ML19035A741
| ML19035A741 | |
| Person / Time | |
|---|---|
| Site: | Callaway  |
| Issue date: | 02/04/2019 |
| From: | Findley A Ameren Missouri, Union Electric Co |
| To: | Document Control Desk, Office of Nuclear Security and Incident Response |
| References | |
| ULNRC06484 | |
| Download: ML19035A741 (8) | |
Text
ULNRC-0648 4 January 24, 2019 Page2 cc:
Mr. Scott A. Morris Regional Administrator U. S. Nuclear Regulatory Commission Region IV 1600 East Lamar Boulevard Arlington, TX 76011-4511 Senior Resident Inspector Callaway Resident Office U.S. Nuclear Regulatory Commission 8201 NRC Road Steedman, MO 65077 Mr. L. John Klos Project Manager, Callaway Plant Office of Nuclear Reactor Regulation U. S. Nuclear Regulatory Commission Mail Stop 09E3 Washington, DC 20555-0001
ULNRC-06484 January 24, 2019 Page 3 Index and send hardcopy to QA File A160.0761 Hardcopy:
Certrec Corporation 6100 Western Place, Suite 1050 Fort Worth, TX 76107 (Certrec receives ALL attachments as long as they are non-safeguards and may be publicly disclosed.)
Electronic distribution for the following can be made via Other Situations ULNRC Distribution:
F. M. Diya T. E. Herrmann B. L. Cox F. J. Bianco S. P. Banker R. C. Wink T. B. Elwood Corporate Communications NSRB Secretary STARS Regulatory Affairs Mr. Jay Silberg (Pillsbury Winthrop Shaw Pittman LLP)
Missouri Public Service Commission
- 1) All fields required excepl those marked optional
- 2) Entries in some fields aulo-populale information in other fields
- 3) Mouse overform fields to view additional information
- 4) Use ofAdobe Reader 8 orlater is required FEl Submission Delete Update Submission Unique Reference ID (License Supplied)
Select Facility Reason for Testing - 26.717(b)(5)
Pre-Access Employment Type - 26.71 7(b)(3)
I Licensee Employee Labor Category - 26.71 7(b)(3)
Supervisor APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPtRES: IllS Estimated burden per response to comply with this collection reqoest is 35 minutes.
This form is a voluntary means of reporting the information required under 15 CFR 26717. The information is reqoired by NRC to obtain on as annual basis site specific fitness-for-duty (FF01 program performance data on drug and alcohel programs from licensees and other entities. Send comments regarding burden estimate to the FOIA, Privacy and Information Collection firanch (T5-F53),
U.S.
Nuclear Regulatory Commission, Washington DC 20555-0551
, or by e-mail to lofocollects.ResourceNRC.gov, and to the Desk Officer, Office of Information and Regulatory
- Affairs, NEOB-1025, (3150-01461, Office ot Management and Budget, Washington DC 25503 If a means used to impose information collection does not display a currently valid 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.
Please elaborate on the 24-hour reporting event Event Number 53426 Substance - 26.717(b)(2) S (b)(6)
I Alcohol SubversionAffempt-Did this collection involve a subversion attempt?-26.717(b)(7)and 26.75(b) [
Alcohol Specimen Tested What 26.103 BAC level was exceeded?
[O4orgreater
[tug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)
LNRC Minimum Specific Sanction Applied t
14-Day Denial MFFD Coordinator First Name Last Name Position Title Person 2 (optional):
First Name Last Name Position Title Company Email Address Final Step(Required) - NRC will coosiderthis form authentic in accordance with 15 CFR 26.11 only when the Validate & Look bufioe is clicked and all errors highlighted in red( have been corrected. The Validate & Lock buSby will change to Locked afterthe data validation pmcess has been successfully completed indicating the form is ready for submission.
I Form Locked On:IMay 31, 2018 at 2:42:40 PM fsave to Local PC I
Printthis Report1 Single Positive Test Form (version 1.7.0
- December 2016)
NRC Form 890 (12/2014)
C NR FED Program Performance Data Reportng System I
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6 ul ry C I
NRC Form 890 Single Positive Test Form PrIectbtg People Wldflte Enrirouameilt (EIE General Submission Portal)
Callaway [50-4831 I
Pre-Access Testing Reason (optional) t Initial Authorization Date of Collection I (mm/dd/yyyy)
I 05/23/2018J Please elaborate (optional)
Outage Worker (optional)?
NO I
Please elaborate on the assigned area of responsibility for the supervisor I
Non-Badged BOP supervisor from Corporate Office Is this a 24-hour reporting event? - 26.719(b)
Yes Was this collection refused? - 26.717(b)(7) & 26.75 j No Test Results - 26.717(b)(4)
Test Type(s) for Result(s) Reported
- 26.717(b)(2)
IAlcohol Only Management Actions - 26.717(b)(B) & 26.75 Reason for the Action Raodi Person(s) Responsible for Information Provided Person 1 required):
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- 1) AIJfie!ds requIred except those marked optional
- 2) Entrtos in some fields auto-populate information in other fields
- 3) Mouse over form fields to view additional information
- 4) Use ofAdobe Reader 8 orlater is required H
Submission Delete Update Submission Unique Reference ID (Licensee Supplied(
I2048801386 Facility Reason for Testing - 26.71 7(b)(5)
Random Employment Type - 26.71 7(b)(3)
Licensee Employee Labor Category - 26.71 7(b)(3)
LOther Is this a 24-hour reportable event under 26.719(b)?
No Was this collection refused? - 26.717(b)(7) & 26.75 No APPROVED BY 0MB: CLEARANCENO.3750-0146 EXPIRES: 0413012021 Estimated burden per response to comply with this collection request is 35 minutes.
This form is a voluntary means of reporting the information required under 10 CFR 26.417(b((2 and 26717. The information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FED) program performance data on drug and alcohol programs from licensees and other entities.
Send comments regarding burden estimate to the FOIA, Privacy and Information Collection Eraoch (T5-F53(, U.S. Nuclear Regulatory Commission, Washington DC 25555-5551, or by e-mail to lnfocollects.ReoourcuNRC,gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEDB-1025, (3155-0146(, Office of Management and eudget, Washington DC 20553.
If a meaos used to impose information collection does not display a currently valid 0MB control number, the NRC mai not conduct or sponsor, and a pemon is not required to respond to, the information Test Results - 26.717(b((4(
Test Type(s( for Result(s( Reported - 26.71 7(b((2(
Drug Specimen Tested
[rug Only
___J
[Urine Test Validity Was this collection observed?- 26.717(b((7( & 26.75 NJ How many substances were confirmed positive for this individual?
j I
FSubstance-26.717(b((2( & (b((6(
Use NRC Initial Confirmatory LImIt of Marijuana I
Yes Cutoffction Cutoffs?
Cutoff Subversion Attempt -
Did this collection involve a subversion attempt? - 26.717(b((7) and 26.75(b([
No
]
ManagementActions - 26.717(b)(8( & 26.75 Reason for the Action I First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administratedl
[icensee Admhdstrated
]
Specific Sanction Applied 14-Day Denial Person(s) Responsible for Information Provided Person 1 (required(:
[Patterson First Name Last Name Person 2 (optiooal(:
US Nr{c FFD Program Performance Data Reporting System L
t I
S p1 vs C NRC Form 890 Single Positive Test Form
&OttSiiltg PeOpkaltdtheIilli*Omltcltt (EIE General Submission Portal)
I Callaway [50-483]
Date ofCoilection
[ 07103/2018 (mm/dd/yyyy(
Please elaborate (optional)
Outage Worker (optional)?
NO I
Please elaborate on the Labor Category selected L
Summer intem iv Operations I I°°FFD Coordinator I
rpaSemon2ameren.com Position Title Company Email Address Hrst Name Lust Name PosItion Title Company Email Address FinalStep (Required) - NRC will considnrthis form authentic in accordancewith 15 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 ULock afterthe data validation pmcess has been successfully completed indicating the form is ready for submiss:on.
Form Locked on:IJan 8, 2019 at 10:50:04 AMJ
[ve to Local PCi this Repo Single Positive Test Form (version 1.8.0 - April 2018)
NRC Form 890 (12/2014)
Labor Category - 26.71 7(b)(3) 7 Date of Collection I
]
(mm/ud/yyyy)
I 1/06/2018 Please elaborate (optional)
Maintenance (general facility)
Is this a 24-hour reportable event under 26.719(b)?
Was this collection refused? - 26.71 7(b)(7) & 26.75 No Test Results - 26.717(b((4)
Test Type(s) for Resslt(s) Reported
- 26.71 7(b)(2)
Drug Specimen Tested LDrug Only
___J
[rine Test Validity
[yid
-:i Was this collection observed?- 26.717(b)(7) & 26.75 Yes How many substances were confirmed positive for this individual? f j
Substance - 26.717(b)(2) S (b)(6)
Use NRC Initial Confirmatory Lim t of Marijuana Yes Deton Cutoffs?
Cutoff Cutoff Subversion Attempt -
Did this collection involve a subversion attempt?
- 26.717(b)(7) and 26.75(b) [Yes n Did not appear for testing n Shy-bladder (no medical condition) 0 Refused to provide initial specimen ci Refused to provide second specimen Specimen temperature (out of range)
- Specimen paraphernalia identified Management Actions - 26.717(b)(8) & 26.75 Reason for the Action Sanction Applied (NRC Minimum or Licensee Administrated) n Specimen characteristics (e.g., color, odor, precipitant)
Invalid test result (initial specimen collected) - 26.185(f) n Refused to follow directions n Donor admitted to subversion attempt n Other
- 1) AIlfields required except those marked optional
- 2) Entries in some fIelds auto-populate information in other fields
- 3) Mouse over form fields to view additional information
- 4) Use ofAdobe Reader 5 or later is required LI Submission Delete Update Submission Unique Reference ID (Licensee Supplied)
I 0254355695 Facility I
Callaway [50-483]
[46 E
en per response to comply with t...s collection request is 35 minL form is a volt tary means of reporting the information required under It CFR 26 and 26.717. The information is required by NRC to obtain on an annual basis site spe,,,,.
fitness-for-duty IFFDI program performance data on drug and alcohol programs from licensees and other entities.
Send comments regarding burden estimate to the FOIA, Privacy and Information Collection Branch (T5-Fa3l, U.S. Nuclear Regulatory Commission, Washiogtun DC 25555-5551, or by e-mail Is thfucollects.Resource@NRC guy, and to the Desk Officer, Office of Informatiun and Regulatory Affairs, NEOB-1525, (3155-5146), Office of Management and Budget, Washington DC 25553.
If a means used to impose information cullectisn does not display a currently valid 0MB cuntrol number, the NRC may nut conduct or sponsor, and a person is not required to respond to, the information Reason for Testing - 26.717(b((5(
Pro-Access Testing Reason (optional)
Pro-Access Initial Authorization Employment Type - 26.71 7(b)(3)
Outage Worker(optional)?
I ContractorNendor No I Subversion attempt 1
First collectiso on this individual was a temperature out of range. We performed a second collection under direct observation. The first collection results were negative. The second collection results were positive.
RCP/Snimurn Specific Sanction Applied Permanent Denial Person(s) Responsible forlnformation Provided Person 1 (required):
First Name Last Name Position Title Person 2 (optional):
it I
rpaeerson2@ameren.com Company Email Address First Name Last Name PosttonTifie Cnipany Email Address Final Step (Required) - NRC will considerthis form authentic in accordance with 10 CFR 26.1 1 only when the Validate & Lock button is clicked and all errors (highlighted in redl have been corrected. The Validate & Lock button will change to Locked afterthe data validation pmcess has been successfully completed indicating the form is ready for submission.
Iocked Form Locked On:
g at 1 1 :20:45 AM ]
tsae to Local Pci [
Print this Report J Single Posibve Test Form (version 1.8.0
- April 2018)
NRC Form 890 (12/2014)
- 1) AlIfleids roquIred cxcept those marked optIonal
- 2) Entries in sonte fields autopopulate information in other fields
- 3) Mouse over form fields to view additional information
- 4) Use ofAdobe Reader 8 or laler is required LI Submission Delete Update Submission Unique Reference ID (Licensee Supplied)
I0254358624 Facility Callaway [50-483]
Reason for Testing - 26.717(b)(5)
Pre-Access Employment Type - 26.71 7(b)(3)
I ConttactorNendor Outage Worker (optional)?
[i I
APPROVED BY 0MB: l.aonn,s m.om,. aao-u so ormoa uqi auiaua Estimated burden per response to comply with this collection request is 30 minutes.
This form is a voluntary means of reporting the information required uoder 10 CFR 26.417(b)(2) and 26.717. The information is required by NRC to obtain on an annual basis site spedfc fitness-forduty (FED) program performance data on drug and alcohol programs from licensees and other entities.
Send comments regarding burden estimate to the FOIA, Prinacy and Information Collection Branch 1T5-F531, U.S. Nuclear Regulatory Commission, Washington DC 25555-5551, or by e-mail to lnfocollects.Resource@NRC.gon, and to the Desk Officer, Office of Informahon and Regulatory Affairs, NEOB-152S, 13155-51461, Office of Management and Budget, Washington DC 20503.
If a means used to impose information collection does not display a currently nalid 0MB contml number, the NRC may not conduct or sponsor, aed a person is not required to respond to, the information Date of Collection 12/04/2018 (mm/dd/yyyy)
Please elaborate (optional)
LaborCategory-26.717(b)(3)
I Maintenance (general facility)
Is this a 24-hour reportable event under 26.719(b)? [jj I Was this collection refused? - 26.717(b)(7) & 26.75 Test Results - 26.717(b)(4)
Test Type(s) for Result(s) Reported
- 26.71 7(b)(2)
Drug Specimen Tested Test Validity Was this collection observed?- 26.717(b)(7) & 26.75 No I
How many substances were confirmed positive for this individual? [
2 1
I Substance-26.717(b)(2) & (b)(6)
Use NRC Initial Confirmatory Lim tof I
tion Cutoffo Cutoff Cutoff IManujua I
I Yes I
Subversion Attempt -
Did this collection involve a subversion attempt?
- 26.717(b)(7) and 26.75(b) L.
..]
ManagementActions -26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive 1
Sanction Applied (NRC Minimum or Licensee Administratedi
[censeeAdmidstrated Specific Sanction Applied I
1-YearDenial Person(s) Responsible forinformation Provided Pemon 1 (requiredl:
I IANFFD Coordinator I
tpaSemo02@ameren.com First Name Last Name
Position Title Person 2 loptionall:
( us i-Rc X FFD Program Performance Data Reporting System 1st
\\
It NRC Form 890 Single Positive Test Form hdiecllltg P#ipkEltdWlv 1,, two, tie I (EIE General Submission Portal)
Pre-Access Testing Reason (optional)
I Initial Authorization Randi Pa5erson Company Email Address First Name Last Name Position Title Company Email Address Final Step (Required) - NRC will considerthis form authentic in accordance with 15 CFR 2e.11 only when the Validate & Lock boSon is clicked and all errors (highlighted in red( have been corrected. The Validate & Lock boSon will change to Locked afterthe data validation process has been successfully completed indicating the form is ready for submission.
I 1oced Form Locked On:IJan 8, 2019 at 1 1:26:10 AM f
[ive to Loci I Printthis Reporti Single Positive Test Form)version 1.8.0 -Apr11 2018)
NRC Form 890 (12/2014)