RCB Form 016 05/2009 20. 3. 3 NMAC New Mexico Environment Department Submittal of the application is required to determine that the applicant is qualified and that adequate facilities and procedures exist to protect the public health and safety and property. In conformity with 20. 3 NMAC Radiation Protection rules and that all information contained herein is true and correct to the best of their knowledge and belief. PRINTED/TYPED NAME AND TITLE OF CERTIFYING OFFICER SIGNATURE DATE WARNING FALSE STATEMENTS AND INFORMATION PROVIDED IN THIS APPLICATION MAY SUBJECT THE CERTIFYING OFFICIAL TO CIVIL AND/OR CRIMINAL PENALTIES. DEPARTMENT USE ONLY Comments Receipt Date Adm. Complete onPN Outstanding Annual Fees Additional Info Required Application Denied on Application Approved License Issued on RCB FORM 016. Send completed and signed form and attachments to Radiation Control Bureau 1190 St* Francis Drive P. O. Box 5469 Santa Fe New Mexico 87502-5469 FASCIMILE NUMBER 505 476-3232 APPLICATION....
Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
How to fill out the NM RCB Form 016 online
This guide provides a comprehensive overview of how to complete the NM RCB Form 016 online. The form is essential for applicants seeking a radioactive materials license in New Mexico, ensuring that they comply with safety and health standards.
Follow the steps to complete the NM RCB Form 016 online effectively.
- Click the ‘Get Form’ button to access the form and open it in your preferred editing tool.
- Begin by selecting the appropriate application type. Indicate whether you are applying for a new license, an amendment to an existing license, or the renewal of an existing license. Make sure to check the correct item.
- Fill in your name and mailing address in the designated fields, ensuring that you provide accurate contact information including your fax number.
- Provide the address where the licensed material will be used or possessed. This information is crucial for regulatory compliance.
- List the name of the person who will be your contact regarding this application, along with their telephone number.
- Prepare the necessary attachments for Items 5 through 11. Each item requires specific information outlined in the corresponding license application guide, including your request for radioactive materials and the intended purpose.
- Detail the radioactive materials you are requesting, including the element and mass number, chemical and/or physical form, and the maximum amount to be possessed at any one time.
- Identify the individuals responsible for the radiation safety program and provide their training experience.
- Describe the facilities and equipment you will use in relation to the licensed material.
- Outline your radiation safety program, ensuring it aligns with regulatory guidelines.
- Explain your waste management plan, detailing how you will handle radioactive waste.
- For new applicants, confirm if you have paid the annual fees, or indicate that you are attaching payment with this application.
- Complete the certification section by confirming that all statements are true and correct. The certifying officer must print or type their name, sign, and date the application.
- Finalize the application by reviewing all entries for accuracy, then save your changes. You can download, print, or share the completed form as needed.
Take the next step towards obtaining your license by completing the NM RCB Form 016 online today.
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Related content
RCB Form 016. New Mexico Environment Department. (01/2025). 20.3.3 NMAC. APPLICATION FOR...
Nov 22, 2023 — Structural atlas of the most abundant human gut virus · Entity ID: 1 ·...
This manual has been authored with simplified grammar, to meet the needs of international...
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down process here.