Get Radioactive Material Registration Application

Filling out the Radioactive Material Registration Application online is a crucial step for users handling radioactive materials. This guide will provide you with clear instructions on each section of the form to ensure accurate and complete submissions.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by selecting the type of application: new registration, two-year renewal, or amendment. This will guide how subsequent sections are completed.
3. In the registrant information section, clearly print or type the name of your company or organization, your telephone number, and your address. Provide the name and contact information for the radiation safety officer (RSO), including their title.
4. Attach a copy of the most recent amendment to your USNRC or Agreement State License, if applicable. Include the relevant license number(s) as indicated.
5. For the use of materials section, specify the facility where the radioactive materials will be used. If there are multiple facilities, a separate application for each is required.
6. List all individuals who will use or supervise the use of radioactive materials, providing their names and titles. If more space is necessary, attach an additional sheet.
7. In the registration agreement section, a responsible individual (such as an owner or administrator) must sign, indicating their understanding of compliance obligations. Ensure their name, date signed, and title are clearly printed.
8. Provide detailed information about the radioactive materials, including a list of sealed sources and materials possessing radioactive components. Each item must include its element, mass number, maximum activity, manufacturer, and type of device.
9. Review the completed application carefully to ensure all information is accurate and complete. Save your changes before proceeding.
10. Once satisfied with your form, you can download, print, or share it as required for submission.

Complete your Radioactive Material Registration Application online today to ensure compliance and safety.