NL-15-022, Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report

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Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report
ML15062A034
Person / Time
Site: Indian Point  Entergy icon.png
Issue date: 02/26/2015
From: Coyle L
Entergy Nuclear Northeast
To:
Document Control Desk, Office of Nuclear Reactor Regulation, Office of Nuclear Security and Incident Response
References
NL-15-022
Download: ML15062A034 (17)
v • d • e


Text

Enter-gv Nuclear Northeast Indian Point Energy Center mEntergy 450 Broadway, GSB3 P.O. Box 249 Buchanan, NY 10511-0249 Tel 914 254 6700 Lawrence Coyle Site Vice President NL-15-022 February 26, 2015 U.S. Nuclear Regulatory Commission Document Control Desk 11545 Rockville Pike, TWFN-2 F1 Rockville, MD 20852-2738

Subject:

2014 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report Indian Point Energy Center Docket Nos. 50-247, 50-286 License Nos. DPR-26, DPR-64

Dear Sir or Madam:

This letter transmits Indian Point Energy Center (IPEC) Fitness for Duty (FFD) Program Performance data for the period January 1, 2014 through December 31, 2014 in accordance with the requirements of 10 CFR 26.717(e). Included is also the Fatigue Management Program data in accordance with 10 CFR 26.203(e).

There are no new commitments contained in this letter. If you have any questions or require additional information, please contact Mr. Robert Walpole, Regulatory Assurance Manager at (914) 254-6710.

Sincerely, LC/rl

Enclosure:

1. 2014 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report Ac4I

NL-15-022 Docket Nos. 50-247, 50-286 Page 2 of 2 cc: Mr. Daniel H. Dorman, Regional Administrator, NRC Region 1 Mr. Douglas Pickett, Senior Project Manager, NRC NRR DORL IPEC NRC Resident Inspectors Office Mrs. Bridget Frymire, New York State Department of Public Service Mr. John B. Rhodes, President and CEO, NYSERDA Mr. Paul Harris, NRC NSIR DSP SPSB

ENCLOSURE 1 TO NL-15-022 2014 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report ENTERGY NUCLEAR OPERATIONS, INC.

INDIAN POINT NUCLEAR GENERATING UNIT NOS. 2 and 3 DOCKET NOS. 50-247 and 50-286

Louie, Richard From: mshd.resource@nrc.gov Sent: Friday, February 27, 2015 7:59 AM To: Louie, Richard

Subject:

General Form Submission Received The NRC received your General Form submission on: 02/27/2015 at 07:59 AM. It is being tracked as submission ID#

4492.

If it is a 'Publicly Available' submission after 6 work days from today the submission's attached document(s) will be available for viewing and download from the Agency's Public Web Based ADAMS website (http://www.adams.nrc.gov/wba) by searching for the following document accession number(s): [ML15058A054 ML15058A055 , ML15058A056 , ML15058A057 , ML15058A058 , ML15058A059 , ML15058A060

, ML15058A061 , ML15058A062 , ML15058A063 , ML15058A064 , ML15058A065]. If this is a 'Non-Public submission the submission's attachment(s) will be retained in NRC's document management system (ADAMS) and will not be published to the public website.

Should you have questions about this submission please contact our Help Desk by phone at 866-672-7640 or by e-mail at mshd.resource@nrc.pgov. When doing so, please refer to the Submission ID#shown above.

Note: The Help Desk is staffed daily from 9:00AM to 7:00PM Eastern Time Monday through Friday (except for Federal holidays)

I

Estmated burden per response to comply withthis collection request is 114 hours0.00132 days <br />0.0317 hours <br />1.884921e-4 weeks <br />4.3377e-5 months <br />. This formis a voluntary means of reporting the information required under 10 CFR 26.717. The information is required byNRC to obtain on an annual basis site specific fitness-for-duty (FFD) program performance data on drug and alcohol programs from licensees and other entifies. Send comments regarding burden estimateto the FOIA,Pdvacy and Information Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to lrfocolects ResourcaRCngo, and to theDesk Officer,Officeof Information and Regulatory Affairs,NEOB-1020, (3150-0146), Officeof Management and Budget, Washington DC20503. Ifa means used to impose information collection doesnotdisplaya currently validOMBcontrol number, tre NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

1) All NOels nequlrd wfunl marted otioomer
2) Use oftAdoibe Reader 8 or lo1w isra iuquire r Submission Update
3) Mouse over flekil far additioae~l inftaenali a.

Select Facility Periodof Rert findian Point [50w247; 50-286] ] 20 4 Tests Conducted in the CalendarYear Reason For Testing Licensee Employees Prel-.Accese 1]22 i949 Random 609 197]

For Cause 2 1_

Post-Event 0 Followup 141 Total (Calculated) 87[4]

FFD ProgramRandom Testing Populationand Rate Average number of Average number of Total size of the random testing pool Annual random testing percentage licensee employees contractors/vendors throughout the period (Calculated) achieved for the testing pool 1zI0-1 1 ~ 4765 S1,5011 S53J.6 Laboratory Testing Does your program use a Licensee Testing Facility? No (Yes / No)

Identify your HHS-Certified Laboratory(ies) QUEST DIAGNOSTIC LABORATORIES Identify your Blind Performance Test Sample supplier(s) IELSOHLY LABORATORIES, INCORPORATED Substances Tested Did your program only test for NRC-required substances [es Does your program conduct LOD testing [

AND at the NRC-specified minimum cutoff levels? (Yes / No) permitted in 26.163(a)(2)? (Yes / No)

SpecialAnalyses Testing Results Total Number of "D'ilute" Total Number of "Ditute" Specimens Specimen Test Result 17 (Special Analyses Testing Conducted) 1 (Optional)

Substance Use Only NRC Cutoff Initial Confirmatory LOD Testing? Comment Levels? (Yes I No) Cutoff Cutoff (Yes / No) (Optional)

Alcohol Yes o b * ]

Cocaine ses Marijuana IYesII I Amphetamines Ye~s I ] Yes Opiates IYosI _ Ies PCPs __s Annual Report Form (version 1.6.0 - December 19, 2014) - Page 1 of 2 - NRC Form 891 (12/2014)

Substances Tested - continued Summary of ManagementActions - 26.717(b)(8)

Summarize actions implemented to improve FFD program performance. As applicable, reference in the topic description audit reports, 30-day reports, and/or corrective action reports. If reporting information on more than three topics, select "Others" for Topic 3 to report any additional topics.

Topic 1 Topic 1 Description Policies and Procedures In 2014 during an Access Authorization Fitness for Duty Snapshot assessment it was identified that during the heavy in-processing period for the 2014 outage the Fitness for Duty follow-up program did not meet the recommended testing schedule on more than one occasion. Program enhancements were made to correct the deficiencies identified during the assessment. Condition Report

  1. 1P3-2014-00965 was written to capture the deficiencies and corrective action taken to address the area for improvement.

Person(s)Responsible for InformationProvided Person 1 (required):

PTC1O ORDINATOR, ACCESSIFFD I KPETTUS@ENTERGY.COM IKELLY First Name Last Name Position Title Company Email Address Person 2 (optional):

WAYNE I IGRIFFIN RSOERSO ACCESS WGRIFF1@ENTERGY.COM First Name Last Name Position Title Company Email Address FinalStep (Required) - NRC will consider this form authentic in accordance with 26.11 only when the "Validate & Lock" button has been selected and all errors (i.e., those highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successfully completed and the form is ready for submission.

Form Locked On:IFeb 26, 2015 at 9:07:38 AM I ]

I Save to L.W PC j I Prim 0* Report Annual Report Form (version 1.6.0 - December 19, 2014) - Page 2 of 2 - NRC Form 891 (12/2014)

Annual Report Form (version 1.6.0 - December 19, 2014) - Page2of2- NRC Form 891 (12/2014)

Estimated burden per response to comply with is collection request is 30 minutes. This form is a voluntary mans of reporting he information required under 10 CFR 26.717. The

3) Movesomar lier,fields to viewalflddoe.,l Infilowwtaso information is required by NRC to obtain on an annual basis site apecitic fitonas-for-duty 4)lJUseo*(Ado"e ReaderI e, late I. required (FFD) program performance data on drug and alcohol programs from licensees and other Fj Sbis~ion LI eleio entities. Send comments regarltng burden estimate to the FOIA. Privacy and Information Collection Branch (T5-453), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001. or by e-mall to Intocolleoto ReucreQiNRC 00, and to the Desk Officer, Olfice of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Office of Management and Budget. Washington DC 20503. Ifa means used to impose informaton collecton does not display a currently valid OMB control number, the NRC may not conduct 121-PEC-001 or sponsor, and a person Is not required to respond to, the information collection.

Select Facility lindian Point [50-247; 50-286]

] Date of Collection (mm/dd/yyyy) 0/221 Reason for Testing - 26.717(b)(5) Pre-Access Testing Reasor I(optional) Please elaborate (optional)

IPre-Access I [Initial Authorization Employment Type - 28.717(b)(3) Outage Worker (optional)?

Coractndor nYes ] L J LaborCategory- 26.717(b)(3)

F aintenance (general facility)

Is this a 24-Hour Reporting Event (YesWNo)?-26.719(b) No Refusal - 26.717(b)(7) &26.75 Was this collection refused (Yes / No)? No Test Results - 26.717(b)(4)

Test Validity TValid Test Type(s) for Result(s) Reported - 26.717(bo)(2)

Drug Testing Drug Only IUrIne Was thl collection observed (Yes No)? - 26.717(b)(7) &26.75 Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Subatence (asapplicable)

[Marijuana I IPlease Select JPlease Select I Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)?

Menaeoment Actions - 26.717(b)(8) &26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Snecific Sanction Aoohed 3- Year Denial Person(*)Responsible for Information Provided Person 1 (requwedS):

KELLY ]I COORDINATOR, ACCESSIFFD jI KPETTUSGENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

WAYNE [GR NSUPERVSOR, ACCESS/FFD WGRIFF1@ENTERGY.COM First Name Last Name Position Title Company Email Address FinalStep (Requlre¢d- NRCWillconsider this formauthentic in accordance fth 26.11onlywhen the Validate &Lock"buttonis clickedand allerrors (highlighted in red) have been corrected. The Validate &Lock'button willchange to tLocked" after the data validationprocess has been successfully completed Indicatingthe formis ready forsubmissioni FormLocked On: Feb 24, 2015 at 1 PM i545 ýI"i -w ýP '

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

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In aaa..* E.Ida .abit.,e~puie kd~bnnegan e o.f ither linai Estimated burden per response to comply with this cullecion request is 30 minutes. This form is a voluntary means of reporting the information required under 10 CFR 26.717. The

3) Mat..ass . frelailia to vim. sladdtiosletfrallne.Uioe ieva,, information is required by NRC to obtain on an annual basis site specific fitness-for-deti
4) Omeof AdobeResadr8 wtltt, 1. reqd.d (FFD) program performance date on drug and alcohol programn from licensees and other entites. Send oumeinets regarding burden estimate to the FOIA. Privacy and Information E-'Submission Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission. Washington DC Update Li Delete Submission 20555-0001, or by e-mail to infocofacts Rjou,.drNRC , and to the Desk Officer, Unique Reference ID (Licensee Supplied) Office of Infornation and Regulatory Affairs, NEOB-1020, (3150-0146), Office ol Management and Budget, Washington DC 20503. If a means, used to impose information 12014-1PEC-002 cnllection does not display a currently valid OMB control number, the NRC may not conducl or sponsor, and a person is not required to respond to. the informeahoncollecion.

Select Faiclllty indian Point [50-247; 50-286] Date of Collection (mm/dd/yy) 02)12/214 Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (optional)

Pre-Access [Reinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3) Outage Worker (optional)?

eContractorenor Ye Labor Category- 26.717(b)(3)

Maintenance (general facility) is this a 24-HourReporting Event (Yea/No)? - 26.719(b) No Refusal- 26.717(b)(7) & 26,75 Was this collection refused (Yes / No)? No Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported - 26.717(b)(2) Alcohol Testing Alcohol Only I Breath Sub*tance - 26.717(b)(2) & (b)(6)

Alcohol What 26,103 BAC level was exceeded?

0.04 or greater Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (YestNo)?

Manaoement Actions - 26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 1- Year Denial Person(a) Responslble for Information Provided Person 1 (required):

PETiU ICOORDiNATOR, ACCESSJFFD I P UCNEG.O KETLUSY IKL KPETTUIS@ENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

IWANEI RFN FO WORIFPi@ENTEROY.COM First Name Last Name Position Title Company Email Address FinalStep (Requiredl. NRC will consider this form authentic in accordance with 26.11 onlywhen the 'Validate &Locki button is clicked and all errors (highlighted in red) have been corrected. The 'Validate &Lockn button will change to "Locked after the data validation process has been successinsy completed indicating the form in ready for submission.

Form Lock1edO Deeb24, 201t1 :26PMC For 890(1/214 Single Positive Tost Form (version 1.6.0 - December 19, 2014) NRC Form890 (12/2014)

v)iemws. ,.aquie zer, n" ome.morw...opoorwe Estinated burden per response to comply with this coilechon request is 30 minutes. The 2)Eintrin in soe. ffold. aetepeodliault IhirrewfEre,hi ew faied form is a voluntary means of reporting the informnion required under 10 CFR 26.717. The

3) Aloie.. everteen,, fieilds to viem.dtokiflcrfftlonowedon nformaeton is required by NRC to obtain on an annual basis site specdfc fitneosfor-dutl
4) UmiofAdabe Roew.5alwaht., i. ,quil'ed [FFD) program performance data on drug and alcohol program from ficensees and othe mnotles.Send comments regarding burden estimate to the FOIA, Privacy and Informatior Submission r7 Delete oillection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Weshington DC Update 11 Submission 20505-0001, or by e-mail to Intocallets Reaoeuro.NRC n, and to the Desk Officer Office of Informaeon and Regulatory Affairs, NEOB-1020. (3150-04M), Offe o Unique Reference ID (ucensee Supplied) Management and Budget, Washington DC 20503. If ameans used to impose information 12014-IPEC-003 collection don not display a currently valid OMB control number, the NRC may not conduc or sponsor, and a person is not required to respond to. the information coliection.

select Facility Indian Point [50-247; 50-286] Date of Collection F 1-(mm/dd/yyyy)

D-t- 02/1020147 Reason for Tasting - 26.717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (optional)

IPra-Acoess Initial Authorization Employment Type - 26.717(b)(3) Outage Worker (optional)?

Contractor/endor IY-e L Labor Category- 26.717(b)(3)

IFaintenance (general facility)

Is this a 24-Hour Reporting Event (Yes/No)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? F~o TesatResults - 26,717(b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only Urine Wea this collection observed (Yes/No)?- 26.717(b)(7) & 26.75 [i i Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) AdditionalSubstance (asapplicable)

IPlease Select

[Marijuana I IPlease Select Use NRC Cutoff (Yes I No)? e;Z]

Subversion Attempt. - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? No Management Actions - 26.717('b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Ucensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Person(s)Responsible for Information Provided Person I (required):

ICOORDINATOR, ACCESSIFFD KPETTUS@ENTERGY.COM KELLYPETTUS First Name Last Name Position Title Company Email Address Person 2 (optional):

IWAYNE IN SUPERSOR ACCESS/FFD WRIFFI@ENTERGY.COM First Name Last Name Position Title Company Email Address Final Step (Wequlreod. NRC will consider ths form authentic in accordence with 26.11 only when the Validate &Lock" button Is clicked and all errors (highllghted in red) have been corrected, The Validate &Lock button will change to "Lcked' after the data validation process has been successfully completed inmicating the form is ready for submisson.

Form Locked On: Feb 24, 2015 at 1:59:52 PM W Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

Estimated burden per response to comply with this collecton request is 30 minutes. Thii E,*ta55lS bel~oc suejeeei.Olatbm. Inother laid.

in brm is a voluntary means of reporung the infomnation required uoder 10 CFR 26.717. The 2)Meoun. Amo en,ffiedstoviewsodloeioef Infiaerearde nformabon is required by NRC to obtain on an annual basis fte specific itrtnes-for-duti

4) tse.of AdobeReadwr 8rwatter, inrequired :FFD) program performance data on drug and alcohol program from licensees and othet entifies. Send comments regarding burden estimate to the FOIA, Privacy and infonmation

-]Submission r7 Delete Zotlection Branch (T5-F53), U.S. Nuclear Regulatory Comnisslon, Washiington DC Update "i Submission 20555-0001. or by e-mail to IntofncofgaotRean-or@NRC.oov, and to the Desk Officer Unique Reference ID (Licensee Supplied) Dt5lce of Infornation and Regulatory Affairs. NEOB-1020, (3150-0146), Office o Management and Budget. Washington DC 20503. If a means used to impose information 12014-IPEC-004 -oliection does not display a currently valid OMB control number, the NRC may not conduc xvsponsor, and a person is not required to respond to, the information collection.

Select Facility Ilndian Point [50-247; 50-286] Date of Collection o2 1 (mrn/dd/yyyy) 0/721 Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (opthonal)

JPre-Access IReinstatement (Between 31 and 365 days)

Employment Type- 26.717(b)(3) Outage Worker (optional)?

ICntractorNendor Yes Labor Category- 26.717(b)(3)

Maintenance (general facility)

Is this a 24-Hour ReportingEvent (Yes/No)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? No Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported - 26.717(b)(2) Alcohol Testing JAlcohol Only Breath Subetance - 26.717(b)(2) & (b)(6)

What 26.103 BAC level was exceeded?

10.04 or greater Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)?

Mneaoemeqt Actions - 26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 1- Year Denial Persn~s)Resonsile or iformtio Proide Porsonn(s)Responsible for Information Provided Person I (required):

IKELLY FETUS I ] 1COORDINATOR.ACCESSFFE) KPETTUS@ENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

WYNE - 7 G.RIFFIN I SUPERVISOR, ACCESSfFFD WGRIFF1@ENTERGY.COM First Name Last Name Position Title Company Email Address FinalStep (Require) - NRC wil conasder this foam authentic in accordance with 26.11 only when the "Validate &Lock button is choked and all enors t(highlightedin red) have betn corrected. The 'Validate &Lock' button .wilchange to 'Locked" after the data validation process has been succesafully completed indicating the form Is ready for submission.

Form Locked On: Feb 24,2015 at 2:01:26 PM O R o l Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

1) Mlume.t tequav excalps etc. rues..eopeoati Estimated burden per response to comply with this collection request is 30 minutes. This 7j fintre Insome Notallmaut le~padoe Indoesiaw n In other field form is a voluntary means of reporting the information required under 10 CFR 26.717. The
3) toue. coveform,filaks to viewaddtlfinalihnfration Information is required by NRC to obtain on an annual basis site spectfic fitess-tfor-uty Q We ofiAdobeReactoror later' Is requir'ed (FFD) program performance date on drug and alcohol progranm from licenseees and other entities. Send comments regarding burden estimate to the FOIA, Privacy and Infomaltson

[7 Submission Update i-Di Delete Submission Collecton Branch (TS-F53), U.S. Nuctear Regulatory Commission, Washington DC 20555W-0001,or by e-mcl to Infocaots R-oee.@NRC*gmt, and to the Desk Officer, Unique Reference ID (Licensee Sumpid Office of Informatton and Regulatory Affairs, NEOB-1020, (3150-0146), Office of Managementand Budget, Washington DC 20503. Ifa means used to Impose infomthon 2014-1PEC-005 collecion does not driplay a currently valid OMB control number, the NRC may not conduct or sponsor, and e person is not required to respond to, the Informaton collection.

Select Facility Indian Point [50-247; 50-286] Deft of Collection (mm/ddtyyyy)

Reason for Teoting - 26.717(b)(5) F'lease elaborate on the reason for testing (optional)

Followup L Employment Type - 26.717(b)(3)

Contractor/VendorI I Outage Worker (optional)?

Labor Category- 26.717(b)(3)

Maintenance (general faclity)

Is this . 24-HourReporting Event (Yes/No)? - 26.719(b) INo Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? INoI Teat Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported - 26.717(b)(2) Alcohol Testing Alcohol Only Breath Substance - 26.717(b)(2) & (b)(6)

Alcohol Vhat 26.103 BAC level was exceeded?

0.04 or greater Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? No ManawerrmetActions - 26.717(b1(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 1- Year Denial Person(s)Responsible for Information Provided Person 1 (required):

First Name m [IOOO, pESS Last Name DT OR A.CESSFFD Position Title KPETTUSGENTERGY.COM Company Email Address Person 2 (optimal):

IWAYNE GRIFFIN SUPERISOR, ACCESS/FFD WGRIFFI@ENTERGY.COM First Name Last Name Position Titde Company Email Address Flnl Step (Required) - NRC will consider this form authentic in accordance with 26.11 only when the Validate & Lock" button is clicked and all errow (highlighted in red) have been corrected, The 'Validate & Lock" button wiltchange to tLocked' after the data validation process has been successfully completed indicating the form is ready for submission.

Form LockedrOn: Feb2 2015at2:00:11

, PMNRC FPM 89 20 Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

3)LEonbriv IansomeldsA.aute-ppelafe hallormseon Inodw Nelda 3)Naow. oerw0en, fisfad. to view,adEends*"inssww,

4) Ub. ofAdobe Reader8 rlatea'Is repire (FFD) program performance data on drug and alcohol pr, entites. Send comments regarding burden estimate to tV IL pat I Submiso I ssion Collection Branch (TS-F53), U.S Nuclear Regulatory 20555-0001, or by e-mall to Infonoaicts RespurcefNR Office of Information and Regulatory Affairs, NEOE Management and Budget, Washington DC 20503. If a m collection doea not display a currently valid OMB control n or sponsor, and a person is not required to respond to, the Select Facility Date of Collection Indian Point [50-247; 50-286]

(mm/ddlyyyy)

Reason for Teating - 26.717(b)(5) For Cause Testing Reason Please elaborate (optional)

For Cause I jPhysical Conndition/Smell of Alcohol Employment Type - 26.717(b)(3) Outage Worker (optional)?

Licensee Employee I [Ie LaborCategory- 26.717(b)(3) Please elaborate iSupervisor ] MAINTENANCE SUPERVISOR Please elaborate on the 24-hour reporting event Is thlsa 24-Hour Reporting Event (YewNo)? - 26.719(b) Yea EN49949 FFDeanet writen on3/24/2014 MAINTENANCE SUPERVISOR TESTEDPOSITIVEFORALCOHOL ONA FOR-CAUSE Refusal.- 26.71 7(b)(7) & 26.75s-1 (OBSERVED BEHAVIOR) TEST.

Was this collection refused (Yes / No)? FIoiI Teat Reaulte - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported - 26.717(b)(2) Alcohol Testing Alcohol OnlyBreath Substance- 26.717(b)(2) & (b)(6)

Alcohol]

Vtat 26.103 BAC level was exceeded?

0.04 or greater Subveraion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? [N I Management Actions - 26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s)Responsible for Information Provided F II Person t (required):

I..", 1COOROATOR.ACCESS FFD F KPETTUS@ENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

WAYNE FGRIFFIN UPERVISOR, ACCESS/FFD WGRIFFI@ENTERGY.COM First Name Last Name osition Title Company Email Address Flnet Step (oequirss - NRC will consider this form authentic in accordance with 26.11 only when the "Validate & Lock" buton is dicked and all erros (highlighted in red) have been corrected. The "Validate & Look"button will change to 'Locked" after the data validation process has been successfully completed inlicatong the form is ready for submission.

Form Locked On:IFeb 24, 2015 at 2:02:21 PM F t P ],F N Single Positive Test Form (version 1,6.0 - December 19, 2014) NRC Form 890 (12/2014)

hi eat,-papoiaf Infomued*"Inoffia.'Mds Estimated burden per response to comply with this collection request is 30 minutes. This Eale zz M Reanefte form is a voluntary means of reporting the information required under t1 CFR 26.717. The 3)Al,,ove ffelds to ~ awddgloW kWaesmiie r fi-erns information is required by NRC to obtain on an annual basi site specific Itoseo-for-duty

4) 111"of AdobeReederSer fater is req.*d (FFD) program performance data on dulg and alcohol programs from lcensees and other ontifies. Send comments regarding burden estimate to the FOIA, Privacy and Information Submission r7 Delete Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Washington DC Update " Submission 20555-0001, or by e-mail to Infonotecta Resourna@NRC nec and to the Desk Olficer, Unique Reference ID (Licenses Suppid Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Office ol Management and Budget, Washington DC 20503. Ifa means used to inpose intonnation 20-14-IPEC-007 colleclion does not display a courrently valid OMB control nomber, the NRC may not conduct or sponsor, and a person is not required to respond to, the Information collection.

Select Facility, Indian Point [50-247; 50-28615 Date of Collection (mmlddiyyyy) 08/13/2014 Reason for Tesating - 26,717(b)(5) F'lease elaborate on the reason for testing (optional)

Followup I [

Employment Type - 26.717(b)(3) Outage Worker (optlona*?

Licensee Employee I Io J Labor Category- 26.717(b)(3)

Maintenance (general facility)

Is this a 24-HourReporting Event (Yesaf o)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

Test Validity

]

IValid Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing LDrugOnly I IUrine]

Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.75 Substance- 26.717(b)(2) & (b)(6) AdditionalSubstance (as applicable) Additional Substance(as applicable)

Marijuana I IPlease Select I [Please Select Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I Io ManaoementActions - 26.717(b)(8) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s)Responsiblefor Information Provided Person 1 (required):

First Name Last Name Position Title Company Email Address Person 2 (optional):

IWAYNE First Name GFE  : Last Name SUPERVISOR, ACCESSNFFD Position Title WGRIFFI @ENTERGY.COM Company Email Address Fialt Sltp (Required) -NRC sill consider this form authentic in accordance with 26.11 only ofhen the Validate & Lock* button is clicked and all errors (highlighted in red) have been corrected. The 'Validate & Lock" button will change to 'Locked' after the data validation process has been successfully completed indicating the form is ready for submission.

Form Locked On: Feb 24, 2015 at 2:02:45 PM ] t- iwa I w Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

"- n- ,.V-- .. q0 - . --

2) EntriesIn soeen. 0"i aed-pi oRetainld n i~en*a-larbnfe Estimated burden per response to comply with this collection request is 30 minutes. This form is a voluntary means of reporting the Information required under 10 CFR 26.717. The
3) 111miom overlorrm Sfldeto view additionaliflormfianm. information is required by NRC to obtain on an annual basis site specific fitnens-for-duty
4) Useof Adoe. R.eatrl8 orlowf Isrequired (FFD) program performance data on drug and alcohol programs from icensees and other wntiten. Send comments regarding burden estimate to the FOIA, Privacy and Information Subus on LI eletO Collection Branch (TS-F53), U.S. Nuclear Regulatory Commsnion, Washington DC 20555-0001, or by e-mail to Infocollacts RsourcsO@NRC 00. and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Office ol Management and Budget, Washington DC 20503. If a means used to mropse infonnation collection does not display a crrently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

Select Facilit Fndian Point [50-247; 50-2861 (mm/ddtyyyy) Please I

_Date of Collection Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (optional)

Pre-Access IReinstatement (Between 31 and 365 days) 7 Employment Type - 26.717(b)(3) Outage Worker (optional)?

iBontractor/endor No Labor Category - 28.717(b)(3)

Fality Support Is this a 24-HourReporting Event (YesiNo)? - 26.719(b) FNo]

Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? FI Test Results - 26.717(b)(4)

Test Validity INotAppliceble I Test Type(s) for Result(s) Reported - 26.717(b)(2) Alcohol Testing Alcohol Only Breath Substance - 26.717(b)(2) & (b)(6)

Alcohol Mhat 26.103 BAC level was exceeded?

0.04 or greater Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)?

ManagementActions - 26.717Wb18) & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Ucensee Administrated)

Licensee Administrated Specific Sanction Applied 1- Year Denial Porson(e)Responsible for Information Provided Person 1 (reqbired):

IKELLY I PEE-T I RO,AOR. ACCES FFD I KPETTSENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

WAYNE IN SUPERVISOR, ACCE FD WRIFF1 @ENTERGY.COM First Name Last Name Position Title Company Email Address Finlr Step (Require).-NRC will consider this form authentic in accordance with 26.11 only when the 'Validate & LockRbutton is clicked and all errors (highlighted in red) have been corrected. The 'Validate & Lock"boon u,*llchange to 'Locked* after the data validation process has been successfully completed indicating the fotm Is ready fto submission.

Form Locked On:Feb24, 2015at 2:03 :16PM I Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

Estirnated burden per response to comply with this collection request is 30 minutes. This

Eo-bfo hrI~on, fa bn.U oIe~w ine.elt Ask form is a voluntory means of reporting the Information required under 10 CFR 26.717. The
3) Now*. overbm field.1s to view additinalkllamordtlo information is required by NRC to obtain on Os annual basis site speciic fliness-for-duty
4) Use ofAdobe ReadwCer 8 l ar is roqo.*wd (FFD) program performance date on drug and alcohol progrant from licensees and other entites. Send comments regarding burden estimate to the FOIA. Privacy and Informailon Submission r Delete Collection Branch (TS-F53). U.S. Nuclear Regulatory Commission, Washington DC Update L Submission 20555-0001, or by e-mail to Infoollects ResnursdbNRCgoo, and to the Desk Officer, Unictuei Reference ID (Licensee Supplid Office of Information and Regulatory Affairs, NEOB-t020. (3150-0146). Office of Management and Budget, Washington DC 20503. It a means used to impose intormation 12014 "lPEC-009 colilection does not display a currently valid OMB contol number. the NRC may not conduct or sponsor, and a person is not required to respond to, the informaeton collecton, Select Facility Date of CollectonF12i08*14 7 Indian Point [50-247; 50-288]

(mm/ddlyyyy) I~ ~i Reason for Tetling - 26,717(b)(5) Pre-Access Testing Reason (optional) Please elaborate (optional)

Pre-Access I [initial Authorization J

Employment Type- 28.717(b)(3) Outage Worker (optional)?

IContactor/Vendor I IN-Labor Category- 26.717(b)(3)

Facility Support I Is this a 24-Hour Reporting Event (YealIro)? - 26.719(b) [No -

Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? FNo Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only Urins Was thls collection observed (Yea/No)? - 26.717(b)(7) & 26.75 [N i Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) AdditionalSubstance (asapplicable)

Marjuana I Please Select Please Select Use NRC Cutoff (Yes / No)? [IIYe I Subversion Attempts - 26.717(b)(7) and 25.75(b)

Did this collection involve a subversion attempt (Yes/No)? No fMnao'eme.'nt Actions - 26.717(b)(8) & 26.75 Reason for the Action Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Senction Applied 3- Year Denial Person(a) Responsible for Information Provided Person 1 (required):

First Name Last Name Position Title Company Email Address Person 2 (optioal):

IWAYNE WAYNEFFIN - 7 F ~ ~ SUPERVISOR, 0 ,C ~

ACCESS/FFO DWGRIFFI@ENTERGY.COM GIF EN RY.O First Name Last Name Position Title Company Email Address Flnal Step (RequIred) - NRC will consider this form authentic in accordance with 26.11 only when the 'Validate & Lock* button is clicked and at errors (highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked after the date validation process has been successfully completed indisuting the form is ready fo submissiso.

Form Locked On: IFeb 2, 2015 at 2Z:3 P.Iý3] F8 F t Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

2) Entitis Insores Stickauto-Voloeteletnfrlasmerfn ine*wlfasl
3) Mm.ewa ftels goviewadditonl I.nfonhhw, Wifre
4) Us., viAdee ReadwI0ltler.lIs equilrse F Submission r7Dlt Unftue Reftecs ID (Licne ~Sup le Mnanagement ana 005gem, vasningion iv.. zuou4.* ian collection does not display a currently valid OMB control r or sponsor, and a person is not required to respond to, Vti Select Facility Date of Collection IIndian Point [50-247; 50-285] ] (mm/ddlyyyy)

Reason for Teasting- 26.717(b)(5) Pre-Access Testi ng Reason (optional) Please elaborate (optional)

P iAccessI] Reinstatement (Between 31 and 365 days)

Employment Type- 26.717(b)(3) Outage Worker (optional)?

IContrect~r/Vandor IN Labor Category- 26.717(b)(3)

Facility Support Is this a 24-HourReporting Event (Yes)No)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26,717(b)(4)

Test Validity IValid Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only I IUine I Was this collection observed (Ye /No)? - 26.717(b)(7) & 26.75 Substance - 26.717(b)(2) & (b)(6) AdditionalSubstance (asapplicable) Additional Substance (as applicable)

Marijuana Please Select I Please Select Use NRC Cutoff (Yes I No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? No ManagementActions - 26.717(b1(81 & 26.75 Reason for the Action IFirst drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Person(s) Responsible for Information Provided Person 1 (required):

IKELLYI 7I IEUS [COORDINATOR, ACCESS/FFD KPETTUS@ENTERGY.COM First Name Last Name Position Title Company Email Address Person 2 (optional):

WAYNE GRIFFIN SUPERMVSOR, ACCESS/FFD WGRIFF1 tENTERGY.COM First Name Last Name Position Title Company Email Address Final Step (Requirvd. - NRC nellconaider this form authentic in accordance oW 26.11 only when the Validate & Lock" nottonis clicked and all errors (highlighted in red) have been corrected. The Validate & LockW button wilt change to "Locked' afterthe data validation process has been successfullycompleted indicating the form is ready for submisaion.

Form Locked On:IFeb 24, 2015 at 2:03:59 PM I Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

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