ML19058A545
| ML19058A545 | |
| Person / Time | |
|---|---|
| Site: | Wolf Creek  |
| Issue date: | 02/19/2019 |
| From: | Black P, Tate M Wolf Creek |
| To: | Office of Nuclear Security and Incident Response |
| Shared Package | |
| ML19058A542 | List: |
| References | |
| D3-18, RA 19-0030 | |
| Download: ML19058A545 (1) | |
Text
- U.S.NRC \\
FFO Program Performance Data Reporting System NRC Fc11n 2,r,, S,ng*e Po~1t1,.-c T,~st ~ 01111 I /~ f' /' o/1/lf/r, /
/II I/
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- 1) All fltid* required except those marlced 'optlonal' APPROVED BY 0MB: CLEARANCE NO. 3150-0141 EXPIRES: 04/30/2021
- 2) EntrlH In some field* auto-populate Information In othw tr*lds Estimated burden per response to compty with this collection request Is 30 minutes. This
- 3) MouH over form ff.Jd* to view addltlonal Information fo<m Is a voluntary means of reporting the informatfon required under 10 CFR 26.417(b)(2)
.f) U.a of Adobe RNdw I or later I* ~ulred and 26.717. The Information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FFD) program performance data on drug and alcohol programs from D Submission D ~~~e!~ssion licensees and other entities. Send comments regarding burden estimate to the FOIA,
Update Privacy and Information Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to lofocoflocta Be1ouccc @NRC goy and to the Unlaue Reference ID (Licensee Suooliedl Desk Officer, Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146}, Office ID3-18 I
of Management and Budget, Washington DC 20503.
If a means used to impose information collection does not display a currentty valid 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the Information Facility collection.
IWolf Creek (50-482)
I Date of Collect/on I 0312112018 I (mm/dd/yyyy)
Reason for Tutlng. 28. 717(b)(5)
Pre-Access Testing Reason (optional)
Please elaborate (optional)
I Pre-Access I
lrnitial Authorization I
I i
Employment Type. 26.717(b)(3)
Outllge Worl<er (optional)?
IContraclorNendor I
jves I
Labor Category. 26.717(b)(3)
I Maintenance (general facility)
I Is this a U.hour reportable event under 28.719(b)? ~
Was this collect/on refused?
- 28.717(b)(7) & 26.75 ~
Test Result$. 28.717(b)(4)
Test Type(s) fo, Result(s) Reported* 26.717(b)(2)
Drug Specimen Tested I
Drug Only I junne I
Test Validity
!valid I
Was this collect/on observed?
- 28.717(b)(7) & 26. 75 ~
How many substances were confirmed positive for this individual? J 1
I Substance - 26.717(b)(2) & (b)(6)
UseNRC Initial Confirmatory Limttof Cutoffs?
Cutoff Cutoff Detection I Marijuana I
I~
Subversion Attempt* Did this collection involve a subversion attempt?. 26.717(b)(7) and 26.75(b) I No I
Management Actions. 26.717(b)(8) & 26.75 Reason for the Action I
First drug or a lcohol positive I
Sanction Applied (NRC Minimum or Licensee Administrated)
INRC Minimum I
Specific Sanction Applied 114-Day Denial I
Person(s) Responsible for lnformlttion Provided Person 1 (requhd):
IPamefa I
la1ack I
!Access Specialist I
pabfack@wcnoc.com First Name Last N ame Position T itle Company Email Address Person 2 (optional):
!Michael (Kenn)
First Name
)ITate Last Name 11 Superintendent Security Pos1t1on Title I mitate@wcnoc.com Company Email Address Final St*p (Required)
- NRC wHI consider this form authentic in accordance with 10 CFR 26.11 only 'When the 'Validate & lock* button la dicked 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:!Feb 19, 2019 at 1:41:09 PM I I Save to Local PC 11 Print this Report I Single Positive Test Form (version 1.6.0. April 2018)
NRC Form 890 (12/2014)