ML23011A251

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Form 1.3-1
ML23011A251
Person / Time
Site: Monticello Xcel Energy icon.png
Issue date: 11/10/2022
From:
Nuclear Management Co, Xcel Energy
To:
NRC/RGN-III/DORS/OB
Iskierka-Boggs T
Shared Package
ML21188A293 List:
References
Download: ML23011A251 (1)
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Text

QF-1071-01 , Rev. 2 (FP-T-SAT-71 Paqe 1 of 2 (l Xcel Energy* MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge that I have acquired specialized knowledge about the MNGP ILT NRC examination(s) scheduled for the date(s) of 10/17/22 -

10/28/22 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 an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration . I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the examinations administered during the date(s) of _ _ _ _ _ _ _ _ _ . 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 individuals who were administered these examinations.

PRINTED NAME JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

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Retention : Life of Plant Retain in : Exam File

F-1071-01, Rev. 2 (FP-T-SAT-71 Paqe 1 of 2 Xcel Energy* MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge that I have acquired specialized knowledge about the MNGP ILT NRC examination(s) scheduled for the date(s) of 10/17/22 -

10/28/22 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 an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me . I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the examinations administered during the date(s) of _ _ _ _ _ _ _ _ _ . 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 individuals who were administered these examinations.

PRINTED NAME JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

1. -~AN' Dae/<;/" AIA'C f:datr:J. J)(/£~/  ;,.z/7/21 /~'f~z
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QF-1071-01, Rev. 2 (FP-T-SAT-71 Paqe 2 of 2 (l Xcel Energy* MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

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Retention: Life of Plant Retain in : Exam File

QF-1071-01, Rev. 2 (FP-T-SAT-71 Paqe 2 of 2 Xcel Energy- MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

PRINTED NAME JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 8.

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Retention: Life of Plant Retain in : Exam File

QF-1071-02, Rev. 2 (FP-T-SAT-71) Page 1 of 2 I~ Xcel Energy- I LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge that I have acquired specialized knowledge about the 2022 MONTICELLO ILT NRC examination scheduled for the date(s) of 10/17/22 - 10/28/22 as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor. . I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration . I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of _ _ _ _ _ _ _ _ _ . From the date that I entered into this security agreement until the completion of this examination administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated w ith the contents of this examination with ANY examinee until the completion of their examination administration . I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.

PRINTED NAME JOB TITLE/ RESPONSIBILITY ~ SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

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Retention : Life of plant /Vt1.J~.J; /V't> /tJN¥'r W I -fl, Cd~~~/

Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .

QF-1071-02, Rev. 2 (FP-T-SAT-71) Page 2 of 2 I fl Xcel Energy- j LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

PRINTED NAME JOB TITLE/ RESPONSIBILITY DATE SI RE (2) DATE NOTE

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NOTES:

Retention : Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .

QF-1071-02, Rev. 2 (FP-T-SAT-71) Page 1 of 2 I 'll Xcel Energy- I LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge that I have acquired specialized knowledge about the 2022 MONTICELLO IL T NRC examination scheduled for the date(s) of 10/17/22 - 10/28/22 as of the date of my signature . I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor. . I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration . I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration . Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee . Furthermore , I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised .

2. Post-Examination To the best of my knowledge , I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of _ _ _ _ _ _ _ _ _ . From the date that I entered into this security agreement until the completion of this examination administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore , I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.

PRINTED NAME JOB TITLE/ RESPONSIBILITY DATE SIGNATWRE f2) _ DATE NOTE

1. ~,a.d ~o;~ :Ro P-13~ I.J-5-.;J.;l - -
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Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071-02 , Rev. 2 (FP-T-SAT-71) Page 2 of 2 I~ Xcel Energy- I LI MITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Conta inment.

PRINTED NAME JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

5. J ~Scr,J 1-fEfl.JI SQ.f E:,c4r.1 T£4Ni (!A/Srf<,~ f"c,1() Jot,5/2-z I , /0127/Zt..,
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NOTES :

Retention : Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .

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