ML17334B028
| ML17334B028 | |
| Person / Time | |
|---|---|
| Site: | Cook  |
| Issue date: | 12/30/1986 |
| From: | Alexich M INDIANA MICHIGAN POWER CO. (FORMERLY INDIANA & MICHIG |
| To: | Harold Denton Office of Nuclear Reactor Regulation |
| Shared Package | |
| ML17334B029 | List: |
| References | |
| AEP:NRC:0773V, AEP:NRC:773V, NUDOCS 8701070345 | |
| Download: ML17334B028 (447) | |
Text
REGULATORY GRADATION DISTRIBUTION SY N (RIDS)
ACCESSION NBR 8701070345 DOC. DATE: 86/12/30 NOTARXZED: NO DOCKET 0 FAC IL: 50-315 Donald C. Cook Nuclear Pomer Planti Unit i. Indiana 0 05000315 50-316 Donald C. Cook Nuclear Power Plant Unit 2 Ind,iana 5, 05000316 AUTH. NANE AUTHOR AFFILIATION ALEXICH,N: P. Indiana Zc Michigan Electric Co.
RECIP. NANE RECXPIENT AFFILIATION DENTON> H; R. Office of Nuclear Reactor Regulation. Director (post 851125
SUBJECT:
Forwards Vol 1 of "DCRDR Summary Rept> " Vol 2 of "DCRDR App" 5 Vol 3>Books 1 5 2 of "DCRDR CLO/HED Descriptions 0 Assessments " per 840928 ltr 5 NRC 850712 modified confirming order.
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TITLE: OR/Licensing A003D COPIES RECEIVED: LTR ( ENCL + SIZE:~~
Submittal: Supp l 1 to NUREQ-0737(Qeneric Ltr 82-33)
D+lv'XSTRIBUTION NOTES:
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INDIANA 8 MICHIGAN ELECTRIC COMPANY P.O. BOX 16631 COLUMBUS, OHIO 43216 December 30, 1986 AEP:NRC:0773V Donald C. Cook Nuclear Plant Unit Nos. 1 and 2 Docket Nos. 50-315 and 50-316 License Nos. DPR-58 and DPR-74 DETAILED CONTROL ROOM DESIGN REVIEW
SUMMARY
REPORT Mr. Harold R. Denton, Director Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, D.C. 20555
Dear Mr. Denton:
The purpose of this letter is to transmit the D. C. Cook Nuclear Plant Units 1 and 2 Detailed Control Room Design Review (DCRDR) Summary Report which includes our corrective action plan and a proposed schedule for implementation. This report is submitted in accordance with our letter AEP:NRC:0773I, dated September 28, 1984, and the subsequent U.S. Nuclear Regulatory Commission Modified Confirming Order dated July 12, 1985.
In our September 28, 1984 letter we also committed to providing semi-annual DCRDR status reports until submittal of this Summary Report. In the final semi-annual status report, dated September 30, 1986, we indicated that work was'ontinuing on control room enhancements. We believe the enhancements we have already implemented, and those we intend to implement during 1987, are noteworthy--particularly in light of the considerable effort required in applying the NUREG-0700 guidelines to the all-vertical main control panels and the unique annunciator system at the Cook Plant. Volume 1, Section 6.0, pages 6-1 thxough 6-3 of the attached summary report provide descriptions, and Table 6.1 provides the updated status of these enhancement tasks. There are thirty-one tasks listed in Table 6.1; twelve are completed; seven are well under way and planned for completion in the first quarter of 1987; four are planned for completion during the next refueling outage for each unit; and the remaining eight long-term tasks are planned for completion by the end of 1987.
The corrective action plan does not include the Safety Parameter Display System (SPDS). The SPDS was implemented on March 31 of this year. The SPDS was reviewed but we did not have time to complete an assessment and determine corrective actions, if necessary, for inclusion in this report. As verbally requested, the SPDS has been reviewed and the preliminary evaluation of the documented departures from guidelines has been included in the summary report (refer to volume 1, page 7-2). The SPDS assessment and corrective action planning activities are planned for late 1987. On>
8701070345 861230 I PDR ADOCK 05000315 f
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Mr. Harold R. Denton AEP:NRC:0773V The overall corrective action plan, outlined in the attached DCRDR Summary Report, augments and enhances the inherent advantages of our U-shaped/vertical board control room design. Substantial control room operator input and feedback was incorporated into the various corrective action designs. We believe the overall implementation schedule shown in Table 6.1 and Table 6.2 corrects the highest-priority human factor problems in the most expedited manner practical within the constraints of our current outage schedules and other ongoing work.
Please note that major modifications requiring unit outages are scheduled to begin in approximately April 1987. In this light, we respectfully request that you conduct your review taking into account the time schedule outlined in NUREG-0737, Supplement 1. A timely review will enable us to resolve issues that may arise, prior to starting our major modification program.
This document has been prepared following Corporate procedures which incorporate a reasonable set of controls to insure its accuracy and completeness prior to signature by the undersigned.
Very truly yours, M. P. lexich Vice President cc: John E. Dolan W. G. Smith, Jr. - Bridgman R. C. Callen G. Bruchmann G. Charnoff NRC Resident Inspector - Bridgman(w/ attachment)
J. G. Keppler - Region III(w/ attachment)
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CLOIHEDN 7 ~
ASSESSMENT RECORD POTENTIAI FOR ERROR (PFE) HIG H EDIU LOW CONSEQUENCE OF ERROR (COE) HI G H ME D I UM LO Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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CLOWEO>> 7, (
EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOVI COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION OR JUSTIFICATIO %0 I6'ii 0 'L'As P a ~ ~
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ASSESSMENT RECORD POTFNTIAL FOR ERROR (PFE) H IG H M ED I U M LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
Cl CLO/HED¹ 7 is EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED I: NO ACTION CI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YE POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW 1
CONSEQUENCE OF ERROR (COE) HIG H MEDIUM', LOW FULL LOW . NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION OR JUSTIFICATION ~ S UL 4 v C, Co SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE DATE ~~
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Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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CLOIHEDff 7 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) Hl G H MEDIUM W I
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 0 Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY D FURTHER REVIEW BY DISPOSITION APPROVED ': PARTIALLY APPROVED 6 NO ACTION ~ OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH- MEDIUM% LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV RESOLVED EXPLANATION OR JUSTIFICATION c4.
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AEPSC PROGRAM LEAD ENGINEER DATE DATE
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CLO/HEDN 7 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H ED IU LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Ol Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective ection is highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOWEO>> 7,i- >
EVALUATIONAND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION j5, APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM 'OW NO LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M 9-WSW Vc'~~a (a utw
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Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEO>> 7.i- +Q EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION JE, APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFEAND OR COE JUSTIFY AND DOCUMENT
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Category II - Medium priority; corrective action Is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDII 7,(- cLLI.
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE Q FURTHER REVIEW BY D FURTHER REVIEW BY D FURTHER REVIEW BY DISPOSITION jE, APPROVED C3 PARTIALLYAPPROVED D NO ACTION D OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM ., LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES, RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M P-MS& Vcc ~a (c uIm
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Category II - Medium priority; corrective action is highly recommended.
Category Ill - Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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CLOJHEO¹ 7,i-~.
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ASSESSMENT RECORD POTENTlAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HlGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOlHED>> 7.(- 4 4 EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION JK APPROVED, 0 PARTIALLY APPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 'OW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M 0 MS& Pc'~~a (n atm
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AEPSC PROGRAM LEAD ENGINEER DATE DATE
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CLO/HEDN 7 I +7 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H EDIU LOW CONSEQUENCE OF ERROR (COE) HI G H MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSIVIENT CATEGORY
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CLOIHEDN 7,i >7 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE C3 FURTHER REVIEW BY D FURTHER REVIEW BY D FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED D NO ACTION I:I OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM, LOW FULL NO LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M 0 MS& Vc'u~a (~ utm
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AEPSC PROGRAM LEAD ENGINEER DATE DATE
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) IG MEDIUM LOW CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM OW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I ~~
High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESS IVI ENT CATEG 0 R Y
CLOIHEDN 7,i-+g.
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION JK. APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM '- LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M P MS& Vcc ~a (~ utm
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AEPSC PROGRAM LEAD ENGINEER DATE DATE
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 0 Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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CLOIHEDN 7. l EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY CI FURTHER REVIEW BY LJ FURTHER REVIEW BY DISPOSITION R APPROVED 2 PARTIALLY APPROVED <
NO ACTION 'THER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR
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CLOfHEDII '7 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 0 II Consequence Of Error High Medium Low Migh Potential For Error Medium Low Category I ~ . Migh priority; corrective action should be taken.
Category II Medium priority; corrective action ls highly recommended.
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Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOJHEDS 7,)-Q <
EVALUATIONAND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION jE, APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) . HIG H MEDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I M 0-MS& VCc CASa (C utCC
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Category II Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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CLO/HEDN 7, ( -Q ]
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Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY J
CLOIHED>> .i EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE CI FURTHER REVIEW BY CI FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
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Category II- Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY J
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Category III- Low priority; corrective action Is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN 6 o)
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION dI APPROVED 0 PARTIALLYAPPROVED C3 NO ACTION Ci OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO. ~YES PQTENTIAL FOR ERROR'(PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM, LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND'OW OR COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION OR JUSTIFICATI N ~4 ~ Cb SIG NOFF H.F. CONSULTANT (ESSEX) DATE i AEPSC P ROG RAM LEAD EN G I NEER DATE LED~
CLOIHEDN ASSESSMENT RECORD FOR ERROR (PFE) HIG H MEDIUM LOW
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Category III- Low priority; corrective ection Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSM ENT CATEGORY
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Category II- Medium priority; corrective action is highly recommended.
Category lll - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ 8 l 5 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FIJRTHER REVIEW BY 0 FURTHER REVIEW BY
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Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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Category II'- Medium priority; corrective action is highly recommended; Category III- Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR USTIFICATION Cubo <
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Category III- Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
0 CLO/HED¹ EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS
' DATE PENDING FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION d APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION EI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM 0 CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 0 FULL "NO LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLV EXPLANATION OR JUSTIFICATION SIGNOFF H.F. CONSULTANT (ESSEX) DATE > E AEPSC PROGRAM LEAD ENGINEER DATE LCL7~
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Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
0 CLO/HEDII +
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 8 APPROVED 0 PARTIALLYAPPROVED EI NO ACTION Cl OTHER EVALUATION FLJLL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM, 0 CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 'OW FULL NO LOW NO MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVE EXPLANATION OR JUSTIFICATION C'W SIGNOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE ~MM
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Category III - Low priority; corrective ection is recommended.
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ASSESSMENT CATEGORY S;i
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ASSESSMENT CATEGORY
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ASSESSM ENT CATEGORY
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Category III - Low priority; corrective action Is recommended.
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1 ASSESSMENT CATEGORY
CLO/HEDII EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY Q FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Kl APPROVED 0 PARTIALLY APPROVED 0 NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES'OTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIF Y AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION OR JUSTIFICATION m V 6 44 I 4~4 Iti A a SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~Ne AEPSC PROGRAM LEAD ENGINEER DATE ~~6
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Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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ASSESSIVIENT CATEGORY
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ASSESSMENT CATEGORY K
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Category IV- No corrective action necessary, but should be considered.
ASSESSM ENT CATEGORY
0 0
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ASSESSMENT CATEGORY
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ASSESSIVIENT CATEGORY
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ASSESSMENT CATEGORY
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ASSESSMENT CATEGORY
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ASSESSMENT CATEGORY
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Category II- Nledtum priority; corrective action Is highly recommended.
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ASSESSMENT CATEGORY
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0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 8 APPROVED 0 PARTIALLYAPPROVED Q NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES ~
POTENTIAL FOR ERROR (PFE) H IG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES
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~RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION. deco"Je o T- fob~~- flu<<.CX]e~ /~ 5RI,Ee pre~ ~x-e e A<I,',-I wc' SIGNOFF
'I H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE lLLQZ@
CLO/HED¹ gi t i ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H M ED IU 'OW /~
CONSEQUENCE OF ERROR (COE) HI G H MEDIUM LOQ'onsequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASS ESSIVl ENT CAT EGO R Y
CLO/HED¹ V (-
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLY APPROVED E3 NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES g POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESO 0 RESOLVED EXPLANATION OR I JUSTIFICATION ID Mteee tcelt 3 ~
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AEPSC PROGRAM LEAD ENGINEER DATE ~)~
DATE ~4
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) LOW CONSEQUENCE OF ERROR (COE) H IG H M ED I U M LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE E3 FURTHER REVIEW BY G FURTHER REVIEW BY FURTHER REVIEW BY DISPOSITION B, APPROVED C3 PARTIALLYAPPROVED Q NO ACTION D OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~ES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW
, FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED EXPLANATION OR JUSTIFICATION Z Mx%c SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~~
AEPSC PROGRAM LEAD ENGINEER DATE D
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 0 FURTHER REVIEW BY DISPOSITION 6( APPROVED 0 PARTIALLY APPROVED D NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW
~ ~
FULL NO LOW NP MODIFY RECOMMENDATION COMP LIANC E PFE AND OR LOW COE 'USTIFY AND DOCUMENT YES YES
~RESOLVED EXPLANATION OR JUSTIFICATION
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RESOLVED cc,Q U7- 2Q
<<'- 4<~ - ~C~ . (.,AA SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE Ii/MK
CLO/HED¹ g' ) 0 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIU LOW
~ CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low l
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Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective
'0 action is recommended.
Category IV- No corrective action necessary, but should be considered.
~ ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED {El NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM 'OW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW >
FULL NO LOW p I, ODIFY RECOMMENDATION COMPLIANCE PFE AND LOW COE JUSTIFY AND DOCUMEN YES YES RESOLVED RESOLVED E .PLANATION OR JUSTIFICATION
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CLOIHEDN p~ t f ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW ~
CONSEQUENCE OF ERROR (COE) HIGH INEDIUM~ LOW Consequence Of Error High Medium Low High
,Potential For Error Medium Low Category l- High priority; corrective action should be taken.
Category il - Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEON V f I I EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION IZ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV D RESOLVED EXPLANATION OR JUSTIFICATION >' l ~r'Pn- "e -(4'-- (~'K c's~""
SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE ~K
CLO/HEO¹ g [ - l~
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) MEDIUM LOW
'IGH Consequence Of Error High Medium 'ow High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category 'I V- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY Qo 4.. Dcw~4? cc.s V r -I 2-
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY Q FURTHER REVIEW BY P
Q FURTHER REVIEW BY DISPOSITION P APPROVED Q PARTIALLYAPPROVED 0 NO ACTION CI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLV EXPLANATION OR JUSTIFICATION ~~ i v SIGNOFF H.F. CONSULTANT (ESSEX) DATE ~<
AEPSC PROGRAM LEAD ENGINEER DATE @LE
CLOIHEDN g ]i
( 5 ASSESSMENT RECORD POTENTIAl FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH INEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category l High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category ill - Low priority; corrective action is recommended.
Category IV << No corrective action necessary, but should be considered.
ASSESSMENT GATEGORY
CLO/HEON P' ("3 EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION H APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION u.'ll( l~5or8 ceo'fa b. (i4 . Ld 4(4 c,)ct( b4 r4vta~8 oa ~D-x.'j (8 6a(
I. ~ I~(-ra r SIGNOFF H.F. CONSULTANT (ESSEX) DATE hQ AEPSC PROGRAM LEAD ENGINEER DATE /~K
CLOIHKDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ClOW~
CONSEQUENCE OF ERROR {COE) HIGH MEDIU LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action ls highly recommended.
Category ill - Low priority; corrective action ls recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
0 CLOIHEDe EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION lE APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO (YES
'OW POTENTIAL FOR ERROR (PFE) HIGH MEDIUM CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW
..-0, Wbbl ~ ~ ~ IC FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED+
EXPLANATION OR JUSTIFICATION '
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CLOIHEDN P t l 5 .
EVALUATION AND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION mt OTHER EVALUATION I
FULL COMPLIANCE WITH GUIDELINES NO YES~
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMP LIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES
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Ct.. C e; CLONIC. (MX(A ~ ~ tLS C'A'ECC>( ~OULT..
SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~4~
AEPSC PROGRAM LEAD ENGINEER DATE ~i
CLO/HEDff ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) EDIUM ) LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM'OW Consequence Of Error High Medium Low High "
Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category Ill - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY ~l
~,
CLOIHEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE C3 FURTHER REVIEW BY 0, FURTHER REVIEW BY C3 FURTHER REVIEW BY D IS POS IT I0N
+ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION Q OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESOLVE RESOLVED EXPLANATION OR JUSTIFICATION R C N SIG NOFF H.F. CONSULTANT (ESSEX) DATE i AEPSC P ROG RAM LEAD ENGINEER DATE LLMF~
CLO/HEDN Q t - t t ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM (LOW CONSEQUENCE OF ERROR (COE) MEDIUM PLOW)
'IGH Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSIVIENT CATEGORY
CLOIHEO¹ V' I, EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED tRf NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM ~
+~LOW CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM ~cow NO LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED D
RESOLVED'XPLANATION OR JUSTIFICATION 6 L'r C,d~+g ~~ i d.(c~S,XQ SIG NOFF H.F. CONSULTANT (ESSEX) OATE j~<l~ ~
AEPSC PROGRAM LEAD ENGINEER DATE LlLXZ6
CLONEDN g I ASSESSMENT RECORD, POTENTIAL FOR ERROR (PFE) HIGH <INEDIUM .
LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW"'onsequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
GLo/HEDGE 94-5 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 5 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESOLV RESOLVED EXPLANATION OR JUSTIFICATION SIGNOFF H.F. CONSULTANT (ESSEX) DATE XQQQ~
AEPSC PROGRAM LEAD ENGINEER DATE LLQ~
CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH CMEDIUM i LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM C LOW)
Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION S APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO (YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULl LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED "
RESOLVED EXPLANA OR JUSTIFICATION Cdc ~~dc i (~ C>- tZOB ~"~~
~A ) U4 fl'io (i (NQA'Y + w ~c'.d.~wi t CI.C SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~nl >I AEPSC PROGRAM. LEAD ENGINEER DATE i im&
i
CLOIHEDN V (- 'Z-V .
EVALUATION AND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION K OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES, NO
(
'POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW (
FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED M~ ~
EXPLANATION QR JUSTIFICATION I~a w a t t ~L (i~~.
ST. ~(c c (C PuqzX s~co-SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE DATE ~~
CLO/HED¹ g( ~ Ir ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~LO~
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low
~iM Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE Cl FURTHER REVIEW BY C3 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED g NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ONQ YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR USTIFICATION 5 Q SIG NOFF H.F. CONSULTANT (ESSEX) DATE 0 AEPSC PROGRAM LEAD ENGINEER DATE
CLOIHEON Q ( L '~
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOtHEDN y'-
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION R APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM "
LOW'IGH CONSEQUENCE OF ERROR (COE) MEDIUM LOW (
FULL LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES ESOLVED RESOLVED EXPLANATION OR JUSTIFICATION 7ro 4r e 6efn
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CLOIHEON Z..
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW~'IGH CONSEQUENCE OF ERROR (COE) MEDIUM ~LolIY Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION J% APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW
(
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW (
FULL LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION c &ri o s r eve hos nv o r8 e~ Ji~ L/SC. r cia v So o cd'IG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE ~il
CLO/HEDN jr ( w C ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LO~W.
~f CONSEQUENCE OF ERROR (COE) HIGH MEDIUM. L~O Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highiy recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSM ENT CATEGORY
CLO/HED¹ Q ( -Q Q .
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED CI NO ACTION Q OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES
'P 4
E OLV RESOLVED EXPLANATION OR JUSTIFICATION e h SIG NOFF H.F. CONSULTANT (ESSEX) DATE i4 AEPSC PROGRAM LEAD ENGINEER DATE
CLOIHED¹ Q (
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) 'HIGH'EDIUM LOW CONSEQUENCE OF ERROR (COE) ~~HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ Q (- +g .
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING ' DATE FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES r POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV D "" RESOLVED EXPLANATION OR JUSTIFICATION u,@nXu~ - u -n >
SLY gA, 'lc lo~ 5( vdi.a (<uteM ~ccAe SIG NOFF H.F. CONSULTANT (ESSEX) DATE 'I)
AEPSC PROGRAM LEAD ENGINEER PATF ~cP~
GLOIHED¹ I! [
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) H~IGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low w
0, Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ (,> I 2 4 ~
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION 6.~mG~-
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SIG NOFF H.F. CONSULTANT (ESSEX) OAZE ~in AEPSC PROGRAM LEAD ENGINEER DATE /// ~k
CLOlHEDN g I'SSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH INEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM L Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED< Vl Z- t EVALUATION AND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION tH APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES~
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION cZ~ i"~Ca ~i~i e ~ <-28ee 3 A
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AEPSC PROGRAM LEAD ENGINEER DATE i i~ir&
CLOIHEOtf g ( Zy ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH INEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW~'onsequence Of Error High Medium, Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV - No corrective action necessary, but should be considered.
4<SESEMENT CATEGORY
CLOIHEDN 9 [
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EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW
'IGH CONSEQUENCE OF ERROR (COE) MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION '2c.c~ el~;S a.~n( a.-n5c5 on.o 0. FR V C
P ( 0N 0 LA% GL) IL bL UYl C5 8 ( (C.4(fg ~S IS Q4 Jul ~M-SIGNOFF H.F. CONSULTANT (ESSEX) DATE I~XV AEPSC PROGRAM LEAD ENGINEER DATE ~1~8&
CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW'IGH CONSEQUENCE OF ERROR (COE) MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- ,No corrective action necessary, but should be considered.
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ASSESSMENT CATEGORY
CLOIHEDII U (Z EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED JE NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED SOLV~D>
EXPLANATION OR JUSTIFICATION A~ ~~~
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SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC P'ROGRAM LEAD ENGINEER DATE ~~~
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~~LQ CONSEQUENCE OF ERROR (COE) HIGH lNEOIUM LOW >
Consequence Of Error High Medium Low Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category ll - Medium priority; corrective action Is highly recommended.
Category ill - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS P ENDING DATE Q FURTHER REVIEW BY 0 FURTHER REVIEW BY, Q FURTHER REVIEW BY DISPOSITION CI APPROVED Q PARTIALLYAPPROVED @ NO ACTION 5 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM 0 CONSEQUENCE OF ERROR (COE) HIGH MEDIUM t
0 FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY ANDNOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION SIG NOFF H.F. CONSULTANT (ESSEX) DATE Mh~
AEPSC PROGRAM LEAD ENGINEER DATE ~~~
CLO/HEDII V(- 8 (
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM OW ~
Consequence Of Error High Medium Low High Potential For Error Medium Low
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Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV -
1 No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY V
CLOIHEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY El FURTHER REVIEW BY DISPOSITION
%APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION (~~e 'It~ -i-
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SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC P ROG RAM LEAD ENGINEER DATE ~PK4
CLO/HED¹ ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should, be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED N OR JUSTIFICATION (-nc.c ' .L~ L~~ <:"Xi.~
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e SIG NOFF H.F. CONSULTANT (ESSEX) DATE 0 AEPSC PROGRAM LEAD ENGINEER DATE 2QHK
CLO/HEON Q[ g3 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ( LOOP CONSEQUENCE OF ERROR (COE) HIGH EDIU LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDII EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 5 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES. ~
POTENTIAL FOR ERROR (PFE) H IG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED 1 g
EXPLANATION OR JUSTIFICATION Ulrt. i%+
SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE ~4 DATE ~
CLOJHEOII V (- m ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM L W CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM LOW Of Error 'onsequence High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY t
I CLO/HEDN EVALVATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE C3 FURTHER REVIEW BY Q FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 6 APPROVED 0 PARTIALI Y APPROVED 0 NO ACTION '3 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM CONSEQUENCE OF ERROR (COE) HIG H MEDIUM OW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED ESO EXPLANATION OR JUSTIFICATION Y ~ V (MS %WAN ~ A!i 4 h~c c <w SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE DATE ~
CLO/HED¹ i/t ~ g~g ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~LOW!
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW.)
Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN Q I Q5 EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEN ACTIONS PENDING DATE C3 FURTHER REVIEW BY C3 FURTHER REVIEW BY C3 FURTHER REVIEW BY DISPOSITION jE APPROVED C3 PARTIALLYAPPROVED C3 NO ACTION C3 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~LO CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW (
FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED ESOLVED EXPLANATION OR JUSTIFICATION End c for
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SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC P ROG RAM LEAD ENGINEER DATE DATE ~(~
CLO/HEO ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) . HIGH MEDIUM ~LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ V( ~
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED E NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW
'ONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION Ao . O-II& 7o o u~ e "og 5C~ MiO~ . L00 J e m eoW~Q C"eau ( r owe.~g-g
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AEPSC PROGRAM LEAD ENGINEER, DATE ~
DATE i~~
CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM OW.- i CONSEQUENCE OF ERROR (COE) HI6 H MEDIUM OW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ r
'VALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED A NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO~W sal ~ Sk ~ ~ 4 LOW NP MODIFY RECOMMENDATION FULL NO COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION C ~
cvx SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC P BOG RAM LEAD ENGINEER DATE ~I&K
CLO/HEDN gt ASSESSMENT RECORD U
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM L CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ g~ t -'Q$ .
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION C APPROVED 0 PARTIALLYAPPROVED jE NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LO~W CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW~
LOW NO MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUST FICATION oir ~eoecX -4o SIGNOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE LLL9Ek
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM L W>>'IGH CONSEQUENCE OF ERROR {COE) MEDIUM ~LO~W Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN Q I EVALUATION AND DISPOSITION, RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE
'0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES~
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED e
EXPLANATION OR SUSTIFIOATION MI L.><'~<<
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SIG NOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE ~~
DATE ~~1~
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CLOIHEDN g I Qg ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ Qt 4 C'VALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
~ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION CI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO U~zs POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES
' RESOLVED ESOLVE EXPL(NATION OR JUSTIFICATION G<(i~i'a~ k<<m,lj ba ~no~~J C~<<<<'t5
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P feist& Ot CK(M LN SIG NOFF 'I H.F. CONSULTANT (ESSEX) OATE ~O AEPSC PROGRAIVI LEAD ENGINEER DATE /Mg9~
CLO/HEDII p'J. Q ASSESSMENT RECORD POTENTIAL FOR fRROR (PFE) HIGH MEDIUIVI LOW
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CONSEQUENCE OF ERROR (COE) HIGH MEDIUM OW Consequence OI Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSIVIENT CATEGORY
CLOIHED¹ g~ I Q EVALUATION AND DISPOSITION RECORD I
ASSESSMENT/REVIEW ACTIONS
' DATE PENDING FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Z} APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES i POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION OR JUSTIFICATION ~
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SIG NOFF H.F. CONSULTANT (ESSEX) oAze ~I34 AEPSC P ROG RAM LEAD ENGINEER DATE lLZ98~
CLOIHEDII ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) H1G H EOIUAM LOW CONSEQUENCE OF ERROR (COE) HIGH M DIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
@ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO CYY~)
POTENTIAL FOR ERROR (PFE) Hl G H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESOLVED RESOLVED EXPLANATION OR JUSTIFICATION ~~~SIP%Khics'
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. H.F. CONSULTANT (ESSEX) DATE AEPSC P ROG RAM LEAD ENGINEER DATE ~/ gal@
CLO/HEDff (/(- tf Q ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH M EDIUM OW'IG CONSEQUENCE OF ERROR (COE) H MEDIUM LOW'onsequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY E3 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~ve~s POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES ESOLV RESOLVED EXPLANATION OR JUSTIFICATION Ld I( U'X. PPH'o w.c~U~
SIG NOFF H.F. CONSULTANT (ESSEX) DATE~~D AEPSC PROGRAM LEAD ENGINEER DATE ~~
CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H M ED IUM LO%
CONSEQU.ENCE OF ERROR (COE) Hl G H MEDIUM LO Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY JV
CLOIHED¹ V ( 0 f EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING ~ DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 4 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION
,COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV D-EXPLANATION OR JUSTIFICATION 8<9.C-&- ~ l ~a RESOLVED
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CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW
'IG CONSEQUENCE OF ERROR (COE) H MEDIUM LO Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ t
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EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY CI FURTHER REVIEW BY C3 FURTHER REVIEW BY DISPOSITION gR APPROVED C3 PARTIALLYAPPROVED C3 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO
+YE~S'IGH POTENTIAL FOR ERROR (PFE) MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW b&L t ~ ~ ~ \"A FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLA I N OR JUSTIFICATION (K ~>c ce SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER ~(~
DATE ~U DATE
C LOIHEDff ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LO CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ IJ (- Q(p EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 'FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLY APPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YE~S POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE. OF ERROR (COE) HIG H 'EDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANA ON OR JUSTIFICATION 7Iecuv ~u, ~~~<X o am<--~
SIG NOFF H.F. CONSULTANT (ESSEX) DATE (~i+)
AEPSC PROGRAM LEAD ENGINEER DATE // M~A
4 CLOIHEDII g t LL 7 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM~ LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUIYIl LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ P t g EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
ÃI APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV RESOLVED EXPLANATION OR JUSTIFICATION iLIo~ facow6ngg~~ .h~i cwqfaSiJ Mi8- T-~ . 8 ZOe- 250C9 W. t'ai(,( f7, ~vi 5'~li~g II c vvLecu.A LMA.e. ~~ I e ~A. 700 6-
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SIGNOFF H.F. CONSULTANT (ESSEX) DATE ~KB AEPSC PROGRAM LEAD ENGINEER DATE ~Rgb)
CLOIHED¹ ij EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLY APPROVED 0 NO ACTION g OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YESi POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH -
MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED EXPLANATION OR JUSTIFICATION
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CLOIHEDN g I Lj g ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM - LOW CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM ~L~O Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, should be considered.
'ut ASSESSMENT l7 CATEGORY
4 I CLO/HED¹ 4" (-IJ g.
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Pj APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW PFE AND
'P MODIFY RECOMMENDATION OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION LJi it CoW ec~ <<,e. eLa. ~. rocu
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CLO/HED¹ ASSESSMENT RECORD
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POTENTIAL FOR ERROR (PFE)
CONSEQUENCE OF ERROR (COE)
HIGH HIGH MEDIUM MEDIUM
~l C~OW OW'onsequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
/
ASSESSMENT CATEGORY
CLOIHEDN t,'(,5 >.
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
+ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES EYES~
POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM 'OW
~ ~ 0 ~ 184 I LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE,D RESOLVED ~i'm/
EXPLANATION OR JUSTIFICATION Vl.'Jr- 8~> d- f'LcA <<4. WZ 4Ah~ uJ<ir P~
SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE DATE ~(~ g
CLOIHED¹ g( 5(
ASSESSMENT RECORD 1
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM &0%
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective I action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY CI FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION t2 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION CI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES Y~ES .
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED'ESOLVED EXPLANATION OR JUSTIFICATION ~~he-t nacho~ re+.'I e c~4~ -'R.
SIGNOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER
CLO/HEDff V( - 5'L ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM ~LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ t f 5K EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY Cl FURTHER REVIEW BY DISPOSITION
@ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION C3 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV D RESOLVED EXPLANATION OR JUSTIFICATION Caa.l C' CE~C r cZC.c.ci~u C.L.O g I - -Q SIG NOFF H.F. CONSULTANT (ESSEX) oal e ~~~
AEPSC PROGRAM LEAD ENGINEER DATE ~/M6.
0
CLONED>> g r- 5'g ASSESSMENT RECORD
. POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW )
CONSEQUENCE OF ERROR (COE) H IG H MEDIUM LOW Consequence Of Error High Medium Low High potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION gj APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM i OW ~
CONSEQUENCE OF ERROR (COE) HIG H MEDIUM 'OW.i LOW NP MODIFY RECOMMENDATION FULL OR" COMPLIANCE PFE AND LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED EXPLANATION OR JUSTlf ICATION
>wC,c.
RESOLVED nwwn~ .~ 9 ~ a~( fir)
SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~4@ t~
AEPSC PROGRAM LEAD ENGINEER DATE LLl9S~
CLOIHEDif yi 5 Q ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LNW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN VI 5 "t EVALVATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE C3 FURTHER REVIEW BY 0, FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION G. APPROVED 0 PARTIALLYAPPROVED Q NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES Qwo YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM L6W CONSEQUENCE OF ERROR (COE) HIGH MEDIUM OW i FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES
/
RESOLVED RESOLVE EXPLANATION OR JUSTIFICATION ~0 ~%me . Pic~ -tuiulu ~s.=i fo(e uu~ ..r > ) >~) l g
/\
A<~i i~8 '.c. I 8'-DDT<' 5 >~ c
'I /
I ~ C ~
I ccrc (ideas SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~lQ)~
AEPSC PROGRAM LEAD ENGINEER DATE ~/I~k
CLOIHED¹ g (-5g ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) Hl G H MEDIU i LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV No corrective action necessary, but should be considered.
0 ASSESSMENT CATEGORY
CLOIHEDN P'(-6 5 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
!5 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLAN OR JUSTIFICATION M'iPco c~.6c'Gt(cut CJ 4am I SIGNOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE ~73~
CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE} HIGH MEDIUM LON CONSEQUENCE OF ERROR (GOE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low
, Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action ls highly recommended.
Category III - L'ow priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
Q ASSESSMENT CATEGORY
CLOIHEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY CI FURTHER REVIEW BY DISPOSITION N APPROVED CI PARTIALLYAPPROVED CI NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW
'ES FULL NO LOW NP MODIFY RECOMMENDATION "COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES I
RE OLVE RESOLVED
~~~
EXPLANAT/ON OR JUSTIFICATION c( r-.e - upw M De /
g.
/i r
~it'/ ie4' l /
PiD (sitz's.~ ~
C~ '2 4: C SIG NOFF H.F. CONSULTANT (ESSEX) DATE I~)ch 7 AEPSC PROGRAM LEAD ENGINEER DATE LLlRE6
CLO/HED¹ gi ( 5
'SSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM~ LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIU LOW Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO(HED¹ I, E- 5 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YE )
POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW LOW NP MODIFY RECOMMENDATION FULL PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPr.ANATION OR JUSTIFICATION <b.lu-
"0~6,i. e. .6(o e" SIGNOFF H.F. CONSULTANT (ESSEX) DATE 0 AEPSC PROGRAM LEAD ENGINEER DATE ~M&.
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN V( 52 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES WEGQJ.YED RESOLVED EXPLANATION OR JUSTIFICATION k3 II 0c X . l1I ( <rc lw4e(~X 6 ~PJ((
4o&Dvvl OP c~X K~ ow i 6 c..
SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE lLCM6
CLOIHEDII gl (
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM L W CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ V EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIGH -
MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM . LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED l
EXPLANATION OR JUSTIFICATION I
gz 1 C'.PIC 'I /AC.
'IG NOFF H.F. CONSULTANT (ESSEX) DATE ~~
AEPSC PROGRAM LEAD ENGINEER DATE ~j~
0 CLO/HEDII ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium.
Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDII 9 i gQ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY' FURTHER REVIEW BY DISPOSITION 0 APPROVED 8 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) H IG H MEDIUM CONSEQUENCE OF ERROR (COE) HIG H MEDIUM 0 0
FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED OLVE EXPLANATION OR JUSTIFICATION iQ 44k.4No~ a SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE LL/M~
CLOIHED¹ g(
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIG H MEDIUM OW CONSEQUENCE OF ERROR (COE) H IG H M ED I U M LO Cons'equence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDII Q~ (
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO (vVs)
POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MfDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES 1
RESOLVED RESOLVED EXPLANATION PR JUSTIF[CATION ~ &O n Iuu.. ~,~Vi~ (a wiKiW ~~MiQ -JLL ~ a.&~~Le av L 8 .4 v~co i~d-~~2 8 SIGNOFF H.F. CONSULTANT (ESSEX) DATE l~IO 4 AEPSC PROGRAM LEAD ENGINEER DATE ~IgjK~
CLO/HED¹ Vt ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM COW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
5 Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN Q( ( ~.
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 . FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED CI NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION w /
(t<<L<P 5 k~f b~ r Cz v(~ec(~
~MP I'A 'TC~<AO SIGNOFF H.F. CONSULTANT (ESSEX) ~4 AEPSC PROGRAM LEAD ENGINEER DATE DATE ~c~
CLOIHED¹ V'f -(
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~L~O CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low, Category I High priority; corrective action should be taken.
Category II Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ q ( 4 5 EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION P APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO~ YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEOIUIoOI ~LOWO FULL LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED ExPLANQTIQN QR JUsTIFIGATloN
~e.tie'P5 D ~I (~k' RESOLVED
><<r o l M(s 4o SIGNOFF V H.F. CONSULTANT (ESSEX) DATE i AEPSC PROGRAM LEAD ENGINEER DATE ~/
CLO/HED¹ p(
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOS CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT . CATEGORY
CLOIHED¹ I,i L-6 F .
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED Q NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES 'NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~LOW~
CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION r lZZO 0 YBAA4'(g.~
i~
c d (1 L'et uP1tf'(U¹r INM<(rt f'e 8prr 4 Tf ~tit5 er .t¹"d tn (ul SIGNOFF H.F. CONSULTANT (ESSEX) DATE AEPSC P ROG RAM LEAD ENGINEER DATE ~/ PEW
CLOIHED¹ Q( Qc ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM >
LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM ~LOW Of Error 'onsequence High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is'recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ Q ( Q$
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Pj APPROVED 0 PARTIALLY APPROVED Cl NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YESj POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM LOW C
FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RES ED RESOLVED LANATION OR JUSTIFICATION ~ ~ +~ ~ 4~~.l'X centi~~~."c(>
Plj '
SIG NOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE DATE
~~
~S~g,
CLOIHEO>>
ASSESSMENT RECORD POTENTIAL'OR ERROR (PFE) H IG H MEDIUM LO CONSEQUENCE OF ERROR (COE) HIG H MEDIUM OW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I High priority; corrective action should be taken.
Category II Medium priority; corrective action is highly recommended.
Category III Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ g (
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY CI FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO Cves
'IG POTENTIAL FOR ERROR (PFE) H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED. RESOLVED EXPLANATION OR JUSTIFICATION vs e oorreo.Pe (> o SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~~
AEPSC PROGRAM LEAD ENGINEER DATE ~/M&
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) Hl G H MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHED¹ 4' ('p EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS I
PENDING DATE D FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION CI OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO, YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM,LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES I
RESOLVED RESOLVED EXpLANATION OR JUSTIFICATION e ( I i~be( cap'll be eorrec 'oI o 4~
&aA4L Si,z c>. e-'ttu< t v SIG NOFF H.F. CONSULTANT (ESSEX)
AEPSC PROGRAM LEAD ENGINEER DATE ~~
DATER<~
CLO/HE 0¹ ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) H!GH MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM OW Consequence Of Error High Medium Low High Potential For Error Medium Low ilier mMI l t)~~4 Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION X APPROVED D PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES (YVES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV D RESOLVED EXPLANATION OR JUSTIFICATION cZ Qa c tun G r s'Mi SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~R AEPSC PROGRAM LEAD ENGINEER DATE ~PEG
CLOIKEDII Q g- f EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
+ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW l ~ ~ ~
I.,
W I1 FULL NO LOW NO MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESO~LVE RESOLVED EXPLANATION OR JUSTIFICATION <PSC Le. n'hafelcclah'I(>< emcucaS(~
& <ZX. Hh(iWIc .%~i Cue tide rE (a DEl i~ Ot. C'Ou. nOi e+
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r> 'Wl ~ Ie LLIAe. C~rrec C'le(~e~l
( H P CltL.
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SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE MIME
CLO/HEDN Q L (
ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW I
CONSEQUENCE OF ERROR (COE) HIGH MEDIU LOW Consequence Of Error High Medium, Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY X
CLO/HEDN V Z.L EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 'URTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION jE1 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV RESOLVED EXPLANATION OR JUSTIFICATION be l I bc c' I. f eo.s 'rv1( o4 8( is r 4 ~, dr cc ev<T o ~eke SIGNOFF H.F. CONSULTANT (ESSEX) DATE ~bb ~b AEPSC P BOG RAN LEAD EN G INEER e
DATE ~RKz
CLOIHEDff ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low g,,
Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary,
. but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION g. OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIGH . MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION S~
SIG NOFF H.F. CONSULTANT (ESSEX)
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CLOIHEON V7-ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM O~W CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LO Consequence Of Error High Medium Low High Potential For Error Medium Low
'I Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN ~7 EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 5 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW.
CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT-YES YES RESOLVED EXPLANATION OR JUSTIFICATION
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CLOIHEON ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEOIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIU LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
. ASSESSMENT CATEGORY
CLOIHEDN 'J 7 5, EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 38 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM "
LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION I I (d4 I vlT'ALL& l h 2 ~
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Category II- Medium priority; corrective action is highly recommended.
Category III Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDII EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION gl APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION ~
FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) MEDIUM LOW
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CLOIHEDN lj'Q EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION fK OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL -FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW IVIED FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED
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CLOIHEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH EDIUM I OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low
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Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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EVALUATIONAND DISPOSITION RECORD ASSESSMENTIREVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY D FURTHER REVIEW BY DISPOSITION 4R APPROVED 0 PARTIALLYAPPROVED D NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES>'
POTENTIAL FOR ERROR (PFE) IG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESO VED RESOLVED EXPLANATION OR JUSTIFICATION SIG NOFF H.F. CONSULTANT (ESSEX) DATE AEPSC PROGRAM LEAD ENGINEER DATE ~~a
CLO/HEDN ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM SCOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM L~O Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action ls recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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NO ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESOLVED RESOLVED EX LANATION OR JUSTIFICATION I oc.e o lac~ eu oil~ erg a~) . ~j SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~E AEPSC PROGRAM LEAD ENGINEER DATE ~ILES
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Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED>> U c- iI EVA1UATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION QL APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH 'GUIDELINES ~Y~ES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION > 'u.~L< ul'1 <4-5 G. c~c d.lA~oH.
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Category II - Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD
'SSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
+ APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YS POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES ESOLV RESOLVED EXPLANATION OR JUSTIFICATION king V 4 Ska < iI 1c gw o SIGNOFF H.F. CONSULTANT (ESSEX) DATE AEPSC P ROG RAM LEAD ENGINEER DATE g/~M
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Category II- Medium priority; corrective action is highly recommended.
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ASSESSMENT CATEGORY LL
CLOIHEDN 'LJ L ~.
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AEPSC PROGRAM LEAD ENGINEER DATE
CLOIHED¹ ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Ot Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
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CLO/HEON ASSESSMENT RECORD POTENTIAL FOR ERROR {PFE) HIGH MEDIUM ~o)
CONSEQUENCE OF ERROR {COE) HIG H MEDIUM OW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDII EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 8 APPROVED C} PARTIALLYAPPROVED Q NO ACTION Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR, LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVE RESOLVED EXPLANATION R JUSTIFICATION T4 J'.~( rv;uii&~a8as M
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Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE CI FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLY APPROVED Cl NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO ~ES >
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ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION
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Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action 'necessary, but should be considered.
ASSESSMENT CATEGORY
CLOIHEDN Q Z (9 ~
EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g, APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~ES POTENTIAI FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM, ~ LOW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES di i ESOLVE EXPLANATION OR JUSTIFIC TION RESOLVED t 1444'revue d'tt r<dc.
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Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION . Cl OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLV RESOLVED EXPLANATION OR USTIFICATION ik/L C.~du@
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM ~LO Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
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0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION APPROVED 0 PARTIALLYAPPROVED 0. NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM OW CONSEQUENCE OF ERROR (COE) HIG H MEDIUM (LOWI FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVE EXPI.ANATION OR JUSTIFICATION ~~ n- uu a' 7 en~~ 6c &~5 ie>
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Category II- Medium priority; corrective action is highly recommended.
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ASSESSMENT CATEGORY
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Category III - Low priority; corrective action is recommended.
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ASSESSMENT CATEGORY
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EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY Cl FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED Q NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~LNVF',
CONSEQUENCE OF ERROR (COE) HIG H MEDIUM 0 LOW NO MODIFY RECOMMENDATION FULL NO COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED EXPLANATION OR JUSTIFICATI N RESOLVED Nu '~ e. ~c'c.ca 0 .e-e er SIG NOFF H.F. CONSULTANT (ESSEX) DATE ~I~~
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ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM ~I.OW CONSEQUENCE OF ERROR (COE) HIG H NlEDIUM LOW.
Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action is highly recommended.
Category Ill - Low priority; corrective action is recommended.
Category IV- No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
0 CLOIH ED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED Ã NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) H IG H MEDIUM 0 CONSEQUENCE OF ERROR (COE) HIG H MEDIUM OW FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED ESOLV EXPLANATION OR JUSTIFICATION SIG NOFF H.F. CONSULTANT (ESSEX) OAV~ ~~~~
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CLOIHEDII g~ 7~ i6~ I0 ( q ZE 7 ASSESSMENT RECORD POTENTIAL FOR. ERROR (PFE) HIGH MEDIUM'OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III- Low priority; corrective action is recommended.
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ASSESSMENT CATEGORY
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Category III - Low priority; corrective action is recommended.
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ASSESSMENT CATEGORY
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'EVALUATIONAND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 . FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION g APPROVED 0 PARTIALLYAPPROVED D NO ACTION G OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW NO LOW NP MODIFY RECOMMENDATION FULL COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESO RESOLVED
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CLOIHEDII g/ Z, 'P ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium . Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II- Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HEDN g ~( .
EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY .
DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED O'O ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES ~NO YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVE EXPLANATION OR JUSTIFICATION He 6uf l+o;~~ c.Lo t. t-6 SIG NOFF H.F. CONSULTANT (ESSEX) DATE i~4 AEPSC PROGRAM LEAD ENGINEER DATE ~9~
CLO/HEON ASSESSMENT RECORD POTENTIAL FOR ERROR {PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR {COE) HIGH MEDIUM LOW Consequence OI Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II -. ~ Medium priority; corrective action is highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV No corrective action necessary, but should be considered.
ASSESSMENT CATEGORY
CLO/HED¹ EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE CI FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION Q APPROVED 0 PARTIALLYAPPROVED Q NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM ~OW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW')
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CLO/HEDN ASSESSMENT RECORD I
POTENTIAL FOR ERROR (PFE) HlGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low
~ ~ Sl~l SLY Category I- High priority; corrective action should be taken.
Category II "- Medium priority; corrective action ls highly recommended.
Category III - Low priority; corrective action is recommended.
Category IV - No corrective action necessary, but should be considered, ASSESSMENT CATEGORY
CLOIHEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 5f NO ACTION 0 OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LO CONSEQUENCE OF ERROR (COE) HIGH MEDIUM ~LOW (
FULL NO LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED ESOLVED EXPLANATI N OR JUSTIFICATION o of(ao Bi IL. C o
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CLO/HEDN EVALUATION AND DISPOSITION RECORD ASSESSMENT/REVIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY DISPOSITION 0 APPROVED 0 PARTIALLYAPPROVED 0 NO ACTION ISL OTHER EVALUATION FULL COMPLIANCE WITH GUIDELINES NO YES POTENTIAL FOR ERROR (PFE) HIG H MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW C
FULL LOW NP MODIFY RECOMMENDATION COMPLIANCE PFE AND OR LOW COE JUSTIFY AND DOCUMENT YES YES RESOLVED RESOLVED EXPLANATION OR JUSTIFICATION
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CLO/HEDN
~ ~5 ASSESSMENT RECORD POTENTIAL FOR ERROR (PFE) HIGH MEDIUM . LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW Consequence Of Error High Medium Low High Potential For Error Medium Low Category I- High priority; corrective action should be taken.
Category II - Medium priority; corrective action Is highly recommended.
Category III - Low priority; corrective action Is recommended.
Category IV No corrective action necessary, but should be considered.
ASSESSM ENT CATEGORY
CLOIH EDN EVALVATIONAND DISPOSITION RECORD ASSESSMENT/RE VIEW ACTIONS PENDING DATE 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY 0 FURTHER REVIEW BY
,DISPOSITION APPROVED Cl PARTIALLYAPPROVED Q NO ACTION Q OTHER EVALUATION "FULL COMPLIANCE WITH GUIDELINES NO I ~YES POTENTIAL FOR ERROR (PFE) HIGH MEDIUM LOW CONSEQUENCE OF ERROR (COE) HIGH MEDIUM LOW FULL LOW NP MODIFY RECOMMENDATION PFE AND OR COMPLIANCE LOW COE JUSTIFY AND DOCUMENT YES YES OLVED RESOLVED EXPLANATION OR JUSTIFICATION '8 <2 l mIQ.'hi CxglC Ski 1
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