ML17170A316
| ML17170A316 | |
| Person / Time | |
|---|---|
| Site: | Perry  |
| Issue date: | 02/22/2017 |
| From: | David Reeser NRC/RGN-III/DRS/OLB |
| To: | FirstEnergy Nuclear Operating Co |
| Shared Package | |
| ML16242A243 | List: |
| References | |
| Download: ML17170A316 (4) | |
Text
Attachment 8 L-17-067 Original Form ES-201-3, "Examination Security Agreement," with a Pre- and Post-examination Signature by Every Individual Who Had Detailed Knowledge of Any Part of the Operating Tests or Written Examination before They Were Administered (3 pages)
ILONRC Exam 2017 ES-201 Examination Security 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 2/6/17 & 2/13/17 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 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 ~&/17 ~ L//J/ 11 . From the date that I entered into this security agreement until the completion of examination administration, I did r:c: :, s:: :.:ct, c*.::::iu;J:c, or provide performance feedback k; ~r.c:;e applicants who were administered thes 1ic::_*;-;3;:<g ;:;xarnin<>tions, except as specifically noted below and authorized by the NRC.
PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE
- 1. i--
!~ k,1.fk5
~~= l~z:,~I Auu~C)~~ ;'f_W" ~
z, 1 J.
- 2. i£~d~ C)uC\\\ * ~'1FZ- ~JZ iff\4> -z. \'T 1l _ _
- 3. lON\. GA"{rDOS\~ f....~.klJ f'-~~7 l)C"~ "l'~ 3"'.3-1" ~-
- 4. s::Lr~p I\U' T_.11~'F'j"J-I i. r */ ?')
. fs'-1 ;t-7 /< e1i*f!.))/' / ,,, .
=
16 "'//';7/1'.7 _ _
- 5. N,,,(ze/6,n,tlle' 0,{)t?r'e}f;&,,i'S ff~c~d"',-e_. 3~~~ .:;/;:?~/
- 6. D~**'3 .£...,.;f"'- 'k'a...:.--r"" Op2n:.-far <6/tSlfC Z-cof
- 7. C.L; f"°".l G J;'>vts Jr. s*llO f/ii'ft i).!'17 __
- 8. t2uJ/1l'I k'~:::.r J~iJ <Pg'-/G ~ ~1 __
- 9. /tC;.Jv,'l r.
k ~-' <:/SO d
of-L'if
~
Z r7. __
- 10. 8v101M L .£v,c~~*EL(.o OPS !NJ.,,,_.,"'~~r- 9'A/ib /.~ '2//1/;7 _ _
11 ..~&~
- 12. {
- 13. j~<h
~ W=TV!')
hc4WV<
SW ltlC.A~T<>A of~ro.t{.
se.,uoc eeac.b'> Opuo.ki
~
'f_fJ&_
11y~~*
~
~.
2;J~f 1__
=
- 14. ~D c;,.,_...,.'U::? SiZO C/ 7. t 17 _ _
- 15. MJui1...., l)~kp 5-.Z.O "lltl/16 Z-Zl-17 NOTES:
- ~
Sheet _J_ of __..2 FENOC Facsimile
ILO NRC Exam 2017 ES-201 Examinatio*n Security 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 2/6/17 & 2/13/17 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 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 z./t./)7 f: z./iJ/1 J . 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
- 1. Jl..,,,,._ frlcu<;li /l,Pacf-o,"
CXJ~
v
~
- 2. jA'.'=,..) W1\~ (/~<-.\bl? t>r.>02A\blf Ot°'ra~o~
~**~
- 3. /.C,...s 6 ..:Sie:5a :Se,-,.-,r J?<o.e.for
- 4. D4t-c .e~4;20d? VAtcl£.4i7YL UAJ) _ ~ >".,~ ~ //
- s. ~°S #~AJC7 ~~ ~r~
6.
7.
a.
9.
10.
tfr41l!AJ R "'""'
~e:r
- v1J 8/rt{
- rt
. .ct
.Jcu.,~$ A. G<l.rbu"
~*:, ..
r
~
~EN1fft. ~17.1.2. P&1'~
'fr~,.;. ,;. ~ ;L.;t,..,J.,;
SEN1utZ. Reltc.."TZ>f, OPee.Jtf()
Jl r 5;m Svrfc1~ fvJ S'C'EL.
2~111 .s'vpf*~.+=. 51..J
(._
= ¥'
~/
- 1/,0/17 00/17 e~.
11~>1->>C ,; ;; -10>__
'Z-/n/11 2/a:::>/17---
- 11. ~ (?_t:. /1'1>-j.,,,~J.,r
- 12. $1~ f,._}'7T~[Ct*/L
- 13. 'S. ~ \ r\ S-tn.ido r Stf D ;,,J {1 f/Luc...~
S-ao /;JD-4. ./e fl:l"l NOTES:
Sheet __1__ of _3 FENOC Facsimile
ILO NRC Exam 2017 ES-201 Examination Security 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 2/6/17 & 2/13/17 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 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 knowl~df,e, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of L/4Jl ef z./1J/t1 . 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
- 1. Jt,,,.fst.4-Ntv A!lll-tf-to C'a1:..;t;~*.<...
<;go J:',.;,sr~'"'""'-
/Jt,>r<.,ch.*£.*
~ _,
-n ~
- J"'-8*17~. ~
J*l?-11 _ _
2.
- 3. Lu\<£- \l~i."t6-J c;k tN':.~vcrutL ~ :i/r5"/o -i./11/17 4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
NOTES:
Sheet _3_ of _j_ FENOC Facsimile