ML041890194

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Final QA, Exam Preparation Checklist/Related Forms
ML041890194
Person / Time
Site: Oyster Creek
Issue date: 04/19/2004
From: Hackenberg J
AmerGen Energy Co
To: Conte R
NRC/RGN-I/DRS/OSB
Conte R
References
050-219/04-301
Download: ML041890194 (20)
v • d • e


Text

ES-201 Examination Preparation Checklist Form ES-201-1 f l o -3 Facility: 6ys?@ &Cy Date of Exaqination: L/1//6 -tb/b) 7 F&/l,y Examinations Developed by:

I Facility I NRC (circle one) u~&

Target Chief Date* Task Description / Reference Examiners Initials by NRC and feedback

assignment sheet updated; w m administration guidelines reviewed with uthorization granted to give written exams e measures, and questions
  • 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.

25 of 25 NUREG-1021, Draft Revision 9

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

cted number a schedule with0 plement an alternate path or abnormal condition, and

d. NRC Supervisor Note:
  • Not applicable for NRC-developed examinations.
  1. Independent NRC reviewer initial items in Column %; chief examiner concurrence required.

NUREG-1021, Draft Revision 9 24 of 25

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

1. Pre-Examination +h\ LW qsr,&4 &yf ILT NPc W-k-chZ I xknowledge that I have acquired specialii ed knowledge about the NRC licensing examinations scheduled for the week($ of as of the date of my signature. 1 agree that Iwill not knowingly divulge any information about these examinations to any persons who have not been authorii ed by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback lo those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and alithorii ed by the NRC.Furtherniorc, I am aware of the physical security measures and requirements (as documented in the facility licensee's pi ocedures) and understand that violation of the conditions of thisagreement may result in cancellation of the examinations and/or an enforcement ac.tion against me or the facility licensee. I will immediately report to facility management or tKe 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 unauthoriz ed persons any information concerning the NRC licensing examinations administered diiring the week($ of 44223h 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 authorir ed by the NRC.

PRlhKED NAME I OB TITLE I RESPONS1BILITT

-U r P s -. --

2.

3.

4.

5.

6.

7 NOTES:

NUREG-l0 !I, Revision 8, Supplement l 24 of 24 e-

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

1. Pre-Examination VAlADmQK Of= &c aim *. & ILT M a Qh& &U
  • I acknowledge that I have acquired specialii ed 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 informationabout these examinations to any persons who have not been authorii ed 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 aiithorii ed by the NRC.Furtherniorc, I am aware of the physical sccurity measures and requirements (as documented in the facility licensees pi ocedures) and understand that violation of the conditions of thkagreement may result in cancellation of the examinations andlor an enforcement ac tion 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 unauthorii ed persons any information concerning the NRC licensing examinations administered diiring the week(s) of h* , From the date that I entered into this security agreement until the completion of examination administration, 1 did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorii ed by the NRC.

I OB TITLE I RESPONSlBlLlTV SIGNATURE (1) DATE SIGNATURE (2) DATENOTE 1.

2.

3.

4.

5.

6.

IO.

11.__-

17.

1:.

NOTES:

NUREG-IO !l, Revision 8, Supplement 1 24 of 24

I r

/ke&4m+ ~h w\LkbL\

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

1. Pre-Cxamination l4yMbcf 9L IM E.cRce&*

I ,icknowled!je that I have acquired specialii ed knowledge about the NRC licensing examinations scheduled for the week(s) of CCUY 01-1 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 authoriz ed 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 ai ithoriz ed by the NRC.Furthermorc, 1 am aware of the physical security measures and requirements (as documented in the facility licensee's pi ocedures) and understand that violation of the conditions of this.agreement may result in cancellation of the examinations andlor an enforcement a( tion against me or the facility licensee. I will immediately repoit 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 unauthoriz ed persons any information concerning the NRC licensing examinations administered dtiring the week(s) ofd-f9-6 4 . 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 authorii ed by the NRC.

PRINTED NAME I OB TITLE I RESPONSIBILITY SIGNATF(1) DATE SIGNATUEE (2) DATENOTE T L -

NOTES:

NUREG-10 '1, Revision 8, Supplement 1 24 of 24

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

1. -

Pre-Examination I iIcknowled!je that I have acquired specializ ed 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 have not been authoriz ed 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 at rthoriz ed by the NRC.Furtherniorc, I am aware of the physical security measures and requirements (as documented in the facility licensee's pi ocedures) and understand that violation of the conditions of thisagreement may result in cancellation of the examinations andlor an enforcement a( tion 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 uf my knowledge, I did not divulge to any unauthorii ed persons any information concerning the NRC licensing examinations administered diiring the week(s) of &'?4 . From the date that 1 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 authoriz ed by the NRC.

PRINTED NAME I OB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATENOTE i

NOTES:

NUREG-10 !l, Revision 8, Supplement 1 24 of 24

ES-201 Examination Security Agreement F o ES-201-3

~

1. -

Pre-Examination 1 ; ? ~ k ~ :ha; ~ ~I have k ~ ~ Sp!?&!!i! e!!k#-!C!!&&Q &?c!J! !he :$Rlz :kegsi?g ~~~mi~&~~~ns s&&!cd fer Le?

~ & ac@rpd '&'&e) of 9c 4

.a- ...-

-. *be date of my signature. I agree that Iwill no1knowingly divulge any informaUon about these examinations to any persons who have not been authorii ed by the NRC chief examiner. I understandthat Iam not to instruct, evaluate. or provide performance feedback to those applicants scheduled to be adminisrered lhese licensing examinations from this date until completion of examinationadministration, except as specifically noted below and authorh ed by Ihe NRCFurthermore, Iam aware of the physical sccuriry measures and requirements (as documenled in the facility licensee's piocedures) and understand thal violation of the conditions of thisagreement may result in cancellation of the examinations andlor an enforcement adion againsl me or the facility licensee. I will immedialely reporl LO facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Fxamjnatian To the best of my knowledge, I did not divulge to any unaulharit cd persons any inlormation concerning h e NRC licensing examinations administered during the week(s) of 4.(44 . From the dale h a t I enlcred inlo this securily agreement unlil the completion of examination adrninistralion, I did not inslrucl, evaluate, or provide performancefeedback to those applicants who were administered these licensing examinations, excepl as specifically noted below and authoril ed by the NRC.

PRINTED NAME I OB TITLE / RESPONSlBlLlTl' ENOTE l.J&olaJL"Q$13rc cps ' - $76.&qq 2.

3.

c;'-$6q---

Ni*-

(PPS tr-rJ* --

274PeZ-y 4 . a k 0 c

MAN ~~

NOTES:

0 0

NUREG-70 !I. Revision 8,Supplement 1 24 of 24 # N

ES-301 Operating Test Quality Checklist Form ES-30 1-3 Facility: Date of Examination: Operatir Test Number:

lnitis

1. GENERAL CRITERIA
a. The operating test conforms with the previously approved outline; changes are consikent with
d. Overlap with the written examination and between different pa is within acceptable limits.

. initial conditions

. initiating cues

- statements describing i

- criteria for successful c g

- identification of crikal nce standards The associated sim;!

Printed Name I Signature in accordance with i$i Date B Y

//

NOTE:

  • The facilitv sianature is not aDDlicable for NRC-develooed tests.
  1. IndependentiRC reviewer initial items in Column c;; chief examiner concurrence required.

NUREG-1021, Draft Revision 9 24 of 27

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 It 25 of 27 NUREG-1021, Draft Revision 9

4-13-04; 9:08 ; A M E R G E N OC T R A I N I N G ;609 971 2110 4 2/ 10 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: 1 CT zoo%

i i

NUREG-1021, Draff Revision 9 26 of 27

4-13-04; 9:08 ;AMERGEN OC TRAINING ;609 971 2 1 1 0 tf 3/ 10 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: 1L .

i NUREG-1021, Draft Revision 9 26 of27

4-13-04; 9:OS ;AMERGEN OC T R A I N I N G ;609 9 7 1 2110 # 4/ 10 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: ILT i

Author:

NRC Reviewer:

NUREG-1021, Draft Revision 9 26 of 27

4-13-04; 9:08 ;AMERGEN OC TRAINING ;609 971 2110 ff 5/ 1 3 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: 4 LT Zeoq I

NUREG-1021, Draft Revision 9 26 of 27

4-13-04; 9:08 ;AMERGEN OC TRAINING ;609 971 2110 tf 6/ 10 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: I bT -4.

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

&YL Author: ---

NRC Reviewer:

NUREG-1021, Draft Revision 9 26 of27

~- ~~~ -

4-13-04; Y : O 8 ;AMERGEN OC TRAINING  ; 6 O Y 971 2110 # 7/ 10 I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: I LT -4 g test number and Form ES-D-1 event numbers for NRC Reviewer:

NUREG-1021, Draft Revision 9 26 of27

4- 13-04; 9:08 ;AMERGEN OC TRAINING ;609 971 2110 # 8/ 1 0 i ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: I LT 2-Author: ---

NRC Reviewer: _____-

NUREG-I021,Draft Revision 9 26 of 27

~~

4-13-04; 9:08 ;AMERGEN OC TRAINING ;609 971 2110 ff 9/ 10 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.: ~ L ; T 2s0q NUREG-11021, Draft Revision 9 26 of 27

ES-301 Competencies Checklist Form ES-301-6 27 of 27 NUREG-1021, Draft Revision 9

Comments:

ES-401 Written Examination Form ES-401-36 Quality Checklist h Initial the audit exam was syst he audit exam was com Printed Name / Sigpture , n 3.

3.

Author Facility Reviewer (*)

-v

. NRC Chief Examiner (#)
1. NRC Regional Supervisor 33 of 34 NUREG-1021, Draft Revision 9

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Facility: 0 y S - b Date of Exam: 4J6-04 Ixarn Level: RO/SRO

2. Answer key changes and question deletions j
4. Grading for all borderline cases (80 +/- 2%

Date NUREG-1021, Draft Revision 9

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