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INSTRUCTIONS FOR COMPLETING

NRC'S LOW-LEVEL RADIOACTIVE

WASTE MANIFEST

LISTED IN THESE INSTRUCTIONS ARE THE ITEMS OF

INFORMATION THAT ARE FEDERALLY REQUIRED OR

OTHERWISE NEEDED FOR THE COMPLETION OF THE

UNIFORM LoW-LEVEL RADIOACTIVE WASTE MANIFEST

(NRC FORMS 540, 541, AND 542). AN EXPLANATION OR

REFERENCE FOR EACH ITEM IS INCLUDED TO ASSIST YOU IN

PROPERLY COMPLETING EACH FORM. PLEASE CALL THE

DESIGNATED CONSIGNEE, THE U.S. NUCLEAR

REGULATORY COMMISSION (301-415-6196), OR THE U.S.

DEPARTMENT OF TRANSPORTATION (202-366-4488) IF

YOU SHOULD NEED CLARIFICATION OF ANY OF THE ITEMS.

OBTAIN COPIES OF NRC's UNIFORM LoW-LEVEL

RADIOACTIVE WASTE MANIFEST FORMS AND THE GENERAL

INSTRUCTIONS FROM THE GRAPHICS AND ELECTRONIC

COMPOSITION SECTION OF THE PUBLISHING SERVICES

BRANCH, MAIL STOP T-4 E16, U. S. NUCLEAR

REGULATORY COMMISSION, WASHINGTON, DC 20555-

0001 OR TELEPHONE 301-415-5877 OR E-MAIL ADDRESS

<INTERNET:BAM1 @NRC.GOV>.

SAMPLE NRC FORMS 540, 541, AND 542 ARE SHOWN AS

EXHIBITS AT THE END OF THESE INSTRUCTIONS.

THE ONLY CHANGES BETWEEN REV. 2 AND REV. 1 OF

THESE INSTRUCTIONS ARE (1) UPDATED INFORMATION FOR

REQUESTING FORMS AND INSTRUCTIONS, (2) UPDATED

SAMPLE FORMS THAT SHOW THE CURRENT OFFICE OF

MANAGEMENT AND BUDGET CLEARANCE NUMBER AND

(3) A MINOR CLARIFICATION TO THE CERTIFICATION

STATEMENT ON NRC FORM 540.

NUREG/BR-0204, Rev. 2
The Uniform Low-Level Radioactive Waste Manifest

consists of the following forms:

(1) NRC Form 540 and 540A': Uniform LowLevel Radioactive Waste Manifest (Shipping

Paper) and continuation page;

(2) NRC Form 541 and 541A: Uniform Low-Level

Radioactive Waste Manifest (Container and

Waste Description) and continuation page; and

(3) NRC Form 542 and 542A: Uniform Low-Level

Radioactive Waste Manifest (Manifest Index &

Regional Compact Tabulation) and

continuation page.

The entities who must comply with manifesting regulations

are defined in Appendix G, Section I, to 10 CFR Part 20.

Typically, all shipments of low-level radioactive waste for

which the consignee is a licensed low-level radioactive

waste disposal facility are subject to NRC manifesting

requirements.

With exceptions as defined in the regulations, shipments of

low-level radioactive waste (as determined by the consignor

within the definitions in the regulation) to waste processors

or waste collectors, prior to ultimate disposal of the

radioactivity at a licensed disposal facility, are also subject

to these manifesting requirements. Note that State or

'Forms 540 and 540A and their respective

instructions are based on Department of Transportation

regulations, including changes issued on September 28,

1995 (60 FR 50292).

NUREG/BR-0204, Rev. 2 2
Compact manifesting requirements may encompass

shipments beyond those defined by the NRC.

NRC Form 540 is to be completed by specified shippers of

low-level radioactive waste intended for ultimate disposal at

a licensed land disposal facility.

NRC Form 541 is to be completed by specified shippers of

low-level radioactive waste intended for ultimate disposal at

a licensed land disposal facility, unless agreement has been

reached between appropriate parties to transmit the required

information electronically.

NRC Form 542 should be completed by processors and

collectors of low-level radioactive waste who are shipping

low-level radioactive waste attributed to others for ultimate

disposal at a licensed land disposal facility, unless

agreement has been reached between appropriate parties to

transmit the required information electronically.

Note: The NRC requires all users of the Uniform Manifest

forms to report information in metric units, and all the forms

have been developed for the use of metric units. Metric

units are used in NRC Form 540 as permitted by DOT

regulations, and required after April 1, 1997, with the

exception of Item 18 (Total Weight or Volume) in which

DOT allows the shipper to specify appropriate units. DOT

allows reporting of English units following the International

System of Units (SI). NRC Forms 541 and 542 are

designed for metric reporting. However, if the consignor,

consignee, and others having authority over reporting

requirements agree, metric and English units may be used.

In this case, the shipper may need to add the English units to

the forms in a manner that prevents misinterpretation.

3 NUREG/BR-0204, Rev. 2
Note: Information in these instructions that is typed in

italics is not required by Federal law or regulation.

Radioactive shipments that are not manifested under NRC

regulations must continue to comply with Department of

Transportation (DOT) regulations.

NUREG/BR-0204, Rev. 2 4
NRC FORM 540: UNIFORM

LOW-LEVEL RADIOACTIVE WASTE MANIFEST

(Shipping Paper)

NRC Form 540 must be completed for shipments of lowlevel radioactive waste intended for ultimate disposal at a

licensed land disposal facility. The majority of the

information on NRC Form 540 is needed to meet DOT

shipping paper requirements for radioactive material

shipments. The following are general instructions. Details

regarding DOT requirements can be found in 49 CFR Part

172.

1. Emergency Telephone Number - The shipper is to

provide an emergency response telephone number or

numbers for use in the event of an emergency. If a

single number applies to every entry on the shipping

papers, enter this number in the space provided. If

there are multiple numbers, each individual number

must be entered in Item 11 immediately following the

applicable description of the radioactive material.

Enter the name of the organization responsible for

providing the emergency response information.

Note that additional emergency response information

must be available and presented in accordance with 49

CFR 172.602.

2. Is This an "Exclusive Use" Shipment? -The

shipper answers by checking "yes" or "no." See 49

CFR 172.203. If "yes," then specific instructions for

maintenance of exclusive use shipment controls must

be provided by the shipper to the carrier and must be

included with the shipping paper as required at 49

CFR 173.403.'

5 NUREG/BR-0204, Rev. 2
3. Total Number of Packages Identified On This

Manifest - Indicate the total number ofpackages

listed on this manifest.

4. Does EPA Regulated Waste Requiring a Manifest

Accompany This Shipment? - If the answer to this

question is "Yes," the shipper completes the

applicable EPA manifest and attaches it to the NRC

Form 540. The shipper should also identify the EPA

manifest number in the space provided (if acceptable

to the consignee, the manifest number appearing in

Item 8 of NRC Form 540 may be identical to the EPA

manifest number).

5. Shipper - Indicate the comnpany or facility name,

facility address, contact person, and telephone

number. If applicable, indicate the permit or other

similar number assigned to the shipper by the

appropriate host State in which the designated

licensed disposal facility is located. Indicate whether

the shipper is a waste generator, collector, or

processor, as defined in the regulation, by checking

the appropriate box. Ifyou are a generator, enter one

of the following letter codes (Government - G, Fuel

Cycle Industry - FC, Nuclear Power - NP, University

(Academic) - A, Medical - M Industrial - I, Other - 0)

in the "GENERATOR TYPE" space. The space for a

shipper identification number is provided for the

shipper to record the number, if any, assigned to the

shipper by the consignee or the designated disposal

facility operator. A space provided under the

heading, "SHIPMENT NUMBER, "isfor any use

deemed appropriate by the shipper.

NUREG/BR-0204, Rev. 2 6
6. Carrier - Indicate either the carrier's name, address,

contact person, and telephone number, or the carrier's

name and EPA identification number. Also include

the shipping date. Upon receipt of the shipment, an

authorized carrier representative will acknowledge

shipment receipt by signing and dating in the space

provided

7. Enter the total number of pages for EACH set of

NRC Forms (i.e., Forms 540 and 540A, Forms 541

and 541A, and Forms 542 and 542A). In addition,

identify the number ofpages of additional information

(e.g., host State) that requires a separate page or

pages and is a part of this manifest. If an EPA

manifest accompanies the NRC Forms, do not include

its pages in Item 7.

If NRC Form 542 or additional pages are not part of

this manifest, enter "None" in the appropriate blank.

If only NRC Form 540 (and 540A, if necessary) is

intended to physically accompany the shipment (e.g.,

the shipper is electronically or otherwise providing

NRC Forms 541 and 542 and any additional

information separately to the consignee), then this

must be indicated by placing parentheses around the

number of pages entered for NRC Forms 541, 542,

and additional information.

8. Manifest Number - A traceable manifest number of

at least four number/letter characters must be entered

by the shipper. This number may be dictated by the

consignee of the low-level radioactive waste (e.g., the

7 NUREG/BR-0204, Rev. 2
waste processor, waste collector, or licensed disposal

site operator) prior to the shipment.

9. Consignee - Indicate the company or facility name,

address, contact person, and telephone number. Upon

receipt of the shipment, an authorized person at the

facility will acknowledge receipt of the shipment by

signing and dating in the space provided.

10. Certification - The certification on the manifest must

be signed and dated by the person responsible for the

packaging and labeling operations. The person must

also be authorized to sign on the behalf of the

shipping company or facility.

11. U.S. Department of Transportation Description

(Including Proper Shipping Name, Hazard Class,

UN ID Number, and Any Additional Information)

- The requirement for providing this information is

contained within DOT regulations at 49 CFR 172.202.

For purposes of transportation in commerce, DOT

regulations at 49 CFR 172.101 provide a listing of

hazardous materials. If this information is required,

the shipper must use the exact descriptors, in the order

specified, in the DOT regulations. Additional

description requirements (e.g., indication of

Reportable Quantity and NRC Certificate of

Compliance, if applicable) are specified at 49 CFR

172.203.

12. DOT "Radioactive" Label - See DOT regulations at

49 CFR 172.203 and 49 CFR 172.403. Indicate the

type of radioactive label that appears on the package

(White - I, Yellow II, or Yellow III). The shipper

does not need to repeat the word "RADIOACTIVE."

NUREG/BR-0204, Rev. 2 8
6. Carrier - Indicate either the carrier's name, address,

contact person, and telephone number, or the carrier's

name and EPA identification number. Also include

the shipping date. Upon receipt of the shipment, an

authorized carrier representative will acknowledge

shipment receipt by signing and dating in the space

provided

7. Enter the total number of pages for EACH set of

NRC Forms (i.e., Forms 540 and 540A, Forms 541

and 541A, and Forms 542 and 542A). In addition,

identify the number ofpages of additional information

(e.g., host State) that requires a separate page or

pages and is a part of this manifest. If an EPA

manifest accompanies the NRC Forms, do not include

its pages in Item 7.

If NRC Form 542 or additional pages are not part of

this manifest, enter "None" in the appropriate blank.

If only NRC Form 540 (and 540A, if necessary) is

intended to physically accompany the shipment (e.g.,

the shipper is electronically or otherwise providing

NRC Forms 541 and 542 and any additional

information separately to the consignee), then this

must be indicated by placing parentheses around the

number of pages entered for NRC Forms 541, 542,

and additional information.

8. Manifest Number - A traceable manifest number of

at least four number/letter characters must be entered

by the shipper. This number may be dictated by the

consignee of the low-level radioactive waste (e.g., the

7 NUREG/BR-0204, Rev. 2
waste processor, waste collector, or licensed disposal

site operator) prior to the shipment.

9. Consignee - Indicate the company or facility name,

address, contact person, and telephone number. Upon

receipt of the shipment, an authorized person at the

facility will acknowledge receipt of the shipment by

signing and dating in the space provided.

10. Certification - The certification on the manifest must

be signed and dated by the person responsible for the

packaging and labeling operations. The person must

also be authorized to sign on the behalf of the

shipping company or facility.

11. U.S. Department of Transportation Description

(Including Proper Shipping Name, Hazard Class,

UN ID Number, and Any Additional Information)

- The requirement for providing this information is

contained within DOT regulations at 49 CFR 172.202.

For purposes of transportation in commerce, DOT

regulations at 49 CFR 172.101 provide a listing of

hazardous materials. If this information is required,

the shipper must use the exact descriptors, in the order

specified, in the DOT regulations. Additional

description requirements (e.g., indication of

Reportable Quantity and NRC Certificate of

Compliance, if applicable) are specified at 49 CFR

172.203.

12. DOT "Radioactive" Label - See DOT regulations at

49 CFR 172.203 and 49 CFR 172.403. Indicate the

type of radioactive label that appears on the package

(White - I, Yellow II, or Yellow III). The shipper

does not need to repeat the word "RADIOACTIVE."

NUREG/BR-0204, Rev. 2 8
If no label is required by DOT, place "NA" in this

column.

13. Transport Index - See DOT regulations at 49 CFR

173.403. This is a dimensionless number, which, for

nonfissile material packages, is equivalent to the

radiation dose rate in millirem per hour at one meter

from the surface of the package. The Transport Index

is placed on the label of a package to designate the

degree of control necessary during transportation. If

reporting of the Transport Index is not required, place

"NA" in this column.

14. Physical and Chemical Form - See DOT regulations

at 49 CFR 172.203. Describe the physical form of the

contents of the package as "Solid," "Liquid," or

"Gas." List the most prevalent chemical form, e.g.,

cellulose, cement, metallic oxides. Additional

generic information on material description may be

included, as needed, to satisfy requirements of

shipment consignee. Further information on the

physical and chemical description of the waste is

required on NRC

Form 541.

15. Individual Radionuclides - See DOT regulations at

49 CFR 172.203 and official abbreviations at 49 CFR

173.435. List the radionuclides (as determined in

DOT regulations at 173.433(f)) that are present in the

transport package. The element symbol may be

immediately followed by the nuclide's mass number,

i.e., a dash is not needed. A semicolon and space

should separate the listing of multiple nuclides.

9 NUREG/BR-0204, Rev. 2
16. Total Package Activity in SI Units - Report the total

activity in the transport package in SI units (e.g.,

megabecquerels). If desired, this activity may also be

reported in units of millicuries, in parentheses below

the listing in SI units.

17. LSA/SCO Class - See DOT Regulations at 49 CFR

172.203. For a shipment of low specific activity

material or surface contaminated objects, provide the

appropriate group notation.

18. Total Weight or Volume - See DOT regulations at

49 CFR 172.202. Using the most appropriate units,

identify the total weight or total volume (net or gross

as appropriate) of the material identified in Item 11.

19. Identification Number of Package - For each

package, a package identification number, unique

among the individual package identification numbers

within the shipment, should be provided Both

numbers and letters may be used

DO NOT WRITE IN THE AREA LABELED "FOR

CONSIGNEE USE ONLY." THIS AREA HAS BEEN LEFT

BLANK INTENTIONALLY TO ALLOW EACH DISPOSAL

FACILITY TO RECORD DISCREPANCIES, BURIAL

INFORMATION, ETC. (THE INFORMATION IN THIS SPACE

IS TO BE DETERMINED BY THE INDIVIDUAL

CONSIGNEES.)

Use NRC Form 540A if additional space is needed to

describe this shipment. Indicate the page number, total

Form 540 and 540A pages, and the manifest number

reported in Item 8.

NUREG/BR-0204, Rev. 2 10
NRC FORM 541: UNIFORM

LOW-LEVEL RADIOACTIVE WASTE MANIFEST

(Container and Waste Description)

This form must be completed by shippers of low-level

radioactive waste as defined on pages 2 and 3, unless the

information is being transmitted electronically, as noted on

page 3 of these instructions.

If waste shipments are to a consignee other than the disposal

facility operator or are uncontainerized, not all the

information is required by NRC regulations. For shipments

of containerized waste to a consignee other than the disposal

facility operator, the information requested under Items 5

through 10 of "DISPOSAL CONTAINER

DESCRIPTION" and Item 16, "Waste Classification," is

not required by NRC regulations. (Note that container

information, however, may be required by the consignee.)

For all shipments of uncontainerized waste, Items 5, 6, and

10 are not applicable; the volume of the waste would be

reported in Item 7, the weight of the waste in Item 8, and

surface radiation levels in Item 9. For those uncontainerized

wastes shipped to a consignee other than the disposal

facility operator, the information requested in Items 9 and

16 is also not required by NRC regulations.

1. Manifest Totals - Indicate the total number of lowlevel waste disposal containers described on this

manifest (the total number ofpackages may be listed,

if the consignee is not a licensed low-level waste

disposal facility), the total net waste volume (cubic

meters), and the total net weight (kilograms).

Appendix G of 10 CFR Part 20 requires separate

11 NUREG/BR-0204, Rev. 2
manifest totals for tritium (H-3), C-14, Tc-99, 1-129, U-233,

U-235, plutonium, and uranium and thorium in source

material. For the first four nuclides, enter the totals in

megabecquerels (MBq) in the appropriate boxes. If the

radionuclides are not present, place "NP" in the appropriate

space. If the radionuclides are present in any of the

containers within a shipment, but are identified in Item 15 in

quantities no greater than the lower limit of detection

(LLD), the quantities of these nuclides must be recorded as

the sum of the respective LLD values (with the summed

value included in parentheses). (Note that Item 15,

beginning on page 18, would also be expanded to reflect the

reporting of tritium (H-3), C-14, Tc-99, and 1-129 below

LLDs). If both detectable and quantities based on LLD

values of radionuclides exist in containers making up a

shipment, the sum of the detectable and "LLD-based" values

must be reported separately, the latter in parentheses. The

total activity for all nuclides on the manifest (excluding

LLD values) must be indicated in the "ALL NUCLIDES"

column.

Also indicate the total manifested quantity of uranium and

thorium in source material (kilograms) and special nuclear

material (grams), including uranium and thorium in

unimportant quantities defined in 10 CFR 40.13. Note: The

mass being requested is not the weight of the waste

containing these nuclides. Ensure that the totals in grams

for U-233, U-235, and plutonium equal the grand total of the

weight of these nuclides in Special Nuclear Material.

Indicate the total number of disposal containers containing

NUREG/BR-0204, Rev. 2 12
each type of Special Nuclear Material in parenthesis

after the quantity listing.

2. Manifest Number - Transfer the manifest number

from NRC Form 540, Item 8.

3. Page 1 of__ page(s) - Include the total number of

Form 541 and 541A pages.

4. Shipper Name and ID Number - Same as reported in

Item 5 of NRC Form 540.

NOTE: SEE PREVIOUS DISCUSSION

REGARDING THE COMPLETION OF ITEMS 5

THROUGH 10 ON FORM 541.

5. Container Identification Number/Generator ID

Number(s) - Provide a disposal container

identification number unique among the individual

container identification numbers within the shipment

(both numbers and letters may be used). Also indicate

ID number(s) of the generator(s) contributing waste to

the disposal container. If more than one disposal

container is assigned to a single generator, the

generator ID number need not be repeated. Note that

the definition of "generator" identified in this item

includes (a) "waste generators" as defined in

Appendix G of 10 CFR Part 20 and (b) those

licensees to which waste can be reasonably attributed,

in the context of the Low-Level Radioactive Waste

Policy Amendments Act of 1985, as a result of

processing, decontamination, or transfers of

radioactive materials.

13 NUREG/BR-0204, Rev. 2
The spacing between the vertical listings of generator

ID numbers in this column (if more than one

generator contributes waste to a single disposal

container) allows for the recording, on an individual

generator basis, of all information required under the

heading, "Waste Description for Each Waste Type in

Container." Note that information on discrete waste

types (i.e., activated material, contaminated

equipment, mechanical filter, or sealed source/device

wastes or individual disposal container wastes

contained in different solidification/stabilization

media) is requested. No more than one generator

should be listed per outlined row. Individual

consignees (e.g., disposal facility operators) may

require more extensive breakdowns of radiological

descriptions (e.g., for Class AS or A U waste).

6. Container Description - Using the codes found in

Note 1 at the bottom of NRC Form 541, describe the

disposal container. When Code 13 (High Integrity

Container) is used, also identify the manufacturer and

the model number. NRC and/or host State Certificate

of Compliance Number(s) should be identified, as

appropriate. If Code 19, "Other," is used, describe the

container in Item 6. If the explanation is not entered

in Item 6 (the preferred method), enter "see additional

page" and provide the description on that page. The

additional page must be included in the "additional

information" total pages called for in Item 7 of NRC

Form 540. If the container and waste require disposal

in an approved structural overpack, the letters "-OP"

must be entered following the appropriate code

number.

NUREG/BR-0204, Rev. 2 14
7. Volume (Cubic Meters) - As a minimum, indicate

the volume of the outside dimensions of each

container to the nearest hundredth of a cubic meter.

Consignees (e.g., disposal facility operators) may

require a greater sensitivity of measurement. For

volumes of less than 1 cubic meter, always include a

zero in front of the decimal. For bulk unpackaged

waste or unpackaged components or equipment, enter

the estimated volume of the waste.

8. Waste and Container Weight (Kilograms) - List the

combined weight, in kilograms, of the container plus

the contents. For uncontainerized waste, provide the

weight of the waste. Consignees may require specific

sensitivities of measurement.

9. Surface Radiation Level (jtSv/hr or mSv/hr) -

Indicate the radiation level on contact with the

disposal container or uncontainerized waste. If this

level does not represent the highest radiation level on

the disposal container, provide additional descriptive

information. Select appropriate units for the entire

page. Do not use "BKG" for background levels

unless the background level is indicated in this

column.

10. Surface Contamination (MBq/1J00 cm2):

Alpha, Beta-Gamma - Record the results of

contamination surveys performed on the disposal

container. Do not use "BKG "for background levels

unless the background level is indicated in this

column. Estimated values are acceptable ifpotential

occupational exposures limit survey data collection.

15 NUREG/BR-0204, Rev. 2
11. Waste Descriptor - Using the codes found in Note 2

at the bottom of NRC Form 541, indicate the codes

that most specifically describe the type of waste in the

container. For discrete waste types (i.e., activated

material, contaminated equipment, mechanical filter,

sealed source/device or for wastes contained in

different solidification/stabilization media), the

spacing between these vertical listings of waste

descriptors or medias (if more than one waste type or

media is included in a single disposal container)

allows for the provision of radiological descriptions

on an individual waste descriptor and individual

solidification/stabilization media basis. Individual

consignees (e.g., disposal facility operators) may

require more extensive breakdowns of radiological

descriptions. If Code 59, "Other," is used, a written

explanation is required. The preferred option is to

include the explanation in Item 11, but if additional

space is required, enter "see additional page" in Item

11. The additional page must be included in the

"additional information" total pages called for in

Item 7 of NRC Form 540.

12. Approximate Waste Volume(s) in Container -

Indicate the approximate volume in cubic meters of

containerized waste, as applicable, by generator,

waste descriptor (if activated material, contaminated

equipment, mechanical filter, or sealed source/device

waste or waste contained in different

solidification/stabilization media). ">85%" may be

entered if (1) the disposal container "fill volume"

exceeds 85%; (2) the disposal container does not

contain the aforementioned discrete wastes, together

or mixed with other waste types, and does not contain

NUREG/BR-0204, Rev. 2 16
more than one solidification/stabilization media; and

(3) the external volume reported in Item 7 is

approximately equal to the internal disposal container

volume.

13. Sorbent, Solidification, Stabilization Media - All

shipments must use the codes found in Note 3 at the

bottom of NRC Form 541. Indicate the code(s) that

identifies the material used to solidify or absorb waste

material. The spacing between the vertical listings of

media descriptors (if more than one media descriptor

is included in a single disposal container) allows for

the provision of radiological descriptions on an

individual "media-descriptor" basis. Individual

consignees may require more extensive breakdowns of

radiological descriptions. Similarly, individual

disposal facilities may require solidification of certain

wastes (e.g., oil) in specified media and may require

identification of media vendor (manufacturer) and

brand name. If Code 89 or 99, "Other," is used, a

written explanation is required. The preferred option

is to include the explanation in Item 13, but if

additional space is required, enter "see additional

page" in Item 13. The additional page must be

included in the "additional information" total pages

called for in Item 7 of NRC Form 540.

If the solidification process is intended to stabilize the

waste in accordance with applicable NRC regulations

at 10 CFR 61.56(b) and disposal site requirements, a

letter, "-S", must be entered following the appropriate

code number. Note that all Class B and C wastes

must meet stability requirements. For all wastes

claimed to meet the aforementioned stability

17 NUREG/BR-0204, Rev. 2
requirements, the vendor (manufacturer) and the brand

name of the solidification media must be identified in this

column.

14. Chemical Description - List the most prevalent

chemical forms of the waste. Information in Item 14

should expand upon the chemical form description in

Item 14 of NRC Form 540. If animal carcasses were

coded in Item 11, the chemical form should include

the word "LIME," if applicable, in addition to any

other significant chemicals. Also indicate the name of

the chelating agents that are present in amounts

greater than 0.1% by weight of waste. Specify the

percent in the column under the heading "Weight %

Chelating Agent if >0.1%." If chelating agents are

not present indicate "NP." If chelating agents

represent less than 0.1% by weight, indicate "0." If

wastes were generated from large decontamination

processes (e.g., LOMI, Can-Decon, Citrox, etc.),

indicate the process in this column. If an additional

sheet describing the content of these wastes is needed,

note this in Item 7 of NRC Form 540.

15. Radiological Description - This information may be

presented in either of two ways. First, list all

significant radionuclides followed by their respective

activities in megabequerels that are present in the

waste in each container and for each waste generator

(e.g., if waste from more than one generator is

contained in a single container). Daughter products

must be either individually reported or, if within a

factor of 2 of being in equilibrium with its (their)

parent, reported as the parent with its activity listed,

but with the symbol "D" or "NAT" indicating

NUREG/BR-0204, Rev. 2 18
daughter products in equilibrium (e.g., Cs-137D or

ThNAT). For waste included within a single

container, the significant radionuclides and their

respective activities must be separately reported for

discrete waste types (i.e., activated materials,

contaminated equipment, mechanical filters, and

sealed source/devices and wastes in

solidification/stabilization media). Other wastes may

be described by a combination of waste descriptor

codes and, as a result, the radionuclides and activities

may be reported as a combined total. When the

radionuclides tritium (H-3), C-14, Tc-99, or 1-129 are

present, but the quantities are below the LLD, note the

radionuclide and report the LLD value in parentheses.

After listing the individual radionuclides as described

above, enter the word "Total" on a new line and enter

the total activity contained in the container. However,

if any LLD values were included in the container,

these values should not be included in the container

sum because they will be totaled separately under

Item 1.

OR, alternatively, for containers containing a single

waste type, enter the total megabequerels in the

container (for each waste generator, if waste from

more than one generator is included in a single

container) and enter the percent of each radionuclide.

Always include the "%" sign when using this option.

Individual consignees may require more extensive

breakdowns of radiological descriptions or may not

allow the alternative method of reporting described

above.

19 NUREG/BR-0204, Rev. 2
Note: The activity for uranium and thorium in source

material and U-233, U-235, and plutonium in Special

Nuclear Material must be reported in megabecquerels.

The quantity of these isotopes must be reported, in

kilograms for source material - including the

abbreviation "kg", and in grams for Special Nuclear

Material - including the abbreviation "g." The

weight quantities must be reported in brackets, either

adjacent to the activity listing or below the

radionuclide listing.

A radionuclide is "significant" if it is contained in the

waste in concentrations greater than 0.01 times the

concentration of that nuclide listed in Table 1 of 10

CFR 61.55 or 0.01 times the smallest concentration of

that nuclide listed in Table 2 of 10 CFR 61.55. A

radionuclide other than one listed in the tables is

considered significant if it is contained in the waste in

concentrations greater than 0.26 megabecquerels/cm 3.

Furthermore, any radionuclide whose activity

represents a Reportable Quantity under DOT

regulations or is 0.01 or' more of the total activity

within the disposal container should be listed even if

the above concentration criteria are not exceeded.

Listing only the most abundant radionuclides or the

category "mixed fission products" is not acceptable.

Use official abbreviations only.

To save space, two nuclides and their respective

activities may be entered on each line in this bisected

column. Additional nuclides and their respective

activities may be entered on subsequent lines that may

be included in each "outlined" row; that is, the lines

separating rows are not intended to limit the vertical

NUREG/BR-0204, Rev. 2 20
reporting of nuclides and activities, but are provided

to aid the transcription and readability of the

provided information.

16. Waste Classification - Using the following codes,

indicate waste classification and the structural

stability of the waste in accordance with applicable

NRC requirements or the radioactive material license

applicable at the disposal facility to which the waste

will be consigned. Waste generators shipping to

processors need not complete this item.

AS - Class A Stable

AU - Class A Unstable

B - Class B

C - Class C

BU or CU (unstable class B or C) may be used

to classify waste requiring appropriate handling

or processing at a disposal facility to achieve

required stability. If Greater-than-Class C

wastes are shipped, use "GTCC" (see 10 CFR

61.7(b)(5)).

Use NRC Form 541A if additional space is needed to

describe this shipment. Indicate the page number, total

number of Form 541 and 541A pages, and the manifest

number from NRC Form 540, Item 8.

21 NUREG/BR-0204, Rev. 2
I
NRC FORM 542: UNIFORM

LOW-LEVEL RADIOACTIVE WASTE MANIFEST

(Manifest Index and Regional Compact Tabulation)

1. Waste Collector/Processor - Complete the collector

or processor's'name, ID number, and the shipping

date. Space has' also been provided for any use

deemed appropriate by the shipper.

A waste collector or processor is an entity, operating

under a Commission or Agreement State license,

whose principal purpose for possessing the

radioactive material or waste is asfollows:

* A collector collects and consolidates waste

generated by others and transfers this waste,

without processing or. repackaging, to another

waste collector, processor, or licensed land

disposal facility.

* A processor processes, repackages, or

otherwise treats low-level radioactive material

or waste generated by others before the

eventual transfer of the waste, or waste residue,

to a licensed land disposal facility.

2. Manifest Number - Transfer the manifest number

from NRC Form 540, Item 8.

3. Page I of__ Page(s) - Include the total number of

Form 542 and 542A pages.

4. Generator Identification Number - Each row should

include one of the generator ID numbers from NRC

Form 541, Item 5. All generator numbers associated

23 NUREG/BR-0204, Rev. 2
with generators to whom low-level radioactive waste

is being attributed should appear in this column.

5. Generator Name, Permit Number (if applicable)......

and Telephone Number - Specify the information

requested about the generator to whom waste is being

attributed List one and only one generator, and

accompanying information, in each block. If the

permit number is reported in Item 4, it need not be

repeated here. Provide the generator information

requested in Items 6 through 11 in the same row.

6. Generator Facility Address - List the complete

address of the generator's facility that has

contributed low-level waste to the shipment. List one

and only one generator address in the block

consistent with the generator information provided in

Item 5.

7. Preprocessed Waste (or Material) Volume - Indicate

the approximate volume in cubic meters (not

including the container) of the preprocessed waste or

material. This is the volume of waste or material

received from the consignor's facility. This

information may be that indicated on the consignor's

NRC Form 541, Item 12, or the shipping paper used

to facilitate the transfer of radioactive material.

8. Manifest Number(s) Under Which Waste (or

Material) Received and Date of Receipt - List the

previous manifest number(s) applicable to the lowlevel waste that has been attributed to the generator

listed in Item 5, and date(s) of waste or material

NUREG/BR-0204, Rev. 2 24
receipt by the shipper identified in Item 5 of NRC

Form 540.

9. Waste Code: Processed or Collected - Indicate the

proper waste code, "P" or "C, " using the definitions

of waste processor and waste collector in Appendix G

of 10 CFR Part 20. Do not mix processed and

collected waste on the same line, list separately.

10. Originating Compact Region or State - Identify the

originating compact region, or unaffiliated state. The

information to be provided is for the original

generator of the waste, as defined in Appendix G,

Section I, of 1O CFR Part 20. For each generator

listed in Item 5, provide the information in the same

row. State abbreviations may be used Compact

abbreviations may be used when it cannot be

confused with a State abbreviation (do not use 2

letter Compact abbreviations).

11. As Processed/Collected Total - For each original

generator in Item 5, list the total Source Material (in

kilograms), Special Nuclear Material (in grams),

activity (in megabequerels) contained in the waste,

and the volume (in cubic meters) attributed to that

generator. Special Nuclear Material and Source

Material are defined in 10 CFR 70.4 and 40.4,

respectively.

Total ofAll Pages (NRC Form 542 and 542A) - At

the bottom of the page, indicate the totals for Items

I IA through lID that are reported on all pages of

the NRC Form 542 and 542A. Do not include

subtotals.

25 NUREG/BR-0204, Rev. 2
Use NRC Form 542A if additional space is needed to

describe this shipment. Indicate the page number, total

number of Form 542 and 542A pages, and the manifest

number from NRC Form 540, Item 8.

NUREG/BR-0204, Rev. 2 26
APPROVED BY OMB: NO. 3150-0164 Estimated burden per response to comply with this information collection request: 1.17 hours. This uniform manifest is required by NRC to meet reporting requirements of Federal and State Agencies for the same transportation and disposal of low-level waste.

EXPIRES: 05131l2001 Forward comments regarding burden estimate to the Records Management Branch (T-6 F33), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, and to the Paperwork Reduction Project (3150-0164), Office of Management and Budget, Washington, DC 20503. if an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

NRC FORM 540

(5-1998)

U. S. NUCLEAR REGULATORY COMMISSION 15. SHIPPER - NAME AND FACILITY

UNIFORM LOW-LEVEL RADIOACTIVE

WASTE MANIFEST

SHIPPING PAPER

SHIPPER ID. NUMBER

COLLECTOR

PROCESSOR

GENERATORTYPE

(Specify)

7. NRC FORM 540 AND 504A

NRC FORM 541 AND 541A

NRC FORM 542 AND 542A

ADDmONAL INFORMATION

PAGE 1 OF __ PAGE(S)

___ PAGE(S)

___ PAGE(S)

PAGE(S)

8. MANIFEST NUMBER (Use this number on all continuation

pages)

I a I USER PERMIT NUMBER

1. EMERGENCY TELEPHONE NUMBER (Include Area Code)

ORGANIZATION

SHIPMENT NUMBER 9. CONSIGNEE -- Name and Facility Address CONTACT

CONTACT TELEPHONE NUMBER (Include Area Code) TELEPHONE NUMBER (Include Area Code)

& i .1.

6. CARRIER - Name and Address EPA I.D. NUMBER SIGNATURE - Aufhcrized consignee acknowledging waste receipt DATE

2. IS THIS AN "EXCLUSIVE USE' SHIPMENT?

YES

NO

3. TOTAL NUMBER OF

PACKAGES IDENTIFIED

ON THIS MANIFEST

'6 SHIPPING DATE 10. CERTIFICATION

I I 9

I

DOES EPA REGULATED II YES WASTE REQUIRING A NO

MANIFEST ACCOMPANY N

THIS SHIPMENT?

If "Yes," provide Manifest Number

EPA MANIFEST NUMBER CONTACT TILEPHOUNE NUMBIER (Include Area Code)

This is to certify that the herein-named materials are properly classified, described, packaged, marked, and labeled and are

in proper condition for transportation according to the applicable regulations of the Department of Transportation. This also

certifies that the materials are classified, packaged, marked, and labeled and are in proper condition for transportation and

disposal as described in accordance with the applicable requirements of 10 CFR Parts 20 and 61, or equivalent state

reoulations. 1 _________

SIGNATURE - Authorized carrier acknowledging waste receipt DATE AUTHORIZED SIGNATURE TITLE DATE

11. U.S. DEPARTMENT OF TRANSPORTATION DESCRIPTION 12. 13. 14. 15. 16. 17. 18. TOTAL WEIGHT 19. IDENTIFICATION Oncluding proper shipping name, hazard class, UN ID number, DOT LABEL TRANSPORT PHYSICAL AND INDIVIDUAL TOTAL PACKAGE LSA/SCO OR VOLUME NUMBER OF and any additional information) "RADIOACTIVE" INDEX CHEMICAL FORM RADIONUCLIDES ACTIVITY IN SI UNITS CLASS (Use appropriate units) PACKAGE

r 4 1 4 1 I

* + I' 4 4 4 1

r r 1 4 1 4

* + I 4 - 4 4 1 4

r r 4 1 4 1 4

I I I i I I C

NI'IR, FURM 54U (5-1998)
NRC FORM 540A U.S. NUCLEAR REGULATORY COMMISSION 8. MANIFEST NUMBER (3-W (Use this number on all continuation pages)

UNIFORM LOW-LEVEL RADIOACTIVE

WASTE MANIFEST

SHIPPING PAPER (CONTINUATION) PAGE OF PAGE(S)

11. U.S. DEPARTMENT OF TRANSPORTATION DESCRIPTION 12. 13. 14. 15. 16. 17. 18. TOTAL WEIGHT 19. IDENTIFICATION (Including proper shipping name, hazard class, UN ID number, DOT LABEL TRANSPORT PHYSICAL AND INDIVIDUAL TOTAL PACKAGE LSA/SCO OR VOLUME NUMBER OF and any additional information) "RADIOACTIVE' INDEX CHEMICAL FORM RADIONUCLIDES ACTIVITY IN SI UNITS CLASS (Use appropriate units) PACKAGE

NRC FORM 540A (3-95)
APPROVED BY OMB: NO. 3150-0166 Estimated burden per response to comply with this information collection request: 5.43 hours. The uniform manifest is required by NRC to meet reporting requirements of Federal and State Agencies for the safe transportation and disposal of low-level

EXPIRES: 05131/2001 waste. Forward comments regarding burden estimate to the Records Management Branch (T-6 F33), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, and to the Paperwork Reduction Project (3150-0166), Office of Management and

Budget. Washinaton. DC 20503. If an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

NRC FORM 641 U.S. NUCLEAR REGULATORY COMMISSION 1. MANIFEST TOTALS 2. MANIFEST NUMBER

(5-1998) NUMBER OF NET WASTE NET WASTE SPECIAL NUCLEAR MATERIAL (grams) DISPOSAL VOLUME WEIGHT CONTAINERS (m 3) (kg) U-233_U-235 TOTAL

UNIFORM LOW-LEVEL RADIOACTIVE 3 PAGE 1 OF __ PAGE(S)

WASTE MANIFEST 4. SHIPPER NAME ACTIVITY (MBq) SOURCE

CONTAINER AND WASTE DESCRIPTION ALL NUCLIDES TRmUM C-14 Tc-99 1-129 (kg)

SHIPPER ID NUMBER

Additional Nuclear Regulatory Commission (NRC) Requirements for Control, Transfer and

Disposal of Radioactive Waste ___

DISPOSAL CONTAINER DESCRIPTION WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER 16.WASTE

5. 6. 7. 8. 9. 10. SURFACE PHYSICAL DESCRIPTION 14.' CHEMICAL DESCRIPTION 15. RADIOLOGICAL DESCRIPTION CLASSIFICONTAINER CONTAINER WASTE SURFACE CONTAMINASON -CATION IDENTIFICATION DESCRIP- VOUE AND AD RADIATION RDAIN2A-ls COTMNTO I1. 12. 13. SORBENT WIH ,-ls

NUMBER) TION VOLUME LEVEL MBq/100 cm WASTE APPROXIMATE SOLIDIFICATION, % INDIVIDUAL RADIONUCLIDES AND ACTIVITY (MBq) AND Stable IDENE CONTAINER DESCRIP- WASTE STABILIZATION,FORM/ U-Class A

GENERATOR (m3) WEIGHT CHELATING CONTAINER TOTAL; OR CONTAINER TOTAL ACTIVITY

IDSee (e Note Note 1) m(.uiSv/hr) ALPHA BETA- TOR VOLUME(S) IN MEDIA CHELATING AGENT AGENT AND RADIONUCLIDE PERCENT -Classtb NUMB 1) GAMMA See Note 2) CONTAINER (SeNoe3 (SeeNote3) IF 0.1% C-Class C

flit W110 £. p 0SWUVL Ctlhi~iiiL *p~fl M VI*UISC. J5.~~,iS p U U11 

waste requiring disposal In approved structural overpacks,

the numerical code must be followed by "-OP."

1. Wooden Box or Crate 9. Demineralizer

2. Metal Box 10. Gas Cylinder

3. Plastic Drum or Pail 11. Bulk, Unpackaged Waste

4. Metal Drum or Pail 12. Unpackaged Components

5. Metal Tank or Liner 13. High Integrity Container

S. Concrete Tank or Liner 19. Other. Describe in item 6,

7. Polyethylene Tank or Liner or additional page

B. Fiberalass Tank or Liner

- Z: - C F-r - es. %-oose up - three - c pre om mite by vo ume., For all solidification media, the vendor (manufacturer) and brand name must also be Identified In Item 13. Code 100-NONE REQUIRED. 20. Charcoal

21. Incinerator Ash

22. Soil

23. Gas

24. Oil

25. Aqueous Liquid

26. Filter Media

27. Mechanical Filter

28. EPA or State Hazardous

29. Demolition Rubble

30. Cation Ion-exchange Media

31. Anion Ion-exchange Media

32. Mixed Bed Ion-exchange Media

33. Contaminated Equipment

34. Organic Liquid (except oil)

35. Glassware or Labware

36. Sealed Source/Device

37. Paint or Plating

38. Evaporator Bottoms/Sludges/Concentrates

39. CompactibleTrash

40. Noncompactible Trash

41. Animal Carcass

42. Biological Material (except animal carcass)

43. Activated Material

59. Other. Describe in item 11,

or additional page

Sorption

60. Speedi Dri

61. Celetom

62. Floor Dry/

Superfine

63. Hi Dri

64. Safe T Sorb

65. Safe N Dri

66. Florco

67. Florco X

68. Solid A Sorb

69. Chemsil 30

70. Chemsil 50

71. Chemsil 3030

72. Dicaperl HP200

73. Dicaped HP500

74. Petroset

75. Petroset II

76. Aquaset

77. Aquaset 11

89. Other.

Describe in

item 13, or

additional

page

Solidification

90. Cement 94. Vinyl Ester Styrene

91. Concrete 99. Other. Describe

(encapsulation) in item 13, or

92. Bitumen additional page

93. Vinyl Chloride 100. None Required

NRC FORM 541 (5-1998)
U

NRC FORM "41A

(3- UNIFORM LOW-LEVEL RADIOACTIVE

WASTE MANIFEST

CONTAINER AND WASTE DESCRIPTION (CONTINUATION)

U.S. NUCLEAR REGULATORY COMMISSION 12. MANIFEST NUMBER

3.

PAGE __ OF __ PAGE(S)

a . -

WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER

14. CHEMICAL DESCRIPTION 15. RADIOLOGICAL DESCRIPTION

t

CHEMICAL FORM/

CHELATING AGENT

WEIGHT

CHELATING

AGENT

IF > 0.1%

INDIVIDUAL RADIONUCLIDES AND ACTIVITY (MBq) AND

CONTAINER TOTAL; OR CONTAINER TOTAL ACTIVITY

AND RADIONUCLIDE PERCENT

16.

WASTE

CLASSIFICATION AS-Class A

Stable

AU-Class A

Unstable

B-Class B

C-Class C

4 4. 4

4 * 4

- 4 4. 4

4 * 4

4 * 4

4. 4. 4

4. 4 ____

4- * 4

4- 4 4
NRC FORM 641A U.S. NUCLEAR REGULATORY COMMISSION 2. MANIFEST NUMBER

UNIFORM LOW-LEVEL RADIOACTIVE

WASTE MANIFEST

CONTAINER AND WASTE DESCRIPTION (CONTINUATION) PAGE OF __ PAGE(S)

DISPOSAL CONTAINER DESCRIPTION WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER 16.WASTE 5. 6. 7. 8. 9. 10. SURFACE PHYSICAL DESCRIPTION 14. CHEMICAL DESCRIPTION 15. RADIOLOGICAL DESCRIPTION CLASSIFICONTAINER ONTAINER WASTE SURFACE CONTAMINATION CATION IDENTIFICATION DESCRIP- AND RADIATION N11 12. 13. SORBENT WEIGHT AS-Class A NUMBERN TION VOLU CONTAINER LEVEL MBq/100 cm 2 WASTE APPROXMATE SOLIDIFICATION, % INDIVIDUAL RADIONUCLIDES AND ACTIVITY (MBq) AND Stable DESCRIP- WASTE STABILIZATION, CHEMICAL FORM/ CHELATING CONTAINER TOTAL; OR CONTAINER TOTAL ACTIVITY AU-Class A GENERATOR 3 WEIGHT CHELATING AGENT Unstable (See Note 1) ( (,Sv/hr) BETA- TOR VOLUME(S) IN CHELATINGNAGENTUUnstable ID NUMBER(S) (kg) ALPHA GAMMA Note 2) CONTAINER MEDIA AGENT AND RADIONUCLIDE PERCENT GAMMA (See Not 3)OIFAINEB-Class C

(mvh)(See Note 3) IF >0.1% C-Class C

1* t I I * I t t I

-- -11 -1 -A- - .f-
APPROVED BY OMB: NO. 3150-0165 Estimated burden per resonse to comply with this information collection request: 26 minutes. The uniform manifest is required by NRC to meet report requirements of Federal and State Agencies for the safe transportation and disposal of low-level

EXPIRES: 513112001 waste. Forward comments regarding burden estimate to the Records Management Branch (T-6 F33), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, and to the Paperwork Reduction Project (3150-0165), Office of Management and D,,1...Mt W fintnn r fl• (n• Il mn nfnrm.tin ,-nll~,-finn rl• nnt Hin~ a -lrnl ,,~li AUt~R r•nntrnl nsmn *ho I•1JPA: m~, nnt •ndl~ nr •nnn~nr •nJ n~rnn ik nnt r~nlir~d tn ,nqnnnd tn thA infnrm~stinn ,~nllnfinn

NRC FORM 542 U.S. NUCLEAR REGULATORY COMMISSION 2. MANIFEST NUMBER

(5-1998) WASTE COLLECTOR/PROCESSOR

UNIFORM LOW-LEVEL RADIOACTIVE NAME SHIPPER USE ONLY

WASTE MANIFEST IDEN11FICAT10N NUMBER

MANIFEST INDEX AND REGIONAL COMPACT TABULATION 3.

List all original "PROCESSED WASTE" generators (if any) SHIPPING DATE PAGE 1 OF PAGE(S)

before "COLLECTED WASTE" generators. _1

4. 5. 6. 7. 8. 9. 10. 11. AS PROCESSED/COLLECTED TOTAL

PREPROCESSED

GENERATOR GENERATOR NAME, GENERATOR WASTE MANIFEST NUMBER(S) UNDER WASTE CODE ORIGINATING A.SOURCE

IDENTIFICATION PERMIT NUMBER (IF APPLICABLE), FACILITY (OR MATERIAL) WHICH WASTE (OR MATERIAL) P = PROCESSED COMPACT AB.SNM S C. ACTIVITY VOLUME

NUMBER AND TELEPHONE NUMBER ADDRESS VOLUME RECEIVED AND DATE C = COLLECTED REGION STTERIAL

[ m

3 ) OF RECEIPT OR STATE kg) (g) (MBq) (m3

4 r I I r I T I

4 4 ¶ 1 1 1 I I I T

4 4 t 1 1 1 I I I T

4 4 1 I t 1 I I I T

I 4 1 I 1 I 1 1 1

I I 4 I 4 4 1 1 1 1

_______________________ __________________________ 1 1 1 1 1

TOTALS OF ALL PAGES (NRC FORMS 542 AND 542A)

______________________ i i I

NRC FORM 542 (5-1998)
NRC FORM 642A U.S. NUCLEAR REGULATORY COMMISSION 2. MANIFEST NUMBER

(395 UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST 3.

MANIFEST INDEX AND REGIONAL COMPACT TABULATION (CONTINUATION) _ IPAGE OF PAGE(S)

4. 5. 8. 7. 8. 9. 10. 11. AS PROCESSEDICOLLECTED TOTAL

PREPROCESSED

GENERATOR GENERATOR NAME, GENERATOR WASTE MANIFEST NUMBER(S) UNDER WASTE CODE ORIGINATING

(OR MATERIAL) WHICH WASTE (OR MATERIAL) P = PROCESSED COMPACT A.SSOURCE

IDENTIFICATION PERMIT NUMBER (IF APPLICABLE), FACILITY VOUERCIE N AE P=POESD REGION MATERIAL B. SNM C. ACTIVITY D. VOLUME

NUMBER AND TELEPHONE NUMBER ADDRESS VOLUME RECEIVED AND DATE C = COLLECTED OR STATE MATE L3 (m,3 ) OF RECEIPT ORSAE(kg) (g) (MBq.) (m3
Federal Recycling Program
I