Get Notification Of A Norm Facility Form Regarding General ...

This guide provides step-by-step instructions on how to fill out the Notification of a NORM Facility Form regarding general licensure electronically. By following these instructions, users can efficiently complete and submit the necessary documentation while ensuring compliance with regulations.

Follow the steps to complete your form online:

1. Click the ‘Get Form’ button to access the Notification of a NORM Facility Form and open it in your document editor.
2. Start with PART I: NORM notifier information. Fill in your name, job title, telephone number, fax number, and email address. Verify that all contact details are accurate to ensure communication.
3. Enter the mailing address, providing the complete address, city, state, and zip code.
4. Proceed to the billing address section and input the necessary details if they differ from the mailing address.
5. Move to PART II: NORM site information. Indicate the type of site, site name or well name, and site ID number or well serial number. If applicable, include the field lease name and its ID.
6. Provide the physical location and the complete address, alongside the city, state, zip code, county, section, township, and range.
7. Enter the longitude and latitude coordinates noting the required format.
8. Fill in the location telephone number and provide clear directions to the site from the nearest city limits.
9. Briefly describe the site, including its size, terrain, and any existing structures.
10. Describe how the site became subject to NORM regulations and the type of contamination.
11. Continue to PART III: Survey information. Document the survey date and the radiation instrument used, along with its calibration date.
12. Record the background reading in microR/hr and the surveyor's name and company information.
13. Enter the maximum exposure readings for equipment, ground or solids, and at the boundary of the NORM storage area.
14. Provide background results and concentrations of various NORM nuclides, including Ra-226, Ra-228, and others.
15. Include details of the approved laboratory that performed the analysis and attach any exposure reading reports or survey maps.
16. Complete PART IV: Procedures, attaching Worker Protection Plans and/or Waste Management Plans as applicable.
17. In PART V: Certification, print your name, job title, and sign the form. Date your entry.
18. Review all entries for accuracy and completeness before saving, downloading, printing, or sharing the form as needed.

Begin completing your Notification of a NORM Facility Form online today!