REQUEST FOR DEROGATION OF AN INSTALLATION FROM THE RULES GOVERNING THE FORM AND FREQUENCY OF NOTIFICATIONS
ANNEX IXSupplementary provisions
ANNEX IX REQUEST FOR DEROGATION OF AN INSTALLATION FROM THE RULES GOVERNING THE FORM AND FREQUENCY OF NOTIFICATIONS EUROPEAN COMMISSION — EURATOM SAFEGUARDS 1. Date: 2. Installation: 3. Material balance area code: 4. Category of nuclear material: 5. Enrichment or isotopic composition: 6. Quantities: 7. Chemical composition: 8. Physical form: 9. Number of items: 10. Type of derogation (Article 19(2)): (a) small quantities kept unchanged for a long period (b) non-nuclear activities (c) sensing components (d) Pu with Pu-238 content greater than 80 % 11. Intended use: 12. Particular safeguards obligation: 13. Date of transfer… From Date and place of dispatch of request: Name and position of signatory: Signature: Derogation granted as above… Name and position of signatory granting the derogation: Signature:… (for the Commission) Date: Explanatory Notes This form should be used either when the initial request is made for derogation of an installation from the rules governing the form and frequency of notifications, or when nuclear material which may qualify for a derogation is imported from a third country. Point 13 should be used only in the case of imports, and should state the name and address of the shipper. A separate request should be submitted for each type of derogation (Article 19(2)). NB: Under Article 79 of the Treaty, those subject to safeguards requirements shall notify the authorities of the Member State concerned of any communications they make to the Commission pursuant to Article 78 and the first paragraph of Article 79 of the Treaty. This form, duly completed and signed, must be forwarded to the European Commission, Euratom Safeguards, L-2920 Luxembourg.