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General License Device Registration Form

General License Device Registration Form 2026

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55 votes

The document is a General License Registration Form from the California Department of Public Health's Radiologic Health Branch. It outlines the requirements for registering devices that contain specific radioactive materials, including details on fees, registrant information, and procedures for maintaining control over depleted uranium. The form also includes sections for new device information and changes to registered devices.

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Click ‘Get Form’ to open the General License Device Registration Form in the editor.
Begin by filling in the registrant's details, including Company Name, Registrant’s Name, Title, Address, City, State, Zip Code, and Telephone Number. Ensure all information is accurate for processing.
Next, provide the Appointed Person's information. Fill in their Name, Title, and Telephone Number to ensure proper communication regarding the registration.
Indicate your GLD Registration and Current Radioactive Material License number if applicable. This is crucial for compliance with regulations.
In the 'New General License Device Information' section, list each device's Manufacturer Name, Address of Stored Device, Date of Acquisition, Model Number, Serial Number, Isotope Activity, and Distributor’s License Number as required.
If there are any changes to registered devices or information updates needed later on, utilize the 'Changes to Registered General Licensed Device Information' section to document these changes clearly.
Finally, review all entries for accuracy before signing and dating the form at the bottom. Once completed, you can save or print your form directly from our platform.

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Versions	Form popularity	Fillable & printable
2021	4.1 Satisfied (55 Votes)
2017	4.7 Satisfied (60 Votes)
2013	4 Satisfied (57 Votes)

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What are the requirements for NRC?

To obtain an NRC operating license, candidates must successfully complete a comprehensive training program at a nuclear site and pass a comprehensive examination administered by the Nuclear Regulatory Commission. The site training programs are usually 18 to 24 months in duration.

Who needs an NRC license?

Through the licensing process, the U.S. Nuclear Regulatory Commission (NRC) authorizes an applicant to conduct any or all of the following activities: Construct, operate, and decommission commercial reactors and fuel cycle facilities.

Why is the NRC necessary?

The NRC licenses and regulates the Nations civilian use of radioactive materials, to provide reasonable assurance of adequate protection of public health and safety, to promote the common defense and security, and to protect the environment.

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