This chapter governs the procedures to be followed in performing a cremation or alkaline hydrolysis in this State. Upon receipt of human remains, a permit holder in the presence of the authorizing agent or representative of the funeral establishment engaging crematory services shall: Verify that the information on the wrist tag is consistent with the: Documentation accompanying the deceased; and Visual observation of the remains themselves; Use a metal detector wand to inspect for the presence of any battery operated, implanted devices including pacemakers, defibrillators, or pain relief devices; Refuse to accept human remains for cremation if an inspection of the human remains indicates the presence of any battery operated, implanted device; Ensure the removal and properly dispose of any hazardous object or any other materials that the individual authorized under this subtitle deems should be removed from the human remains, the crematory container, or the hydrolysis container, in order to prevent harm to the public health or damage to the cremator or alkaline hydrolysis unit; Remove any jewelry: On the human remains; In the crematory container; or In the hydrolysis container; Return any removed jewelry to the authorizing agent or representative of the funeral establishment engaging crematory services; and Obtain a signed, itemized receipt from the authorizing agent or representative of the funeral establishment engaging crematory services for the removed jewelry and retain the receipt as a permanent record. Foreign objects removed from the human remains: Shall be treated as medical waste and disposed of accordingly; and May not be donated until a sterilization process through a third party recognized by the Board to dispose properly of medical waste has been performed. Materials identifying the human remains that are placed in the custody of a permit holder shall contain the following information about the decedent: Name; Date of birth; Date of death; Name of funeral establishment or authorizing agent; Gender; and Name and relationship of authorizing agent to deceased. A permit holder may not accept unidentified human remains for cremation or alkaline hydrolysis. A crematory container: Shall be a readily combustible, rigid container suitable for cremation; Shall provide a completely enclosed covering for the human remains; Shall be resistant to leakage or spillage; Shall be of sufficient strength and rigidity for ease of handling; Shall provide protection to the health and safety of crematory establishment personnel and the public; Shall comply with all local, State, and federal governmental emissions regulations; May not be composed of metal or polyethylene material; and Which appears to be heavily coated with varnish, lacquer, or any other highly combustible substance, shall be: Placed in a cold cremator; or Coated completely with water before being placed in the cremator. An alkaline hydrolysis container: Shall consist of a completely enclosed covering for the human remains; Shall be resistant to leakage or spillage; Shall provide protection to the health and safety of the crematory establishment personnel and the public; Shall comply with all local, State, and federal emissions regulations; and Once inside the alkaline hydrolysis unit, may be removed prior to the start of the alkaline hydrolysis process as long as the human remains are covered to protect the dignity of the decedent. A holding facility shall: Comply with applicable public health laws; Preserve the dignity of human remains; Recognize the integrity, health, and safety of crematory establishment personnel; and Be secure from access by unauthorized persons. Unless prevented by emergency circumstances, human remains that have been designated for cremation or alkaline hydrolysis shall be cremated or hydrolyzed by a permit holder within 48 hours after receipt. A permit holder may not hold human remains for cremation or alkaline hydrolysis unless the human remains are contained within an individual, closed cremation or hydrolysis container as required under Regulation .03 of this chapter. A permit holder may not accept a cremation or alkaline hydrolysis container from which there is any evidence of leakage of the body fluids from the human remains therein. Whenever a permit holder is unable to cremate or hydrolyze human remains within 48 hours of taking custody thereof due to emergency circumstances, the permit holder shall maintain the human remains in a refrigerated holding facility, either on or off site, at 40°F or less, unless the remains have been embalmed. Immediately before being placed within the cremator or the alkaline hydrolysis unit, the individual authorized under this subtitle shall: Verify the identification of the human remains; and Place in or on the cremator or the alkaline hydrolysis unit the hard metal or plastic identification disc of the human remains being processed where it shall remain in place until the cremation or the alkaline hydrolysis process is complete. The permit holder’s designee may not leave the: Immediate area of the cremator during the cremation process; or Facility for the alkaline hydrolysis unit during the alkaline hydrolysis process. The alkaline hydrolysis unit shall be monitored at all times during the alkaline hydrolysis process. Records. The permit holder shall maintain the written authorizations required by Regulation .08 of this chapter as required pursuant to Health-General Article, §4-304, Annotated Code of Maryland, and COMAR 10.01.16.04B. The records are subject to inspection and copying by the Board. Except as otherwise provided in COMAR 10.29.18.02, a permit holder may not cremate or hydrolyze human remains until: The body has been identified as required under Health Occupation Article, §7-411, Annotated Code of Maryland; The permit holder crematory has received: A crematory services authorization on a form approved by the Board and signed by an authorizing agent; If applicable, a written delegation document or facsimile; and Any other documentation required by federal, State, or local law; and The permit holder has documented that at least 12 hours have elapsed from the time of death of the individual prior to beginning cremation or alkaline hydrolysis. The crematory services authorization form shall: Be provided by the permit holder to the authorizing agent; Contain the following information: The identity of the decedent; Date of death; The name and address of the authorizing agent and the relationship between the authorizing agent and the deceased; Authorization for the permit holder to cremate or hydrolyze the human remains; An indication of whether the decedent is: A veteran, as defined in State Government Article, § 9-901, Annotated Code of Maryland; or An eligible dependent of a veteran, as defined in Business Regulation Article, §5-803, Annotated Code of Maryland; Authorization to verify that the following have been removed before cremation or alkaline hydrolysis: An implanted pacemaker or defibrillator; and Any other materials that should be removed to prevent harm to the public health or damage to equipment; A representation by the authorizing agent that radiologic implant treatment has not occurred within 5 days before cremation or alkaline hydrolysis; A representation that the authorizing agent is aware of no objection to the human remains being processed by any person who has a right to control the disposition of the human remains; The name and address of the person authorized to claim the processed human remains from the permit holder or to accept the processed remains via registered mail; and The name and address of the crematory to which the authorizing agent has given permission; and Be signed by the authorizing agent. If an authorizing agent is not readily available to execute the crematory services authorization form, the authorizing agent may transmit the document in writing with notary seal electronically: In writing; or If located outside the area, by transmitting to the permit holder: A signed statement electronically or by facsimile that contains the name, address, and relationship of the sender to the decedent and the name and address of the individual to whom authority is delegated; and Once the authorizing agent is located in the area, a notarized document through U.S. Postal Service attesting to the delegation of authority. Upon receipt of the written delegation document or a copy transmitted electronically or by facsimile, the permit holder shall allow the named individual to serve as the authorizing agent. The documents shall be signed by the authorizing agent in the presence of a notary. A person signing a crematory services authorization form is deemed to warrant the truthfulness of any facts set forth in the crematory services authorization form, including the identity of the deceased whose remains are sought to be processed and the authority of that person to order such a cremation or alkaline hydrolysis. A permit holder shall notify and obtain written consent of the authorizing agent before the cremation or the alkaline hydrolysis of human remains at a location other than the location named on the crematory services authorization form. A permit holder shall maintain a copy of every crematory services authorization form required under this regulation as permanent records. Crematory services authorization records are subject to inspection and copying by the Board. A permit holder shall provide to an individual who delivers human remains for cremation or alkaline hydrolysis a receipt signed by both the permit holder authority and the individual who delivered the human remains, that includes the: Name of the individual from whom the human remains were received and the name of the individual’s employer, if any; Name and address of the crematory; Name of the deceased; Gender of the deceased; Date of death of the deceased; and Verification of the authorized burial transit permit. The permit holder shall maintain a record of each cremation or alkaline hydrolysis, which shall include the: Name of the decedent; Date of birth of the decedent; Gender of the decedent; Date of death; Name and address of the authorizing agent; Date, time, and location of cremation or alkaline hydrolysis; and Name of the individual who performed the cremation or the alkaline hydrolysis. The permit holder shall provide a certificate of disposition of processed human remains to the authorizing agent or funeral establishment that arranged for the cremation or the alkaline hydrolysis that includes the: Name of the decedent; Name of the authorizing agent; Name and address of the person who received the processed human remains from the permit holder; and If ascertainable: The location, including the name of the cemetery and plot location if the remains are interred; and The manner and date of the disposition of the processed human remains. The permit holder shall maintain a copy of every record and receipt required by this chapter as permanent records. All records and receipts required by this chapter are subject to inspection and copying by the Board. Except as provided in §B of this regulation, a permit holder may not: Require that human remains be placed in a casket before cremation or that human remains be cremated in a casket; Refuse to accept human remains for cremation because the remains are not in a casket; or Refuse to accept human remains for cremation because the remains are in a suitable, combustible wooden casket, but may require the authorizing agent or funeral establishment engaging the services of the crematory authority to remove the metal mattress holder in the casket. Human remains delivered to a crematory establishment may not be removed from the cremation container. The cremation container shall be cremated with the human remains unless the authorizing agent for the deceased requests a more natural environment for the deceased. A permit holder is not required to accept this manner of disposition. A permit holder may not require that human remains be subjected to embalming before cremation. On completion of the cremation or the alkaline hydrolysis, insofar as is possible: All of the recoverable residue of the cremation or the alkaline hydrolysis process shall be: Removed from the cremator or the alkaline hydrolysis unit; Except for medical devices remaining after cremation or alkaline hydrolysis, pulverized; and Placed in a sealable container; and The identification disc required by Health Occupations Article, §7-411, Annotated Code of Maryland, shall be: Removed from the cremator or the alkaline hydrolysis unit; and Placed in the sealable container with the processed human remains. Medical devices which remain after the completion of the cremation or the alkaline hydrolysis process shall be treated as medical waste and disposed of accordingly. After pulverization, all of the processed human remains, together with the identification disc, shall be placed in a sealable container. If the sealable container opening is not of adequate dimensions to accommodate a disc, it shall be affixed to the exterior of the sealable container and a record of the cremation number shall be placed in the sealable container. If all of the processed human remains and the identification disc will not fit within the dimensions of a sealable container, the remainder of the remains shall be returned to the authorizing agent, or the agent’s representative, in a separate, sealable container. Container seams shall be taped. If the processed human remains and identification disc do not adequately fill the container’s interior dimensions, the extra space may be filled with packing material that will not become intermingled with the remains and then securely closed. If a sealable container is to be shipped, it shall: Be placed within a separate sturdy box with all box seams securely taped closed; and Have the name of the deceased person whose processed remains are contained therein clearly identified on the outside of the container. If processed human remains have been in the possession of a permit holder, as originally authorized by the authorizing agent without instructions for disposition for a period of 10 days or more from the date of cremation or alkaline hydrolysis, the permit holder may send the processed human remains, using the current mailing standard approved by the U.S. Postal Service, return receipt requested, to the authorizing agent. Veteran and Eligible Dependent Decedents. Unless the authorizing agent directs otherwise, if a permit holder in possession of processed remains of a decedent veteran or a decedent eligible dependent, the permit holder shall provide the decedent’s identifying information to a veterans service organization, as defined in Business Regulation Article, §5-803, Annotated Code of Maryland. The veterans service organization will notify the permit holder whether the decedent is a veteran or an eligible dependent eligible for burial in a veterans cemetery. If the unclaimed processed remains are those of a veteran or an eligible dependent, the permit holder may transfer the processed remains to a veterans service organization for the purpose of disposition of the processed remains. If a veterans service organization does not take possession of unclaimed processed remains that qualify for a plot in a State veterans cemetery under State Government Article, §9-906, Annotated Code of Maryland, within 10 days after the permit holder receives the notification required in this regulation, the permit holder shall: Notify the Department of Veterans and Military Families of the status of the processed remains for the purpose of the appropriate disposition of the processed remains; and Transfer the processed remains to the Department of Veterans and Military Families for the purpose of the appropriate disposition of the processed remains. A crematory offering cremation shall maintain, at its own expense, the following tool inventory: Safety placement tool measuring a minimum of 49 inches in length; Wire brushes for cleaning cremators; Brush with fine bristles for cleaning pulverizers; Mortar and pestle; Funnel; High temperature protective gloves and heat-resistant leather gloves; Hand magnet and metal detector wand to detect and remove metal from cremated human remains; Tweezers to remove nonmetal objects from cremated human remains; and National Institute for Occupational Safety and Health certified N95 filtering facepiece respirators. A crematory offering alkaline hydrolysis shall maintain, at its own expense, the following tool inventory: Suitable tools for cleaning the alkaline hydrolysis unit; Brush with fine bristles for cleaning pulverizers; Mortar and pestle; Funnel; Hand magnet and metal detector wand to detect and remove metal from hydrolyzed human remains; Tweezers to remove nonmetal objects from hydrolyzed human remains; National Institute for Occupational Safety and Health certified N95 filtering facepiece respirators; and An emergency shower and eyewash combination unit meeting the criteria established under the American National Standards Institute and the International Safety Equipment Association Z358.1-2014 (R2020) or its successor. The permit holder or the designated crematory operator shall: Submit to the Board the number of persons not affiliated with the operations of the crematory who can safely be within the same room and within 10 feet of the cremator door or the alkaline hydrolysis unit; and Verify to the Board that the permit holder has submitted the information required in §A(1) of this regulation to their liability insurance carrier. Crematories that begin operation after July 1, 2014, shall construct a viewing room in the area of the cremator if the crematory intends to have more than two visitors present in the area of the cremator during the cremation. Crematories providing alkaline hydrolysis shall construct a viewing room in the area of the alkaline hydrolysis unit if the crematory intends to have more than two visitors present in the area of the alkaline hydrolysis unit during the alkaline hydrolysis. Health-General Article, §§5-502—5-504, 5-508, and 5-511—5-514; Health Occupations Article, §§7-101, 7-102, and 7-205, Annotated Code of Maryland Effective date: April 14, 2014 (41:7 Md. R. 421) Chapter revised effective May 11, 2026 (53:9 Md. R. 413)