ML111930578

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Job Performance Measure Ilc 26 NRC Retake Exam Admin JPM#1
ML111930578
Person / Time
Site: Turkey Point  NextEra Energy icon.png
Issue date: 06/02/2011
From: Wilson M
Florida Power & Light Co
To:
NRC/RGN-II
References
Download: ML111930578 (53)
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Text

ri; Ta7 iei current revision and that there are no unresolved TWR AIs. I Date verfied. Initials.

TWR AI# AR 00402402 Assgn 02 0

FPL Nucear Division FLORIDA POWER & LIGHT COMPANY TURKEY POINT NUCLEAR STATION NUCLEAR TRAINING DEPARTMENT JOB PERFORMANCE MEASURE ILC 26 NRC RETAKE EXAM ADMIN JPM #1 Mark Wilson Preparer:

2/17/2011 Date:

Technical Reviewer (Print/Sign) Date Discipline Training Supervisor (Print/Sign) Date F-630-Rev.1 (01/31/08 NTP-002)

Appendix C Job Performance Measure Form ES-C-I Worksheet Facility: Turkey Point Task No: 02201005100 Determine License Status Task

Title:

(Active-Inactive) JPM No: ILC 26 NRC Retake A1.a K/A

Reference:

2.1.1 SRO4.2 Examinee: NRC Examiner:

Facility Evaluator: Date:

Method of testing:

Simulated Performance Actual Performance x Classroom X Simulator Plant Read to the examinee:

I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues. When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS Three (3) Reactor Operators (ROs) have the following history:

  • All three ROs have off-shift assignments at the plant.
  • All three ROs are current in License Operator Requalification Training.
  • All three ROs have had a physical in the last two years with no medical restrictions.
  • None of the three ROs have worked any shifts since March 22, 2011.
  • Active/Inactive status and time on shift since January 1, 2011 is as follows for each of the Reactor Operators (Assume shift rotation are 8 hour9.259259e-5 days <br />0.00222 hours <br />1.322751e-5 weeks <br />3.044e-6 months <br /> periods):

Reactor Operator A License was active on January 1, 2011 Watch Date 1/02/2011-Worked day shift as Unit 3 RCO (0700 am 0300 pm) 1/09/2011-Worked peak shift as Admin RCO (0300 pm 1100 pm) 1/26/2011-Worked day shift in the Work Control (0700 am 0300 pm) 1/29/2011-Worked mid shift as Unit 3 RCO (1100pm 0700 am) 2/03/2011-Worked day shift as Admin RCO (0700 am 0300 pm) 2/04/20 1 1-Worked day shift as Unit 3 RCO (0700 am 0300 pm) 2/20/20 1 1-Worked mid shift as Admin RCO (1100 pm 0700 am) 2/21/2011-Worked mid shift as Unit 3 RCO (1100 pm 0700 am) 2/22/2011-Worked mid shift as Admin RCO (1100pm 0700 am)

Reactor Operator B License was active on January 1, 2011 Watch Date 1/04/2011-Worked day shift as Admin RCO (0700 am 0300 pm) 1/16/2011-Worked day shift in Work Control (0700 am 0300 pm) 1/22/20 1 1-Worked peak shift in the Tagging Office (0300 pm 1100 pm) 2/03/2011-Worked peak shift in the Tagging Office (0300 pm 1100 pm) 2/06/2011-Worked mid shift on Unit 4 RCO (1100 pm 0700 am) 2/21/2011-Work mid shift as Admin RCO (1100pm 0700 am) 2/23/2011-Worked mid shift as Unit 4 RCO (1100pm 0700 am) 2/27/2011-Worked mid shift as Admin RCO (1100pm 0700 am) 3/22/20 1 1-Worked day shift as Unit 4 RCO (0700 am 0300 pm)

NUREG 1021 Rev9AppendixC

Appendix C Page 2 of 10 Form ES-C-I Reactor Operator C - License was Inactive on January I, 2011 1/05/2011 through 1/09/2011- worked 40 hrs under the direction of Unit 4 RCO and completed all requirement for license re-activation Watch Date 2/2/2011-Worked day shift as Unit 4 RCO (0700 am 0300 pm) 2/3/2011- Worked day shift as Unit 4 RCO (0700 am 0300 pm) 2/4/2011- Worked day shift as Unit 4 RCO (0700 am 0300 pm) 2/5/2011-Worked day shift as Admin RCO (0700 am 0300 pm) 2/6/2011- Worked day shift as Admin RCO (0700 am 0300 pm) 2/7/2011- Worked day shift as Admin RCO (0700 am 0300 pm) 3/2/2011- Worked day shift in LOCT Training (0700 am 0300 pm) 3/3/2011 Worked day shift in LOCT Training (0700 am 0300 pm) 3/4/2011-Worked day shift in LOCT Training (0700 am 0300 pm) 3/5/2011- Worked day shift as LOCT Training (0700 am 0300 pm) 3/6/2011-Worked day shift in Unit 3 RCO (0700 am 0300 pm)

INITIATING CUE:

You are to determine if each of the Reactor Operators is qualified to work as a reactor operator on Unit 3 or Unit 4 on the day shift on June 1, 2011. Circle you answer below (YES or NO)

Reactor Operator A Unit 3: YES / NO Unit4: YES/NO Reactor Operator B Unit 3: YES / NO Unit 4: YES/NO Reactor Operator C Unit 3: YES / NO Unit 4: YES / NO HAND JPM BRIEFING SHEET TO EXAMINEE AT THIS TIME!

NUREG 1021 Rev9AppendixC

Appendix C Page 3 of 10 Form ES-C-I]

Task standard: -

  • References Reviewed
  • Determines that Operator A and C licenses are still active and may stand watch.
  • Determines Operator B is inactive and is not qualified to stand watches in the control room.

Required Materials:

  • O-ADM-200, Conduct of Operations
  • O-ADM-202, Shift Relief and Turnover
  • NAP-402, Conduct of Operations
  • NAP-408, License Maintenance and Activation Program General

References:

  • O-ADM-200, Conduct of Operations
  • O-ADM-202, Shift Relief and Turnover
  • NAP-402, Conduct of Operations
  • NAP-408 License Maintenance and Activation Program Time Critical Task: No Validation Time: 15 minutes NUREG 1021 Rev9AppendixC

Appendix C Page 4 of 10 Form ES-C-I SIMULATOR SETUP Reset to IC #

N!A Load Lesson NIA Ensure Simulator Operator Checklist is complete NIA NUREG 1021 Rev9AppendixC

I Appendix C Page 5 of 10 Form ES-C-I Denote critical steps with a check mark(

Start Time STEP 1  : SAT Obtain the procedural guidance.

UNSAT Standard: The examinee requests to look at Operations procedural guidance.

Make the fol lowing required materials available:

. 0-ADM-200, Conduct of Operations Cue

  • 0-ADM-201, Shift Manning
  • NAP-402, Conduct of Operations
  • NAP-408, License Maintenance and Activation Program Comment NOTE: NAP-408 requires 56 hrs/qtr for 8 hr shifts and 60 hrs for 12 hr shifts.

Determine status of Reactor Operator A.

STEP 2  : SAT J

UNSAT Operator determines that Reactor Operator A license is active Standard: because he stood more than 56 hrs in the previous quarter in a licensed position.

Cue Comment Reactor Operator A Unit NO Unit 4I NO NOTE:

NUREG 1021 Rev 9AppendixC

Appendix C Page 6 of 10 Form ES-C-I Determines license status of Reactor Operator B. -

STEP 3  : SAT q

UNSAT Standard: Operator determines that Reactor Operator B is inactive because he did not stand 56 hrs in a licensed watch standing position.

Cue Comment Reactor Operator B Unit 3: YES Unit 4: YES NOTE: Operator stood 48 hours5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> of watch.

NUREG 1021 Rev 9 Appendix C

Appendix C Page 7 of 10 Form ES-C-I Determines license status of Reactor Operator C.

STEP 4 SAT q

UNSAT Standard Determines that Reactor Operator C license is active because it was reactivated in the previous quarter and he stood 56 hours6.481481e-4 days <br />0.0156 hours <br />9.259259e-5 weeks <br />2.1308e-5 months <br /> of watch.

Cue Comment Reactor Operator C Unit 3 NO Unit 4 NO NOTE:

Terminating The task is complete when the Examinee returns the cue sheet to Cue: the examiner. STOP Stop Time NUREG 1021 Rev9AppendixC

Appendix C Page 8 of 10 Form ES-C-I Verification of Completion Job Performance Measure No. ILC 26 NRC Retake A.1.a Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:

Response

Result: Satisfactory/Unsatisfactory Examiners signature and date:

NUREG 1021 Rev9AppendixC

JPM BRIEFING SHEET (1 of 2)

The examiner will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS Three (3) Reactor Operators (ROs) have the following history:

  • All three ROs have off-shift assignments at the plant.
  • All three ROs are current in License Operator Requalification Training.
  • All three ROs have had a physical in the last two years with no medical restrictions.
  • None of the three ROs have worked any shifts since March 22, 2011.
  • Active/Inactive status and time on shift since January 1, 2011 is as follows for each of the Reactor Operators (Assume shift rotation are 8 hour9.259259e-5 days <br />0.00222 hours <br />1.322751e-5 weeks <br />3.044e-6 months <br /> periods):

Reactor Operator A License was active on January 1, 2011 Watch Date 1/02/2011-Worked day shift as Unit 3 RCO (0700 am 0300 pm) 1/09/2011-Worked peak shift as Admin RCO (0300 pm 1100 pm) 1/26/2011-Worked day shift in the Work Control (0700 am 0300 pm) 1/29/2011-Worked mid shift as Unit 3 RCO (1100pm 0700 am) 2/03/2011-Worked day shift as Admin RCO (0700 am 0300 pm) 2/04/2011-Worked day shift as Unit 3 RCO (0700 am 0300 pm) 2/20/2011-Worked mid shift as Admin RCO (1100 pm 0700 am) 2/21/2011-Worked mid shift as Unit 3 RCO (1100pm 0700 am) 2/22/2011-Worked mid shift as Admin RCO (1100pm 0700 am)

Reactor Operator B License was active on January 1,

- 2011 Watch Date 1/04/2011-Worked day shift as Admin RCO (0700 am 0300 pm) 1/16/2011-Worked day shift in Work Control (0700 am 0300 pm) 1/22/2011-Worked peak shift in the Tagging Office (0300 pm 1100 pm) 2/03/2011-Worked peak shift in the Tagging Office (0300 pm 1100 pm) 2/06/2011-Worked mid shift on Unit 4 RCO (1100pm 0700 am) 2/21/2011-Work mid shift as Admin RCO (1100pm 0700 am) 2/23/2011-Worked mid shift as Unit 4 RCO (1100pm 0700 am) 2/27/2011-Worked mid shift as Admin RCO (1100 pm 0700 am) 3/22/2011-Worked day shift as Unit 4 RCO (0700 am 0300 pm)

Reactor Operator C License was inactive on January 1, 2011 1/05/2011 through 1/09/2011- worked 40 hrs under the direction of Unit 4 RCO and completed all requirement for license re-activation Watch Date 2/2/20 1 1-Worked day shift as Unit 4 RCO (0700 am 0300 pm) 2/3/2011- Worked day shift as Unit 4 RCO (0700 am0300 pm) 2/4/2011- Worked day shift as Unit 4 RCO (0700 am 0300 pm) 2/5/2011- Worked day shift as Admin RCO (0700 am0300 pm) 2/6/2011- Worked day shift as Admin RCO (0700 am 0300 pm) 2/7/2011- Worked day shift as Admin RCO (0700 am 0300 pm) 3/2/2011-Worked day shift in LOOT Training (0700 am0300 pm) 3/3/2011-Worked day shift in LOOT Training (0700 am 0300 pm) 3/4/2011- Worked day shift in LOCT Training (0700 am 0300 pm) 3/5/20 1 1- Worked day shift as LOCT Training (0700 am 0300 pm) 3/6/20 1 1- Worked day shift in Unit 3 RCO (0700 am 0300 pm)

NUREG 1021 Rev 9 Appendix C

Appendix C Page 10 of 10 Form ES-C-I JPM BRIEFING SHEET (2 of 2)

INITIATING CUE:

You are to determine if each of the Reactor Operators is qualified to work as a reactor operator on Unit 3 or Unit 4 on the day shift on June 1, 2011. Circle you answer below (YES or NO).

Reactor Operator A Unit 3: YES I NO Unit 4: YES I NO Reactor Operator B Unit 3: YES / NO Unit 4: YES / NO Reactor Operator C Unit 3: YES I NO Unit 4: YES I NO Acknowledge to the examiner when you are ready to begin.

HAND THIS PAPER BACK TO YOUR EVALUATOR WHEN YOU HAVE SATISFACTORILY COMPLETED THE ASSIGNED TASK.

NUREG 1021 Rev9AppendixC

current revision and that there are no unresolved TWR AIs.

!fL J TWR AI# AR 00402402 Assgn 02 0

FPL Nucear Division FLORIDA POWER & LIGHT COMPANY TURKEY POINT NUCLEAR STATION NUCLEAR TRAINING DEPARTMENT JOB PERFORMANCE MEASURE ILC 26 NRC RETAKE EXAM ADMIN JPM #2 Mark Wilson Preparer:

2/17/2011 Date:

Technical Reviewer (Print/Sign) Date Discipline Training Supervisor (Print/Sign) Date F-630-Rev.1 (01/31/08 NTP-002)

Appendix C Job Performance Measure Form ES-C-I Worksheet Facility: Turkey Point Task No: 02201026100 Task

Title:

Maintain Operations Key Log JPM No: ILC 26 NRC Retake A.1.b KA

Reference:

2.1.29 SRO4.0 Examinee: NRC Examiner:

Facility Evaluator: Date:

Method of testing:

Simulated Performance X Actual Performance Classroom X Simulator Plant Read to the examinee:

I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues. When you complete the task successfully, the objective for this job performance measure will be satisfied.

Initial Conditions:

You are the Unit 3 Unit Supervisor. The crew has entered 3-ONOP-049.1, Deviation or Failure of Safety Related or Reactor Protection Channels, to mitigate the effects of P-3-457, Pressurizer Pressure, failing low. Unit 3 is stable at 100% with no other testing in progress or failures.

Initiating Cue:

You have directed performance of Step 5.11 of 3-ONOP-049.1 to trip the bistables of P-3-457.

  • Identify which rack(s) the RCO will enter to trip bistables for P-3-457.
  • Fill out F-527, Operations Key Log, to checkout a key for U3 RCO.
  • For this plant event, identify 1) why a notification is required and 2) whom jf anyone in the NRC is required to be notified.

HAND JPM BRIEFING SHEET TO EXAMINEE AT THIS TIME!

NUREG 1021 Rev9AppendixC

Appendix C Page 2 of 8 Form ES-C-I Task Standard:

  • Control Protection Rack access
  • Maintain Operations Keg Log
  • Identify plant event and NRC notification (whom)

Time Critical Task: NO Validation Time: 20 minutes Required Materials:

  • 3-ONOP-049. 1, Deviation or Failure of Safety Related or Reactor Protection Channels
  • 0-ADM-205, Administrative Control of Valves, Locks, and Switches
  • F-527, Operations Key Log (hard copy & blank)
  • 0-ADM-1 15, Notification of Plant Events
  • NAP-402, Conduct of Operations
  • Control Room Master Key Index
  • PTN Technical Specifications General

References:

  • 3-ONOP-049. 1, Deviation or Failure of Safety Related or Reactor Protection Channels
  • 0-ADM-205, Administrative Control of Valves, Locks, and Switches
  • F-527, Operations Key Log
  • 0-ADM-1 15, Notification of Plant Events
  • NAP-402, Conduct of Operations
  • Control Room Master Key Index
  • PTN Technical Specifications NUREG 1021 Rev9AppendixC

Appendix C Page 3 of 8 Form ES-C-I I SIMULATOR SETUP Reset to IC #

N/A Load Lesson N/A Ensure Simulator Operator Checklist is complete N/A NUREG 1021 Rev9AppendixC

Appendix C Page 4 of 8 Form ES-C-I Critical steps are denoted with checkmark (I)

Start Time STEP 1 : Obtain a copy of 3-ONOP-049.1, Deviation or Failure of Safety SAT Related or Reactor Protection Channels.

(From the initiating cue.) UNSAT A copy of 3-ONOP-049.1, Deviation or Failure of Safety Related or Standar&

Reactor Protection Channels is obtained.

Provide a copy of 3-ONOP-049. 1, Deviation or Failure of Safety Cue Related or Reactor Protection Channels.

Comment STEP 2 SAT Identify which rack(s) the RCO will enter to trip bistables for P-3-457.

U N SAT Examinee uses Attachment 4, Failed Channel Bistable List, to identify Standard Racks 14 & 15 will be opened to trip bistables Rack(s) for tripping P-3-457 Bistables Comment 14 15 NUREG 1021 Rev9AppendixC

I Appendix C I Page 5 of 8 I Form ES-C-I STEP 3  : SAT Fill out F-527, Operations Key Log, to checkout a key for U3 RCO.

1 UNSAT Standard: The examinee fills out F-527, Operations Key Log, to checkout a key for U3 RCO.

Provide a hardcopy of

. F-527, Operations Key Log

. Control Room Master Key Index Critical Step Parts

. Key#

. Name (similar variation acceptable)

. Work Control Comment System, major component, cubicle or rackdoororpaneltobomanipulated WORK -

KEY MODE CONTROL KEYISSUED NO. or Opened that allows EVAL manipulation To PERSON ISSUED (INIT) DATE B

. NAME NUMBER (procedure or (NAME &

clearance No.) DEPT) & TIME

<NAME) it U3 Protection Racks 14 & 15 INIT 3-ONOP-049.1 Name- OPs Name /xx/ c it = Keys 3,37,155,156 or 158 (Any cceptable)

NUREG 1021 Rev9AppendixC

Appendix C Page 6 of 8 Form ES-C-I STEP 4  : SAT For this plant event, identify 1) why a notification is required and 2) whom if anyone in the NRC is required to be notified. UNSAT The examinee identifies:

1. Unplanned entry into a 72 Hr (or less) Action Statement Standard: 2. NRC Resident Inspector Note: The candidate may also mention Plant Management. Anytime the NRC Resident Inspector is notified, Plant Management is required to be notified.
1) Provide a hardcopy of PTN Technical Specifications, if asked.
2) Provide a hardcopy of O-ADM-1 15, Notification of Plant Events, Cue if asked.
3) Provide a hardcopy of NAP-402, Conduct of Operations, if asked.

Comment Terminating The task is complete when the Examinee returns the cue sheet to Cue the examiner. With no action taken by Examinee, the Examiner STOP completes the JPM.

Stop Time NUREG 1021 Rev 9 Appendix C

[ Appendix C Page 7 of 8 Form ES-C-I Verification of Completion Job Performance Measure No. ILC 26 NRC Retake A.1.b Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:

Response

Result: Satisfactory/Unsatisfactory Examiners signature and date:

NUREG 1021 Rev9AppendixC

JPM BRIEFING SHEET The examiner will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues.

When you complete the task successfully, the objective for this job performance measure will be satisfied.

Initial Conditions:

You are the Unit 3 Unit Supervisor. The crew has entered 3-ONOP-049.1, Deviation or Failure of Safety Related or Reactor Protection Channels, to mitigate the effects of P-3-457, Pressurizer Pressure, failing low. Unit 3 is stable at 100% with no other testing in progress or failures.

Initiating Cue:

You have directed performance of Step 5.11 of 3-ONOP-049.1 to trip the bistables of P3-457.

  • Identify which rack(s) the RCO will enter to trip bistables for P-3-457.
  • Fill out F-527, Operations Key Log, to checkout a key for U3 RCO.
  • For this plant event, identify 1) why a notification is required and 2) whom anyone in the NRC is required to be notified.

Acknowledge to the examiner when you are ready to begin.

Rack(s) for tripping P-3-457 Bistables NRC Notification (whom)?

HAND THIS PAPER BACK TO YOUR EVALUATOR WHEN YOU HAVE SATISFACTORILY COMPLETED THE ASSIGNED TASK.

NUREG 1021 Rev9AppendixC

OPERATIONS KEY LOG.

KEY Viii Ii QARECORDPAGE 11 System, major component, cubicle or WORK .

V rack door or panel to be manipulated CONTROL KEY KEY V

MODE .

ISSUED KEY RETURNEDILOCK RESTORED NO. or opened that allows EVAL . . V. V. V manipulation. TO PERSON INIT ISSUED VERIFIED NAME NUMBER .

(procedure or. NAME & DATE V BY (NAME & DATE &

BY LoCKED

& TIME DEPT)

V clearance No.)

V V

V DEPT) V (NAME) TIME (NOTE 1)

. . V*

T3 Protection Racks 14 & 15 INIT 3-ONOP-049.1 Name- .OPs Name :c/x/ x V V

HHM V

  1. = Keys 3,37,155,156, or 158 CAny cceptable) . V NOTE 1: Each cubicle, ract door, or panel that was unlocked shall be verified to be closed and locked. Enter name of person performing the verification (Ref. Step 5.4.4).

Reviewed By: Date: ..

orSROJ)esignee

-527Rv. 2(05121108 0-ADM-205)

current revision and that there are no unresolved TWR AIs. I i

Date verjIed. Initials.

TWR AI# AR 00402402 Assgn 02 0

PL Nucear Dh,ision FLORIDA POWER & LIGHT COMPANY TURKEY POINT NUCLEAR STATION NUCLEAR TRAINING DEPARTMENT JOB PERFORMANCE MEASURE ILC 26 NRC RETAKE EXAM ADMIN JPM #3 Mark Wilson Preparer:

3/3/2011 Date:

Technical Reviewer (Print/Sign) Date Discipline Training Supervisor (Print/Sign) Date F-630-Rev.1 (01/31/08 0-NTP-002)

Appendix C Job Performance Measure Form ES-C-I Worksheet Facility: Turkey Point Task No: 02201056100 Review Boric Acid Pump Task

Title:

Discharge Valve Clearance JPM No: ILC 26 NRC Retake A.2 K/A

Reference:

2.2.13 SRO4.3 Examinee: NRC Examiner:

Facility Evaluator: Date:

Method of testing: Classroom Simulated Perl:ormance Yes Actual Performance Classroom Yes Simulator Plant Read to the examinee:

I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues. When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS You are the Unit Supervisor.

  • Valve 342, 3A Boric Acid Transfer Pump Disch to Unit 3 BA Fltr, has a valve body leak.
  • The Admin RCO has prepared the attached ECO and marked up P&ID for Valve 342 and has submitted it for your review.
  • NOMS Database is not available for clearance research and preparation.
  • All Technical Specification issues associated with the removal from service of equipment associated with Valve 342 have already been addressed.
  • Separate guidance has been developed and approved to ensure the availability of boric acid to Unit 3 while this EGO is in effect.

INITIATING CUE The Shift Manager directs you to review the EGO for Valve 342. If the ECO is correct and complete, sign it showing your approval. If the ECO is not correct or complete, revise it to make it correct and complete.

Note: Restoration steps are NOT required for this ECO.

HAND JPM BRIEFING SHEET TO EXAMINEE AT THIS TIME!

NUREG 1021 Rev9AppendixC

Appendix C Page 2 of 8 Form ES-C-I Task Standard:

  • The clearance order is reviewed.
  • Errors existing in the clearance ordered are discovered.

Required Materials:

  • O-ADM-212.1, Operations In-Plant Equipment Clearance Orders
  • Student EGO Package
  • Red Pen & Highlighter General

References:

  • O-ADM-212.1, Operations In-Plant Equipment Clearance Orders Time Critical Task: NO Validation Time: 40 minutes NUREG 1021 Rev9AppendixC

I Appendix C I Page 3 of 8 I Form ES-C-I SIMULATOR SETUP Reset to IC #

NIA Load Lesson NIA Ensure Simulator Operator Checklist is complete NIA NUREG 1021 Rev 9AppendixC

Appendix C Page 4 of 8 Form ES-C-I Denote critical steps with a check rnark(T Start Time STEP 1  : SAT Review ECO U N SAT The Examinee:

1. Asks for ECO Package
2. Reviews a marked up copy 5610-M-3046, Sheet 1 Standard: .. .
3. identifies the need to isolate and drain the affected equipment.
4. Identifies the ECO Boundary
5. Looks up 3A BA Pump breaker number (30725) in the Breaker Book.

i Hand the applicant the ECO Package Comment NOTE:

NUREG 1021 Rev9AppendixC

Appendix C Page 5 of 8 I Form ES-C-I I STEP 2  : Identifies errors and omissions on the ECO form. SAT q

UNSAT The Examinee:

1. Discovers 3A BA Transfer Pump has wrong breaker number.

Breaker number shown (30610) is for the 3B BA Transfer Pump, not the 3A pump which is actually breaker 30725.

2. Discovers Breaker 30725 step is at the end of the ECO after valves are closed. Notes that 30725 should be tagged out before valves Standard:

are closed.

3. Discovers Valve 337, PW to 3A BA Xfer Pump Suct., has been omitted.
4. Discovers the valve to be worked, Valve 342 is listed on the ECO form as a valve to be Danger tagged close. 342 may be left open for draining.

Cue Comment NOTE:

NUREG 1021 Rev 9 Appendix C

Appendix C Page 6 of 8 Form ES-C-I STEP 3  : SAT Annotates ECO form to reflect the 4 discovered errors.

UNSAT Standard: The Examinee annotates the ECO form and returns it to the evaluator.

Cue Comment NOTE:

Terminating The task is complete when the Examinee returns the cue sheet to Cue: the examiner. STOP Stop Time NUREG 1021 Rev9AppendixC

Appendix C I Page 7 of 8 Form ES-C-I I Verification of Completion Job Performance Measure No. ILC 26 NRC Retake A.2 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:

Response

Result: Satisfactory/Unsatisfactory Examiners signature and date:

NUREG 1021 Rev 9 Appendix C

JPM BRIEFING SHEET The examiner wilt exp[ain the initial conditions which steps tu simulata or discuss, and provida initiating cues.

When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS You are the Unit Supervisor.

  • Valve 342, 3A Boric Acid Transfer Pump Disch to Unit 3 BA Fltr, has a valve body leak.
  • The Admin RCO has prepared the attached ECO and marked up P&ID for Valve 342 and has submitted it for your review.
  • NOMS Database is not available for clearance research and preparation.
  • All Technical Specification issues associated with the removal from service of equipment associated with Valve 342 have already been addressed.
  • Separate guidance has been developed and approved to ensure the availability of boric acid to Unit 3 while this ECO is in effect.

INITIATING CUE The Shift Manager directs you to review the ECO for Valve 342. If the ECO is correct and complete, sign it showing your approval. If the ECO is not correct or complete, revise it to make it correct and complete.

Note: Restoration steps are NOT required for this ECO.

Acknowledge to the examiner when you are ready to begin.

HAND THIS PAPER BACK TO YOUR EVALUATOR WHEN YOU HAVE SATISFACTORILY COMPLETED THE ASSIGNED TASK.

NUREG 1021 Rev 9 Appendix C

ECO # 3-XX-XX-XXX ECO FORM L

TAG HANG LIST FOR ECO Page 1 of 2 Tag Equipment Equipment Equipment Tag Place Place st 1 nd 2

Serial Notes ID Description Location Type Seq Config Number 3A Boric Acid 3P203A Control Room Hang Info Transfer Pump Info Tag 1 Control Console Tag Control Switch Switch 3A Boric Acid Non-Critical Boric Acid Tank 6 Transfer Pump 1 Danger Close Plus Suction valves closed after 338 Room Suct Vlv discharge vlvs-any order Batch Tk to 3A Non-Critical BoricAcid Tank 7 Boric Acid Transfer 2 Danger Close Plus Suction valves closed after 398A Room Pump Suct discharge vlvs-any order 3A Boric Acid Non-Critical Boric Acid Tank Transfer Pump 3 Danger 3 Close Plus Discharge valves closed 332 Room Disch to A BAST before suction vlvs-any order 3B Boric Acid Non-Critical Transfer Pump Boric Acid Tank Discharge valves closed 4 Danger Close Plus 341 Disch to Unit 3 Room 5 before suction vlvs-any order BA Fltr Non-Critical Unit-3 BA Fltr Boric Acid Tank 5 5 Danger Close Plus Discharge valves closed 3-347 Inlet Iso! Room before suction vlvs-any order 3A Boric Acid Boric Acid Tank 9 Drain Line 396A Drain No Tag Transfer Pump Drn Room Installed Line 3A Boric Acid Boric Acid Tank 10 No Tag Throttle 396A Transfer Pump Drn Room S Critical Error 3A Boric Acid Student will not tag valve Transfer Pump Boric Acid Tank close plus.

Danger Close Plus (may be open no tag)

Disch to Unit 3 Room BA Fltr 3A Boric Acid Boric Acid Tank 11 Place Seq. # may be +1 if 7 Danger Open 342 is OPENwith no tag.

396A Transfer Pump Drn Room F-392/3:5 Rev. 2(2/5/11 ADM-212.I)

ECO FORM TAG HANG LIST FOR ECO Pa2e 2 of 2 Equipment Equipment Tag Equipment Tag Place Place st 1 nd 2

Serial Notes ID Description Location Type Seq Config Number 30725 2 Critical Error Boric Acid Transfer 3C 480v MCC 8 Danger Off Plus 30610 1) Wrong Bkr #

Pump3ABkr 2)Seguence#2 30725 Boric Acid Transfer De- Critical Error 3C48OvMCC - ZVC 12 30610 Pump 3A Bkr Energized 1) Wrong Bkr#

PW to 3A BA Xfer Boric Acid Tannk Critical Error 1 Danger 8 Close Pump Suct. Room Omitted If the ECO is correct and complete, sign it showing your approval.

US Reviewed By F-392/3:5 Rev. 2 (2/5/11 ADM-212.1)

ri;;;;,

i current revision and that there are no unresolved TWR AIs. I L___ L J TWR AI# AR 00402402 Assgn 02 0

FPL Nudear Division FLORIDA POWER & LIGHT COMPANY TURKEY POINT NUCLEAR STATION NUCLEAR TRAINING DEPARTMENT JOB PERFORMANCE MEASURE ILC 26 NRC RETAKE EXAM ADMIN JPM #4 Mark Wilson Preparer:

3/3/2011 Date:

Technical Reviewer (Print/Sign) Date Discipline Training Supervisor (Print/Sign) Date F-630-Rev.1 (01/31/08 - 0-NTP-002)

Appendix C Job Performance Measure Form ES-C-I Worksheet Facility: Turkey Point Task No: 022033021 100 Determine the Airborne Task

Title:

Activity Dose Rate JPM No: ILC 26 NRC Retake A.3 K/A

Reference:

2.3.4 SRO 3.7 Examinee: NRC Examiner:

Facility Evaluator: Date:

Method of testing: Classroom Simulated Performance Actual Performance Yes Classroom Yes Simulator Plant Read to the examinee:

I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues. When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS An NLO has been assigned the task of performing a valve lineup in the Unit 4 Safety Injection Pump Room. The dose rates for the area are located on the survey map. In this area, there is some airborne activity. From experience, the NLO knows that it will take 60 minutes to perform the valve lineup without a respirator, or 80 minutes to complete the job with a respirator. If the job is done without a respirator, the NLO will receive 2 DAC-hours of internal exposure. (NOTE: Ignore transient time in dose calculation, use only data at the work location.)

INITIATING CUE You have been directed to determine the dose the NLO will receive if he doesnt wear a respirator while performing the valve lineup and the dose he will receive if he wears a respirator. Report back to the Shift Manager which method will result in the lowest dose and keep the exposure ALARA.

ADDITIONAL INFORMATION 2000 DAC-Hours is equivalent to the Annual Federal TEDE exposure limit.

HAND JPM BRIEFING SHEET TO EXAMINEE AT THIS TIME!

NUREG 1021 Rev 9 Appendix C

Appendix C Page 2 of 8 Form ES-C-I Task Standard:

  • Dose is correctly calculated with a respirator and without a respirator and determines that the job should be performed without a respirator and reports findings.

Required Materials:

  • Calculator
  • Unit 4 Safety Injection Pump Room Survey Map
  • Valve Locator Map General

References:

  • O-ADM-600, RADIATION PROTECTION MANUAL

I Appendix C Page 3 of 8 I Form ES-C-I SIMULATOR SETUP Reset to IC # -

NIA Load Lesson N/A Ensure Simulator Operator Checklist is complete N/A NUREG 1021 Rev9AppendixC

Appendix C Page 4 of 8 Form ES-C-I Denote critical steps with a chck mrk(

Start Time Calculates NLO dose without a respirator.

STEP I  : SAT J

UNSAT Accurately calculates NLQ dose without a respirator.

(1.0 hour0 days <br />0 hours <br />0 weeks <br />0 months <br />) x (34 mR/hour) = 34 mRem Standard:

(2 DAC hours) x (2.5 mRem/DAC-hour) = 5.0 mRem Total = (34.0) + (5.0 mRem) = 39.0 mRem Cue Comment NOTE:

NUREG 1021 Rev9AppendixC

Appendix C Page 5 of 8 Form ES-C-I I aculates NLO dose with a respirator. -

STEP 2  : SAT UNSAT Accurately calculates NLO dose with a respirator.

Standard:

(1.33 hours3.819444e-4 days <br />0.00917 hours <br />5.456349e-5 weeks <br />1.25565e-5 months <br />) x (34 mRem/hour) = 45.22 mRem (44-46 mRem)

Cue Corn ment NOTE:

NUREG 1021 Rev 9 Appendix C

Appendix C Page 6 of 8 Form ES-C-I Determines that the job should b performed without a respirator.

STEP 3  : SAT q Reports findings UNSAT

. Determines that the job should be performed without a respirator.

Standard:

. Reports findings.

Cue Corn ment NOTE:

Terminating The task is complete when the Examinee returns the cue sheet to Cue: the examiner. STOP Stop Time NUREG 1021 Rev9AppendixC

I Appendix C

, Page 7 of 8 Form ES-C-I Verification of Completion Job Performance Measure No. ILC 26 NRC Retake A.3 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:

Response

Result: Satisfactory/Unsatisfactory Examiners signature and date:

NUREG 1021 Rev9AppendixC

JPM BRIEFING SHEET The examier will explain the initial conditions, which steps to simulate or discuss, and provida iatthg cues When you complete the task successfully, the objective for this job performance measure will be satisfied.

INITIAL CONDITIONS An NLO has been assigned the task of performing a valve lineup in the Unit 4 Safety Injection Pump Room. The dose rates for the area are located on the survey map. In this area, there is some airborne activity. From experience, the NLO knows that it will take 60 minutes to perform the valve lineup without a respirator, or 80 minutes to complete the job with a respirator. If the job is done without a respirator, the NLO will receive 2 DAC-hours of internal exposure. (NOTE: Ignore transient time in dose calculation, use only data at the work location.)

INITIATING CUE You have been directed to determine the dose the NLO will receive if he doesnt wear a respirator while performing the valve lineup and the dose he will receive if he wears a respirator. Report back to the Shift Manager which method will result in the lowest dose and keep the exposure ALARA.

ADDITIONAL INFORMATION

  • 2000 DAC-Hours is equivalent to the Annual Federal TEDE exposure limit.

Acknowledge to the examiner when you are ready to begin.

HAND THIS PAPER BACK TO YOUR EVALUATOR WHEN YOU HAVE SATISFACTORILY COMPLETED THE ASSIGNED TASK.

NUREG 1021 Rev 9 Appendix C

current revision and that there are no unresolved TWR AIs.

i Date verified. Initials:

TWR Al# AR 00402402 Assgn 02 0

FPL Nuebar Division FLORIDA POWER & LIGHT COMPANY TURKEY POINT NUCLEAR STATION NUCLEAR TRAINING DEPARTMENT JOB PERFORMANCE MEASURE ILC 26 NRC RETAKE EXAM ADMIN JPM #5 Mark Wilson Preparer:

3/3/2011 Date:

Technical Reviewer (Print/Sign) Date Discipline Training Supervisor (Print/Sign) Date F-630-Rev.1 (01/31/08 NTP-002)

Appendix C Job Performance Measure Form ES-C-I

. Worksheet Facility: Turkey Point Task No: 02201019400 Classify Event and Determine Task

Title:

PARS JPM No: ILC 26 NRC Retake A.4 K/A

Reference:

2.4.41 SRO 4.6 Examinee: NRC Examiner:

Facility Evaluator: Date:

Method of testini:

Simulated Performance X Actual Performance Classroom X Simulator Plant Read to the examinee:

I will explain the initial conditions, which steps to simulate or discuss, and provide initiating cues. When you complete the task successfully, the objective for this job performance measure will be satisfied.

Initial Conditions:

  • UNITS 3 and 4 are at 100% Power.
  • 4A SGFP suction pressure piping ruptured resulting in a rapid loss of both SGFPs.
  • UNIT 4 RO manually tripped the reactor.
  • SG WR levels are less than 20%.
  • No Radiation Releases are in progress.
  • Containment Parameters are normal.
  • Wind Speed is 10mph.
  • Wind Direction is from 260°
  • 4-EOP-E.0, Reactor Trip or Safety Injection, has been exited and actions are being taken per the appropriate EOP procedure.

Initiating Cue:

  • You are the Emergency Coordinator in the Control Room. Given the initial conditions classify the event using 0-EPIP-201 01, Duties of Emergency Coordinator, and if necessary, issue protective action recommendations using 0-EPIP-20134, Offsite Notifications and Protective Action Recommendations.
  • By raising your hand will signify that you have completed the event declaration. At that time the Examiner will provide you with a Florida State Notification Form. You will then complete the Florida State Notification Form using 0-EPIP-201 34, Offsite Notifications and Protective Action Recommendations.
  • When you have completed the Florida State Notification Form, raise your hand to inform the Examiner you are done.
  • There is an element of this task that is Time Critical.

HAND JPM BRIEFING SHEET TO EXAMINEE AT THIS TIME!

NUREG 1021 Rev 9 Appendix C

Appendix C Page 2 of 9 Form ES-C-I Task Standard:

  • Classification of Site Area Emergency, FS1, is declared within 15 minutes of starting the task.
  • A Standard General Emergency Protective Action Recommendation (PAR) is made.
  • The Florida Nuclear Plant Emergency Notification Form is completed in accordance 0-EPIP-20134 Offsite Notifications and Protective Action Recommendations, with NO errors on required items identified with a
  • within 15 minutes of event declaration. (Item 2B is not required until offsite agencies are contacted.)

Time Critical Task: Yes Validation Time: 30 minutes Required Materials:

  • F-439, Florida Nuclear Plant Notification Form (hardcopy)
  • F-444, Guidance For Determining Protective Action Recommendations (PARs) (hardcopy)
  • F-668, Hot Conditions Table (hardcopy)
  • F-669, Cold Conditions Table (hardcopy)
  • 0-EPIP-20101, Duties of Emergency Coordinator
  • 0-EPIP- 20134, Offsite Notifications and Protective Action Recommendations General

References:

  • F-439, Florida Nuclear Plant Notification Form
  • F-444, Guidance For Determining Protective Action Recommendations (PARs)
  • F-668, Hot Conditions Table
  • F-669, Cold Conditions Table
  • 0-EPIP-201 01, Duties of Emergency Coordinator
  • 0-EPIP- 20134, Offsite Notifications and Protective Action Recommendations NUREG 1021 Rev9AppendixC

I Appendix C Page 3 of 9 Form ES-C-I SIMULATOR SETUP Reset to IC #

N/A Load Lesson N/A Ensure Simulator Operator Checklist is complete N/A NUREG 1021 Rev9AppendixC

Appendix C Page 4 of 9 Form ES-C-I Critical steps are denoted with explanation point (

Start Time Obtain O-EPIP-20101, DUTIES OF EMERGENCY COORDINATOR STEP I and HOT CONDITONS TABLE, F-668. SAT (From the initiating cue.) UNSAT O-EPIP-20101 DUTIES OF EMERGENCY COORDINATOR is Standard:

obtained with a copy of HOT CONDITONS TABLE, F-668.

Provide a copy of O-EPIP-20101, DUTIES OF EMERGENCY C

COORDINATOR and HOT CON DITONS TABLE, F-668.

Corn ment Review O-EPIP-20l01, DUTIES OF EMERGENCY COORDINATOR STEP 2  : and HOT CONDITONS TABLE, F-668. SAT UNSAT Examinee reviews O-EPIP-20l01, DUTIES OF EMERGENCY Standard: COORDINATOR and HOT CONDITONS TABLE, F-668 for the event depicted in the initial conditions sheet.

Comment NUREG 1021 Rev 9 Appendix C

Appendix C Page 5 of 9 Form ES-C-I The student should consult 0- EPIP- 20134, Attachment 3, or F-444, NOTE: Guidance For Determining Protective Action Recommendations (PARs) for required Protective Action Recommendations.

Classify Off-Normal Event using present available information, AND STEP 3  : declare the emergency classification using HOT CONDITONS TABLE, SAT J F-668.

U N SAT The examinee classifies the event as a Site Area Emergency (FSI)

Standard: by interpreting the information given in the initial conditions within 15 minutes of starting the JPM.

Comment The SAE Classification is based on the following:

EXAMINER

. Loss or Potential Loss of Two Fission Product Barriers NOTE:

(RED Path on Heat Sink affects the RCS and Fuel Barriers.)

EXAMINER Annotate the STOP TIME for the Event Classification here.

NOTE:

Examinee continues with the task to issue Protective Action EXAMINER Recommendations and complete the State Notification Form using NOTE: 0-EPIP-20134, Offsite Notifications and Protective Action Recommendations. The critical time element continues.

EXAMINER Annotate the START TIME for the Florida State Notification here.

NOTE:

NUREG 1021 Rev 9 Appendix C

Appendix C Page 6 of 9 Form ES-C-I STEP Obtain O-EPIP-20134, Offsite Notifications and Protective Action 4 SAT

. Recommendations and Florida State Notification Form F-439.

UNSAT 0-EPI P-201 34, Offsite Notifications and Protective Action Standard: Recommendations and Florida State Notification Form, F-439 are obtained.

Cue Provide a copy of O-EPIP-201 34, Offsite Notifications and Protective Action Recommendations and Florida State Notification Form, F-439.

Comment Review O-EPIP-20134, Offsite Notifications and Protective Action STEP 5  : SAT Recommendations.

(O-EPIP-20134, Attachment 3, form F-444) UNSAT Standard Examinee reviews O-EPIP-20134, or equivalent form F-444, Offsite Notifications and Protective Action Recommendations Corn ment NUREG 1021 Rev9AppendixC

I Appendix C Page 7 of 9 Form ES-C-I Issue Protective Action Recommendations. -

STEP 6  : SAT (Examinee uses 0-EPIP-20134, Attachment 3, or F-444, Offsite Notifications and Protective Action Recommendations Note 1) UNSAT Standard Examinee determines the no Protective Action Recommendations exist.

Comment Note: This is a Critical Step only if the candidate takes Protective Action Recommendations.

Complete Florida Nuclear Plant Emergency Notification Form.

STEP 7 : SAT

.sI (0-EPIP- 20134, Attachment 1B)

UNSAT (Turkey Point Nuclear Form F 439)

The examinee completes a Florida Nuclear Plant Emergency Notification Standard: Form with no errors noted on required items annotated by a

  • within 15 minutes. (Item 2B is not required until offsite agencies are contacted.)

Comment Step by step instructions for completing the Florida Nuclear Plant EXAMINER Emergency Notification Form are contained within 0-EPIP- 20134, NOTE: Offsite Notifications and Protective Action Recommendations, Attachment 1 B.

EXAMINER The time critical element is complete when the Florida State Notification Form is complete.

NOTE:

EXAMINER See the exam key for a copy of the completed Florida State Notification NOTE: Form.

Terminating The task is complete when the Examinee returns the cue sheet to Cue: the examiner. STOP STOP TIME NUREG 1021 Rev9AppendixC

Appendix C Page 8 of 9 Form ES-C-I Verification of Corn p!etion Job Performance Measure No. ILC 26 NRC Retake A.4 Examinees Name:

Examiners Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:

Response

Result: Satisfactory/Unsatisfactory Examiners signature and date:

NUREG 1021 Rev 9 Appendix C

JPM BRIEFING SHEET Th xrniner will explain the irutial conditions, whict-isteps to simulate or discuss, a dpro.videinitiating cuss.

When you complete the task successfully, the objective for this job performance measure will be satisfied.

Initial Conditions:

  • UNITS 3 and 4 are at 100% Power.
  • 4A SGFP suction pressure piping ruptured resulting in a rapid loss of both SGFPs.
  • UNIT 4 RO manually tripped the reactor.
  • SG WR levels are less than 20%.
  • No Radiation Releases are in progress.
  • Containment Parameters are normal.
  • Wind Speed is 10mph.
  • Wind Direction is from 260°
  • 4-EOP-E.0, Reactor Trip or Safety Injection, has been exited and actions are being taken per the appropriate EOP procedure.

Initiating Cue:

  • You are the Emergency Coordinator in the Control Room. Given the initial conditions classify the event using 0-EPIP-20101, Duties of Emergency Coordinator, and if necessary, issue protective action recommendations using 0-EPlP20134, Offsite Notifications and Protective Action Recommendations.
  • By raising your hand will signify that you have completed the event declaration. At that time the Examiner will provide you with a Florida State Notification Form. You will then complete the Florida State Notification Form using 0-EPIP-20134, Offsite Notifications and Protective Action Recommendations.
  • When you have completed the Florida State Notification Form, raise your hand to inform the Examiner you are done.
  • There is an element of this task that is Time Critical.

Acknowledge to the examiner when you are ready to begin.

HAND THIS PAPER BACK TO YOUR EVALUATOR WHEN YOU HAVE SATISFACTORILY COMPLETED THE ASSIGNED TASK.

NUREG 1021 Rev 9 Appendix C

a

  • a a a a U m I I ii FLORiDA NUCLEAR PLANT EMERGENCY NOTIFICATIO*
  • 1. A.

OnUneVeflcatIon

2. A. Date This Is A Drill I I El TAT - [3 MIAMI-DADE COUNTY B. U This Is An Actual Event B.ContactTlme:_____ C. Reportedby:Name______

El MONROE I

K E V D. Message Number: I E. Reported From: Control koom Lj u izUl F. lnitiaIINew Classification OR El Update Notification A. El Crystal River UNIT-4 B. El SL-hueIe4JNIT4 C. El t-Lueie--UNl-T-2 D. El Turkey Point UNIT 3 E. Turkey Point UNIT 4

  • 4 EMERGENCY CLASSIFICATION:

A. El Notification Of Unusual Event B, El Alert C. Site Area Emergency D. 0 General Emergency

  • 5 A. EMERGENCY DECLARATION: B. El EMERGENCY TERMINATION Date: XX lxx IXX Time: XX:XX
  • 6. REASON FOR EMERGENCY DECLARATION:** A. EAL Number:FSI OR B. El Description______________
7. ADDITIONAL INFORMAT1ON OR UPDATE: A. None OR B. El Description_______________________________
  • 5, WEATHER DATA: A. Wind direction from 260 degrees. B. Downwind Sectors Affected D,EF
  • 9 RELEASE STATUS: A. None (Go toltefli 11) B. El In Progress C. El Has occurred, but stopped (go to Item 11)
10. RELEASE SIGNIFICANCE CATEGORY (at the Site Boundary)

A. El Under evaluation B. U Release within Norma) Operating Limits (Tech Specs)

C. El Non-Significant (Fraction of PAG Range)D. El PAG Range (Protective Actions required)

E. El Liquid release (no actions required)

(  :

1. UTILITYRECOMMENDED PROTECTIVE ACTIONS FOR THE PUBLIC:

J No recommended actions at this time. B. El The utility recommends the following protective actions:

EVACUATE ZONES;NOT APPLICABLE OR Jgs Evacuate Sectors Shelter Sectors No Action Sectors SHELTER ZONES:NOT APPLICABLE 0-2 2-5 5-10 AND consider issuance of potassium Iodide (KI) if form Is completed in the Control Room, go to item 15, If completed in the TSC or EOF, continue with item 12.

12. PLANT CONDITIONS:

A. Reactor Shutdown? El YES El NO B. Core Adequately Cooled? El YES El NO C. Containment Intact? El YES El NO D. Core Condition: 0 Stable El Degrading

13. WEATHER DATA: A. Wind Speed mph B. Stability Class_______
14. ADDITIONAL RELEASE INFORMATION: A. El Not applicable (Go to Item 15)

Distance iII.Lu ..,..

--- rp fCflP fnr I Hour

__-. FI.JI.LU. TotI flnqp ITFflF for I 1-Iniw I Mile (Site Boundary) B. mrem C. mrem 2 Miles D, E. mrem 5 Miles F. mrem G. mrem 10 Miles H. mrem I. mrem

15. (Do not read to State) EC or RM Approval Signature SIGNATURE DateXXIXX)XX TImeXX:XX MESSAGE RECEIVED BY: Name Date I 1 Time_______

lF EMERGENCY CLASS ESCALATION IS KNOWN TO BE NECESSARY AND A NEW NOTIFICATION FORM WILL BE TRANSMITrED WITHIN 15 MINUTES, THEN YOU MAY GO TO ECIRM APPROVAL SIGNATURE LINE.

ITEMS ARE EVALUATED FOR NRC PERFORMANCE INDICATORS (PIs)

F-439l1:2 Rev 9(11/09109)

FLORIDA NUCLEAR PLANT EMERGENCY NOTIFICATIPN.FORM METEOROLOGICAL WORKShEET qECTOR

REFERENCE:

ihe chart below can be used to determine sectors affected by a radiological release, through comparison with wind direction from the meteorological recorders in the Control Room.

If the wind direction is directly on the edge of two sectors (e.g., 11°, 33°, 56°, etc.), an additional sector should be added to the protective action recommendations. For example, if the wind direction is from 78°,

then the affected sectors for PARs should be L, M, N and P.

SECTOR INFORMATION:

WIND SECTOR WIND FROM DEGREES WINO TOWARD SECTORS AFFECTED

[A] N 348-11 S 1-IlK

[Bj NNE 11-33 SSW JKL

[C] NE 33-56 SW KLM

[0] ENE 56-78 WSW LMN

[E] E 78-101 W MNP

[F] ESE 101-123 WNW NPQ

[G] SE 123-146 NW PQR

[H] SSE 146-168 NNW QRA

[J] S 168-191 N RAB

[U SW 2 13-236 NE BCD

[M] WSW 236-258 ENE CDE

[N] W 258-281 E DEF

[P] WNW 281-303 ESE EFG

[QJ NW 303-326 SE FGH

[RJ NNW 326-348 SSE 01-U

( CABILITY CLASSIFICATION

REFERENCE:

Either ERDADS or the below chart can be used to determine atmospheric stability classification for notification to the State of Florida. Primary method is from iT via the South Dade (60 meter) tower. Backup method is from Sigma Theta via the Ten Meter Tower. If neither meteorological tower is available, Stability Classification shall be determined using data from National Weather Service (See 0-EPIP-20126, Off-site Dose Calculations).

CLASSIFICATION OF ATMOSPHERIC STABILITY:

Primary Backup Stability Pasquill Delta T Sigma Theta Classification Categories (°F Range (De2rees)

Extremely unstable A AT-l.7 ST 22.5 Moderately unstable B -1.7 <AT -1.5 22.5>ST 17.5 Slightly unstable C -1.5 <AT-l.4 17.5>ST 12.5 Neutral D -1.4 <AT-0.5 12.5> ST 7.5 Slightly stable E -0.5 <AT+l.4 7.5> ST3.8 Moderately stable F +1.4 <AT +3.6 3.8 > ST 2.1 Extremely stable 0 +3.6 <AT 2.1 > ST Meteorological information needed to fill out the Florida Nuclear Plant Emergency Notification Form is available from the Dose Calculation Worksheet (0-EPIP-20 126). The Worksheet shall be filled out by Chemistry and given to the Emergency Coordinator.

F-439I22 Rev 9 (11/09109)

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