• Nuclear Facility Destruction Certification Form

    Use this form to certify the destruction or decommissioning of a nuclear facility and provide supporting details about the facility, completed work, disposal or transfer of materials, and verification.

  • Facility Identification

  • Destruction / Decommissioning Details

  • Certification Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Completion Date of Destruction/Decommissioning*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Current Status of the Facility
  • Method of Destruction/Decommissioning*

  • Disposal, Transfer, and Verification

  • Verification Statement: The information provided is accurate and complete*

  • Certification Attestation

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