Chat

NSSI/RECOVERY SERVICES, INC.
WASTE PROFILE FORM

SUPPLEMENTAL RADIOACTIVE WASTE PROFILE FORM

Generator

Address


City
State
Zip

Phone   

Fax

E-mail

USEPA ID No.

DRUM NO. WASTE TYPE CONT SIZE (gal) WASTE STREAM NAME NUCLIDE TOTAL ACTIVITY (mCi) CONCENTRATION (As applicable) uCi/milliliter uCi/gram
THE ABOVE LISTED WASTE MATERIAL(S) ARE LIQUID SCINTILLATION OR ANIMAL TISSUE, OR WERE GENERATED FROM IN-VITRO OR IN-VIVO LABORATORY TESTING OR RESEARCH ACTIVITIES.

WASTE TYPES:

02. SCINTILLATION VIALS
02P. SCINTILLATION PLATES/PAPERS
02B. BULK SCINTILLATION LIQUID
03. BACTEC VIALS
04. BULK ORGANIC LIQUID
05. BULK AQUEOUS LIQUID
06. URANIUM/THORIUM COMPOUNDS
07. DRY NON-COMPACTED
07C. DRY COMPACTED
07N. DRY NON-COMPACTABLE
08. ANIMAL CARCASS
09. SEALED SOURCES
10. LABPACKED CONTAINERS

This to certify that the listed wastes have been surveyed to assure that the limits specified in subsection(a) of Section 336.225 have not been exceeded and that all labels, tags, and other markings which could indicate the material or content is radioactive have been removed or otherwise obliterated or obscured.

AUTHORIZED SIGNATURE
TITLE
DATE