ML15313A055

From kanterella
Jump to navigation Jump to search
2015 Clinton Power Station Initial License Examination Exam Security Agreements
ML15313A055
Person / Time
Site: Clinton Constellation icon.png
Issue date: 11/06/2015
From: Jennings T
Exelon Corp
To: Kweiser J
Operations Branch III
Zoia, C D
Shared Package
ML15124A054 List:
References
Download: ML15313A055 (8)
v • d • e


Text

Exelon Corporation Men1o To: Jan Kweiser From: Tony Jennings cc: [Name]

Date: May 29, 2015 Re: Examination Security Agreement - Clinton Power Station ILT Class 14-1 Please find enclosed the completed ES-201 Examination Security Agreement forms for Clinton Power Station ILT Class 14-1.

Sincerely, Tony Jennings ILT Exam Facility Author - CPS 217-937-3930 Tony.jennings@exeloncoro.com RE CEIVED JUN 04 1015

ES-201 Examination Secu rity Agreement Form ES-201 -3

1. Pre-Examination ~/. ~

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of '"l's- ~as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facili ty licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my kno~l edge,,J,did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of Yi4/,s - ~~From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE ES-201 , Page 27 of 28

ES-201 Examination Secur ity A greem ent Fo rm ES-201-3

1. Pre-Examinatio n

'?(, (./ !h.,...

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of ltS.

  • 7\Sas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate. or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration. except as specifically noted below and authorized by the NRG (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my kn~led~I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of '~- V,,s, From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE s R0 I~

14 JI'/__:~~~~::;--- )f:x.J.;- - -

___£;~.J..0......L..,l(~~L.:..::.1--- ---~""---------- --=::;;::..-~=..b.~~:?'.'.=---- *0 p . *1 ~ :---c~~~c=='.5Z~

,J...J......f'L.>'~..µ11'1df:~ldo""--"4-- :o.C,- - - - - - - - -~~~-b;.~~~<=:...--=---

- - - -:1"'-*{> 1t<'t.l *ftl__c"""'..Q~-==-----.,...-

$1(.o ES-201, Page 27 of 28

ES-201 Examination S ecurity Agreement Form ES-201-3

1. Pre-Examinat ion I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of o/tJc * %1kras of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration. except as specifically noted below and authorized by the NRC (e.g ., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of . From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1 ) DATE SIGNATURE (2) DATE NOTE 4.

5.

7.

a.

R..*~9 Ll' Mc.:. C."'kk ':I\

  • J "'"'"~
6. ~~_:-=~~....,.,-:--- -~li"Y

,Jtr I N SYNQ\~

'N>'o.=

C~\'f~li'(,"'-"-~------

-::r ~"IQ \\ C? '3--.

\;>

Bc..*s....,."" op.,,..~

=n~~~~===-~

I~37*1:->c.:-_...,_--'-"l~~5:::~"'--9-'-

~~~~Y"'\)~::;.'~

--,,---po;-.-::C'f':~>t-:::1!>-+-~-.....\+

. ---~~---.!:"7~~

9. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---~------------

10._ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -

11._ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - --

12.- - - - - - - - - ----

13._ _ _ _ _ _ __ _ - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -

14._ _ _ __ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - --

15._ _ _ _ _ _ _ _ _ - - - - - - -- - -- - - - - - - - - - - - - - - - - - - - - - -- -- - - - - - -

NOTES:

ES-201 , Page 27 of 28

)

ES-201 Ex am ination Security Agreement Form ES-201-3

1. Pre-Examination

':JI 3/

'it..!,'. lz?I I acknowledge that I hail:! acquired specialized knowledge about lhe NRC licensing exammallons scheduled for the week(s) of .1? - lisas of the date of my signature I agree that I will not knowngly divulge any 1nformallon about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instrucL evaluate. or provide periormance feedback to those applicants scheduled to be administered these licensing exammatrons from lh1s date until completion of examination administration except as specifically noted below and au~hom!:ed by the NRC (e.g., acting as a simulator booth operator or communicator 1s acceptable if the ind1v1dual does not seect the trainmg content or provide direct or indirect feedback) Furthermore. I am aware of the physical security measures and requirements (as documented 1n the facility licensee's procedures) and understand that violation of tte cond1t1ons of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will 1mmed1ately report to facility management or the NRC chief examiner any 1nd1cat1ons or suggestions that examination security may have been compromised

2. Post-Examination To the best or my kno~ledge,id1d not divulge to any unauthon~ed persons any information concerning the NRC licensing examinatmns administered during lhe week(s) or ~'1h
  • LY,~From the date that I entered into this secunty ag1eement until the complet1on of er.am1nat1on adm1111s1rallon I did not in:.truct. evaluate. or provide performance feedback to those applicants who were adm1n1stered these licensing examinations. except as specifically noted below and aulhonzed by the NRC PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1)
.f_.J; _ _

ES-201, Page 27 of 28

l ES-201 Examination Secu rity Agreement Form ES-201-3

1. Pre-Examination ~/. 3/
  • l.i, - ..,_3!c I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of I? t5as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRG chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my kno~ledge,J, did not divulge to any unauthorized persons any information concerning the NRG licensing examinations administered during the week(s) of YJ,;, s - ??P,,From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE NOTE ES-201, Page 27 of 28

Form ES-201 *3

1. P re-Examin ation '.'.?. ~.I l acimow1edge that 1have acquired specialized knoWledge about the NRC licensing examinations sched\Jled tor lhe week(s ) of

. ~- ~

!? 15as of the date or my signature. l agree that I w ill not knowingly divulge any information about these examina tions to any persons who have not b een authortzed by the NRC chiel examiner. I understand that I am.not to instruct, evaluate, or provide performance* feed back to those applicants schecMed to be *administered these licensing examinations from this date until completion of ex aminatJon administration , except as specifically noted below and authorized by the NRC

{e.g., acting as a simulator booth operator or communicator is acceptable if the i ndividual does not selecl the training content or provide direct or indirect fee<ll}ack). Furthermore, I am aware of the physical security measures and requirements {as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may rest.1lt in can~llation of the examinations andlor a11 enforcernenl action against me or the facmty licensee. 1will Immediately report to facility management or tile NRC chief examiner any in.dicatlons or suggestions that examination security may have been _compromised.

2. Post*eaminaUon To tlie best of my kno~~ge,J.dkl not divulge tb any un.authorized persons any information conoorning the NRC _ licensing examinations administered during the week(s) of 11.(ls -~5From* tne* date that I ~ntered into this security agreement until the compfetlon of examination administration, I d id not instruct, evaluate. or provide performaooe feedbad< tt> those applicants who were administered these licensing e)(aminations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1 ) DATE DATE NOTE ES-20 1, Page 27 of 28

ES-201 Exam ination Security Agreement Form ES-201 -3

1. Pre-Examination

~~/ ?>;,.,,,

I acknow ledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 71S. - 7\Sas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my kn~led~I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of '~- Vis. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE

~

I 0/4. ~I'/ J/:nJ.;- _ _

10 z.i*t ~ ~--

l1;'~*t:!.I ----

ES-201, Page 27 of 28

Exelon Corporation Men1o To: Jan Kweiser From: Tony Jennings cc: [Name]

Date: May 29, 2015 Re: Examination Security Agreement - Clinton Power Station ILT Class 14-1 Please find enclosed the completed ES-201 Examination Security Agreement forms for Clinton Power Station ILT Class 14-1.

Sincerely, Tony Jennings ILT Exam Facility Author - CPS 217-937-3930 Tony.jennings@exeloncoro.com RE CEIVED JUN 04 1015

ES-201 Examination Secu rity Agreement Form ES-201 -3

1. Pre-Examination ~/. ~

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of '"l's- ~as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facili ty licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my kno~l edge,,J,did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of Yi4/,s - ~~From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE ES-201 , Page 27 of 28

ES-201 Examination Secur ity A greem ent Fo rm ES-201-3

1. Pre-Examinatio n

'?(, (./ !h.,...

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of ltS.

  • 7\Sas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate. or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration. except as specifically noted below and authorized by the NRG (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my kn~led~I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of '~- V,,s, From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE s R0 I~

14 JI'/__:~~~~::;--- )f:x.J.;- - -

___£;~.J..0......L..,l(~~L.:..::.1--- ---~""---------- --=::;;::..-~=..b.~~:?'.'.=---- *0 p . *1 ~ :---c~~~c=='.5Z~

,J...J......f'L.>'~..µ11'1df:~ldo""--"4-- :o.C,- - - - - - - - -~~~-b;.~~~<=:...--=---

- - - -:1"'-*{> 1t<'t.l *ftl__c"""'..Q~-==-----.,...-

$1(.o ES-201, Page 27 of 28

ES-201 Examination S ecurity Agreement Form ES-201-3

1. Pre-Examinat ion I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of o/tJc * %1kras of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration. except as specifically noted below and authorized by the NRC (e.g ., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of . From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1 ) DATE SIGNATURE (2) DATE NOTE 4.

5.

7.

a.

R..*~9 Ll' Mc.:. C."'kk ':I\

  • J "'"'"~
6. ~~_:-=~~....,.,-:--- -~li"Y

,Jtr I N SYNQ\~

'N>'o.=

C~\'f~li'(,"'-"-~------

-::r ~"IQ \\ C? '3--.

\;>

Bc..*s....,."" op.,,..~

=n~~~~===-~

I~37*1:->c.:-_...,_--'-"l~~5:::~"'--9-'-

~~~~Y"'\)~::;.'~

--,,---po;-.-::C'f':~>t-:::1!>-+-~-.....\+

. ---~~---.!:"7~~

9. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---~------------

10._ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -

11._ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - --

12.- - - - - - - - - ----

13._ _ _ _ _ _ __ _ - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -

14._ _ _ __ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - --

15._ _ _ _ _ _ _ _ _ - - - - - - -- - -- - - - - - - - - - - - - - - - - - - - - - -- -- - - - - - -

NOTES:

ES-201 , Page 27 of 28

)

ES-201 Ex am ination Security Agreement Form ES-201-3

1. Pre-Examination

':JI 3/

'it..!,'. lz?I I acknowledge that I hail:! acquired specialized knowledge about lhe NRC licensing exammallons scheduled for the week(s) of .1? - lisas of the date of my signature I agree that I will not knowngly divulge any 1nformallon about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instrucL evaluate. or provide periormance feedback to those applicants scheduled to be administered these licensing exammatrons from lh1s date until completion of examination administration except as specifically noted below and au~hom!:ed by the NRC (e.g., acting as a simulator booth operator or communicator 1s acceptable if the ind1v1dual does not seect the trainmg content or provide direct or indirect feedback) Furthermore. I am aware of the physical security measures and requirements (as documented 1n the facility licensee's procedures) and understand that violation of tte cond1t1ons of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will 1mmed1ately report to facility management or the NRC chief examiner any 1nd1cat1ons or suggestions that examination security may have been compromised

2. Post-Examination To the best or my kno~ledge,id1d not divulge to any unauthon~ed persons any information concerning the NRC licensing examinatmns administered during lhe week(s) or ~'1h
  • LY,~From the date that I entered into this secunty ag1eement until the complet1on of er.am1nat1on adm1111s1rallon I did not in:.truct. evaluate. or provide performance feedback to those applicants who were adm1n1stered these licensing examinations. except as specifically noted below and aulhonzed by the NRC PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1)
.f_.J; _ _

ES-201, Page 27 of 28

l ES-201 Examination Secu rity Agreement Form ES-201-3

1. Pre-Examination ~/. 3/
  • l.i, - ..,_3!c I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of I? t5as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRG chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my kno~ledge,J, did not divulge to any unauthorized persons any information concerning the NRG licensing examinations administered during the week(s) of YJ,;, s - ??P,,From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE NOTE ES-201, Page 27 of 28

Form ES-201 *3

1. P re-Examin ation '.'.?. ~.I l acimow1edge that 1have acquired specialized knoWledge about the NRC licensing examinations sched\Jled tor lhe week(s ) of

. ~- ~

!? 15as of the date or my signature. l agree that I w ill not knowingly divulge any information about these examina tions to any persons who have not b een authortzed by the NRC chiel examiner. I understand that I am.not to instruct, evaluate, or provide performance* feed back to those applicants schecMed to be *administered these licensing examinations from this date until completion of ex aminatJon administration , except as specifically noted below and authorized by the NRC

{e.g., acting as a simulator booth operator or communicator is acceptable if the i ndividual does not selecl the training content or provide direct or indirect fee<ll}ack). Furthermore, I am aware of the physical security measures and requirements {as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may rest.1lt in can~llation of the examinations andlor a11 enforcernenl action against me or the facmty licensee. 1will Immediately report to facility management or tile NRC chief examiner any in.dicatlons or suggestions that examination security may have been _compromised.

2. Post*eaminaUon To tlie best of my kno~~ge,J.dkl not divulge tb any un.authorized persons any information conoorning the NRC _ licensing examinations administered during the week(s) of 11.(ls -~5From* tne* date that I ~ntered into this security agreement until the compfetlon of examination administration, I d id not instruct, evaluate. or provide performaooe feedbad< tt> those applicants who were administered these licensing e)(aminations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1 ) DATE DATE NOTE ES-20 1, Page 27 of 28

ES-201 Exam ination Security Agreement Form ES-201 -3

1. Pre-Examination

~~/ ?>;,.,,,

I acknow ledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 71S. - 7\Sas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my kn~led~I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of '~- Vis. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE

~

I 0/4. ~I'/ J/:nJ.;- _ _

10 z.i*t ~ ~--

l1;'~*t:!.I ----

ES-201, Page 27 of 28

Retrieved from "https://kanterella.com/w/index.php?title=ML15313A055&oldid=2446438"