ML19058A547

Single Positive Test Form Collected on 03/12/2018

ML19058A547
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: ML19058A539 ML19058A540 ML19058A541 ML19058A543 ML19058A544 ML19058A545 ML19058A546 ML19058A547 ML19058A548 ML19058A549 ML19058A550 ML19058A551
References
D4-18, RA 19-0030
Download: ML19058A547 (1)

Text

• U.S.NRC '

FFO Program Performance Data Reporting System NRC Fo1111,,c,u S11101t: Po....,1t1\\i2 1 t~..... t Fo1111 J o/11//t, /*1 II 11

1) All fields required except thoH marked 'optionllf APPROVED BY 0MB: CLEARANCE NO. 31SO-G141 EXPIRES: 04/30/2021

2) EntrlH In some treld* auto-populate Information In oth.,. ffeld*

Estimated burden per response to compfy with this collection request is 30 minutes. This

3) MouH ovw fonn field* to view additional lntormetlon form Is a voluntary means of reporting the Information required under 10 CFR 26.417{b)(2)

4) u.. of Adobe Reader I or latw I*,-quired and 26.717. The Information is required by NRC to obtain on an annual basis site specific fitness-fOf-duty (FFD) progi"am 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 (TS-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555--0001, or by e-mail to lnfocotltcta Rnource@NBC qoy and to the Un/Que Reference ID (Licensee Supplied)

Deak Officer, Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Office 104-18 I

of Management and Budget, Washington DC 20503.

If a means used to Impose information coHection does not display a currently vaHd 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the Information Faclllty collection.

IWolf Creek [50-482)

I Date of Collect/on I 0311212018 I (mm/dd/yyyy)

Reason for Testing - 28.717(b)(5)

Pr&-Access Testing Reason (optional)

Please elaborate (optional)

I Pre-Access I I Initial Authorization I

I I

Employment Type - 26. 717(b)(3)

Outage Worl<er (optlonaQ 7 I

Contrado<Nendor I jves I

Labor Category - 26.717(b)(3)

!Maintenance (safety-sii,,ifica,t)

I Is this a U.hour reportable event under 26. 719(b)7 ~

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)

Drug Specimen Tested jorugOnly I 'Urine I

Test Validity jvalid I

Was this collect/on observed? - 26. 717(b)(7) & 26. 75 ~

How many substances were confirmed positive for this individual? I 1

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

UseNRC Initial Confirmatory Limit of 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 alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administrated)

INRC Minimum I

Specific Sanction Applied 114-Day Denial I

Person(s) Responsible for /nforrmltlon Provided Person 1 (requi"ed):

!Pamela I

I Black I IAcceas Specialist I

pablack@wcnoc.com First Name Last Name Position TiUe Company Email Address Person 2 (optional):

IMlchael (Kenn)

I Irate I I superintendent Security mltate@wcnoc.com First Name Last Name t-'OSltiOn Title Company Email Address Final Step (Required) - NRC wilt consider this form authentic in accordance with 10 CFR 26.11 only when the "Validate & Lock* button ls 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 at4:29:15 PM I j Save to Local PC 11 Print this Report I Single Positive Test Fonn (version 1.8.0 - April 2018)

NRC Form 890 (12/2014)