Importation Form

ANNEX A

TLLRWDCC §675.23—IMPORTATION FORM

TEXAS LOW-LEVEL RADIOACTIVE WASTE DISPOSAL COMPACT COMMISSION APPLICATION
FOR IMPORTATION OF NON-PARTY LOW-LEVEL RADIOACTIVE WASTE (NOTE: PURSUANT TO
TEXAS HEALTH AND SAFETY CODE, §401.207(j), THIS PETITION MUST BE COMPLETED BY
APPROPRIATE REPRESENTATIVES OF THE DEPARTMENT OF DEFENSE OR THE GENERATOR OF
THE WASTE UNLESS THE GENERATOR IS A SMALL QUANTITY GENERATOR AS DEFINED IN 31
TAC §675.20(19), IN WHICH CASE THE PETITION MAY BE SUBMITTED BY AN APPROPRIATELY
LICENSED BROKER) (Article III, Sec. 3.05(7) of the Compact)

I. Applicant Information:

II. Generator Specifications

III. Agreement Period

Current fiscal year is Sept 1 to Aug 31 of the following year.

IV. Waste Proposed for Importation

V. Compliance

VI. Certifications

* If any box is left unchecked, the Commission will assume that requirement was not met.

VII. Authorized Signatory

VIII. Attachments/Comments