ML041320259

From kanterella
Jump to navigation Jump to search
Init Exam - 02/2004 - Public Forms
ML041320259
Person / Time
Site: Grand Gulf Entergy icon.png
Issue date: 09/16/2003
From:
NRC Region 4
To:
References
50-416/04-301
Download: ML041320259 (22)
v • d • e


Text

APPENDIX I Operations Branch Assignment Check Sheet:

(Includes ES-201-1 & ES-501-1 Rev. 8 intormation)

P:\\GGPOI 8501 examchshestwpd as of:

01/09/04 Chief: McKernon Facility/Task: GG Exam Task Start Date: 02/06/2004 ITEM DESCRIPTION I DUEDATE I INlT I DATE 0

(Exarn/lnspection Schedule Agreement I

I I

I 1

NRC Staff & Fac. Contact Assigned Aug 10, 2003 1 ATG I 12/9/2003

  • Note Supervisor or Independent Reviewer initials required in for lines 10, 11, 14, & 22.

[I Required NRC-auth. exams only for line 5.

ES-201 Exam i nation Out I i ne Form ES-201-2 Quality Checklist Facilifi Item

1.

W R

I T

T E

N

2.

S I

M

3.

W I

T

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

Iv <&

& 6&

Wia

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

quired number of

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, (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 activities.
f. Assess whether the exam fits the appropriate job level (RO or SRO).

Printed Name / Eianatuh Date

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

NUREG 1021 REVISION 8 SUPPLEMENT 1

ES-401 Written Examination Form ES-401-7 Quality Checklist Facility: GRAND GULF NUCLEAR STATION Date of Exam: February 6,2004 Exam Level: RO SR A

Item Description

1.
2.

Questions and answers technically accurate and applicable to facility

a. NRC WAS referenced for all questions
b. Facility learning objectives referenced as available RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate per Section D.2.d of ES-401
3.
4.
5.

Question selection and duplication from the last two NRC licensing exams appears consistent with a systematic sampling process.

Question du lication from the license screening/audit exam was controlled as indicated bekw check the item that applies) and a pears appropriate.

-the audit exam was completed before the license exam was started; or the examinations were developed independently: or x t h e Iicensee,certifies that there is no duplication; or other (explain) the audit exa In was systematically and random& developed; or

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 question distribution at right the exam (including 10 new questions) are written at the comprehension/analysis level; enter the actual question distribution at right Referencedhandouts provided do not give away answers Question content conforms with specific WA statements in the previously approved examination outline and is appropriate for the Tier to which they are assigned; deviations are justified Question psychometric quality and format meet ES, Appendix B, guidelines The exam contains 100, one-point, multiple choice items: the total is correct and agrees with value on cover sheet 12 88

7.

Between 50 and 60 percent of the questions on Memory C/A 46 54

8.
9.

I O.

11.

Printed Name 1 aignajure Initial I

A I b*

+

I I

Date

a. Author
b. Facility Review
c. NRC Chief Examin W

Note:

  • The facility reviewers signature is not applicable for NRC-developed examinations.
  1. Independent NRC Reviewer initial items in Column c: chief examiner concurrence required.

NUREG 1021 REVISION 8 SUPPLEMENT 1

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

+ initial conditions

+ initiating cues

+ references and tools, including associated procedures

+ reasonable and validated time limits (average time allowed for completion) and specific

+ specific performance criteria that include:

designation if deemed to be time critical by the facility licensee

- 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

-r-

b.

The prescripted questions in Category A are predominantly open reference and meet the criteria in Attachment 1 of ES-301.

Stfj fi C.

Repetition from operating tests used during the previous licensing examination is within IC/

acceptable limits (30% for the walk-through) and do not compromise test integrity.

lv

a.

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

Date

b. Facility Reviewer(*) &#-

Y

c. NRC Chief Examiner (#)
d. NRC Supervisor D Y /

NOTE:

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

Revision 1 121312003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Facility: GRAND GULF NUCLEAR STATION Date of Exam: 02/09/2004 - 02/13/2004 ScenarioNumbers: 1 / 2 I 3 QUALITATIVE ATTRIBUTES Initials I

I

2.

The scenarios consist mostly of related events.

lIrc 1HC

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.

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)

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

The events are valid with regard to physics and thermodynamics.

rsL-

/d

4.
5.
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 given.

6 /hJ have sufficient time to carry out expected activities without undue time constraints. Cues are

, w-

8.

The simulator modeling is not altered.

I&pqw$

A

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).

M@

12.

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

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

>kw

1.

Total malfunctions (5-8) 6 1

7 1

7

)Iv Actual Attributes

2.

Malfunctions after EOP entry (1-2) 2 1

2 1

3 P

3 1 2 1

2 u/

r /

3.

Abnormal events (2-4)

4.

Major transients (1-2)

I ! I l l

5.

EOPs enteredlrequiring substantive actions (1-2)

&Ira

6.

EOP contingencies requiring substantive actions (0-2) 2 1 0 I

O fl k**

7.

Critical tasks (2-3)

Revision 1 12/3/2003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Simulator Scenario Qualitv Checklist Form ES-301-4

~

~~

Facility: GRAND GULF NUCLEAR STATION Date of Exam: 02/09/2004 - 02/13/2004 Scenario Numbers: 4 BACKUP Initials QUALITATIVE ATTRIBUTES I

I

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.

The scenarios consist mostly of related events.

2.
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 symptomskues that will be visible to the crew the expected operator actions (by shift position) the event termination point (if applicable)

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.

The simulator modeling is not altered.

r/

4

8.

Revision 1 12/3/2003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Transient and Event Checklist Form ES-301-5 Evolution Type GRAND GULF NUCLEAR STATION DATES: 02/09/2004 - 02/13/2004 I

I I

Minimum Scenario Number Number ss BOP ATC 1

2 3

TOTAL Ap licant I

fYPe Reactivity Normal L

1 1

I Instrument/

Component As RO I n

\\

4 Major 1

Reactivity 1

0 l ( 1 )

1 Normal Instrument/

Component 0

0 0

0 2

5R4, 3'3, 5, 8

5)
6) v Reactivity Normal As SRO 0

0 0

1 q(1) 1 Instrument/

Component Major 2

5(2,3, 5

1 l ( 5 )

1 495)

Reactivity Normal NRC Reviewer:

0 1

Revision 1 12/3/2OQ3 NUREG 1021, REVISION 8 SUPPLEMENT 1 1

SRO-U Instrument/

2 Component Major 1

Ap licant fYPe RO As RO Evolution Minimum Scenario Number Number ATC ss BOP 1

2 3

TOTAL Type Reactivity 1

Normal 1

Instrument/

4 Component Major 1

As SRO Reactivity Normal Instrument/

Component 0

0 0

1 l ( 3 )

I 2

5R4, 5
5)

Major 1

q(5)

I Reactivity Normal I

0 1

Instructions:

(1)

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

Reactivity manipulations ma be conducted under normal or controlled abnormal conditions (refer to Section 8.4.d) but must be significant per Section C.2.a of Appendix D.

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide in ight to the applicant's competence count toward minimum equirem (2 1 (3)

t.

~1~dh-4 Kakxd

%+y/ d SRo-U d

Mpcnvl, L&

A/------

2 1, REVISION 8 SUPPLEMENT 1 Instrument/

2 Component Author:

NRC Reviewer:

Revision 1 12/3/2003 Major 1

ES-301 Transient and Event Checklist Form ES-301-5 Major GRAND GULF f 1

Ap licant PVPe Reactivity RO 1

I 0 I I()

I 1

1 UCLEAR STATION DATES: 02/09/2004 - 0211 312004 Normal Instrument/

Component 0

0 1(3) 1 2

3(3,5) 3R4, 6

5)

As RO Major n

( SRO-I)

W 1

$5) q(5) 2 As SRO Reactivity 0

Normal 1

Instrument/

2 Component Major 1

0 0

q(2) 1 53,4, 5

5 6 )

I Reactivity 0

Normal 1

SRO-U Instrument/

2 Component Major 1

Author:

nducted under normal or controlled abnormal ut must be significant per Section C.2.a of NRC Reviewer:

Revision 1 12/3/2003 NWd<

NU&

1021, REVISION 8 SUPPLEMENT 1

Ap licant QyPe RO As RO Evolution Minimum Scenario Number Number ss TOTAL Type 1

Reactivity 1

Normal 1

Instrument/

4 Component Major 1

Reactivity Normal Instrument/

Component Major 1

0 2

1 Reactivity 0

SRO-U As SRO Normal 1

Instrument/

2 Component l

=

l Major I

I Major I

1 I

I ( ~ ) I I

I l l 1

Instructions:

(1 )

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

Reactivity manipulations ma be conducted under normal or controlled abnormal conditions (refer to Section J.4.d) but must be significant per Section C.2.a of Appendix D.

(2 )

(3)

Whenever practical, both included; only those that Reactivity 0

0 0

Normal 1

q(1) 1

~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Author:

NRC Reviewer:

Revision 1 12/3/2003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Transient and Event Checklist Form ES-301-5 GRAND GULF NUCLEAR STATION BACKUP SCENARIO DATES: 02/09/2004 - 02/13/2004 I

I I

I 1

Evolution Type Minimum Scenario Number Number SS ATC BOP 4

4 4

TOTAL I

Reactivity I

I I

I I

Reactivity Normal Normal Instrument/

Component RO

$2) 0 0

l ( 1 )

Major Instrument/

Component As RO SRO-I As SRO 1(2) 3'2,3,

5)

Reactivity Normal Component Instrument/

Major 0

q(1) 3(2,3,

5) 2(5)

Reactivity 0

Normal Component Instrument/

Major SRO-U q(1) 3(2,3,

5) 2(5)

Reactivity Normal Instrument/

Component Major Instructions:

(1)

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

Reactivity manipulations ma be conducted under normal or controlled abnormal Appendix D.

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions t applicant's competence co conditions (refer to Section 8.4.d) but must be significant per Section C.2.a of (2)

(3)

MiLLcd A.

/

Author:

NRC Reviewer:

Revision 1 12/3/2003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Transient and Event Checklist Form ES-301-5 GRAND GULF NUCLEAR STATION DATES: 02/09/2004 - 0211 312004 Major 1

Reactivity 1

Normal 0

As RO Instrument/

2 I Component Major 1

SRO-I As SRO Reactivity 0

0 0

Normal 1

l ( 3 )

1 n

/

\\

I Instrument/

2 5(2,4, 5

Component

5)

Instructions:

(1 Enter the oDeratina test number and Form ES-D-1 event numbers for each I

evolution type.

Reactivity manipulations ma be conducted under normal or controlled abnormal conditions (refer to Section J.4.d) but must be significant per Section C.2.a of (2)

Appendix D.

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provi applicant's competence count toward minimum requiremen (3)

Author:

r 5 r t k d #

  • hfd NRC Reviewer:

1-h&

c Revision 1 12/3/2003 NUREG 1021, REVISION 8 SUPPLEMENT 1

ES-301 Competencies Checklist Form ES-301-6 Grand Gulf Nuclear Station Dates 02/09/2004 - 0211 312004 I

I1 I1 Competencies SCENARIO SC EN ARlO SS BOP ATC ATC SS 1

2 3

1 2

Understand and Interpret

192, 3949
183, 192,
293, Annunciators and Alarms
394, 5

4959

394, 495 5

6 5

Diagnose Events

293, 495
334, 2939
394, and Conditions 495 5

4, 5 5

Understand Plant

192, 394, 1,3, 1,2, 1,2, and System Response
394, 5
495, 394,
394, Comply With and ALL ALL ALL ALL ALL Use Procedures (I)

Operate Control N/A 3,4, I, 4, I, 2 N/A 5

6 5

5 Boards (2)(4) 5 5,6 3,4, 5

Communicate and ALL ALL ALL ALL ALL Interact With the Crew Demonstrate Supervisory ALL N/A NIA NIA ALL Ability(3)

Comply With and N/A N/A 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.

(4) Onlv aDDlicable to RO Dositions at GGNS.

~

1 1

~

1 BOP 3

3,4, 6

3949 6

284, 6

ALL

294, 6

ALL NIA N/A BOP 1

335 395 3, 5 ALL 3,5

~ ALL ATC SS 2

3 2,3,

193, 435 4,5, 6
394, 3,4, 5

5,6

192, 192,
334, 3,4, 5

5,6 ALL ALL 1,2, NIA 3349 5

ALL ALL NIA ALL NIA nstructions:

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:

NRC Reviewer:

Revision 1 12/3/2003 NUREG 102 1, REVISION 8 SUPPLEMENT 1

ES-301 Competencies Checklist Form ES-301-6 BACKUP SCENARIO Competencies Grand Gulf Nuclear Station Dates 02/9/2004 - 0211 312004 Y

SCENARIO SCENARIO ATC I

4 Understand and Interpret Annunciators and Alarms BOP 4

Diagnose Events and Conditions Understand Plant and System Response Comply With and Use Procedures (I) 2,3,4,5 19293,4, 5

ALL ALL Operate Control Boards f21 Communicate and Interact With the Crew Demonstrate Supervisory Ability (3)

Comply With and Use Tech. Specs. (3)

ALL ALL N/A N/A N/A N/A RO/SRO Applic SRO SCENARIO 2, 3949 5 293,495 +-

2,394, 5 ALL I

N/A 1

_L ALL I 3

I 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 ap Author:

NRC Reviewer:

Revision 1 12/3/2003 NUREG 102 1, REVISION 8 SUPPLEMENT I

ES-403 Written Examination Graqling P Form ES-408-1 Quality Checklist Item Description I

w a

b C

Initials

2.

Answer key changes and question deletions justified and documented

3.

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

4.

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

5.
6.

All other failing examinations checked to ensure that grades are justified 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 / Signature Date

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

8-(*)

The facility reviewers signature is not applicable for examinations graded by the NRC; two independent NRC reviews are required.

5 of 5 NUREG-I 021, Revision 8, Supplement 1

Page 2 of 8 04/29/2004 07:39:00 Report 21 Operator Licensing Exam Schedule From 10/01/2003 To 09/30/2004 Region: 4 Phase Code: 5 Operational 02/09/2004 02/09/2004 02/09/2004 02/17/2004 0211 912004 03/01/2004 0310812004 0311 512004 0311 812004 0312212004 04/04/2004 04/04/2004 0410512004 04/05/2004 0411 912004 Sites: ALL Orgs: 4620 Callaway I 05000483 I2004301 TAC #: X02258 Fort Calhoun 105000285 I2004301 TAC #: X02259 Grand Gulf 105000416 12004301 TAC #: X02237 Grand Gulf 105000416 12004301 TAC #: X02237 Wolf Creek 105000482 12004301 TAC #: X02247 Callaway / 05000483 I 2004301 TAC #: X02258 Callaway 105000483 12004301 TAC #: X02258 Fort Calhoun / 05000285 12004301 TAC #: X02259 Cooper 105000298 I 200401 1 Procedure #: 71 1 11 11 B Fort Calhoun 105000285 / 2004301 TAC #: X02259 Comanche Peak / 05000445 12005301 TAC #: X02269 Comanche Peak / 05000446 12005301 TAC #: X02270 Cooper 105000298 / 200401 1 Procedure #: 41 500 Cooper IO5000298 I200401 1 Procedure #: 71 1 11 1 1 B Wolf Creek 105000482 12004301 TAC #: X02247 SROU - 3 R O - 5 SROU - 3 R O - 6 SROU - 2 SROl - 2 SROl - 4 SROl - 2 Prep Prep Admin Doc Prep Admin Doc Admin Doc Prep Prep Prep FFF FFF FFF FFF FFF FFF NNF NNF JOHNSTON, GARY W.

MURPHY, MICHAEL E.

MCKERNON, THOMAS 0.

MCKERNON. THOMAS 0.

STETKA, THOMAS F.

JOHNSTON, GARY W.

JOHNSTON, GARY W.

MURPHY, MICHAEL E.

JOHNSTON, GARY W.

MURPHY, MICHAEL E.

MURPHY, MICHAEL E.

MURPHY, MICHAEL E.

JOHNSTON, GARY W.

JOHNSTON, GARY W.

STETKA, THOMAS F.

CLAYTON, KELLY D.

HAIRE, MARK S.

JOHNSTON, GARY W.

MURPHY, MICHAEL E.

WERNER, G E.

DRAKE, JAMES F.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

DRAKE, JAMES F.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

CLAYTON, KELLY D.

HAIRE, MARK S.

JOHNSTON, GARY W.

STETKA, THOMAS F.

CLAYTON, KELLY D.

HAIRE, MARK S.

JOHNSTON, GARY W.

DRAKE, JAMES F.

MURPHY, MICHAEL E.

STETKA, THOMAS F.

WERNER, G E.

CLAYTON, KELLY D.

HAIRE, MARK S.

JOHNSTON, GARY W.

DRAKE, JAMES F.

MURPHY, MICHAEL E.

STETKA, THOMAS F.

WERNER, G E.

CLAYTON, KELLY D.

CLAYTON, KELLY D.

HAIRE, MARK S.

JOHNSTON, GARY W.

HAIRE, MARK S.

JOHNSTON, GARY W.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

Exam Author:ALL

4 Page 1 of 8 0412912004 07:39:00 Report 21 Region: 4 Phase Code: 5 Operational Operator Licensing Exam Schedule From 10/01/2003 To 09/30/2004 0811 812003 0911 512003 1012712003 1012712003 1 111 712003 1 111 712003 1 111 712003 12/1 512003 1211 512003 12/1 512003 12/22/2003 12/22/2003 01 I01 12004 01 10512004 01 11 2/2004 0111912004 Sites: ALL Orgs: 4620 Arkansas Nuclear One 105000313 12004301 TAC #: X02257 Waterford 105000382 12003007 Procedure #: 71 11 11 1 B San Onofre 105000361 12003005 Procedure #: 71 1 11 11 B San Onofre I 05000362 12003005 Procedure #: 71 1 11 11 B Cooper 105000298 12003007 Procedure #: 71 11 11 1 B San Onofre 105000361 I 2003301 TAC #: X02242 San Onofre 105000362 12003301 TAC #: X02243 Arkansas Nuclear One I 0500031 3 12004301 TAC #: X02257 San Onofre 105000361 12003301 TAC #: X02242 San Onofre 105000362 12003301 TAC #: X02243 San Onofre 105000361 12003301 TAC #: X02242 San Onofre 105000362 I 2003301 TAC #: X02243 R O - 6 SROU - 4 Columbia Generating Station I 05000397 12004301 TAC #: X02266 Grand Gulf 105000416 12004301 TAC #: X02237 TAC #: X02257 SROU Arkansas Nuclear One I 0500031 3 12004301 R O - 5 Arkansas Nuclear One I 05000313 12004301 TAC #: X02257

- 3 Prep Prep Prep Prep Admin SROl - 2 Admin Doc Doc Admin Prep SROl - 1 Admin Doc NNN GAGE, PAUL C.

GAGE, PAUL C.

JOHNSTON, GARY W.

JOHNSTON, GARY W.

JOHNSTON, GARY W.

STETKA, THOMAS F.

STETKA, THOMAS F.

GAGE, PAUL C.

STETKA, THOMAS F.

STETKA, THOMAS F.

STETKA, THOMAS F.

STETKA, THOMAS F.

NNN MCKERNON, THOMAS 0.

MCKERNON, THOMAS 0.

GAGE, PAUL C.

NNN GAGE, PAUL C.

CLAYTON, KELLY D.

GAGE, PAUL C.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

JOHNSTON, GARY W.

STETKA, THOMAS F.

JOHNSTON, GARY W.

STETKA, THOMAS F.

HAIRE, MARK S.

JOHNSTON, GARY W.

DRAKE, JAMES F.

STETKA, THOMAS F.

DRAKE, JAMES F.

STETKA, THOMAS F.

CLAYTON, KELLY D.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

DRAKE, JAMES F.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

DRAKE, JAMES F.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

DRAKE, JAMES F.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

DRAKE, JAMES F.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

GAGE,'PAUL C.

GARCHOW, STEPHEN M.

DRAKE, JAMES F.

MCKERNON, THOMAS 0.

CLAYTON, KELLY D.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

MURPHY, MICHAEL E.

CLAYTON, KELLY D.

GAGE, PAUL C.

MCKERNON, THOMAS 0.

Exam Author:ALL

z Examination gecurity Agreement Form ES-201-3 ES-201

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week@) of ahhQ4 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 knowled e, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week@) 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 I RESPONSIBILITY SIGNATUREX;1) /

DATE SIGNATURE (2) A DA7;ENOJE NOTES:

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@) of zhhmd 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 administratio authorized by the NRC.Furthermore, 1 am aware of the physical security measures and requirements (

procedures) and understand that violation of the conditions of this agreement may result in cancellatio action against me or the facility licensee, I will immediately rep0 examination security may have been compromised.

cept as specifically noted below and cumented in the facility licensee's e examinations andlor an enforcement cility management or the NRC chief examiner any indications or suggestions that

2.

Post-Examination To the best of my knowled e, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week@) of Z / ? y z ~ d. 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 I RESPONSIBILITY SIGNATURE/Cl) /

DATE SIGNATURE (2) DATENOTE NOTES:

NUREG-1021, Revision 8, Supplement 1 24 of 24 0

I

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

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of i??h&d 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 andlor 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 know1 d e, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of Jqya'& 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:

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@) of iZ&!!./

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 docqmented in the facility licensees procedures) and understand that violation of the conditions of this agreement may result in cancellation of theiexaminations 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 know1 d e, I did not divulge to any unauthorized persons any information concerning the NHC licensing examinations administered during the week(s) of Z h ~ ~ c y t !

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:

NUREG-I 021, Revision 8, Supplement 1 24 of 24

") A a i

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

)(

1.

Pre-Exam i nation I acknowledge that 1 have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(@ of $\\&bad 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 huthorized 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 Tkh2d. 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.

NUREG-1021, Revision 8, Supplement I 24 of 24

Retrieved from "https://kanterella.com/w/index.php?title=ML041320259&oldid=5401659"