DISPOSAL REPORT FOR
SOUTHWESTERN LOW-LEVEL RADIOACTIVE WASTE
COMMISSION- 2022
ALL Waste Generators are required to submit a Disposal Report as agreed to by your approved Petition for Exportation (Section A, paragraph 7-Check your DUE DATE).
Petition #_____________________
FROM: ____________________________________________________________________________________________________________
ADDRESS:_________________________________________________________________________________________________________
Date of shipment_____________________ Date of Disposal____________
Check here___ IF this report is for a final shipment. If there was more than one shipment under this petition, this report may summarize the year’s total for this Petition Year.
Check here___IF the waste was processed and then disposed of as the processors or yours, YOU MUST still submit a Disposal Report to SWLLRWCC. You must have documents to verify receipt to Processor. Volume and radioactivity data are not required for closure.
Check here___IF this is an INTERIM DISPOSAL REPORT. This must be filed not later than the DUE DATE listed on your Petition. You must notify SWLLRWCC that all your waste has not been received for final disposal by the end of the Petition year. A follow-up Disposal Report shall be submitted to SWLLRWCC before closure of the above approved Petition is complete. The Waste Generator understands the failure to submit the report is grounds for the Commission to deny any further approval of future petitions.
ANTICIPATED DATE OF FINAL DISPOSAL?_______________________________________________________________
WASTE CLASS: A B C
FINAL DISPOSAL VOLUME (CUBIC FEET) ______________ _______________ ________________
RADIOACTIVITY (mCi) _______________ _______________ ________________
GENERATOR TYPE (check one): Academic_____Gov’t_____Industry_____Medical_____Utility_____
REPORTED BY___________________________________ ___________________________________________________
(print name) (signature)
Title_____________________________________________________________ Date:______________________________
Telephone:_______________________ FAX____________________________ E-mail______________________________
REMARKS:
FAX or MAIL to:
Southwestern Low-Level Radioactive Waste Commission
1731 Howe Avenue #611, Sacramento, California 95825
PHONE (916) 448 2390 FAX: (916) 720-0144
Call or email if you have questions at (916) 448-2390 or kathydavis@swllrwcc.org