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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 Facility Annual Report
  • Nutrient Management Plan Land Application Work Sheet

Annual Report Forms

  • Industrial and Special Waste Facility Annual Report
  • Inert Waste Facility Annual Report
  • Land Treatment Annual Report
  • Municipal Sold Waste Facility Annual Report
  • Regulated Infectious Waste Facility Annual Report
  • Transfer Station Facility Annual Report

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
  • Disclosure Statement Form
  • 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 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 - 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 53477
Lead-Based Paint Certification Application 53478
Lead-Based Paint Notification of Abatement 53479
Lead-Based Paint Training Course Notification 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

Accessibility Icon We are committed to ensuring our website complies with the Americans with Disabilities Act (ADA) and applicable web accessibility standards. We are actively working to improve the accessibility and usability of our online content. If you experience difficulty accessing any part of this website or require an accommodation, please contact us at DEQ@nd.gov.