South Carolina Department of Health and Environmental Control
Application For Radioactive Waste Transport Permit
Instructions for Completing Permit Application
Applicability: Pursuant to Section 13-7-140, 1976 SG Code of Laws (as amended) and Department
Regulation 61-83, a Radioactive Waste Transport Permit is required to be obtained by all generators,
collectors or processors who transport or have radioactive waste transported into or within the State of
South Carolina. Persons whose activities result in the generation of radioactive waste have the primary
responsibility to obtain a permit.
Instructions:
1. Complete blocks 1-11 of this application. All blocks must be fully completed. Print 3 copies
of the application and be sure to date & sign block# 12.
2. Submit the original signed copy of the application and financial insurance Documents to:
ATTN: Crispulo Isiminger (isimincl@dhec.sc.gov) or Kim Clyburn, SCDHEC, Bureau of
Land & Waste Management/Radioactive Waste Management Section, 2600 Bull St.,
Columbia, SC 29201; (803) 898-0422, (803) 898-0239; Fax: (803) 898-0391.
3. Submit (1) copy of the application and permit fee made payable to SCDHEC send payment
and copy of application to: Bureau of Land & Waste Management/Radioactive Waste
Management Section, 2600 Bull St., Columbia, SC 29201. To avoid delays in processing
do not send payment without a copy of the application. Please note on the remittance
“FOR RADIOACTIVE WASTE TRANSPORT PERMIT.”
4. Keep (1) copy of the application for your records.
5. All items must be completed, required certificate of insurance or bond attached, signed and
dated by an authorized representative who is an employee of the applicant unless otherwise
authorized by the Department. If an item is not applicable, indicate “N/A.” Incomplete forms
  and failure to provide the permit fee and financial evidence will result in delays or denial
of the permit. Additional sheets may be used if necessary.
NOTE: Radioactive Waste Transport Permits will be required for each location of a company, 
corporation, etc. unless otherwise authorized by the Department by special request. Waste 
Collectors/Processors require a Class X Permit and either an NRC or Agreement State Radioactive 
Material License.
Copies:
Copy # 1 - Original & Insurance Document - DHEC/Radioactive Waste Mgmt. Section
Copy # 2 – DHEC to be forwarded to Finance with Permit Fee
Copy # 3 - Generator Copy for your Records
INSTRUCTIONS
DHEC 0800 (03/2015)
South Carolina Department of Health and Environmental Control
Application For Radioactive Waste Transport Permit
Instructions for Completing Permit Application
Applicability: Pursuant to Section 13-7-140, 1976 SG Code of Laws (as amended) and Department
Regulation 61-83, a Radioactive Waste Transport Permit is required to be obtained by all generators,
collectors or processors who transport or have radioactive waste transported into or within the State of
South Carolina. Persons whose activities result in the generation of radioactive waste have the primary
responsibility to obtain a permit.
Instructions:
1. Complete blocks 1-11 of this application. All blocks must be fully completed. Print 3 copies
of the application and be sure to date & sign block# 12.
2. Submit the original signed copy of the application and financial insurance Documents to:
ATTN: Crispulo Isiminger (isimincl@dhec.sc.gov) or Kim Clyburn, SCDHEC, Bureau of
Land & Waste Management/Radioactive Waste Management Section, 2600 Bull St.,
Columbia, SC 29201; (803) 898-0422, (803) 898-0239; Fax: (803) 898-0391.
3. Submit (1) copy of the application and permit fee made payable to SCDHEC send payment
and copy of application to: Bureau of Land & Waste Management/Radioactive Waste
Management Section, 2600 Bull St., Columbia, SC 29201. To avoid delays in processing
do not send payment without a copy of the application. Please note on the remittance
“FOR RADIOACTIVE WASTE TRANSPORT PERMIT.”
4. Keep (1) copy of the application for your records.
5. All items must be completed, required certificate of insurance or bond attached, signed and
dated by an authorized representative who is an employee of the applicant unless otherwise
authorized by the Department. If an item is not applicable, indicate “N/A.” Incomplete forms
  and failure to provide the permit fee and financial evidence will result in delays or denial
of the permit. Additional sheets may be used if necessary.
NOTE: Radioactive Waste Transport Permits will be required for each location of a company, 
corporation, etc. unless otherwise authorized by the Department by special request. Waste 
Collectors/Processors require a Class X Permit and either an NRC or Agreement State Radioactive 
Material License.
Copies:
Copy # 1 - Original & Insurance Document - DHEC/Radioactive Waste Mgmt. Section
Copy # 2 – DHEC to be forwarded to Finance with Permit Fee
Copy # 3 - Generator Copy for your Records
INSTRUCTIONS
DHEC 0800 (03/2015)
Application for Radioactive Waste Transport Permit
Division of Radioactive Waste Management
1.
Name and Address of Applicant:
2.
Person Responsible for Radioactive
Waste Shipments:
a) Name:
b) Title:
c) Address:
d) Telephone:
e) E-mail address:
Additional location:
3.
Total Estimated Annual Cubic Footage
to be transported for disposal, storage,
or processing.
4.
Type of Permit and Amount of Fee Remittal: (check appropriately)
[
] New (First Time Permit)
[
] Renewal (Indicate Previous Permit No.):
[
] For Calendar Year ________________
A.
Class Types (check one only)
[
] CLASS X - $2,500.00: More than an annual total of 75 cubic ft., or more than 100
curies of radioactive waste for disposal, storage, or waste
processing within the State.
[
] CLASS Y - $300.00:
An annual total of no more than 75 cubic ft. of radioactive
waste for disposal, storage, or waste processing within the
State.
[
] CLASS Z - $100.00:
Any shipment of radioactive waste which is not consigned for
disposal, storage, or waste processing within the State, but is
transported into or within the State.
B.
Transport Purpose: (check more than one if necessary)
Disposal
Storage
Processing
Radiopharmaceutical Waste Return
Other (Identify): _________________________________________________________
Amount Remitted: ($
)
5.
Name & address permit should be mailed
6.
Complete Waste Description:
to if different than Item 2:
7.
List 95% of Total Prominent
8.
Total Estimated Annual Radioactiity
Radionuclides:
(Curies):
9.
Name and Address of Authorized Waste
10. Name and Address of Transport Carrier
Collector(s) if used:
if other than Collector:
DHEC 0800 (03/2015)
(COMPLETE REVERSE SIDE)
Transport Permit Application Continued
Information to be Submitted as Attachment
11.  A Certificate of Liability Insurance issued to the generator shall be submitted as evidence of  
financial ability to protect the State of South Carolina and the public at large from possible  
radiological injury or damage due to packaging, transportation, disposal, storage or delivery
of radioactive waste. For those applicants not maintaining liability insurance, they must
deposit and maintain with the Department a cash or corporate surety bond in the amount
of Five Hundred Thousand Dollars ($500,000.00). Failure to submit a current certificate or  
bond will result in processing delays.
Type Financial Evidence Provided
[  ]  Certificate of Liability Insurance
[ ] Insurance Provided by Waste Collector Agreement (Attach Letter of Agreement)
[ ] Bond (Corporate Surety, Cash)
[ ] Letter of Credit
[  ]  Federal Indemnification Certificate
[ ] Other (Specify)
Certification
12. In compliance with Act 429 of 1980, the South Carolina Radioactive Waste Transportation
and Disposal Act, and Department Regulation 61-83, I hereby certify on behalf of the
named applicant to the South Carolina Department of Health and Environmental Control that:
(A) the named applicant will comply fully with all applicable laws and administrative rules and
regulations, both State and Federal, and any disposal facility radioactive material license
requirements and criteria regarding the packaging, transportation, storage, disposal and
delivery of such wastes; (B) the named applicant will hold the State of South Carolina
harmless for all claims, actions, proceedings in law or equity arising out of radiological
injury or damages to persons or property occurring during the transportation of its radioactive
waste into or within the State including all costs defending same; provided, however, that
nothing contained herein shall be construed as a waiver of the State’s sovereign immunity; (C) the
named applicant has current copies of the DHEC Reg. 61-83 for the Transportation of
Radioactive Waste into or within the State of South Carolina, DOT Regulations 49 CFR Parts
171-179 and, when applicable, the disposal site radioactive material license and the disposal
site waste acceptance criteria; (D) the named applicant has prepared this application to conform
with South Carolina Department of Health and Environmental Control’s Regulations for
Transportation of Radioactive Waste into or within South Carolina, and that all information
contained herein, including any required supplements attached hereto, is true and correct to
the best of my knowledge and belief.
Date:
Signature:
Typed Name and Title
DHEC 0800 (03/2015)
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