3, P.O. Box 149347, Austin, Texas 78714-9347. Retain a copy for your files. Upon completion of processing, the general licensee will receive a General License Acknowledgement (GLA), issued in accordance with the provisions of Title 25 Texas Administrative Code, Chapter 289, and the Texas Radiation Control Act. 1. Legal Business Name and Business Mailing Address of Applicant (Texas address only): 2. Responsible Person (RP) (person responsible for maintaining records): 3. Office Telephone No: C.

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How to fill out the TX RC 251-2 online

The TX RC 251-2 is an application form used for obtaining a general license acknowledgement for devices containing radioactive materials. This guide will provide you with clear, step-by-step instructions on how to complete this form online, ensuring a smooth submission process.

Follow the steps to accurately complete the TX RC 251-2 application.

  1. Click the ‘Get Form’ button to access the TX RC 251-2 form and open it in your preferred online editor.
  2. In the first section, enter the legal business name and mailing address of the applicant (must be a Texas address). This information identifies the entity applying for the license.
  3. Provide the name of the responsible person (RP) who will maintain records and ensure compliance. This individual is the primary contact with the Texas Department of State Health Services.
  4. Fill out the office telephone number, cell number, fax number, and email address for the RP to ensure effective communication.
  5. If the address from step 2 is not a physical location, provide the records location here. This ensures the agency can contact you if needed.
  6. Specify the address (including ZIP code) where the radioactive material will be used or stored. If there are multiple sites, ensure each one is listed.
  7. Indicate whether this application pertains to a new general license acknowledgement or an amendment. Check the appropriate boxes for your situation and provide any necessary license numbers.
  8. List device data for each device possessed. Include details such as the manufacturer, model, and serial numbers, as well as the radionuclide and activity levels.
  9. In the certification section, sign and date the form, verifying that the information provided is accurate and true based on a physical inventory.
  10. Review the completed application for accuracy. Save your changes, and then download, print, or share the form as required. Don't forget to retain a copy for your records.

Complete your TX RC 251-2 form online today for a streamlined application process.

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