Does your state regulate if a nuclear medicine technologist can administer adjunctive medications? The information and logos may be subject to copyright or trademark by the respective certification/credentialing organization. If you would like to know more about how to pay your fees electronically please, click here. Reciprocity is granted on a calendar year basis to expire on or before December 31st or concurrent with the out-of-state registration or license. X-RAY RECIPROCAL RECOGNITION - New Mexico Environment Department Applications for licensure to operate x-ray, therapy, or perform nuclear medicine administrations to humans may be submitted and fees paid online. Primary source equivalent: The Nursys licensure and disciplinary database is the repository of the data provided directly from New Mexico State Board of Nursing and is primary source equivalent. Oakbrook Terrace, IL:2018:HR-3. Create an account at app.nm.gov to stay up-to-date on the state's programs and services like Unemployment Insurance; Concealed Carry Applications; the Women, Infants, and Children Program; and more. This section of our website is devoted exclusively to current members of the NMTCB Board of Directors. Legislation, Regulations and Advocacy Legislation, Regulations and Advocacy Individual State Licensure Information In This Section Listed below are links to each state's information regarding radiologic technologist licensure, certification or recognition. Public License Look-up Tool Rebecca.Elicio2 2022-10-03T09:50:25-06:00 The Professional Licensure Bureau online license look-up tool is updated once every 24 hours. Primary source verification is often required during the sonographer hiring process or when a sonographer certification, credential, registration, orstate licenseis renewed (e.g., asrequired by The Joint Commission's Standard HR.01.01.01 EP2 & EP31). List of Active NM Medical Imaging & Radiation Therapy Professionals: Medical Imaging and Radiation Therapy Advisory Council (MIRTAC). This investment will simplify the licensing process, making it easier for applicants and licensees to apply for and renew licenses in New Mexico. New Mexico Sonographer License Required by 07/01/2019 The certification status information provided in this verification cannot be modified by outside sources. If a nuclear medicine technologist is not certified in diagnostic radiography but is certified in CT can they perform diagnostic CT on a hybrid scanner? To request reciprocity in New Mexico, a letter with a copy of the current out-of-state registration/license and a completed request form should be sent at least 2 days in advance of work in the State to: the NM Environment Department Radiation Control Bureau, 1100 St. Francis Drive Suite 2022, P.O. Does your state recognize the CT certification from the ARRT, NMTCB, or both? Under the NMED logo on the top left side of the web page, you will see a line that has the following choices in blue letters, please select PAY NOW instead of LOGIN. Check a health profession license | Mass.gov Nuclear medicine technology is a sophisticated area of health care that helps physicians diagnose and evaluate serious conditionsincluding cancer and heart disease. The Society of Diagnostic Medical Sonography (SDMS) is a professional membership organization founded in 1970 topromote, advance, and educate its members and the medical community in the science of diagnostic medical sonography. Enter the licensee number for the license you would like verified. Email a complete application packet to stephen.sanchez@state.nm.us which includes all the required supporting documents that are requested in each type application form. Nuclear Medicine Technology Certification Board | NMTCB For information regarding this page, contact Stephen Sanchez at stephen.sanchez@state.nm.us. You'll need to contact your statedirectly with questions about licensing requirements. The SDMS is the largest association of sonographers and sonography students in the world. Individuals on this list are considered to be Active and In Good Standing and not involved in pending litigation or ongoing investigations as of the date listed. Iowa Radiology License : Bureau of Radiological Health. Employee Resources: Environmental Emergencies: 505-827-9329 (24 hours), Medical Imaging and Radiation Therapy Program, Radiological and Chemical Advocacy Office, Public Notices of Radioactive Material Licensing Actions. X-Ray Associates of New Mexico | XRANM | Leader in Radiology Indianapolis, Indiana 46204-3003. The New Mexico Regulation and Licensing Department strives to ensure that New Mexicans receive quality care and services from qualified individuals and businesses in different industries, professions and trades. Santa Fe, NM 87502-5469, Physical Address Essential resources for "primary source" verification of sonographer certification, credential, registration, or state licensure. Commonwealth of Massachusetts / Radiation Control Program How to renew By mail + If at any time you have changes to the information submitted on the form, please update and send the appropriate documentation to RadiationControl@massmail.state.ma.us. This resource simply links users to each available primary source for verification of sonographer certifications, credentials, registrations, and licenses. Santa Fe, New Mexico 87505, Harold L. Runnels Building // 1190 St. Francis Drive, Suite N4050 // Santa Fe, New Mexico 87505 // tel (800) 219-6157, (505) 827-2855, Welcome to the Medical Imaging & Radiation Therapy Program, To view a list of Active NM Medical Imaging and Radiation Therapy Professionals Licensees. Santa Fe, NM 87505, Environmental Emergencies: 505-827-9329 (24 hours), Asbestos Government Ordered Demolition form, Permitting Administrative Multi-Form (PAM), GCP-Oil and Gas Registration Form Part 1 of 2, GCP-Oil and Gas Registration Form Part 2 of 2, GCP-2 Multi-Form for Quarrying, Crushing, and Screening Facilities, GCP-3 Multi-Form for Hot Mix Asphalt Plants, GCP-3 Hot Mix Asphalt Plants Carbon Monoxide Emission Calculation Tool, GCP-5 Multi-Form for Concrete Batch Plants, CommForm Communication Updates for Air Quality Permits or Notices of Intent, GCP-6 Storage Vessels Section 9: Emission Reduction Calculation Table, GCP-Temporary Control Minor Registration Form, GCP-Temporary Control Major Registration Form, Acid Rain Program Instructions for Phase II Permit Application, Landfill Control Equipment Removal Report, Relocation Form For Portable Streamline Compressor Engines, Engine Replacement Form Plume Dispersion Energy Comparison, Small Business Compliance Assessment Program Disclosure form, Smoke Management Ventilation Category Tracking form, Smoke Management Statewide Waiver Reporting form, Dry Cleaning Notice of Compliance Status Form, Initial Notification and Notification of Compliance Status Form for Gasoline Dispensing Facilities, Universal Test Notification and Report form, Universal Test Notification and Report Instructions, Universal Test Notification and Report example, Air Dispersion Modeling Waiver Request form, Hemp Extraction Facility Permit Application, Hemp Manufacturing or Processing Facility Permit Application, Edible and Topical Cannabis Manufacturer Certification Form, Cannabis Edible Manufacturing Permit Application, Environmental Information Document (EID) Outline, Request for Proposals (RFP) for Design Professional Services Template, Preliminary Engineering Report (PER) Requirements Guide_USDA bulletin 1780-2, Preliminary Engineering (PER) Report Review Checklist used by CPB, Engineering Contract Template For All Funding Programs, Engineering Contract Template Attachment I Insurance, Engineering Contract Template Attachment II Planning Phase, Engineering Contract Template Attachment III Design Phase, Engineering Contract Template Attachment IV Construction Phase, Engineering Contract Template Attachment V Operation Phase, Engineering Contract Template Attachment VI Amendment to Engineering Contract, Distribution System Sampling Plan template, Surface Water Treatment System Monthly Operating Report, Construction or Modification of Public Water Supply System Application, Virus Inactivation by Chlorine Certification (hypochlorination), Virus Inactivation Certification Checklist, Drinking Water Laboratory Certification Program (DWLCP) Guidance Manual, Application for Laboratory Certification Appendix A, Checklist for Laboratory Certification Application Appendix B, Laboratory Certification Best Practices Appendix C, Public Water System Emergency Response Plan template, Public Water Systems Operation & Maintenance Plan template, Liquid Waste Permit Search Request Auto Fill PDF Form, Liquid Waste Permit Application Auto Fill PDF, Liquid Waste Permit or Registration Application printable version, Affidavit to keep lots/parcels adjoined in perpetuity, Sample letter for public notice of variance, Septage Pumper Qualification Certificate application, Installer Specialist Qualification Certificate application, ATS Maintenance Service Provider (MSP) Qualification Certificate application, Third Party Evaluator Qualification Certificate application, Requirements for Qualification of On-Site Professionals, Application for Homeowner Qualification Certificate, Application for Permit to Operate Food Establishment, Mobile Food Establishment (Food Truck), Food Processing Plant, or Mobile Support Unit, Registration form for baked goods prepared on tribal lands and sold in state, Ground Water Quality Bureau Discharge Permit Application (Non-dairy), Wastewater Land Application Data Sheet- 200 lbs/ac, Wastewater Land Application Data Sheet 125%, Surface Disposal Data Sheet Chile Processing Facilities, Wastewater Sampling Log- Chile & Food Processing Facilities, Dairy Discharge Permit Renewal and/or Modification Application, Dairy Discharge Permit Renewal for Closure Application, Business Concern (Public Owner, Private Operator) Disclosure Statement, Hard copy RCRA Subtitle C Activities Site Identification Form 8700-12, RCRA Subtitle C Activities Site Identification Instructions, OSHA 300, 300A, 301 Formsand Instructions, Initial Incident Report (must be filed within 24 hours of discovering a release), Instructions for completing Initial Incident Report, 30-Day Notification Form for Installations, Modifications, and Repairs, 30-Day Notification Form for Permanent Closure and Changes in Service, 30-Day Notification Form for Temporary Closure, Tank Installer, Qualified Tester, and Operator Trainer Forms, ALLD and Electronic Sump Sensor Testing Evaluation Work Sheet, ATG (Automatic Tank Gauge) and Interstitial or Sump Sensor Test and Inspection Form, Forms for inspection and testing of spill and overfill prevention equipment and containment sumps, Request for Extension of Temporary Closure of Storage Tank System, Petroleum Storage Tank Registration Instructions, Corrective Action Fund Pamphlet: Processes for Payment from the Corrective Action Fund, CAF Reimbursement Applications Instructions, Responsible Party Reimbursement Claim Form, Application form for first time installer certification, Application form for renewal of installer certification, Application form for first time Junior Installer certification, Operator Training Review Application and Matrix, Variance Indemnification / Release of Liability Form, License Renewal Application form for Medical Imaging or Radiation Therapy, InitialLicensure for Medical Imaging or Radiation Therapy Application form, Duplicate or Replacement Certificate of Licensure Application form, Temporary Licensure for Medical Imaging or Radiation Therapy Application form, Request for Written Verification Application form, Particle Accelerator Facility Registration, Amendment or Renewal form, Registration to Operate Radiation Machine form, Instructions for Applying to use Radiation Machines, Medical Diagnostic or Industrial Radiation Machine Facility Application, Form Required for Change of Control or Change of Ownership or both (including name change), Authorized Medical Physicist Preceptor (pdf), Authorized Nuclear Pharmacist Perceptor (pdf), Authorized User Diagnostic Use Preceptor (pdf), Authorized User Therapy Use Preceptor (pdf), Authorized User Sealed Source Therapy Use Preceptor (pdf), Instruction on How to fill-out Preceptor Form (pdf), Licensee Ownership Transfer Name Change Form, General License Application Small Uranium Thorium water filtration systems, General License Registration Form Device Attachment, Out of State Radiation Machine 2 day notification, Reciprocity Recognition form instructions, Financial Assurance Estimate Summary (for landfills), Financial Assurance Estimate Summary Simplified (for transfer stations), 2022 Annual Report Form: Tire Recycling Facility, 2022 Annual Report Form: Scrap Tire Hauler, 2022 Annual Report Form: Civil Engineering Applications, Collection Center Registration Application, Compost Facility Registration Application, Recycling Facility Registration Application, Air Curtain Incinerator Registration Application, Small Animal Crematorium Registration Application, Annual Financial Assurance Cost Estimate Form Transfer Station, Annual Financial Assurance Estimate Worksheets, Irrevocable Standby Letter of Credit (NM Gov Ent as Payee), Irrevocable Standby Letter of Credit (NMED as Payee), Performance Bond (NM Gov Ent as Beneficiary), Standby Trust Agreement (NM Gov Ent as Beneficiary), Standby Trust Agreement (NMED as Beneficiary), Trust Agreement (NM Gov Ent as Beneficiary), Commercial & Special Waste Hauler Registration Form, Help Completing Contingency Plan (Special Waste Haulers Only), Scrap Tire Manifest for Generators (for scrap tire generators that self-haul), Tire Recycling/Storage Facility Application, Affidavit Of Compliance with Local Regulations, Property Owner Affidavit of Acknowledgement, Operator Certification Application (Initial), Operator Certification Application (Renewal), FY24 RAID Grant Illegal Dumpsite Abatement Application, FY24 RAID Grant Additional Dumpsite Information page, On-Site Disposal of Domestic Waste Request Form. Medical Imaging & Radiation Therapy Program P.O. Can I change my NMTCB CE reporting cycle to match my continuing education cycle with another organization? Below you will find helpful information categorized by topic. The NMTCB is the Nuclear Medicine Technology Certification Board, formed for the purpose of creating and maintaining examinations for nuclear medicine technologists (NMTs). Read the ENTIRE notice located above, before completing any application form. How frequently do you have to renew your nuclear medicine technologist license in your state? Environmental Emergencies: 505-827-9329 (24 hours), Medical Imaging and Radiation Therapy Program, Radiological and Chemical Advocacy Office, Public Notices of Radioactive Material Licensing Actions, Instruction Reciprocity Recognition (PDF). Working as a Nuclear Medicine Technologist. ARRT Certification and Registration - ARRT Radiologist Assistant Program Recognition, Certain state-approved postprimary disciplines. No. 1190 St. Francis Dr. Suite N4050 Public License Look-up Tool PO Box 5469 Please see the MIRTP web page /rcb/mirtp/ for information regarding how to submit your complete application packet ELECTRONICALLY, and how the ELECTRONIC PAYMENT PROCESS works by clicking on the two links are located below all the application forms that appear on the MIRPT WEB PAGE. In other words, somebut not allstates require you to be certified and registered through ARRT before you can obtain a state license. The Nuclear Medicine Technology Certification Board Has Developed a Post-Primary Computed Tomography (CT) Credential. Also, email may be the only means of communicating with me. https://www.asrt.org/docs/default-source/practice-standards/ps_nm.pdf?sfvrsn=1ee176d0_22. 4. Payments included with mailed application packets may be deposited (in accordance with state statute) before an application packet has been fully reviewed and processed. If you believe you should have access to this part of our website but do not have a working username and password, please contact the NMTCB office at (404) 315-1739. Currently more than 330,000 technologists hold ARRT credentials. Section 20.3.20.100 - LICENSE REQUIRED, N.M. Code R. - Casetext Radiation Machines - New Mexico Environment Department You may also want to review ourstate licensing FAQs. Does your state require CE for licensing? 6. What is ARRT Certification & Registration? Click "Add a Row" and enter the email address and/or postal mail address you would like the certified verification sent then click "Continue Application". Select the topic you are interested in and explore the resources contained within. Use the following sonographer certification/credentialing organizations' resources to verify a sonographer's certification, credential, and registration status.2, Certification, Credential, & Registration Verification, Certification, Credential, & Registration Verification Is recognized by employers as a valid, high-quality certification exam. Asbestos NESHAP Notification form(Instructions) (Example)Asbestos Emergency Notification formAsbestos Government Ordered Demolition form, Permitting Administrative Multi-Form (PAM)AQB ePermitting PortalCompliance History Disclosure FormGCP-Oil and Gas Registration Form Part 1 of 2GCP-Oil and Gas Registration Form Part 2 of 2GCP-Oil and Gas Stack CalculatorAir Emissions Calculation ToolNOI Oil and Gas Abbreviated Portal FormUniversal Air Quality Permit ApplicationGCP-2 Multi-Form for Quarrying, Crushing, and Screening FacilitiesGCP-3 Multi-Form for Hot Mix Asphalt PlantsGCP-3 Hot Mix Asphalt Plants Carbon Monoxide Emission Calculation ToolGCP-5 Multi-Form for Concrete Batch PlantsCommForm Communication Updates for Air Quality Permits or Notices of IntentNSR Equipment Substitution FormNSR Relocation ApplicationGCP-6 Storage Vessels Registration FormGCP-6 Storage Vessels Section 9: Emission Reduction Calculation TableGCP-Temporary Control Minor Registration FormGCP-Temporary Control Major Registration FormACI Title V Permit ApplicationTitle V Application EPA Transmittal FormAcid Rain Program Instructions for Phase II Permit ApplicationAcid Rain New Unit ExemptionLandfill Design Capacity Report FormLandfill NMOC Emission Rate ReportLandfill Closure ReportLandfill Control Equipment Removal ReportRelocation Form For Portable Streamline Compressor EnginesEngine Replacement Form Plume Dispersion Energy ComparisonCotton Gin Permit Application Supplement, Compliance Assessment Agreement formSmall Business Compliance Assessment Program Disclosure formSmall Business Certification form, Smoke Management Ventilation Category Tracking formSmoke Management Visual Monitoring formSmoke Management Statewide Waiver Reporting form, Dry Cleaning Notice of Compliance Status Form2021 Dry Cleaner Compliance CalendarInitial Notification and Notification of Compliance Status Form for Gasoline Dispensing Facilities, Method 9 Opacity record keeping formMethod 22 Observation form, Universal Test Notification and Report formUniversal Test Notification and Report InstructionsUniversal Test Notification and Report example, Air Dispersion Modeling Waiver Request formModeling report form, Hemp Extraction Facility Permit ApplicationHemp Manufacturing or Processing Facility Permit ApplicationHemp Warehouse Permit ApplicationEdible and Topical Cannabis Manufacturer Certification FormHemp Variance ApplicationCannabis Edible Manufacturing Permit Application, CWSRF ApplicationAsset Management Plan Outline TemplateEnvironmental Information Document (EID) Outline, Request for Proposals (RFP) for Design Professional Services TemplatePreliminary Engineering Report (PER) Requirements Guide_USDA bulletin 1780-2Preliminary Engineering (PER) Report Review Checklist used by CPB, Engineering Contract Template For All Funding ProgramsEngineering Contract Template Attachment I InsuranceEngineering Contract Template Attachment II Planning PhaseEngineering Contract Template Attachment III Design PhaseEngineering Contract Template Attachment IV Construction PhaseEngineering Contract Template Attachment V Operation PhaseEngineering Contract Template Attachment VI Amendment to Engineering Contract, Disinfection By-Products Stage 2 Operational Evaluation, Distribution System Sampling Plan templateSurface Water Treatment System Monthly Operating Report, Construction or Modification of Public Water Supply System ApplicationConstruction Application Checklist, Construction or Modification Change Order Notification, Construction Project Completion Notification, Potable Water Hauling ApplicationPotable Water Hauling Application Checklist, Virus Inactivation by Chlorine Certification (hypochlorination)Virus Inactivation Certification Checklist, Drinking Water Laboratory Certification Program (DWLCP) Guidance ManualApplication for Laboratory Certification Appendix AChecklist for Laboratory Certification Application Appendix BLaboratory Certification Best Practices Appendix CDWLCP Acknowledgement Form Appendix DSubcontract Lab Request Form Appendix E, Template for Quarterly QA Report Appendix F, Corrective Action Response for Audit Findings Appendix G (Micro Labs Only), Examples of Chain-of-Custody Forms Appendix H, Registration Instructions for SDWIS LabToState Appendix I, Corrective Action Response for PT Study Failures (Micro Labs Only) Appendix J, RTCR Sample Reporting and Notification (LabToState) Appendix K, Public Water System Emergency Response Plan templatePublic Water Systems Operation & Maintenance Plan template, Utility Operator Certification Program exam application, Liquid Waste Permit Search Request Auto Fill PDF FormLiquid Waste Permit Application Auto Fill PDFLiquid Waste Permit or Registration Application printable versionApplication ChecklistSite Plan Submittal ChecklistAffidavit to keep lots/parcels adjoined in perpetuityVariance application | Variance application guidance | Variance ChecklistSample letter for public notice of varianceTank Abandonment FormSeptage Pumper Qualification Certificate applicationInstaller Specialist Qualification Certificate applicationInstaller Specialist renewal applicationATS Maintenance Service Provider (MSP) Qualification Certificate applicationThird Party Evaluator Qualification Certificate applicationRequirements for Qualification of On-Site ProfessionalsApplication for Homeowner Qualification Certificate, Application for Permit to Operate Food Establishment, Mobile Food Establishment (Food Truck), Food Processing Plant, or Mobile Support UnitApplication for Temporary Food EventManufactured Food Permit ApplicationRegistration form for baked goods prepared on tribal lands and sold in stateApplication for Food Variance, InstructionsSign in SheetHandout and Trainer NotesPresentation, Employee Health HandbookEmployee Interview FormEmployee Illness Reporting AgreementEmployee Medical Referral FormEmployee Illness Decision GuideFood Worker Decision Guide, Ground Water Quality Bureau Discharge Permit Application (Non-dairy)Notice of Intent to DischargeUIC General Discharge Permit ApplicationWastewater Land Application Data Sheet- 200 lbs/acWastewater Land Application Data Sheet 125%Fertilizer LogSurface Disposal Data Sheet SeptageSurface Disposal Data Sheet SludgeSurface Disposal Data Sheet GreaseSurface Disposal Data Sheet Chile Processing FacilitiesWastewater Sampling Log- Chile & Food Processing FacilitiesVoluntary Remediation ApplicationDairy Discharge Permit Renewal and/or Modification ApplicationSupplemental Form 1-R (Dairy)Supplemental Form 2-R (Dairy)Supplemental Form 3-R (Dairy)Supplemental Form 4-R (Dairy)Dairy Discharge Permit Renewal for Closure ApplicationSupplemental Form 1-C (Dairy)Supplemental Form 2-C (Dairy)Supplemental Form 3-C (Dairy)New Dairy Discharge Permit ApplicationSupplemental Form 1-A (Dairy)Supplemental Form 1-B (Dairy)Supplemental Form 1-C (Dairy), Business Concern Disclosure StatementGovernmental Entity Disclosure StatementKey Employee Disclosure StatementMain Disclosure StatementPersonal History Disclosure StatementBusiness Concern (Public Owner, Private Operator) Disclosure Statement, MyRCRAid Quick GuideMyRCRAid User GuideHard copy RCRA Subtitle C Activities Site Identification Form 8700-12RCRA Subtitle C Activities Site Identification Instructions, Whistleblower formInjury Tracking ApplicationOSHA 300, 300A, 301 Formsand InstructionsOSHA Poster, Initial Incident Report (must be filed within 24 hours of discovering a release)Instructions for completing Initial Incident Report30-Day Notification Form for Installations, Modifications, and Repairs30-Day Notification Form for Permanent Closure and Changes in Service30-Day Notification Form for Temporary Closure30-Day Notification WaiverTank Installer, Qualified Tester, and Operator Trainer Forms, ALLD and Electronic Sump Sensor Testing Evaluation Work SheetATG (Automatic Tank Gauge) and Interstitial or Sump Sensor Test and Inspection FormCathodic Protection Test FormForms for inspection and testing of spill and overfill prevention equipment and containment sumps(scroll down on the page that this link brings you to until you see Download Appendix, then click on the appropriate form under that), Alternate Method FormRequest for Extension of Temporary Closure of Storage Tank SystemRequest for Compliance DeterminationUST O&M ChecklistAST O&M Checklist, Petroleum Storage Tank Registration FormPetroleum Storage Tank Registration InstructionsChange in Ownership Form, Request for Compliance DeterminationCorrective Action Fund Pamphlet: Processes for Payment from the Corrective Action FundCAF Reimbursement Applications InstructionsResponsible Party Reimbursement Claim FormAffirmation and Assent to AuditCost Detail Form Summary SheetDisclosure Form ConsultantDisclosure Form Tank Owner/OperatorDisclosure Form AffidavitState Lead Claim FormReimbursementQuestions and AnswersCompetitive Bid Guidelines, Application form for first time installer certificationApplication form for renewal of installer certificationApplication form for first time Junior Installer certificationTester qualifications submittal formOperator Training Review Application and Matrix, Aquatics Operating Permit ApplicationConstruction Permit Application FormVariance Application FormVariance Indemnification / Release of Liability FormEmergency Action Plan TemplateDaily Opening ChecklistPool Daily Log sheet ExampleInspection FormInspection FormCheat Sheet, License Renewal Application form for Medical Imaging or Radiation TherapyInitialLicensure for Medical Imaging or Radiation Therapy Application formDuplicate or Replacement Certificate of Licensure Application formProvisional License Application formTemporary Licensure for Medical Imaging or Radiation Therapy Application formRequest for Written Verification Application formLegal Name Change Application form, Particle Accelerator Facility Registration, Amendment or Renewal formParticle Accelerator Registration GuideRegistration to Operate Radiation Machine formInstructions for Applying to use Radiation MachinesMedical Diagnostic or Industrial Radiation Machine Facility Application Form Required for Change of Control or Change of Ownership or both (including name change), Radiation Safety Officer PreceptorAuthorized Medical Physicist Preceptor (pdf)Authorized Nuclear Pharmacist Perceptor (pdf)Authorized User Diagnostic Use Preceptor (pdf)Authorized User Therapy Use Preceptor (pdf)Authorized User Sealed Source Therapy Use Preceptor (pdf)Instruction on How to fill-out Preceptor Form (pdf)Licensee Ownership Transfer Name Change FormGeneral License Application Small Uranium Thorium water filtration systemsGeneral License Registration Form Device AttachmentGeneral License Registration FormRCB Form 014RCB Form 016, Vendor Application GuidanceRadiological Services Application, Instruction Reciprocity RecognitionReciprocity 3-day Notification FormOut of State Radiation Machine 2 day notificationReciprocity Recognition form instructions, Log in to SEPAnnual Report InstructionsLandfill Capacity Calculation WorksheetFinancial Assurance Estimate Summary (for landfills)Financial Assurance Estimate Summary Simplified (for transfer stations)Environmental Monitoring SummaryAnnual Reporting Information FormTutorial: SEP RegistrationTutorial: Logging in to SEP2022 Annual Report Form: Tire Recycling Facility2022 Annual Report Form: Scrap Tire Hauler2022 Annual Report Form: Civil Engineering Applications, Collection Center Registration ApplicationCompost Facility Registration ApplicationRecycling Facility Registration ApplicationAir Curtain Incinerator Registration ApplicationSmall Animal Crematorium Registration Application, Main Disclosure StatementBusiness Concern Disclosure StatementGovernmental Entity Disclosure StatementKey Person Disclosure StatementPersonal History Disclosure StatementBusiness Concern (Public Owner, Private Operator) Disclosure StatementSubsidiary Disclosure Statement, Annual Financial Assurance Cost Estimate Form Transfer StationAnnual Financial Assurance Estimate WorksheetsCertificate of InsuranceIrrevocable Standby Letter of Credit (NM Gov Ent as Payee)Irrevocable Standby Letter of Credit (NMED as Payee)Local Government Reserve ResolutionPerformance Bond (NM Gov Ent as Beneficiary)Performance Bond (NMED as Beneficiary)Standby Trust Agreement (NM Gov Ent as Beneficiary)Standby Trust Agreement (NMED as Beneficiary)Trust Agreement (NM Gov Ent as Beneficiary)Trust Agreement (NMED as Beneficiary), Commercial & Special Waste Hauler Registration FormHelp Completing Hauler Registration FormHelp Completing Contingency Plan (Special Waste Haulers Only)Special Waste Manifest FormHauler Unauthorized Waste Tng Outline, Scrap Tire Hauler Registration FormScrap Tire Hauler Bond FormScrap Tire Manifest Form for HaulersScrap Tire Manifest for Generators (for scrap tire generators that self-haul), Civil Engineering Application (Small) for projects using 101 to 999 scrap tires and that are no more than 2 bales highCivil Engineering Application (Medium) for projects using 1000 to 99,999 scrap tires and that are no more than 2 bales highCivil Engineering Application (Large) for projects using 100,000 scrap tires or more or that are more than 2 bales highTire Recycling/Storage Facility ApplicationAffidavit Of Compliance with Local RegulationsProperty Owner Affidavit of Acknowledgement, Operator Certification Application (Initial)Operator Certification Application (Renewal)Alternate CEU Approval Form, FY24 RAID Grant Recycling ApplicationFY24 RAID Grant Illegal Dumpsite Abatement ApplicationFY24 RAID Grant Additional Dumpsite Information page, Solid Waste Facility Grant Fund Application FY24, On-Site Disposal of Domestic Waste Request FormSWB Rules Document, Headquarters Location
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