ML14057A399
| 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: |
| References | |
| 2013-PAL-001, PNP 2014-016 | |
| Download: ML14057A399 (1) | |
Text
[] Submission Delete Update Submission Unique Reference Nsrnber (Licensee Suppled) 201 3-PAL-001 I
Select Facility Palisades [50-255]
Date of Colection (mm/ddIYyyy)08/22/2013 Employment Type - 26.717(b)(3)
Licensee Employee Labor Category-26.717)b)(3)
Licensed Operator Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes I No)?
No Test Results
- 26.717(b)(4)
Test Validity Not Applicable Test Type(s) for Result(s) Reported - 26.717(b)(2)
Alcohol Testing Alcohol Only Breath Substance - 26.717(b)(2) & )b)(6)
Alcohol What 26.103 BAC level was exceeded?
10.03 and in work status at least 1 hr Is this a 24-Hour Reporting Event (Yes/No)?- 26.719(b)lYes Please elaborate on the 24-hour reporbng event Number 49298 Subversion Attempts - 26.717(b)(7) and 26.75(b)
Did this collection involve a subveruion attempt (Yes/No)?
No Management Actions
- 26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)
NRC Minimum Specific Sanction Applied j 14-DayDenia)
Person(s) Responsible for Information Provided Person I )reqvired)
Brian Supervisor, Aooeus AutherizatioolFFD brabldn@entnrgy.oom First Name Last Name Posihon Title Person 2 (ophonal):
lunensina Specialist bdot000thenterai.oem First Name LaSt Name l-osition I tie Liompany Inmalt Ailoress Final Step (Required) - NRC will consider this form authentic in accordance with 26.11 onty when the Validate & Look button has been selected and all errors (i.e., those highlighted in red> have been corrected. The Validate & Lock button will change to Locked after the data validation process has been successfully completed and the form is ready for submission.
Form Locked On:IFeb 13, 2014 at 2:15:41 PM Save to Local PC Print this Report I) AS fields era r.qso-od except those mer*.d opbofl.P.
- 2) flaMes I,, som, fern, fields may result in into.maiion being auto-populated into other torn, fields.
- 3) U. Adobe Reader 8 or later for this tens to worn property.
- 4) Hold your mouse over, fern, fi.ld to view addlllen.J information.
Random Reason for Testing-26.717(b>(5)
Please elaborate (optional)
This was a tent onndutted after roshhen ala shy bladder.
Barb Company Email Address Single Positive Test Form (version I.S.O - Janualy 1, 2014)
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r=FD r'ro~ral1l fJcrformarlCC Della I\\Cportlll~ System Sl(1U1c PCI::-,Itl ll (
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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/_.
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- 4) Hold you, mouae ovar. form field to view MIdIfIonal hrlonrtaINiR.
Date 01 CoNection (mmldcUyyyy) 10812212013 la ",1. a UHou, Reportlnll EVIIIIf (y.slNo)?
- 26.719(b)~ 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 Position 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
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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 II Prfnllhl. Report Single Positive Test Fonm (version 1.5.0 - January 1. 2014)