Waste Management Forms

List of Forms provided by the Division of Waste Management.


Solid Waste Program


Aggregate (Includes Concrete, Asphalt etc.)
Department Of Transportation Projects Inert Waste Beneficial Use Application
Inert Waste Beneficial Use Application
Notification For Concrete Asphalt Recycling Facilities

Agriculture
Nutrient Management Plan Land Application Work Sheet

Asbestos
Asbestos Waste Manifest Form

Landfills - General
Application For A Solid Waste Management Facility Permit
Application For Open Burning Variance Of Clean Wood At Landfills
Emergency Waste Disposal Variance Notification
Notice Of Waste Disposal
Waste Disposal Variance Application

Landfills - Inert
Department Of Transportation Projects Inert Waste Disposal Variance Application
Inert Waste Disposal Variance Application
Inert Waste Facility Annual Report
Inert Waste Landfill Inspection Checklist
Permit By Rule Notification

Land Treatment - Petroleum Contaminated Soil
Land Treatment Site Application - SFN51601
Soil Monitoring Results for Land Treatment of Petroleum Contaminated Soil - SFN50336
Land Treatment Annual Report - SFN58750

Land Treatment - Septage And Sump Waste
Land Application Worksheet

Metal And Abandoned Vehicles
License Application - Scrap Iron Processor - SFN8382
Release Of Abandoned Motor Vehicle Scrap Metal
Request For Reimbursement - Abandoned Motor Vehicle Program

Transportation
Permit Application For Transporting Solid Waste
Solid Waste Transporter Decal Request Form - SFN51744
Waste Rejection Report

Wood
Application For Open Burning Variance Of Clean Wood At Landfills
Department Of Transportation Projects Inert Waste Beneficial Use Application
Inert Waste Beneficial Use Application

Radiation Forms

Form Name

SFN

Application for Radioactive Material License 8418
Application for TENORM Transporter Radioactive Material License 60265
Assembler Registration Link
Authorized Medical Physicist 313A AMP
Authorized Nuclear Pharmacist (NRC 313A ANP) 313A ANP
Authorized User Training & Experience & Preceptor Attestation - [Imaging and localization studies, Uptake dilution, and excretion studies, and Sealed sources of diagnosis uses.] (NRC 313A AUD) 313A AUD
Authorized User Training & Experience & Preceptor Attestation - [Use of unsealed byproduct material for which a directive is required. Oral administration of sodium iodide I-131 requiring a written directive in quantities less than or equal to 1.22 gigabecquerels (33 millicuries). Oral administration of sodium iodide I-131 requiring a written directive in quantities greater than 1.22 gigabecquerels (33 millicuries). Parenteral administration of any beta-emitter, or photon-emitting radionuclide with a photon energy less than 150 keV for which a written directive is required. Parenteral administration of any other radionuclide for which a written directive is required uses.] (NRC 313A AUT) 313A AUT
Authorized User Training & Experience & Preceptor Attestation - [Manual brachytherapy sources, Ophthalmic use of strontium-90, Remote afterloader unit(s), Teletherapy unit(s), and Gamma stereotactic radiosurgery unit(s) uses.] (NRC 313A AUS) 313A AUS
Certificate: Disposition of Radioactive Material 18941
Criminal History Record Check Request Pursuant to NDCC 12-60-24 60688
Current Occupational Radiation Exposure 8416
DOT Exemption Requests for Low Levels of External Radiation: DOT-SP 10656-Shippers & Carriers of Scrap Metal-Special Permit SP 10656
DOT Exemption Requests for Low Levels of External Radiation: DOT-SP 10656-Shippers & Carriers of Scrap Metal Shipment-Approval Form SP 10656
DOT Exemption Requests for Low Levels of External Radiation: DOT-SP 11406-Shippers & Carriers of Liquid & Solid Waste-Special Permit SP 11406
DOT Exemption Requests for Low Levels of External Radiation: DOT-SP 11406-Shippers & Carriers of Liquid & Solid Waste-Shipment Approval Form SP 11406
Facility Close-Out Form/Property Release and/or License Termination Checklist 58229
Authorized User Guidance for the NRC 313A Forms 313A
Health Physics Registration Link
Notice to Employees-Standards for Radiation Protection 8414
Occupational Radiation Exposure History 19443
Personal and Business Information Disclosure 61001
Radiation Machine Registration 8428
Radiation Machine Registration-[Out-of-State Reciprocity] 7590
Radiation Machine Registration-Change of Status Notification Link
Radiation Safety Documents for Radioactive Materials) Link
Radioactive Material Reciprocity Request 58230
Radiological Emergency Assistance Link
Radiation Safety Officer 313A RSO

Lead Forms

Form Name

SFN

Blood Lead Report 60104
Childhood Lead Poisoning Evaluation Questionnaire 59322
Lead-Based Paint Contractor License Application 52477
Lead-Based Paint Certification Application 53478
Notification of Lead-Based Paint Abatement & Demolition Clearance 53479
North Dakota's Lead-Based Paint Training Course Notification Form 58457

Asbestos Forms

Form Name

SFN

Form Type

Asbestos Certification Application (English) 16610 Asbestos
Asbestos Certification Application (Spanish) 16610 Asbestos
Asbestos Contractor License Application 16611 Asbestos
Asbestos Waste Manifest Form 58174 Asbestos
Asbestos Notification of Demolition and Renovation 17987 Asbestos
Asbestos Training Course Notification 60750 Asbestos