NRC Form 541 UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST CONTAINER A

APPROVED BY OMB: NO. 3150-0166
EXPIRES: 01/31/2023

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U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 541
(06-2020)

UNIFORM LOW-LEVEL RADIOACTIVE WASTE MANIFEST
CONTAINER AND WASTE DESCRIPTION

No. of Pkgs/
Disposal
Containers

Net Waste
Volume
(m 3 )

NOTE 1: Container Description Codes. For containers/ waste
requiring disposal in approved structural overpacks, the numerical
code should be followed by "-OP."
1.
2.
3.
4.
5.
6.
7.

Wooden Box or Crate
Metal Box
Plastic Drum or Pail
Metal Drum or Pail
Metal Tank or Liner
Concrete Tank or Liner
Polyethylene Tank or Liner

8. Fiberglass Tank or Liner
9. Demineralizer
NRC FORM 541 (06-2020)

10.
11.
12.
13.

Gas Cylinder
Bulk Unpackaged Waste
Unpackaged Components
High Integrity Container

19. Other. Describe in item 6,
or additional page

11. Surface
Contamination
2
MBq/100 cm
BetaGamma

Alpha

Tritium

21. Incinerator Ash
22. Soil
23. Gas
24. Oil
25. Aqueous Liquid
26. Filter Media
27. Mechanical Filter
28. EPA or State Hazardous

Pu

Total

3. Page

1

of

Page(s)

Source (kg)
C-14

Physical Description
12. Waste 13. Approximate 14. Sorbent
Descriptor
Waste
Solidification,
(See Note 2) Volume(s) in
Stabilization,
Container
Media (See Note 3)

NOTE 2: Waste Descriptor Codes. (Choose up to three which predominate by volume.)
20. Charcoal

U-235

Activity (MBq)
All Nuclides

See NUREG/BR-0204 for detailed instructions for completing this form:
http://www.nrc.gov/reading-rm/doc-collections/nuregs/brochures/br0204/

(mSv/hr)

U-233

2. Manifest Number

4. Shipper Name

Additional Nuclear Regulatory Commission (NRC) Requirements for Control, Transfer and Disposal of Radioactive Waste

Disposal Container Description
5. Container
6. Container
7. Volume 8. Waste
9. Waste
10.
Surface
3
Identification
Description
(m )
and
Weight
Radiation Level
Number/Generator
(See Note 1)
Container
(kg)
(µSv/hr)
ID Number(s)
Weight (kg)

1. Manifest Totals
Special Nuclear Material (grams)

Net Waste
Weight
(kg)

31.
32.
33.
34.

Anion Ion-exchange Media
41. Animal
Carcass
Mixed Bed Ion-exchange Media
Contaminated Equipment
42. Biological
Organic Liquid (except oil)
Material (except
animal carcass)
35. Glassware or Labware
36. Sealed Source/Device
43. Activated
Material
37. Paint or Plating
38. Evaporator Bottoms/
Sludges/Concentrates

39. Compactible Trash
29. Demolition Rubble
30. Cation Ion-exchange Media 40. Noncompactible Trash

59. Other.
Describe in item
12, or additional
page

Tc-99

Shipper ID Number

I-129

Waste Description for Each Waste Type in Container
15. Chemical Description
16. Radiological Description
Chemical Form/
Chelating Agent

Weight
% Chelating
Agent if > 0.1%

17. Waste Class
AS-Class A Stable

AU-Class A Unstable
Individual Radionuclides and Activity
B-Class B
(MBq) and Container Total; or Container
C-Class C
Total Activity and Radionuclide Percent

NOTE 3: For solidification media that meet disposal site structural stability requirements, the numerical code
should be followed by "-S."
For all solidification media, the vendor (manufacturer) and brand name should also be identified in item 14. Code
100=NONE REQUIRED.
Sorption
60. Speed Dri
61. Celetom
62. Floor Dry/
Superfine
63. High Dri
64. Safe T Sorb
65. Safe N Dri
66. Florco

67. Florco X

75. Petroset II

68. Solid A Sorb
69. Chemsil 30
70. Chemsil 50
71. Chemsil 3030
72. Dicaperl HP200
73. Dicaperl HP500
74. Petroset

76. Aquaset
77. Aquaset II
89. Other. Describe in item 14,
or additional page

Solidification
90. Cement
91. Concrete (encapsulation)
92. Bitumen
93. Vinyl Chloride
94. Vinyl Ester Styrene
99. Other. Describe in item 14,
or additional page
100. None Required