ML20217P219

Forwards Revised NRC Form-398, Personal Qualifications Statement Licensee, & Form-396, Certification of Medical Exam by Facility Licensee. Addendum Instructions for Completing Form Are Provided,Due to Error on Form-398

ML20217P219
Person / Time
Site:	Seabrook
Issue date:	04/02/1998
From:	Conte R NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION I)
To:	Hickok R PUBLIC SERVICE CO. OF NEW HAMPSHIRE
References
NUDOCS 9804100029
Download: ML20217P219 (5)

Text

,

L i

(

, APR 2 1999

Mr. Roy Hickok '

, Manager - Nuclear Training; i- ~ North Atlantic Energy. Service Co.

' Seabrook Station P. O. Box 300 Seabrook, New Hampshire 03874~

!' ' Gentlemen:

SUBJECT:

REVISED NRC FORMS 398 and 396

' Enclosed is a copy of the revised forms: NRC Form 398, Personal Qualifications Statement .

- Licensee '(Enclosure 1), and NRC Form-396, Certification of Medical Examination by Facility Licensee (Enclosure 2). Due to error on the instructions for Form 398, addendum

. instructions for completing the form are provided as Enclosure 3 to this letter.' You should use these forms immediately for any new applications or license renewals that you are sending to the NRC.

Enclosure 4 provides a summary of the detailed changes for.these forms. Oh Form 398,

' you should note that applicants are now required to provide evidence on the significant '

' control manipulations performed as trainees at the facility for which the license is being sought. On this matter, you should refer to NRC Information Notice No. 97-67, dated August 21,1997.

On Form 396, the applicable guidance used in making the medical determinations needs to be indicate,d. ' Also, be advised that the NRC staff has recently approved Revision 3 of

- Regulatory Guide 1.134, " Medical Evaluation of Licensed Personnel at Nuclear Power -

Plants," which endorses' ANSI /ANS-3.4-1996," Medical Certification and Monitoring of -

Personnel Requiring Operator Licenses for Nuclear Power Plants." A notice in the Federal, Register ivill be out shortly.

Further, you shoulet keep a copy of Enclosure 3 with the Form 398 until new forms are printed and distributed. Your office can obtain additional copies of both forms by.

contacting Beverly Martin by telephone on 301-415-5877or by writing to her, U.S.

Nuclear Regulatory Commission, Office of the Chief Information Officer, Mail Stop T-6-F-33, Washington, D.C. 20555-0001,or e-mail BAM1@NRC. gov.

1 y

i:

9804100029 980402 $

PDR ADOCK 05000443 a

_ . P. .PDR U

-gw .

riu: ,. -J

Mr. Roy Hickok.

if you have any questions regarding these forms, please contact Viryll Cu'rley at 610-337 '

l - .5379 or by e-mail VNC@NRC. gov.

u Sincerely, I

Qyel QJp Richard J. Conte, Chief Operator Licensing and Human Performance Branch- '

Division of Reactor Safety.

L Docket No. 50-443 Enclosure 1: NRC Form-398- Personal Qualifications Statement - Licensee '

Enclosure 2: NRC Form-396- Certification of Medical Examination by Facility Licensee Enclosure 3: Addendum Instructions for NRC Form 398 Friclosure 4: Description of Changes to NRC Forms 398 and 396

l. cc w/ enclosures:

T. .C. Feigenbaum, Executive Vice President and

i. Chief Nuclear Officer PUBLIC : i l

bec w/ enclosures: ,

? j

'OL Facility File '  ;

i

)

j DOCUMENT NAME: A:\ forms. sea  !

' ' Te receive a copy of this document, Indicate in the box: 'C' = Copy without attachment / enclosure "E" = Copy with attachment / enclosure "N" = No

. copy 0FFICE Rl/DRS , l Rl/0RS.4 /l / l l l NAME Curley & Conte // %

l .. DATE 04/01/98 04/f'/98 04/ /98 04/ /98 04/ /98

l. OFFICIAL RECORD COPY l

L

ENCLOSURE 3 ADDENDUM INSTRUCTION TO NRC FORM 398 1

Applies to ti e Instructions for item 4.g, on the " Type of Application":

g. DATE FASSED GENERIC FUNDAMENTALS EXAM SECTION (GFES) 1 The last sentence of 4.g states: "This does not include instructor 1 l certification examinations or requalification examinations".

l This statement is in error and is not in accordance with Interim Rev. 8, ES-205, I section B, third paragraph, which states as follows:

" Applicants do not need to take the GFE (nor obtain a waiver)if they were previously issaed an RO or SRO license or an instructor certification

[ underline adde 1] based on a site specific written examination (on the same type of facility) that was administered between February 1982 and November 1989 a 3d included the material covered by the GFE. Applicants who were issued a 'icense before 1982, will have to take the examination or apply for a waiver in accordance with ES-204.

The last sentence of 4.g should resd, "This does not include reaualification i examinations." I I l l

l I

ENCLOSURE 4 c'

h CHANGES TO NRC FORMS 398 AND 396 NRC Form - Item Description of Changes Number Number 398 4.g See Enclosure 3 398 13 Instruction Sheet: All new applications must provide evidence in accordance with 10 CFR 55.31(b) that the applicant, as a i trainee, has successfully manipulated the controls of the  !

facility for which a license is sought. This section was changed to read as follows:

"At a minimum, five significant control manipulations must be performed which affect reactivity or power level under item 13.3c. list the five sionificant control manioulations in item

1. 17."

398 18 Instruction Sheet - changed to read: "NRC Form-396, Certification of Medical Examination by Facility licensee must accompany this application unless a waiver of the medical examination is beino reauested.

398- NA Form: The OMB expiration date is now 10/31/2000. In the OMB block the following was added: "If an information collection does not disolav a currentiv valid OMB control number the NRC may not conduct or sconsor, and a person is not reauired to respond to the information collection".

398 NA Form and Instructions: Top and Bottom left-hand side have date changes to 10-1997.

NRC Form - Item Description of Changes Number Number 396 ltem A Medical Exara Information - statement regarding safeguards and fitness for duty requirements has been moved from item B to be included with the statement under A - Medical Exam Information as noted below:

"This is to certify that the above named applicant for an operator / senior operator license has been examined by a physician and that the soolicant has been found to meet the safeauards and fitness for duty reauirements for licensed coerators at this facility."

Item A Below the physician name,...... line, the word " physical" has been added:

" Based on the results of the ohvsical examination, including...."

In this same paragraph it states.as follows: "I certify that in reaching this determination, the guidance contained in ANSI /ANS 3.4-1996, or ANSI /ANS 3.4-1983 was used, item B NONMEDICAL CERTIFICATION (old form) has been changed to: B - CERTIFICATION (new form) 396 NA Top and Bottom left-hand side of the form have date changes to 3-1998 396 NA Top right corner - OMB expiration date changed to :

12/31/1999 g

- . - r -

I .

. _ _ _ _ _ _