ML030730395

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Initial Exam - 07/2002 - Public Forms
ML030730395
Person / Time
Site: Callaway Ameren icon.png
Issue date: 08/23/2002
From: Gody A
Operations Branch IV
To: Randolph G
Union Electric Co
References
50-483/02-301, ES-201-1, ES-501-1 50-483/02-301
Download: ML030730395 (19)
v • d • e


Text

Operations Branch Assignment Check Sheet:

(Includes ES-201-1 & ES-501-1 Rev. 8, Supplement 1 information)

Chief: G. Johnston Facility/Task: CW IN EX Task Start Date: 7/29/2002 as of: 10/15/2001 ITEM DESCRIPTION DUE DATE INIT DATE 0

Exam/Inspection Schedule Agreement (C.l.a;C.2.a&b)

Jan 30, 2002 ATG 10/15/2001 1

NRC Staff & Fac. Contact Assigned (C.l.c;C.2.e)

Jan 30, 2002 ATG 10/15/2001 2

Facility contact briefed on security & other issues (C.2.c)

Jan 30, 2002 A

Y, ý00(

3 jCorp. Notification Letter Sent (C.2.d) (Exams only)

Jan 30, 2002 7!i/;,51A'A6ff 3a Inspection Announcement Letter Sent (PIR & LORT if req'd)

Jun 14, 2002 4

Task Expectations, Issues, & Standards Discussed w/ BC Apr 30, 2002 5# [Reference Material Due (C.1,.d;C.3.c)]

Mar 31, 2002 6# Integrated Exam Outlines Due (C.l.d&e;C.3.d)

Mar 31, 2002 7# Outlines reviewed by NRC & Feedback Sent (c.2.h;C.3.e)

Apr 14, 2002 8# Preliminary Applications Due (C.1.j;C.2.g;ES202)

Jun 29, 2002 9# Draft Exams w/ Doc./Ref. Due (C.1.d/e/f;C.3.d)

May 30, 2002 10" Peer Reviewer Initials As Reviewed All Parts*

Jun 9, 2002 11* NRC Supervisor. Initials Approving for Fac. Rev'. (C.2.;.3.f Jun 9, 2002 12' Exams Reviewed w/ Fac. (C.l.h;C.2.f&h;C.3.g)

Jun 9, 2002 7,1 13# Final Appl. Due & Assign. Sheet Prepared (C.1.j;C.2.h;ES202)

Jul15, 2002 14# NRC Supervisor Approved Final Exams (C.2.i;C.3.h)*

Jul 22, 2002

£ 15* Final Appl. Rec'd & Waivers Sent (C.2.g)

Jul 22, 2002 A

16# Proctor Rules Reviewed w/ Fac. & Written Authorized (C.3.k)

Jul22, 2002 7/j 17 Exam/Insp Material to Team (C.3.i)

Jul 22, 2002 18# Fac. graded exam & Comments Rec'd Aug 10, 2002 19# NRC Written Grading Completed Aug 13, 2002 20# Examiners Finished Grading Op. Tests Aug 13, 2002 21# NRC Ch. Ex. Review Completed Aug 23, 2002

'!f 22 NRC BC Review Completed*

Aug 24, 2002 A

23# RPS/IP # Examinees Updated Before Report Issued Aug 29, 2002

/*/

  • 6 24 License/Denials Signed & Report Issued Aug 29, 2002 3,'*2/*

25 Package Closed Out Sep 19, 2002

/ /)

Final Inspection Report Issued, Exam Package to OLA, Facility. Contact Notified o0 sults

  1. Not required for inspections, except as noted.
  • Note Supervisor/Peer initials required.

[1 Required NRC-auth. exams only.

When complete, for exams, add to pkg & fwd copy to BC, for insp, fwd orig'l to BC.

Last revised 10/15/01 S:\\DRS\\OB\\EXAMS\\CW\\July 2002 Exam\\exam assignment sheet.wpd

ES-201 Examination Outline Form ES-201-2 Quality Checklist Facility:

Callaway Date of Examination:

August 2002 Initials Item Task Description a

b*

c#

a. Verify that the outline(s) fit(s) the appropriate model per ES-401.

w

b. Assess whether the outline was systematically and randomly prepared in accordance with Section R

D.1 of ES-401 and whether all K/A categories are appropriately sampled.

1 T

c. Assess whether the outline over-emphasizes any systems, evolutions, or generic topics.

1 T

E

d. Assess whether the justifications for deselected or rejected K/A statements are appropriate.

4 N

a. Using Form ES-301-5, verify that the proposed scenario sets cover the required number of normal evolutions, instrument and component failures, and major transients.

S

b. Assess whether there are enough scenario sets (and spares) to test the projected number and mix of I

applicants in accordance with the expected crew composition and rotation schedule without M

compromising exam integrity; ensure each applicant can be tested using at least one new or significantly modified scenario, that no scenarios are duplicated from the applicants' audit test(s)*,

and scenarios will not be repeated over successive days.

c. To the extent possible, assess whether the outline(s) conform(s) with the qualitative and quantitative <

criteria specified on Form ES-301-4 and described in Appendix D.

a. Verify that:

D I

(1) the outline(s) contain(s) the required number of control room and in-plant tasks, (2) no more than 30% of the test material is repeated from the last NRC examination, (3)* no tasks are duplicated from the applicants' audit test(s), and T

(4) no more than 80% of any operating test is taken directly from the licensee's exam banks.

b. Verify that:

(1) the tasks are distributed among the safety function groupings as specified in ES-301, (2) one task is conducted in a low-power or shutdown condition, (3) 40% of the tasks require the applicant to implement an alternate path procedure, o

(4) one in-plant task tests the applicant's response to an emergency or abnormal condition, and (5) the in-plant walk-through requires the applicant to enter the RCA.

c. Verify that the required administrative topics are covered, with emphasis on performance-based

~Af activities.

d. Determine if there are enough different outlines to test the projected number and mix of applicants and ensure that no items are duplicated on successive days.

a. Assess whether plant-specific priorities (including PRA and IPE insights) are covered in the

-A appropriate exam section.

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b. Assess whether the 10 CFR 55.41/43 and 55.45 sampling is appropriate.

4" E

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c. Ensure that K/A importance ratings (except for plant-specific priorities) are at least 2.5.

/

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d. Check for duplication and overlap among exam sections.

A L

e. Check the entire exam for balance of coverage.
f. Assess whether the exam fits the appropriate job level (RO or SRO).

Printed Name /Signat Date

a. Author S,

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  • '6/?'6*2
b. Facility Reviewer(*)

"ct.,.A. Q, Lc*.tV:&

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c. NRC Chief Examiner (#)

/

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d. NRC Supervisor

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(*) Not applicable for NRC-developed examinations.

(#) Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

NUREG-1021 0

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AX TRevision 8, Supplement 1

ES-401 Written Examination Form ES-401-7 Quality Checklist Facility:

Callaway Date of Exam:

August 2002 Exam Level:

RO/SRO Initial Item Description a

b*

c#

1.

Questions and answers technically accurate and applicable to facility

2.
a. NRC K/As referenced for all questions
b. Facility learning objectives referenced as available
3.

RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate Q

per Section D.2.d of ES-401

4.

Question selection and duplication from the last two NRC licensing exams

,,=....

appears consistent with a systematic sampling process*,'-

5.

Question duplication from the license screening/audit exam was controlled as indicated below (check the item that applies) and appears appropriate:

__the audit exam was systematically and randomly developed; or

__ the audit exam was completed before the license exam was started; or X the examinations were developed independently; or

__ the licensee certifies that there is no duplication; or other (explain)

6.

Bank use meets limits (no more than 75 Bank Modified New percent from the bank, at least 10 percent new, and the rest modified); enter the actual RO/SRO RO/SRO RO/SRO question distribution at right 57 / 46 0 / 0 43 / 54

7.

Between 50 and 60 percent of the questions on Memory C/A the exam (including 10 new questions) are written at the comprehension/analysis level; RO/SRO RO/SRO enter the actual question distribution at right 40 / 42 60 / 58

8.

References/handouts provided do not give away answers

9.

Question content conforms with specific K/A statements in the previously approved examination outline and is appropriate for the Tier to which they are o,

ýo assigned; deviations are justified I

10.

Question psychometric quality and format meet ES, Appendix B, guidelines 0

11.

The exam contains 100, one-point, multiple choice items; the total is correct and agrees with value on cover sheet Printed Name / Signature Date

a. Author Stan M. Putthoff/

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b. Facility Reviewer(*)

David G. Lantz/

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c. NRC Chief Examiner(#)

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d. NRC Regional Supervisor AMo 'k* -.

r-,n*

/

w Note:

  • The facility reviewer's initials/signature are not applicable for NRC-developed examinations.
  1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrenc2e reuired.

Revision 8, Supplement 1 NUREG-1021

ES-301 Operating Test Quality Checklist Form ES-301-3 Facility:

Callaway Date of Examination:

August 2002 Operating Test Number:

Initials

1. GENERAL CRITERIA a

I c#

a.

The operating test conforms with the previously approved outline; changes are consistent with sampling requirements (e.g., 10 CFR 55.45, operational importance, safety function distribution).

b.

There is no day-to-day repetition between this and other operating tests to be administered during this examination.

c.

The operating test shall not duplicate items from the applicants' audit test(s) (see Section 0.1.a).

d.

Overlap with the written examination and between operating test categories is within acceptable limits.6 6

e.

It appears that the operating test will differentiate between competent and less than-competent applicants at the designated license level.

2. WALK-THROUGH (CATEGORY A & B) CRITERIA
a.

Each JPM includes the following, as applicable:

"* initial conditions

"* initiating cues

"* references and tools, including associated procedures

"* reasonable and validated time limits (average time allowed for completion) and specific designation if deemed to be time critical by the facility licensee

" specific performance criteria that include:

detailed expected actions with exact criteria and nomenclature system response and other examiner cues statements describing important observations to be made by the applicant criteria for successful completion of the task identification of critical steps and their associated performance standards restrictions on the sequence of steps, if applicable

b.

The prescripted questions in Category A are predominately open reference and

)

meet the criteria in Attachment 1 of ES-301.

c.

Repetition from operating tests used during the previous licensing examination is within acceptable limits (30% for the walk-through) and do not compromise test integrity.

d.

At least 20 percent of the JPMs on each test are new or significantly modified.

3. SIMULATOR (CATEGORY C) CRITERIA
a.

The associated simulator operating tests (scenario sets) have been reviewed in accordance with Form ES-301-4 and a copy is attached.

Printed Name / Signature Date

a. Author Stan M. Putthoff/Ulf 5
b. Facility Reviewer(*)

David G. Lantz f/lz

c. NRC Chief Examiner(#)

,k2 A

d. NRC Regional Supervisor

,K.*rVNM

-' C-6opI /

10a Note:

  • The facility signature is not applicable for NRC-developed tests.
  1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

N E 1021

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NUREG-1 022 Reiso 8, uppemet Revision 8, Supplement 1

Callaway Rev. 0, Feb. 27, 2002 ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Facility:

Callaway Date of Exam:

August 2002 Scenario Numbers:

1/2/BU Operating Test No:

QUALITATIVE ATTRIBUTES Initials a

b*

c#

1.

The initial conditions are realistic, in that some equipment and/or instrumentation may be out of service, but it does not cue the operators into expected events.

2.

The scenarios consist mostly of related events.

3.

Each event description consists of

"* the point in the scenario when it is to be initiated

"* the malfunction(s) that are entered to initiate the event

"* the symptoms/cues that will be visible to the crew

" the expected operator actions (by shift position)

"* the event termination point (if applicable)

4.

No more than on non-mechanistic failure (e.g., pipe break) is incorporated into the bi scenario without a credible preceding incident such as seismic event.

5.

The events are valid with regard to physics and thermodynamics.

6.

Sequencing and timing of events is reasonable, and allows the examination team to obtain complete evaluation results commensurate with the scenario objectives.

7.

If time compression techniques are used, the scenario summary clearly so indicates.

Operators have sufficient time to carry out expected activities without undue time constraints. Cues are given.

8.

The simulator modeling is not altered.

9.

The scenarios have been validated. Any open simulator performance deficiencies have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

10.

Every operator will be evaluated using at least one new or significantly modified scenario. All other scenarios have been altered in accordance with Section D.4 of ES 301.

11.

All individual operator competencies can be evaluated, as verified using Form ES-301-6 (submit the form along with the simulator scenarios).

12.

Each applicant will be significantly involved in the minimum number of transients and I W events specified on Form ES-301-5 (submit the form with the simulator scenarios).__

13.

The level of difficulty is appropriate to support licensing decisions for each crew position.

rARGET QUANTITATIVE ATTRIBUTES (PER SCENARIO; SEE SECTION D.4.D)

Actual Attributes ["

I.

1.

Total malfunctions (5-8) 7/6/8

2.

Malfunctions after EOP entry (1-2) 3/2/3

3.

Abnormal events (2-4) 3/3/4

4.

Major transients (1-2) 2/2/1

5.

EOPs entered/requiring substantive actions (1-2) 2/3/1

/

P1

6.

EOP contingencies requiring actions (0-2) 1/1/1

7.

Critical tasks (2-3) 2/2/2 Revision 8, Supplement 1 NUREG-1021

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist F_,acili;t C

Date of Exam:

V)/OZ-Exam Level: RO/SRO Initials Item Description a

b c

1.

Clean answer sheets copied before grading K

I

2.

Answer key changes and question deletions justified and documented

0. A-,.
3.

Applicants' scores checked for addition errors (reviewers spot check > 25% of examinations)

4.

Grading for all borderline cases (80% +/- 2%) reviewed in detail 14c.

Veve,-',,, Cc',,,__

_,_e_".

5.

All other failing examinations checked to ensure that grades are justified

6.

Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of questions missed by half or more of the applicants Printed Name/ Sig ture Date

a. Grader
b. Facility Reviewer(*)
c. NRC Chief Examiner (*)
d. NRC Supervisor(*)

/

3'/f

(*)

The facility reviewer's signature is not applicable for examinations graded by the NRC: two indeDendent NRC reviews are reouired.

4 ~~Lst~~

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f 5 of 5 NUREG-1021, Revision 8, Supplement 1 I

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ES-301 Competencies Checklist Form ES-301-6 Applicant Ul Applicant Applicant SRO-U RO/SRO-I/SRO-U RO/SRO-I/SRO-U Competencies SCENARIO SCENARIO SCENARIO 1

2 3

4 1

2 3

4 1

2 3

4 Understand and Interpret B, C N/A Annunciators and Alarms D, F H

Diagnose Events B, C N/A and Conditions D, F H

Understand Plant B, C N/A and System Response D, E Comply With and B, C N/A Use Procedures (1)

D, E G,H Operate Control N/A N/A Boards (2)

Communicate and A, B N/A Interact With the Crew C, D E, H Demonstrate Supervisory B, C N/A Ability (3)

D, E H

Comply With and B

N/A Use Tech. Specs. (3)

Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

7 (IC 

Author:

NRC Reviewer:

?7// /e, I-7

/

/

NUREG 1021

,Z Jý Revision 8

ES-301 Competencies Checklist Form ES-301-6 Applicants R1, R3, Applicants R2, R4, Applicants 11/12 R5, & R6

& R7 RO RO SRO-I Competencies SCENARIO SCENARIO SCENARIO 1

2 3

4 1

2 3

4 1

2 3

4 Understand and Interpret C, D C, D B, D B, D B, C B, D Annunciators and Alarms F, H F, H F

F D, F F

H Diagnose Events C, D C, D B, D B, D B, C B, D and Conditions F, H F, G F, G F

D, F F

H H

Understand Plant A, C C, F B, D A, B B, C A, B and System Response D, E G, H E, G F

D, E F

Comply With and A, C C, E B, D A, B B, C A, B Use Procedures (1)

D,E F,G E,G E,F D,E E,F G,H Operate Control A, C C, E B, D A, B N/A A, B Boards (2)

D,E F,G E,G E,F E,F Communicate and A, C C, D B, D A, B A, B A, B Interact With the Crew D, E E, F E, G D, E C, D D, E H

G,H F

E,H F

Demonstrate Supervisory N/A N/A N/A N/A B, C N/A Ability (3)

D, E H

Comply With and N/A N/A N/A N/A B

N/A Use Tech. Specs. (3)

Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

Author:

7 4a NRC Reviewer:

7 Revision 8, Supplement 1 NUREG 1021

Callaway Rev. 1, Jun. 26, 2002 ES-301 Transient and Event Checklist Form ES-301-5 REACTOR OPERATOR:

R1, R3, R5, R6 Scenario Position RO BOP DS1 X

DS2 X

Applicant Evolution Minimum Scenario Number Type Type Number 2

Total Reactivity 1

1 0

1 Normal 1

1 0

1 RO Instrument/

4 3

3 6

Component Major 1

2 2

4 Author:

NRC Reviewer:

Revision 8, Supplement 1 NUREG-1021

Callaway Rev. 0, Feb. 27, 2002 ES-301 Transient and Event Checklist Form ES-301-5 UPGRADE SENIOR REACTOR OPERATOR:

L)(

Scenario Position SRO RO DS1 x

DS2 N/A Applicant Evolution Minimum Scenario Number Type Type Number 1

2 Total Reactivity 0

0 N/A 0

Normal 1

1 N/A 1

SRO-U Instrument/

2 5

N/A 5

Components Major 1

2 N/A 2

Author:

NRC Reviewer:

Revision 8, Supplement 1 211; /-.- --5 -%

/1, ýJ- ý 74 e NUREG-1 021

Callaway Rev. 1, Jun. 26, 2002 ES-301 Transient and Event Checklist Form ES-301-5 REACTOR OPERATOR:

R2, R4, R7 ario Position RO BOP DS1 x

DS2 X

Applicant Evolution Minimum Scenario Number Type Type Number 2

Total Reactivity 1

0 1

1 Normal 1

0 1

1 RO Instrument/

4 4

3 7

Component Major 1

2 2

4 Author:

NRC Reviewer:

L Ckv ý Revision 8, Supplement 1

-7/1 41' S I-7Aý2Z NUREG-1021

Callaway Rev. 1, Jun. 26, 2002 ES-301 Transient and Event Checklist Form ES-301-5 INSTANT SENIOR REACTOR OPERATOR:

11, 12 Scenario Position SRO RO DS1 x

DS2 X

Applicant Evolution Minimum Scenario Number Type Type Number 2

Total Reactivity 1

N/A 1

1 Normal 0

N/A 1

1 As RO Instrument/

2 N/A 3

3 Component Major 1

N/A 2

2 SRO-I Reactivity 0

0 N/A 0

Normal 1

1 N/A 1

As SRO Instrument/

2 5

N/A 5

Component Major 1

2 N/A 2

Author:

NRC Reviewer:

7?/

("b/z (7'/

0; 7I Revision 8, Supplement 1 NUREG-1021

Callaway Rev. 1, Jun. 26, 2002 ES-301 Transient and Event Checklist Form ES-301-5 UPGRADE SENIOR REACTOR OPERATOR:

Ul Scenario Position S SRO RO DS1 X

DS2 N/A Applicant Evolution Minimum Scenario Number Type Type Number 1

2 Total Reactivity 0

0 N/A 0

Normal 1

1 N/A 1

SRO-U Instrument/

2 5

N/A 5

Components Major 1

2 N/A 2

Author:

NRC Reviewer:

if, Revision 8, Supplement 1 Llýý J,

-7 / (01' -L-NUREG-1021

Operator Licensing Exam Schedule From 01/01/2002 To 09/30/2003

[ Exam Week 1j Site/Docket No./Insp Rot #

  • 1
  1. Candidates 1 Type i Exam Author F

Chief Examiner IIJ Examiners A~ianed 12/30/2001 Callaway / 05000483 / 2001007 Procedure #: 7111111Q 01/28/2002 Callaway / 05000483 / 2002301 TAC #: X02225 04/07/2002 Callaway / 05000483 / 2002002 Procedure #: 7111111Q 07/07/2002 Callaway / 05000483 / 2002005 Procedure #: 7111111Q 07/08/2002 Callaway / 05000483 / 2002301 TAC #: X02225 07/29/2002 Callaway / 05000483 / 2002301 TAC #: X02225 10/06/2002 Callaway / 05000483 / 2002006 Procedure #: 7111111Q 12/29/2002 Callaway / 05000483 / 2003003 Procedure #: 7111111Q 03/23/2003 Callaway / 05000483 / 2003004 Procedure #: 7111111Q 06/22/2003 Callaway / 05000483 / 2003005 Procedure #: 7111111Q 09/08/2003 Callaway / 05000483 / 2003005 Procedure #: 71111116 09/21/2003 Callaway / 05000483 / 2003006 Procedure #: 7111111Q Prep Prep RO - 8 SROU - 2 SROI - 2 Admin FFF GADDY, VINCENT G.

JOHNSTON, GARY W.

GADDY, VINCENT G.

PECK, MICHAEL S.

JOHNSTON, GARY W.

JOHNSTON, GARY W.

PECK, MICHAEL S.

PECK, MICHAEL S.

PECK, MICHAEL S.

PECK, MICHAEL S.

JOHNSTON, GARY W.

PECK, MICHAEL S.

GADDY, VINCENT G.

HANNA, JOHN D.

JOHNSTON, GARY W.

GADDY, VINCENT G.

HANNA, JOHN D.

GADDY, VINCENT G.

HANNA, JOHN D.

JOHNSTON, GARY W.

MURPHY, MICHAEL E.

GAGE, PAUL C.

JOHNSTON, GARY W.

LANTZ, RYAN E.

MURPHY, MICHAEL E.

HANNA, JOHN D.

PECK, MICHAEL S.

HANNA, JOHN D.

PECK, MICHAEL S.

HANNA, JOHN D.

PECK, MICHAEL S.

HANNA, JOHN D.

PECK, MICHAEL S.

HAIRE, MARK S.

JOHNSTON, GARY W.

HANNA, JOHN D.

PECK, MICHAEL S.

Sites: CALL Orgs: ALL Exam Author:ALL Page 1 of 4 02/21/2003 Report 21 Region: 4 09:25:24 Phase Code: 5 Operational I

11

  1. Candidates 11 Examiners Assinned

Page 2 of 4 02/21/2003 09:25::

Report 21 Region: 4 Summary By Date 12/2001 CALL - Callaway 12/2001 01/2002 CALL - Callaway RO - 0 01/2002 RO - 0 04/2002 CALL - Callaway 04/2002 07/2002 CALL - Callaway RO - 8 07/2002 RO - 8 10/2002 CALL - Callaway 10/2002 12/2002 CALL - Callaway 12/2002 03/2003 CALL - Callaway 03/2003 06/2003 CALL - Callaway 06/2003 09/2003 CALL - Callaway Operator Licensing Exam Schedule From 01/01/2002 To 09/30/2003 Phase Code: 5 Operational SROI - 0 SROI - 0 SROI - 2 SROI - 2 SROU - 0 SROU - 0 SROU - 2 SROU - 2 LSRO - 0 LSRO - 0 LSRO - 0 LSRO - 0 Total for Callaway: 0 Total for 01/2002: 0 Total for Callaway: 12 Total for 07/2002: 12 Sites: CALL Orgs: ALL Exam Author:ALL

Operator Licensing Exam Schedule From 01/01/2002 To 09/30/2003 Page 3 of 4 02/2112003 Report 21 Region: 4 Summary By S-i te CALL - Callaway RO - 8 SROI - 2 SROU -2 LSRO - 0 Total for Callaway: 12 Sites: CALL Orgs: ALL Exam Author:ALL Phase Code: 5 Operational 09:25:24

09:25:24 Operator Licensing Exam Schedule From 01/01/2002 To 09/30/2003 Region: 4 Phase Code: 5 Operational Summary By RegionJ SROI - 2 SROU - 2 LSRO -0 Total for Region 4:12 Sites: CALL Orgs:ALL Exam Author:ALL Page 4 of 4 02/21/2003 Report 21 Region 4 RO -8

ES-201 Examination Security Agreement Form ES-201-3

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who havb not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC.Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of'7zF-W5 From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE / RESPONSIBILITY

2. beAnL I<

3.-Aeres& M. We neriAl 6hl~erk V7r OffiWW*

5.
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NOTES:

SIGATRE 1)

DATE SIGNATURE (2) DATENOTE 1-4.

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IOZZ AA A-L NUREG-1021, Revision 8, Supplement 1 24 of 24

ES-201 Examination Security Agreement Form ES-201-3

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) ofA/ -,)

sas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC.Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination To the best of my know edg, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 5'l'-S 5t.VFrom the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

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JOB TITLE / RESPONSIBILITY U ko SIGNATURE (1)

DATE SIGNATURE (2) DATENOTE 714612 "7-4 Z2 10.

11.

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115_

NUREG-1021, Revision 8, Supplement 1 NOTES:

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