sp 11406 Shipment Approval Form (rev.7 May ... - Dep State Pa

Completing the Annex A DOT-SP 11406 SHIPMENT APPROVAL FORM is essential for the safe and compliant shipment of waste or recyclable materials containing radioactive material. This guide will provide you with clear, step-by-step instructions to accurately fill out the form online.

Follow the steps to successfully complete the shipment approval form.

1. Press the ‘Get Form’ button to access the Annex A DOT-SP 11406 SHIPMENT APPROVAL FORM and open it in your preferred online editor.
2. Enter the approval number at the top of the form in the designated field marked 'Approval No ____'.
3. In the section detailing the shipment, describe the nature of the materials being shipped. Include information about unidentified radioactive material and indicate that the shipment is under Special Permit DOT-SP 11406.
4. Complete the details of the detection site, including the facility name, type, and address. Provide the contact person’s name and their phone and fax numbers.
5. Specify the type of vehicle used for shipment, including the identification number and the operator's details, including their contact information.
6. Document the waste description and any associated release risk factors that may apply.
7. Record the radiation measurement details, including when it was performed, maximum radiation levels, and the surveyor's information.
8. Fill in the shipment origin details, including the company name and address associated with the waste, along with the contact person's information.
9. Identify the radiation control officials from the detection, origin, and destination states. Include their names, organizations, and contact information.
10. Complete the section for the destination of the radioactive material with the company information and emergency contact details.
11. Outline any special conditions or approvals required for the shipment and provide the authorized individual's signature, title, organization, and date.
12. Record identification and disposition information at the destination.
13. If necessary, include additional remarks or other relevant information related to the shipment.
14. After completing all fields, review the form for accuracy. Save your changes, download a copy of the form, or print and share it as required.

Complete your shipment approval documents online today for a smooth and compliant process.