ML18060A237

Single Positive Test for, for Cause, Collected on 01/19/17

ML18060A237
Person / Time
Site:	Indian Point
Issue date:	02/15/2018
From:	Griffin W, Pettus K Entergy Nuclear Northeast
To:	Office of Nuclear Security and Incident Response
References
IPEC 2017-001, NL-18-011
Download: ML18060A237 (1)

Text

., U.S.NRC '

FFD Program Performance Data Reporting System NRC Form 890 Single Pos1t1ve Test Form 1, "'

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1) AJI fields required except thoH marl<ed 'optlonaf APPROVED BY 0MB: CLEARANCE NO. 3150.0146 EXPIRES: 11/30/2017

2) Entries in some fields *uto-populate Information In other fields Estimated burden per response to comply with this collection request is 30 minutes. This

3) Mouse over form field* to view additional Information form is a voluntary means of reporting the Information required under 10 CFR 26.717. The

4) Use of Adobe Read.r a or later I* required information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FFO) program performance data on drug and alcohol programs from licensees and other D Submission D ~~~e!~ssion entities. Send comments regardlng burden estimate to the FOIA, Privacy and Information Update Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to lnfocoHtctB Bcaource@NBC oov. and to the Desk Officer, Unlaue Reference ID <Licen se Sum:lied\\

Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Office of IIPEC 2017-001 I

Management and Budget, Washington DC 20503. If a means used to impose information collection does not display a currenUy valid 0MB control number. the NRC may not conduct or sponsor, and a person is not required to respond to. the information collection.

Select Fac/1/ty llndian Point[50-247; 50-286]

I Date of Collect/on I (mmldd/yyyy) 0111912017 I Reason for Testing. 26. 717(b)(5)

For Cause Testing Reason Please elaborate (optional)

I For Cause I I Observed Behavior I

Medical vendor detected an odor of alcohol during employee's annual physical Employment Typo

• 26. 717(b)(3)

Outage Worker (options/)?

I Licensee Employee I INo I

Labor Category

• 26. 717(b)(3)

I Non-Licensed Operator I

Is this

• 24-hour reporting event?

• 26. 719(b) ~

Was this collect/on refused?

• 26.717(b)(7) & 26.75 ~

Test Results. 26.717(b)(4)

Test Type(s) for Result(s) Reported* 26.717(b)(2)

!Alcohol Only I

Substance. 26. 717(b)(2) & (b)(6)

!Alcohol I

Alcohol Specimen Tested

!Breath I

IMlat 26.103 BAC level was exceeded?

lo.04 or greater I

Subversion Attempt -

Did this collection involve a subversion attempt?. 26.717(b)(7) and 26.?S(b) I No I

Management Actions

• 26. 717(b)(8) & 26. 75 Reason for the Action I

First drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administrated)

INRC Minimum I

Specific Sanction Applied 114-Day Denial I

Porson(s) Rosponslble for Information Provided Person 1 (required):

I Kelly I I Pettus I lsr. Secunty Coordinato,, Access/FFD I kpettus@entergy.com First Name Last Name Position Title Company Email Address Person 2 (optional):

lwayne IIGriffin I I supervisor, Access/FFD I wgriff1@entergy.com First Name Last Name Position Title Company Email Address Flnal Step (Required) - NRC wi11 consider this form authentic in accordance with 10 CFR 26.11 only when the 'Validate & lock* button is clicked and all errors (highlighted in red) have been corrected. The "Validate & lock* button will change to *Locked* after the data validation process has been successfully completed indicating the form is ready for submission.

Form Locked On:IFeb 15, 2018 at 10:08:58 AM I I Save to Local PC 11 Print this Report I Single Positive Test Form (version 1.7.0. December 2016)

NRC Form 890 (12/2014)