Get Certificate Of Disposition Online Form

Completing the Certificate Of Disposition Online Form is an essential step in terminating a Radioactive Material License in Wisconsin. This guide will provide you with a clear, step-by-step process to ensure all required information is submitted accurately and efficiently.

Follow the steps to complete the online form successfully.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. In 'Item 1', enter the name and mailing address of the applicant. Ensure all details are accurate as this information will be used for future correspondence.
3. In 'Item 2', provide your Wisconsin Radioactive Material License Number, which is essential for processing your request.
4. In 'Item 3', fill in the name of the contact person, ensuring they are someone available to respond to any inquiries.
5. Also in 'Item 3', include the telephone number of the contact person, providing the full area code.
6. In the 'Termination and Disposition Information' section, check 'Item 4' to indicate that all use of radioactive material authorized under your license has been terminated.
7. For 'Item 5', confirm that radioactive contamination has been removed to the specified levels as relevant to your license.
8. In 'Item 6', specify how radioactive material has been disposed of by checking all applicable methods. Make sure to include details for each disposal method chosen.
9. In 'Item 7', attach any radiation surveys or equivalent documents that are specified in the guidelines, ensuring to follow the required standards.
10. For 'Item 8', list the locations where records required for the termination are maintained. Include a contact person and their telephone number.
11. Utilize the 'Additional remarks' section to provide any further necessary information, attaching additional pages as needed.
12. In the 'Certification' section, have an authorized individual sign and print their name and title. Include the date of signing.
13. Review the completed form for accuracy, and ensure all required fields are filled. Once satisfied, you can save changes, download the completed form, print, or share it as needed.

Complete your Certificate Of Disposition Online Form online to ensure a smooth license termination process.