ML17079A485
| ML17079A485 | |
| Person / Time | |
|---|---|
| Site: | LaSalle |
| Issue date: | 11/16/2016 |
| From: | NRC/RGN-III |
| To: | Exelon Generation Co |
| Shared Package | |
| ML15274A408 | List: |
| References | |
| Download: ML17079A485 (5) | |
Text
t t
o mØ I
1\\)o
-^
-t g)
(oo
\\){o
+l N)
ES-201 Examination Security Ag reement 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 tolz to/al tht 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'notbe'en áuthorized 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.9., 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,s\\tr,,"\\zr ro\\T,\\. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate,'or'provide erformance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
PRINTED NAME JOB TITLE / RESPONSIBILITY STGNATURE (1)
DATE STGNATURE (2)
DATE NOTE 1
3.
7
- 8. UtS l¿,aro NS C)
J0 i^sf¿-n Å'2,<-
/ rSf-¿üC.fo(?-
.1sf4tlcrG lo-ío-iG røLr¿Tl er-J!S-!ç
/'5-/t Wt ffi ul416
+M l,-tz-lA f-t-1-i,
,M
,tl:lLo tt/r l¿ (t-foJl 1
1 I
1 13 14 15 v
q9. 1iq5to{ç (ç H -( u(us "r\\r\\ç ['\\'\\
t<.
b'"a- ?r1-L'(U'\\l' NOTES:
,. Gp'r-t aFç gY t¿<\\)
tfi.ir6 /¿-J//',,/
{F fu.
Examination PRINTED NAME JOB TITLE / RESPONSIBILITY reement Form ES-201-3 DATE NOTE
- 1.
pre-Examination L n S.\\Lt zt,,
l acknowredge that r have acquired specia[zed knowredge about the NRC licensing examinations scheduled for the week(s) of to/t7rtttl"/ ' /¿' z -s of the date of my signature. I agree that t.will not xno*ingly di-vulge "ny int**"tion aboutthese examinations to uny páttont *n naue nt't'bee authorized by the NRC chief examiner. r understand that r am noi.t ín"tru"i, "uuiui",
oifiovioe p.rro*"nt teoacr to th'oe applicants scheduled to be administered these ricensing examinations from this date unlir cmpetion of exaiinatn administratio", "*""pt as specificatty niteo below and authorized by the NRC (e.g., acting as a simutator booth operator oi.rruncator is ".t"ui" i tn inoiui¿uio"r not select the trining content or provide direct or indirect feedback). Furthermore, r am aware of tná prvscar security.meárlr", and requirem""it t"" o"""ttented in the faéitity licensee's procedures) and understand that viotation of the conditions of'this agreement *"virurt in cancellation of tn'" examination' un/ot an enfor"ement action against me or the facility licensee. I will immediately report to t""iriiír"nagemeni oine Nnc crriet examiÃer any indications or suggestions that examination security may have been comPromised.
ES-201 13.
14 15 10.3¿s..^ - A.l-- S 11..n,*t-aorLof.
m U)
IN)o I
ç
tr I
2.
3.
5 6
7II 12 c.t Mar 1l o)
(oo N){
o+
N) 00 rl
- ^,-.kL-r,
É-o^^
tru¿e-DATE
¿Jiar-
á->^t/
b tÇ
Ç)t-lÇ 1-çtb r?S s
b
úo
,'t-qe./
Zr._-
\\
t " sr3r..) ersÉ -t.-" l il
- i. "is*cD
'{r& t-' Lu rr\\\\v 5r.1-i^\\- aLt
\\)fl"r-'^
h{^ 4\\1=
NOTES
.tt
mv, I\\)o ll o)
(oo N)\\
o N)
- 1.
pre-Examination LASALLí lacknowledgethalhaveacquiredspecializedknowledgeabouttheNRClicensingexaminationsscheduledfortheweek(s) of tçrlt't,.lt,'/rtt\\k'.23.oftfre date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who havé not been'authorized by the NRC chief eiaminer. 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 a a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect ieeUacf).- 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 {id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) o tolt-t la/24 loltt LiFrom the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluaté, o piovíOé performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
STGNATURE (1)
STGNATURE (2)
DATE NOTE PRINTED NAME 1
mj 3-D. u\\*i=:rc-bo(
JOB TITLE / RESPONSIBILITY Sc Vql of\\
(L{,
ø^J DATE 1-2-3-16
-zt 4
lt-y-t )
6.
7.
e+r/
L
ç 1
11.
12 13 1
ttDA NOTES
lr ftn t
Form ES-201'3 ma I
N)oj
'o A)
(oo N)\\
o N)
ES-201 Examination
- 1.
Pre-Examination as of the câ knowledge about the NRC licensing exami nations scheduled forthe week(s) of date of mY signature. I agree that lwill not knowinglY divulge anY information about these examinations to anY Persons who have not authorized bY the I acknowledge that I have acquired 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 specincally noted below and authorized bY the NRC NRC chief examiner. I understand that (e.9., 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 resuIt in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately have been comPromised.
- 2.
Post-Examination report to facilitY management or the NRC chief examiner any indications or suggestions that examination security may To the best of mY
, I did not divulge to anY unauthorized Persons anY tnformation concerning the NRC licensing examinations administered during the week(s) of
?tcFrom the date that I entered into this securitY agreement untilthe completion of examination administration, t did not
- instruct, 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 RESPONSIBILTTY SI TURE (1)
DATE (2) gt" tn
\\¿1¿.tr specialized ilg sø 5Po
DATE NOTE ulufuu 1
2 7II
=
S tl It n
7 4.
5.
10.
o 11 LrttL 3.
I 1
1
\\,
15
- l. S 5\\u, ro$A 4'ç'{crl. N<^r.¿r
=* *g-"srI,,cc-,.n. \\).
<.f,a^t^^kxr.[.
tt bll6 l.
"{ :rtsntD o(Ç ?(ç- a(sqt,r.,r /--ç^ f[l<
.t\\blrv
?-n-n}1- '"rsoo
"\\
NOTES
)
q/,r//é
fl
'Q fu.
Form ES-201-3 Examination 1'
Pre-Examination
' - ^--^-:-^rr^^o chor{r rlod fr tt lc'/ zt ' ltf zt as of the r acknowredge that r have acquired speciarized knowredge about the NRC licensing examinations scheduled for the week(s) of -4 date of my signature. r agree thar t.wil not rl.,o*ingry d'úulge unv'iit-*tion auoúttnes examnations to "nl páont *r'tb nuG;[6á"n'aúthorized by the NRc chier examiner. r understand tnat r a'ii'i.rit*"i,
"""i"i,'ipiu" q"1o,n;; i;Jback to tn! pJri"ants scheduled to be administered these ricensing examinations from tns oate uni",...,ór"tion ot
"*"i',-nin aominstrati", -""pt "s specmca-tt! nit n"n* and authorized by the NRc (e.g., acting as a smutaior boorh operato, oir*rnuncator i, u"i"itn i"oi"lo;;iu;;-fu seléct tneüáning content or provide direct or indirect feedback). Furthermre, r am aware ot tn'nsic; iecutv_meáslis ano,"qur"rn"ür-tr o**9t"d in in taitity licensee's procedures) and understand that vioration of the conditions otiní* ug*"r"nirn"yruiin "an"étt"tion oiin'e examinations un"t n ntot""*"nt action against me or the facirity ricensee. r *rn,,.',',"iatety report a t*r*v r"nagement oi *, Ñnc cniet exaiin"' ny indications i sugtestions that examination security may have been comPromised' ES-201 2
11.
12.
13.
14, m
IN)O
-t 1l q)
(oo N\\
o+
N)
3.
4 5.
6 7
8.
10.I 15.
NOTES: