ML14121A510

Single Positive Test Form Collected on 09/09/2013

ML14121A510
Person / Time
Site:	Peach Bottom
Issue date:	05/01/2014
From:	Exelon Generation Co
To:	Document Control Desk, Office of Nuclear Security and Incident Response
Paul Harris - 287-9294
References
Download: ML14121A510 (1)

Text

NRC FFD Program Performance Data Reporting System Single Positive Test Form for the EIE General Submission Portal Please explain the change(s) to the form Note:

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

2) Entries in some form fields may result in information being auto-Unique Reference Number (Licensee Supplied) populated into other form fields.

3) Use Adobe Reader 8 or later for this form to work properly.

2013-PBS-139 4) Hold your mouse over a form field to view additional information.

Select Facility Peach Bottom [50-277; 50-278] Date of Collection (mm/dd/yyyy) 09/09/2013 Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

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

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

Maintenance (Craft)

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 - 26.717(b)(2) Drug Testing Drug Only Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.75 Yes Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

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

Did this collection involve a subversion attempt (Yes/No)? Please elaborate on the choice(s) selected:

Yes 1st collection was low temperature - out of the range. The 2nd collection was observed and the MRO confirmed the Refused to provide initial specimen Specimen characteristics (e.g., color, odor, precipitant) final results a positive marijuana.

Refused to provide second specimen Invalid test result (initial specimen collected) - 26.185(f)

Specimen temperature (out of range) Refused to follow directions Specimen paraphernalia identified Other Management Actions - 26.717(b)(8) & 26.75 Reason for the Action Subversion attempt Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum Specific Sanction Applied Permanent Denial Person(s) Responsible for Information Provided Person 1 (required):

Adams Dolores Corp. FFD Security Analyst dolores.adams@exeloncorp.com First Name Last Name Position Title Company Email Address Person 2 (optional):

First Name Last Name Position Title Company Email Address Final Step (Required) - NRC will consider this form authentic in accordance with 26.11 only when the Validate & Lock 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.

Locked Form Locked On: May 1, 2014 at 1:33:12 PM Save to Local PC Print this Report Single Positive Test Form version 1.4.0 - Oct 31, 2012