Canadian Nuclear Safety Commission
Symbol of the Government of Canada

Annual Compliance Reporting Forms

The following Annual Compliance Reporting forms pertain to licences issued by the Directorate of Nuclear Substance Regulation (DNSR) of the Canadian Nuclear Safety Commission (CNSC).

The Annual Compliance Reporting forms listed below are grouped by category and customized for the licensed activity authorized by the licence. The licensed activity name and number (e.g. “industrial radiography (812)”), can be found on each licence.

Each licence has a licence condition specifying the due date when the Annual Compliance Reporting form must be submitted. To view the applicable Annual Compliance Reporting form, simply select it from the list below. The form may be downloaded and completed as a hard copy or electronically using word processing software.

The completed Annual Compliance Reporting form can be submitted to CNSC in one of four ways:

The Annual Compliance Reporting form groups are:

Class II Nuclear Facilities, Prescribed Equipment And Associated Activities
Number
Licensed Activity
Word
PDF
504 Operate a geophysical logging accelerator word pdf
507 Operate a neutron generator for industrial application word pdf
515 Construct a PET cyclotron facility word pdf
516 Operate a PET cyclotron facility word pdf
517 Decommission a PETcyclotron facility word pdf
518 Construct a research or an industrial particle accelerator facility word pdf
519 Operate a research or an industrial particle accelerator facility word pdf
520 Decommission a research or an industrial particle accelerator facility word pdf
521 Construct a medical accelerator facility word pdf
522 Operate a medical accelerator facility word pdf
523 Decommission a medical accelerator facility word pdf
524 Operate a consolidated medical accelerator facility, with servicing word pdf
525 Operate a consolidated medical accelerator facility, without servicing word pdf
531 Construct a calibration irradiator facility word pdf
532 Operate a calibration irradiator facility word pdf
533 Decommission a calibration irradiator facility word pdf
534 Construct an irradiator facility word pdf
535 Operate an irradiator facility word pdf
536 Decommission an irradiator facility word pdf
537 Construct a pool type irradiator facility word pdf
538 Operate a pool type irradiator facility word pdf
539 Decommission a pool type irradiator facility word pdf
541 Construct a radioactive source teletherapy facility word pdf
542 Operate a radioactive source teletherapy facility word pdf
551 Construct a low dose rate brachytherapy facility word pdf
552 Operate a low dose rate brachytherapy facility word pdf
554 Construct a high dose rate rate or pulsed dose rate brachytherapy facility word pdf
555 Operate a high dose rate brachytherapy facility word pdf
558 Operate other brachytherapy prescribed equipment word pdf
560 Construct a radioactive source stereotactic
teletherapy facility
word pdf
561 Operate a radioactive source stereotactic teletherapy facility word pdf
565 Service (by independant provider) Class II prescribed equipment word pdf
566 Service Class II prescribed equipment (servicing by possessor of the prescribed equipment) word pdf
567 Development and testing of Class II equipment word pdf
912 Manual brachytherapy word pdf
Consolidated Licences And Processing Unsealed Nuclear Sources
Number
Licensed Activity
Word
PDF
815 Consolidated uses of nuclear substances word pdf
847 Processing: total unsealed source possession limit of more than 10 GBq word pdf
849 Consolidated licence: between 11 and 50 locations, inclusive, where radioisotopes are used word pdf
851 Manufacturing of nuclear substances word pdf
857 Consolidated licence: between 1 and 10 locations word pdf
863 Processing: total unsealed source possession limit of 10 GBq or less word pdf
Industrial Field Uses
Number
Licensed Activity
Word
PDF
812 Industrial radiography word pdf
816 Logging - sealed source word pdf
844 Subsurface zone location word pdf
846 Subsurface tracer studies word pdf
858 Tracer studies word pdf
861 Logging: sealed source use with 1 to 5 storage locations, inclusive word pdf
868 Borehole tube tagging word pdf
Servicing And Manufacturing Radiation Devices
Number
Licensed Activity
Word
PDF
817 Development and testing word pdf
822 Servicing, installation and dismantling of devices – basic servicing word pdf
823 Servicing, installation and dismantling of devices – complex servicing word pdf
864 Device manufacturing word pdf
Calibration, Irradiation, Teaching Or Research
Number
Licensed Activity
Word
PDF
827 Calibration: less than 740 MBq word pdf
828 Calibration: 740 MBq or more word pdf
867 Neutron activation word pdf
873 Research: maximum sealed source size of more than 50 MBq word pdf
878 Irradiation: self-shielded type word pdf
879 Calibration word pdf
889 Research: maximum sealed source size of 50 MBq word pdf
894 Teaching: more than 50 MBq word pdf
907 Teaching: maximum sealed source size of 50 MBq word pdf
Gauges: Fixed And Portable
Number
Licensed Activity
Word
PDF
811 Portable gauges word pdf
814 Fixed gauges word pdf
886 Beta backscatter gauging word pdf
908 Demonstration word pdf
970 Portable gauges: 5 to 14 devices word pdf
990 Portable gauges: 2 to 4 devices word pdf
993 Portable gauges: 1 device word pdf
Nuclear Medicine
Number
Licensed Activity
Word
PDF
862 Diagnostic nuclear medicine procedures word pdf
872 Therapeutic nuclear medicine word pdf
875 Human research studies word pdf
Laboratories And Other Non-Human Uses
Number
Licensed Activity
Word
PDF
813 Laboratory studies word pdf
836 Laboratory studies: 10 or more laboratories word pdf
837 Laboratory studies: 3 - 9 laboratories word pdf
838 Laboratory studies: 1 to 2 laboratories word pdf
885 Repair of components containing radioactive luminous compounds word pdf
888 Electronic component testing word pdf
901 Display or use of components containing radioactive luminous compounds word pdf
915 Veterinary nuclear medicine word pdf
916 Possession of deuterium word pdf
Distribution
Number
Licensed Activity
Word
PDF
824 Distribution – drop shipment word pdf
825 Distribution – less than 740 MBq word pdf
826 Distribution – 740 MBq or more word pdf
Storage
Number
Licensed Activity
Word
PDF
906 Storage word pdf
918 Temporary possession – no use word pdf
Other Radiation Devices
Number
Licensed Activity
Word
PDF
880 X-ray fluorescence analysis word pdf
881 Electron capture detection word pdf
883 Bone mineral analysis word pdf
884 Low energy imaging word pdf
895 Fuel gauges on board aircraft word pdf
896 Dew point detection word pdf
897 Static elimination word pdf
898 Static detection word pdf
899 Radioluminescence word pdf
900 Surge voltage protection word pdf
902 Remote blade inspection word pdf
903 Smoke detection word pdf
904 Lightning warning word pdf
919 Radioactive check sources word pdf
940 Liquid scintillation counters word pdf