ANNUAL WASTE MANAGEMENT PLAN/APPLICATION FOR
APPROVAL TO DISPOSE OF UNSEALED RADIOACTIVE
SUBSTANCES FOR THE PERIOD
1 OCTOBER 20
–30 SEPTEMBER 20
(Insert year)
PLEASE POST COMPLETED APPLICATION/PLAN TO:
THE DIRECTOR
RADIATION PROTECTION DIVISION
ENVIRONMENT PROTECTION AUTHORITY
GPO BOX 2607
ADELAIDE SA 5001
Enquiries: Dr Tony Hooker Tel: (08) 8463 7825
Email: tony.hooker@epa.sa.gov.au
NAME & ADDRESS OF ORGANISATION:
NAME OF APPLICANT:
APPLICANT’S TITLE:
CONTACT NO:
EMAIL ADDRESS:
SIGNATURE:
DATE:
ESTIMATED QUANTITIES OF UNSEALED RADIOACTIVE SUBSTANCES PURCHASED & DISPOSED OF
–30 September 20
(1 October 20
)
(Insert year)
RADIONUCLIDES
ACTIVITY
PURCHASED
Chemical &
Physical Form
(MBq)
TOTAL:
ACTIVITY DISPOSED OF VIA PROPOSED PATHWAYS
Gaseous
Aqueous Liquid
Solid/Liquid
Via fumehood
Via sinks or sewers
Via Veolia incinerator at
Kilburn
(MBq)
(MBq)
(MBq)
Total:
Total:
Total:
Solid/Liquid
Allow for decay,
then via general
waste
(MBq)
Total:
Solid/Liquid
Interim storage pending
disposal
(please specify proposed pathway)
(MBq)
Total:
NOTE: The application must also include a Waste Management Plan containing details like record-keeping, working rules, segregation, packaging,
labelling, storage, monitoring and transport of the waste (refer to attached Guidelines for waste management application/plan)
(Cont’d)
ESTIMATED QUANTITIES OF UNSEALED RADIOACTIVE SUBSTANCES PURCHASED & DISPOSED OF
–30 September 20
(1 October 20
)
(Insert year)
RADIONUCLIDES
ACTIVITY
PURCHASED
Chemical &
Physical Form
(MBq)
TOTAL:
ACTIVITY DISPOSED OF VIA PROPOSED PATHWAYS
Gaseous
Aqueous Liquid
Solid/Liquid
Via fumehood
Via sinks or sewers
Via Veolia incinerator at
Kilburn
(MBq)
Total:
(MBq)
Total:
(MBq)
Total:
Solid/Liquid
Allow for decay,
then via general
waste
(MBq)
Total:
Solid/Liquid
Interim storage pending
disposal
(please specify proposed pathway)
(MBq)
Total:
NOTE: The application must also include a Waste Management Plan containing details like record-keeping, working rules, segregation, packaging,
labelling, storage, monitoring and transport of the waste (refer to attached Guidelines for waste management application/plan)