Nrc Form 748 PDF Details

Are you looking for information about NRC Form 748? Whether you’re a business owner, management team member, or employee wanting to understand how the nuclear regulatory commission works – this blog post is for you. In it we will explain what exactly NRC Form 748 is and why it matters. We'll also discuss who should submit the form and when, as well as how to complete the form step-by-step so that your company can meet all requirements in an effortless manner. Keep reading on to learn today about understanding and effectively using NRC Form748!

QuestionAnswer
Form NameNrc Form 748
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesnational transaction report, nrc transaction report, nrc reporting form, nrc form 748b

Form Preview Example

NRC FORM 748

U.S. NUCLEAR REGULATORY COMMISSION

APPROVED BY OMB: NO. 3150-0202

EXPIRES: 01/31/2016

(5-2012)

 

 

 

10 CFR 20.2207

 

Estimated burden per response to comply with this mandatory information collection request: 9.5 minutes. NRC requires this information to

 

 

populate the National Source Tracking System for certain sealed sources. Send comments regarding burden estimate to the Records and

NATIONAL SOURCE TRACKING TRANSACTION REPORT

FOIA/Privacy Services Branch (T-5 F53), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to

infocollects.resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0202), Office of

 

 

Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid

 

 

OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

 

 

 

 

1. LICENSEE INFORMATION

A. LICENSEE NAME

B. LICENSE NO.

C. LICENSEE STREET ADDRESS

D. CITY

E. STATE

F. ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. TRANSACTION DATE

3A. TRANSACTION INFORMATION

3B. TRANSACTION TYPE (Check all that apply)

 

 

 

 

 

 

 

(Only transactions completed on the same

 

 

 

 

 

 

date may be reported together on this form)

NEW

CORRECTION

REPORT SOURCE

TRANSFER

RECEIPT

DISPOSAL

 

IF CORRECTION, PREVIOUS TRANSACTION DATE:

INVENTORY

 

 

 

 

 

 

 

 

 

 

 

NEW SOURCE

IMPORT

EXPORT

DISASSEMBLE

 

 

 

MANUFACTURED

 

 

 

 

 

 

 

 

 

 

4. PREPARER INFORMATION

A. NAME OF PREPARER

B. DATE PREPARED

C. PREPARER PHONE

D. PREPARER E-MAIL (REQUIRED FOR CONFIRMATION)

9. NEW MANUFACTURED SOURCE DATA

A1. SOURCE MAKE

B1. SOURCE MODEL

C1. SOURCE SERIAL D1. ISOTOPE NUMBER

E1. ACTIVITY AND UNIT

F1. COMMENTS

G1. SOURCE LOCATION ADDRESS

H1. CITY

I1. STATE

J1. ZIP CODE

K1. SAME AS STREET ADDRESS

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 WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.

NRC FORM 748 (5-2012)

NRC FORM 748

U.S. NUCLEAR REGULATORY COMMISSION

LICENSEE NAME

(5-2012)

NATIONAL SOURCE TRACKING

 

10 CFR 20.2207

 

 

TRANSACTION REPORT (continued)

 

 

 

 

 

9. NEW MANUFACTURED SOURCE DATA

LICENSE NO.

A2. SOURCE MAKE

G2. SOURCE LOCATION ADDRESS

A3. SOURCE MAKE

G3. SOURCE LOCATION ADDRESS

A4. SOURCE MAKE

G4. SOURCE LOCATION ADDRESS

A5. SOURCE MAKE

G5. SOURCE LOCATION ADDRESS

B2. SOURCE MODEL

H2. CITY

B3. SOURCE MODEL

H3. CITY

B4. SOURCE MODEL

H4. CITY

B5. SOURCE MODEL

H5. CITY

C2. SOURCE SERIAL D2. ISOTOPE

 

 

E2. ACTIVITY AND UNIT

F2. COMMENTS

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I2. STATE

J2. ZIP CODE

 

K2. SAME AS

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C3. SOURCE SERIAL D3. ISOTOPE

 

 

E3. ACTIVITY AND UNIT

F3. COMMENTS

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I3. STATE

J3. ZIP CODE

 

K3. SAME AS

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C4. SOURCE SERIAL D4. ISOTOPE

 

 

E4. ACTIVITY AND UNIT

F4. COMMENTS

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I4. STATE

J4. ZIP CODE

 

K4. SAME AS

 

 

 

 

 

 

 

STREET ADDRESS

F5. COMMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

C5. SOURCE SERIAL D5. ISOTOPE

 

 

E5. ACTIVITY AND UNIT

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

K5. SAME AS

 

I5. STATE

J5. ZIP CODE

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 WILLFULLY FALSE STATEMENT OR REPRESENTATION TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.

NRC FORM 748 (5-2012)

INSTRUCTIONS TO NRC AND AGREEMENT STATE LICENSEES FOR REPORTING HIGH-RISK SEALED SOURCE TRANSACTIONS

The completed form is considered to be Official Use Only – Security Related Information; it is not considered to be Safeguards Information.

Use an addendum sheet for reporting additional sources.

Note to Licensees: This form may be used to report source transactions in lieu of using the NSTS online application. Sections 1-4 on Page 1 of the form are required for all source transaction types. Sections 5-12 should only be populated for the associated Transaction Type (3B) selected. For example, when reporting a Source Transfer and a Source Export, Sections 6 and 11 should be populated. Multiple Transaction Types may be selected if they occur on the same Transaction Date, and should be reported on NRC Form 748. Licensees reporting only one transaction type may use the condensed form for the Transaction Type. For example, when reporting a Source Receipt, NRC Form 748c should be used.

1.Licensee Information – Enter the name, license number, and street address of the licensed facility.

2.Transaction Date – Enter the date the transaction occurred, which would be the date of the transfer, receipt, manufacture, etc.

3.Transaction Information and Transaction Type – Indicate if this is a new transaction or a correction. For corrections, select the date of the previously submitted transaction that the correction should be associated with. Select the Transaction Type. Report Source should only be used for initial inventory submissions, or to report a source excluded from the initial inventory submission. Dispose Source should only be used by a Disposal Licensee. If you are sending your source back to the manufacturer, or sending it to a disposal facility, the transaction should be recorded as a Transfer. Multiple Transaction Types may be selected if they occur on the same Transaction Date.

4.Preparer Information – An email address is required for a confirmation. For regulatory purposes, your source transaction report is not considered complete without a confirmation from the NSTS Help Desk that the transaction report has been received.

5.Source Inventory Data – This section should only be used for initial inventory submissions. The Make, Model, and Serial Number refer to the Source, not the Device. All fields are required in Section 5 EXCEPT G. Comments. If the licensee is reporting multiple sources on the Source Inventory transaction at the same Source Location Address, the location address information may be populated once, and referenced in the Comments block for the additional sources.

6.Source Transfer Data – For Transfer transaction reports, all fields in Section 6 are required EXCEPT M. Waste Manifest Number, N. Container ID, and P. Comments. If the licensee is reporting multiple sources on the Transfer transaction to the same Receiving Licensee, the receiving licensee information may be populated once, and referenced in the Comments block for the additional sources.

7.Source Receipt Data – For Receipt transaction reports, all fields in Section 7 are required EXCEPT M. Waste Manifest Number, N. Container ID, and T. Comments. If the licensee is reporting multiple sources on the Receipt transaction at the same Source Location Address, the location address information may be populated once, and referenced in the Comments block for the additional sources.

8.Source Disposal Data – For Disposal transaction reports, all fields in Section 8 are required EXCEPT J. Comments. If the licensee is reporting multiple sources on the Disposal transaction at the same Source Disposal Address, the source disposal address information may be populated once, and referenced in the Comments block for the additional sources.

9.New Manufactured Source Data – For New Manufactured Source transaction reports, all fields in Section 9 are required EXCEPT F. Comments. If the licensee is reporting multiple sources on the Manufacturer transaction at the same Source Location Address, the location address information may be populated once, and referenced in the Comments block for the additional sources.

10.Source Import Data – For Import Source transaction reports, all fields are required EXCEPT L. Comments. If the licensee is reporting multiple sources on the Import transaction at the same Source Location Address, the location address information may be populated once, and referenced in the Comments block for the additional sources.

11.Source Export Data – For Export Source transaction reports, all fields are required EXCEPT M. Comments. If the licensee is reporting multiple sources on the Export transaction to the same Foreign Company/Foreign Address, the information in cells A-E may be populated once, and referenced in the Comments block for the additional sources.

12.Source Disassemble Data – For Disassemble Source transaction reports, all fields are required EXCEPT H. Comments. If the licensee is reporting multiple sources on the Disassemble transaction at the same Source Location Address, the location address information may be populated once, and referenced in the Comments block for the additional sources.

DISTRIBUTION

For most timely processing, click the "Submit by Email" button on page 1. You may also:

>manually submit this form by email to: NSTSFax.Resource@nrc.gov,

>FAX to: 1-888-821-2534, or

>mail to: NSTS Help Desk

30 West Gude Drive, Suite 300

Rockville, MD 20850