PNP 2014-016, Single Positive Test Form, for Pre-Access, Collected on 11/25/2013
| ML14057A400 | |
| Person / Time | |
|---|---|
| Site: | Palisades  |
| Issue date: | 02/13/2014 |
| From: | Dotson B, Rabideau B Entergy Nuclear Operations |
| To: | Document Control Desk, Office of Nuclear Security and Incident Response |
| Shared Package | |
| ML14057A574 | List: |
| References | |
| 2013-PAL-004, PNP 2014-016 | |
| Download: ML14057A400 (1) | |
Text
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~lllgl( Positive r Test Data r\e;)ortrll~
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0 I;:p:i; UniQue Referance Number 12013-PAL-004 Number (Ucensaa (Licensee Supplied)
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Select Facility Salacl Facility IPalisades Palisades [50-255]
[50-255] Date 01 of Conection (mm/dd/yyyy) 111/25/2013 Collection (mmiddlyyyy) 111/25/2013 1 I Reason for ReNon 26.717(b))5)
Testing-- 26.717(b)(5) for Teaftnll Pro-Access Testing Reason f'n>.Access Reason (optional) loptionat Please elaborate (optioneQ Ptease elaborate (optional)
Ipre-Access Pre-Access I Iinitial
[Initial Authorization I
Employment Type Type - 26.717(b)(3) 26.71 7(b)(3)
I I Employmen1 -
IcontractorNendor ContractorNendor II Please elaborate Lebo, Category-- 28.717(b)(3)
Labor Cal8flory 26.717)b)lS) Cafeteria PPersonnel lelfoteril ......not Other IOther Refusal-* 26.717(b)(7) & 28.75 Reru.el 26.75 I I Ta.,
Was this collection refused (Yes II No)?
was Test R 26.717(b)(4)
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- 26.717(b)(4)
Results -
E=:J No Test Validity Test
[ Valid IValid I Test Type(s) for Result(s) Reported - 26.717(b)(2) - 26.717(b)(2) Drug TestiOQ Testing
[ Drug Only IDrug I IUrine
[Urine I
Was tltl.
We.
Su_nce this call_on observed collecl.ion obs.rwd (Yes I/ No)? - 28.717(b)(7)
Substance
- 26.717(b)(2) & (b)(8)
- )b)(6)
- 26.71 7(b))7) & 28.75 26.75 INO INO Additional Su_nce Addl1lonel Substance (e.
II (as eppllceble) applicable) Addl1lonel Additional Submnca Substance (e. (as eppllceble) applicable)
IMarijUana
[Marijuana I j Please Select Iplease I I Please Select IPlease I I
Use NRC NRC Cutoff (Yes I/ No)? ~ Yes this e Is tlt/. a U-Hou,Repor1lnll 24-Hour Repotfing EVtHIf (Yes/No)? --26.71 Event (yesINo)? 26.719(b)~
9(b)INo Subversion Attempts SubVfllSlon 26.717(b)(7) and 26.75(b)
Attempta - 28.717(b)(7)
Did this collection involne a subversion collection involve subversion attemptattempt (Yes/No)? [No INo 1 Management Mane_ ant Actions Action.
- 26.717(b)(8) 826,75
- & 28.75 Reason Reason for the the Action IIFirst First drug or or alcohol alcohol positive positive I Sanction Sanction Applied (NRC (NRC Minimum Minimum or or Licensee Ucensee Administrated)
[ILicensee Administrated Licensee Administrated I
Specific Specific Sanction Sanction Applied
[13' Year Denial 3- Year Denial I
Person(s)
Person(.) Responsible R..pon.,b'e for Information Inform<<Ion Provided ProvIded Poison Peraon 11 )roquiredl:
(required):
I Brian ISrion 1IIRI~delU jideos Ssperrisof, IIS<II>tMo ..., Access Ac.... AottrorizotiorilFFD
_orizationifFO II fuabrrie@entengy.com brabJdeGentergy.com First First Name Name Last Last Name Name Position PositionTIua Title Company Company Email Email Address Addre.s Person )optonofl:
Person 22 (optional):
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arto t-irst First Name Name I [ootson Ii00mon Last LSt Name Name J [uceoo.rngSpecitltst Ilucenon Spoclollst rosioon Position TItle lee I bdomon@ontorgy.com Company Lompany Ema" AoOress bmail Address Flnel Step Final (RequIred) - NRC Slap (Required) - NRC will will consider consider this lonm authentic this form authentic inin accordance accordance withwith 26.11 26.11 only when tIre only when Validute && Lock the "Validate Lock" button button has has been been selected selacled and and all all errors errors (i.e.,
Q.e.. thosethose highlighted highlighted in red) have in red) hav. been baan corrected.
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submission.
_ Fonm Locked Form on:lFeb 13, Locl<ed On.IFeb 13, 2sl4at 2014 at 153:23 1:53:23 PMPM I [I Save Save to L~ PC to Local Prinl this Report I PC [I [I Print this Report Single Single PositivePositive Test Test Form Fonm (version (version 1.5.0 1.5.0* January
- January 1. 1, 2014) 2014)