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  • Il Iema 473-0013 2010

Get Il Iema 473-0013 2010-2025

State of Illinois Illinois Emergency Management Agency - Division of Nuclear Safety REGISTRATION RADIATION MACHINE INSTALLATION ILLINOIS EMERGENCY MANAGEMENT AGENCY DIVISION OF NUCLEAR SAFETY 1035 OUTER PARK DR SPRINGFIELD IL 62704 ORIGINAL REGISTRATION AMEND REGISTRATION change of operator/address IEMA will assign if new change of equipment The following information is provided in accordance with 32 Ill. Adm. Code 320. 10 a regarding radiation machines. OPERATOR Name and Title FACILITY NAME STREET ADDRESS CITY STATE FEIN/TAX FILING TELEPHONE E-MAIL FAX EQPT. REF* NUMBER Check here if new ZIP COUNTY MANUFACTURER NAME MODEL NAME/NUMBER CONTROL SERIAL NUMBER ACQUISITION DATE LOCATION STATUS OF UNIT Operable Sold to supplier Inoperable Stored Junked Traded Sold / Private radiographic flouroscopic dual purpose mobile therapy dental CT UNIT TYPE mammography industrial This state agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined ....

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How to fill out the IL IEMA 473-0013 online

Completing the IL IEMA 473-0013 form is an essential step for registering radiation machines in Illinois. This guide will provide you with detailed instructions to help you fill out the form online accurately. Follow these steps to ensure your submission is correct and complete.

Follow the steps to complete your registration form effectively.

  1. Press the ‘Get Form’ button to obtain the form and display it in the online editor.
  2. Begin by selecting whether you are submitting an original registration or amending an existing registration. Indicate your choice by checking the appropriate box.
  3. Fill in your registration number if applicable. This is essential for identifying your record.
  4. Provide the operator's name and title in the designated fields. Ensure that this information is accurate to avoid processing issues.
  5. Next, complete the facility name and address sections. Include the street address, city, state, ZIP code, and county to ensure that the location is fully documented.
  6. Enter your Federal Employer Identification Number (FEIN) or tax filing number in the corresponding field.
  7. Include your telephone number, email address, and fax number. This information will enable the agency to contact you if necessary.
  8. Input the equipment reference numbers for the radiation machines you are registering. If this is new equipment, check the appropriate box.
  9. Fill in the manufacturer's name and model number for each item listed. This information is vital for record-keeping.
  10. Provide the control serial number and acquisition date for each piece of equipment in the respective fields.
  11. Specify the location of the equipment in the designated area.
  12. For each unit, indicate its status by selecting the appropriate option, such as 'Operable,' 'Inoperable,' 'Sold to supplier,' etc.
  13. Lastly, you can add any comments or additional details relevant to your registration if necessary.
  14. Once you have completed all fields, review the information for accuracy, then proceed to save changes, download, print, or share the form as needed.

Complete your IL IEMA 473-0013 online today to ensure compliance and efficient processing.

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Emergency management directors are responsible for planning and leading the responses to natural disasters and other emergencies. Directors work with government agencies, nonprofits, private companies, and the public to develop effective plans that minimize damage and disruptions during an emergency.

The Illinois Emergency Management Agency is responsible for protecting Illinois residents from the potentially harmful effects of ionizing radiation. IEMA is recognized across the nation and around the world as a leader in radiation safety.

Sean Madison - Director - Kane County Sheriff's Office of Emergency Management | LinkedIn.

Alicia Tate-Nadeau Tate-Nadeau brings more than three decades of experience in national security, emergency management, and public safety issues.

Director Alicia Tate-Nadeau.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232