Form NRC Form 244 NRC Form 244 NRC Form 244 - Registration Certificate - Use of Deplete

NRC FORM 244

U.S. NUCLEAR REGULATORY COMMISSION

MM/DD/YYYY
10 CFR 40

REGISTRATION CERTIFICATE -- USE OF DEPLETED
URANIUM UNDER GENERAL LICENSE

APPROVED BY OMB: NO. 3150-0031 EXPIRES: MM/DD/YYYY
Estimated burden per response to comply with this mandatory collection request: 1
hour. NRC requires this information to identify the general licensee and to facilitate
subsequent communication. Send comments regarding burden estimate to the
Records and FOIA/Privacy Services Branch (T-5 F52), U.S. Nuclear Regulatory
Commission, Washington, DC 20555-0001, or by internet e-mail to
[email protected], and to the Desk Officer, Office of Information and Regulatory
Affairs, NEOB-10202, (3150-0031), Office of Management and Budget, Washington,
DC 20503. If a means used to impose 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.

Section 40.25 of 10 CFR Part 40 establishes a general license authorizing the use of depleted uranium contained in industrial products or devices for
mass-volume applications. Submit this NRC form 244 within 30 days after the first receipt or acquisition of such depleted uranium.

1. INSTRUCTIONS:
A. Print or type the name and address of the registrant (including ZIP Code) for whom this form is filed in Box 3 below.
B. Submit this form in duplicate to:
Director, Office of Nuclear Material Safety and Safeguards
U.S. Nuclear Regulatory Commission
Washington, DC 20555-0001

with a copy to the appropriate Regional Administrator
at the address listed on the reverse.
(NRC will assign a file number, and a copy of this
form will be returned to you.)

2. I hereby file NRC Form 244 pursuant to 10 CFR 40.25, for use of depleted uraniu m contained in industrial products or devices for
mass-volume applications.
3. NAME AND ADDRESS OF REGISTRANT FOR WHOM THIS FORM IS FILED
(Include Zip Code)

4. FILE NUMBER (Leave blank - to be assigned by NRC)

5. INDIVIDUAL DULY AUTHORIZED TO ACT FOR AND ON BEHALF OF THE REGISTRANT IN SUPERVISING THE
PROCEDURES
A. NAME

B. TITLE

C. ADDRESS
D. TELEPHONE NUMBER

E. FACSIMILE TELEPHONE NUMBER

F. E-MAIL ADDRESS

6. CERTIFICATION
I hereby certify that:
A. All information in this registration certificate is true and complete.
B. This registrant has developed and will maintain procedures designed to establish physical control over the depleted
uranium described in 10 CFR 40.25(a) and designed to prevent transfer of such depleted uranium in any form,
including metal scrap, to persons not authorized to receive the depleted uranium.
C. I understand that Commission regulations require that any changes in information furnished by a registrant on this
registration certificate be reported in writing to the Director, Office of Nuclear Material Safety and Safeguards, with a
copy to the appropriate Regional Administrator at the address listed on the reverse, within 30 days after the effective
date of such change.
D. I understand that the registrant is required to comply with the provisions of Section 40.25 of the NRC's regulation 10
CFR Part 40 (reprinted on the reverse side of this form) with respect to all depleted uranium which the registrant
receives, acquires, uses, or transfers under the general license for which this registration certificate is filed with the
U.S. Nuclear Regulatory Commission.
E. PRINTED OR TYPED NAME AND TITLE OF PERSON FILING FORM

F. SIGNATURE

G. DATE

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 WILFULLY
FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO
ANY MATTER WITHIN ITS JURISDICTION.
NRC FORM 244 (4-2008)

PRINTED ON RECYCLED PAPER

REGIONAL ADDRESSES
REGION IF YOU ARE LOCATED IN

ADDRESS

REGION IF YOU ARE LOCATED IN

I
and
II

ALABAMA, CONNECTICUT,
DELAWARE, DISTRICT OF
COLUMBIA, FLORIDA, GEORGIA,
KENTUCKY, MAINE, MARYLAND,
MASSACHUSETTS, MISSISSIPPI,
NEW HAMPSHIRE, NEW JERSEY,
NEW YORK, NORTH CAROLINA,
PENNSYLVANIA, PUERTO RICO,
RHODE ISLAND, SOUTH CAROLINA,
TENNESSEE, VERMONT, VIRGINIA,
VIRGIN ISLANDS, AND WEST
VIRGINIA

REGIONAL ADMINISTRATOR
REGION I
U.S. NUCLEAR REGULATORY COMMISSION
475 ALLENDALE ROAD
KING OF PRUSSIA, PA 19406-1415

III

ILLINOIS, INDIANA, IOWA,
MICHIGAN, MINNESOTA, MISSOURI,
OHIO, AND
WISCONSIN

REGIONAL ADMINISTRATOR
REGION III
U.S. NUCLEAR REGULATORY COMMISSION
2443 WARRENVILLE ROAD, SUITE 210
LISLE, IL 60532-4352

IV

ALASKA, ARIZONA, ARKANSAS,
CALIFORNIA, COLORADO,
HAWAII, IDAHO, KANSAS,
LOUISIANA, MONTANA,
NEBRASKA, NEVADA, NEW
MEXICO, NORTH DAKOTA,
OKLAHOMA, OREGON,
PACIFIC TRUST TERRITORIES,
SOUTH DAKOTA, TEXAS,
UTAH, WASHINGTON, AND
WYOMING

ADDRESS
REGIONAL ADMINISTRATOR
REGION IV
U.S. NUCLEAR REGULATORY COMMISSION
612 E. LAMAR BOULEVARD, SUITE 400
ARLINGTON, TX 76011-4125

10 CFR 40.25
§40.25 General license for use of certain industrial products
or devices.
(a)
A general license is hereby issued to receive, acquire,
possess, use, or transfer, in accordance with the provisions of
paragraphs (b), (c), (d), and (e) of this section, depleted
uranium contained in industrial products or devices for the
purpose of providing a concentrated mass in a small volume
of the product or device.
(b)
The general license in paragraph (a) of this section
applies only to industrial products or devices which have been
manufactured or initially transferred in accordance with a
specific license issued pursuant to §40.34(a) of this part or in
accordance with a specific license issued by an Agreement
State which authorizes manufacture of the products or
devices for distribution to persons generally licensed by the
Agreement State.
(c)(1) Persons who receive, acquire, possess, or use
depleted uranium pursuant to the general license established
by paragraph (a) of this section shall file NRC Form 244,
"Registration Certificate--Use of Depleted Uranium Under
General License," with the Director, Division of Nuclear
Material Safety, U.S. Nuclear Regulatory Commission,
Washington, D.C. 20555, with a copy to the appropriate NRC
Regional Administrator. The form shall be submitted within 30
days after the first receipt or acquisition of such depleted
uranium. The registrant shall furnish on NRC Form 244 the
following information and such other information as may be
required by that form:
(i)

of the appropriate U.S. Nuclear Regulatory Commission
Regional Office listed in Appendix D of Part 20 of this chapter,
any changes in information furnished by him in the NRC Form
244, "Registration Certificate--Use of Depleted Uranium Under
General License." The report shall be submitted within 30
days after the effective date of such change.
(d)
A person who receives, acquires, possesses, or uses
depleted uranium pursuant to the general license established
by paragraph (a) of this section:
(1)
Shall not introduce such depleted uranium, in any form,
into a chemical, physical, or metallurgical treatment or
process, except a treatment or process for repair or restoration
of any plating or other covering of the depleted uranium.
(2)

Shall not abandon such depleted uranium.

(3)
Shall transfer or dispose of such depleted uranium only
by transfer in accordance with the provisions of 40.51 of this
part. In the case where the transferee receives the depleted
uranium pursuant to the general license established by
paragraph (a) of this section, the transferor shall furnish the
transferee a copy of this section and a copy of NRC form 244.
In the case where the transferee receives the depleted
uranium pursuant to a general license contained in an
Agreement State's regulation equivalent to this section, the
transferor shall furnish the transferee a copy of this section
and a copy of NRC Form 244 accompanied by a note
explaining that use of the product or device is regulated by the
Agreement State under requirements substantially the same
as those in this section.

Name and address of the registrant;

(ii)
A statement that the registrant has developed and will
maintain procedures designed to establish physical control
over the depleted uranium described in paragraph (a) of this
section and designed to prevent transfer of such depleted
uranium in any form, including metal scrap, to persons not
authorized to receive the depleted uranium; and
(iii)
Name and/or title, address, and telephone number of
the individual duly authorized to act for and on behalf of the
registrant in supervising the procedures identified in
paragraph (c)(1)(ii) of this section.
(2)
The registrant possessing or using depleted uranium
under the general license established by paragraph (a) of this
section shall, in writing to the Director, Division of Nuclear
Material Safety, with a copy to the Regional
Administrator

(4)
Within 30 days of any transfer, shall report in writing to
the Director, Division of Nuclear Material Safety, with a copy to
the Regional Administrator of the appropriate U.S. Nuclear
Regulatory Commission Regional Office listed in Appendix D
of Part 20 of this chapter, the name and address of the person
receiving the source material pursuant to such transfer.
(e)
Any person receiving, acquiring, possessing, using, or
transferring depleted uranium pursuant to the general license
established by paragraph (a) of this section is exempt from the
requirements of Parts 10, 20, and 21 of this chapter with
respect to the depleted uranium covered by that general
license.