ML14057A399

Single Positive Test Form, for Random, Collected on 08/22/2013

ML14057A399
Person / Time
Site:	Palisades
Issue date:	02/13/2014
From:	Dotson B, Rabideau B Entergy Nuclear Operations
To:	Document Control Desk, Office of Nuclear Security and Incident Response
Shared Package
ML14057A574	List: ML14057A389 ML14057A390 ML14057A391 ML14057A392 ML14057A393 ML14057A395 ML14057A397 ML14057A398 ML14057A399 PNP 2014-016, Single Positive Test Form, for Pre-Access, Collected on 11/25/2013
References
2013-PAL-001, PNP 2014-016
Download: ML14057A399 (1)

Text

, " U.S. N (= r=FD fJcrformarlCC Della System -Sl(1U 1 c PCI::-,Itl ll ( I "..:.i ! lJ"l1 D Submission Update Select Facility Ipalisades

[50-255) D Delete Submission R .. san forT_nil' 26.717(b)(5)

IRandom Employment Type* 26.717(b)(3)

ILicensee Employee Labo, category. 26.717(b)(3)

ILicensed Operator Please elaborate (optional)

This waa. test conducted after r.aokrtion ot. shy bladder. Rafusa/* 26.717(b)(7)

& 26.75 r::=--I Was this correction refused (yes' No)? Tut Raaulta. 26.717(b)(4)

TastValidity INot Applicable I Test Type(s) lor Result(s)

Reported -26.717(b)(2)

IAlcoholonly Su_nca-26.717(b)(2)

& (b)(6) IAlcohol V'lhat 26.103 BAC revel was exceeded?

10.03 and in work status at least 1 hr Alcohol Testing I Breath -f)AII fI.a ON "'-.xe.ptllloa.

_od *opf/_.

"""'a _ruultlnlnlonnatJonbol

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_ ""'" fI.a. J) II .. A_Rood ... fK _tor 1ItI. ""'" to -* _ody. 4) Hold you, mouae ovar. form field to view MIdIfI onal hrl onrtaINiR.

Date 01 CoNection (mmldcUyyyy) 10812212013 la ",1. a UHou, Reportlnll EVIIIIf (y.slNo)?*

Please elaborate on the 24-hour On event Event Number 49298 Subvera/on Attempm -26.717(b)(7) and 26.75(b) Did this collection involve a subversion attempt (Yes/No)?

LIN_o _____ -' Manlf/Mlanf ACflona -26.717(b)(6)

& 26.75 Reason lor the Action IFirst drug or alcohol positive Sanction Applied (NRC Minimum or Utensee Administrated)

INRC Minimum Specific Sanction Applied 114-Day Denial Peraon{s)

R .. ponslb/a fo,lnformafJon Provided Pel1lon 1 (required)

LIBrian ___ ....,,===

___ ---'",R._.bI_de_au_-.===:-

__ -.J11Sup.rvi.or. Acce .. Au1IoortzalioniFFD First Name Last Name Pos i tion Tille Person 2 (optionon: I brabideOentergy

.com Company Email Address LIBa_rb ___ -..::==",.-

___ ...JIILD_OIs_O_" __ r::c==",.-

___ ...J '----........ ==_r.:----'

bdomonOlnt.rgy

.com F,rst Name Last Name Flnel Step (Requlr.d) " NRC will consider this lonm authentic in accordance with 26.11 only when the "Validate

& Loci<" button has been s.lected and all errors (i .*.* those highlighted in red) have been corrected.

The "Validate

& Loci<" button will change to "LocI<.cr alier the data validation process has been successfully completed and the lann Is ready for submission.

Fonn Lock.d On:lFeb 13. 2014 at2: 15: 41 PM I Save 10 Local PC I I Prfnllhl.

Report Single Positive Test Fonm (version 1.5.0 -January 1. 2014)