ML033140020

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Final Qa/Related Forms
ML033140020
Person / Time
Site: Millstone Dominion icon.png
Issue date: 09/25/2003
From:
NRC/RGN-I/DRS/OSB
To: Conte R
NRC/RGN-I/DRS/OSB
Conte R
References
50-336/03-302
Download: ML033140020 (11)
v • d • e


Text

ES-201 Examination Preparation Checklist Form ES-201-1 Task Description I Reference I.

Examination administration date confirmed (C. I

.a; C.2.a & b)

Facility: -

Examinatic Chief Examiner's Initials Target Date*

-120

[-go]

-1 80

4. Corporate notification letter sent (C.2.d)

[5. Reference material due (C.l.e; C.3.c)l P

fl

-120

~

-70

-45

-30

-1 20

7. Examination outline(s) reviewed by NRC and feedback provided to facility licensee (C.2.h; C.3.e)
8. Proposed examinations, supporting documentation, and reference materials due (C.l.e, f, g & h; C.3.d)
9. Preliminary license applications due (C.l.I; C.2.g; ES-202)

~~~~

-14

-1 4

-14

~

I O. Final license applications due and assignment sheet prepared (C.1.l; C.2.9; ES-202) fl

11. Examination approved by NRC supervisor for facility licensee review (C.2.h; C.3.9
12. Examinations reviewed with facility licensee (C.1.j; C.2.f & h; C.3.g) w 11

-75 I 6. Integrated examination outline(s) due (C.l.e & f; C.3.d)

I I

~~

~

13. Written examinations and operating tests approved by NRC supervisor (C.2.i; C.3.h)

-7 :

-7

-7

-7

14. Final applications reviewed; assignment sheet updated; waiver letters sent (C.2.9, ES-204)
15. Proctoringhritten exam administration guidelines reviewed with facility licensee and authorization granted to give written exams (if applicable) (C.3.k)
16. Approved scenarios, job performance measures, and questions distributed to NRC examiners (C.3.i)

I 4

/

Target dates are keyed to the examination date identified in the corporate notification letter. They are for planning purposes and may be adjusted on a case-by-case basis in coordination with the facility licensee.

Applies only to examinations prepared by the NRC.

[ J I

' 3

ES-201 Examination Outline Quality Checklist Form ES-201-2 (including PRA and IPE insights) are covered in the Note-Not applicable for NRC-developed examinations.

  1. Independent NRC reviewer initial items in Column "c," chief examiner concurrence required.

NUREG-1021, Draft Revision 9 24 of 25

i Form ES-201-3

(

ES-201 Examination Security Agreement

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 7h~?/s3 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who h a d notbeen 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 licensees 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

, 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 NOTES:

NIJREG-1021, Revision 8 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) of ?/ ZZ,/o3 as 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 licensees 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

. 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 SIGNATURE (1)

DATE SlGNATURE(2)

DATE NOTE NOTES:

NUREG-1 021, Revision 8 24 of 24

4

a.

I,

/

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

1.

Pre-Examinatiou I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of ?/k$b as 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 knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of

. 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.

NOTES:

I NUREG-1 021, Revision 8 24 of 24

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

lIq>&W 2 Date of Examination: $/lz - $/26/030peratin6 I

'est Number: i Initials

1. GENERAL CRITERIA 0 initiating cues 0 references and tools, including associated 0 reasonable and validated time limits (av designation if deemed to be time critic Date NOTE:

The facility signature is ndt applicable for NRC-developed tests.

  1. Independent NRC reviewer initial items in Column %;" chief examiner concurrence required.

~ l r q q &w. deuC\\lJp$ t c \\ d y &

  • 5 /

NUREG-1021, Draft Revision 9 24 of 27

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Date of Exam: 9/22 - 9/zd33Scenario Numbers:

I I, $ Operating Test No.: I QUALITATIVE A'ITRIBUTES Initials a

b' c#

have sufficient time to carry out expected ac 25 of 27 NUREG-I 021, Draft Revision 9

ES-301 Transient and Event Checklist Form ES-301-5 Applicant TY Pe OPERATING TEST NO.: 1 Evolution Type Minimum Number 0

I

  • Normal Scenario Number 1

2 3

4 RO BOP RO BOP RO BOP RO BOP 3

5 4

4 1

1 2

SR0-U Instrument/

Com onent P Maior 2*

1 4,8 2

2,3 8

3,8 1,6 9

5.7 6

6 7

5 7

Instructions: (I)

(2)

(3)

Enter the operating test number and Form ES-301-D-1 event numbers for each evolution type.

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.5.d) but must be significant per Section C.2.a of Appendix D. *Reactivity and normal evolutions may be replaced with additional instrument or component malfunctions on a one-for-one basis.

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicants competence count toward the minimum requirement.

I Author:

NRC Reviewer:

NUREG-1021, Draft Revision 9 26 of 27

ES-301 Competencies Checklist Form ES-301-6 NIA NIA NIA NIA NIA NIA Scenario 2

3 4

NIA NIA N/A NIA NIA NIA NIA NIA NIA NIA NIA NIA NIA NIA NIA 2

3 NIA NIA NIA RO BOP Competencies

=-I-Sce 2

2, 5, 6, 7 1

1 1

4

~~

~

InterpretIDiagnose Events and Conditions 3, 5, 7

N/A NIA -

NIA -

NIA -

NIA NIA -

NIA -

NIA -

NIA Comply With and Use Procedures (1) 5, 6, 7

7; I NIA NIA 3, 5

--t-Operate Control Boards (2)

NIA NIA f 7 3,

NIA NIA NIA NIA Communicate and Interact NIA NIA -

NIA NIA -

NIA NIA NIA Demonstrate Supervisory Ability (3)

Comply With and Use Tech. Specs. (3)

Notes:

NIA NIA NIA NIA I I NIA NIA NIA (1 ) Includes Technical Specification compliance for an RO (2) Optional for an SRO-U

13) Only applicable to SROs Instructions:

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

Author:

NRC Reviewer:

27 of 27 NUREG-I 021, Draft Revision 9

ES-401 Written Examination Form ES-401-76 v

Quality Checklist Date of Exam: 4//8/G3 Exam Level: RQE%?D I-Initial b' -

w w-k Date

d. NRC Regional Supervisor Note:

The facility reviewer's initialslsignature are not applicable for NRC-developed examinations.

  1. Independent NRC reviewer initial items in Column "c;" chief examiner concurrence required.

NUREG-1021, Draft Revision 9 30 of 34

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Facility:

Date of Exam:

Exam Level: R@SRO; NUREG-1021, Draft Revision 9

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