ML15128A227

2014 Prairie Island Nuclear Generating Plant Initial License Examination Form ES-201-3

ML15128A227
Person / Time
Site:	Prairie Island
Issue date:	08/22/2014
From:	Bielby M NRC/RGN-III/DRS/OLB
To:	Northern States Power Co
Shared Package
ML13093A444	List: ML15126A237 ML15126A466 ML15127A185 ML15128A227 ML15128A244 ML15128A250 ML15128A259 ML15128A292
References
Download: ML15128A227 (9)

Text

(l Xce l Ener g y N O V 0 3 2014 Regional Administrator , Region Ill US Nuclear Regulatory Commission 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Prairie Island Nuclear Generating Plant Units 1 and 2 Dockets 50-282 and 50-306 Renewed License Nos. DPR-42 and DPR-60 L-Pl-14-110 NUREG-1021 2014 Initial Operator Licensing Examination Security Agreement Forms Pursuant to NUREG-1021, Revision 9, Supplement 1 , Operator Licensing Examination Standards for Power Reactors, section ES-501 , Initial Post Examination Activities, the facility licensee must submit the original examination security agreement forms to the NRC's regional office for retention after the examinations are complete.

Northern States Power Company, a Minnesota corporation, doing business as Xcel Energy (hereafter "NSPM"), submits the original signed examination security agreements as Enclosure

1. Summary of Commitments This letter contains no new commitments and no revisions to existing commitments.

' /) / ';,, /tu Kevin Davison Site Vice President, Prairie Island Nuclear Generating Plant Northern States Power Company -Minnesota Enclosures (1) cc: Mike Bielby, US NRC Region Ill , with enclosure Hironori Peterson, US NRC Region Ill, without enclosure 1 7 17 W a kon a de D ri ve E a st o Welch , M in nes o ta 550 89-96 4 2 T elephone: 651.388.1121 ' m::CE IV E O 0 4 20 14 QF-1071-01, Rev. 2 (FP-T-SAT-71)

MASTER SECURITY AGREEMENT I (l Xcel Energy-Page 1 of 2 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 .2oi4 u_r tJ£'-examination(s) scheduled for the date(s) o f 'iS/t.Jh4

-1?/it/1'1 as of the date of my signature.

I agree that I will not knowingly divulge any information about these examina ti ons to any persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruc t or provide pe rf ormance 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 doc u men t ed 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 t hat examination security may have been compromised.

2. Post-Examination To the best of my , , 1 did not divulge to any unauthorized any inf?rmation concern!ng the exami.nations during the date(s) of 15 L/ /lt -./r-, 1'f . From the date that I entered into this security agreement until the completion of exam1nat 1 on administration, I did not in *truct, evaluate, or provide performance feedback to those individuals who were administered these exa m inations.

PRINTED NAME 1.

S A120\S 1) 2. f a.eo (j;;, urtJ\ 3. -z;iAv?s C *. 1, 1 ,.zer 4. H t lftM' .pii-7U?f!J 5. ,,Yl !1 s c s n e.v 0 + I , I . l. 6. \!Jhi'\-S o r, 1. A n+/-ho oj S nort Retention:

Life of Plant Retain in: Exam File JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE oPS Ir' ;WJCJ tY r"L 10 1.1)1 *(1>/1<< / I , DP> IA!8 r£JHM =:= _ £1-0; --£ /J _ , .* /:ft ttl 0f ,._'?. </-11 fy --; -f J/L N.* O gA-b'f. /t i

</\t,..,\ \' i ._, Il l"*! --s i V'r1 TP b+er 11-1/-/3 £\ /

QF-1071-01, Rev. 2 (FP-T-SAT-71)

[ ll Xcel Energy-MASTER SECURITY AGREEMENT Pcige 2 of 2 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. T. ITLE I RESPONSIBILITY SIG. NATURE (1) DATE (2) :: 1 0.. M1 c.J i olt1t\ A.bvie11 {')f J L'-7! __ 'i/z/t'f

___ _ "'-!Kl..J.... "i . !_ (l.[)(\ -.. ' ' /-.-t. (\ ,"'""/ );£\.. ____ L_ ______ _ c1 , scov , D'* , , , ., w' / l:CL+'-:,1 , KG r: il 1 , "l' __ 12. 1 3. 1 4. 1 5. 1 6. 1 7. 18. 19. 2 0. NOTES: Retention:

Life of Plant Retain in: Exam File DATE NOTE g-fts-/ty

<J/t5/i'i

')(1°! QF-1071-02, Rev. 2 (FP-T-SAT-71)

Page 1 ot-r' <JP I fl Xcel Energy-I LIMITED SECURITY AGREEMENT I 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 that I have acquired specialized knowledge about the .;}oi'i il:r rJ\l<.. examination scheduled for the date(s) of 'iiL\h'l

• 111 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 f eedback 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 prov i de direct or in direc t 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 ac t ion against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that exam in ation security may have been compromised.

2. Post-Examination

1. 2. 3. 4. To the best f y kn wledge, I did not divulge to any unauthorized persons any information concerning the examination administe r ed during th e date(s) of <t 14. -'l 6 . From the date that I entered into this security agreement until the completion of this examinat i on administrati n, I did. not instruct, evaluate, or provide performance feedback to those individuals who were administered this exam ina tion. Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY exam in ee until the completion of their examination administration.

I further understand that violation of the conditions of th i s agreement may resu lt in cancellation of t he examination and/or enforcement action against the facility licensee or me. PRINTED NAME JOB TITLE I RESPONSIBILITY DATE ./\SIGNA/lf E (2) DATE NOTE "s *41 -r , / C....11. 'i-<....v 1..-S' ') / 5:r} I , Ut,.. J,, LI\, V:; /"J...., 2'-r (JI 't -fc;._ _ _, /Z ).,<.p l </ ' 1/// r/ I r '* --J ___ (l 1) 9_),_.JLf Kr, y /, uh J HWI I \_o.., 0.r-Q....

0-\,.)J\.

\,(.. Lt o t/cu 1 fJ --f5ttcH S:S' ;;;;: 2 c cv-

--Retention:

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

Q F-107 1-02, Rev. 2 (FP-T-SAT-71)

I fl Xcel Energy-LIMITED SECURITY AGREEMENT

'flJ' Page 2 pl T h e 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.

5. 6. 7. 8. 9. 1 0. PRINTED NAME f \*hAtt---::') fN'v-\ l-------------:-7 f)g..vc.(.

l YL1t5l-, Jc.-e..

t1((1'k /..17 o j.b r v cl >c<.+/-en-e )vi,r a, ff> :t>1.'i3s . 1 1. -\ " \,.-.... )( ... \?)' JOB TITLE I RESPONSIBILITY L Rn L f_o ,,;* J.-"'-Sf-r'-"-<-

J-.:,..,,.,.-5,;Vf SIGNATURE (2) W'f= ,¢ " 7 \__ I? SIGNATURE (1) ( (\ . DATE I7. i!fi!? , , £M . s s/ s*-r1t zi: ... '3/'>/tl no 1/->f 1q /l j/L-DATE NOTE

-qf 1 1/r f r/rt/1t I v/:J/; I/ t..:::.L:.-

' --,, , , M S

'x f "ii: 1 3 , 0te '" 3 ,ll 1'/ 0= 1 4 * , . <" _,, ,. (,?A ,.., ' / * //,/ /,?i ?-1 1 2. JJD.N 'ffi_W * / \-;1\)-'\{l;_t<;,., ..::.LH t:: C'-\L\.;..J *";t1 1 5. -J" eU Vvt o..A.. 1 6. t /,.t :7 C/ t" A r<) r._., 1 7. /V t c\;,,ohs /V]o ocl y 1 8. R.os s 1Y,; of!t 1 9. ..

20. .Jo.s oi-\ £-t v-;t.

NOTES: Retention:

Life of plant Retain i n: Exam file 55 Ro ,..., <' >.) Ofs lt--1J6 I 1rw 6-P ;;JJ < :I/V::::r* 55 ;l_>TA r---* -t)l.....,_..I c..------=-F orm retained in accordance with record retention schedule identified in FP-G-RM-01. 1-/ I /,J ,ll .l.... *, "-'-L -_._fl-I i/;11 \ q;!t,A*L{_

'1/i<J(1 'i o/-z."111:{

QF-1071-02, Rev. 2 (FP-T-SAT-71) ef2 I (l Xcel Energy-I LIMITED secURllY 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

5. 6. 7. 8. 9. 10. PRINTED NAME

612..vc_(, fu_.Ll,sz.:

!1i&!'K J..(7esbrrd... .

}Vfl(1q U J, J.LL .. <J r o,,," V\G<.,..., f>, bu...s JOB TITLE I RESPONSIBILITY LRn L2-D DATE SIGNATURE (2) $/1:4 see. ')X'e'.'I\

e...;> z../2-1/tf s ee ?r-e-nc,,;,'> e c..se.... f;M p rs'{10-is ?°.J..,_ s S' I St.ft ;Jbb_i.£._

"3/8/!'( S ee. ?re.--J 1c:>->S e c--se....

11. \. 'l l tl 0 --* ;...... 1 .:.rs " s e.:: 16. 12. VwvtJ. ffi=E'P l\JJS f&$C5a7' 13. 3\eph0Y\ Se.;l1L!ifv\ef SIV\.

14. / \J'l\.A<2.<-E<;.

Rei :3iu//o/ See 1s. Jeif 1h;.1Mo.....__

ss <fa>>Lf;;>(

• KO -

• see. 1.:.-.;\

see. ¥' re \, (( 0-.) e c.-S ee i6i l o-.> f?O..'J-'L 17. N ('tl.rto\.._5 Mooay SS

18. Ross

/17 u. . 19.

20.

5t-v-;l'..

m/rtP 'I/ J;,;.,--

SS 5TI\

4/z,/11 Ots lr-rJ6 See e re" lo..>S ftA.Sk NOTES: Retention:

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

DATE NOTE 'l'/r;{N' -g-z.a-f'f Rev. 2 ff P-T-SAT-71 MASTER SECURITY AGREEMENT 4 a.I' sc;1:11i'-'

1of1*1 *F. --The Master Security Agreement is used for those personnel having both knowledge of Exam Sens i tive Materia l and u nrestricted access t o Primary *and Secondary Containment.

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

'X Ji -s/20 11-1 s l(l 1'i I acknowledgi:!'tha I

special i zed knowledge about the 2014 NRC IL T EXAM examinat i on(s) sc h eduled for the da t e (s) of 8/4/2014 e/2atzr of the date of my signature.

I agree that I wil l not knowingly divulge any informat i on about these exam i n a t ions to any -persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to inst r uct or prov i de pe rf o r mance feedback to those individuals scheduled to be administered these examinations from this date unt il completion of examinat i on a dm i n i stration. I also understand that I am not to evaluate individuals scheduled to be admin i stered these exam i nations from this date unt i l the da t e of administration.

Acting as a simulator booth operator or communicator is acceptable if I do not select the train i ng content or prov i de d i rec t o r indirect feedback to an examinee.

Furthermore, I am aware of the physical security meas u res a n d requiremen t s (as documen t ed i n NSPM procedures) and understand that violation of the conditions o f this agreement may result in cance l l ation of the examinations and/o r a n enforcement action against my facility or me. I will immediate l y report to the Exam Project Manager any indicat i ons or suggest i o n s t h at examination security may have been compromised.

2. Post-Examination the date(s) of :r:\l.u, J -\"?\ 1y . From the date that I entered into th i s secu ity agreeme t until the comp l et i on of ex

• a 1 0 To the best of my knowle,ge, I did not divulge to any unauthorized persons any the exam i nations adm i niste r e. d during administration , I did not instruct', evaluate , or provide performance feedback to tho e individua l who were admin i s t ered PRINTED NAME JOB TITLE I RESPONSIBILITY

1. J A th "'(J.f C e.*c ('.h e ti l.,/d,;<</, /.Je w f 2.

C_ '-r tJ .. ..,-tJ.C..

/ \>o 1-.,\ \'>'" L-3. 4. 5. 6. 7. Retention:

Life of Plant Retain in: Exam File .. 3/5/1 i f NO T E -a/Zi;/1 ( --

QF-1071-02, Rev. 2 (FP-T-SAT-71)

S..,, Page ""1-f'o'l+-f..:;;2"-

• lio \ l "i 1' o f IP '° (t Xcel Energy* 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 I have acquired specialized knowledge about the 2o 1 t L-f examination scheduled for the date(s) of bf.., I 1 i.i -S/llS' I 1:t 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

1. 2. 3. 4. To the best o my know edfle, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of a t.t/i'i -8 ;'( / 1'-f

• 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 m°'r k H°'(e n f(, tJ, 4-ei m . l 11 Mn*-' J f::v1,.J .1YI I/

JOB TITLE I RESPONSIBILITY DATE Lt?0id Ro fo C: ::;7 4*ZI-ttf _5' -;-r.::-v* _, r *' ' -1::./

'===== *---*-----------* r* *'.*?"J ./ g.z")-1<{

_ <2/

o..ktiz. ... I-'l'<fl..v(.:l'-

1, 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-% of 2 s.,,1 (, c;, fl Xcel Energy-LIMITED SECURITY AGREEMENT T h e 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 c* C: 5. 0 c..tirr-t<.f' 6. 7. 8. 9. 10. j S"l e: e.r=J l:)Ud. \ """ *]<)S or'\ fo ,.,.. ,/r c1 ,.J Ek e b-S

/' ;; .'.J I"""-Lc.-i-\J""{..-r-'

t 1 fJ ti 1 1. ""J*;_;f 7 sC::l'*:\. 12. Pec t..r\. 13. -;-;;J ,J :5 fr'a,1 ;-1 14. \L-sf ;;t 1£. <oil .-: 15. __ <;j-rul ljgMjt 16. -* I .... f-

17. Ctl\LV 6 12-E.6.Sol\I

18. 1J;o,../

19. /111 ;c_.,t:: /5/z.W 2 0. 1'-A:tY<.*4f r/!,.,.,: L NOTES: Retention:

Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY USD MJF l<o /... 1::'71,!J

,!( 0 5"_5 L W kv --------1 ) / ,¢? '* / .('_ "1u7' /) C.) I Leo..cO --g O :51/l {/ * /A .. /r1 <; l r-<AC l o.-.-Ot1 s -1 r t...u ) ... /,,. AH_v\".s c, r 71 ). v u +r"' ch r _,..., J, ../-, _/.-/tJf ,...., c' 1 0 J..-' /

-::Z:,.r_,?

vt. c-h / w<< ae.---. , -.,.,------,-,..........

Form retained in accordance with record retention schedule identified in FP-G-RM-01.

DATE DATE NOTE h'f ..,,/ I g!'--t;/l t ff /'r/!'1 .JJ.j jfJ'f_ CJ-12*/i-/

.....____, '1-f,2.-!'f

--;_off/; I_ "

I" --

.t?i t/ =----ff;/,,/,"' ',./ .,.._.,

8/ i [ii./

__ rhl/I/ __