DOE/NRC-F-742 US Department of Energy and US Nuclear Regulatory Commis

DOE/NRC F 742

U.S. DEPARTMENT OF ENERGY
AND
U.S. NUCLEAR REGULATORY COMMISSION

(08-98) Previous editions are obsolete.
MANDATORY DATA COLLECTION
AUTHORIZED BY 10 CFR 30, 40, 50,
70, 75, 150. Public Laws 83-703,
93-438, 95-91.

OMB Control No.
1910-1800
OMB Burden Disclosure
Statement on Reverse

MATERIAL BALANCE REPORT

1. NAME AND ADDRESS

2. LICENSE NUMBER(S)

3. REPORTING IDENTIFICATION SYMBOL (RIS)

4. REPORT PERIOD (MM/DD/YYYY)
FROM

TO

5. MATERIAL TYPE
(Submit separate report
for each type)

MATERIAL ACCOUNTABILTY

SECTION A
7. DOE/NRC 740M ATTACHED

YES

NO

A. ELEMENT WEIGHT

8. BEGINNING INVENTORY - DOE OWNED
9. BEGINNING INVENTORY - NOT DOE OWNED
RECEIPTS
11. PROCUREMENT FROM DOE

RIS

FROM:

13. PROCUREMENT - FOR THE ACCOUNT OF DOE
14. DOD RETURNS - USE A
15. DOD RETURNS - USE B
16. DOD RETURNS - OTHER USES
21. PRODUCTION
22. FROM OTHER MATERIALS

a. ICT
b. ICT
c. ICT

30. RECEIPTS REPORTED TO DOE/NRC ON DOE/NRC F 741 (Not listed elsewhere)
FROM:

RIS

34. RECEIPTS - MISC
37. PROCUREMENT BY OTHERS
38. DONATED MATERIAL - FROM DOE TO OTHERS
39. DONATED MATERIAL - FROM OTHERS TO DOE
40. TOTAL (LINES 8-39)
REMOVALS
41. EXPENDED IN SPACE PROGRAMS
42. SALES TO DOE RIS TO:

RIS

TO:
43. SALES TO OTHERS FOR THE ACCOUNT OF DOE

RIS

TO:
44. DOD - USE A
45. DOD - USE B
46. DOD - OTHER USES
47. EXPENDED IN DOE TESTS
48 ROUTINE TESTS
49. SHIPPER - RECEIVER DIFFERENCE
51. SHIPMENTS REPORTED TO DOE/NRC ON DOE/NRC F 741 (Not listed elsewhere)
RIS

TO:

54. SHIPMENTS - MISC
58. DONATED MATERIAL - TO DOE BY OTHERS
59. DONATED MATERIAL - TO OTHERS BY DOE
65. ROUNDING BIAS
71. DEGRADATION TO OTHER MATERIALS

a. ICT
b. ICT

72. DECAY
73. FISSION AND TRANSMUTATION
74. NORMAL OPERATIONAL LOSSES/MEASURED DISCARDS
75. ACCIDENTAL LOSSES
76. APPROVED WRITE-OFFS
77. INVENTORY DIFFERENCE
80. ENDING INVENTORY - DOE OWNED
81. ENDING INVENTORY - NOT DOE OWNED
82. TOTAL (Lines 41-81)
83. BIAS ADJUSTMENT

18 U.S.C. SECTION 1001; ACT OF JUNE 25, 1948; 62 STAT. 749; 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.
Printed with soy ink on recycled paper

B. ISOTOPE WEIGHT

DOE/NRC F 742
(08-98) Previous editions are obsolete.
MANDATORY DATA COLLECTION
AUTHORIZED BY 10 CFR 30, 40, 50,
70, 75, 150. Public Laws 83-703,
93-438, 95-91.

OMB Control No.
1910-1800
OMB Burden Disclosure
Statement on Reverse

SECTION B

COUNTRY CONTROL NUMBER DATA
2. ELEMENT WEIGHT

1. COUNTRY CONTROL NUMBER

3. ISOTOPE WEIGHT

4. TOTAL WEIGHT
(Total must agree with total on line 80 or 81 or both)
SECTION C

CERTIFICATION

To the best of my knowledge and belief, the information given above and in any attached schedules is true, complete, and correct.

SIGNATURE (See instructions for provisions on confidentiality)

TITLE

DATE

OMB BURDEN DISCLOSURE STATEMENT

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to Information, Records, and Resource Management, HR-41 - GTN, Paperwork
Reduction Project (1910-1800), U.S. Department of Energy, 1000 Independence Avenue, S.W., Washington, DC 20585; and to the
Office Management and Budget (OMB), Paperwork Reduction Project (1910-1800), Washington, DC 20503.