541A NRC Form 541A

NRC FORM 541A

U.S. NUCLEAR REGULATORY COMMISSION

(3-95)

UNIFORM LOW-LEVEL RADIOACTIVE
WASTE MANIFEST

3.

PAGE

CONTAINER AND WASTE DESCRIPTION (CONTINUATION)
DISPOSAL CONTAINER DESCRIPTION
5.

6.
CONTAINER
IDENTIFICATION
NUMBER/
GENERATOR
ID NUMBER(S)

CONTAINER
DESCRIPTION

7.

8.
VOLUME
(m 3)

(See Note 1)

WASTE
AND
CONTAINER
WEIGHT
(kg)

9.

(µSv/hr)
(mSv/hr)

NRC FORM 541A (3-95)

OF

WASTE DESCRIPTION FOR EACH WASTE TYPE IN CONTAINER
10.

SURFACE
RADIATION
LEVEL

2. MANIFEST NUMBER

SURFACE
CONTAMINATION
MBq/100cm 2

ALPHA

BETAGAMMA

PHYSICAL DESCRIPTION
12.
11.
WASTE
APPROXIMATE
DESCRIPWASTE
TOR
VOLUME(S) IN
CONTAINER
(See Note 2)

14.

CHEMICAL DESCRIPTION

13.

SORBENT
SOLIDIFICATION,
STABILIZATION,
MEDIA
(See Note 3)

CHEMICAL FORM/
CHELATING AGENT

15.
WEIGHT
%
CHELATING
AGENT
IF > 0.1%

RADIOLOGICAL DESCRIPTION

INDIVIDUAL RADIONUCLIDES AND ACTIVITY (MBq) AND
CONTAINER TOTAL; OR CONTAINER TOTAL ACTIVITY
AND RADIONUCLIDE PERCENT

PAGE(S)
16.
WASTE
CLASSIFICATION
AS-Class A
Stable
AU-Class A
Unstable
B-Class B
C-Class C