ML050190363
| ML050190363 | |
| Person / Time | |
|---|---|
| Site: | Kewaunee  |
| Issue date: | 11/16/2004 |
| From: | Nuclear Management Co |
| To: | NRC/RGN-III |
| Shared Package | |
| ML050190172 | List: |
| References | |
| 50-305/04-302 50-305/04-302 | |
| Download: ML050190363 (14) | |
Text
ES-201 Examination Preparation Checklist Form ES-201-1
-180
-120
-120
-120 II l-@l Facility: Kewaunee (RO written retake exam only)
Date of Examination: 11/16/2004 Examinations Developed by:
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NRC (circle one)
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- 1.
- 2.
- 3.
Examination administration date confirmed (C.1.a; C.2.a and b)
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- 4.
Corporate notification letter sent (C.2.d) w4 NRC examiners and facility contact assigned (C.1.d; C.2.e)
Facility contact briefed on security and other requirements (C.2.c)
N/A Target Date*
-75 Task Description (Reference)
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r rrrn Chief Examiners Initials
-70 I@@
- 7.
Examination outline(s) reviewed by NRC and feedback provided to facility licensee (C.2.h; C.3.e)
-45
-30
- 8.
Proposed examinations (including written, p, as applicable), supporting documentation (including Forms ahd h;%)
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4 Es r e 3W-6, and ES-401-6), and reference mate%;&?;,fe;f,.e?g
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-14
- 11. Examination approved by NRC supervisor for facility licensee review (C.2.h; C.3.f)
-7 11
-14 I 12. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g)
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- 14. Final applications reviewed; examination approval and waiver letters sent (C.2.i; ; ES-204)
- 13. Written examinations approved by NRC supervisor (C.2.i; C.3.h)
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-7
-7 M f q
- 15. Proctoring/written exam administration guidelines reviewed with facility licensee (C. 3. k)
I N/A 1
II
-7 I 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.
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ES-201 Examination Securitv Aareement Form ES-201-3
- 1.
Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekNof I I s 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.
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 een authorized
- 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 j Y $ / b f. From the date that I entered into this security agreement until the completion of examination administration, I did not
- instruct, evaluate, or pr vi e 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 SIGNATURE (2) DATENOTE NOTES:
NUREG-I 021, Revision 8, Supplement 1 24 of 24
W NUREG-1022, Revision B, Supplement I 24 of 24
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 date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons 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 slrggestions that examination security may have been compromised.
- 2.
Post-Examinatiou 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 @ b p $. From the date that I entered into this security agreement until the completion of examhation administration, I did not instruct, evaluate, or provi e performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1)
DATE SIGNATURE (2) DATENOTE NOTES:
NUT, '-1021, Revision 8, Supplement 1
P W d Form ES-201-3 ES-201 Examination Security Agreement
- 1.
Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC.Furthermore, I am aware of the: physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or Wggestions that examination security may have been compromised.
- 2.
Post-Examinatipn To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of wk$. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provi e performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
PRINTED NAME JOB TlJLE / RESPONSIBILITY SIGNATURE (1)
DATE SIGNATURE (2) DATENOTE NOTES:
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ES-201 Examination Security Agreement Form ES-201-3
- 1.
Pre-Examination ran enforcement examination security may have been compromised.
- 2.
Post-Examination NRC licensing examinations administered ion of examination administration, I did not PRINTED NAME
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- 14.
15 NUREG-1021, Draft Revision 9 25 of 25
ES-201 Exarninalian Security Agreement F w ~
- 2.
Post-xaminatiw noted below end authorized by the NRC.
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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 kb3?ff 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, 1 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 shggestions that examination security may have been compromised.
- 2.
p o s t - E x a m i m To the best of my knowledge, I di not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered 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.
during the week(s) of&{2m 4 From the date that I entered into this security agreement until the completion of examination administration, I did not PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1)
DATE SIGNATURE (2) DATENOTE
- 14.
- 15.
NOTES:
NUT, '-1021, Revision 8, Supplement 1 2' '24
I Form ES-201-3 Pre-Examinalion
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[he L acknowledge Ibst I have acquired specialized knowledge aboul the NRC Ifcenshg eramlnatlons scheduled for h e wsek(s) of date of my sigrtatura L sgme that I Will nol knowingty dilge any Inlwmau'cn about lhese examinerions to any perwns who havs nat been aumorized by the MRC chief examiner, I undersland hat I am not la Insmt evaluate, or prouide perfamame Feedback to !hose applicants scheduled LO be admlnisiwed these licensing examlnetims from this dab until completion d examination adrninistra!Jm, except as specifically noled bslow and aulhurlzed by lhe NRC.FuWwmore, 1 am aware of Ih$ phyrimal security measures and raquhrnenb (as documented in ule lacilily licensee's procedures) end undersbnd that V b # a h nl the cond~ons 01 ais agreemenl may result in. cancellalion of ha examlnathns andlor an enforcemenl-acflon agalnst me or Ute faclllty lkensea. I wldl immedlateiy report tolacfllty managemenl Wlhe NRC cMef examiner any fndicatians or sltggixilions \\ha1 ewamine~ion securlty may bsve k n cornpramked.
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not dlvulge to any unauthorked persons any mformalian concerning the NRC llcensfng ewaminalions sdrninistefed the dare thar I enlered inb this securlty agreemen1 until the completion of eramination adminisration, I did no[
feedback b those applicants who wem administered h s e Ilcenshg enamlnau'om. except a5 speclncally during the noted below and authmlzed by Ihe NRC.
PRINTED NAME JOB TITLE I RESPONSIBILITY SlGNATURE {I)
DATE SIGNATURE [Z) DATENOTE NOTES:
NUT, '-1021, Revision 8, Supplement 1' 2' - 2 4 ixl hl...
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ES-201 Examination Security Agreement Form ES-20 1-3
- 1.
Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have w not een 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.
I 1s 3 as of the
- 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 N+f~d. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provi e 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 SIGNATURE (2) DATENOTE
- 3.
- 4.
- 5.
- 6.
7 I.
- 8.
- 9.
I O.
- 11.
- 12.
- 13.
- 14.
- 15.
NOTES:
NUREG-1021, Revision 8, Supplement 1 24 of 24
ES-201 Examination Securlty Agreement Farm ES-201-3
- 1.
Pm-Examinallon f acknowledge (hat I h a m acquired specCalized knwukxtgeeboul the NRC licsnsiogexaminalions scheduled for the we&@} of I lb a by UleNRC chief examiner. t undeisland Ulal I am not lo imttmt, eualuale, or provide performance feedback to those appllcantsscheduled to be administemd lhese kens tng er(amin8titiorcs Imrm LhIs dale unlil cornptetian or examhalion admimislratioo, excepl as specTkally ncled below and authwized by the NRC.Furlhemom, I am aware dthephysical security rneasuras and requlrements (as documenled in the faclllty ticensads procedures) and uftdersland Ulat violation d the conditions OF this agreement may mull In cancellation csf [he examinations andlor an enforcemad actir~~
againsl m e w [he fmlli%y licensee. I will Irnmedialdy report tn Jacility management or the NRC chbf examiner any indicelions or suggeslions uhal mmlnaUm fmurily may have been compromised.
as of fie dated my signature. I agree thal I will no1 knwhglydivulge any infarmalion about ~hase emhations lo m y persons who have M nt e m authorized m
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To the best of my knowledge, 1 did not divulge to any unauthorized persons any iniormalion concerning the NRC licensing eKaminafions adrninislered durlng ihe week(s) of 104. From ihe data fhal I entered into thiB s~curity agreement until the campletion of examination administration, I did no1 InSUuCt, evaluate, or p*de parfrrrrnanoe feedback Io hose applicanls who were adminislsmd these licensing examinations, except as specifically nolsdbelaw and aulhorined by the NRC.
JOB TWLE I RESPONSlBlLlTY SIGNATURE (1)
DATE SlGNATURE (2) DATENOTE NOTES:
NURliGIMI, ReYisian 8, Supplement 9 24 of 24
ES-403 Written Examination Grading Form ES-403-1 Quality Checklist