Get (basic) License Application - Maine.gov

Filling out a license application can appear daunting, but this guide aims to simplify the process for you. By following these clear, step-by-step instructions, you will be able to complete the basic License Application for radioactive materials in the State of Maine with confidence.

Follow the steps to navigate the online application process.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by indicating the type of application you are submitting. Select either 'new license,' 'renewal,' or 'amendment of license number' by checking the appropriate box.
3. Provide your full name and mailing address in the designated applicant section.
4. Fill in the address where the radioactive material will be used or stored. Include a contact phone number.
5. Enter the name, phone number, and email of the person who will be the point of contact for inquiries regarding your application.
6. For items 5 through 11, use standard-size paper to provide detailed information required for each item. If an item does not apply, indicate this by writing 'not applicable' next to the corresponding item number.
7. For item 5, list the radioactive materials you will be using, including the element and mass number, chemical or physical form, and maximum possession amounts.
8. In item 6, describe the purposes for which you will use the radioactive material, including relevant details for sealed sources.
9. For item 7, name the individuals responsible for the radiation safety program and include their respective training, experience, and contact details.
10. In item 8, provide documentation of training for individuals working in restricted areas, including any required HHE forms.
11. For item 9, describe your facilities and equipment related to the use or storage of radioactive materials, including ventilation systems and a sketch of the layout.
12. In item 10, detail your radiation safety program, including supervision, training records, and procedures for leak testing sealed sources.
13. Provide a comprehensive description of your radioactive waste management program in item 11, detailing types of waste, amounts generated, and disposal methods.
14. Finally, in item 12, certify the application by signing and dating it, ensuring all information is accurate to the best of your knowledge.
15. Once you have completed the application, save any changes, and choose to download or print the form as needed.

Start filling out your application online today to ensure a smooth licensing process!