ML22158A133

From kanterella
Jump to navigation Jump to search
Fer 2020 Ile Final Es 201-3
ML22158A133
Person / Time
Site: Fermi DTE Energy icon.png
Issue date: 02/05/2021
From: Randy Baker
NRC/RGN-III/DRS/OLB
To:
DTE Energy
Baker R
Shared Package
ML19128A199 List:
References
Download: ML22158A133 (3)


Text

),::r:U 1-ozo l~~

)

)

ES-201 Examination Security Agreement Form ES-201-3

1.

Pre-Examination I acknowledge that I hre required specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of

\\ --Z- -7 t..-Q as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC's chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination m

To the best of my knowledg, I id not divulge to any unauthorized persons any information concerning the NRC licensing examinations_ administered r-0 during the week(s) of 1,.,-

1 1.,,-0. From the date that I entered into this security agreement until the completion of examination administration, I did

~ not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically

--u noted below and authorized by the NRC.

Ol (0

CD PRINTED NAME 0J E ~: ~ cf Jt;J)

--'- 3. v f;'b N W6 0Jt 1<

4. /YI!'!( e. QoMr,. lA/11.
5. bAlli'?) bvN ~
6. [),-,.,,..., Tc. ' f-r....,,
7. 1-<£,.J r;,._,,::;:, __,
8. 11A <<4... t..-_~
9. T~ GroW? \\

1 o. p. 0 t..e,,,,,,.. b Ci..(~.,e, u..J 11.,ii~ s s:J-k 12.?~ ~

13. ---

~

14.1 1-,~

9....~ I

15.

. lJ n J JOB TITLE/RESPONSIBILITY

~gr

~

fAtic.,11)'.

-:Si~

J

/

'R,(..

NU L rJ =

?tlo

~

Sf__..eJ

~

-<L-V

~

l. ;11; 0

~tJu NOTES:

1. c; 1srie~

o-(.l'.;

v1*Q vet<ID1<'.\\I +e. te co I\\

SIGNATURE (1)

'~

ES-201, Page 31 of 32 DATE SIGNATURE (2)

~

~

l

~

v-f. fvvv'<iVI

/ S /

,, 1 oilgp, JJ!*;1/4.Not IS /

IIziw*. ~--

,a.:, D, Ovnc Ao /s/

e/1 z/?(/?~ B. T-e.1-1 v,. J 5* I 8/17/2.-.2,,, K-£1'*-~~n t;; I /

~

o

c.
c. - \\I' Js

/'

J l:z5 J *Crr-o-l fi-"J.'f-tt*

r<. c~ ~e::

s 1 fh-/-)(f

/V, *(

I~

(i*--ztt -z,;,) e. i-lst v ~

t,o\\.-

.. 1 t::X\\~1z...

J. iv~ 1 ~s l fi/2-S )U>

s ~=

.jt; I 9 L 0tt bo R. wA~'h'.),~ l DATE NOTE 1/4s-/z1 -

i.h..J.11 _I_

1.il5Ui __L_

~

_J_

Jn[11 _ 1_

i1.i£JJJ_j_

wl/1J _l_

ilisf1L __L_

ili£.1ll. _ I _

thsJ..lL __L_

~. _L__

J.l15l,4 j_

ti1shl-l--

i.Ll.rli.t _j_

)

IL T 2020 ONLINE VALIDATION

)

(

. 11

r:;cr V> ZD \\J1i' 2--)

)

ES-201 Examination Security Agreement Form ES-2O1-3

1.

Pre-Examination

<r-ive ac uired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for

....,..~~__,_1_1---+-~"-"" as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons w have not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the N RC's chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination m

To the best of my knowle~C' l did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of

\\

1 2-0

. From the date that I entered into this security agreement until the completion of examination administration, I did

~ not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically

"'O noted below and authorized by the NRC.

!l) co

{l) w PRINTED NAME JOB TITLE/RESPONSIBILITY

~ 1. Ethan W, Hauser

...::Sc.:..R_,_,O:c--.,;::;S-'-T.:....;A'-------

2.M'idrv"""' '"~b
,.,ich '51/2r::~':"°v:

->- 3. t\\,111\\M,,..,., l\\,NI\\ (

__.~~Llllb.LJ. i::~='--=~~---

4.e~ot, 13. n;Her

,50-° -,:S T d

5.

/VI

/

_ t.......:;N,:....::::.C> ______

6.

~

~iN~fo~~U)........__. ____

7,....,...;;~~*--H~'LJ,-

-?t,,:,.'"=~ =0--..-,---=-----

8.~'.IJq..-'l,Cl...u:.:.£~f--J,

<:.,u;>.- 5T/t ft L ~

9......ll_~LU.,;1.--f!-~~=

-K14'~=AA=-i" 1=a...ce=-=-----

10.~!..l..,,{,.1L,4.:,l:.......,_,jµ...:J~

___,S:

="tfl""--"-

(J ______

11.___,_.,~-=--"--"'-"--

6,,fl t "',+i *,\\

12. _____
13. _____
14. _____
15. _____

NOTES:

SIGNATURE (1)

~

ES-201, Page 31 of 32 DATE SIGNATURE (2) s-1 3-20 E ltl\\v':iN J ~}

=

t\\

  • 1-b m~\\~_vc\\-1 / j HJ-J,l>

~: ri~1te 11,

/$1 l! \\~.I.

l.J I I LJJiLi1 DATE NOTE

/ n I *2; I

-~ -,

2

_J_

_L_

u.nLu. _J_

'~--

W-lL-/)l _L_

J.zJlL ~'~

~

_L__

( __

)

IL T 2020 ONLINE VALIDATION ES-201

)

Exa;?.:Z~3;:?~ @JJ

)

Form ES-201-3

1.

Pre-Exam ination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of TBD as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the N RC's chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination m To the best of my k nowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of 12 / 7 } 20

. From the date that I entered into this security agreement until the completion of examination administration, I did

~ not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically

--u noted below and authorized by the NRC.

!l) co (D

w PRINTED NAME

~ 1.Thomas A. Kicinski

2. _

_._ 3. ______

4. ___ ___
5. ______ _
6. ______
7. _ _____
8. ______
9. ______
10. ___ ___
11. ______ _
12. ____ __
13. ______
14. ____ __
15. ______ _

NOTES:

JOB TITLE/RESPONSIBILITY LNO SIGNATURE (1) 7b-Jna4-A. ~~-

ES-201, Page 31 of 32 DATE SIGNATURE (2) 5-13-20 r.K1c1nsK: )1 /

DATE NOTE 1h.illl I