NRC Form 540A Uniform Low-Level Radioactive Waste Manifest (Shipping P

APPROVED BY OMB: NO. 3150-0164
EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this information collection request: 45 minutes. This uniform manifest or its equivalent is required by NRC to meet reporting requirements of Federal and State Agencies for the safe transportation and disposal of lowlevel waste (10 CFR 20, App G). Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to
[email protected], and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0164), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; e-mail:
[email protected]. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.

NRC FORM 540A
(MM-YYYY)

U.S. NUCLEAR REGULATORY COMMISSION

UNIFORM LOW-LEVEL RADIOACTIVE
WASTE MANIFEST SHIPPING PAPER (Continuation)
See NUREG/BR-0204 for detailed instructions for completing this form: http://www.nrc.gov/reading-rm/doc-collections/nuregs/brochures/br0204/

11. U. S. Department of Transportation Description
(Including UN ID number, proper shipping name,
hazard class, and any additional information)

NRC FORM 540A (MM-YYYY)

12. DOT
Labels

13. Transport
14. Physical and Chemical Form
Index

15. Individual Radionuclides

8. Manifest Number
(Use this number on all continuation pages)

Page
16. Maximum Package
Activity in SI Units

Of
17. Total Weight
or Volume
(Use appropriate units)

Page(s)
18. Identification
Number of
Package