Text

Final As-Administered Administrative Jpms for the Perry Initial Examination - Jan/Feb 2003
	ML030700609
Person / Time
Site:	Perry
Issue date:	01/27/2003
From:	Pierson J; FirstEnergy Nuclear Operating Co
To:	; NRC/RGN-III
References
	-RFPFR, 50-440/03-301 50-440/03-301
	Download: ML030700609 (87)
	v • d • e

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 299-910-03-01 Task

Title:

Determine Dress Out JPM No: 2003 NRC RO/SRO A.3 Requirements for a Contaminated Area K/A

Reference:

2.3.4 Examinee

NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Candidate determines that he must wear Full Protective Clothing and a Discrete Particle Suit, as a minimum, in order to enter the RWCU Heat Exchanger Room.

Required Materials: Radiation Work Permit (marked up copy)

Survey Map (marked up copy)

General

References:

HPI-C0005, Rev. 7 PAP-0114, Rev. 4 Time Critical Task: NO Validation Time: 15 minutes READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is operating at 100% power. There has been an increasing temperature trend in the Reactor Water Cleanup (RWCU) System Heat Exchanger Room over the past 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months . Operations Management has determined that entry into the room is required in order to confirm if any leakage exists, and to quantify the amount.

As a member of the Relief Crew, you have been assigned to enter the room to perform this activity.

Initiating Cue: Determine the minimum protective clothing requirements for you to enter the RWCU Heat Exchanger Room.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 2 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Performance Step: 1 Locate the correct Radiation Work Permit (RWP) in order to determine the Radiation Protection Program requirements for the assigned task.

Standard: Locates the Specific RWP that allows entry into the RWCU Heat Exchanger Room for Leakage Inspection.

Comment: Cue: Provide Candidate with marked up RWP after he either shows or states that the RWPs are kept at the RRA entrance.

Performance Step: 2 Locate the correct Survey Map in order to determine the contamination levels inside the RWCU Heat Exchanger Room.

Standard: Locates the Survey Map for the RWCU Heat Exchanger Room.

Comment: Cue: Provide Candidate with marked up Survey Map after he either shows or states that the Survey Maps are kept at the RRA entrance.

Performance Step: 3 Determine the minimum protective clothing requirements for the assigned job task.

Standard: Evaluates RWP and associated Survey Map, and determines that he must wear Full Protective Clothing and a Discrete Particle Suit, as a minimum, in order to enter the RWCU Heat Exchanger Room.

Comment:

Terminating Cue:

When the Candidate has determined that he must wear Full Protective Clothing and a Discrete Particle Suit, as a minimum, the evaluation for this JPM is complete.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 3 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC RO/SRO A.3 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 4 of 71 Form ES-C-1 JPM CUE SHEET INITIAL The plant is operating at 100% power. There has been an increasing CONDITIONS: temperature trend in the Reactor Water Cleanup (RWCU) System Heat Exchanger Room over the past 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months . Operations Management has determined that entry into the room is required in order to confirm if any leakage exists, and to quantify the amount.

As a member of the Relief Crew, you have been assigned to enter the room to perform this activity.

INITIATING CUE: Determine the minimum protective clothing requirements for you to enter the RWCU Heat Exchanger Room.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 299-893-03-01 Task

Title:

Evaluate Proposed Work JPM No: 2003 NRC RO A.1.a Schedule Against Established Overtime Guidelines K/A

Reference:

2.1.2 Examinee

NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Determines that he cannot work the proposed overtime without additional authorization (a Technical Specification Overtime Deviation Request is requested by his Supervisor and authorized by the Plant Manager or his designees), for either one of the following reasons;

- He will not receive a break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months from Sat. to Sun.,

or,

- He will exceed 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in the 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period from 1200 on Fri.

through 1200 on Sun.

Required Materials: NOP-LP-1002, Rev 0 General

References:

NOP-LP-1002, Rev 0 Time Critical Task: NO Validation Time: 10 minutes NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is operating at 100% power. Operations Section shift manning is being severely affected due to a flu epidemic. All healthy licensed operators are being scheduled to work extra hours in order to cover shift vacancies.

Listed below is your proposed Work Schedule for the next 10 days.

Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Off Off 12-24 12-24 12-24 12-24 16-24 06-14 Off 08-16 Note: All work hours shown exclude turnover time.

Initiating Cue: As a licensed operator, determine if you can work the proposed overtime without any additional authorization.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 9 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: Ensure a copy of NOP-LP-1002, Fitness For Duty Program, is available for use by the Candidate.

Performance Step: The following guidelines are applicable to personnel performing 4.14.3 safety-related functions (e.g., licensed Senior Reactor Operators, Reactor Operators, Health Physicists, Auxiliary Operators, Perry Plant Operators, Perry Plant Attendants and Key Maintenance Personnel).

Overtime Deviation shall be controlled as specified in each plants licensing documents, and may be supplemented as directed by site management.

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months straight (excluding shift turnover time).

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months in any 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period, 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in any 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period, or 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in any 7 day period (all excluding shift turnover time).

- A break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months should be allowed between work periods. (Shift turnover time should not be part of the 8 hour9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months break period.)

- Except during extended shutdown periods, the use of overtime should be considered on an individual basis and not for the entire staff on a shift or crew.

- The crew performing fuel loading operations should not normally be expected to work more than 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months out of each 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period when scheduled for consecutive daily duty.

Standard: Determines that he cannot work the proposed overtime without additional authorization (a Technical Specification Overtime Deviation Request is requested by his Supervisor and authorized by the Plant Manager or his designees), for either one of the following reasons;

- He will not receive a break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months from Sat. to Sun.,

or,

- He will exceed 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in the 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period from 1200 on Fri.

through 1200 on Sun.

Comment:

Terminating Cue:

When the Candidate has determined that he cannot work the proposed overtime without additional authorization, the evaluation for this JPM is complete.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 10 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC RO A.1.a Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

INITIAL The plant is operating at 100% power. Operations Section shift manning is CONDITIONS: being severely affected due to a flu epidemic. All healthy licensed operators are being scheduled to work extra hours in order to cover shift vacancies. Listed below is your proposed Work Schedule for the next 10 days.

Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Off Off 12-24 12-24 12-24 12-24 16-24 06-14 Off 08-16 Note: All work hours shown exclude turnover time.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet INITIATING CUE: As a licensed operator, determine if you can work the proposed overtime without any additional authorization.

Facility: Perry Task No: N/A Task

Title:

Determine the Effect(s) of Relay JPM No: 2003 NRC RO A.1.b 1E51A-K51 Removal K/A

Reference:

2.1.24 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Candidate determines that the removal of Relay 1E51A-K51 will defeat the RCIC automatic suction transfer (i.e., prevent the automatic opening of RCIC Pump Suppression Pool Suction Isolation Valve, 1E51-F031, on low CST level or high SP level).

Required Materials: Electrical Drawings - 208-075 Series General

References:

Electrical Drawings - 208-075 Series Time Critical Task: NO Validation Time: 20 minutes READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Initial Conditions: The plant is operating at 100% power. The Reactor Core Isolation Cooling System (RCIC) is in the normal Standby Readiness lineup.

Agastat Relays has issued an industry-wide notice that has identified a specific batch of relays that were not built to design specifications.

Agastat Relays has recommended that these relays be replaced as soon as practicable. Perry has identified that currently installed Relay 1E51A-K51 was part of this batch.

Initiating Cue: The Unit Supervisor directs you to determine the potential effect(s) on the RCIC System if Relay 1E51A-K51 were to be removed with the plant in its current operating condition.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 13 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: The Candidate will require access to the Plant Electrical (208) Drawings located either in the Simulator, TEC Reference Library, or the Unit 1 Control Room.

Performance Step: 1 Using the Plant Electrical (208) Drawings, determine the potential effect(s) on the RCIC System if Relay 1E51A-K51 were removed with the plant in its current operating condition.

Standard: Determines that the removal of Relay 1E51A-K51 will defeat the RCIC automatic suction transfer (i.e., prevent the automatic opening of RCIC Pump Suppression Pool Suction Isolation Valve, 1E51-F031, on low CST level or high SP level).

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 14 of 71 Form ES-C-1 PERFORMANCE INFORMATION Comment: Detailed discussion of Relay 1E51A-K51 removal.

1. B208-075 Sh 02:

Locates Relay 1E51A-K51 (in far-left column).

Determines relay is shown on Sh 04.

Determines relay contact T1-M1 is shown on Sh 21 (for valve E51-F031).

2. B208-075 Sh 04 Line 25:

Identifies Relay 1E51A-K51.

Determines relay is normally de-energized.

Determines relay would not energize on either a low CST level (K78) or high SP level (K79)

(B208-075 Sh 10 Lines 05 & 17).

Note: Relay K50 is normally de-energized, therefore, relay contact M1-R1 is normally closed.

3. B208-075 Sh 21 Line 09:

Identifies Relay 1E51A-K51 contact M1-T1.

Determines contact would not close.

Determines RCIC Pump Suppression Pool Suction Isolation Valve, 1E51-F031, would not automatically open if either a low CST level or high SP level condition were to occur.

Note: It is not critical for the Candidate to determine the Operability of the RCIC System in accordance with Technical Specifications.

Terminating Cue:

When the Candidate has determined that the RCIC automatic suction transfer has been defeated, the evaluation for this JPM is complete NUREG 1021, Revision 8, Supplement 1

Appendix C Page 15 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC RO A.1.b Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

INITIAL The plant is operating at 100% power. The Reactor Core Isolation Cooling CONDITIONS: System (RCIC) is in the normal Standby Readiness lineup. Agastat Relays has issued an industry-wide notice that has identified a specific batch of relays that were not built to design specifications. Agastat Relays has recommended that these relays be replaced as soon as practicable. Perry has identified that currently installed Relay 1E51A-K51 was part of this batch.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet INITIATING CUE: The Unit Supervisor directs you to determine the potential effect(s) on the RCIC System if Relay 1E51A-K51 were to be removed with the plant in its current operating condition.

Facility: Perry Task No: 299-655-03-01 299-574-03-01 Task

Title:

Perform Independent Verification JPM No: 2003 NRC RO A.2 of Tag Placement K/A

Reference:

2.2.13 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Candidate determines that valve P42-F295B was incorrectly closed and tagged. Notifies the Clearance Authority of the tagging discrepancy.

Required Materials: NOP-OP-1001, Rev 1 Clearance PY1-P47-0040 (Copy for training only)

General

References:

NOP-OP-1001, Rev 1 Time Critical Task: NO Validation Time: 10 minutes READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is operating in MODE 1. The chilled water coils for Controlled Access and Misc. Equipment Areas HVAC System (CA&MEA) Supply Plenum M21-B001B has a 2 gpm leak. The chilled water coils are being isolated and tagged per Clearance PY1-P47-0040.

The initial placement of the Control Room tags has been completed.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Initiating Cue: The Unit Supervisor directs you, as a Reactor Operator, to perform the independent verification of the Control Room tag placement for Clearance PY1-P47-0040 in accordance with NOP-OP-1001.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 18 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: The Evaluator will role-play as the SRO / Clearance Authority for this Admin JPM.

Note: Hand the Candidate the Clearance for his review and independent verification of tag placement.

Note: The NOMS Clearance System will not be required / used for this JPM.

Note: Each Control Room clearance tag independent verification can be evaluated in any order and will be documented in separate Performance Steps.

Note: The following Performance Step is for Valve P47-F290B.

Performance Step: Verify tags hung as follows:

4.10.2

1. For each tag, perform the following:

a. Confirm that the proper component was selected by comparing the information placed on the tag, the clearance and in-plant label. Abbreviated terms need not match exactly.

b. Confirm the component in the specified position.

c. Confirm the tag is securely fastened to the component in a visible location.

d. Check Placement 2nd Verification for that tag on the clearance.

Standard: For valve P47-F290B:

Determines that the component was properly selected by comparing the information placed on the tag, the clearance and in-plant label.

Confirms the component is in the specified position (closed).

Confirms the red tag is securely fastened to the valve control switch.

Checks Placement 2nd Verification for that tag on the clearance.

Comment: Note: It is not required for the Candidate to enter NOMS and electronically sign for Placement 2nd Verification for that tag on the clearance.

Cue: Inform the Candidate that he will not be required to update NOMS for the Placement 2nd Verification of tags.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 19 of 71 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Step is for Valve P47-F295B.

Performance Step: Verify tags hung as follows:

4.10.2

1. For each tag, perform the following:

a. Confirm that the proper component was selected by comparing the information placed on the tag, the clearance and in-plant label. Abbreviated terms need not match exactly.

b. Confirm the component in the specified position.

c. Confirm the tag is securely fastened to the component in a visible location.

d. Check Placement 2nd Verification for that tag on the clearance.

Standard: For valve P47-F295B:

Determines that the component was not properly selected by comparing the information placed on the tag, the clearance and in-plant label.

Determines red tag was placed on the control switch for valve P42-F295B instead of the control switch for valve P47-F295B.

Confirms the component is not in the specified position (closed).

Determines valve P42-F295B was closed instead of valve P47-F295B.

Confirms the red tag is not securely fastened to the valve control switch.

Determines red tag was secured on the control switch for valve P42-F295B instead of the control switch for valve P47-F295B.

Does not check Placement 2nd Verification for that tag on the clearance.

Comment:

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 20 of 71 Form ES-C-1 PERFORMANCE INFORMATION

Performance Step: Correcting discrepancies:

4.9.2 If conflicts between clearances or technical problems arise, Then inform the Clearance Authority.

Standard: The Clearance Authority (SRO) is informed that the tag for valve P47-F295B was initially placed on the wrong valve (P42-F295B).

Does not remove the incorrectly placed tag on valve P42-F295B, reposition valve P42-F295B to open, close correct valve P47-F295B, and tag valve P47-F295B control switch.

Comment: Note: The Candidate is not allowed to correct the clearance discrepancy (as discussed in NOP-OP-1001). The clearance will have to be revised.

Terminating Cue:

When the Candidate completes the independent verification for the red tag for valve P47-F290B control switch and determines that the red tag for valve P47-F295B control switch was improperly placed and informs the Clearance Authority, the evaluation for this JPM is complete.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 21 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC RO A.2 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 22 of 71 Form ES-C-1 JPM CUE SHEET INITIAL The plant is operating in MODE 1. The chilled water coils for Controlled CONDITIONS: Access and Misc. Equipment Areas HVAC System (CA&MEA) Supply Plenum M21-B001B has a 2 gpm leak. The chilled water coils are being isolated and tagged per Clearance PY1-P47-0040. The initial placement of the Control Room tags has been completed.

INITIATING CUE: The Unit Supervisor directs you, as a Reactor Operator, to perform the independent verification of the Control Room tag placement for Clearance PY1-P47-0040 in accordance with NOP-OP-1001.

NUREG 1021, Revision 8, Supplement 1

NUREG 1021, Revision 8, Supplement 1 Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: N/A Task

Title:

Perform Site Accountability JPM No: 2003 NRC RO A.4 Actions for Control Room Staff K/A

Reference:

2.4.39 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Candidate obtains temporary relief as the Licensed Operator At the Controls and then locates the Emergency Personnel Accountability card reader located in either the Unit 1 or 2 Control Room and simulates inserting his keycard into the card reader.

Required Materials: EPI-B0005, Rev 6, PIC 7 PAP-0126, Rev 2, PIC 2 General

References:

EPI-B0005, Rev 6, PIC 7 PAP-0126, Rev 2, PIC 2 Time Critical Task: NO Validation Time: 5 minutes READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is in MODE 3. You are the Licensed Operator At the Controls when a Site Area Emergency is announced. In addition, the Emergency Coordinator has announced that site accountability is now in effect.

Initiating Cue: The Shift Manager directs you, as a member of the Control Room staff, to perform your action(s) for site accountability.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 25 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: The Evaluator will role-play as another licensed Reactor Operator for the Candidate.

Note: The Candidate may explain that he can give his keycard to another member of his crew who will then insert his keycard into the designated accountability card reader for him. If this occurs, then cue the Candidate that he is required to demonstrate the action(s) himself.

Performance Step: The Licensed Operator At the Controls may be temporarily 6.8.3.1 relieved for personal reasons by another licensed operator as long as a verbal turnover of applicable items below has occurred:

a. The status of work in progress, with emphasis on unit/personnel safety items and safety related systems.

b. Any changes in the Unit status since shift turnover.

c. The status of testing and evolutions that has changed since shift turnover.

d. Any alarms or equipment out-of-service that has changed since shift turnover.

Standard: Obtains temporary relief from another licensed Reactor Operator in order to leave the Horseshoe Area.

Comment: Cue: As another Reactor Operator on his crew, inform the Candidate that he is temporarily relieved.

Note: The Unit 1 Control Room Emergency Personnel Accountability card reader is located outside of the Horseshoe Area near the main entrance to the Unit 1 Control Room.

Note: Per PAP-0126, Step 6.3.1, the Licensed Operator At the Controls shall not leave the Horseshoe Area until relieved by another licensed operator or senior reactor operator, except as specified in 6.3.2.

Note: PAP-0126, Step 6.3.2 does not allow the Licensed Operator At the Controls to momentarily leave the Horseshoe Area without relief for the sole purpose of performing site accountability actions.

Note: This Step is not critical. If the Candidate does not obtain temporary relief, this would only be a violation of plant procedure (PAP-0126).

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 26 of 71 Form ES-C-1 PERFORMANCE INFORMATION

Performance Step: Utilize Card Readers in either Unit 1 or 2 Control Rooms for 5.6.1.1 accountability purposes.

Standard: Locates the Emergency Personnel Accountability card reader in either the Unit 1 or 2 Control Room.

Inserts (simulates) and then withdraws keycard into the designated accountability card reader.

Comment: Cue: The red light has blinked on the Accountability card reader.

Note: Control Room staff shall respond as outlined in Control Room Staff and General Site Accountability Actions (EPI-B0005, Attachment 3).

Terminating Cue:

When the Candidate completes his actions to demonstrate Site Accountability, the evaluation for this JPM is complete.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 27 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC RO A.4 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet INITIAL The plant is in MODE 3. You are the Licensed Operator At the Controls CONDITIONS: when a Site Area Emergency is announced. In addition, the Emergency Coordinator has announced that site accountability is now in effect.

INITIATING CUE: The Shift Manager directs you, as a member of the Control Room staff, to perform your action(s) for site accountability.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 343-710-03-02 299-892-03-01 Task

Title:

Evaluate Proposed Work JPM No: 2003 NRC SRO A.1.a Schedule Against Established Overtime Guidelines K/A

Reference:

2.1.2 Examinee

NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: Candidate determines that Fred can work the proposed overtime without additional authorization and either Bill or John cannot work the proposed overtime without additional authorization, for the following reasons;

- Bill will exceed 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in the 7 day period from Mon. through Sun.,

or,

- John will exceed 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in the 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period from 0800 on Sat.

through 0800 on Mon.

Candidate completes a Technical Specification Overtime Deviation Request for either Bill or John.

Required Materials: NOP-LP-1002, Rev 0 Access to Computer Workstation with Lotus Notes software (or hardcopy of Technical Specification Overtime Deviation Request Form 7699)

General

References:

NOP-LP-1002, Rev 0 Time Critical Task: NO Validation Time: 15 minutes NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is operating at 100% power. You are the Unit Supervisor for your crew. Two (2) Reactor Operators from your crew are needed to work a 12-hour overtime assignment on Sunday (2/10) from 0800 to 2000.

It is not expected that any of the Reactor Operators who work on Sunday will work the following Monday.

Listed below is the current work week schedule for the three (3)

Reactor Operators on your crew.

Sun Mon Tue Wed Thu Fri Sat 2/3 2/4 2/5 2/6 2/7 2/8 2/9 Bill Off 08-20 08-20 08-16 08-16 08-20 08-20 Fred Off 08-16 08-20 08-20 08-16 08-16 08-16 John Off 08-20 08-16 08-20 08-20 off 08-24 Note: All work hours shown exclude turnover time.

Initiating Cue: Determine which Reactor Operator(s) can work the proposed overtime without any additional authorization and complete any form(s) required in order to fill the two (2) overtime assignments.

NUREG 1021, Revision 8, Supplement 1

Answer Key - Hard Copy DEPT/SECTION TECHNICAL SPECIFICATION OVERTIME DEVIATION REQUEST PNPPD/OPS PNPP No. 7699 Rev. 9/27/00 DEVIATION CODES:

1 - MORE THAN 16 HRS STRAIGHT 3 - MORE THAN 24 HRS IN 48 HRS 5 - LESS THAN 8 HR BREAK BETWEEN ASSIGNMENTS 2 - MORE THAN 16 HRS IN 24 HRS 4 - MORE THAN 72 HRS IN 7 DAYS (CODES 01 -04 EXCLUDE SHIFT TURNOVER TIME)

NAME SOCIAL SECURITY CODE START END DATE REASON No. DATE Reason shall include as a minimum: 1) the specific work to be performed, 2) why other individuals cannot not be used and 3) why the work cannot be rescheduled. General statements such as outage support and to meet the schedule are not acceptable.

Bill xxx-xx-xxxx 4 2/10/2003 2/10/2003 Work additional hours due to flu epidemic.

John yyy-yy-yyyy 3 2/10/2003 2/10/2003 Work additional hours due to flu epidemic.

Supervisors requesting an overtime deviation are signifying that they are familiar with the condition of the individual involved and that the individuals condition is such that the additional overtime hours can be safely worked.

REQUESTED BY GENERAL MANAGER/DIRECTOR APPROVAL

/ / /

Signature Date Section Signature Date

Appendix C Page 32 of 12 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: This JPM is intended to be performed using the electronic database version of the Technical Specification Overtime Deviation Request (PNPP No. 7699) located in Lotus Notes. However, if the Candidate desires, he can complete a hardcopy of the form.

Note: Ensure a copy of NOP-LP-1002, Fitness For Duty Program, is available for use by the Candidate.

Note: Each Reactor Operator (Bill, Fred, and John) can be evaluated in any order and will be documented in separate Performance Steps.

Appendix C Page 33 of 12 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Steps are for Bill.

Performance Step: The following guidelines are applicable to personnel performing 4.14.3 safety-related functions (e.g., licensed Senior Reactor Operators, Reactor Operators, Health Physicists, Auxiliary Operators, Perry Plant Operators, Perry Plant Attendants and Key Maintenance Personnel).

Overtime Deviation shall be controlled as specified in each plants licensing documents, and may be supplemented as directed by site management.

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months straight (excluding shift turnover time).

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months in any 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period, 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in any 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period, or 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in any 7 day period (all excluding shift turnover time).

- A break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months should be allowed between work periods. (Shift turnover time should not be part of the 8 hour9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months break period.)

- Except during extended shutdown periods, the use of overtime should be considered on an individual basis and not for the entire staff on a shift or crew.

- The crew performing fuel loading operations should not normally be expected to work more than 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months out of each 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period when scheduled for consecutive daily duty.

Standard: Determines that Bill will exceed 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in the 7 day period from Mon. through Sun.

Determines that Bill cannot work the proposed overtime without additional authorization (a Technical Specification Overtime Deviation Request is requested by his Supervisor and authorized by the Plant Manager or his designees).

Comment:

Appendix C Page 34 of 12 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Step is only critical if the Candidate determines that Bill (not John) will be designated as the second Reactor Operator to work the proposed overtime on Sunday.

Note: Provide the Candidate with the following directions before he prepares the electronic version of the Technical Specification Overtime Deviation Request:

1. Use a fictitious Social Security Number for Bill.

2. Do not submit the completed Technical Specification Overtime Deviation Request for approval.

3. Print a copy of the completed Technical Specification Overtime Deviation Request.

4. Closeout the completed Technical Specification Overtime Deviation Request without saving the request.

5. Exit the Lotus Notes electronic database.

Performance Step: Deviations from the overtime guidelines are normally requested by 4.14.5 the immediate supervisor and authorized by the Plant Manager or his designees using the Technical Specification Overtime Deviation Request (PNPP No. 7699).

Standard: Using Lotus Notes, accesses the Overtime Deviation electronic database from the Perry Main menu on PY-NOTES01.

Properly completes the Technical Specification Overtime Deviation Request.

The following items are critical: Name (Bill), Code (4).

See attached Technical Specification Overtime Deviation Request Answer Key.

Comment: Note: The Start Date and End Date blocks are not critical items because they are used for administrative purposes only.

As a minimum, the dates should both be 2/10/03, but they could include the entire time interval of the hours worked or limit exceeded.

Note: If the electronic database version of the form is not available, then provide the Candidate with a hardcopy of PNPP No. 7699.

Appendix C Page 35 of 12 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Step is for Fred.

Performance Step: The following guidelines are applicable to personnel performing 4.14.3 safety-related functions (e.g., licensed Senior Reactor Operators, Reactor Operators, Health Physicists, Auxiliary Operators, Perry Plant Operators, Perry Plant Attendants and Key Maintenance Personnel).

Overtime Deviation shall be controlled as specified in each plants licensing documents, and may be supplemented as directed by site management.

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months straight (excluding shift turnover time).

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months in any 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period, 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in any 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period, or 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in any 7 day period (all excluding shift turnover time).

- A break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months should be allowed between work periods. (Shift turnover time should not be part of the 8 hour9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months break period.)

- Except during extended shutdown periods, the use of overtime should be considered on an individual basis and not for the entire staff on a shift or crew.

- The crew performing fuel loading operations should not normally be expected to work more than 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months out of each 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period when scheduled for consecutive daily duty.

Standard: Determines that Fred can work the proposed overtime without additional authorization.

Comment: Note: Fred should be designated for 1 of the 2 proposed overtime assignments since he does not require additional authorization.

Appendix C Page 36 of 12 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Steps are for John.

Performance Step: The following guidelines are applicable to personnel performing 4.14.3 safety-related functions (e.g., licensed Senior Reactor Operators, Reactor Operators, Health Physicists, Auxiliary Operators, Perry Plant Operators, Perry Plant Attendants and Key Maintenance Personnel).

Overtime Deviation shall be controlled as specified in each plants licensing documents, and may be supplemented as directed by site management.

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months straight (excluding shift turnover time).

- An individual should not work more than 16 hours1.851852e-4 days 0.00444 hours 2.645503e-5 weeks 6.088e-6 months in any 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period, 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in any 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period, or 72 hours8.333333e-4 days 0.02 hours 1.190476e-4 weeks 2.7396e-5 months in any 7 day period (all excluding shift turnover time).

- A break of at least 8 hours9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months should be allowed between work periods. (Shift turnover time should not be part of the 8 hour9.259259e-5 days 0.00222 hours 1.322751e-5 weeks 3.044e-6 months break period.)

- Except during extended shutdown periods, the use of overtime should be considered on an individual basis and not for the entire staff on a shift or crew.

- The crew performing fuel loading operations should not normally be expected to work more than 12 hours1.388889e-4 days 0.00333 hours 1.984127e-5 weeks 4.566e-6 months out of each 24 hour2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months period when scheduled for consecutive daily duty.

Standard: Determines that John will exceed 24 hours2.777778e-4 days 0.00667 hours 3.968254e-5 weeks 9.132e-6 months in the 48 hour5.555556e-4 days 0.0133 hours 7.936508e-5 weeks 1.8264e-5 months period from 0800 on Sat. through 0800 on Mon.

Determines that John cannot work the proposed overtime without additional authorization (a Technical Specification Overtime Deviation Request is requested by his Supervisor and authorized by the Plant Manager or his designees).

Comment:

Appendix C Page 37 of 12 Form ES-C-1 PERFORMANCE INFORMATION Note: The following Performance Step is only critical if the Candidate determines that John (not Bill) will be designated as the second Reactor Operator to work the proposed overtime on Sunday.

Note: Provide the Candidate with the following directions before he prepares the electronic version of the Technical Specification Overtime Deviation Request:

1. Use a fictitious Social Security Number for John.

2. Do not submit the completed Technical Specification Overtime Deviation Request for approval.

3. Print a copy of the completed Technical Specification Overtime Deviation Request.

4. Closeout the completed Technical Specification Overtime Deviation Request without saving the request.

5. Exit the Lotus Notes electronic database.

Performance Step: Deviations from the overtime guidelines are normally requested by 4.14.5 the immediate supervisor and authorized by the Plant Manager or his designees using the Technical Specification Overtime Deviation Request (PNPP No. 7699).

Standard: Using Lotus Notes, accesses the Overtime Deviation electronic database from the Perry Main menu on PY-NOTES01.

Properly completes the Technical Specification Overtime Deviation Request.

The following items are critical: Name (John), Code (3).

See attached Technical Specification Overtime Deviation Request Answer Key.

Comment: Note: The Start Date and End Date blocks are not critical items because they are used for administrative purposes only.

As a minimum, the dates should both be 2/10/03, but they could include the entire time interval of the hours worked or limit exceeded.

Note: If the electronic database version of the form is not available, then provide the Candidate with a hardcopy of PNPP No. 7699.

Terminating Cue:

When the Candidate has determined that Fred can work the proposed overtime without additional authorization and either Bill or John cannot work the proposed overtime without additional authorization (and completes a Technical Specification Overtime Deviation Request for either Bill or John), the evaluation for this JPM is complete.

Appendix C Page 38 of 12 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC SRO A.1.a Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

Appendix C Page 39 of 12 Form ES-C-1 JPM CUE SHEET INITIAL The plant is operating at 100% power. You are the Unit Supervisor for CONDITIONS: your crew. Two (2) Reactor Operators from your crew are needed to work a 12-hour overtime assignment on Sunday (2/10) from 0800 to 2000.

It is not expected that any of the Reactor Operators who work on Sunday will work the following Monday.

Listed below is the current work week schedule for the three (3) Reactor Operators on your crew.

Sun Mon Tue Wed Thu Fri Sat 2/3 2/4 2/5 2/6 2/7 2/8 2/9 Bill Off 08-20 08-20 08-16 08-16 08-20 08-20 Fred Off 08-16 08-20 08-20 08-16 08-16 08-16 John Off 08-20 08-16 08-20 08-20 off 08-24 Note: All work hours shown exclude turnover time.

INITIATING CUE: Determine which Reactor Operator(s) can work the proposed overtime without any additional authorization and complete any form(s) required in order to fill the two (2) overtime assignments.

Appendix C Job Performance Measure Form ES-C-1 Worksheet TECHNICAL SPECIFICATION OVERTIME DEVIATION REQUEST PNPP No. 7699 Rev. 9/27/00 DEVIATION CODES:

1 - MORE THAN 16 HRS STRAIGHT 3 - MORE THAN 24 HRS IN 48 HRS 5 - LESS THAN 2 - MORE THAN 16 HRS IN 24 HRS 4 - MORE THAN 72 HRS IN 7 DAYS (CODES 01 -04 NAME SOCIAL SECURITY CODE START END DATE No. DATE Reason shall inclu performed, 2) why work cannot be re support and to m Supervisors requesting an overtime deviation are signifying that they are familiar with the condition of the individual involved and that the individuals can be safely worked.

REQUESTED BY GENERAL MANAGER/DIRECTOR

/ /

Signature Date Section Signature

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 341-513-03-02 341-640-03-02 341-641-03-02 Task

Title:

Make a Four Hour JPM No: 2003 NRC SRO A.1.b (10CFR50.72 Non-Emergency)

Notification K/A

Reference:

2.1.17 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: The Candidate determines that a Four Hour Notification is required and determines when the notification is due in accordance with PAP-1604, Reports Management. Form PNPP No. 6912, Event Notification, is correctly prepared.

Required Materials: PAP-1604 Rev 6, PIC 2 Event Notification (Form PNPP No. 6912)

General

References:

PAP-1604 Rev 6, PIC 2 Time Critical Task: NO Validation Time: 20 minutes

Appendix C Job Performance Measure Form ES-C-1 Worksheet READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: You are the on-duty Shift Manager. The plant was conducting a shutdown in preparation for entering a refueling outage. The shutdown schedule called for power to be reduced to 20% and then a manual reactor scram was to be inserted.

Thirty minutes ago while shifting reactor feed pumps, a problem with the Master Level Controller resulted in an excessive feed rate and an increasing RPV level. The Reactor Operator inserted a manual reactor scram just prior to reaching RPV Level 8. Reactor power at the time of the scram was 30%. All equipment operated as designed following the scram and plant conditions are now stable.

Initiating Cue: As the Shift Manager, evaluate this event for reportability per PAP-1604, Reports Management, and perform any required notifications to the NRC Operations Center within the required time frame.

ANSWER KEY EVENT NOTIFICATION Perry Nuclear Power Plant PNPP No. 6912 Rev. 1/16/01 Unit 1 PAP-1604 Callers Name/Signature Title Time/Date of Call Event Time & Zone Event Date Power/Mode Before Power/Mode After XX:XX Eastern X/XX/2003 Mode 1 Mode 3 EVENT CLASSIFICATION 1-Hr Non-Emergency 10CFR50.72 (b)(1) (v)(A) Safe S/D Capability AINA General Emergency GEN/AAEC TS Deviation ADEV (v)(B) RHR Capability AINB Site Area Emergency SIT/AAEC 4-Hr Non-Emergency 10CFR50.72(b)(2) (v)(C) Control of Rad Release AINC Alert ALE/AAEC (i) TS Required S/D ASHU (v)(D) Accident Mitigation AIND Unusual Event UNU/AAEC (iv)(A) ECSS Discharge to RCS ACCS (xii) Offsite Medical AMED X 50.72 Non-Emergency (see next columns) X (iv)(B) RPS Actuation (scram) APRS (xiii) Lost Comm/Asmt/Resp ACOM Physical Security (73.71) DDDD (xi) Offsite Notification APRE 60-Day Optional 10CFR50.73(a)(1)

Material /Exposure B??? 8-Hr Non-Emergency 10CFR50.72(b)(3) Invalid Specified System Fitness for Duty HFIT (ii)(A) Degraded Condition ADEG Actuation AINV Other (see last column) (ii)(B) Unanalyzed Condition AUNA Other Unspecified Requirement (Identify)

Information Only NNF (iv)(A) Specified System NONR Actuation AESF NONR DESCRIPTION Include: Systems affected, actuations & their initiating signals, causes, effect of event on plant, actions taken or planned, etc. CR No.

Manual actuation of the Reactor Protection System (RPS) due to failure of the Feedwater Level Control system.

NOTIFICATIONS YES NO WILL BE Anything unusual or not understood? Yes No NRC Resident (Explain above)

State(s) Did all systems function as required? Yes No Local (Explain above)

Other Gov Agencies Mod of operation until corrected: Estimated Restart Additional info on back?

Date: Yes No Media/Press Release Other Information Requested by NRC:

Name of Individual Contacted: ENF No.

ANSWER KEY EVENT NOTIFICATION (Cont.)

PNPP No. 6912 Rev. 1/16/01 ADDITIONAL INFORMATION PAP-1604 RADIOLOGICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description)

Liquid Release Gaseous Release Unplanned Release Planned Release Ongoing Terminated Monitored Unmonitored Offsite Release T.S. Exceeded RM Alarms Areas Evacuated Personnel Exposed or Contaminated Offsite Protective Actions Recommended *State release path in description Release Rate (Ci/sec) % T.S. Limit HOO Guide Total Activity (Ci) % T.S. Limit HOO Guide Noble Gas 0.1 Ci/sec 1000 Ci Iodine 10 uCi/sec 0.01 Ci Particulate 1 uCi/sec 1 mCi Liquid (excluding tritium & dissolved 10 uCi/min 0.1 Ci noble gases)

Liquid (tritium) 0.2 Ci/min 5 Ci Total Activity Plant Stack Condenser/Air Ejector Main Steam Line Other RAD Monitor Readings:

Alarm Setpoints:

% T.S. Limit (if applicable)

RCS TUBE LEAKS: CHECK OR FILL IN APPLICABLE ITEMS: ( specific details/explanations should be covered in event description)

Location of the Leak (e.g., valve, pipe, etc.):

Leak Rate: Units: gpm/gpd T.S. Limits: Sudden or Long Term Development:

Leak Start Date: Time: Coolant Activity & Units:

List of Safety Related Equipment Not Operational:

EVENT DESCRIPTION (Continued from front)

Appendix C Page 45 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Performance Step: Ensure that each event or condition is evaluated under the 6.1.1.1 notification requirements specified in Attachment 1.

Standard: Evaluates PAP-1604, Attachment 1, and determines that a Four Hour (10CFR50.72 Non-Emergency) Notification is required due to the RPS actuation (when the reactor is critical).

Comment: Note: The Candidate must determine that the manual reactor scram was not part of the pre-planned shutdown sequence.

Note: The Candidate is not required to physically notify the NRC Operations Center in the next Step.

Performance Step: Ensure that the required notifications are made within the specified 6.1.1.2 time requirements to the NRC Operations Center via the Emergency Notification System (ENS) unless otherwise specified in Attachment 1.

Standard: Determines that the notification is due four hours from the time of the manual reactor scram.

Comment: Note: The Evaluator may need to prompt the Candidate to verbalize the latest time that the notification is required to be made.

Appendix C Page 46 of 71 Form ES-C-1 PERFORMANCE INFORMATION

Performance Step: Ensure that information provided to the NRC is recorded on an 6.1.1.3 Event Notification (form PNPP No. 6912, Attachment 3) including any additional information requested by the NRC Duty Officer.

Standard: Form PNPP No. 6912, Initial Notification, is properly filled out.

Only the RPS Actuation box is a critical step for the completion of the form.

Comment: Cue: If asked, inform the Candidate that the Condition Report (CR) has not been written yet.

Note: See attached copy of completed Form PNPP No. 6912, Event Notification, in order to verify proper completion of the Event Notification Form.

Note: The Candidate should identify where he can obtain Form PNPP No. 6912. When Candidate identifies the need for Form PNPP No. 6912, hand the Candidate a blank form.

Note: The Candidate is only required to complete Form PNPP No.

6912 through the completion of the Description block.

Terminating Cue:

When Form PNPP No. 6912, Event Notification, is properly filled out through the completion of the Description block, the evaluation for this JPM is complete.

Appendix C Page 47 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC SRO A.1.b Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

Appendix C Page 48 of 71 Form ES-C-1 JPM CUE SHEET INITIAL You are the on-duty Shift Manager. The plant was conducting a shutdown CONDITIONS: in preparation for entering a refueling outage. The shutdown schedule called for power to be reduced to 20% and then a manual reactor scram was to be inserted.

Thirty minutes ago while shifting reactor feed pumps, a problem with the Master Level Controller resulted in an excessive feed rate and an increasing RPV level. The Reactor Operator inserted a manual reactor scram just prior to reaching RPV Level 8. Reactor power at the time of the scram was 30%. All equipment operated as designed following the scram and plant conditions are now stable.

INITIATING CUE: As the Shift Manager, evaluate this event for reportability per PAP-1604, Reports Management, and perform any required notifications to the NRC Operations Center within the required time frame.

`

EVENT NOTIFICATION Perry Nuclear Power Plant PNPP No. 6912 Rev. 1/16/01 Unit 1 PAP-1604 Callers Name/Signature Title Time/Date of Call Event Time & Zone Event Date Power/Mode Before Power/Mode After EVENT CLASSIFICATION 1-Hr Non-Emergency 10CFR50.72 (b)(1) (v)(A) Safe S/D Capability AINA General Emergency GEN/AAEC TS Deviation ADEV (v)(B) RHR Capability AINB Site Area Emergency SIT/AAEC 4-Hr Non-Emergency 10CFR50.72(b)(2) (v)(C) Control of Rad Release AINC Alert ALE/AAEC (i) TS Required S/D ASHU (v)(D) Accident Mitigation AIND Unusual Event UNU/AAEC (iv)(A) ECSS Discharge to RCS ACCS (xii) Offsite Medical AMED 50.72 Non-Emergency (see next columns) (iv)(B) RPS Actuation (scram) APRS (xiii) Lost Comm/Asmt/Resp ACOM Physical Security (73.71) DDDD (xi) Offsite Notification APRE 60-Day Optional 10CFR50.73(a)(1)

Material /Exposure B??? 8-Hr Non-Emergency 10CFR50.72(b)(3) Invalid Specified System Fitness for Duty HFIT (ii)(A) Degraded Condition ADEG Actuation AINV Other (see last column) (ii)(B) Unanalyzed Condition AUNA Other Unspecified Requirement (Identify)

Information Only NNF (iv)(A) Specified System NONR Actuation AESF NONR DESCRIPTION Include: Systems affected, actuations & their initiating signals, causes, effect of event on plant, actions taken or planned, etc. CR No.

NOTIFICATIONS YES NO WILL BE Anything unusual or not understood? Yes No NRC Resident (Explain above)

State(s) Did all systems function as required? Yes No Local (Explain above)

Other Gov Agencies Mod of operation until corrected: Estimated Restart Additional info on back?

Date: Yes No Media/Press Release Other Information Requested by NRC:

Name of Individual Contacted: ENF No.

Appendix C Job Performance Measure Form ES-C-1 Worksheet EVENT NOTIFICATION (Cont.)

PNPP No. 6912 Rev. 1/16/01 ADDITIONAL INFORMATION PAP-1604 RADIOLOGICAL RELEASES: CHECK OR FILL IN APPLICABLE ITEMS (specific details/explanations should be covered in event description)

Liquid Release Gaseous Release Unplanned Release Planned Release Ongoing Terminated Monitored Unmonitored Offsite Release T.S. Exceeded RM Alarms Areas Evacuated Personnel Exposed or Contaminated Offsite Protective Actions Recommended *State release path in description Release Rate (Ci/sec) % T.S. Limit HOO Guide Total Activity (Ci) % T.S. Limit HOO Guide Noble Gas 0.1 Ci/sec 1000 Ci Iodine 10 uCi/sec 0.01 Ci Particulate 1 uCi/sec 1 mCi Liquid (excluding tritium & dissolved 10 uCi/min 0.1 Ci noble gases)

Liquid (tritium) 0.2 Ci/min 5 Ci Total Activity Plant Stack Condenser/Air Ejector Main Steam Line Other RAD Monitor Readings:

Alarm Setpoints:

% T.S. Limit (if applicable)

RCS TUBE LEAKS: CHECK OR FILL IN APPLICABLE ITEMS: ( specific details/explanations should be covered in event description)

Location of the Leak (e.g., valve, pipe, etc.):

Leak Rate: Units: gpm/gpd T.S. Limits: Sudden or Long Term Development:

Leak Start Date: Time: Coolant Activity & Units:

List of Safety Related Equipment Not Operational:

EVENT DESCRIPTION (Continued from front)

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 343-723-03-02 343-692-03-02 Task

Title:

Controlling Containment JPM No: 2003 NRC SRO A.2 Penetration to Meet the Isolation Requirements of Tech Spec 3.6.1.3 K/A

Reference:

2.2.15 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: The Candidate determines the following administratively-controlled boundaries are required to isolate penetration P113:

Identifies the following automatic valves are to be closed and de-activated (i.e., MCC disconnect opened) with OPS Admin Tags placed on each valves control switch, MCC disconnect, and local valve handwheel operator;

- Valve 1E12-F028A and its disconnect EF1B07-R

- Valve 1E12-F037A and its disconnect EF1B07-S

- Valve 1E12-F042A and its disconnect EF1B07-X Required Materials: OAI-1701, Rev 3 TAI-1120-7, Rev 2, PIC 1 PDB-G0001, Rev 1, PIC 5 Technical Specification 3.6.1.3 and Bases Mechanical and Electrical Drawings - 302 and 208 Series General

References:

OAI-1701, Rev 3 TAI-1120-7, Rev 2, PIC 1 PDB-G0001, Rev 1, PIC 5 Technical Specification 3.6.1.3 and Bases Mechanical and Electrical Drawings - 302 and 208 Series Time Critical Task: NO NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Validation Time: 20 minutes NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: The plant is in MODE 1. During the performance of SVI-E12-T2001, RHR A Pump and Valve Operability Test, valve 1E12-F027A (RHR A TO CNTMT SHUTOFF) blew all 3 main line fuses during its valve stroke time test. The valve is currently open and cannot be manually closed because it is mechanically bound. The valve has been declared inoperable and Technical Specification 3.6.1.3 (PCIVs), Condition A has been entered.

Initiating Cue: The Shift Manager, directs you as the Shift Engineer, to determine the component(s) that will require Operations Administrative Tags in accordance with OAI-1701, Attachment 1 in order to comply with Technical Specification 3.6.1.3, Condition A.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 55 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Note: The Candidate is not required to prepare the Operations Administrative Control Tagout; only to identify the components to be tagged as discussed in OAI-1701, (Emergent Items).

Note: The Candidate is not required to generate the LCO Tracking Form or document in the Plant Narrative Log the actions taken to meet Technical Specification 3.6.1.3 Action A as discussed in OAI-1701, Attachment 1 (Emergent Items).

Note: The Candidate may refer to any of the following plant references in order to determine the penetration (P113) associated with Valve 1E12-F027A and the corresponding components that must be administratively controlled:

Mechanical and Electrical Drawings - 302 and 208 Series

PDB-G0001, Containment Isolation Valve Table

TAI-1120-7, Containment Penetration Listing

SVI-E12-T9113, Type C LLRT of 1E12 Penetration P113 NUREG 1021, Revision 8, Supplement 1

Appendix C Page 56 of 71 Form ES-C-1 PERFORMANCE INFORMATION

Performance Step: Equipment deficiencies resulting in inoperable Primary Containment OAI-1701, Emergent Isolation Valves should be handled as follows:

Items / WCU Clearance Personnel

The Operations Administrative tags should be prepared for the inoperable equipment and have the same information that would have been provided by the Clearance Unit.

When Technical Specifications require a component to be closed and de-activated, the normal practice will be to provide tags for the control switch, disconnect or air supply, and local operator for the component(s) maintaining control of the penetration.

Standard: Identifies the following automatic valves are to be closed and de-activated (i.e., MCC disconnect opened) with OPS Admin Tags placed on each valves control switch, MCC disconnect, and local valve handwheel operator;

- Valve 1E12-F028A and its disconnect EF1B07-R

- Valve 1E12-F037A and its disconnect EF1B07-S

- Valve 1E12-F042A and its disconnect EF1B07-X Comment: Note: The Candidate may identify manual valve 1E12-F604A is to be closed and capped with an OPS Admin Tag placed on its local handwheel. This is not a critical item; it is only a conservative action which is not required to meet Required Action A.1.

Note: Since valve 1E12-F027A cannot be closed, this valve cannot be administratively controlled in order to meet Required Action A.1 for Tech Spec 3.6.1.3.

Note: Automatic valves 1E12-F028A, 1E12-F037A, and 1E12-F042A are normally closed when RHR A is in standby readiness.

Terminating Cue:

When the Candidate has determined the components that must be administratively controlled in order to isolate penetration P113, the evaluation for this JPM is complete.

NUREG 1021, Revision 8, Supplement 1

Appendix C Page 57 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC SRO A.2 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet INITIAL The plant is in MODE 1. During the performance of SVI-E12-T2001, CONDITIONS: RHR A Pump and Valve Operability Test, valve 1E12-F027A (RHR A TO CNTMT SHUTOFF) blew all 3 main line fuses during its valve stroke time test. The valve is currently open and cannot be manually closed because it is mechanically bound. The valve has been declared inoperable and Technical Specification 3.6.1.3 (PCIVs), Condition A has been entered.

INITIATING CUE: The Shift Manager, directs you as the Shift Engineer, to determine the component(s) that will require Operations Administrative Tags in accordance with OAI-1701, Attachment 1 in order to comply with Technical Specification 3.6.1.3, Condition A.

NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet Facility: Perry Task No: 344-526-05-02 344-532-05-02 Task

Title:

Issue a Revised Off-Site JPM No: 2003 NRC SRO A.4 Protective Action Recommendation (PAR)

Following a Change in Meteorological Conditions K/A

Reference:

2.4.44 Examinee: NRC Examiner:

Facility N/A Date:

Evaluator:

Method of testing Simulated Actual Performance Performance Classroom Simulator Plant Task Standard: The Candidate revises the default PAR to evacuate Subareas 1, 2 and 3.

Within the next 15 minutes, form PNPP No. 7794, Initial Notification, is correctly prepared in accordance with EPI-B1, Emergency Notification System.

Required Materials: EPI-B1, Rev 11 EPI-B8, Rev 8, PIC 5 Initial Notification (Form PNPP No. 7794)

Marked up copy of Initial Notification (Form PNPP No. 7794)

General

References:

EPI-B1, Rev 11 EPI-B8, Rev 8, PIC 5 Time Critical Task: YES 15 minutes for Step 5.1.10 Validation Time: 20 minutes NUREG 1021, Revision 8, Supplement 1

Appendix C Job Performance Measure Form ES-C-1 Worksheet READ TO THE EXAMINEE I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this Job Performance Measure will be satisfied.

Initial Conditions: You are the on-duty Shift Manager and Emergency Coordinator. The Plant is in a General Emergency due to a Loss Of Coolant Accident with an unisolable primary containment penetration discharging outside containment.

The General Emergency default Protective Action Recommendation (PAR) was issued to evacuate Subarea 1 and the Lake. (See attached Initial Notification Form) This was based on the meteorological conditions at the time. No dose projection data was initially available.

You have just been provided with the following updated radiological and meteorological conditions due to a change in the wind direction.

Release In Progress Projected Dose from 5 - 10 miles:

TEDE: < 500 mr CDEct: < 2 Rem Wind Speed: 10 MPH Wind Direction: 350° Initiating Cue: As the Emergency Coordinator, evaluate the updated radiological and meteorological conditions with respect to the current default PAR per EPI-B8, Protective Actions and Guides, and perform any required action(s).

NUREG 1021, Revision 8, Supplement 1

ANSWER KEY INITIAL NOTIFICATION PNPP No. 7794 Rev. 9/17/01 Page 1 of 2 EPI-B1

1. This is the Perry Nuclear Power Plant:

Control Room Technical Support Center (TSC) Emergency Operations Facility (EOF)

Backup EOF (Communicator: State your NAME and ERO POSITION TITLE.)

2. This is a(n): Actual Emergency Drill For step 3 below: Use only step a when classifying or reclassifying an event. Use both steps a & b when simultaneously classifying and terminating from an Unusual Event or Alert. Use step c when classifying after a transitory event. Use step d when revising a protective action recommendation.

3. a. A (n) UNUSUAL EVENT ALERT SITE AREA EMERGENCY GENERAL EMERGENCY has been declared at _______ hours on ___/___/__ based on EAL(s): ____________________

b. The emergency situation has been terminated at hours on / / .

(Time) (Date)

c. A transitory event has occurred which would have required the declaration of a(n):

ALERT SITE AREA EMERGENCY GENERAL EMERGENCY but was mitigated prior to classification. Current event status is at a(n):

UNUSUAL EVENT ALERT SITE AREA EMERGENCY declared at hours on / / based on EAL(s): .

(Time) (Date)

d. General Emergency protective actions are being changed at XX:XX hours onX/XX/2003.

(Time) (Date)

4. Brief non-technical description of event: A Loss of Coolant Accident (LOCA) has occurred with leakage outside containment.____________________________________________________________________

5. a. NO unplanned radioactive release has occurred.

b. An unplanned radioactive release is in progress.

6. Utility recommended protective actions:

a. None.

b. Evacuation of people in Subareas: 1 2 3 4 5 6 7 Lake Erie (circle)

7. I repeat, this is a(n): Actual Emergency Drill COMMENTS:

Notification is due at: XX:XX hours on_X_/_XX_/_2003___; _______

(Time) (Date) EMERGENCY COORDINATOR APPROVAL (signature)

ANSWER KEY INITIAL NOTIFICATION PNPP No. 7794 Rev. 9/17/01 Page 2 of 2 EPI-B1 COMMUNICATOR INSTRUCTIONS:

A. Ensure Items 1-7 (page 1) are completed, and Emergency Coordinator has approved release of information.

B. Pickup the 5-Way Ringdown. As parties answer, perform a roll call to verify that the State and county agencies listed below are on-line; record time contacted below. If party does NOT answer, initiate a separate call per EPI-B1.

5-WAY USED? 5-WAY USED?

TIME CONTACTED YES NO TIME CONTACTED YES NO ASHTABULA COUNTY LAKE COUNTY GEAUGA COUNTY STATE OF OHIO Read the following: Please obtain an Initial Notification form to copy this transmission.

Communication on the 5-Way Circuit is being recorded. (Pause 5-10 seconds to allow agencies to obtain form before continuing.) Read the following: The current date and time is: date /

/ , time.

C. Transmit data on page 1. When completed, record the name of contact below; request a call back if the 5-Way was NOT used.

NOTE: The following step can be done in parallel with step C. above if additional communicators are available.

D. Once State and county agencies have been contacted, initiate call on NRC ENS Circuit. Read the following: The following is a communication from the Perry Nuclear Power Plant. Communication on the ENS Circuit is being recorded.

E. Transmit data on page 1. When completed, record the name of contact below; request a call back if the ENS was NOT used.

TIME NRC CONTACTED:

If the 5-Way Ringdown or ENS Circuit was NOT used, a verification call back is required.

TIME OF CALLBACK ORGANIZATION PERSON CONTACTED JOB TITLE (If Applicable)

Ashtabula County N/A Geauga County N/A Lake County N/A State of Ohio N/A Nuclear Regulatory N/A Commission COMMON OFFSITE ACRONYMS:

SD Sheriffs Department EOC Emergency Operations Center HP Highway Patrol EMA Emergency Management Agency OSHP Ohio State Highway Patrol OEMA Ohio Emergency Management Agency Communicator(s) Name: (1) (2)

[TSC & EOF ONLY] Forward a copy of completed form to the Information Liaison and Regulatory Affairs Coordinator.

Appendix C Page 63 of 71 Form ES-C-1 PERFORMANCE INFORMATION (Denote Critical Steps with an asterisk)

Performance Step: Ensure that PAR is periodically evaluated based on degrading plant 5.1.3.3 conditions or changes in wind direction or other meteorological conditions using Attachments 2 and 3, as appropriate.

Standard: Evaluates EPI-B8, Attachments 2 and 3, and determines PAR must be revised to evacuate Subareas 1, 2 and 3, based on the new wind direction.

Comment: Note: This Step is critical but not time critical.

Appendix C Page 64 of 71 Form ES-C-1 PERFORMANCE INFORMATION Note: Candidate will refer to EPI-B1, Emergency Notification System, to perform the following step.

Performance Step: Upon the decision to reclassify the event or issue a revised offsite 5.1.10 PAR, perform an initial notification to the State of Ohio, local counties, and NRC per section 5.1.3.

Standard: Form PNPP No. 7794, Initial Notification, is properly filled out within 15 minutes from the decision to issue the revised PAR.

Items 3.d, 6.b, and Emergency Coordinator Approval line are critical steps for completion of the form.

Comment: Note: See attached copy of completed Form PNPP No. 7794, Initial Notification, in order to verify proper completion of the Initial Notification Form.

Note: The Candidate should identify where he can obtain Form PNPP No. 7794. When Candidate identifies the need for Form PNPP No. 7794, hand the Candidate a blank form.

Note: The Candidate is not required to complete any other E-Plan forms such as PNPP No. 9100, Pager Messages.

Note: The Evaluator will role-play as the Control Room Communicator by accepting the completed Form PNPP No. 7794 when the Candidate is ready for the Control Room Communicator to make the initial notifications to the counties, state, and NRC.

Terminating Cue:

When Form PNPP No. 7794, Initial Notification, is properly filled out, the evaluation for this JPM is complete.

Appendix C Page 65 of 71 Form ES-C-1 VERIFICATION OF COMPLETION Job Performance Measure No. 2003 NRC SRO A.4 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator: N/A Number of Attempts:

Time to complete:

Question Documentation:

Question:

Response

Result: SAT OR UNSAT Examiners Signature and Date: __________________________ _________________

Appendix C Page 66 of 71 Form ES-C-1 JPM CUE SHEET INITIAL You are the on-duty Shift Manager and Emergency Coordinator. The Plant CONDITIONS: is in a General Emergency due to a Loss Of Coolant Accident with an unisolable primary containment penetration discharging outside containment.

The General Emergency default Protective Action Recommendation (PAR) was issued to evacuate Subarea 1 and the Lake. (See attached Initial Notification Form) This was based on the meteorological conditions at the time. No dose projection data was initially available.

You have just been provided with the following updated radiological and meteorological conditions due to a change in the wind direction.

Release In Progress Projected Dose from 5 - 10 miles:

TEDE: < 500 mr CDEct: < 2 Rem Wind Speed: 10 MPH Wind Direction: 350° INITIATING CUE: As the Emergency Coordinator, evaluate the updated radiological and meteorological conditions with respect to the current default PAR per EPI-B8, Protective Actions and Guides, and perform any required action(s).

INITIAL NOTIFICATION PNPP No. 7794 Rev. 9/17/01 Page 1 of 2 EPI-B1

1. This is the Perry Nuclear Power Plant:

Control Room Technical Support Center (TSC) Emergency Operations Facility (EOF)

Backup EOF (Communicator: State your NAME and ERO POSITION TITLE.)

2. This is a(n): Actual Emergency Drill For step 3 below: Use only step a when classifying or reclassifying an event. Use both steps a & b when simultaneously classifying and terminating from an Unusual Event or Alert. Use step c when classifying after a transitory event. Use step d when revising a protective action recommendation.

3. a. A (n) UNUSUAL EVENT ALERT SITE AREA EMERGENCY GENERAL EMERGENCY has been declared at hours on / / based on EAL(s):

b. The emergency situation has been terminated at hours on / / .

(Time) (Date)

c. A transitory event has occurred which would have required the declaration of a(n):

ALERT SITE AREA EMERGENCY GENERAL EMERGENCY but was mitigated prior to classification. Current event status is at a(n):

UNUSUAL EVENT ALERT SITE AREA EMERGENCY declared at hours on / / based on EAL(s): .

(Time) (Date)

d. General Emergency protective actions are being changed at hours on / / .

(Time) (Date)

4. Brief non-technical description of event:

5. a. NO unplanned radioactive release has occurred.

b. An unplanned radioactive release is in progress.

6. Utility recommended protective actions:

a. None.

b. Evacuation of people in Subareas: 1 2 3 4 5 6 7 Lake Erie (circle)

7. I repeat, this is a(n): Actual Emergency Drill COMMENTS:

Notification is due at: hours on / / ;

(Time) (Date) EMERGENCY COORDINATOR APPROVAL (signature)

Appendix C Page 70 of 71 Form ES-C-1 JPM CUE SHEET INITIAL NOTIFICATION PNPP No. 7794 Rev. 9/17/01 Page 2 of 2 EPI-B1 COMMUNICATOR INSTRUCTIONS:

A. Ensure Items 1-7 (page 1) are completed, and Emergency Coordinator has approved release of information.

B. Pickup the 5-Way Ringdown. As parties answer, perform a roll call to verify that the State and county agencies listed below are on-line; record time contacted below. If party does NOT answer, initiate a separate call per EPI-B1.

5-WAY USED? 5-WAY USED?

TIME CONTACTED YES NO TIME CONTACTED YES NO ASHTABULA COUNTY LAKE COUNTY GEAUGA COUNTY STATE OF OHIO Read the following: Please obtain an Initial Notification form to copy this transmission. Communication on the 5-Way Circuit is being recorded. (Pause 5-10 seconds to allow agencies to obtain form before continuing.) Read the following: The current date and time is: date / / , time.

C. Transmit data on page 1. When completed, record the name of contact below; request a call back if the 5-Way was NOT used.

NOTE: The following step can be done in parallel with step C. above if additional communicators are available.

D. Once State and county agencies have been contacted, initiate call on NRC ENS Circuit. Read the following:

The following is a communication from the Perry Nuclear Power Plant. Communication on the ENS Circuit is being recorded.

E. Transmit data on page 1. When completed, record the name of contact below; request a call back if the ENS was NOT used.

TIME NRC CONTACTED:

If the 5-Way Ringdown or ENS Circuit was NOT used, a verification call back is required.

TIME OF CALLBACK ORGANIZATION PERSON CONTACTED JOB TITLE (If Applicable)

Ashtabula County N/A Geauga County N/A Lake County N/A State of Ohio N/A Nuclear Regulatory N/A Commission COMMON OFFSITE ACRONYMS:

SD Sheriffs Department EOC Emergency Operations Center HP Highway Patrol EMA Emergency Management Agency OSHP Ohio State Highway Patrol OEMA Ohio Emergency Management Agency Communicator(s) Name: (1) (2)

[TSC & EOF ONLY] Forward a copy of completed form to the Information Liaison and Regulatory Affairs Coordinator.

Appendix C Page 71 of 71 Form ES-C-1 JPM CUE SHEET

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