1. LICENSEE INFORMATION

NRC FORM 748D

(05-22-2023)

10 CFR 20.2207

DISPOSE SOURCE 

NATIONAL SOURCE TRACKING TRANSACTION REPORT

U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 748D (05-22-2023)

APPROVED BY OMB: NO. 3150-0202 EXPIRES: 05/31/2026

A. LICENSEE NAME B. LICENSE NO. C. LICENSEE STREET ADDRESS

A. NAME OF PREPARER B. DATE PREPARED C. PREPARER PHONE 

4. PREPARER INFORMATION

(Only transactions completed on the same

date may be reported together on this form) NEW CORRECTION

3B. TRANSACTION TYPE (Check all that apply)

REPORT SOURCE TRANSFER RECEIPT

DISASSEMBLE

DISPOSAL

NEW SOURCE 

MANUFACTURED

IF CORRECTION, PREVIOUS TRANSACTION DATE:

IMPORT EXPORT

D. PREPARER E-MAIL (REQUIRED FOR CONFIRMATION)

2. TRANSACTION DATE 3A. TRANSACTION INFORMATION

D. CITY E. STATE F. ZIP CODE

INVENTORY

8. SOURCE DISPOSAL DATA

D1. SOURCE MAKE E1. SOURCE MODEL F1. SOURCE SERIAL

NUMBER

G1. ISOTOPE H1. ACTIVITY AND UNIT I1. ACTIVITY DATE J1. COMMENTS

A1. WASTE MANIFEST NUMBER B1. CONTAINER ID

K1. SOURCE DISPOSAL ADDRESS

C1. METHOD OF DISPOSAL

L1. CITY M1. STATE N1. ZIP CODE O1. SAME AS STREET

ADDRESS

Page 1

WARNING: FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS 

TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE 

STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.

Estimated burden per response to comply with this mandatory information collection request: 9.5 minutes. NRC requires this information to populate 

the National Source Tracking System for certain sealed sources. Send comments regarding burden estimate to the FOIA, Library, and Information 

Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by email to Infocollects.Resource@nrc.gov, 

and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0202), Attn: Desk Officer for the Nuclear Regulatory 

Commission, 725 17th Street NW, Washington, DC 20503; email: oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a 

person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid 

OMB control number.
NRC FORM 748D

(05-22-2023)

10 CFR 20.2207

U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 748D (05-22-2023)

LICENSEE NAME LICENSE NO.

8. SOURCE DISPOSAL DATA (continued)

D2. SOURCE MAKE E2. SOURCE MODEL F2. SOURCE SERIAL

NUMBER

G2. ISOTOPE H2. ACTIVITY AND UNIT I2. ACTIVITY DATE J2. COMMENTS

A2. WASTE MANIFEST NUMBER B2. CONTAINER ID

K2. SOURCE DISPOSAL ADDRESS

C2. METHOD OF DISPOSAL

L2. CITY M2. STATE N2. ZIP CODE O2. SAME AS STREET

ADDRESS

D3. SOURCE MAKE E3. SOURCE MODEL F3. SOURCE SERIAL

NUMBER

G3. ISOTOPE H3. ACTIVITY AND UNIT I3. ACTIVITY DATE J3. COMMENTS

A3. WASTE MANIFEST NUMBER B3. CONTAINER ID

K3. SOURCE DISPOSAL ADDRESS

C3. METHOD OF DISPOSAL

L3. CITY M3. STATE N3. ZIP CODE

ADDRESS

O3. SAME AS STREET

DISPOSE SOURCE 

NATIONAL SOURCE TRACKING TRANSACTION REPORT 

(continued)

Page 2

WARNING: FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS 

TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE 

STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.
NRC FORM 748D

(05-22-2023)

10 CFR 20.2207

U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 748D (05-22-2023)

LICENSEE NAME LICENSE NO.

8. SOURCE DISPOSAL DATA (continued)

D4. SOURCE MAKE E4. SOURCE MODEL F4. SOURCE SERIAL

NUMBER

G4. ISOTOPE H4. ACTIVITY AND UNIT I4. ACTIVITY DATE J4. COMMENTS

A4. WASTE MANIFEST NUMBER B4. CONTAINER ID

K4. SOURCE DISPOSAL ADDRESS

C4. METHOD OF DISPOSAL

L4. CITY M4. STATE N4. ZIP CODE O4. SAME AS STREET

ADDRESS

D5. SOURCE MAKE E5. SOURCE MODEL F5. SOURCE SERIAL

NUMBER

G5. ISOTOPE H5. ACTIVITY AND UNIT I5. ACTIVITY DATE J5. COMMENTS

A5. WASTE MANIFEST NUMBER B5. CONTAINER ID

K5. SOURCE DISPOSAL ADDRESS

C5. METHOD OF DISPOSAL

L5. CITY M5. STATE N5. ZIP CODE

ADDRESS

O5. SAME AS STREET

Page 3

DISPOSE SOURCE 

NATIONAL SOURCE TRACKING TRANSACTION REPORT 

(continued)

WARNING: FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS REQUIRE THAT SUBMISSIONS 

TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS. 18 U.S.C. SECTION 1001 MAKES IT A CRIMINAL OFFENSE TO MAKE A WILLFULLY FALSE 

STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.
INSTRUCTIONS TO NRC AND AGREEMENT STATE LICENSEES FOR REPORTING HIGH-RISK SEALED SOURCE TRANSACTIONS 

The completed form is considered to be Official Use Only – Security Related Information; it is not considered to be Safeguards Information. 

Use an addendum sheet for reporting additional sources.

Note to Licensees: This form may be used to report source transactions in lieu of 

using the NSTS online application. Sections 1-4 on Page 1 of the form are required 

for all source transaction types. Sections 5-12 should only be populated for the 

associated Transaction Type (3B) selected. For example, when reporting a Source 

Transfer and a Source Export, Sections 6 and 11 should be populated. Multiple 

Transaction Types may be selected if they occur on the same Transaction Date, and 

should be reported on NRC Form 748. Licensees reporting only one transaction type 

may use the condensed form for the Transaction Type. For example, when reporting 

a Source Receipt, NRC Form 748c should be used. 

1. Licensee Information – Enter the name, license number, and street address of 

the licensed facility. 

2. Transaction Date – Enter the date the transaction occurred, which would be the date 

of the transfer, receipt, manufacture, etc. 

3. Transaction Information and Transaction Type – Indicate if this is a new transaction

or a correction. For corrections, select the date of the previously submitted 

transaction that the correction should be associated with. Select the Transaction 

Type. Report Source should only be used for initial inventory submissions, or to 

report a source excluded from the initial inventory submission. Dispose Source 

should only be used by a Disposal Licensee. If you are sending your source back to 

the manufacturer, or sending it to a disposal facility, the transaction should be 

recorded as a Transfer. Multiple Transaction Types may be selected if they occur on 

the same Transaction Date. 

4. Preparer Information – An email address is required for a confirmation. For

regulatory purposes, your source transaction report is not considered complete 

without a confirmation from the NSTS Help Desk that the transaction report has 

been received. 

5. Source Inventory Data – This section should only be used for initial inventory 

submissions. The Make, Model, and Serial Number refer to the Source, not the 

Device. All fields are required in Section 5 EXCEPT G. Comments. If the licensee is 

reporting multiple sources on the Source Inventory transaction at the same Source 

Location Address, the location address information may be populated once, and 

referenced in the Comments block for the additional sources. 

6. Source Transfer Data – For Transfer transaction reports, all fields in Section 6 are 

required EXCEPT M. Waste Manifest Number, N. Container ID, and P. Comments. If 

the licensee is reporting multiple sources on the Transfer transaction to the same 

Receiving Licensee, the receiving licensee information may be populated once, and 

referenced in the Comments block for the additional sources. 

7. Source Receipt Data – For Receipt transaction reports, all fields in Section 7 are 

required EXCEPT M. Waste Manifest Number, N. Container ID, and T. Comments. If 

the licensee is reporting multiple sources on the Receipt transaction at the same 

Source Location Address, the location address information may be populated once, 

and referenced in the Comments block for the additional sources. 

8. Source Disposal Data – For Disposal transaction reports, all fields in Section 8 are 

required EXCEPT J. Comments. If the licensee is reporting multiple sources on the 

Disposal transaction at the same Source Disposal Address, the source disposal 

address information may be populated once, and referenced in the Comments block 

for the additional sources. 

9. New Manufactured Source Data – For New Manufactured Source transaction 

reports, all fields in Section 9 are required EXCEPT F. Comments. If the licensee is 

reporting multiple sources on the Manufacturer transaction at the same Source 

Location Address, the location address information may be populated once, and 

referenced in the Comments block for the additional sources. 

10. Source Import Data – For Import Source transaction reports, all fields are required 

EXCEPT L. Comments. If the licensee is reporting multiple sources on the Import 

transaction at the same Source Location Address, the location address information 

may be populated once, and referenced in the Comments block for the additional 

sources. 

11. Source Export Data – For Export Source transaction reports, all fields are required 

EXCEPT M. Comments. If the licensee is reporting multiple sources on the Export 

transaction to the same Foreign Company/Foreign Address, the information in cells 

A-E may be populated once, and referenced in the Comments block for the 

additional sources. 

12. Source Disassemble Data – For Disassemble Source transaction reports, all fields 

are required EXCEPT H. Comments. If the licensee is reporting multiple sources on 

the Disassemble transaction at the same Source Location Address, the location 

address information may be populated once, and referenced in the Comments block 

for the additional sources. 

DISTRIBUTION

For most timely processing, click the "Submit by Email" button on page 1. 

You may also: 

 > manually submit this form by email to: NSTSFax.Resource@nrc.gov, 

 > FAX to: 1-888-821-2534, or 

 > mail to: NSTS Help Desk 

 9737 Washingtonian Blvd, Room #3145, Mail Stop #9 

 Gaithersburg, MD 20878