ML18236A277
| ML18236A277 | |
| Person / Time | |
|---|---|
| Site: | Vogtle  |
| Issue date: | 08/24/2018 |
| From: | NRC |
| To: | NRC/NRO/DLSE/LB4 |
| References | |
| Download: ML18236A277 (30) | |
Text
Vogtle PEmails From: Hoellman, Jordan Sent: Friday, August 24, 2018 9:17 AM To: Vogtle PEmails
Subject:
Draft Exemption Request and Draft NRC Form 398 for Transferring Operator Pass Letters from VCS to VEGP Docket Attachments: ND-18-1126_Operator Exam_Exemption_Draft_PreSub Mtg.pdf; NRC Form 398 Block 25 Example.pdf; NRC Form 398 Example redacted.pdf The attached draft exemption request and draft NRC Form 398/Block 25 comments are being provided to support a requested 9/6 pre-submittal meeting. Please let me know if staff can support the requested 9/6 pre-submittal meeting. The documents have placeholders for personally identifiable information (PII), but all PII has been removed for the purposes of supporting the pre-submittal meeting. Thus, the entirety of the attached documents can be made available to the public; final submittal will have withheld PII.
Please note that the approach in these documents differs from what was discussed below. Specifically, the NRC Form 398 has been drafted assuming the exemption has already been granted, and a waiver from the written and operating exam have been checked on the form (with the exemption provided as the basis for the waiver). These changes were made based on discussions with Region II, who is responsible for signing off the NRC Form 398. We are providing the draft NRC Form 398 concurrently with exemption request to ensure alignment among all organizations with this approach and to ensure that there are no other exemption requests needed to support approval of the forms.
Please let me know if you have questions.
Thanks!
From: Patel, Chandu [1]
Sent: Monday, July 2, 2018 11:24 AM To: Roberts, Kelli Anne Cc: Hoellman, Jordan
Subject:
RE: RE: Follow up to June 28th meeting for Vogtle 3 and 4 Hi Kelli, Jordan and Lauren are on leave this week. Lauren is gone until July 16th. Also, I wanted to let you know that I had VogtlPEmail on distribution. So, your e-mail will go to public also. Do we want to have some discussion or can you wait until Jordan comes back next week for the sake of consistency?
Thanks, Chandu From: Roberts, Kelli Anne [2]
Sent: Monday, July 02, 2018 10:42 AM To: Patel, Chandu <Chandu.Patel@nrc.gov>; Hoellman, Jordan <Jordan.Hoellman2@nrc.gov>; Nist, Lauren
<lauren.nist@nrc.gov>
Cc: Vogtle PEmails <Vogtle.PEmails@nrc.gov>
Subject:
[External_Sender] RE: Follow up to June 28th meeting for Vogtle 3 and 4 1
Thank you for following up, Chandu.
We can certainly submit applications prior to or concurrently with the exemption request. I want to make sure were in alignment on how exemption request relates to NRC Form 398 applications. Per Jordans 6/19 email, the staff thinks the proper regulation to seek the exemption from is 55.33(a)(2) rather than 55.47.
Should an exemption from 55.33(a)(2) be approved, there would be no need to request a waiver from written and operating exam on NRC Form 398 since the candidates would be exempt from that requirement. If SNC submits the exemption request and package of NRC Form 398s concurrently, then we could note the exemption request under the comments box #17 on the form. Is this consistent with what staff was thinking?
- Thanks, From: Patel, Chandu [3]
Sent: Monday, July 2, 2018 9:50 AM To: Roberts, Kelli Anne; Hoellman, Jordan; Nist, Lauren Cc: Vogtle PEmails
Subject:
Follow up to June 28th meeting for Vogtle 3 and 4 Hi Kelli, I got the following response to your question.
Comment At the public meeting on 6/28/18, SNC asked a question about completion of the NRC Form 398 (applications). The staff discussed the question after the meeting and determined there needs to be an application in front of the staff in order to consider granting an exemption. Therefore, the applications should be submitted prior to or concurrently with the exemption request.
Please let me know if you have any questions or comments.
Sincerely, Chandu Patel 2
Hearing Identifier: Vogtle_COL_Docs_Public Email Number: 346 Mail Envelope Properties (SN6PR0901MB236630D2A1A19D0A91F7ACDFD5360)
Subject:
Draft Exemption Request and Draft NRC Form 398 for Transferring Operator Pass Letters from VCS to VEGP Docket Sent Date: 8/24/2018 9:17:19 AM Received Date: 8/24/2018 9:17:36 AM From: Hoellman, Jordan Created By: Jordan.Hoellman2@nrc.gov Recipients:
"Vogtle PEmails" <Vogtle.PEmails@nrc.gov>
Tracking Status: None Post Office: SN6PR0901MB2366.namprd09.prod.outlook.com Files Size Date & Time MESSAGE 3962 8/24/2018 9:17:36 AM ND-18-1126_Operator Exam_Exemption_Draft_PreSub Mtg.pdf 217480 NRC Form 398 Block 25 Example.pdf 323591 NRC Form 398 Example redacted.pdf 971756 Options Priority: Standard Return Notification: No Reply Requested: No Sensitivity: Normal Expiration Date:
Recipients Received:
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The Commission shall- a. prescribe uniform conditions for licensing individuals as operators of any of the various classes of production and utilization facilities
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(2) Written examination and operating test. The applicant has passed the requisite written examination and operating test in accordance with 55.41 and 55.45 or 55.43 and 55.45. These examinations and tests determine whether the applicant for an operator's license has learned to operate a facility competently and safely, and additionally, in the case of a senior operator, whether the applicant has learned to direct the licensed activities of licensed operators competently and safely.
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(a) The Commission shall also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared by power reactor facility licensees pursuant to paragraph (b) of this section.
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(4) Power reactor facility licensees must receive Commission approval of their proposed written examinations and operating tests.
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Title 10 of the Code of Federal Regulations (10 CFR) Part 55, Operators Licenses, requires that applicants for reactor operator (RO) and senior reactor operator (SRO) licenses must pass both a written examination and an operating test. The regulation at 10 CFR 55.40(b) allows power reactor facility licensees to prepare the site-specific written examinations and operating tests provided that (1) the facility licensee shall prepare the examinations and tests in accordance with the criteria contained in this NUREG, (2) the facility licensee shall establish, implement, and maintain procedures to control examination security and integrity, (3) an authorized representative of the facility licensee shall approve the examinations and tests before they are submitted to the NRC for review and approval, and (4) the facility licensee shall obtain NRC approval of its proposed written examinations and operating tests. The regulation requires that the license examinations must be developed and administered in accordance with 10 CFR 55.41, Written Examination: Operators, and 10 CFR 55.45, Operating Tests, for ROs, or 10 CFR 55.43, Written Examination: Senior Operators, and 10 CFR 55.45 for SROs.
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In accordance with Title 10 of the Code of Federal Regulations (10 CFR) 55.31(a)(4), an applicant shall do the following:
Provide evidence that the applicant has successfully completed the facility licensees requirements to be licensed as an operator or senior operator and of the facility licensees need for an operator or a senior operator to perform assigned duties. An authorized representative of the facility licensee shall certify this evidence on Form NRC-398. This certification must include details of the applicants qualifications, and details on courses of instruction administered by the facility licensee, and describe the nature of the training received at the facility, and the startup and shutdown experience received. In lieu of these details, the Commission may accept certification that the applicant has successfully completed a Commission-approved training program that is based on a systems approach to training [SAT] and that uses a simulation facility acceptable to the Commission under [10 CFR 55.45(b)].
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To the extent applicable, the operating test will require the applicant to demonstrate an understanding of, and the ability to perform, the actions necessary to accomplish a representative sampling of the 13 items identified in 10 CFR 55.45(a). (All 13 items do not need to be sampled on every operating test). In addition, the content of the operating test will be identified, in part, from learning objectives contained in the facility licensees training program and information in the final safety analysis report, system description manuals and operating procedures, the facility license and amendments thereto, licensee event reports, and other materials that the Commission requests from the facility licensee
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The ES-401N applies to new reactors licensed under 10 CFR Part 52. The content of the written licensing examinations for ROs and SROs is dictated by 10 CFR 55.41, Written Examinations: Operators, and 10 CFR 55.43, Written Examinations: Senior Operators, respectively. Each examination shall contain a representative selection of questions concerning the knowledge and abilities (K/As) and skills needed to perform duties at the desired license level. Both the RO and SRO examinations will sample the 14 items specified in 10 CFR 55.41(b), and the SRO examination will also sample the 7 additional items specified in 10 CFR 55.43(b).
Except as noted in Section D.1.b of this examination standard, NUREG-2103, Knowledge and Abilities Catalog for Nuclear Power Plant Operators:
Westinghouse AP1000 Pressurized-Water Reactors, provide the basis for developing content-valid operator licensing examinations. Each K/A stem statement has been linked to an applicable item number in 10 CFR 55.41 and/or 10 CFR 55.43. Preparing the license examination using the appropriate K/A catalog, in conjunction with the instructions in this NUREG-series report, will ensure that the examination includes a representative sample of the items specified in the regulations.
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The Reactor Operator (RO) and Senior Reactor Operator (SRO) training programs, including initial and requalification training, provide the means to train individuals in the knowledge, skills, and abilities needed to perform licensed operator duties Before initial fuel loading, the number of persons trained in preparation for RO and SRO licensing examinations will be sufficient to meet regulatory requirements, with allowances for examination contingencies and without the need for planned overtime.
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The Knowledge and Abilities Catalog for Nuclear Power Plant Operators:
Westinghouse AP1000 NUREG-2103 provides the basis for development of content-valid written and operating licensing examinations for reactor operators (ROs) and senior reactor operators (SROs). The Catalog is designed to ensure equitable and consistent examinations.
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The catalog is used in conjunction with NUREG-1021 "Operator Licensing Examination Standards for Power Reactors." NUREG-1021 provides policy and guidance and establishes the procedures and practices for examining licensees and applicants for RO and SRO licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). All knowledge and abilities (K/As) in this catalog are directly linked by item number to 10 CFR 55.
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PERSONALLY IDENTIFIABLE INFORMATION - WITHHOLD UNDER 10 CFR 2.390 NRC FORM 398 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-0090 EXPIRES: 03/31/2019 DATE RECEIVED (10-2017) Estimated burden per response to comply with this mandatory collection request: 2.56 hours6.481481e-4 days <br />0.0156 hours <br />9.259259e-5 weeks <br />2.1308e-5 months <br />. (To be completed by NRC) 10 CFR 55.31, 55.33, NRC requires this information to ensure that applicants/licensees meet all the requirements for 55.35, 55.47, 55.53, PERSONAL taking reactor operator examinations. Send comments regarding burden estimate to the and 55.57. Information Services Branch (T-2 F43), U.S. Nuclear Regulatory Commission, Washington, DC QUALIFICATION 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer,Office of Information and Regulatory Affairs, NEOB-10202, (3150-0090), Office of Management and STATEMENT -- LICENSEE Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.
- 1. Last Name 2. First Name 3. Middle Initial 4. Birth Date: (MM/DD/YYYY) 5. E-mail Address XXX XXX X XXX XX
- 6. Address (Number & Street, line 1) 7. Address (Suite, Unit No, etc., line 2) 8. City 9. State 10. Zip Code XXXXX Augusta GA XXXXX
- 11. Type of Application (Check applicable boxes) 12. Deferrals/Excusals/Waivers (check all that apply and justify in item 25)
A. NEW E. REAPPLICATION a. DEFERRAL b. EXCUSAL c. WAIVER B. RENEWAL 1 - FIRST DENIAL 1 - ELIGIBILITY 1 - WRITTEN (Category) 1 - WRITTEN (Category) SSS C. UPGRADE 2 - SECOND DENIAL 2 - EXPERIENCE 2 - OPERATING (Category) 2 - OPERATING (Category) OPT D. MULTI-UNIT (amend 3 - THIRD DENIAL d. DATE PASSED GFE 3 - MEDICAL to include additional unit) 4 - WITHDRAWAL (MM) September (09) (YY) 13 4 - OTHER GFE
- 14. Current or Previous License(s) Held Docket Number RO License Number(s) Expiration Date(s) Facility Docket Number(s) 055 - XXXX LSRO 050 SRO 052
- 15. Name of Applicant's Facility 16. Facility Docket Number 17. Additional Facility Docket Number(s) (Multi-unit Licenses)
Vogtle Electric 050 052-025 Generating Plant 052
- 18. Current Position at Facility A. Plant Supervisor/Manager E. Shift Technical Advisor/Shift Engineer I. Trainee B. Assistant Plant Superintendent/Manager F. Instructor J. Non-Licensed Operator C. Shift Supervisor G. Senior Control Room Operator K. Other (Specify in block 25)
D. Staff Engineer H. Control Room Operator
- 19. Education
- a. High School b. College DEGREE CODES c. Vocational/Technical Number of Certificate Received
("Highest Degree" obtained) Months Number HIGHEST DEGREE 0 - None Type of Training Graduate Major Area(s) of Study of Years (Use Codes) 1 - Certificate 2 - Associate GED Equivalency ENGINEERING 2.5 3 3 - Bachelor Yes No 4 - Master No OTHER 1 2 5 - Doctoral Yes No
- 20. Power Reactor Operator Training Program
- a. Has the applicant completed the Operator Training Program accredited by the National Nuclear Accrediting Board? Yes No
- b. Is a "Plant-Referenced Simulator" (As defined in 10 CFR 55.4) used in the Operator Training Program? Yes No
- 21. Training (Since Last Application - See Instructions)
- a. Classroom From (MM/YYYY) To (MM/YYYY) No. of Weeks From (MM/YYYY) To (MM/YYYY) No. of Weeks 1 - Nuclear Power Plant Fundamentals d. Extra Person on Shift in Control Room 2 - Plant Systems e. Time on Shift Above 20% Power 3 - Plant Procedures 05/2018 05/2018 f. Requalification
- b. Simulator g. Other (Specify below)
- c. SRO Instruction Continuing Training Program 10/2017 7/2018 4
- 22. Significant Control Manipulations DESCRIPTION PLANT SIMULATOR DESCRIPTION PLANT SIMULATOR
- a. See attached (Block 25) f.
- b. g.
- c. h.
- d. i.
- e. j.
NRC FORM 398 (10-2017) Page 1 of 3
NRC FORM 398 U.S. NUCLEAR REGULATORY COMMISSION (10-2017) 10 CFR 55.31, 55.33, 55.35, 55.47, 55.53, and 55.57.
PERSONAL QUALIFICATION STATEMENT -- LICENSEE (Continued)
- 1. Last Name 2. First Name 3. Middle Initial Docket Number XXX XXX X 055 - XXXX
- 23. Nuclear Experience Details POSITION TITLE FROM DATE TO DATE MONTHS FACILITY DUTIES Sr. Reactor Operator, VC Summer Initial License Class, from Nuclear Station, Procedure Writing &
Sr. Auxiliary Operator 09/2012 09/2017 60 Units 2 & 3 Reviews, Training Material Reviews.
Engineer II Brunswick FAC Program Engineer (Qualified FAC), Nuclear Plant, Lead intern program 2yrs from 01/2010 09/2012 32 Units 1 & 2 Assisted MR, PMs, SysEng Engineer III Wrote VBA/DBs (Part time) Temporary Crystal River Developed VBA/DBs for HU Student Worker, Nuclear, inc. Site Observation, from (Full time) 05/2009 1/2010 3 Unit 3 Sim Performance, Trng Nuclear Eng. Intern Matl, & Whse DBs.
- 24. For Renewals Only
< 100 (LESS THAN) Date Result
- b. Date and result of last
- a. Hours Operated Facility written comprehensive W PASS FAIL 100 - 1000 requalification exam and
> 1000 (MORE THAN) annual operating test. O PASS FAIL
- 25. Comments See attached.
- 26. NRC FORM 396, CERTIFICATION OF MEDICAL EXAMINATION BY A FACILITY LICENSEE, IS ATTACHED Yes No NRC FORM 398 (10-2017) Page 2 of 3
NRC FORM 398 U.S. NUCLEAR REGULATORY COMMISSION (10-2017) 10 CFR 55.31, 55.33, 55.35, 55.47, 55.53, and 55.57.
PERSONAL QUALIFICATION STATEMENT -- LICENSEE (Continued)
- 1. Last Name 2. First Name 3. Middle Initial Docket Number XXX XXX X 055 - XXXX
- 27. Signatures ANY FALSE STATEMENT OR OMISSION IN THIS DOCUMENT, INCLUDING ATTACHMENTS, MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS.
I certify under penalty of perjury that the information in this document and attachments is true and correct in accordance with the instructions. I also authorize 27a.
the NRC to submit the results of examinations to my employers for use in preparing retraining programs, as necessary.
Signature - Applicant Date Electronic Correspondence Option: By checking this box, you are acknowledging that the NRC will be providing operator licensing correspondence electronically.
27b. CHECK APPLICABLE BOX(ES) FOR TYPE OF APPLICATION (i.e., check 1 if item 11 a, c, d, or e is checked; check 2 if item 11 b is checked; and check 3 if item 12 a, b, or c is checked.)
- 1. I certify that: (1) the above named individual has successfully completed the facility licensee's requirements to be licensed as an Operator/Senior Operator pursuant to Title10, Code of Federal Regulations, Part 55; (2) the individual has a need for an Operator/Senior Operator license to perform his/her assigned duties; and (3) the facility will be made available for the examination. I also certify under penalty of perjury that the information in this document and attachments is true and correct in accordance with the instructions.
- 2. I certify that the above named individual completed the approved requalification program (with the exceptions noted in Item 25) required by section 50.54(i-1) of 10 CFR 50, and that he/she has discharged his/her licensed responsibilities competently and safely. I also certify under penalty of perjury that the information in this document and attachments is true and correct.
- 3. I certify that the justifications provided in item 25 support the deferrals, excusals, and/or waivers requested in item 12 for the above named individual. I also certify under penalty of perjury that the information in this document and attachments is true and correct in accordance with the instructions.
TRAINING COORDINATOR Typed or Printed Name and Title (Training Coordinator)
Signature (Training Coordinator) Date SENIOR MANAGEMENT RESPRENTATIVE ON SITE Typed or Printed Name and Title (Senior Management Representative on Site)
Signature (Senior Management Representative on Site) Date FOR NRC USE GRANTED BY DENIED BY Deferral/Excusal/Waiver Requests (Check or Complete items, as applicable) HEADQUARTERS REGION HEADQUARTERS REGION Eligibility Deferral Experience Written Excusal Operating Written Operating Waiver Medical Other Explanation:
MEETS REQUIREMENTS DOES NOT MEET REQUIREMENTS Signature Date NRC FORM 398 (10-2017) Page 3 of 3
NRC FORM 398 U.S. NUCLEAR REGULATORY COMMISSION (10-2017)
PERSONAL QUALIFICATION STATEMENT -- LICENSEE (INSTRUCTIONS)
You must complete items 1-11, 19, and 20, plus changes since your last application, and other items as specified below. For additional guidance refer to NUREG-1021, "Operator Licensing Examination Standards for Power Reactors," or NUREG-1478, "Non-Power Reactor Operator Licensing Examiner Standards."
- 11. TYPE OF APPLICATION A. NEW - X if you are a new applicant at this facility (i.e., this is your first request to take the site-specific NRC exam at this facility). Complete items 13, 18-23 (10 CFR 55.31).
B. RENEWAL - X if you are renewing a current license. Complete items 20, 21.f and 23 (10 CFR 55.57); if items 20.a and 20.b are checked YES then item 21.f does not have to be completed.
C. UPGRADE - X if you hold an RO license and are applying to upgrade your license to an SRO at the same facility. Complete items 20, 21 and 23 relevant to the SRO upgrade.
D. MULTI-UNIT - X if you hold a license at your facility and are applying to amend your current license to an additional unit. Complete item 21 as it applies to unit differences.
E. REAPPLICATION - X if you have previously been denied a license. Indicate whether you are applying after a first denial, second denial, or third denial.
Describe, in detail, in items 21 and 25, the additional training completed since the last denial (10 CFR 55.35). If you previously withdrew an application, check item 11.E.4 and complete items 19-23.
- 12. GFE and Excusals/Deferrals/Waivers - Refer to NUREG-1021 or NUREG-1478 for additional guidance.
- a. Deferral - X if you are requesting a deferral of certain requirements to be able to sit for the scheduled NRC exam. Check which requirements (1 -
Eligibility or 2 - Experience) you are requesting deferral of. Indicate the expected completion time for these requirements in item 25.
- b. Excusal - X if you are requesting to have a previously passed portion of the NRC exam excused (10 CFR 55.35(b)). Indicate which requirements of the requested portion you are requesting excusal from (1 - Written or 2 - Operating), and indicate the category.
For Power Reactors:
For written exam excusals, check box 12.b.1 and enter a category of SSR for the site-specific RO exam or SSS for the site-specific RO and SRO exams.
For operating test excusals, check box 12.b.2 and enter a category of SIM for simulator operating test ONLY, JPM for the complete JPM operating test ONLY, SYS for the systems portion of the JPM operating test ONLY (i.e., for an Admin-only JPM retake exam), or OPT to request excusal from both the simulator operating test and the complete JPM operating test. Provide justification in item 25. Also indicate the expected date of the NRC exam.
For Non-Power Reactors:
For written exam excusals, check box 12.b.1 and enter a category of A: to request an excusal of category A, enter a category of B to request an excusal of category B, enter a category of C to request an excusal of category C. For operating text excusals, check box 12.b.2 and enter a category of ALL to request excusal of an operating test. Individual categories will not be excused.
- c. Waiver - X if you are requesting a waiver. For waivers of the written examination and/or operating test, check 12.c.1 and/or 12.c.2 respectively and identify the examination categories using the same designations identified in the instructions for 12.b above. For medical waivers, check 12.c.3. For GFE waivers, check 12.c.4. For all waivers, provide additional justification information in item 25.
- d. Date passed GFE - This is not applicable to research and test reactors, licenses limited to fuel handling (LSRO), renewal or upgrade applications (items 11.b and 11.c). Enter month and year you passed GFE for the type of facility (BWR/PWR) identified in item 15. If this date is more than two years prior to the date of your application, item 12.c.4 must be checked, and the method used to justify the GFE waiver must be described in item 25.
- 19. EDUCATION - For college, enter the major area(s) of study, the number of years spent in each major area of study and the highest degree obtained (using degree codes listed on the form). For vocational/technical, enter the number of months for each type of training and whether a certificate was awarded. If additional space is needed, use item 25.
- 20. POWER REACTOR OPERATOR TRAINING PROGRAM - Check the appropriate box in items 20.a and 20.b.
Checking YES in item 20.a indicates that you have completed a SAT-based training program that is accredited by the National Nuclear Accrediting Board and meets the education and experience requirements outlined in the National Academy for Nuclear Training in its current guidelines for initial training and qualification of licensed operators. If YES is checked in both items 20.a and 20.b, then items 21 and 23 do not have to be completed with the following exceptions: (1) certified instructors seeking an SRO license must complete item 23; (2) any exceptions, deferrals, or waivers from the education and experience requirements outlined by the National Academy for Nuclear Training must be explained in item 25.
- 21. TRAINING - All requalification training time is to be accounted for in item 21.f (unless items 20.a and 20. b are checked YES). Do not double list the time spent in requalification training for classroom or simulator time under items 21.a or 21.b.
- 22. SIGNIFICANT CONTROL MANIPULATIONS - If you are a NEW applicant (item 11.a), you must provide evidence that you have successfully manipulated the controls of the facility for which a license is sought. Describe (date, time, type, and magnitude) at least five significant control manipulations that affect reactivity or power level and whether the manipulations were performed in the plant or on the simulator (10 CFR 55.31(a)(5), 10 CFR 55.46(c)).
If needed, use item 25 or attach information.
- 23. EXPERIENCE DETAILS - For each position held, provide position title, time in position (from/to and number of months), facility, and a description of duties performed while in that position. Do not double count time. If you had overlapping duties, the time should reflect the amount of time you were assigned to those particular duties. In no case should the number of months reported exceed the number of months that are in that time period. If more space is needed, use item 25 or attach additional information.
- 24. FOR RENEWALS ONLY - (a) Check the box that most accurately reflects your approximate number of operating hours since previous renewal or issuance of license if first renewal. (b) Enter the date and results of your most recent comprehensive written requalification examination and annual operating test (10 CFR 55.57).
- 25. COMMENTS - Use this space to include any extra information or clarification for other items on the application form. If the space provided is not sufficient, you may attach extra information with your application.
- 26. NRC FORM 396, CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE, IS ATTACHED - NRC Form 396 must accompany this application unless a waiver of the medical examination is being requested in item 12.c.3 (10 CFR 55.23).
NRC FORM 398 (10-2017)
NRC FORM 398 U.S. NUCLEAR REGULATORY COMMISSION (10-2017)
PERSONAL QUALIFICATION STATEMENT -- LICENSEE (INSTRUCTIONS)(continued)
- 27. SIGNATURES - You must sign and date item 27a. If you prefer to check the Electronic Correspondence Option, you will be authorizing the NRC to forego receiving paper documents and receiving your operator license related correspondence using the Electronic Information Exchange. The NRC will automatically create a digital certificate for you to allow you to access your documents from a secure location for quicker access to your documents. If you do not check this box, the NRC will provide your correspondence using ground mail. Obtain signatures of your training coordinator and the senior management representative on site.
ADDRESSES In accordance with 10 CFR 55.5, Communications, this form shall be submitted to the appropriate NRC office. Where practicable, submission shall be electronic; examples include via Electronic Information Exchange or CD-ROM. Electronic submissions must be made in a manner that enables the NRC to receive, read, authenticate, distribute, and archive the submission, and process and retrieve it a single page at a time. Detailed guidance on making electronic submissions can be obtained by visiting the NRC's Web site at http://www.nrc.gov/site-help/e-submittals.html; by e-mail to MSHD.Resource@nrc.gov; or by writing the Office of the Chief Information Officer, U.S. Nuclear Regulatory Commission, Washington, DC 20555 -0001.
This form may also be submitted by mail, addressed to:
REGIONAL ADMINISTRATOR, REGION I REGIONAL ADMINISTRATOR, REGION III U.S. NUCLEAR REGULATORY COMMISSION U.S. NUCLEAR REGULATORY COMMISSION 2100 RENAISSANCE BOULEVARD, SUITE 100 2443 WARRENVILLE ROAD, SUITE 210 KING OF PRUSSIA, PA 19406-2713 LISLE, IL 60532-4352 REGIONAL ADMINISTRATOR, REGION II REGIONAL ADMINISTRATOR, REGION IV U.S. NUCLEAR REGULATORY COMMISSION U.S. NUCLEAR REGULATORY COMMISSION 245 PEACHTREE CENTER AVENUE, NE., SUITE 1200 1600 E. LAMAR BOULEVARD ATLANTA, GA 30303-1257 ARLINGTON, TX 76011-4511 U.S. NUCLEAR REGULATORY COMMISSION RESEARCH AND TEST REACTORS OVERSIGHT BRANCH OFFICE OF NUCLEAR REACTOR REGULATION WASHINGTON, DC 20555-0001 PRIVACY ACT STATEMENT NRC FORM 398 PERSONAL QUALIFICATION STATEMENTLICENSEE Pursuant to 5 U.S.C. 552(e)(3), enacted into law by Section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement is furnished to individuals who supply information to the Nuclear Regulatory Commission (NRC) on NRC Form 398. This information is maintained as part of a system of records designated as NRC-16, described at 81 FR 81331(November 17, 2016), or the most recent Federal Register publication of the NRC's "Republication of Systems of Records Notices" that is located in NRC's Agencywide Documents Access and Management System (ADAMS).
- 1. AUTHORITY: 42 U.S.C. 2131-2141; 10 CFR Part 55.
- 2. PRINCIPAL PURPOSE(S): To ensure that applicants/licensees meet all the requirements for taking reactor operator examinations.
- 3. ROUTINE USE(S): Information may be used to determine if the individual meets the requirements of 10 CFR part 55 to take an examination or to be issued an operators license; to provide researchers with information for reports and statistical evaluations related to selection, training, and examination of facility operators; to provide examination, testing material, and results to facility management. Information may be disclosed to an appropriate Federal, State, local or Foreign agency in the event the information indicates a violation or potential violation of law; in the course of an administrative or judicial proceeding; to an appropriate Federal, State, local and foreign agency to the extent relevant and necessary for an NRC decision about you; in the course of discovery under a protective order issued by a court of competent jurisdiction, and in presenting evidence; to a Congressional office to respond to their inquiry made at your request; to NRC-paid experts, consultants, and others under contract with the NRC, on a need-to-know basis; or to appropriate persons and entities for purposes of response and remedial efforts in the event of a suspected or confirmed breach of data from this system of records.
- 4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: Disclosing this information is voluntary. However, if the information requested is not provided, NRC will not be able to evaluate whether the applicant meets the requirements of 10 CFR Part 55.
- 5. SYSTEM MANAGER(S) AND ADDRESS: Chief, Operator Licensing and Training Branch, Division of Inspection and Regional Support, Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.
NRC FORM 398 (10-2017)