ML20072V421
| ML20072V421 | |
| Person / Time | |
|---|---|
| Site: | Davis Besse  |
| Issue date: | 04/12/1991 |
| From: | Shelton D CENTERIOR ENERGY |
| To: | Davis A NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION III) |
| References | |
| 1-946, NUDOCS 9104220188 | |
| Download: ML20072V421 (39) | |
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CENTERIOR ENERGY Donald C. Shelton 3@ Maison Avenue Vice Presdent.Naclear Toledo, OH 43552 0001 Davts Besse (419)2.f 9 2300 Docket Number 50-346 License flumber NPF-3 Serial Number 1-946 April 12, 1991 Mr.
A.
B. Davis Regional Administrator Uni t ed S ta tes Nuclear Regula tory Commis:: ion Region III 799 Roosevelt Road Glen Ellyn, IL 60137 Subj ec t :
Non-Certified License Applications for May 13, 1991
Dear Mr. Davis:
On May 13, 1991, the Nuclear Regulatory Commission is scheduled to administer Reactor and Senior Reactor Operator Examinations for the Davis-Besse Nuclear Power Station.
Attached are unsigned license applications (Form NRC-398) and medical certifications (Form NRC-398) for the below listed License Candid?.tes:
Reactor Operator (RO)
Senior Reactor Operator (SRO)
~
Villiam J. Amyx James H. Bonfiglio Kevin B. McLain James E. Fawcet(*
Darren A. Taylor Charles A. flawley Gregory V. Valter Dennis H. Jones Donald G. Vood, Jr.
David J. Lange Senior Reactor Operator Upgrade Upon completion of Toledo Edison's certification of the license candidates, signed applications will be submitted by April 26, 1991.
If you have any questions, please contact Mr. R. V.
Schrauder, Manager -
fluclear Licensing, at (419) 249-2366.
Sincerely,
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Ci Jm-P. M. Byron, DB-1 NRC Senior Resident Inspector cc:
J. R. flall, NRC Senior Project Manager H. D. Lynch, NRC Senior Project Manager Utility Radiological Safety Board Operanng Compontes Cleveiano Eiectnc illuminahng 1 (',l'V 1 @(
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- 16. EXPERIENCE DET AILS
.. osmo = tit 68 i # aons to a sacautv 6 Dutit8 Qualification 6/89 Pres. Davis-Besse Develops and implements training and requali-Instructor Nuclear Power fication programs for non-licensed operators.
Station reactor operator candidates, senior reactor operator candidates, licensed reactor opera-tors, and licensed senior reactor operators; effectively using training resources to meet training objectives.
(See Section 17) 13, rn. mas NT 8 (J
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Addendum Lange, David John Item 16, Experience Details:
l Position Title From/To Facility Duties
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Senior Specialist /
9/87-5/89 Davis-Besse Develops and implements train-Principal Specialist Nuclear Power ing and requalification (General Physics Station programs for non-licensed q
Corp.)
operators, reactor operator candidates, senior reactor operator candidates, licensed reactor operators, and licensed senior reactor operators effectively using training resources to meet training objectives.
Senior Specialist /
1/87-8/87 Zion Nuclear Involved in development, reviev Principal Specialist Power Station and implementation of opera-(General Physics Corp.)
tions procedures.
Senior Specialist /
9/84-12/86 Vogtle Nuclear Involved in development, reviev Principal Specialist Power Plant and implementation of Opera-(General Physics Corp.)
tions procedures.
Senior Specialist /
8/81-8/84 Midland Nuclear Involved in procurement and Principal Specialist Power Plant testing of site specific (General Physics Corp.)
simulator,- irt'uding duties as lead simulator instructor.
Responsibilities included development and implementation of effective simulator training for Reactor Operator and Senior Reactor Operator candidates.
Operations 10/79-8/81 D.C. Cook Developed and implemented Instructor Nuclear Power training and requalification Plant programs for non-licensed operators, reactor operator candidates, senior reactor =
operator candidctes, licensed reactor operators, and licensed senior reactor operators) effectively used training resources to meet training objectives.
Performed. licensed Reactor Operator duties during this time period.
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4 Non-Licensed 6/76-10/79 D. C. Cook Under direct supervison in Operator Nuclear Power accordance with the Operating Plant License, Technical Specifications, normal and special operating procedures, tend the nuclear steam supply systems, turbo-generators, station auxiliaries and associated equipments operate radiosctive vaste disposal and water treatment systemst monitor radiation and assist in the receipt, storage, loading, and unloading of new and spent fuel.
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l Addendum: Jones, Dennis Michael Item 16, Experience Details:
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Position Title From/To Facility Duties Licensed Reactor 5/89-3/90 Perry Nuclear Under general directive super-Operator Power Plant vision, in accordance with the station Operating License, Technical Specifications, and normal and special Operating Procedures, operates the l
nuclear steam supply system, l
turbine generator, their auxiliaries, and all other equipment to maintain continuous production with maximum safety and efficiency; performs reactor fuel handling operations and other duties.
License Training 1/87-5/89 Perry Nuclear Develop and implement training Instructor Power Plant and requalification programs for non-licensed operators, reactor operator candidates, senior reactor operator candidates, licensed reactor operators, and licensed senior reactor operators effectively using training resources to meet training objectives.
This rotation of assignment to the Operations Training Unit was during INP0 accreditation activities.
Supervising Operator 6/82-1/87 Perry Nuclear Assigned to the procedures unit Power Plant for the preparation of plant instructions. Temporarily assiged as a system test l
engineer in the startup test organization.
Assigned to an operating crew as a Reactor Operator responsible for the operation of the plant during initial fuel load and the lov power testing program.
During thf.s period was also assigned to assist in operations procedure reviews as well as du'.les leading to a Perry nuclear Power Plant Reactor j
Operator Certification.
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SAINTt0 NAMt AND StGNATynt tamer mayupunmir Aseroomter.e sa 3,sel l TtTLt DATE D. C. Shelton Vice President - Nuclear sa accoreence
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{ APPLICANT'$ FULL NAME /ust NW. 400 of ANO ADORI18 ectuae It* Caoes 41YPE 08 APPLICATION <Chara epomaNo ceases
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l Reactor Operator 10/85 Pres. Davis-Besse Under general directive supervision, in accor-Nuclear Power dance with the Station Operating License.
Station Technical Specifications, and normal and j
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Fawcett, James Edvard Item 16, Experience Details:
Position Title From/To Facility Duties Equipment Operator 8/80-9/85 Davis-Besse Under directive supervision in Nuclear Power accordance with the Operating l
Station License, Technical Specifica-tions, normal and special operation procedures tends the nuclear steam supply systems, turbo-generators, station auxiliaries and associated equipments operates radioactive vaste disposal and vaste treatment systems monitors radiation and assists in the receipt, storage, loading, and unloading of new and spent fuel.
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ne w ro in e ev rt.c PatNT ED NAWi AND SIGN ATURt (Joner aeriepparut sepauseiserew ese 3,ses flT LE OATE D. C. Shelton Vice President - Nuclear m accorsec,. ra to C8 A St.S Commwewsat*8 i.tNs form saani es e,emnetes to ine umC as leite.t. O Y MAIL A00mtl$50 70 s
teceans Aom.a.itester moyen i Repenal Aem agtreter. Repea It Aepeam Aemia. strate,, as,ea ett v1 N ciese 8iewevery Commenen U.S. Neceet mapaiorv Commenen u s. N ciese Rawaterv Comm asen eis Ansaea.e mese tot 8eeriette Street. bee 3100 fte me ne est mass G8ea tilv. IL 80137 E.ag of pn.se.a. PA 1Da04 Atiaats GA E323 a
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- 11. EDUCATION a mionscwoo6
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- 1. NUCLE AR Powt A PLANT 8vNOAMENTALS me=#
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3 (See Section 17) 7/85! 3/90. 57 i
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- 14. F ACILITY O*ERATOR TR AINING PROGRAU e6 csuti' iso om eenc no.m m, s,eeu r,on ne,6,t,
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36 part aero 8ttaubt os esop Dave aus av novaa oet a a tIo e aciLetv meetett sene aanseensteaso AGovakIfICatsoes a maasiamattoes PAE F All 14 EXPERIENCE DETAILS a positio= tit 6
- now to a 8 aci6siv s outits Qualification 3/90 Pres.
Davis-Besse Develops and implements training and requali-Instructor Nuclear Power fication programs for non-licensed operators, Station reactor operator candidates, senior reactor operator candidates, licensed reactor opera-tors, and licensed senior reactor operators; effectively using training resources to meet training objectives.
(See Section 17) n conestwTs sa e
.J Item 11.2, Vocational / Technical Training:
See Addendia (Attached)
Item 16., Experience Details:
See Addendum (Attached)
- 18. NRC FORM 398bCERTIFICATION oF MEDICAL EXAM 18tATION SY P ACILIPY LiL dNBEE,68 ATTACHED AN Y F a'55 ST ATE WENT on oMISSiope tes TMtA DocuenENT. Is*CWotNG ATT ACH4 DENTS. AAAY SE tutJECT To CivtL ANo CRiutNat SANCTIONS Mn a genity vs.o. essen, el paewer tesi tee saa
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TR AINING COORDINATOR em=vto on tveto mama 84NIOR IAA4405AMNT REPRGSElf1 Afivt Oss SITE emittlo om Tvrtu osaut Richard A. Simpkins D. C. Shelton 8'Gh*Tunt goats seonatunt joatt FOR NRC LSE WAlvIR tchers or Cbmswere n ne. as asse.ase#
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- Addendum:
Bonfiglio, James Michael Item 11.d., Vocational / Technical Training:
Certificate Type of Training Number of Months Received
- Leadership and Management Education Trng.
1/2 yes
-0 Cenerator Electrical Maintenance 1
yes
- Noise Measurement and Reduction 1/2 yes
- Auxiliary Equipment Controllers 1/2 yes
- Basic Electricity and Electronics 2
yes
- Electrician's Mate "A" 3
yes
- Electrician's Mate "C-7" 8
yes
- Variable Speed Controllers 1/2 yes
- Career Information and Counselling 1/4 yes
- Temperature Monitoring and Salinity 1/4 yes Item 16,, Experience Details:
Position Title FrotyTo Facility Duties Instructor / General 7/85-3/90 Braidwood Develop and implement training Instructor - SRO Nuclear Power and requalification programs Station Units 1 for non-licensed operators, and 2 reactor operator candidates, senior reactor operator candidates, licensed reactor operators, and licensed senior reactor operators; effectively using training resources to meet training objectives.
Administration of Licensed Operator requalification exams, as well as perfore licensed SRO duties on a dual-unit facility.
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Naut as apek CANT James Michael Bonfiglio eACw f v l8 ACILITY 00CittY seveseta Davis-Besse Nuclear Power Station 50-346 A MtOICAL E x. AMIN ATION CERTIFICATION ut$ i$ 'O Ctafis v NAT tat asovt N Awt0 AP*LiCANT som AN OPta Afon SIN Om Optm Afon LICENSE *A5 SEtN t xAM Nto 87 A 'w'SiCIAN Pain Y t 0 N A u t ee ears,c.eas l$T ATE ANO LiC1N54 Nuweim lixAwineAfl0N O ATI Dr. Wehrmister Ohio 47692 1/1B/91 4A$t0 0N 'at atSULT5 05 Tut ExaWiNAT ON INCLvoiNG IN#0awATCN pumNISMio tv TMt APPLICANT TML 'Mv5 C! AN MA5 0tflowiNto TMAT TMt ape (ICANT $ #wv5l CAL CON 06T10N AND GENER AL Mt ALTM Amt NOT SUCH THAT IT WIGHT CAUSE Opt m ATiONAL t amon$ INDANGlalNG 'VOLIC Mt ALTH AND SAF tTV
- Ctm Ti8 v THAT iN mt ACMtNG THIS Of TinMINAfiON THE GUl0ANCE CONTAINto IN AN$h,ANS 3 e 'S$3, On AN$UAN$ fl a 1977.N3801 w AS 80LLowt0 AND TMAT 00CvwtNT ATCN IS AV AILABLE 80m af vitw ev NmC.
ON TME BASI 5 08 TML etCOMMENDAfiON os THE PMv5lCIAN I mtCOMutNO THAT THE APPLICANT *$ C#tm AT0m LiCtNSE St CONottiCNED As a0ggows L
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FCm LittNst0 0PtmAfons. AND I MAvt NO ENowLEDGE 08 THE APPLICANT E KCitolNG TME cut 078 LivtLS 70m ALCCHOL OR CONTROLLtc SuesTANCES AS ESTA4LISMto PunSuANT TO 10 CFm 24.
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PaiNTto NAME AND SIGN ATum t tJaver asetsponerer esemesseer.e sa J,res l TITLE
{0ATI D. C. Shelton Vice President - Nucleer sa acco<eeace. en 10 Cs a 55.5 Commwa.r.ations tn.s term tami me e omittaa to im NRC m toinows. 8 Y MAIL Acomt1540 TO.
m,. ease Aom.a.itrator As,.on i megenes Aamineratet m egen 14 meg. ease Aemia.itrator. Aq,oa itt y 5 a ces, eispoetory Commmuna u.5. Nwciw moosetorv Communea U 1 Nweer mooaistory Comm. asea e
w 475 Ashaceae moed 101 untsetta Street. Suite 3100 790 moosevet mean E.ag oe pn.n. PA I9404 Atieate.GA 33323 Gien ieva. IL to127 a,waai Aom.am,eto, meg.on lv movease Aem.a.stresor, me,ea y s
V 5 8eweiest needstory Comm sema u 1 Nwcanor meP.Leterv Commassa
$11 myea P'au 0<.,e. $w.te t000 1450 ussie uae. bte 210 Asi.agroa f x 10011 weiaut Crees. CA 94104 PmiV ACY ACT ST Af tutNT mouTINt USts ?Ne.aformet on mov to aiutooed to sa esemor ete 8eocen. Siete o
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1974 IPweat L.s= 91 5791, tae loeowing statement ri swen.ered to.aei.. ewes eae m.ooey a%=4 tea to tae U S Nwesos, meewaatory Commoisea oa NRC Form 396 ene in ene evene tNe.amemet.oa.as<etet a moietoa se setentie v.e4c ea of 'en and '
a t% cow ie of wi secreatstrat w os swd.cc procoecing la socitea tait.a%r=4eea me, os inn.a%, met oa.e me ate. nee.a a switca of e, cores oenignateo as Nmc to one r
e once.neo et Si #eoere mes. ster 33157 (Stoicaoe, te itsen i,saiN,,eo to en eso,oci.ete posere. 5 tete. emiioca egeaev to rav esteat movaat ea AUTMORITv Secteas 107 eno 18144 of tae Atom.t taeegy Act of 1954. as acteus'v 8** ** NmC eocimen soowt vow wMETMtm 015CLOSumt tS MANDAT0mv Cm v0LuNTARY AND (88tCT ON a=msee t42 y.$ C 2137 s,e 220lidt
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PERSONAL QUALIFICATION STATEMENT-LICENSEE s'o tae i='oawa"oa aao atCoaos wa=4ct=E=t aa4Cm <* l101 U$ anuCLlaa atovutomv couwier 5:04 easmissGrom oC 2 ante amo to tut eaetamana stouCtion enoJact 43 nommi. ossect os uamact To AEMAIN VALIO. THis 80mM Must NOT St ALTERED ut=f ano evoott mal ** Groan DC 20eos 1 APeklCANT'S Full NAME fW8f %. ##81 AND A008 513hac'we llP Coves 4 7YPE of APPLICATION (CRect eco#Casse poses;
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- 16. EXPERIENCE DETAILS
,,os,,io.,,iv te enou to a pacessiv a ot'T'es Equipment operator 10/85 Pres.
Davis-Besse Under directive supervision in accordance with Nuclear Power the Operating License, Technical Specifica-Station tions, normal and special operation procedures tends the nuclear steam supply systems, turbo-generators, station auxiliaries and associated equipment; operates radioactive waste disposal and water treatment systems; monitors radia-tion and assists in the receipt. storage.
loading, and unloading of new and spent fuel.
(See Section 17) u connen wTs ra,,
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Item 11.d. Vocational / Technical:
See Addendum (Attached)
Item 16., Experience Details:
See Addendum (Attached) la. NnC FonM ses, cEnTsFICATION OF MEDtCAL EXAMIN ATION SY P ACluTY UCENSEE, SS ATT ACHED aNY # ALSE ST ATE MENT OR OMISSION IN TMts o0CUutNT. INCLUDING ATT ACMMENTS MAY BE SUEJECT TO Civil AND CRlWINaL SAN t to i esm%.aoe seann, ee on.w.5 inc e
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Simpkins D. C. Shelton 8'G"'TV't joaTa sionaTvet goats FOR NRC USE wAlva m tcheca er Comesse,,rar. es essessem j ustvs atoviatusNf 3 l l cols hof utET 8tOul#EutNTS The*ea a.
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Addendum Vood, Donald George Jr.
Item 11.d., Vocational / Technical Training _
Certificate Type of Training Number of Months Received
- Machinist Mate "A" 2
yes
- R11 and LiBr Air Conditioning School 1
yes
- Basic Academics for Nuclear Power Reactors 3
yes (General Physics Corp.)
Item 16, Experience Details:
Position Title From/To Facility Duties
~
"B" Han 4/84-10/85 LaSalle County Under directive supervison in Generating accordance with the Operating Station License, Technical Specifica-tions, normal and special operation procedures tends the nuclear steam supply systems, turbo-generators, station auxiliaries and associated equipment; operates radioactive vaste disposal and water treatment systems.
Nuclear Plant 9/82-1/84 V. H. Zimmer Under directive supervision in Operator Nuclear Power accordance with the Operating Station License, Technical Specifications, normal and special operation procedures tends the nuclear steam supply systems, turbo-generators, station auxiliaries-and associated equipment; operates radioactive vaste disposal and water treatment systems; monitors radiation and assists in the receipt, storage, loading and unloading of new and spent fuel.
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Amyx, Vill 2am Jeffrey Item 16, Experience Details:
Position Title From/To Facility Duties Equipment Operator 3/81 8/84 Consumer's Under directive supervision in Power Co.
accordance with the Operating Midland Nuclear License, Technical Specifica-Station tions, normal and special operation procedures tends the nuclear steam supply systems, turbo-generators, station auxiliaries and associated equipments operates radioactive vaste disposal and water treatment systems; monitors radiation and assists in the receipt, storage, loading, and unloading of new spent' fuel.
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- 16. FOR RENEW ALS ONLY b DAf t Aaq0 mgsvlt Os neory oa's asent eeOU8tl opin a'ge e agigst v mgCENT esmC ADessasitygago agovaggetCAttoh E nAwapeAf toe, PASS F AIL
- 16. EXPERIENCE DETAILS a positiO= tiss 1 8 aoss To
- ' Acik'T'
- DVT '8 8 Integrated Plan-8/86 Pres.
Davis-Besse Supervise an on-site organization of ning & Facility Nuclear Power engineers whose mission is to provide engi-Modificaticn Station neering design management services for modif1-Manager cations to the Davis-Besse Nuclear Power station and provide technical and engineering services to support Davis-Besse operation and maintenance.
This includes providing engineer-ing required for resolution of plant opera-tional/ maintenance problems and improvement of plant performance, n.ConesewTscu
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- =~a=====-va Item 16 Experience Details:
See Addendum (Attached)
- 18. Nr.C FORM 396. CERTIFICATION OF MEDICAL EXAMIN ATION SY F ACILITY LICENSEE,IS ATTACHEO ANY F ALSE S TATEMENT om owissioN IN THis occuutN? NCLUDING ATTACHMENTS MAY SE SutJECT TO Civil AND CmiMIN AL SANCTIO inn i eerbei vaeor seveste et reewer thei tae ea'ermen ea e the escumem ens.. -,,e = **we one eerrect t ownaar earttey thee t mese aeidass m, sweveat empever et (21 eav sastance eraeve a asse seea vesse tv e nessen eeut **, mea tecnces (MMti Caesdese Orwe tenwie Lanoesterv er e Leoane e tenwie tusemey ter mesmei er e soaire8+es asismease. erst tas testill ee reseni esesemes tae eseea towe estaehemes sureaeat to 10 Cs a Pen 29 (31 saw meuase waere i ns=
rw tai sav ressore ser renenei er roweessoa et vessense eseou se e sesseer enemy, e see evenann= tae i mC to mama sae remeses e emera amese se my am s
overoao e aerseenry stG h A T we t - AP'LIC AN I OAT 4 CHICK APPLICA8Lt Box a e eaav ene t=s seen aemes wesaam,c nei e,eeeeee n, secwices ts tense,isenesse reo nemeans es se heeness se en oosemertssator oserver ourwesi to Teen 10. Cece se 8 eee c
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'AINT EC QA f v'4 D Naut SENIOR MANAGEMENT REPMtstNTATivt oN 3ff t paint (O OM TYPtD peaut Richard A.
Simpkins D. C. Shelton 5'G
- T V " I l Dart stomarung g oa ts FOR NRC USE Yi Alvt m (Check or Ctp<aaserv erests. se asiipescaose; l ustis m sovin svants l j oots poor utef atoviatusNTs atees.a ee,
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Addendum -Havley, Charles-Alfred 4
O Item 16, Experience Details:
Position Title From/To Facility Duties Project Engineer 2/84-8/86 H. B.' Robinson Minimize forced outage and lost Nuclear Power capacity by providing Plant supervision-of systems engineering services to ensure proper installation, operation, maintenance, testing, and problem resolution ~for optimum system performance and reliability.
Resident Engineer 3/80-1/84 Marble Hill Coordinate and perform initial Nuclear Power construction startup testing Plant and assist Operations Depart-ment in the performance of pre-operational testing on Vestinghouse Nuclear. Steam-Supply Systems and related safety systems.
Desing Engineer 4/78-2/80 Louisville Designed and installed pre-Insulating &
insulated panels and Supply Co.
reflective insulation per ASME,Section II requirements at various fossil and nuclear facilities.
Construction /
10/76-3/78 Presque Isle Coordinate and perform-initial-Startup Engineer Generating construction startup testing Bechtel Power-Co.
Units, Cleveland and assist Operations: Depart-Cliffs Iron Ore-ment in the_ performance of Co.
pre-operational testing-on three (3) fossil-units.
Field Engineer-6/73-9/76 Davis-Besse Coordinate and perform. initial Nuclear Pover-construction-startup' testing Station.
and assitt_ Operations
' Department in the performance of_ pre-operational-testing on Babcock and Wilcox Nuclear Steam Supply Systems and related. safety systems.
4
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'oa aa. o..m.o
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Charles Alfred Hawley i
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Davis-Besse Nuclear Power Station 50-346 A MEDICAL E XAMIN ATION CERTIFICATION
'M15 is 'O CE a Ss v NAf NE A80 t Navt3 AP'L' CANT 804 AN 0814 ATOR SENIOn opinafoe UCENSE M AS 8EEN E x AMiNED 8 v A *Mv5lCI AN peiN T E0 N Avt o' oa s<c am j $7 AT{ ANC UC(N$( Nygg[R E x AMINAfl0N D ATE v
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APouCANY 5 FMVSICAL CON 0ifiON AND GENE R AL ME A(TM AR( NOT $UCH THA T IT %ilGMT CAU$E 09(R ATiON AL ( ARCAS ENDANGE RING PUSLIC ME ALT AND SAtt'v i Ct RTIF v f M AT iN RE ACMING TMi$ OETERMIN AflON THE GUID ANCE CONT AINED IN AN$t, ANS 3 4 i963. 0 A ANSI ANS 15 419t1.N3aci e At sonowt3 AND ' MAT DOCYMENTATICN IS AV AILABLE som mEviEW Sv NRC.
ON TME $A$l$ 08 'ME SECOMMENDAfiCN OF THE PMv51CI AN i #ECOMMENO THAT THE APPUCANT'S OPER ATOR uCENSE SE CON 0!TIONED As sc uows X
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- 2. ComatC'Ivt i.ENSE5 8t *0AN
- MEN PE AFC AWING uCENSEO DUTIES
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- 8iOPOSEQ *040iNG Os mESTalCTION 8< ore 4 4co es R E LA TICNSMi* Os atST RIC'10N TO DISQU Au8 viNG CONOlfiCN i8ner& eno. care ao. reirncred d corrvet tae searwao&my cono,t ons 4 E u A mt.$ 80R R ESTalCTION CMANCE '8Accf $ aoovej 8, NONMEDICAL CER TIFICATiON sowg m at ACTC AS Twi$ CERTipit$ TMAT THE APPUCANT MAS SEEN FOUNO To wtET THE SA8tGUAA05^ ANO s.TNESS FOR Ouf v a E0VinEWENT105 Twi$ F ACILITY 80A LICENSED OPE R Afoni NO4Po*ERnEACToms Twi$ CERTIFIES THAT THE APPLICANT MAS SEEN WOUNO TO wtET TMt SAFEGUAROS mE0uinEWENTS Os Twi$ F ActuTY 80m uCENSED OPER ATORS ANO e MAVE NO ENowtEOGE 08 THE AP*LICANT ExcitolNG TME CUT 08F LEVELS 80R ALCOMot.
0 A CONT 40LLIO SueSTANCES AS ESTASUSMEO PunsuANT 70 to CF A 26 st ca aw.wom in rain ooCvue=r i=Cwoino a rtaC=wam rs wa, sa sve4act to civi6 a=o caiw nas sa=ctiou i cta t s v w=cea atmau, as sse s t a r e we.48OMuaf SQM.N fi.f 3 DCCvuott aNO a fTaCMwtNf S 13 Ya t ANO Comag ct.
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megionai Ad**istrator 4e9+on i Retoaar Aom amrator, Reg.oe il Repac Admiaittestof Negion ill u $. %ciar A sowiatory Cammeuen U.S. Nweest Asavetory Comea nea u $. Nuc*nt Gewaiory Commiu on 47$ Allencate Roao 101 Marietta Servet. Lite 3100 799 moosevert Roao King of Pausua P A '9406 Atianta GA 30323 Gien Eitya. IL 60137 metoaa Aom.aiserator aeq.on av meg case Admiamentor. Retoa V U $ %out Aspcorv Comm.u.oa u S. Nwcmas Repatory Commin.on 6t ! Avaa P'aaa On e $+te 1000 1450 Maria Laae bite 210 v
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- ursuant to S U 1C 5524 red 3) eaacteo ato ee or semoa 3 of t% Pancy Act o8 AOUTINE u$t$ Tae.cfo<mation mav oe sicoseo to an aooroor aie 8ece<*. State or low ageaty in EM neat tae <ahrmat ca 'aoiutet a vo 4t oa or noteat
- e o'c ca of 'sa 1974 i wohc Law 13 $191. tae todow ng ttatemeat is Nrainaec to acivowei wao P
e= aad swooey womarca to tae U S Nwciar Ragwiatory Commauien oa NRC f orm 396 and ia tae neat t'io iaformat.ca no<atn a vioia00a or ooreativ ooset.oa ofco<mai on e
tae cou se of aa aamianuative os moce oroceen.aq se sooit.on. 'a.
ra.i.**o,me.oa i meatpaso.a a evitem of recoros oeugesteo as N AC 16 and r
oeicocco at St pase.c Aegmee 33157 iSeatemee, i8.19661.
traastengo to an soorooriate f eceras State. sad now ageacy to t*e esteat <t'euat and amsurv 'or sa NRCoecision acout eow AUTHORtfv Senoat 107 and 16tli) of ine Atomic Eae<gy Act of 1964 as
emiNCiP AL suRPOSEtSi la'ormt.oa eatent on tmi o<m it useo to oete,m.ae f
'eowenso c'e' mat'oa t act D'o*deo ac*ev* t% acce<wea *or a *acio, socato* i
.aetae< tN sa i.m coao, tea are geNess aea ta o* tN sooncant are suca taat tuv e*ia not cause 1oerstrongi erroeg erw34a9ering skeoh4 Matta and 34Fety This aforme. or te*o# ooerafof'l hCease may oe cea'so v
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SacN naguimoTom oC 20E58 Amo To Tut taptowoma stouchoN *nostCT 131%0 0090s o88sC4 08 waNaos.
To REMAIN V Allo. THIS FORM Must Noi St ALTERf D weNr aNo evoort aan===oro=1oc toeos
- 1. AP9(ICANT'S P ull N AMt (Larr. f rst. %ddee.f AND ADOR E Ss haetwee lis ceaes 4 7YPE of APPLICAtloN (Chece acoscanse coeees i
1 no?
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McLain. Kevin Brian 2-coso 1 s ea rt i a o rt t wc-e.,,,
2746 Bleeker St.
L 2 steo~o 2 atma r mo,c-Oregon, OH 43616
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- 7. N AME AND A00mtS4 (eacevoo IfP Cocol oF APPLICANT'S EMPLoYtn
- 10. CURRENT POSITION AT F ACILITY a PLANTtvetaiNTENotNT
'ggy*,",j,Y,N,Q,f, Toledo Edison Company
. assistANr. tant iu.tametNotNT evitomo m inut~r 300 Madison Avenue
. Snier svetavisom
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. 44. o, 4,.uc4= r i.aciurv paciurvoccairavesa Davis-Besse Nuclear Power Station 50-346
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- 11. EDUCATION i d:7I T :::;
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- 12. TR AINmo ismet vsr arouca rros - ser msrnvertonsa
- 13. s xPenns NCs 100 No r couBLE CouN r - $lt MS TRUCrioNSs o.e,
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L CussacoM 8/89 3/91 17 3.sws,,mws 9fg4 tojg3 13 08sE RV AfloN
- 4. E R s/CRW 3-oPER ATING PR ACTICg 5.oTHER isese*' Chie f Reactor CoNTRot acoM optn Afioss oN suiPT Auxiliaries Ooerator 11/83 9/84 10 siMutAToa cPE R AtiNo n - c=m ~'
11/89 8/90 5
Possit slMULAfoR NAMES nii,m e. m
- 6. OPE R ATO R
_ cy Babcock & Wilcox d$$CMk 7. sVPE RVisoR a
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- 14. Auxxouir. oetm Atom m.****
1/86 Pren.
51 Emerg./ Abnormal Procedures 1/90 3/90 2
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- 16. FOR RENEW ALS ONLY a
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- 18. EXPERIENCE DETAILS
, m...o,,,, t g t l p aces 70 e 8 ACitify
- a. 00T188 Equipment Operator 1/86 Pres. Davis-Besse Under directive supervision in accordance with Nuclear Power the Operating License, Technical Specifications normal and special operation procedures tends
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the nuclear steam supply systems, turbo-genera-tors, station auxiliaries and associated equip-ment, operates radioactive vaste disposal and water treatment systems; monitors radiation and assists in the receipte storage, loading, and unloading of new and spent fuela
- 17. cremos asis sses.#, no non emmeer o seaanrow er,
_ Asume enamoner seese en ese.J
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- mtNTio om TYPED NAME Richard A. Simpkins De C Shelton
$4aATu t e
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$4GN ATUR E l Daft FOR NRC USE W Alvt p (Check er Co,reaere sro**s. ae anstacesses l watis atovissutNTs l l 00:s 407 utti atovia tutNTs tseens a eeen.s CAftGomy Om ak'e D e' Oemd D ev HE ABouan e E 4 A MEG,04 ees Ancuamru ega aggic%
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cowwis s,o, oc mi a a t ouCT soas eso,e gy.jiggantes ossiCf os wam&G4 weet amo #LOGif maswe=Qfont oC Uto3 Ne wt 06 apet CAN f Kevin Brian McLain
- AC.g t v gs ACiuty 00Cagt muustR Davis-Besse Nuclear Power Station 50-346 A MEDICAL E XAMIN ATION CERTIFICATION
?Mi$ is *o ria ns v *aAf '=1460w I Nauto AP'LiCANT 8 0s AN O*1R ATOR SENIOR OPE R ATOR UCEN54 a A5 SitN lxaMiNto Ov A #ww$iCIAN 80 iN T (0 N AVE o' 0ays.c.am l$T AIt AND UCENSE Nuv6ta j ExAwiNAfioN O Af t Dr. Wehrmister Ohio 47692 3/21/91 s A5f o o% 'Nt at $ubf$ 08 *Hf (X AMIN ATION INCLuciNG IN#0RM AfiON e URN 45Mt0 0v THE Ap*uCANT THE ** v5tCI AN = A5 0E f f R uiNt0 f M AT TMt APPuCANt $ Pwv$icAL CON 0ifiON AND GENER AL Mt ALfM ARE NOT SUCM f =AT if viGHT CAust OPER AT 0NAL (RRORS END ANGERsNG Pusuc Mt ALTH ANO SAF E?v i CIR Tit y ?MailN Rf ACMtNG THIS OEtt putNATION fME GUID ANCE C3NTAINto tN ANSL AN$ 3 4 '983 QR AN$1 AN$ 1$ 419M.N330t wa$
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.s RE$?RICTto UCENSE OR E xCErfioN.Peo <ie cetout oco. ano attaca wooortseg meo.ca eveece Por NRC rev.e.
'i atST alCTION C* ANGt s ROM PR E vious Su6Mtf? AL +P*oe oe aeta.m seio and attaca tuocoes maoicai moeace 'or N RC <eview PROPO540 WQRoiNG 08 m(57RICTION < san a aco et RiuATION5Mi* 08 af stalC* ION TO OiSQuAUF vlNG CON 0ifiON 18^er4 me.cate aow reirneren **d conect tae asarwa%.av cono,e ons REMARKS 80R sitSTRrCTioN CnANGE,swa 5 aoo.e4
- 8. NONMEDICAL CERTIFICATIO*e PCwtm at ACTCR$
Twi5 CERTl8st5 THAT THE APruCANT MAS titN FOUNO TO witT TML SAf tGUARO5' ANO 8tfNt53 POR OUTY REQutREwtNT408 TMis F ActuTY POR UCENSE0 0PERAToni No4PowtR RE ACTOR $
THis CIRT181ES THAT THE AP*LICANT MAS SitN 80VNO TO Mtt? THE SAFtGUARDS REQutRtutNf 3 0F ? MIS P AClufV SOR uCENSE0 0PtR ATOR$. ANC i MAvt NO ENowLEDGE Of THE APruCANT EXCIEDING TME CUTOP8 LEvtL180R ALCOMOL OR CONTROLLEO SutSTANCES A$ ESTA$u$wt0 PVR5uANT TO 10 CFR 26 etan,,a v,a s',a re we a.r ca owissio.n,on rais occuwea r mctwomo a rrac=we%rs wa s sa sveasce to cms a%o caiwinas sanctic%s i caa rie, wnota et%.c.*
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Daf t PRINTIO N AME AN0 51GNAf unt ISerier *dansso'aear doesvismestne on s,tes l fit LE D. C. Shelton Vice President - Nuclur sa acco<cance. ta to Cp R 55.5 Com,a n.catecas.tnis form smas ce morarrted to tN NRC as toniows. av WAIL A00RE5340 TO.
w Regionai Admietitf ator Regica i Regmaal Aamiantf ator. Agion Il Regicap Aomensstratof, m 906 Ill e
U S Nwow 8'oeustorv Commeuson U.S. Nwow Rewatory Commenen u S. Nwaar Rey,iatory Comraunion 475 Aneoaw Road 101 Marietta St eet. bite 3 00 199 Roowwt Road
<iag of Prusi a P A 19406 Atiaars.GA 30323 Gien Ettva. IL 60137 Regicaan Aamiaistrator metoa av Reg.casi Aamiantrator. Regica V U S Nweiest Repeatory Comea tica U i Nwcioat Reyesatory Coramismoa 6I t Ryan P'eaa Onn $#te 1000 taSO Mstia Lane Lite 2to Arteagroa fx 76011 wonut Creen. CA S4596 PRIV ACY ACT STAf tMENT ROUTINE ust$ The.abamat1oa may be cincoied to aa accroor ate 8=wa. Sta'e n Puriwant o S U.1C 5524teil3L easeteo.ato is ov section 3 of tae Puncy Act of
<ow soeur.a tae enat tN information iao. cam a conat.oa o< oceaet.a. coic on e s a
19?a IPwonc Law 93 5191 tm %uomag itatomeat s *ura ineo to iao.. owes ao tuoosy.ntoematea to tae U S Nweest Ragusatory Commimica oa NRC 8erm 396 ano in tM eveat tae information ico4am a cosat ca or octet.as v.o.c.ca F s. W u
1 fain a'o< mat oa.i m+atraeo a a ivstem of tecoros ces.geseso as NRC 16 e d tae cowrie of an aowa4tratin or ivoice orocewmq in aco tion mi a'o.av o- -4.
a traastereed to sa aoorooriate Seoerai. Stata ano ioca agrace to t9 euet
- en-W descriOoo at il 883ef st R eg.ft ef 331$745ectemoset$ 19661 aequarv gr sa NRC oocaica accwt vow.
AUTHORefv $reboai 107 and 161bi of tu Atomic tae qv Act of 1954 as
- MtTHER Ot$ CLOSURE IS MANDATORY On v0LuNTARY ANO E88 W P amedas ta7 v $ c. 2931 ano 220tW iNoivtOVAL 08 NOT PROvi0iNG IN80RMAfl0N 0 *owre $ io e <.
PRINCI AL PvRPO$il5 la'ormatma eteteo on inet %<m re wuc to oeteemee
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tae aco**tatea 'or a.sc - t,
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.acaer tae onvio cono tea ano geaeras aesita o6 tae soonnat are wcn tast taev o' sea or occatoe s ocease may be ceaieo
.as act cawie operet.oasi *<rors coaegeneg owene neaitm and safety. f>>s.a%rma-
$Y$fEW WANAGERIS) ANO A00RE55 Chie Occatoe Liceat aq 9.av 3" '
- r tion mav ee seo ey tae NRC staM to oetermine if tu moiv.owas meevi tae 'egwere-Nucue Reacto, ma, sat on U i Nucear Repasatory Comminoa *aia aw 3C M H meats at 10 CF R 55 to 'see e eumiaet oa or to os.swoo e oce<ator's ocease e.. m.se
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