Section He-P 4040.09 - Renewal of Certificates of Registration(a) Renewal of a certificate of registration for possession of a radiation or MRI machine shall be made in writing prior to August 1st of each year.(b) The machine renewal application shall include the following: (1) Updated or changed information about the radiation or MRI machine status since issuance of the most recent certificate of registration, including any of the following: d. Transfer to alternate site;e. Change in status from in use to storage;f. Change in status from storage to in use; org. Addition of any radiation or MRI machine;(2) A completed FORM DHHS/RHS A "Application for Radiation or Magnetic Resonance Imaging Machine Registration" (May, 2015) as required in He-P 4040.04 if any changes have been made;(3) A completed FORM DHHS/RHS D "Certificate-Disposition or Change of Ownership of Radiation or MRI Machine" (May, 2015) as required in He-P 4040.05, if applicable;(4) A check made payable to "Treasurer- State of New Hampshire" for the appropriate fee listed in He-P 4070.06; and(5) An attestation signed and dated by the registrant, or a certifying officer signing on behalf of the registrant, attesting to the following: "I, the registrant or certifying officer signing on behalf of the registrant, understand and shall follow the relevant requirements of the New Hampshire Rules for the Control of Radiation (He-P 4000) and confirm that all of the information herein is complete and accurate."(c) Each prospective or renewing registrant who fails to submit the registration fee within 30 days of the date that the application and fee are due, shall be assessed an administrative fine of $100 with the fee as described in He-P 4070.08.(d) Renewal of registration as service providers pursuant to He-P 4040.07 shall be made in writing prior to August 1st of each year.(e) The service provider application for a renewal of registration shall include the following: (1) A signed and dated renewal of a certificate of registration for servicing and services shall be made on FORM DHHS/RHS-RSP "Annual Renewal of Radiation or MRI Machine-Related Service Provider Registration" (May, 2015) provided by DHHS/RHS;(2) An attestation signed and dated by the applicant, or management representative stating "I certify that the applicant (1) understands and shall follow the relevant requirements of the New Hampshire Rules for the Control of Radiation (He-P 4000) applicable to the types of services or servicing to be provided under this registration and (2) shall adhere and require adherence to them and good radiation safety practices."; and(3) A check made payable to "Treasurer- State of New Hampshire" for the appropriate fee listed in He-P 4070.06.N.H. Admin. Code § He-P 4040.09
#6827, eff 8-6-98; ss by #7919, eff 7-18-03; ss by #9945-A, eff 6-22-11
Amended by Volume XXXV Number 27, Filed July 9, 2015, Proposed by #10864, Effective 6/25/2015, Expires 6/25/2025.