ML18060A247
| ML18060A247 | |
| 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 2017-0010, NL-18-011 | |
| Download: ML18060A247 (1) | |
Text
.l U.S.NRC ' FFD Program Performance Data Reporting System "-, NRC Form 890 Single Pos1t1ve Test Form ,, '" h,. l'rolt'1llllJ:
/1,011/t'multht' I 111,r, ,11m,111 1EII::.. r>eneral Subrrnss1on Portal 1) AJI fields requirN except those marked 'optional' APPROVED BY 0MB: CLEARANCE NO, 3150-'>146 EXPIRES: 11/30/2 0 17 Z) Entries in some fields auto-populate Information in oth.,-field s Esti m a te d burden p er response to comply with this collection reque st is 30 minutes. This 3) Mouse over form fields to view *dditional I nformation form is a voluntary mean s of reporting the i nformation required unde r 10 CFR 26.717. The 4) Use of Adobe Reader 3 or later is required information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FFO) program performan c e data on drug and alcohol programs from licensees and other D Submission D ~~~e!~ssion entities. Send comments regarding burden estimate to the FOIA. Privacy and Information Update Colle ction Branch (T5-F53), U.S , Nu c lear Regulatory Comm issio n , Washington DC 20555-0001 , or by e-mail to lnfocoOects Resourcc@NRC gov , and to the Desk Officer , Unlc,ue Reference ID (License Supplied)
Offic e of Information and Regulat ory Affairs , NEOB-1020 , (3150-0146), Office of IIPEC 20 1 7-0010 I Management and Budget , Washington DC 20503. I f a m ea ns u se d to impose information colle c tion doe s not di s play a currently valid 0MB control numb er, th e NRC may not conduct or spo n so r , and a person is not required t o respond to , the information collecti on. Select Fac/1/ty I Indian Po int [50-247; 50-286) I Date of Collect i on I (mm l dd/yyyy) 12/12/2017 I Reason for Test i ng-26.717(b)(5)
Pre-Access Testing Reason (opti onal) Please elaborate (o pt io nal) I Pre-Access I I Reinstatement (Between 31 and 365 days) I I I Employment Type -26.717(b)(3)
Outage Worker (optional)?
IContractorNendor I INo I Labor Category -26. 717(b)(3)
I Maintenance (general facility)
I Is this a 24-hour reporting event? -26. 719(b) Was this collection refused? -26.717(b)(7)
& 26.75 Test Results -26.717(b)(4)
Test Type(s) for Result (s) Reported -26.717(b)(2)
Drug Specimen Tested lorug Only I IUrine I Test Va l id ity !val i d I Was this collect i on observed?
-26. 717 (b)(7) & 26. 75 How many substances were confirmed posit iv e for this indiv i dual? I 1 I Substance-26 , 717(b)(2)
& (b)(6) Use NRC Init i al Confirmatory U mitof C utoff s? Cutoff Cutoff Detection I Marijuana I I~ Subversion Attempt -Did this collection i n volv e a subversion attempt? -26.717(b)(7) and 26.75(b) j Yes I D Did not appear for testing D Specimen cha racterist ics (e.g., color , odor , precip it ant) Please elaborate on the choice(s) selected: D Shy-bladde r (no medical condition) 181 I nvalid test result (ini tial specimen collected) -26.185(n Initial spe ci men collecte d was return e d from lab as invalid. D Refused to provide i n iti al specimen D Refused to follow d i rect io ns Don or agreed to o bserv ed collection. Se con d collection which was an observed collectio n was confirme d pos itiv e D Refused to prov i de second specimen D Donor admitted to subversion attempt for marijuana. MRO de e m e d first collection a subversion attempt. D Specimen temperature (out of range) OOther D Specimen parapherna lia i dent ifi ed Management Act i ons -26.717(b)(8) & 26.75 Reason for the Action I subversion attempt I Sanctio n Applied (NRC Min i m u m or Licensee Ad m i n is trated) INRC M i n imum I Specific Sanction Applied I Permanent Den ial I Person(s)
Respons i ble for Information Pro v ided Pe rson 1 (requir ed): I Kelty I I Pettu s I l s r. Secudty Coordinator , Access/FFO I kpettus@enlergy
.com F ir st Name Last Name Position Title C ompany Ema il A ddress P erson 2 (optional}
- lw ayne IIGriffin I I supervisor , A ccess/FFO I wgriff1@entergy
.co m First Name Last Name Posit i on T itle Company Ema i l Address Final Step (Requir e d)* NRC will co n si der th is form a uthentic i n accordance with 10 CFR 26.11 only when the "Valid ate & Lo c k" butt on i s clic ked and all e rrors (highlighted in red) have been co rrect ed. Th e " V alida te & Lo c k" butt o n will change to " L ocked" after the d ata validatio n pro cess has been success fully completed in d ic ating the form i s ready for sub mi ssio n. -Form Locked On: IFeb 15 , 2018 at 10: 41: 04 AM I I Save to Loca l P C 1 1 P ri n t t h i s Re p o rt I Single Positive Test Form (versio n 1.7.0-December 2016) NRC Form 890 (12/2014)