Text

2009 Fitness for Duty Program Performance Data
	ML100601283
Person / Time
Site:	Ginna
Issue date:	02/25/2010
From:	Palmer E; Constellation Energy Group, Ginna
To:	; Document Control Desk, Office of Nuclear Reactor Regulation
References
	Download: ML100601283 (36)
	v • d • e

Eugene F. Palmer Director - Security R.E. Ginna Nuclear Power Plant, LLC 1503 Lake Road Ontario, New York 14519-9364 585.771.5223 Gene.Palmer@cengllc.com CENG.

a joint ven tur-e of Constellation.

Eneorgr

,*,e~

February 25, 2010 U. S. Nuclear Regulatory Commission Washington, DC 20555 ATTENTION:

SUBJECT:

Document Control Desk R.E. Ginna Nuclear Power Plant Docket No. 50-244 2009 Fitness for Duty Pro2ram Performance Data In accordance with the requirements set forth in 10 CFR 26.203 (e) and 26.717, R.E. Ginna Nuclear Power Plant, LLC has compiled and is submitting the enclosed annual 2009 Fitness for Duty (FFD) Program Performance Data covering the period January 1, 2009 through December 31, 2009.

Should you have any questions regarding the information in this submittal, please contact Mr. Thomas Harding at (585) 771-5219.

Very truly yours, Eugene F. Palmer

Attachment:

2009 Fitness for Duty Program Performance Data cc:

S. J. Collins, NRC D. V. Pickett, NRC Resident Inspector, NRC W./PL/N R C- / 00 Z,

?659`

ATTACHMENT 2009 FITNESS FOR DUTY PROGRAM PERFORMANCE DATA

NRC FFD Program Performance Data Reporting System Oln"eHe~l Annual Reporting Form for Drug and Alcohol Tests Note:

1) All fields required except those marked 'optional'.

2) Use Adobe Reader 9.3 to ensure this form works properly.

Period of report 2009I Select Facility R.E. Ginna FFD Program Random Testing Population.

Average number of licensee employees subject to Part 26 throughout the period 484 Average number of contractors/vendors subject to Part 26 throughout the period Total size of the random testing pool throughout the period (Calculated) 1480 1

1964 Pre-Access Tests Conducted Throughout the Period Total number of tests conducted (Licensee Employees)

Total number of tests conducted (Contractors/Vendors) 1,244 Total number of positive, adulterated, substituted, and refusal to test results 26 Followup Tests Conducted Throughout the Period Total number of tests conducted (Licensee Employees) 143 Total number of tests conducted (ContractorsNendors) 93 Total number of positive, adulterated, substituted, and refusal to test results F2 For Cause Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees)

(Contractors/Vendors) substituted, and refusal to test results 116 1

2 Random Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, Annual random testing percentage (Licensee Employees)

(ContractorsNendors) substituted, and refusal to test results achieved for the testing pool 247 248 0

F52.4 Post-Event Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees)

(ContractorsNendors) substituted, and refusal to test results 0

13 0 O Other Tests Conducted Throughout the Period Total number of tests conducted Totalnumber of tests conducted Total number of positive, adulterated, (Licensee Employees)

(ContractorsNendors) substituted, and refusal to test results 0

1 o

Substances Tested Did your program only test for NRC-required substances AND at the NRC-specified minimum cutoff levels? (Yes / No) INo Substance Use Only NRC Cutoff Initial Confirmatory LOD Testing?

Comment Levels? (Yes / No)

Cutoff Cutoff (Yes / No)

(Optional)

Alcohol Yes Not Applicable L See narrative comment lCocaine IYes

-1 Testing conducted in accordance with 10 Yes CFR 26.163(a)(2)(ii)

I ICa~tIj iy l.tUfl tU~U I]I OtA..I UOGIIL VVILI I IV CFR 26.1 63(a)(2)(ii)

Do you want to add additional substances? (Yes / No)

No How many additional substances do you want to add? (up to 6)

Narrative (as applicable)

If reporting information on more than three narrative topics, select "Other(s)" for the Narrative Topic 3 to report any additional narrative topics. List each additional narrative topic title to be addressed in the "Please Elaborate" box. Ensure that each topic is identified and discussed in the "Narrative text" box that appears to the right of the Narrative Topic 3.

Narrative Topic 1 Policies and Procedures Narrative Text ANY reading of equal or greater than 0.01% BAC requires:

1. Individual is prohibited from performing duties

2. Perform additional testing until BAC shows a downward trend.

3. The sponsor or Access Requestor is notified and asked if there is a continued need to have UAA/UA.

r7 Add an additional Narrative Topic This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document L~~~to~~ocalI,§P Oeboft to NRIC

~hti~p Annual Test Results Form version 1.1.16

NRC FFD Program Performance Data Reporting System 10 CFR Part 26, Subpart I - Managing Fatigue Annual Fatigue Reporting Form Seled Facility

[R.E.GJ....

7 Peio f " I' Uod:

Us, Adobe Reader 9.3 for this form to wor. pwopetv.

Was this faclity In an outage for aoy part of the Did any single site outage last mor than 60 Did any of the first 60 days of an outage occur Did any of the outage days after day 60 occur reporting period? (Yes I No) days in total? (Yes I No) dudng the reporling period? (Yes I NO) during the reporfing perdod? (Yes I No)

Yes No~

Yes_

No S y I

-° I

F ISummary of Waiver issuance - 26.203(e) (7) Fi-ii Nomber of Walvero Issued (Waroe:

Evrlreni10 N

wal.eIssurebed. pleaseot.,r. aluoe (e.g.. 0) 10 artoIa.on 000 e. rmcello In rob.ohte]

Operacfing or 00n'sle -daoolrrg of Performing healthr dhysics orf performidng duties ofia fire brigade Pedoenrong erainoaos or Pedfoortiog osawdy cldobs. as Operating Outage Oans2 omrbl~odo tire operations of syslerrrs.ns chremistry duties. ns described mo

emober, as desoribed In nails diertnofo mainratenance.

described In

o.

Total Tob tald' Tr~

Workr Hour Conroflos descrtibad in 26.41(a)(l) 26.4(a)(2) 26.4(a)(3) on described In 26.4(aX4) 26,11(a)(5)

(days 1-60).(idlerltay 60)I~

Oorrstlioaq (days rnri DOutage outage 0prt

'Outage 2

010Oaan 006 (Calcutated)

(Cloolfr)kaodir Clrlrr 140)tin (01101.60)

Operating (days i-SO)

(otra 6

days 1460) -,(aft r day SO)

~

dayn 1-ee)

(afterday 0 a

(days 146) jailnr day 60)

Hoss ce~eded 2016 Irk ra in any 24 ire period Fo__

1o__1 F

i W

I (o(

1 1.

Exoteoded 72 wori his in mny I day period El--]

F] --

Fo Fo 01 16 1l]

E l Fl]

El]

El__

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Fo LM~ doan 10 tor brenak b1) succesolorsrive R(

orkd 058 h break oooonorrodadosg El0l E I l

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E ]

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l erab scaredrled trnsition bit shiftn)

-o

_______o_____

o_____

F ED lo_____________

Average of los doesa I day off We -00kElE

]

Average of leaw doens 2 days off per woeik 0l Fl]

II]

l bnlom for 10-h-oshift.li E ]-

Days Off Avraoge of lens tran 2.5 days off peerseni Peir Shift for 12-ioroi shifts Eli]o Cycle 26,205(d)(53)

Avraonge of foss than 2 days 09f poronnk

1a for 12-boor -inron-a..

sthifts

-o L-7L Average o1 lens thean 3 riaysonff per wveak r

i j1 for 12-hour securrity shifts F0.

-___1_

n~unDays Off poniod 26.205.(d)(4)

z.

l 0

for Ouotage Actfiftl~o (daring first Less than I day off pere 7-day period for 5:odays ofoutage) madintenanceperonarnel 2&205.(dXd5

[-

2620)1

.Ls than 4 dlays off per saccessive IS-day C-(7 Period for scournty p-rano OF29)55

.lL rind l El]26120El5ll.(dX5)

E l]

E l ll aE I

]~ ]

-NOTE: For individuals perorleming fire brigade duies and other dutie, please count them only under ihe fire brigade colurmr. Do not double count these Idbdoas.

Distribution of Waivers for Individuals in Each Category - 26.203(e)(1)(iii)

Number of Employ.os Issued Waives

[Nore: Even 11no waIvers were issued fora given eolumn. please eoter a value (e.g.. 0) in r least 000 orf the cells in the corlum]

Ope*Lting or o-sh performng heath Pedroming duaies of0a Pnerornig maLt enanPe omsng securty deoerans of physc or chemistry ft brigadpe nmmpe cs or onsita dkectLtg of duties as described ig Nuamber ssems as daties as describod Is described In maintenance as d

ho fdWa iv e s system s, as 26.4 (a X 2 )

2 6.4 (a )(3 )

d escrib ed In 2 6.4 )0541 2 6.4((a5 5 desrie in 26.4(a)(1)

E=II E=l m=

3 I]

11 1I 4,I I

I Summary of Corrective Action - 26.203(e)(2)

(as applicable)]

Analynis of Waiver Assessment Data:

J-I 5.00 r.*r0,M No Wair reitroed during rfor rrgssio perad.

Analysis of Fatigue Assessment Data:

l D.

new dasnon) or Fatige-As

.essmao c

rplerrd drloinngrfos rofrol peried..s tr.1 of. pfrc-drrg sod aotobt trt.

5 F_--_1 F----i I F----i

Hours 26.205(dX1) z.add263 h.l hon to ny 48 he period Fo

-1 EZHEZK

~I:

F~~

I,~ -

0 I

1 I

t t-~

I I.

f-v T

o Exceeded 72 work Io in any 7 day period O-F RE-]

Z FO----]

110-1 FO O

E=

EI R1 pras(or 8hr breakooounmondating Fo-1 tFt OF FL--]

A F

D F -

F oII]--

F 1F--

O 26.205(dX2)

Lross rethan 3r4nffo hA er o fma In__

any 9 d___y_

period__

to=

k=~

Fo F

o-J fverago of les than I day ofl per weak or 8*5o0r shtffos FoE-l oFI-1 FO-El h50Sono Days off Par Shift~

cycle 26-205(d)(3)

%-ore of Iess5005 2 days off per week,-

-E

-' E~

or 04boaor shift.

Fi~

~Ei]IJ

________LJ koosoge of loss tlhon 2. days allpor week

.4]

l E ]-'-

or 112-Itour rnainterrance shift

_____L...

______[______

E 5500060 of Insthtm 3 idayn off p" eoek ar 2-hournodYshil lEl

'1~ iiii:

fo ta.

Loss thon 3 days off per seaeonnlon 05400sy Min..... Days period 26.205.()(4)

[

for Outagoe ActitieS (during fost Leso than day-off per T-day period for

'l:]

60 day. of 00106) ean~fternwim peronnerrl 26.205.(dX4)

[o 26.205(,d5)

Loss ;tan 4 05ay doff pot s

.o5-day period for ctall pernonnl 222"05(.15)

._-_-+

Toa EC=

ElF00 l

0 El

'NOTE. Formandualdolperforming rie brigade 0uties and othrer dulinn, please coun0 thorn ouly under the 000e1b0i0ad cofonro. Do nor double count100 thew ldh~alt.

Distribution of Waivers for Individuals in Each Category - 26.203(e)(1)(iii)

I Summary of Corrective Action - 26.203(e)(2)

(as applicable)I Number of Employees Issed Waivets

[Note: Even lion waivers were issued fera given column, please enter a value (eg.. O) nat least oe of the cells in the colmunn Operating or e-ste Perfrmin health Perforodng 00ti00 0f0 Perforning mnaintenaonc p directing of wfaa ciy th

,110 of physlen or chemistry 000e brigade 00050000 or onafte 0d0r1cting P, 011 9

of duie 0a00sriedI Noonlooa of Wd.Ur

.y.ro n

0000 descthribe In described In rarintenoneen do s Ostbd1 described In 26.4(a)(1) 26.4(052) 26A.4(e3) described in 260102X4) 56425 4

7 n

m nr rnr rna rnrnr IsudMorn uso 2F r n r0n n

r Analysis of WalverAssessmeont Data:

I I-I 00.00Coe 50N0.

rviono during 0510 Teonmg pi10.

Ana0p0.01o F.Ugon A.--noero Dafota1:0

~oos 0-eo1goAoseoent o-ooepord drirg thi, ri-veng peo~dsoaeWel nf, po.vodosged kl l lott CovnclusonsO: -toa000 es Wot hosrs b-ors l-o, e b.-ee edgooively ielcod e otv od Io-d 10 h on1 00w0

-n00vood by hommo perfeeoee buo. I.-t sohowot isoor Summary and Status of Correetire Actions:

tIo lo-00

),0oe One nook ho-s deionn.c-ond driog the epeeiog period oithin 1e thc eity orgniislien due lo. I.00 hed.1is -or in ti00 IEeepceor eekig sy"-p.

-oe th hou e

et

&Ld. it -o d ereovi d-

-s I niolslif oro the thOty-Pfo (34) hour bomk ie oy nine (9) day period. The vinlafli- -,

u*taid iota tue C rivte Avon. 1oprgram+.

-d an Apparent Cos tva04atio w0 condacted resulting in o depooealo t clte esvt-The iolmonor notr I0 0

t1ho NRC qumruely tog:

MWd oreopmo. meiro hv bo prot in poace oil that time most W0aiver 100de toilla gl Itd~d~

m m

FO Oeeno F0o~s OsOsOs tOonooeosn

U I

'IiI'V.

a 0-X NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 11925 Select Facility Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 104/23/00 I R.E. Ginna Reason for Testing - 26.717(b)(5)

Followup Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Please elaborate on the reason for testing (optional)

MRO requirement after a Determination of Pitnocc fMr nrinr mnriuinn jo ico a

Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4)

Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)I~es Use NRC Cutoff(Yes / No)l Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate 1-1 Observed Actions/Behaviors

[]

Other 17 Management Actions - 26.717(b)(8)

Disciplinary Action II er Denia Z

IZ Reason(s) for the Action (select all that apply):

[] MRO Confirmation

[] First drug or alcohol positive r7 Subversion E1 Misuse E Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA lJ

[]

Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 Save~to Local PC, Send ~ep6Wto NRC S*Print this eot Single Positive Test Form version 1.1.26

Elcro i

0n

-:~,Ecag NRC FFD Program Performance Data Reporting System Single Positive Test Form

[ýý hl ýbp`Z Optional Reference Number for Licensee Use tSingle Form 2009 12001 Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 4272009 j

Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) lCocaine Additional Substance (as applicable)

Please Select I

Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)Y Use NRC Cutoff (Yes / No)m Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate El Observed Actions/Behaviors 17 Other nl Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial 71 Reason(s) for the Action (select all that apply):

[] MRO Confirmation

[

First drug or alcohol positive r-Subversion Fl Misuse El Violation of 5-hour abstinence rule 17 Sale, Use or Possession in PA Ml Resignation/Withdrawal El Subsequent positive test result from testing El Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Clickto Digitally Sign This Document Sav t PcalK F Send Reportito NRC'.-

PSintFthisvRepor Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12002 Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) [4/27/209 Select Facility JR.E. Ginna Reason for Testing - 26,717(b)(5)

Pre-Access I

Pre-Access Testing Reason (optional)

Initial Authorization Employment Type - 26.717(b)(3) lContractorNendor Labor Category-26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) lCocaine Use NRC Cutoff (Yes / No)le Additional Substance (as applicable)

UMarijuana I

Use NRC Cutoff (Yes / No)lYes Drug Testing Urine Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)[

Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 13 1`

Refusal to Cooperate Other 7l E]

Management Actions - 26.717(b)(8)

Disciplinary Action 1-Yer DeniaZ Reason(s) for the Action (select all that apply):

'R MRO Confirmation

[

First drug or alcohol positive El Subversion 17 Misuse El Violation of 5-hour abstinence rule Rl Sale, Use or Possession in PA-El Resignation/Withdrawal nl Subsequent positive test result from testing E] Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right--clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

[ ýratq,100!,

[-Send Repor to NRC Print this.Report Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 12062 Select Facility R.E. Ginna Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 05/1 Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Engineering Pre-Access Testing Reason (optional)

IReinstatement (Between 6 and 30 days)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity FNot Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes / No)?- 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

Additional Substance (as applicable)

I Please Select I

Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes I No) Yes Use NRC Cutoff (Yes / No)[Ys Use NRC Cutoff (Yes I No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors

]l El Refusal to Cooperate Other 17 Ml Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation Ig First drug or alcohol positive Fl Subversion

[3 Misuse El Violation of 5-hour abstinence rule Ml Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Sae oLcalPC1 SSendRep6rtot NRC PrintthisRkeport]

Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12244 1

Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Select Facility

[R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Finitial Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes No)? - 26.717(b)(7) & 26.1 No Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) 1Cocaine Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)[e

]

Use NRC Cutoff (Yes / No) i Is this a 24-Hour Reportable Event (Yes/No)?- 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence R

C Refusal to Cooperate 11 Observed Actions/Behaviors Other r]

Management Actions - 26.717(b)(8)

Disciplinary Action F1-Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation fK First drug or alcohol positive 17 Subversion

[3 Misuse

[

Violation of 5-hour abstinence rule jJ Sale, Use or Possession in PA E3 1-1 Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Savto Lo~Ical 1,,-Send Reporitto NRC PrintS P

this oRepo1ort Single Positive Test Form version 1.1.26

Elcroi Ino' xcag NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required excep Sing

2) Entries in some form fields Optional Reference Number for Licensee Use Single Form 2009 12349 being auto-populated into othe t those marked 'optional'.

may result in information r form fields.

sure this form works 8/10/200 Select Facility IR.E. Ginna

3) Use Adobe Reader 9.3 to en:

properly.

Date of Collection (mm/ddlyyyy)

Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

Contractor/Vendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional) lReinstatement (Between 31 and 365 days)' j Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4)

IMarijuana ZX Additional Substance (as applicable)

I Please Select I

Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 1-Observed Actions/Behaviors 1-Other El Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation

[] First drug or alcohol positive E7 Subversion 17 Misuse E] Violation of 5-hour abstinence rule E3 Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Sav3toLocalP I Send Reportto NRC.

PrintSthis Report Single Positive Test Form version 1. 1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12426 Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

[Pre-Access Employment Type - 26,717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

SUpdate Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? [o Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

IMarijuana 77 Use NRC Cutoff (Yes / No)o Initial Cutoff 50 Confirmatory Cutoff 15 Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)e Drug Testing Urine Additional Substance (as applicable)

Use NRC Cutoff (Yes/ No)m Is this a 24-Hour Reportable Event (Yes / No)?- 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate El Observed Actions/Behaviors 1-Other 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial ZI Reason(s) for the Action (select all that apply):

R MRO Confirmation Z

First drug or alcohol positive

[] Subversion r-Misuse E] Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El Resignation/Withdrawal El Subsequent positive test result from testing

[] Other: Please elaborate Sample was found positive at LOD.

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

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n NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12434 Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 08/

j Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

FOther Pre-Access Testing Reason (optional) lnitial Authorization Please elaborate (optional)

Siemens Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Ivalid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Drug Testing lUrine Substance - 26.717(b)(2) & (b)(4)

ICocaine 77 7

Use NRC Cutoff (Yes / No)Ye

]

Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)

Iis Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El El Refusal to Cooperate Other Ml 1-Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation

[

First drug or alcohol positive El Subversion El Misuse El Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El Resignation/Nithdrawal El Subsequent positive test result from testing El Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 4eto o!l7R, I Send Reipor toNRC

['Print this Report*

Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form 1,Onhnei0elR]

Optional Reference Number for Licensee Use Single Form 2009 12481 Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 0/I2009 Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

[Pre-Access Employment Type - 26.717(b)(3)

ContractorNendcor Labor Category - 26.717(b)(3)

Other Pre-Access Testing Reason (optional)

[Initial Authorization Please elaborate (optional)

Office Works furniture delivery and set-up1 Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes / No)?- 26.717(b)(7) & 26.1 f~o Z

Substance - 26.717(b)(2) & (b)(4)

Marijuana C f

so Use NRC Cutoff (Yes / No)le Additional Substance (as applicable)

Please Sele s

]

Use NRC Cutoff (Yes / No)Ie Drug Testing Urine Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate El Observed Actions/Behaviors El Other El Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Z

Reason(s) for the Action (select all that apply):

[] MRO Confirmation

[K First drug or alcohol positive E3 Subversion

[E Misuse E] Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA

[] Resignation/Withdrawal El Subsequent positive test result from testing El Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Save._t6.lLo.c4I',PC,*

[Send Repo rt to *NRCQ, gPrint this Report, Single Positive Test Form version 1. 1.26

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NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12482 Note:

1) All fields are required except those marked 'optional"

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 84200 I

Select Facility

[R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported IDrug Only Was this collection observed (Yes/No)?-26.717(b)(7) & 26.1 Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) lCocaine Additional Substance (as applicable)

IMarijuana I

Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes I No)[s Use NRC Cutoff (Yes / No)I I

Is this a 24-Hour Reportable Event (Yes /No)?- 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 11 Observed Actions/Behaviors El Other El Management Actions - 26.717(b)(8)

Disciplinary Action 11-Year Denial7 I

Reason(s) for the Action (select all that apply):

0 MRO Confirmation

[] First drug or alcohol positive 17 Subversion 1` Misuse El Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA Ml Resignation/Withdrawal El Subsequent positive test result from testing El Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

[ SaveIP Send"Rep°4fto7NRC Print thiý Report Single Positive Test Form version 1.1.26

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NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 12494 Select Facility R.E. Ginna Note:

1) All fields are required except those marked 'optional"

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 8/20009 Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3) iContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity F

Test Type(s) for Result(s) Reported Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

Use NRC Cutoff (Yes / No)l Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate N]

Observed Actions/Behaviors Please elaborate on the choice(s) selected:

El Other 17 Refused to take drug and alcohol test Management Actions - 26.717(b)(8)

Disciplinary Action jermanent Denial 7

Reason(s) for the Action (select all that apply):

El MRO Confirmation El First drug or alcohol positive El Subversion El Second drug or alcohol positive El Misuse El Violation of 5-hour abstinence rule El Sale, Use or Possession in PA Resignation/Withdrawal Subsequent positive test result from testing Other: Please elaborate Permanently denied due to refusing to take the drug and alcohol test. He appealed but the appeal was upheld because he had refused to take the druc and alcohol test, which is a reouirement to obtain unescorted access.0 This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Ocl Sendieport to NRC]

S eiPTrinti Reo rt Single Positive Test Formn version 1. 1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional"

2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12495 being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility R.E. Ginna Date of Collection (mm/dd/yyyy) 8/2/009 Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

I I

Use NRC Cutoff (Yes / No)I Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)t IZ Is this a 24-Hour Reportable Event (Yes/No)?- 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate

[]

Observed Actions/Behaviors Please elaborate on the choice(s) selected:

Li Other 17 Refused to take drug and alcohol test Management Actions - 26.717(b)(8)

Disciplinary Action Permanent Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation El First drug or alcohol positive rl Subversion El Second drug or alcohol positive Ml Misuse E] Violation of 5-hour abstinence rule

[] Sale, Use or Possession in PA El Resignation/Withdrawal El Subsequent positive test result from testing

[] Other: Please elaborate Permanently denied due to refusing to take the drug and alcohol test..

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document P~toWLo66I:P Send Report to NRC 1P

.Print this'Report Single Positive Test Forn version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form

-ilie eljn Optional Reference Number for Licensee Use ISingle Form 2009 12533 Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 832009 I

Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

Contractor/vendcor Labor Category - 26.717(b)(3)

HP/RP Pre-Access Testing Reason (optional)

IReinstatement (Between 31 and 365 days) I Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported IDrug Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 No Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) lCocaine Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No)Y Use NRC Cutoff (Yes / No)[Ys Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes /No)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 1-Refusal to Cooperate Other 7l F7 Management Actions - 26.717(b)(8)

Disciplinary Action S1-year Denial Reason(s) for the Action (select all that apply):

9 MRO Confirmation

[] First drug or alcohol positive El Subversion Ml Misuse E] Violation of 5-hour abstinence rule C]

Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1,"SavejtoLocal, ISend Report to NRC trint this Repo1 Single Positive Test Form version 1. 1.26

Elcro i

In

11x h

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12625 Note:

1) All fields are required except those marked 'optional'

] 2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 832009 Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Update Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported IDrug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4)

IMarijuana I

Additional Substance (as applicable)

[PleaseSelect Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)m Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 1-Observed Actions/Behaviors 17 Other 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation ZJ First drug or alcohol positive Ml Subversion Ml Misuse E] Violation of 5-hour abstinence rule El Sale, Use or Possession in PA 13 El 17 Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document SaetoLocalC

<,Send Repor*ttoiNRC 1 P~rint thig Reort Single Positive Test Form version 1.1.26

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e mto NRC FFD Program Performance Data Reporting System Single Positive Test Form IRK',

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Optional Reference Number for Licensee Use Single Form 2009 12770a I

Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Select Facility IR.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

Pre-Access Testing Reason (optional)

Ilnitial Authorization IContractorNendor Labor Category - 26.717(b)(3)

FMaintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

O Test Results - 26.717(b)(4)

Test Validity valid Test Type(s) for Result(s) Reported

[Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

Please Select I

Use NRC Cutoff (Yes / No)[Yes Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)

I I

Drug Testing Urine Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence 17 Refusal to Cooperate I-Observed Actions/Behaviors 17 Other rJ Management Actions - 26.717(b)(8)

Disciplinary Action Please I ther I

7Sample Reason(s) for the Action (select all that apply):

12770b El MRO Confirmation

[K First drug or alcohol positive Ml Subversion r] Misuse E] Violation of 5-hour abstineno elaborate temp 102. Sent to the lab with a result of negative. 2nd sample is on report Single Form 2009 as a refusal to test.

El Resignation/Withdrawal El Subsequent positive test result from testing a rule El Other:

'A E]

Sale, Use or Possession in P This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I - alýoio- ý6 1ýý Seri&Riepoit46NRC SirintostivtTetsormverio 1,.2 Single Positive Test Form versIon 1.1.26

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.,.0 Electronic In AXca NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required excep

2) Entries in some form fields Optional Reference Number for Licensee Use ISingle Form 2009 12770b being auto-populated into othe t those marked 'optional'.

may result in information r form fields.

Select Facility R.E. Ginna

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Please elaborate (optional)

Reason for Testing - 26.717(b)(5)

For Cause Employment Type - 26.717(b)(3)

ContractorNendor Labor Category-26.717(b)(3)

Maintenance (Craft)

For Cause Testing Reason (optional)

FSuspect I

Original sample temp (pre-access) was 102.

qsza ;innl *Fnrm "')nOQ 1 ?77fln a

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?Yes Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

I I

Use NRC Cutoff (Yes / No)I Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes /INo)? - 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate Rl Observed Actions/Behaviors Please elaborate on the choice(s) selected:

U]

Other 1-Refused to take drug and alcohol test Management Actions - 26.717(b)(8)

Disciplinary Action Permanenteial Reason(s) for the Action (select all that apply):

E] MRO Confirmation E] First drug or alcohol positive 1-Subversion El Second drug or alcohol positive El Misuse E] Violation of 5-hour abstinence rule

[] Sale, Use or Possession in PA El El Resignation/Withdrawal Subsequent positive test result from testing Other: Please elaborate Donor was in the FFD waiting area with numerous other people when he got up and left. His employer was notified after he wasn't found in the building and confirmed he had aone home. claimina his doo was hit bv a car.

A This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I 6v~oLocalPw 11 Send Reporto1-NRC]

Print this Repor Single Positive Test Form version 1.1.26

ec le an'hejJ'nnn U.S.NR NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12824 Note:

1) All fields are required except those marked 'optional"

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

[ContractorNendor Labor Category - 26.717(b)(3)

FMaintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity alid Test Type(s) for Result(s) Reported FDrug Only Was this collection observed (Yes/ No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) uMarijuana j

Use NRC Cutoff (Yes / No)le Additional Substance (as applicable)

Please Select

]

Use NRC Cutoff (Yes / No)e Drug Testing Urine Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)[Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 1`

1-Refusal to Cooperate Other 1-17 Management Actions - 26.717(b)(8)

Disciplinary Action I -Year Denial Z

Z Reason(s) for the Action (select all that apply):

[

MRO Confirmation

[

First drug or alcohol positive El Subversion 1` Misuse El Violation of 5-hour abstinence rule Ml Sale, Use or Possession in PA Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I @ay ito.Local. C LSend, Report to NRCI Prointvthi s.FRepo1rt.

Single Positive Test Form version T.1.26

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NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 12837 Select Facility 1R.E. Ginna Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 9/42009 Reason for Testing - 26.717(b)(5) 1Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

IReinstatement (Between 31 and 365 days)

Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes/No)?-26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

Cocaine I

Use NRC Cutoff (Yes / No)le Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)e Drug Testing Urine Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

'If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 17 El Refusal to Cooperate Other 1-1 l Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation

[] First drug or alcohol positive El Subversion El Misuse El Violation of 5-hour abstinence rule Ml Sale, Use or Possession in PA El Resignation/Withdrawal

[] Subsequent positive test result from testing E] Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

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[Sen~l.Reoortt&INRC Print this ReP-rt Single Positive Test Form version 1.1.26

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R NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use ISingle Form 2009 12957 Select Facility R.E. Ginna Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)090/2009 Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

Contractor/Vendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

IReinstatement (Between 31 and 365 days)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?NO Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

!cocaine Use NRC Cutoff (Yes / No)Ies Additional Substance (as applicable)

Please Select 7 Use NRC Cutoff (Yes I No)e Drug Testing Urine Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 1-Observed Actions/Behaviors F1 Other nl Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

El MRO Confirmation fK First drug or alcohol positive El Subversion El Misuse E] Violation of 5-hour abstinence rule

[] Sale, Use or Possession in PA 11 El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by'right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1.Sýto-Local P I: Send Repprtto.RC i".p-nt'.thisIRepo rt J Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13112 Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 9/0/00 Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

IReinstatement (Between 31 and 365 days)

I Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) iMarijuana Use NRC Cutoff (Yes / No)e Additional Substance (as applicable)

[Please Select Use NRC Cutoff (Yes / No)

IIs Drug Testing Urine Additional Substance (as applicable)

[Please Select Use NRC Cutoff (Yes I No) Yes Is this a 24-Hour Reportable Event (Yes/No)? -26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence 17 Refusal to Cooperate El Observed Actions/Behaviors El Other 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial Reason(s) for the Action (select all that apply):

gj MRO Confirmation

[] First drug or alcohol positive El Subversion El Misuse El Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El El 17 Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I Sv o Lool.

Send Re*ort toNRc rint thiskRelobirt Single Positive Test Form version 1.1.26

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i-ý Elcroi Sn xchng NRC FFD Program Performance Data Reporting System Single Positive Test Form hithe H

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Pý Optional Reference Number for Licensee Use Single Form 2009 13376a Select Facility JR.E. Ginna Note:

1) All fields are required except those marked 'optional',

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

FUpdate Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Substituted I

Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

INot applicable Use NRC Cutoff (Yes I No)e Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)Ie Drug Testing Urine Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No) ?- 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate 171 Observed Actions/Behaviors Please elaborate on the choice(s) selected:

il Other 0

Initial sample temp was 84.5 and laboratory results were negative. 2nd sample was observed and positive for cocaine. See report 13376b. A wet spot was observed at the back of the donors knee area Management Actions - 26.717(b)(8)

Disciplinary Action Reason(s) for the Action (select all that apply):

IR MRO Confirmation El First drug or alcohol positive 9

Subversion Second drug or alcohol positive M Misuse

[] Violation of 5-hour abstinence rule M Sale, Use or Possession in PA 1-Resignation/Withdrawal

[] Subsequent positive test result from testing M

Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

-S ye ' LcalP~

Siend'Reporftt NR6 IPin thi ep Single Positive Test Form version 1.1.26

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S-.ca NRC FFD Program Performance Data Reporting System Single Positive Test Form

ýielp Optional Reference Number for Licensee Use Single Form 2009 13376b Select Facility R.E. Ginna Note:

1) All fields are required except those marked 'optional"

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 09/1/2009 Reason for Testing - 26.717(b)(5)

For Cause Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

For Cause Testing Reason (optional)

LOw Temperature Please elaborate (optional)

Temp on 1st sample was 84.5.

Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Yes Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) lCocaine I

Additional Substance (as applicable)

IPlease Select I

Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) ll Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Refusal to Cooperate El Observed Actions/Behaviors Please elaborate on the choice(s) selected:

I I-i Other 171 Initial sample temp was 84.5 and laboratory results were negative. 2nd sample was observed and positive for cocaine. A wet spot was observed at the back of the donors knee area Management Actions - 26.717(b)(8)

Disciplinary Action Please Ither This wa.

Reason(s) for the Action (select all that apply):

I 9

MRO Confirmation

[] First drug or alcohol positive Ml Subversion Ml Misuse

[

Violation of 5-hour abstinenca E] Sale, Use or Possession in P tlaborate s his 1st positive, but the denial was permanent based on the substituted sample he initially I. See report 13376a.

E] Resignation/Withdrawal E] Subsequent positive test result from testing e rule 1-Other:

A This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by dight--clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1ý saVeto:Local pc I Senqd oFrt 6NRC Print this Report Single Positive Test Form version 1.1.26

Prtctq Pepl aud the Evvioi U.S.NR0 va.

NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13460 Select Facility JR.E. Ginna Note:

1) All fields are required except those marked 'optional'*

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 110/520 Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

IReinstatement (Between 31 and 365 days)

Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Fvalid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Drug Testing Urine Additional Substance (as applicable)

Substance - 26.717(b)(2) & (b)(4) 1Cocaine 777 Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)[

Is this a 24-Hour Reportable Event (Yes /No)?- 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 17 Observed Actions/Behaviors El Other Ml Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation JR First drug or alcohol positive rl Subversion E7 Misuse E] Violation of 5-hour abstinence rule Ml Sale, Use or Possession in PA El Resignation/Withdrawal E]

Subsequent positive test result from testing E]

Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removirg your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document F V616oLoca:FF&

ISeind, F~epo~q7

[Print this Report ]

Single Positive Test Form version 1.1.26

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-g NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13572 Select Facility Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 1 JR.E. Ginna I

Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

[ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

Initial Authorization Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported FAlcohol Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

Alcohol Use NRC Cutoff (Yes / No)

Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)es

]

Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)?- 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Refusal to Cooperate Other Management Actions - 26.717(b)(8)

Disciplinary Action I1-Year Denial Reason(s) for the Action (select all that apply):

F1 MRO Confirmation Z

First drug or alcohol positive Ml Subversion E] Misuse E] Violation of 5-hour abstinence rule

[3 Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

Tis reotms edgitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be promdwhen the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 Z6ve-to'Loal PC 1'-Send Repýr to NRC I..lPrint tP ie sF Single Positive Test Formn version 1. 1.26

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~kca NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13573 Select Facility R.E. Ginna Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Reason for Testing - 26.717(b)(5)

Pre-Access Testing Reason (optional)

Pre-Access IInitial Authorization Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

I Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported Alcohol Only Alcohol Testing SBreath Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

Additional Substance (as applicable)

IPlease Select I

Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)?- 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Ml El Refusal to Cooperate Other El

.El Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial i

Reason(s) for the Action (select all that apply):

[]

MRO Confirmation

[9 First drug or alcohol positive E] Subversion El Misuse E]

Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El El El 171 Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document oLoca-PcO Send-Rep~t'to NIRC Prntthis'R~p6itr Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form t6olinFeep Optional Reference Number for Licensee Use ISingle Form 2009 13574 Note:

1) All fields are required except those marked 'optional'

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5) 11Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

[Initial Authorization Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

UAlcChol (Ys/No Ie Use NRC Cutoff (Yes / No)Ye

]

Additional Substance (as applicable)

Please Select I

Use NRC Cutoff (Yes / No)

Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 1-El Refusal to Cooperate Other 1`

El Management Actions - 26.717(b)(8)

Disciplinary Action FI-Year Denial ZZ Reason(s) for the Action (select all that apply):

[]

MRO Confirmation 0

First drug or alcohol positive 1-Subversion 1-Misuse Cl Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA 11 13 17 Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

.~tjoclO

ýen,:,pýt 1,RC, SirintostivtTeisormveeioo1rt2 Single Positive Test Form~

version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form

~Onhin&Help~'i L~ZL~~~J Optional Reference Number for Licensee Use ISingle Form 2009 13604 Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 1/1/2009 Select Facility R.E. Ginna Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

Pre-Access Testing Reason (optional)

I lnitial Authorization Contractor/Vendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid I

Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

Marijuana Cf e

I Use NRC Cutoff (Yes / No)le Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No)e Drug Testing Urine Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)!

Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence 11 Refusal to Cooperate 1-Observed Actions/Behaviors El Other El Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

9 MRO Confirmation 10 First drug or alcohol positive E3 Subversion El Misuse E] Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

';Svet o~lPcto Sýend Report t NlRC Sinle osttv thisormveeport..2 Single Positive Test Form version 1. 1.26

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`S1 ElcrncI NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13605 Select Facility 1R.E. Ginna Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 1 Reason for Testing - 26.717(b)(5)

Pre-Access Pre-Access Testing Reason (optional)

[Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

FMaintenance (Craft)

Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.71.7(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4)

Marijuana Z

Use NRC Cutoff (Yes / No) Yes Additional Substance (as applicable)

Please Select7 7 Use NRC Cutoff (Yes/ No)le Z

Drug Testing Urine Additional Substance (as applicable)

Please Select Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)?- 26.719(b)

NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 17 Refusal to Cooperate Other 17 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1-YerDenial Reason(s) for the Action (select all that apply):

EK MRO Confirmation 0

First drug or alcohol positive 1` Subversion El Misuse E] Violation of 5-hour abstinence rule E] Sale, Use or Possession in PA Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1`0ve o Lo.lPC

~Snd ReporqoNC Sinlrinstiv tetiormvRripo1.r2 Single Positive Test Form version 1. 1.26

Urrctn Pepl aydte'zi-~;.i U..R S

0 NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use Single Form 2009 13669 Select Facility IR.E. Ginna Note:

1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy)

/

Reason for Testing - 26.717(b)(5)

Pre-Access Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Pre-Access Testing Reason (optional)

[Initial Authorization Refusal-26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

Marijuana C Use NRC Cutoff (Yes / No)le

-Additional Substance (as applicable)

Please Select

]

Use NRC Cutoff (Yes / No)

Drug Testing Urine Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)m Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence El Refusal to Cooperate 17 Observed Actions/Behaviors 1l Other In Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation Rl First drug or alcohol positive E] Subversion E] Misuse E] Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El ResignationAWithdrawal El Subsequent positive test result from testing E] Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document SendReportto NRC.

1,to p'Loc~lP 1',-SýnqýiRelpok tkhs epr Single Positive Test Form version 1.1.26

Elcroi I

Exchang Ma ii-NRC FFD Program Performance Data Reporting System Single Positive Test Form Optional Reference Number for Licensee Use I Single Form 2009 13674 Note:

1) All fields are required except those marked 'optional',

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Date of Collection (mm/dd/yyyy) 1 2/14200 Select Facility FR.E. Ginna Reason for Testing - 26.717(b)(5)

Followup Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Other Please elaborate on the reason for testing (optional)

Determination of Fitness requirement from tha RAPn ý.ttr All I n

v,nr~nwn-21 Please elaborate (optional)

Cafeteria staff Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity FNot Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4)

Additional Substance (as applicable)

[Please Select Additional Substance (as applicable)

IPlease Select' I

Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)[Yes Is this a 24-Hour Reportable Event (Yes /No)? - 26.719(b)

No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors F1 17 Refusal to Cooperate Other Management Actions - 26.717(b)(8)

Disciplinary Action, I -Year Denial Reason(s) for the Action (select all that apply):

17 MRO Confirmation gl First drug or alcohol positive El Subversion

[7 Misuse E] Violation of 5-hour abstinence rule El Sale, Use or Possession in PA El El El Resignation/Withdrawal Subsequent positive test result from testing Other:

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved, After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

~toLo~RC Send~epbifr I~RC, Pritlt histiv T FR Single Positive Test Form version 1. 1.26

ML100601283

Text

SUBJECT:

Attachment:

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