ML22052A014

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Single Positive Test Forms Collected on 02/03/2021
ML22052A014
Person / Time
Site: River Bend Entergy icon.png
Issue date: 02/07/2022
From: Deignan M
Entergy Operations
To:
Document Control Desk, Office of Nuclear Security and Incident Response
References
RBS-2021-001, RBS-2021-002, RBS-2021-003, RBS-2021-004, RBS-2021-005, RBS-2021-006, RBS-2021-007, RBS-2021-008, RBS-2021-009, RBS-2021-010, RBS-2021-011, RBS-2021-012, RBS-2021-013, RBS-2021-014, RBS-2021-015, RBS-2021-016, RBS-2021-017, RBS-2021-018
Download: ML22052A014 (18)
v • d • e


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usNf t JFD Program Pertorma nce Data Reportmg System NRC Form 890 Singl e Pos1l1 ve Tes t For*11 l'ri*h"f lfll,: l'ropll'11t1d1ht* J' ,r *F ~><! *' l S 1,ss r;' r*r *,

1) AJI fields raqulred except those mMt<<t 'optional' APPROVED BY 0MB: CLEARANCE NO.31-141 EXPIRES: 04/Sll/2021
2) Enfrl* In aomo ffelds 11uto-,populI* Inform.don In other llelds Estimated bunion per n,sponse lo co.-.,ly with this collodion request Is 30 ninutes Tiis JJ Mouse over form fields to v#.w additional Information form Is a volunb11y moano of rep0f1ing lhe lnronndon reqtired under 10 CFR 26.417(b)(2)
4) Use of Adobe Reader e or /tter Is required and 28.717 The Information ts reqlired by NRC to obtain on an annual basis lite specific ltness-lo<-duty (FFD) program perlonnance data on drug and alcohol programs lrom D UpdateSubmission Delete Submission lcensees and other entitles. Sand comments regardng burden estimate to the FOIA, Information Services Branch (T8-lll<IM). U.S Nucloar Regulat..y Comnialon. llll8'hlngton DC 20555-0001, or by a-mall to lnlomlJodl B9SOurC8@NRC qoy , and to the Desk Ofltcer, Oftlco of Information and Regula!Of'I A1111in1, NEOB-1020, (3150-0148). Oftlco of Unlouo Reference ID (Ucensae Sunnlled)

Management and Budget, Weshlngton DC 20503. If a means used to Impose Information IRBS-2021-001 collecllon doos not display a cunonlly vald 0MB conuol number. tho NRC may not conducl I or sponsor, and a person bl not required to respond to, the Information coffectk>n.

Facility jRlvar Bend 1-1 I Dato of Collection (mm/dd/yyyy)

I 2!.l/2021 I

Reason for Test/ng -26.717(b)(5) Pre-Access Tasting Reason (optioneQ Please elaborate (optionan JPre-Access I IRelnslatement (Between 31 and 365 days)

I Employment Type - 26.717(b)(3) Outage Worl<er (optional)?

lcontractorNendor I jves I I I Labor Category - 26. 717(b)(3)

!Maintenance (general fecility)

I Is this a U-hour reportable event under 26.119(b)? ~

Was this collect/on rafused?

  • 26.717(b)(7} & 26.75 ~

Test Results

  • 26.717(b)(4)

Test Type(&) for Resull(s) Reported* 26.717(b)(2) Drug Specimen Tested lorug Only I Jurina I

Test Validity lvaHd I

Was this collection obaerved? - 26.717(b)(7} & 26.75 ~

How many subslances ware confinned poslUva for this Individual? I 1 I

Use NRC Initial Conflrmalory Umltol Substance - 26.717(b)(2) & (b)(6)

Cutoffs? cutoff Cutoff Detedlon jMethamphelamlna I IGJ Subven,/on Attempt - Did this collection Involve a subversion attempt?- 26,717(b)(7} and 26,75(b) J No I

Management Actions - 26.717(b)(8) & 26.75 Reason for the Action IFlr.;t drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administrated) jucensee Administrated I

Specific Sanction Applied J3-Year Denial I

Parson(s) Responsible for Information Provided PonlOn 1 (n,qtJlrod).

I- llee~n IisupoNisor AA/FFO I mdelgnaC!lantor;v.com Flr.;t Name Last Name PosltionTrtle Company Email Address Person 2 (opllonaQ:

IKeNy liNo1m Iisr. s.a.tty Coor<flnator I knotandC!lentergy.com First Name Last Name PositlonTrtle Company Ema,I Address Fina/ Stop (Roc,uln,d)

  • NRC w!H consider this form authentic In accordance with 10 CFR 26.11 only when Iha -Validate & Lock" button Is clcked end all errOnl (lighlghted In red) have been comodod The -Valdate & Lock" button w!H change to 'Locked" after tho date valdotion process has been auccossfully co"1)latod Indicating lhe form Is ready lot ""brrisslon

- Fann Locked On:jJan 27, 2022 at 3 53*13 PM I I Save to Local PC 11 Print this Report I Single Positive Test Fann (vor.;ion 1.9.0 -January 2020) NRC Fonn890

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FF O Program Performance D ata Repor:1ng System NRC Form 890 S1ng :e Pos,:1 ve Tes t Form J'rrlft 't. 1111;: ,*~*1rte 111,d 1//1* I mlftllJIIU'Uf \r1r. Ge 'P ll St Jl l!c.', ~ ,)or.,

1) All fields required except those marlfed 'optional' APPROVED BY 0MB: CLEARANCE NO. S115CMl141 EXPIRES: 04/3ll/2021
2) Entrles In some flelds auto-populate lnfonmllon In other fields Esllrreted burden per response lo a,mply with this collec1ion n,quest Is 30 ninutos. This
3) Mouse over fonn ffelds to view additional lnfonnatlon rorm Is a volunlary means of Rtponing Iha lnfmnation n,qu!rod under 10 CFR 28.417(b)(2)
4) Use of Adobe R*der
  • or later /3 requlr<NRC goy and to the Desk Ofllcer, Un/au* Rer,,n,nce ID (Licensee Suoolied) Ofllca of lnfonnatlon and Regulotory Affairs, NEOB-1020, (3150-0148). Ofllca of Menagement and Budget, Washington DC 20503 If a means used to Impose Information IRBS-2021-002 collac:tlon does nol display a cunantly veld 0MB control number, lhe NRC may not conduct I or sponsor, and a pe180n Is not required to respond to. the lnformallon coflectlon.

I Fec/1/ty River Bend [50-458)

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

I 2/512021 I

Reason for Tutlng

  • 28 717(b)(5) Pre-Access Testing Reason (optlonaij Please elaborate (optionaij I Pre-Access I jRelnstatement (Between 31 and 385 days)

I Employment Type

  • 28.717(b)(3) Outage Worker (optional)?

lcontractorNendor I Ives I I I Labor Category

  • 26.717(b)(3)

IHP/RP I

Is this a 24-hour reportable event under 26.719(b)? ~

Was this collect/on refused?

  • 28 717(b)(7) & 28.75 ~

Test Ruu/ts

  • 28 717(b)(4)

Test Type(s) for Result(s) Reported. 26.717(b)(2) Drug Specimen Tested IDrugOnly I IUrine I

Test Validity lvaRd I

Was this co/faction observed?

  • 28.717(b)(7) & 26.75 ~

How many substances were confinned positive for this individual? J 1 I

UH NRC lnltlal Confillnatory Umttof Substance - 26 717(b)(2) & (b)(6)

Cutoffs? Cutoff cutoff Detection jMartjuana I IGJ Subversion Attempt* Did this collection Involve a subversion attempt? - 26.717(b)(7) end 28 75(b) I No I

Man1111ement Actions

  • 26.717(b)(6) & 26.75 Reason for the Action I First drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Adminis1nlted)

I Licensee Administrated I

Specific Sanction Applied 13-Year Denial I

Person(s) Responsible for Informal/on Provided Parson 1 (n,qulRtd):

IM*tthew ll~nan IIsupervisor AA/FFD I mdelgna@antergy.com First Name Last Name Position Tn!e Company Email Address Person 2 (oplloneQ IKaly II- I ls,* Security Coo<dlnalor I llnoland@erurgy.com First Name Last Name Position nila Company Email Address Rnlll Step (Requl,-d)

  • NRC win consider 1h11 form authentic In aoconlance with 10 CFR 28 11 only when Iha 'Valdate & Lock" button Is clckad and all enors (lighlghted In red) have been corrected. The 'Valdate & Lock" button win chenga to "Locked" after lhe dote vaidatlon process has bean suCOB11Sfully completed Indicating tho fonn Is ready for aubnisslon,

- Fonn Locked On:!Jan 27, 2022 at 4;12*12 PM I ISave to Local PC II Print this Report I Singla Positive Test Fonn (ven;ion 1.9.0-Jenuary 2020) NRC Fonn890

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1) All ffe/ds required ercopl fh050 marl<od 'apUona/'

NRC Fo rm 890 Sin gle Positive Test Form

,r :~ GL*1**;,, s~.hn,*s*o1c1 P:-: ..il APPROVED BY 0MB: CLEARANCE NO. 311MM1141 EXPIRES: 04/30/2021

2) Entries In some fields auto-populate Information In othw fields Esllmated burden per response to comply with this coDectlon request 19 30 ninutes. This
3) MouN over fonn fields to view additional lnfonnatlon fonn 19 a voluntary 111B11na of repcxting lhe lnlurmation required ur<lor 10 CFR 26.417(b)(2)
4) Uso of Adobe Reader B or later Is required ar<l 26.717, The lnforma11on Is required by NRC to obtain on an annual basis site specific ltness-for-duty (FFD) program pelformance data on drug ar<I alcohol programs from lc:ensees end other entlUes. Send comments ragan:lng burden estimate to the FOIA, Submission Information Services Branch (T&-A10M), U.S Nuclear Regulatory Commsslon, Weshlngton Update DC 20555-0001, or by e-mail to lnfomlltds Rasourco@NBC goy. and to the Desk Officer.

Oftico of Information ar<I Regulatory Atlalra, NEOB-1020, (3150-0148), Ofllce of Uni ue Reference ID Licensee Su lied Management and Budget, Washington DC 20503. If a means used to Impose Information RBS-2021-003 coRectlon does not display a currently vaid 0MB control number, the NRC may not cor<luct or aponsor, and a person Is not required to respond to, the Information collection Facility I River Band (50-458] Date of Collect/on (mmldd/yyyy)

I 2/10/2021 I

Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optlonaQ Please elaborate (opUonaQ jPre-Access !Reinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3) Ouu,ge Worker (opt/anal)?

IContractorNendor !Yes Labor Category - 26. 717(b)(3)

!Maintenance (general facility)

Is this a 24-hour reportable ewnt under 26. 719(b)? ~

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)

IAtcohol Only Substance - 26.717(b)(2) & (b)(6)

Alcohol Specimen Tested IBraath

\M\at 26.103 BAC level was exceeded?

10.02 and in work status at least 2 hrs Subversion Attempt- Did this collection involve a subversion attempt? - 26.717(b)(7) and 28 75(b) ~I___N_o_ _~

Management Actions - 26 717(b)(6) & 26,75 Reason for the Action I First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

!Licensee Administrated Specific Sanction Applied j1-Year Denial Person(s) Respanslble for Information Provided Person 1 (required)*

mdolgnaC!Jentergy.com

~IM_atlh_ew

__-,,,.--,-,.,-----~' l~~-lgn-a_n_--,-===---~' lsupefVlsorAA/FFD First Name Last Name ~--~P~o-s"'IIJ~o-n~n~,u~e---~ Company Email Address Pel90n 2 (optlonaQ*

!Kally 11- I lsr. SeaJrily Coordinator I knolar<l@entorgy.com

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Rna/ Stop (Rsqulred) - NRC wlff consider lhls form authentic In accordance with 10 CFR 26.11 only when ths 'Vaidata & Lock- button 19 cicked ar<I all OITOl9 (h/ghllghted In red) have been corracted, The 'Vaidate & Lock" button wlR change to "Locked" after the data vaidatlon process haa been succesafutly completed lr<llcatil'Q Iha form 19 ready for submission, Form Locked On:!Jan 27, 2022 at 4:17:34 PM ISave to Local PC 11 Print this Report I Single Positive Test Form (version 1.9.0-January 2020) NRC Form 890

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~ FFD Program Performance Data Reporting System NRG Form 890 Single Pos,:1vf' ,es: Forr 1 1 l 1r1I11. *r111I1,* /'tuplt' ,nu/ lfrt" I 111*Ir1111111 ,.. ,u ' f ,...,1..: ~

1) AU ne1m ~Ired ucepf tho:s* trNrlf<<I 'optlonlll' APPROVED BY 0MB: CLEARANCE NO. 31&CMll41 EJIPIRE&: 04/30/2021
2) Entrl.s In &otM fields aulo-populate lnformarlon In oth* fl91ds Estlmabld burden per response lo a,mpy v.ilh this ailtecllon requesl Is 30 mmrles. Tiis
3) Mouse over form ffelds to view additional Information fO!Tn Is a volunta,y moans of rapo,llng Ille lnformellon required under 10 CfR 28.417(b)(2)
4) Use of Adobe Reader I or later Is ,-qulrwd and 28.717. The Information Is required by NRC lo oluln on an annual basis site apedfte ltnea-for-<futy (FFD) program performance data on dn,g and alcohol programs from D Submission Update D~~:::,~sston lc:ieneees and other entiUas. Send convnenta regarding burden estimate to the FOIA.

lnformollon SelViees Branch (T8-A10M) , US Nuclear Regulatory Comrri881on, Washington DC 20555-0001 , or by &-mall to lnfQmliPr:11. RnmHWCNRC pew. and to the Desk Officer, Oftlc:e of Information and Regulatory Affairs, NEOB-1020, (3150-0141!) , Office of UnllJ.U& Raferanca ID !Ucensee ~e!ledl Management and Budget, Washington DC 20503. If a means used to lff1)0S8 Information IRBS-2021-004 collection does not dtsplay a currently veld 0MB control number, the NRC may not conduct I or sponsor, and a pelSOn is not required to respond to, the Information coHection Facility IRtver Band [~BJ I Data of Collect/on (mmldd/yyyy)

I 02/04/2021 I

Reason for Testing

  • 2B 717(b)(5) Follow-up TesUng Reason (optional)

IFollow-up I IPotanUaAy disqualifying FFD lnfonnation I

Employment Typo - 28.717(b)(3) 0u1"11e Womer (opUonal)?

lcontractorNendor Ives I I Labor Category - 28 717(b)(3)

I Maintenance (general facility)

I Is this B 24-hour raportllble event under 26.719/b)? ~

Was this col/ecUon refused? - 28 717(b)(7) & 28.75 ~

Tut Results

  • 26 717(b)(4)

Test Type(s) for Rasult(s) Reported. 28.717(b)(2) Drug Specimen Tastad IDrugOnly I junne I

Test Validity

!valid I Was this collect/on observed? - 2B.717(b)(7) & 26.75 ~

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How many substances were confinned positive for this Individual? I 1 UseNRC Initial Confinnatory Umttol Substance

  • 28.717(b)(2) & (b)(B) Cutoffs? Cutoff Cutoff Detedlon

!Marijuana I

Subversion Attempt - Did this collection involve a subversion attempt?* 26.717(b)(7) and 28 75(b) I No I

MBn"llement Actions

  • 28.717(b)(B) & 28.75 Reason for the Action I First drug or alcohol positive I

Sanction Applied (NRC Minimum or Ucansee Administrated) lucensee Administrated I

Specific Sanction Applied 13-Year Danial I

Person(s) Responslbla for lnformaUon Provided Peraon I (required).

!Matthew ,,~nan I/supelVi,or ANFFD I mdelgnaClentOfllY.a>m First Name last Name Position nue Company Email Addrass Person 2 (opllonaO

'Kelly IINofand I jsr Security Cooltllnator I knolandOentergy.com First Name last Name Position Title Company Email Address Rna/ Step (Roqulrod)

  • NRC"1H consider this form eulllenlk: In acconlance"111110 CFR 28.11 onlywhentha "1/aidate & Loelt" button Is cleked and all erroni (hlghllghlod In rod) have been comidad. The "1/aldato & Lock'" button "1H change to 'Locl<ad" after the data valdatlon process has bean succesalully complatad looleallng the form ts raedy for submission.

- Fonn Locked On:!Jan 27, 2022 at 4 1915 PM I I Save to Local PC 11 Print this Report I Single Positive Test Fonn (version 1.9.0 - January 2020) NRC Fonn 890

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FFD Program Performance Data Reporting System NRC Form 890, Single Pos itive Test Form

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1) All ffelds required except those marlced 'aptlonal' APPROVED BY 0MB: CLEARANCE NO. 31IO.o141 EXPIRES: 04/30/2021
2) Entrfu In some fleltb auto-populate Information In other flelm Estlmelod bwden per response lo co~ with 1hls collectlon Olquesl Is 30 ninutes. T1is
3) Mouse over fonn fields to view addldonal Information form Is a voluntary means of reporting lhe lnforrnollon required under 10 CFR 211.417(b)(2)
4) Use of Adob* RNtNf I or later,~ required and 211.717. The Information Is ""llirod by NRC lo oblaln on an annual basis llffe specilc fitnes&.lor-<fi<y (FFD) program perfomlance data on drug and alcohol prugrame lnlm D UpdateSubmission D Submission Delete lcensees and other enlfttes. Send commanta reganlng burden estimate lo the FotA.

lnformallon Services Brandi (T6-A111,1). U.S Nuclear Regulatory Cormisalon, W.shlnglon DC 20555-0001 , or by a-mall lo lnlocoUe<:11 R8SOllco4l1NRC gqy end lo Iha Desk Officer, Ofllce of Information and Regufalory Affllira, NEOB-1020, (3150-0148), Office of Unlaua Refvrence ID (Ucensee Suooliedl Management and Budget, W.shlnglon DC 20503 If a means used to unpose lnfonnatfon IRBS-2021-005 I collection does no1 display a curranlly vald 0MB control number, the NRC mey not conduct or sponsor. and a person Is not required to respond to, the Information collection Facility

!River Bend [50-458]

I Date of Col/action (mm/dd/yyyy)

I 0311 0/202 1

I Reason for Testing - 28.717(b)(5) Please elaborate (optional)

!Random I I I Employment Type - 26.717(b)(3) Outage Worker (opUonsl)?

lcontractorNendor I Ives I

Labor Category - 28.717(b)(3)

!Engineering I

Is this s 24-hour reportable event under 26 719(b)? ~

Wes this col/action refused? - 28 717(b)(7) & 28 75 ~

Test Results - 28.717(b)(4)

Test Type(s) for Result(s) Reported-26.717(b)(2) Drug Specimen Tested

!Drug Only I junne I Test Validity lvand I

Was this col/action observed? - 28 717(b)(7) & 26.75 ~

How many substances wera confinned positive for this Individual? I 1 I

UseNRC lnltlal Conftrmalory Umltof Substance

  • 26,717(b)(2) & (b)(B)

Cutoffs? Cutoff Cutoff Detec:Uon

!Marijuana I I~

Subversion Attempt* Did this collec11on 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 Ucensee Administrated) lucensee Administrated I

Specific Sanction Applied 13-Year Danial I

Person(s) Responsible for lnformsUon Provided Paraon 1 (required):

IMetlhew First Name ll~*an LastNama 11 Supervisor A/1/FFD Position Title I rrclolgnaC!lanla!vY.com Company Email Address Peraon 2 (optionaO, IK*My II- 11Sr.SeaJrffy CoomlnBlor I knolandC!lenlargy.com First Name last Name Position Title Company Email Addreas Rna/ Stop (Roqul,-d)

  • NRC wlH conllklor this form authentic In aocordance wl1h 1Q CFR 211.11 only when tha 'Vaidale & Lock' button fl cffcked and all enors (lighlghtod In rod) hove been comtetod. The 'Valdale & Lock" button will dianga lo "Locked' after Iha deta valdation process he* been 11Uccessfully cofl1)1etod Indicating Iha form Is ready for 11Ubrrisslon.

- Form Locked on:!Jan 27, 2022 et 4 20 33 PM I I Save to Local PC 11 Print this Report I Single Positive Test Fann (version 1.9.0 - January 2020) NRC Fonn890

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  • l 'ro f, '(tm;: f',*111ilr m rd the Im 1mnwr11t
2) Entries In aoma flelc& auto-populate lrrtormallon In other fleld:J FFD Program Performance Data Reporting System NRC Fo rm I

890.

L Single Pos1tIve Test Form

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Estlnated burden per response to comply with this collection request ts 30 ninutas. TNs

3) Mouse over form fldlds to view additional Information form Is a voluntary means of rapor11ng Iha lnformdon n,qtired urder 10 CFR 26.417(b)(2)
4) U~* of Adobe Reader I "'later l5 n,qulred ard 26.717, The Information Is n,qtired by NRC to oblaln on an annual basis Bite spacllo ltn8SS-for-<luty (FFO) pn,gram pertormanoa data on drug ord ak:ohol program, from D Submission Update ~:~salon lc:enslfl and other anttttas. Send comment& rvgardlng bufUen estimate to tha FOIA.

Information Services Branch (111-A1DM), U.S Nudaar Regulato,y Cormnslon, Washlng1on DC 20555--0001, or by e-mail to lnfocoiltcb BnoLGOCNRC gov, and to the Deak Oflcer1 Un/au& Refe,unce ID (Licensee Suooliedl Ollloa of Information ard Regulato,y Affairs, NEOB-1020, (3150-014B), Office of Management ard Budget, Washington 0C 20503, II a means used to Impose Information IRBS-2021-006 I oolteciion dOH not display a currently veld 0MB c:ontrol number, lhe NRC may not oorduc1 or sponsor, and e person is not required to respond to, the Information collection ,

Fac/1/ty

!River Bend [50-458]

I Date of Collect/on (mm/ddlyyyy)

I 03/23/2021 I

Reason for Tut/ng -28,717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (optionaij I Pre-Access I IInitial Authorization I

Employment Type - 28 717(b)(3) Outage Worker (optional)?

lcontractarNendor I IY*s I I I Labor Category - 28 717(b)(3)

JMaintanance (general facility)

I Is this a 24-hour ,uportab/e event under 26.719(b)? ~

Was th/a collect/on ,ufused? - 28 717(b)(7) & 28,75 ~

Test Resu/u - 2e 717(b)(4)

Test Type(*) tor Result(s) Reported - 28.717(b)(2) Drug Specimen Tested

!Drug Only I !Urine I

Test Validity lvalld I Was this collect/on observed? - 28.717(b)(7) & 28.75 ~

How many substancas were confinned positive for this Individual? I 1 I

U19NRC Initial Confirmatory Umltol Substance- 28.717(b)(2) & (b)(8)

Cutoffs? Cutoff Cutoff Oetadlon

!Marijuana I I~

Subversion Attempt - Did this collection Involve a subversion attempt? - 28.717(b)(7) and 28.75(b) I No I

Management Act/ons - 28.717(b)(8) & 28.75 Reason for the Action I First drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administra1ed) lucansee Administrated I

Specific Sanction Applied 13-Year Denial I

Person(s) RHpons/b/e for lnformaUon Provided Person 1 (n,qulred)*

!Matthew First Name ll~n.. I I supervisor AAIFFO Position nue I

mdelgnaC!)en1ergy,oom Company Email Address Last Name Parson 2 (optionaO, IK*lly 11~and Ils,,Security Coonllnalor I knoland011rte1VY,com First Name Last Name Poslilon nue Company Email Address Rna/ Step (Roqulrod)

  • NRC win c:o!11k18f this form authentic In aooonlonoa wl1h 10CFR 28.11 only when tho -Vaidate & Loc1<" button Is c:lokod and all errors (Nghlghted In red) have been oonedad. The "\/aldate & Look" button will dlange to 'Lodced" after Iha data veldatlon proc:ess has bean suooasslully oompletad lrdlcating the form Is ready for sutxrialon,

- Fann Locked on:!Jan 27, 2022 at 4'23'31 PM I ISava to Local PC J I Print this Report J Single Positive Test Form (version 1.9.0 -January 2020) NRC Form 890

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1) All flelda f<<tUlred except those marlced 'optlonM' APPROVED BY 0MB: CLEARANCE NO. 31&0-0141 EXPIRES: 04/S0/2021
2) Enata In aome n-,cu 11ulo--popul11t* Information In olher flelda Eatlmalad burden par n,sponea kl co!11llY with this colectioo raquesl Is 30 rnnut89. This JJ Mouse over fonn nelds to vf11W ddltlonal Information fonn Is a volunla,y moans ol repo,11no Iha lnlormollon raqulrad under 10 CFR 26.417(b)(2)
4) U!Je of Adobe Reader I or l11ter Is ~ulred and 28.717 The Information Is reqLired by NRC lo ol:uln on an annual basis site spedftc 11nasa-lor-duty (FFD) program porlormanca dala on drug end alcohol programs l'rom lcensees and other entlUes Stnd convnenll: regarding burden estimate to the FOIA.

Submission Delete lnlonnatlon Services Branch (T8-A10M), U.S. Nudear Reoulalory Commlssloo. ll'lashinotoo Update Submission DC 20555-0001 , or by e-mal\ to \nfocdLects BUQUCc;eONRC gpy. and to the Deak Oflcer, Olllce of lnlormatlon and Ragulato,y Affaira, NEOfl..1020, (3150-0148), Olllce of Unique Reference ID (Licensae Supplied) Management and Budget, wasl!lngton DC =3. If a means used to Impose Information IRBS-2021-007 I collection doas not display a amonlly vald 0MB control number, Iha NRC may not conduct or sponsor, and a paraon HI not required to respond to, the lntonnalfon coKed:lon Fae/Illy

!River Bend (50-45B] Date of Col/ec1/on (mmldd/yyyy)

I 02/23/2D2 1 I

Reason tor Testing - 26 717(b)(5) Please elaborate (optional)

!Random Employment Type 717(b)(3) Outage Worl<er (optlonsl)7 jeontractorNendor jves Labor Category - 28.717(b)(3)

IMaintensnce (general facility)

Is this* 24-hour repottab/e event under 24.119(b)7 ~

Was this collec1/on refused? - 26 717(b)(7) & 26. 75 ~

Subversion Attempt - Did this collection Involve a subversion attempt? - 26.717(b)(7) and 26.75(b) LI_ _ _ ve_s_ _...J D Old not appear for testing D Spaclmen characteristics (e_g,, color, odor, precipitant) Please elaborate on the choicalsl selected 181 Shy-bladder (no medical condition) D Invalid test result (inl!Jal specimen collacted) - 26.185(1) Individual could not provide adequate oample wllhln tha 3 hour3.472222e-5 days <br />8.333333e-4 hours <br />4.960317e-6 weeks <br />1.1415e-6 months <br /> Uma frame and provided not anough medical condtion D Refused to follow directions MRO declared a subversion attemp D Donor edmitted to subwl'Sl0f1 attempt D Specimen temperatun, (out of range) D Other D Spacimen paraphernalia Identified Menegemerit Ac1/ons . 26.717(b)(B) & 26.75 Reason for the Action

!subversion attempt Sanction Applied (NRC Minimum or Ucensee Administrated)

INRC Minimum Specific Sanction Applied I Permanent Denial Person{s) Responsible tor Information Provided Parson 1 (raqulrad):

IMatthaw II~*** I lsupe,v1sor AAIFFD mdelg1111@entargy.com Fir.it Name Last Name Position Tltie Company Email Address Penson 2 (optlonaQ:

IKelly I lsr. Sa<Urity Coordinator I knoland@entargy.com II-Fir1t Name LastNama Position Tit!* company Email Address Rnal Step (Roqul,.,,, - NRC wlff consldar lhls fonm authentic In acconlance with 10CFR 26 11 only whan tho 'Valdata & Loci<" button Is clcked and aH erro111 (hlghlghtod In red) have been comlded Tha 'Valdata & Loclt" button wlD c:llango to "Locked" after Iha data valdatlon process has been ouccosslully completed lndlcatino Iha form Is ready lo, subrrialon Form Locked On:!Jan 27, 2022 al 4"27:57 PM I Save to local PC 11 Print th(s Report I Single Positive Test Form (ver.iion 1.9.0 -January 2020) NRC Form890

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FFD Program Performance Data Report in g System NRC Form 890 S,ngle Pos1t.ve Test For *n f'ni/i 'f w,,: l'i ,111/t' um/ till* l .111*rr1*11mi*rif *. 1*1r. G!J'H r , S 1( rw, ,1G ,~~.:,11 1/ All fields requlrod """""' u,..., nu,rhd 'opUonel' APPROVED BY 0MB: CLEARANCE NO. S1l50-0146 EXPIRES: 04/30/2021

2) Entries In a0ffl4J fleltb uto-populat* lnfonnadon In other tfelds Eslhraled bunlen par raspom,e lo comply "1th this collection requlll ii 30 ninulao. This
3) Mouse over form flelcb to vfttW addillonal Information lonn ii a voluntary IMBIIS of n,portlfll lh* lnfolmalion reqtired uooor 10 CFR 26 417(b)(2)
4) Use of Adobe RNder I or later Is requlnd and 28.717. The lnfom1o11on ii reqtired by NRC to obtain on an annual basll 111* spoc:llc ltness-lD<-<luty (FFD) pogram pe<(ormance dale en drug aoo ak:ohol programs Imm lcensees and other enlftl*. send corrment& r.gardlng booJen estimate to the FotA.

D Submission Information Services Bntncll (Tll-A10M), US. Nuclear Regulatory Comnisolon, Vl/ashlfll1on Update D~~:~sslon DC 20555-0001 , or bye-mall to lnfocoffecb RosowceONRC gov_and to the Desk Officer, otllca of Information eoo Regulatory Afllllrs, NEOB-1020, (3150-0148), otllca of Unlg_ue Reference ID !Licensee Sueeliedl Menagemen, aoo Budget, Weshlflllon DC 20503. If a meens used lo Impose Information IRBS-2021-008 I ooHectioo d - not display a currently veld 0MB con1rol nurrber, the NRC may not cooouct or sponsor, and a person hi not required to respond to, the Information collection.

I Facility jRlver Bend [50-458)

I Date of Collect/on (mm/dd/yyyy) 05/05/202 1

J Reason for Testing - 26.717(b)(S) Pre-Access Testing Reason (opllonaQ Please elaborate (optlonaQ j Pre-Access I IUpdate Authorization I

Employment Type - 26 717(b)(3) Outage Worker (optional)?

I Licensee Employee I

!No I I I Labor Category - 26.717(b)(3)

!Engineering I

Is this a 24-hour repor1Bble event under 26.719(b)? ~

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 lorug Only I !Urine I Test Validity lvand I

Was this collect/on ob&erved? - 26.717(b)(7) & 28 75 ~

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

Use NRC Initial Confim1a1ory Umltof Substance- 2B.717(b)(2) & (b)(6)

Culolfs? Culoff CUlofl Detadlon

!Marijuana I IGJ Subversion Attempt - Did this collectlon Involve a subversion attempt? - 26.717(b)(7) and 2B.75(b) I No I

Management Actions 717(b)(B) & 28.75 Reason for the Acllon I First drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administrated)

!Licensee Administrated I

Specific Sanction Applied j3-Year Denial I

Person(s) Responsible for lnfonn.Uon Provided Pen,on 1 (required)

!Matthew First Name ll~nen Last Name I!supervisor AMFD Position nue I rrllelgneC!lenlergy com Company Email Address Person 2 (optionaQ.

IKely 11- I lsr Seall1y Coordinator I lcnolendC!lantargy_com First Name last Name Posldon Title Company Email Address Rnel Sfep (Required} - NRC wlH consider lhil fonn authonllc In ecoordanca "1th 10 CFR 28.11 only when the "Velda1e & Loci<" button Is clicked and eR errors (highlghled In red) have been co.-cted. The "Valdete & Lock" button win change to "Locked" after the date valdetlon procesa has been aucoaoafully oompleted lmlca1!fll the fonn ii ntedy for aubrrisslon.

- Form Locked On:IJan 27, 2022 at 4*31*29 PM I I Save to Local PC II Print this Report I Single Positive Test Form (version 1.9.0 -January 2020) NRC Form 890

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1) All fields required except rhos* marked 'optional' APPROVED BY 0MB: CLEARANCE NO.31-141 EXPIRES: 04/3Ql2021
2) Entries In *om* fields *uto-popul*t* Information In oth* fields Estlmaled burden pe< rasponse lo compy wtth this conection n,qunt Is 30 rrinutes. Tiis
3) Mouse over fonn fields to v#ow additional Information form Is* voluntary maena of n1pol1ino the Information n,qlired under 10 CFR 28.417(b)(2)
4) Use of Adob* lfeador I or later Is required and :ie 717, Too Information Is n,qlired by NRC lo obtain on an aMual basis 8110 apecllc llness-for-duty (l'1'D) p,og,am performance dela on dn,g and alcohol programs from lcensees and other enllHes Send commentll roganfng burden esHmeta to Iha FOIA.

Submission lnformatlan Services Branch (llh', 1ll,IJ, U S Nuclear Reoulatory Cormiulon. Washington Update DC 20555-0001 , or bye-mall to lnfoc:oOftdl BesourceGNRC gov. and to the Desk Officer, Olllce of Information and Regulatory Affal19, NEOB-1020, (3150-0148), 0111ce of Un/quo Reference ID (Ucensee Supplied)

IRBS-2021-009 I Management and Budget, Washington 0C 20503, If a moans used to lmposo lnfonnatlon collection d - not display a currently valid 0MB control number, lhe NRC may not conduct or sponsor, and a person Is nol required to respond to, the lnfonnation coltecUon.

Fec/1/ty jRJver Bend [50-458] Date of Collect/on (mm/dd/yyyy)

I 041271202 1 I

Reason for Testing

  • 26 717(b)(5) Please elaborate (optional)

!Random I I Employment Type . 26.717(b)(3) Outage Worker (optional)?

jucansea Employee INo Labor Caf9QOry - 26. 717(b)(3) Pf88se elaborate on the Labor Category selected

!Other IPer1onnance Improvement Is this 1124-hour reportable event under 28.719(b)? ~

Was this col/action refused? - 26 717(b)(7) & 26.75 ~

Test Ruu/lJJ

  • 26.717(b)(4)

Test Type(s) for Result(s) Reported* 28 717(b)(2)

IAlcohol Only Substance - 26 717(b)(2) & (b)(8)

!Alcohol Alcohol Specimen Tasted I Breath I

\M\al 28 103 BAC level was excaeded?

jo.04 or greater Subversion Attvmpt* Did this collec1Jon involve a subversion attempt? -26 717(b)(7) and 26.75(b) l~__ N_o_ __,

Management Actions

  • 26 717(b)(8) & 28 75 Reason for the Action IFirst drug or alcohol positive Sanction Applied (NRC Minimum or Ucensea Administrated) lucansee Administrated Specific Sanction Applied I14-Day Denlal Person(s) Responsible for Information Provided Pal90n 1 (n,qulred)*

IMatthaw ll~nan I!supervisor AA/FFO mdelgnaC!lantargy.com First Name ---~==-------'

Last Name Position TiUe Company Email Address Pal90n 2 (opllonaij IKe>>y First Name II- IIs,,Seality Coordinator

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last Name I knolandC!lenlB,vy,com

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Rna1 Step (Reqund}

  • NRC will consider this form aulhenHc In accordance with 10 CFR :ie.11 only when the "Valdata & Lock" button Is cickad and aN enol9 (Nghighted In red) have bean corradad Toa "Valdate & Lock" button wlH change to *Locked" after the data vaidatlon process hes baen auccessMly complelad lndlcaUng lhe form Is n,ady for aubrrnslon.

- Fonn Locked on:!Jan 27, 2022 st 4 34*07 PM I Save ID Locel PC 11 Print this Report I Single Positive Test Fonn (version 1.9.0-Jenuary 2020) NRC Fann 890

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1) Alt ffelds ,_.Ired except rhosa mal1cad 'opUOIJM' APPROVED BY 0MB: CLEARANCE NO. l16CMl14' EXPIRES: 04/lG/2021
2) Entrlu In some ne1c1s *uro-populat* Information In ott,., ffelds Estimated btJotlen per rnponse to COJTVI wtth !his coloctioo n,quest Is 30 ninutao This
3) Mou.w ovor form ffeld!J ro vtew addldonal lnfonnatlon fonn Is* volunlaiy moarB of reporting tho lnfonretlon n,qulred w-.lar 10 CFR 26 417(b)(2)
4) U.se of Adobe Reader I or later l.s raqulred ard 26,717, The lnlonna1ion Is n,qulred by NRC to oblaln on an annual basis alto spedftc ltneo&-for-duty (FFD) program performanoe data on drug ard alcohol programs from lcensees and other entitles_ Send convnents regenlng burden estimate to the FOIA, Submission Information Services Branch (T8-A1IJd), U.S Nuclear R01Julato,y Comrrlulon, Washington Update DC 20555-0001 , or by 9-maff to lnfomUad!I BgsourceCNBC poy, aim to the Desk Officer, Uni ue Reference ID Licensee Su lied Olllce of lnfonnation ard R91JUlatory Affolrs, NEOB-1020, (3150-0146), Olllca of Man91Jomont and Budgot, Washington DC 20503. If a means used to Impose Information RBS-2021-010 collection does not dispfay a currently vald 0MB control nurmer, the NRC may not conduct or sponsor, and a person Is not required to respond to, the lnfonnalion coNection.

!River Bend (50-458) Date of Collection (mm/dd/yyyy)

I 051031202 1 I

Reason for Test1n11 - 28.717(b)(5) Pre-Access Testing Reason (optionaij Please elaborate (oplionaij I Pre-Access IInitial Authorization Employment Type - 28 717(b)(3) Outage Worl<er (optional)?

jcontractorNendor I ~IN_o_ _ _ _~

Labor Category - 28. 717(b)(3) jFacility Support Is this a 24-hour reportable ewnt under 26.719(b)7 ~

Was this collect/on refuaed?

  • 26 717(b)(7) & 28.75 ~

Test Resulta . 26 717(b)(4)

Test Type(s) for Resutt(s) Reported- 28 717(b)(2) Drug Specimen Tested

!Drug 0n1y junne I Test Validity lvand Was this collectlon omervec/7

  • 28.717(b){7) & 28.75 ~

How many substances were confirmed positive for this individual? .._I_ _ _ _ ___.

Uso NRC Initial Confirmatory Umtt of Substance

  • 26.717(b)(2) & (b)(8)

Cutolfl? Cutoff Cutoff Detection Subversion Attempt

  • Did this coHection involve a subversion attempt?* 28,717(b){7) and 28.75(b) ... I___ N_o_ __,

Management Actions

  • 28.717(b)(8) & 26.75 Reason for the Action I First drug or alcohol positive Sanction Applied (NRC Minimum or Licenses Administrated) lucensee Administrated Specific Sanction Applied I3-Year Denial Person(s) Responsible for /nformlll/on Prov/-

Person 1 (n,qulred):

I._Matlhew_~~-----'\l._~_--,-~~----'I First Name Last Name

\supervisol' AAIFFD

~---,P"'o"'s-.,

\ rrdelgna@enlafVl.com

,u"'o.,.n""T"'itle..,...---' ---~Com--pan-y""E'"m-a'"'ll~A~dd~res-*----

Pen,on 2 (optionaQ:

ILK-*l_ly--~~~-----'I INoland First Name I lsr Security Coordinator I knoland@entargy.com

~----,La-st'"'N~a_m_e_ _ __, .__ _ _Pro-1~Iu~o-n~Ti~it1~e-----' ----"'c"om=pa"'n"'y"'Ein'=a"',ir.Ar.aa=-,e:::s=s---- 1 Rna/ Step (Required} - NRC will consider this form authentic In accordance wtth 10 CFR 2611 only whan tha 'Vaidota & Lock" button Is clckod ard aM 0ITilnl (hlghlghted In rod) havo been conaded. The 'Vaidale & Lock" button will change to "Locked" after the data vaidetlon process has been successfully completad Indicating Iha fonn Is ready fo, sulmsslon.

Form Locked On*!Jan 27, 2022 at 4:38:57 PM I Save lo Local PC 11 Print this Report I Single Positive Test Form (version 1.9.0-January 2020) NRC Form8BO

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2) Entrlu In some fl.tds *u,o.popul*t* Information In other fields Elllmaled burden per response to 00"W with this ccRoction raquHI Is 30 ninutn. Thia
3) Mouse over form Nolds ro vtew additional Information lnnn Is a voluntary moans of n , ~ the Information raqLired uooar 1D CFR 26.417(b)(2)
4) Use of Adobe Ruder 8 or lat-, Is required aoo 26.717 The lnlormalion Is raqLired by NRC to obtain on an annual basis silo opedlc lilness-for-<!uty (FFO) program performance data on dnrg 100 alcohol programs from lcenseea aoo other entlt!as. Seoo CCITfTenls n,ganJlng burden osllmata to the FOIA, D Submission lnlnnnatlon Services Branch (1'8,A11IM), U.S Nudeer Regulato,y Comnisalon, Weshlngton Update D~~:~~sslon DC 205~001 , or by HMII to lnfocoUects BnourceONRC oov. and to tha Desk Officer, Olllce of lnlnnnatlon aoo Regulatory Affoln,, NEOB-1020, (3150-01415), Ofllce of Unl!J.Ue Refvrenco ID (Licensee Sueelled) Management and Budget. Weshlngton DC 20503 , If a means used to Impose Information IRBS-2021-011 coHectlon does not dfsplay a amentty veld 0MB control number, the NRC may not conduct I or sponsor, and a person ls not required to respond to, the lnfonnation collection.

Facility

!River Bend [~BJ Reason tor To:rt/ng - 26.717(b)(5)

I Folla.v-up Testing Reason (opUonaf)

Date of Collect/on I (mm/ddlyyyy) 5/12/2021 I

!Follow-up I

JPrior positive nasull not related to 10 CFR Part 26 testing I Employment Type - 2B.717(b)(3) Outage Worl<er (opUonal)?

lcontractorNendor I INo I

Labor Ca18f1ory - 26 717(b)(3)

IMmntenanca (general facility)

I Is this a 24-hour reportable avant under 28.719(b)? ~

Was this collect/on refused?

  • 26.717(b)(7) & 26.75 ~

Subversion Attempt - Did this collection Involve a subversion attempt? - 2B 717(b)(7) and 2B.75(b) I Yes I

D Did not appaar for testing D Specimen characteristics (e.g., color, odor, precipitant) Plaasa elaborate on the cholcals) selected.

D Shy-bladder (no medical condition) D Invalid test result (Initial specimen collected)

  • 26.165(Q lndMdual coukl not provide an adequate amount and the Individual left the tosllng ladily.

181 Refused to provide Initial specimen D Refusad to folla.v directions D Refused to provide second specimen D Donor admitted to subversion attempt D Specimen temperatuna (out or range) Other D Specimen paraphernalia Identified Management Actions

  • 26.717(b)(8) & 26.75 Reason for the Action ISubversion attempt I

Sanction Applied (NRC Minimum or Licensee Administrated)

INRC Minimum I

Specific Sanction Applied IPennanent Denial I

Person(s) Responsible for /ntormaUon Provided Parson 1 (raqulred)*

IM- 11~.. \lsuperv1so< AAIFFD I nmlgna@enlOTg'/.com First Name Last Name PoSilionTrtle Company Email Address Pen,on 2 (optlonaQ.

!Kelly IINo- Ilsr Security Cooridnator I knolaoo@entergy.com F1n1tName Last Name PosliionTrtle Company Email Address Rna/ s,-,, (Required) - NRC wlM consider this form authantlc In accordance with 10 CFR 26.11 only when tho "Vaidale & Lock" button Is ticked ooo aH orron, (hlghlghled In red) have been corroded. The "Valdete & Loclc" button will change to "Locked" after tho data valdatlon prt>C8tlS hu been succesafuly ccirc>lated loolcaUng the form Is n,ady fo, subrrisslon.

- Fonn Locked On:!Jan 27, 2022 at 4:40:47 PM I I Save to Local PC 11 Print this Report I

Single Positive Test Fonn (version 1.9.0 - January 2020) NRC Fonn 890

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l) Entries In .some Rllcls uto,.pol)(Jl t Information In other fields Eslrralod bunlen per mponse to co.-.,ty wflh lhta oolloc:tion raquest Is 30 rrinules. This
3) Mouse over farm f1elds ro view ddtlonal Information lonn Is a voluntary means of ruporllng the lnfonnatlon raqtored und0110 CFR 28.417(b)(2)
4) Use of Adobe RNder I or later /s required and 28 717. The lnlonnation Is raqtored by NRC lo obtain on an aooual basis site apedRc lltnlla-lo<-duty (FFO) program perlonnanca data on drug and alcohol programs from lcensaes and other enttttes. send commanta rvganlng burden estimate to the FOIA, Submission Dalate lnlonnallon Services Branch (TII-A11J,1), U.S, Nuclear Regulato,y Ccmnilllon, Washington Updata Submission DC 20555-0001, or by e-mail to lnfomHocls Besource@NBC qoy, and to the Desk Officer, Olllca of lnlonnation and Regulato,y Alfalro, NEOB-11120, (3150-0148), Office of Uni ue Reference ID Ucensee S led Management and Budget, Washington DC 20503. If a means used lo Impose Information RBS-2021-012 collection does not dtsplay e currentty vald 0MB control nutmer, the NRC may not conduct or aponsor, and a person ls not required to respond to, the lnfonnatlon collectfon_

Facll/ty

!River Bend [50-458] Data of Collect/on (mmldd/yyyy)

I_ 09113/2021 Reason for Testing - 26 717(b)(5) Pre-Access Testing Reason (optional)

!Pre-Access IPlease Selact Employment Type . 26.717(b)(3) Outage Worl<er (opUonol)1 IContractorNendor !No Labor Cater,ory - 26.717(b)(3)

I Maintenance (general lacHity)

Is this a 24-hour reportable event under 28.719(b)1 ~

Was this collect/on refused? - 26 717(b)(7) & 26.75 ~

Test Resutu - 26.717(b)(4)

Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Specimen Tested j0rugOnly junne j TestVahdrty

!valid Was this collect/on observed? - 26.717(b)(7) & 26.75 ~

How many substances ware confirmed positive for this individual? LI_ _ _ _ _ _ _ ,

UsaNRC lnHial Confirmatory LlmK of Substance - 26.717(b)(2) & (b)(6)

Cutoffs? Cutoff Cutoff Dated ion jMarijuana Subversion Attempt - Did this coliaction Involve a subversion attempt? - 26.717(b)(7) and 28. 75(b) IL _ _ _ N_o_ __,

Management AC1/ons - 26.717(b)(B) & 28-75 Reason for the Action I First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated) jucensae Administrated Specific Sanction Applied 13-Year Denial Person(*) Responsible for lnformllllon Provided Peroon 1 (raqtored):

IM- First Name ll~nan

- - - ~Last ~ Name

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I\supervisor WVFFD Position Title rrdalgnaC!lenllfllY.com Company Email Address Paroon 2 (opllonaQ:

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Last Name Company Email Address Rna/ Step (Requlrod) - NRC 'MIi consider this form authanUc In accoldanca 'Mlh 1DCFR 28 11 only when Iha -VaHdata & Lock" button Is cickad and aN aRora (highlighted In red) have bean corractad. The -Valdolo & Lock" button 'MH change lo "Locked" ofter the data validation procesa has bean successfully completed lndlcaUng the form Is n,ady for aubnHslon Form Locked on:!Feb 7, 2022 at 12.15*57 PM I Save to Local PC 11 Print this Report I Single Positive Test Form (version 1.9.0 -January 2020) NRC Fann 890

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,11°1 EXPIRES: 04/30/2021 EsUmated burden per rasponee lo comply with this collection reque&I Is 30 ninutes. This

3) Mouse over form fields to view additional Information lonn Is e voluntary means of reporting the lnrarmatlon required under 10 CFR 26.417(b)(2)

.fJ Use of Adobe Read.- 8 or later Is required and 26.717. The lnlonnation Is reqtirad by NRC lo obtain on an annual basis elte spedlc lllnes&-lor-duty (FFD) program performance data on drug and alcohol progrems from lc:ensees and other entities. Sand comments regarding burden estimate to the FOIA, Submlsskm Information Services Branch (T8-A111,1), U.S. Nuclear Regulatory Comnisslon. Wllshlngton Update DC 20555-0001 , or by e-mail to ~ c b BnowOOCNRC 91))1 and to the Desk Officer, Otllce of Information and Regulatory Allans, NEOB-1020, (3150--0148), Otllce of Uni ue Reference ID Licensee S lied Management and Budget, Woshlngton DC 20503. II a moans used to Impose Information RBS-2021-013 collec1lon does not display a currentiy vald 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the lnfommtlon collection Facility

!River Bend [5~] Date of Collect/on 1 I (mm/dd/yyyy) 10/26/2021 Reason for Testing

  • 26.717(b)(5) Pre-Access Testing Reason (optionaQ Please elaborate (opUonaQ I Pre-Access J1nltial Authorization Employment Type - 26 717(b)(3) Outage Worker (optional)?

JLicensee Employee JNo Labor Category - 26 717(b)(3)

Jsecurtty Is this a 24-hour reportable event under 28.719(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 J0rugOnly Junne I Test Validity Jvalid Waa this collect/on observed?

  • 26.717(b)(7) & 26.75 ~

How many substances were confirmed positive for this individual? LI_ _ _ _ __ ,

UseNRC Initial Confirmatory Limit of Substance - 26.717(b)(2) & (b)(6)

Cutoffs? Cutoff Cutoff Detection JMarijuana Subversion Attempt* Did this collection involve a subversion attempt?* 26 717(b)(7) and 26.75(b)IL _ _ _ Y_es_ _-"

D Did not appear for tasting D Specimen charaderistics (e.g.. color, odor, precipitant) Please elaborate on the choleAls\ seleded:

D Shy-bladder (no medical condition) D Invalid test result (initial specimen collected) - 26.185(1) lncivldual was sSow In coning out of the coHection room with bal8ly enough specimen It> fiH the 30 mi"s The te"1)8rature D Refused lo provide initial specimen D Refused to follow directions was lnlllally 100 and turned It> 99 degrees as II was being checked . The second test under direct observation was 95 D Refused to provide second specimen D Donor admitted to subversion attempt degrees with close lo 150 mi's of spedman 181 Specimen temperature (out of range) Other D Specimen paraphernalia Identified Management Actions - 26 717(b)(8) & 26.75 Reason for the Action Jsubverslon attempt Sanction Applied (NRC Minimum or Licensee Administrated)

JNRC Minimum Specific Sanction Applied

!Permanent Denial Person(s) Responsible for Information Provided Person 1 (required):

mdelgna@anlergy.com

!Matthew ll~nan 11 Supervisor AA/FFD First Name Last Name Position Trtle Company Email Address Parson 2 (optionaQ

!Kelly IINo- I Jsr. Security Coordinator I knotand@enlargy.com First Name LsstNeme PoslilonTIUe Company Email Address Rna/ Step (Required)

  • NRC v.iH consider 1h11 form authentic In accordanoe with 10CFR 26.11 only when Iha 'Valdota & Lock" bution Is clckad and all errors (hlghigh1ad In red) have bean correctad The 'Valdate & Lock' button v,;11 change lo "Locked" after the data vaidation process has been auccenlu!ly complelad Indicating the form Is ready fo, subnisslon, Form Locked On:IFeb 7, 2022 at 12:58 41 PM J Save to Local PC J J Print this Report I Single Positive Test Form (version 1.9.0-January 2020) NRC Form 890

~), U.S.N--~ir.~ RC *~ FFD Program Performance Data Report ,ng System

'-.: **-~---*~- _

_..........,~l.-_,. NRC Form 890 Single Posit ve Test Form I " " """1"'1 .. .,, ..

l'rrPh'r lwr: } 1('r,plf' mu/ tlt1* I 1t1 lfll flll/ :'III It- I- .:.( '," ,' 1 s~l ). I',* r,

  • P:-i *,*
1) All ffelds required uc-,,t rhose mried 'opllonal' APPROVED BY 0MB: CLEARANCE NO.31-141 EXPIRES: 04/30/2021
2) Entries In some ffe/m auto-populate Information In other Raids Estimated btmltn per response to comply IMth this collacllon requell Is 30 ITinutes. Tlis 3} Mouse over furm fields to view additional Information lonn Is a voluntary moans ol n,po111ng tho lnlonnotlon reqlirod under 10 CFR 28.417(b)(2)
4) Use of Adobe Reader B or later Is requlr<<I and 28.717. Tllo lnfonnaUon Is reqlirod by NRC to oblaln on an annual basis site opedlc ltne5-lor-<futy (FFD) program perlonnance data on drug and elcoliol programs Imm lcensew aim other entfttes Sand corrmants reganlng burden estimate to the FotA.

Subml,slon Delete lnlormatloo Sarvk:es Bn,nch (lll,A111M), US. Nudeor Regulatory Cormisslon, Weshlngton Update Submission DC 205SS-0001, or bye-mall to lnfomHects RMOurcalf)NRC goy, and to the Desk Officer, Ofllce of lnlormetlon end Regulatory Affainl, NEOB-1020, (3150--0141!), 0fflca ol Uni uo Reference ID Licensee S ied Maneoement and Budge~ Washington DC 20503. If a maans used to Impose lnfonnaUon RBS-2021-014 c:ollec:1lon does not display a currenttv veld 0MB contmt number, the NRC may not conduct or sponsor, end a pelSOn Is not requlntd to respond to, the lnfonnatlon col1ection I

Facility River Bend (50-458) Date of Collect/on (mm/dd/yyyy)

I 091011202 1 I

Reason for Tasting - 28 717(b)(5) Pn>-Access Testing Reason (optlonaQ Please elaborate (optionaQ I Pra-Access !Initial Authorization Employment Type - 26 717(b)(3) Outage Worker (optional)?

JcontractorNendor jNo Labor Cafegory - 28 717(b)(3)

JMaimenanca (general facility)

Is this a 24-hour reportable event under 26. 719(b)? ~

Was this col/action refused?- 28 717(b)(7) & 26 75 ~

Test Resulta - 26.717(b)(4)

Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Specimen Testad

!Drug Only Jurtne I Was this col/action obaerved? - 26.717(b)(7) & 26.75 ~

How many substances were confirmed positive for this Individual? I~------'

UH NRC Initial Confimlatory Umtt of Substance - 26 717(b)(2) & (b)(6)

Cutoffs? Cutoff Cutoff Datadlon

)Marijuana GiJ Subversion Attempt- Did this collection involve a subversion attempt? - 26 717(b)(7) and 28.75(b) LI_ _ _ N_o_ _..,

Management Actions - 26.717(b)(8) & 26. 75 Reason for the Action JFirst drug or alcohol positive Sanction Applied (NRC Minimum or Ucensee Adminls1rated) jucensaa Administrated Specific Sanction Applied I 3-Year Denial Porson(s) Responsible for lnformll1ion Provided Parson 1 (requlll!d):

!Matthew FlrstNeme ll~nan

- - - - , Last - =Name=-----'

1 SUpelVisor AA/FFD Posmon Titie mdalgne@entorgy.com Company Email Address Person 2 (optlonaQ IK*~ First Name 11- - - - - ,Last - -Name IIS,, Secu,tty Coortlinotor I lolol*ndGentargy.com

~ - - - - ~ ~---Pro-s~ld~o-n~'n~itl~e---~ ----.,.c'=om=pa:::n=y"E"'m"'a"'ll"'A.-:ar.ar::ra"'sc:c,----

Rn.i Step (Requlf8d) - NRC win consider this fonn authentic In acoordonce with 10 CFR 28.11 only when the 'Valdate & Lock" button 11 cicked and au errors (hlghlghtod In red) have been corrected TIit 'Valdete & Lock" button will changa to "Locked" after the date veldetlon process has boon succesaMly COIT1)1atod Indicating tha ronn Is roody fo, subnioalon Form Locked On:IFab 7, 2022 at 1:15:56 PM J Save to Locel PC 11 Print this Report I Single Positive Test Form (version 1.9.0 - January 2020) NRC Form890

~,1u.s.NRC"lf*,~- FFD Program Performance Data Report ,ng System NRC 890 S ng le Tes t

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1 - 1 , 1.. .,,,_., ,r ~QfJI.._ Form P os 1uve Form 1r r: ,_jj'~, .1 Sllf , S ,in\ I r, T

  • 1)AJ1ne1r1s ,,_d ucopl "' osa ,,,.,,,.,, op uon el' APPROVED BY 0MB: CLEARANCE NO. 3150-41>18 EXPIRES: 0Q/30/2024
2) Entries In some fftlcls au,o.populate Information In ofhw netds Eotimatod bunlon per -
  • to comply wtth this oolledlon request Is 30 minutes. This fonn
3) Mouse over form flllrb ro vfew additional lnlo#TFJatlon Iii a vDlurtary means of reporttrcJ the lnformaUon required order 10 CFR 26.417(bX21 and
4) Use of Adobe Ruder I or lat.,. ls raqulred 26.717 The Information II required by NRC to attain on an aMual basll site apecfflc fitness-for-duty (FFD) program pet'fonnance data on drlJ!i1 and alcohol programs from licensees and D Submission Update ~~::i..I0n other entities. Sand comments regardlrg burden estimate to the FOIA. Library, and Information Collodiono Branch (T-6 A10MI. U 5 NtJcleaf Regulatory Convnlsolon, Wnhl'9on, DC 205!55-0001 or by e_mal to lnfocojledl BnourccQNBC goy and the 0MB reviewer at 0MB Office of lnformallon and Regulatory Aflan. (3150-01481, Ann Desk Officer for the Nudear Unlaue Raference ID (licensee SuDDliedl Regulatory Commission 725 17th Street NW, Washington, DC 20503, e-mail IRBS-2021-015 DiCil IUbDlHi~b: ~ gm!: The NRC may not oonduc:t or aponsor, and a person rs nOI I required to respond to, a collection of Information unless the document requesting or requ!rtng the coHedion displays a currently valid 0MB control number Facility

!River Bend (50-458]

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

I 11111/2021 I

Reeson for Te,rting - 26.717(b)(5) Pre-Access Testing Reason (oplionaQ Please elaborate (opUonaQ I Pre-Access I jInitial Authorization I Emp/oymont Type - 26.717(b)(3) Outage Worl<er (optional}?

lcontractorNendor I !No I I I Labor Carer,ory - 26.717(b)(3)

!Maintenance (general lacHity)

I ts this a 24-hour reportable event under 26.719(b}? ~

Was this collect/on refused? - 26.717(b)(7) & 26.75 ~

Test Resu/U - 26.717(b)(4)

Test Type(s) for Resull(s) Reported- 26.717(b)(2) Drug Specimen Tested j0tugOnly I !Urine I Test Validity jvand I

Was this collect/on obaerved? - 26.717(b)(7) & 26.75 ~

How many substances wera confinned positive for this Individual? I 1 I

Uso NRC Initial Confirmatory Umltof Substance - 26.717(b)(2) & (b)(6)

Cutoffs? Cutoff Cutoff Detection IMarijuana I I~

Subversion Attempt - Did this collection involve a subversion attempt?-26,717(b)(7) and 26.75(b) I No I

Management Act/ans - 26.717(b)(8) & 26,75 Reason for the Action I First drug or alcohol positive I

Sanction Applied CNRC Minimum or Licensee Administrated)

!Licensee Administrated I Specific Sanction Applied I3-Year Denial I

Person(s} Responsible for Informal/on Provided Pel90n 1 (required):

!Matthew ll~an Ilsuporvll0< M/FFD I mdelgna@ente,vy cam First Name Last Name Posillon Title Company Email Address Pel90n 2 {optionaQ IKeMy II-nd 116r. Security COo!dlnelor I knoland@enl8r;y.com First Name Last Name Position 'nile Company Email Address Rna/ Step (Required) - NRC will conlidor 1h11 Conn authentic In accordance with 10 CFR 2!1.11 only when the 'Valdllle & Lock" button Is clcked and on lfTOIO (hlghlghtod In red) hove been corrected. Toa 'Valdate & Lock" button will change to "Locked" after the data valdat!on plOCNI has been successfully completed lndlcaUrQ the Conn Is reedy (0< subnisslon

- Fann Locked On:!Feb 7, 2022 at 1:17:40 PM I I Save to Local PC 11 Print this Report I

Single Positive Test Fann (version 1.10,0-0ctober 2021) NRC Fenn 890

r-i) US NRC -\

, . ~ , , .,. , ... : .._,, ; . . .... _ . , _

FFD Program Performance Data Reporting System NRC Form 890 Single Pos1t1ve Test Form 1

= l;;;;t/- ~t. 1r,;,,, 11<::: ut**, *,r,=11 ,)or, 1} All fields required uc-,,t lhos* marl<ed 'optional' APPROVED BY OMe: CLEARANCE NO, 3150-0140 EXPIRES: 09/30/2024

2) Entries In some fields aUIO-fJopulate Information In other fields Estimated bu'den per response to comply wtth this collection request Is 30 minutes This form
3) Mouse over fonn flelm to view additional lnfonnatlon Is a volurtary means of reporting the infonnation required under 10 CFR 26,417(b)(2) and
4) Use of Adobe Ruder 8 or later Is required 26.717 The Information Is required by NRC to obtain on an annual basis ske specific fltne1&-

for-duty (FFO) prcgram performance data on drug and akx>hol programs from licensees and other entitles Send comments regarding burden estimate to the FOIA, Library, and Information Submission Collections Branch (T-6 A10M), US Nuclear Regulatory Convnlsslon, Wnhlngton, DC Update 20555-0001, or by e_maH to JnfocoUeds RCl9Ya;;oQNRC qoy and the 0MB reviewer at: 0MB Office of Information and Regulatofy Affairs, (3150-0146), Attn: Desk Officer for the Nuclear Uni ue Roference ID Licensee S lied RegulalDfY Commission, 725 17th Street MN, Washington, DC 20503; e-maH RBS-2021-016 Pica submruiooQomb cPP qgy The NRC may not conduct or sponsor, and a person Js not required lo respond to, a colledlon of intormatlon unless the document requesting or requiring the collection displays a currently valld 0MB control number Facility

!River Berni [50-458) Date of Collect/on (mm/dd/yyyy)

I 12/0712021 I Reason for Testing

  • 26.717(b)(5) Pre-Access Testing Reason (optionaQ Please elaborate (optlonaQ I Pre-Access IInitial Authorization Employment Type - 26.717(b)(3) Outage Worker (optional)?

IContractorNendor INo Labor Category

  • 26. 717(b)(3)

!Maintenance (general facility)

Is this a 24-hour reportable event under 26.719(b)? ~

Was this collection refused?

  • 26.717(b)(7) & 26.75 ~

Te6t Ra:,u/ts

  • 26.717(b)(4)

Test Type(s) for Result(s) Reported - 26. 717(b)(2) Drug Specimen Tested jDrug Only !Urine I Test Validity lvaHd Was this collect/on observed?

  • 26.717(b)(7) & 28.75 ~

How many substances were confinned positive for this Individual? ~I-----~

Use NRC tnlllal Confirmatory Limit of Substance - 28.717(b)(2) & (b)(6)

Cutoffs? Cutoff Cutoff Detection

!Marijuana Subversion Attempt - Did this collectlon Involve a subversion attempt? - 26.717(b)(7) and 26.75(b) ~I__v_e_s_ _~

D Did not appear for tasting D Specimen characteristics (e.g., color, odor, precipilant) Please elaborate on the cholceCsl selected:

D Shy-bladder (no medical condition) D Invalid test result (Initial specimen collected). 28.185(Q Direct Observation was done due to Insufficient armunt and low tentl) on Initial colledlon, Direct Obse,vation was D Refused to provide Initial specimen D Refused to follow directions conducted and tested positive for Marijuana.

D Refused to provide second specimen D Donor admitted to subversion attempt 181 Specimen temperature (out of range) Other D Specimen paraphernalia Identified Management Actions

  • 26 717(b)(6) & 26.75 Reason for the Action I Subversion attempt Sanction Applied NRC Minimum or Licensee Administrated NRCMlnlmum Specific Sanction Applied I Pennanent Denial Parson(s) Responsible for Information Provided Pemon 1 (required)*

!Matthew 11 Supervisor AA/FFD rndaigna@onlelJIY.com lloaonan First Name Last Name Posl1lon TIile Company Email Address Pemon 2 (optionaQ, IKelly IIN~nd 11 Sr. Security Coortllnator I knoland@ente1J1Y.com First Name Last Name Poaldonnde Company Email Addreaa Final Step (R-,ulred}

  • NRC v.ill consider this fonn authentic In accordence with 10 CFR 26.11 only when the 'Vaidate & Lock" button 111 clcked and ell errors (hlghHghted In rad) have been corradad. The 'Valdate & Lock" button v.iN change to "Lod<ed" after the data veidatlon process has been successfully completed Indicating the fonn 111 ready for sublrisslon.

Fonn Locked On,!Feb 7, 2022 at 1*23:17 PM I Save to Local PC 11 Print this Report I Single Positive Test Fonn (version 1.10 a - October 2021) NRC Fonn 890

rfl U.S.N..~

11. ,, ..1~,, * . , ..., .,K .,.,c1 ,,,.,

= FFD Program Pertormance Data Reporting System NRC Form 890 Si ngle Pos1t,ve Te st Fo *m

~ :w Ge t ,11 SL:,:*, ss10P f'*i,, 11

1) All fie/els requlrod except those marl<ed 'opUonal' APPROVED BY 0MB: CLEARANCE NO. 3150-41.e EXPIRES: 00/30/2024
2) Entries In some ffelds auto-populate Information In other no1c1s Estimated bu-den per rHpOnse to comply With this collection request Is 30 minutes This fonn
3) Mouse over form fields to view add/Ilona/ Information Is a voluntary means of reporting the Information required under 10 CFR 26 417(b)(2) and
4) Use of Adobe Reader 8 or latt1r Is required 26.717 The Information Is required by NRC to obtain on an annual basts site specmc fitnew-for-duty (FFD) program performance data on drug and alcohol programs from licensees and other entitles. Send comments regarding burden estimate to the FOIA, Library, and Information Submission Delete C<>llediono Br.Inch (T,6 A10M). US Nuclear Rogulato,y Commission. Washington, OC Update Submission 20555-0001 , or by e_maff to ln.fQc:okdf Rnow;eQ;NRC gm,.. and the 0MB reviewer at OMS Office of Information and RegUiatory Atfalru, (3150-0146), Attn_ Desk Officer for the Nudear Uni ue Reference ID Licensee Su lied Regulatory Commission, 725 17th Street tm, Washington, DC 20503 e-ma*L RBS-2021-017 Pica &YOOH5skm0omb egq gay The NRC may not conduct or sponsor, and a peBOn is not required to respond to, a collection of klfonnatlon unless the document requestlng or requiring the collection displays a currently valkf 0MB control number Faclllty

!River Bend [50-458) Date of Collect/on 1 I (mm/dd/yyyy) 1211412021 Reason for Testing - 28 717(b)(5) Pre-Access Testing Reason (optionaQ Please elaborate (optional)

!Pre-Access Jlnltiel Authortzation Employment Type - 28.717(b)(3) Outage Worker (optional)?

IContractorNendor INo Labor Category - 26 717(b)(3)

!Maintenance (general facility)

Is this a 24-hour reportable event under 26.719/b)? ~

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

Test RMults - 26.717(b)(4)

Test Type(s) for Resutt(s) Reported - 26.717(b)(2) Drug Specimen Tested JDrug Only jurtne I Test VaHdity lvafid Was this collect/on observed? - 26.717(b)(7) & 26 75 ~

How many substances were confinned positive for this lndlvlduel? LI-----~

Substance - 26.717(b)(2) & (b)(6) UseNRC Initial Confirmatory Limit of Cutoffs? Cutoff Cutoff Detection JMarijuana

~

Subversion Attempt* Did this collection Involve e subversion attempt?- 26.717(b)(7) and 26.75(b) LI_ _ _ N_o_ _~

Man1111ament Actions - 26.717(b)(8) & 26 75 Reason for the Action I First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated Licensee Administrated Specific Sanction Applied I3-Year Denial Person(s) Responslble for Information Provided Person 1 (required):

!Matthew 11 Supervisor AA/FFD mdetgnll@enlergy.com ll~nan First Name ----,-===-----'Last Name Position Title Company Email Address Person 2 (optionaQ:

IKeHy 11Nm~ IIs,, Securtly Coordlnator I knoland@entergy.com First Name ----,-~=---------~Pro-,~,ti~o-n~T~IU~e-----'

Last Name ----~c_o_m_pa_n_y~Erm-a~ll~A~a~a~re-s_s_ _ __

Rnal Step (R-,ulred)

  • NRC will consider lhls fonn authentic In accordance with 10CFR 2t5.11 only when Iha "Vaktata & Lock" button la clcked and aH erro1B (hlghlghted In red) have been corrected. The "Veldate & Lock" button win change lo "Locked" after Iha dote valdetlon process has bean succassfuHy completed Indicating Iha fonn Is ready for subrrlsslon.

Fenn Locked On:!Feb 7, 2022 at 1'27:09 PM I Save to Local PC 11 Print this Report I Single Positive Test Fenn (version 1.10 0-October 2021) NRC Fenn 890

'?"~ 1 U.S.NR -~,-- C - FFD Program Performance Data R e p or ti ng System I an....,"'t&i*'l'.t. ,rlt.,_t,lftf;...._...

NRC Fo r m 890. Sing le P os1tIve T es t Fo'm l'r111aum; l'1 *,,plt' ,m,J tll1' I ,,. 1rm1111.--111 , 1:l f: Ge~c>* 1 S 1: r* S', o fr1:, ,

fJ All llelds requlm ucepf those marltod 'opdona/' APPROVED BY 0MB: CLEARANCE NO. 3150-0148 EXPIRES: 08/30/2024 ZJ Entrla In some nelds uto,.,populat lnfonn tlon In other flelds Eatimal:ad burden per response to compty wtth this collection request ts 30 minutes This form

3) Mouse over fonn ffelds ro vt.w additional Information II a volurtary means of reporting the lnform&Uon requlred under 10 CFR 26.417(b)(2I and
4) Use of Adobe RNder 8 or l ttr ls required 26 717 The Information II required by NRC to obtain on an annual basil llte apedfic fitness-tor-duty (FFO) program performance data on drug and alcohol prograrre from flcensees and D Submission Update D ~~:~ssion othef entiUes Send comments regard!~ burden esUmate to the FOIA. Library, and Information Collections 8'>nch (T-6 A10M), US Nuclear Regulatory Comml9olon Wnh!ngton, DC 20555-0001 or by e_maH to lnfocoflftdl BMOllfPIGNBC DOV ard the 0MB reviewer at 0MB Office of lnfannation and Regulatory Affairs, (31~148), Attn Desk Officer for the Nudear Unlaue Reference ID IUcensee Suooliedl Regulatory Commission, 725 17th Streat NW, Washington, DC 20503, e-mail IRBS-2021-018 AP :,;,ibC!YHtoOOnmb ~ The NRC may not conduct or apoll!IOf, and a person Is not I required to respond to, a cdlectlon or Information unlesa the document requesting or requiring the collection d)splays a currently vaHd 0MB control number Facll/ty

!River Bend (50-458]

I Date of Collect/on (mmldd/yyyy)

I 121141202 1 I

Reason for Testing - 26.717(b}(5) Pre-Access Testing Reason (optionaij Please elaborate (opOonaQ I Pre-Access II Initial AU1hO<ization I

Employment Type - 26.717(b)(3) Outage Worl<er (optlonal)7

!conb"adorNendor I IND I

I I Labor Category - 26.717(b)(3) j Maintenance (ganeral facility)

I Is this a 24-hour reportable event under 26,719(b)7 ~

Was this collect/on refused? - 28.717(b)(7) & 26.75 ~

Test Resulu - 28.717(b)(4)

Test Type(s) for ResuH(s) Reported - 26.717(b}(2) Drug Specimen Tested lerugOnly I Junne I

Test Validity jvand I

Was this collect/on observed? - 28.717(b)(7) & 28.75 ~

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

UseNRC Initial Confirmatory limit of Substance - 28.717(b)(2) & (b)(B) Cutoff Cutoff Detection Cutoffs?

!Marijuana I I~

Subversion Attempt - Dtd this collection Involve a subversion attempt? - 26.717(b)(7) and 26.75(b) I No I

Man1111ement Actions - 28 717(b)(8) & 28 75 Reason for the Action IFirst drug or alcohol positive I

Sanction Applied (NRC Minimum or Licensee Administrated)

IUcensae Admlnlstrated I Specific Sanction Applied I3-Year Denial I

Person(s) Responsible for Information Provided Person 1 (required):

I- ll~*n IISUpoMsor MIFFD I IT'detgnamentervt,oom First Name Last Name Position Tolle Company Email Address Person 2 (optlonaQ.

IK*lly I!Noland Ilsr. Secu~ty coordlnat01 I kn0land@enterv1.com First Name Last Name Position flue Company Email Addres Fina/ Stop (Required) - NRC wllt oom11dor thla fonn authentic In accordance with 10 CFR 26.11 only when the 'VaBdete & Loci<" button lo cltked end all em** (hlgh8ghled In red) have been conected. The 'Valdato & Lock" button wtn change to 'Locked" after Iha data valdatlon pmc:eu has been ouccesaMly completed lndlcaUng the fonn Is ready lor subrrisslon.

- Form Locked On jFeb 7, 2022 at 1;30:44 PM I I Save to Local PC 11 Print this Report I Single Positive Test Fonn (version 1.10.0-0ctober 2021) NRC Form 890

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