Form 244 Registration Certificate -- Use of Depleted Uranium Unde

NRC FORM 244

U. S. NUCLEAR REGULATORY COMMISSION

(MM-DD-YYYY)
10 CFR 40

REGISTRATION CERTIFICATE -USE OF DEPLETED
URANIUM UNDER GENERAL LICENSE

APPROVED BY OMB: NO. 3150-0031

EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this mandatory collection request: 1 hour. NRC requires this
information to identify the general licensees and to facilitate subsequent communication. Send comments
regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear
Regulatory Commission, Washington, DC 20555-0001, or by email to Infocollects.Resource@nrc.gov, and the
OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0031), Attn: Desk Officer
for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; email:
oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a person is not required to respond
to, a collection of information unless the document requesting or requiring the collection displays a currently valid
OMB control number.

Section 40.25 of 10 CFR Part 40 establishes a general license authorizing the use of depleted uranium contained in industrial products or
devices for mass-volume applications. Submit NRC form 244 within 30 days after the first receipt or acquisition of such depleted uranium.

1. Instructions:
A. Print or type the name and address of the registrant (including ZIP Code) for whom this form is filed in Box 3 below.
B. Submit this form in duplicate to:
Director, Office of Nuclear Materials Safety and Safeguards
U. S. Nuclear Regulatory Commission
Washington, DC 20555-0001

with a copy to the appropriate Regional Administrator at the
address listed on the reverse.
(NRC will assign a file number, and a copy of this form will
be returned to you.)

2. I hereby file NRC Form 244 pursuant to 10 CFR 40.25, for use of depleted uranium contained in industrial products or
devices for mass-volume applications.
3. Name and Address of Registrant for whom this form is
filed (include Zip code)

4. File Number (Leave blank - to be assigned by NRC)

5. Individual Duly Authorized to Act for and on Behalf of the Registrant in Supervising the Procedures.
A. Name

B. Title

C. Address

D. Office Phone Number

E. Office Facsimile Phone Number

F. E-mail Address

6. Certification

I hereby certify that:
A. All information in this registration certificate is true and complete.
B. This registrant has developed and will maintain procedures designed to establish physical control over the depleted
uranium described in 10 CFR 40.25(a) and designed to prevent transfer of such depleted uranium in any form,
including metal scrap, to persons not authorized to receive the depleted uranium.
C. I understand that Commission regulations require that any changes in information furnished by a registrant on this
registration certificate be reported in writing to the Director, Office of Federal and State Materials and Environmental
Management Programs, with a copy to the appropriate Regional Administrator at the address listed on the reverse,
within 30 days after the effective date of such change.
D. I understand that the registrant is required to comply with the provisions of Section 40.25 of the NRC's regulation 10
CFR Part 40 (reprinted on the reverse side of this form) with respect to all depleted uranium which the registrant
receives, acquires, uses, or transfers under the general license for which this registration certificate is filed with the
U. S. Nuclear Regulatory Commission.
E. Printed or Typed Name and Title of Person Filing Form

F. Signature

G. Date

WARNING: FALSE STATEMENTS IN THIS CERTIFICATE MAY BE SUBJECT TO CIVIL AND/OR CRIMINAL PENALTIES. NRC REGULATIONS
REQUIRE THAT SUBMISSIONS TO THE NRC BE COMPLETE AND ACCURATE IN ALL MATERIAL RESPECTS. 18 U.S.C. SECTION 1001
MAKES IT A CRIMINAL OFFENSE TO MAKE A WILFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY
OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.
NRC FORM 244 (MM-DD-YYYY)

NRC FORM 244
(MM-DD-YYYY)
10 CFR 40

U. S. NUCLEAR REGULATORY COMMISSION

REGISTRATION CERTIFICATE -- USE OF DEPLETED
URANIUM UNDER GENERAL LICENSE (Continued)
REGIONAL ADDRESSES

REGION IF YOU ARE LOCATED IN
I
and
II

ALABAMA, CONNECTICUT,
DELAWARE, DISTRICT OF
COLUMBIA, FLORIDA, GEORGIA,
KENTUCKY, MAINE, MARYLAND,
MASSACHUSETTS,
NEW HAMPSHIRE, NEW JERSEY,
NEW YORK, NORTH CAROLINA,
PENNSYLVANIA, PUERTO RICO,
RHODE ISLAND, SOUTH CAROLINA,
TENNESSEE, VERMONT, VIRGINIA,
VIRGIN ISLANDS, AND WEST
VIRGINIA

III

ILLINOIS, INDIANA, IOWA,
MICHIGAN, MINNESOTA, MISSOURI,
OHIO, AND WISCONSIN

ADDRESS

REGION IF YOU ARE LOCATED IN

REGIONAL ADMINISTRATOR
REGION I
U.S. NUCLEAR REGULATORY COMMISSION
475 ALLENDALE ROAD, SUITE 102
KING OF PRUSSIA, PA 19406-1415

IV

ALASKA, ARIZONA, ARKANSAS,
CALIFORNIA, COLORADO,
HAWAII, IDAHO, KANSAS,
LOUISIANA, MISSISSIPPI,
NEBRASKA, NEVADA,
NEW MEXICO, NORTH DAKOTA,
OKLAHOMA, OREGON,
PACIFIC TRUST TERRITORIES,
SOUTH DAKOTA, TEXAS,
UTAH, WASHINGTON, AND
WYOMING

ADDRESS
REGIONAL ADMINISTRATOR
REGION IV
U.S. NUCLEAR REGULATORY COMMISSION
1600 E. LAMAR BOULEVARD
ARLINGTON, TX 76011-4125

REGIONAL ADMINISTRATOR
REGION III
U.S. NUCLEAR REGULATORY COMMISSION
2443 WARRENVILLE ROAD, SUITE 210
LISLE, IL 60532-4352

10 CFR 40.25

§40.25 General license for use of certain industrial products or
devices.

Director, Office of Nuclear Material Safety and Safeguards, with a
copy to the Regional Administrator of the appropriate U.S. Nuclear
Regulatory Commission Regional Office listed in Appendix D of Part
(a) A general license is hereby issued to receive, acquire,
20 of this chapter, any changes in information furnished by him in the
possess, use, or transfer, in accordance with the provisions of
paragraphs (b), (c), (d), and (e) of this section, depleted uranium NRC Form 244, "Registration Certificate--Use of Depleted Uranium
Under General License." The report shall be submitted within 30
contained in industrial products or devices for the purpose of
providing a concentrated mass in a small volume of the product days after the effective date of such change.
or device.
(d) A person who receives, acquires, possesses, or uses depleted
(b) The general license in paragraph (a) of this section applies
uranium pursuant to the general license established by paragraph
only to industrial products or devices which have been
(a) of this section:
manufactured or initially transferred in accordance with a specific
license issued pursuant to §40.34(a) of this part or in accordance
(1) Shall not introduce such depleted uranium, in any form, into a
with a specific license issued by an Agreement State which
authorizes manufacture of the products or devices for distribution chemical, physical, or metallurgical treatment or process, except a
treatment or process for repair or restoration of any plating or other
to persons generally licensed by the Agreement State.
covering of the depleted uranium.
(c)(1) Persons who receive, acquire, possess, or use depleted
(2) Shall not abandon such depleted uranium.
uranium pursuant to the general license established by
paragraph (a) of this section shall file NRC Form 244,
(3) Shall transfer or dispose of such depleted uranium only by
"Registration Certificate--Use of Depleted Uranium Under
General License," with the Director, Office of Nuclear Materials, transfer in accordance with the provisions of 40.51 of this part. In the
case where the transferee receives the depleted uranium pursuant to
by an appropriate method listed in §40.5, with a copy to the
the general license established by paragraph (a) of this section, the
appropriate NRC Regional Administrator. The form shall be
transferor shall furnish the transferee a copy of this section and a
submitted within 30 days after the first receipt or acquisition of
copy of NRC form 244. In the case where the transferee receives the
such depleted uranium. The registrant shall furnish on NRC
depleted uranium pursuant to a general license contained in an
Form 244 the following information and such other information
Agreement State's regulation equivalent to this section, the transferor
as may required by that form:
shall furnish the transferee a copy of this section and a copy of NRC
(i) Name and address of the registrant;
Form 244 accompanied by a note explaining that use of the product
or device is regulated by the Agreement State under requirements
(ii) A statement that the registrant has developed and will
substantially the same as those in this section.
maintain procedures designed to establish physical control over
the depleted uranium described in paragraph (a) of this section
(4) Within 30 days of any transfer, shall report in writing to the
and designed to prevent transfer of such depleted uranium in
Director, Office of Nuclear Material Safety and Safeguards, with a
any form, including metal scrap, to persons not authorized to
copy to the Regional Administrator of the appropriate U.S. Nuclear
receive the depleted uranium; and
Regulatory Commission Regional Office listed in Appendix D of Part
(iii) Name and/or title, address, and telephone number of the
20 of this chapter, the name and address of the person receiving the
individual duly authorized to act for and on behalf of the
source material pursuant to such transfer.
registrant in supervising the procedures identified in paragraph
(c)(1)(ii) of this section.
(e) Any person receiving, acquiring, possessing, using, or
transferring depleted uranium pursuant to the general license
(2) The registrant possessing or using depleted uranium under established by paragraph (a) of this section is exempt from the
the general license established by paragraph (a) of this section requirements of Parts 19, 20, and 21 of this chapter with respect to
shall report, in writing to the
the depleted uranium covered by that general license.