ML18074A356

Final Qa/Related Forms (Folder 1)

ML18074A356
Person / Time
Site:	Millstone
Issue date:	12/01/2017
From:	Peter Presby Operations Branch I
To:	Dominion Energy Nuclear Connecticut
Shared Package
ML17094A469	List: ML18029A643 ML18029A662 ML18074A356 ML18074A358 ML18074A360 ML18074A361 ML18074A362 ML18074A363 ML18074A364 ML18074A365 ML18074A366 ML18074A368
References
CAC U01946, ES-201, ES-201-1
Download: ML18074A356 (12)

Text

ES-201 Examination Preparation Checklist Form ES-201-1 Facility: Millstone Unit 3 Date of Examination: 121412017 Developed by: Written: Facility ~ NRC D II Operating: Facility ~ NRC D Target Task Description (Reference) Chief Examiner's Date* Initials

~

1. Examination administration date confirmed (C.1.a; C.2.a-b). For NRG-prepared exams,

-240 arrangements are made for the facility to submit reference materials (C.1.e; C.3.c; 4/8/2017 Attachment 3).  ;;.,-

-210 2. NRC examiners and facility contact assigned (C.1.d; C.2.f). ~:;;,,e; 5/8/2017 I~~

3. Facility contact briefed on security and other requirements (C.2.c). As applicable, the facility

-210 contact submits to the NRC any prescreened K/As for elimination from the written 5/8/2017 examination outline, with a description of the facility's prescreening process (ES-401, D.1.b).

-210 4. Reference material due for NRG-prepared exams (C.1.e; C.3.c; Attachment 3). ~k 5/8/2017

-210 5. Corporate notification letter sent (C.2.e). 1--p

~e-5/8/2017

-195

6. NRG-developed written examination outline (ES-401-1/2 or ES-401N-1/2 and ES-401-3 or ES-401 N-3) sent to facility contact (must be on the exam security agreement) (C.1.e-f;

~ 5/23/2017 C.2.h; C.3.d-e). k

-150

7. Operating test outline(s) and other checklists due, including Forms ES-201-2, ES-201-3, ES-301-1, ES-301-2, ES-301-5, and ES-D-1, as applicable (C.1.e-f; C.3.d-e). ~;&, 7/7/2017 8.

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Operating test outline(s) reviewed by the NRC and feedback provided to facility licensee

-136 7/21/2017 (C.2.h; C.3.d-e).

9. Proposed examinations (written, JPMs, and scenarios, as applicable) and outlines (Forms ES-301-1, ES-301-2, ES-D-1, ES-401-1/2 or ES-401 N-1/2, and ES-401-3 or ES-401 N-3);

~j 9/20/2017

-75 supporting documentation (including Forms ES-301-3, ES-301-4, ES-301-5, ES-301-6, ES-401-6, ES-401 N-6, and any Form ES-201-2 and ES-201-3 updates); and reference materials due (C.1.e-h; C.3.d). µ

-75

10. Examinations prepared by the NRC are approved by the NRC supervisor and forwarded for facility licensee review (C.1.i; C.2.h; C.3.f-g).

r,J /fr 9/20/2017

-60 11. Preliminary waiver/excusal requests due (C.1.m; C.2.c; ES-202). ~~ 10/5/2017

-50 12. Written exam and operating test reviews completed (C.3.f). ~~ 10/15/2017

13. Examination review results discussed between the NRC and facility licensee (C.1.i; C.1.k-1;

-35 C.2.h; C.3.g). The NRC and the facility licensee conduct exam preparatory week. ~)l, 10/30/2017

-30

14. Preliminary license applications and waiver/excusal requests, as applicable (NRC Form 398) due (C.1.m; C.2.i; ES-202). 12--:::;,fa 11/4/2017 t C.,, ~ 11/20/2017

15. Final license applications and waiver/excusal requests, as applicable (NRC Form 398), due

-14 and Form ES-201-4 prepared (C.1.m; C.2.k; ES-202).

-7 16. Written examinations and operating tests approved by the NRC supervisor (C.2.j-k; C.3.h). ~ 11/27/2017

-7 17. Request facility licensee management feedback on the examination (C.2.1). ~~1/27/2017

18. Final applications reviewed; one or two (if more than 10) applications audited to confirm

-7 qualifications/eligibility; and examination approval and waiver/excusal letters sent (C.2.k; - ~ 11/27/2017 Attachment 5; ES-202, C.3.j; ES-204).

-~-

-7 19. Proctoring/written exam administration guidelines reviewed with facility licensee (C.3.k). ;4? 11/27/2017

-7 20. Approved scenarios and job performance measures distributed to NRC examiners (C.3.i). -r-0. ~ 11/27/2017

• Target dates are based on facility-prepared examinations and the examination date identified in the corporate notification letter. These dates are for planning purposes and may be adjusted on a case-by-case basis in coordination with the facility licensee.

ES-201 Examination Outline Quality Checklist Form ES-201-2 Facility: Date of Examination:

1oi/~M11 Initials Item Task Description a b* c**

1. a. Verify that the outline(s) fit(s) the appropriate model in accordance with ES-401 or ES-401 N. RS ,vJA /._

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b. Assess whether the outline was systematically and randomly prepared in accordance with Section D.1 of ES-401 or ES-401 N and whether all K/A categories are appropriately sampled. (b t1/;q Ji(/

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T C. Assess whether the outline overemphasizes any systems, evolutions, or generic topics. ~) NJA b E

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d. Assess whether the justifications for deselected or rejected K/A statements are appropriate. rl) N/IJ

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2. a. Using Form ES-301-5, verify that the proposed scenario sets cover the required number of

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~ 1vf normal evolutions, instrument and component failures, technical specifications, and major s transients. /I;::::,

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b. Assess whether there are enough scenario sets (and spares) to test the projected number and mix of applicants in accordance with the expected crew composition and rotation schedule

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T without compromising exam integrity, and ensure that each applicant can be tested using at least one new or significantly modified scenario, that no scenarios are duplicated from the applicants' audit test(s}, and that scenarios will not be repeated on subsequent days.

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C. To the extent possible, assess whether the outline(s) conforms with the qualitative and quantitative criteria specified on Form ES-301-4 and described in Appendix D and in

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Section 0.5, "Specific Instructions for the 'Simulator Operating Test,"' of ES-301 (including overlap). ~ ffe

3. a. Verify that the systems walkthrough outline meets the criteria specified on Form ES-301-2:

(1) The outline(s) contains the required number of control room and in-plant tasks distributed ~)

w among the safety functions as specified on the form.

A (2) Task repetition from the last two NRG examinations is within the limits specified on the form.

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(3) No tasks are duplicated from the applicant's audit test(s).

(4) The number of new or modified tasks meets or exceeds the minimums specified on the form.

1-'

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(5) The number of alternate-path, low-power, emergency, and radiologically controlled area tasks meets the criteria on the form.

R r 0 b. Verify that the administrative outline meets the criteria specified on Form ES-301-1:

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H (1) The tasks are distributed among the topics as specified on the form.

(2) At least one task is new or significantly modified.

(3) No more than one task is repeated from the last two NRG licensing examinations.

I< *-;l &P C. Determine whether there are enough different outlines to test the projected number and mix of applicants and ensure that no items are duplicated on subsequent days. !Z ~ ~

4. a. Assess whether plant-specific priorities (including probabilistic risk assessment and individual plant examination insights) are covered in the appropriate exam sections.

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G E b. Assess whether the 10 CFR 55.41, 55.43, and 55.45 sampling is appropriate. /(, ¥ ~~

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c. Ensure that K/A importance ratings (except for plant-specific priorities) are at least 2.5. I ¥ ~ *~ ~

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d. Check for duplication and overlap among exam sections and the last two NRG exams. (/~ ¥ ~

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L e. Check the entire exam for balance of coverage. /( ~ *~

f. Assess whether the exam fits the appropriate job level (RO or SRO). fl ¥ If'~,

Printed Namflignature Date a.

b.

Author Facility Reviewer(*)

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c. NRG Chief Examiner(#) TH&IIIV+-5> * : , . ~..... , ~ ~ ~ ~J-- . "':"i' '; :tl ? ~ ; § : / ~ 1z.../ I It 1

d. NRG Supervisor 'i) .. - L _J/6_P

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• Not applicable for NRG-prepared examination outlines.

1. The independent NRG reviewer initials items in column "c"; the chief examiner's concurrence is required.

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

1. Pre-Examination ;t47 I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of ~ j) 4..c. 17 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 rn To the best of my knowle.dge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of 12/y- I} /JI 1 2..o 17 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

~ noted below and authorized by the NRC.

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ES-201, Page 31 of 32

Et ;z._ :f J ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination 2-k/7 I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of J./ j)~ c. 117 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 mTo the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered

"' during the week(s) of 12.. /1.!* n.(,\ zat 7. From the date that I entered into this security agreement until the ccmpletion of examination administration, I did

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

~ noted below and authorized by the NRC.

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NOTES:

ES-201, Page 31 of 32

(J"'"J'- 3 fJ r3 ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of 4 DE<. \7 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 rn To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of 1 z../v- 12/11 1 2.,., 17 Frorn 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.

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ES-201, Page 31 of 32

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ES-301 Operating Test Quality Checklist Form ES-301-3 Facilit : Date of Examination:

Initials

1. General Criteria

a. The operating test conforms to the previously approved outline; changes are consistent with sam lin re uirements e.. , 10 CFR 55.45, o erational im ortance, safe! function distribution .

b. There is no day-to-day repetition between this and other operating tests to be administered durin this examination.

C. The o eratin test shall not du licate items from the a licants' audit test s see Section 0.1.a ..

d. Overlap with the written examination and between different parts of the operating test is within acce table limits.

e. It appears that the operating test will differentiate between competent and less-than-competent a licants at the desi nated license level.

2. Walkthrou h Criteria

a. Each JPM includes the following, as applicable:

initial conditions initiating cues references and tools, including associated procedures reasonable and validated time limits (average time allowed for completion) and specific designation if deemed to be time critical by the facility licensee operationally important specific performance criteria that include-detailed expected actions with exact criteria and nomenclature system response and other examiner cues statements describing important observations to be made by the applicant criteria for successful completion of the task identification of critical steps and their associated performance standards restrictions on the se uence of ste s, if a licable

b. Ensure that any changes from the previously approved systems and administrative walkthrough outlines (Forms ES-301-1 and ES-301-2) have not caused the test to deviate from any of the q..

acceptance criteria (e.g., item distribution, bank use, repetition from the last two NRG examinations s ecified on those forms and Form ES-201-2.

3. Simulator Criteria The associated simulator operating tests (scenario sets) have been reviewed in accordance with Form ES-301-4, and a co is attached.

Date a.

b.

Author Facility Reviewer(*) ;1;F~7 c.

d.

NRG Chief Examiner(#)

NRC Supervisor 1;7ijb 1.... '

• The facility licensee signature is not applicable for NRG-developed tests.

1. The inde endent NRC reviewer initials items in column "c"; the chief examiner concurrence is re uired.

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Date of Exam: Scenario Numbers: I 2I $

QUALITATIVE ATTRIBUTES Initials a

1. The initial conditions are realistic in that some equipment and/or instrumentation may be out of service, but it does not cue the operators into expected events.

2. The scenarios consist mostly of related events.

3. Each event description consists of the following:

• the point in the scenario when it is to be initiated

• the malfunction(s) or conditions that are entered to initiate the event

• the symptoms/cues that will be visible to the crew

• the expected operator actions (by shift position)

• the event termination point (if applicable)

4. The events are valid with regard to physics and thermodynamics.

5. Sequencing and timing of events is reasonable and allows the examination team to obtain complete evaluation results commensurate with the scenario objectives.

6. If time compression techniques are used, the scenario summary clearly so indicates.

Operators have sufficient time to carry out expected activities without undue time constraints.

Cues are given.

7. The simulator modeling is not altered.

8. The scenarios have been validated. Pursuant to 10 CFR 55.46(d), any open simulator performance deficiencies or deviations from the referenced plant have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

9. Scenarios are new or significantly modified in accordance with Section D.5 of ES-301.

10. All individual operator competencies can be evaluated, as verified using Form ES-301-6 (submit the form along with the simulator scenarios).

11. The scenario set provides the opportunity for each applicant to be evaluated in each of the applicable rating factors. (Competency rating factors as described on Forms ES-303-1 and ES-303-3.)

12. Each applicant will be significantly involved in the minimum number of transients and events specified on Form ES-301-5 (submit the form with the simulator scenarios).

13. Applicants are evaluated on a similar number of preidentified critical tasks across scenarios, when possible.

14. The level of difficulty is appropriate to support licensing decisions for each crew position.

Target Quantitative Attributes per Scenario (See Section D.5.d)

1. Malfunctions after EOP entry (1-2)

2. Abnormal events (2-4)

3. Major transients (1-2)

4. EOPs entered/requiring substantive actions (1-2)

5. Entry into a contingency EOP with substantive actions (.:: 1 per scenario set) I

6. Preidentified critical tasks (.:: 2)

• The facility licensee signature is not applicable for NRG-developed tests.

1. An independent NRC reviewer initials items in column "c"; chief examiner concurrence is required.

ES-301 Transient and Event Checklist Form ES-301-5 Facility: Millstone Unit 3 Date of Exam: 12/04/17 Operating Test No.: 2K17 A E Scenarios (Rev 1) p V p 1 2 3 (DELETED) 4 (SPARE) T M E

0 I L N CREW CREW POSITION CREW POSITION CREW POSITION T N I T POSITION I

C A A T s A B s A B s A B s A B M R T 0 R T 0 R T 0 R T 0 L u N y 0 C p 0 C p 0 C p 0 C p M(*)

T p E R I u R0-1 RX 3 ,, 1 1 1 0 Ox NOR 2 1 1 1 1 SRO-I 1/C 1,2,6, 1 5 4 4 2 D

SRO-U 8

MAJ 5 3,7 3 2 2 1 D TS 0 2 2 RX 2 1 1 1 0 R0-2,3 De NOR 3 1 1 1 1 SRO-I 1/C 2,7, 4,5, 6 4 4 2 D

SRO-U 8 6 MAJ 5 3,7 3 2 2 1 D TS 0 2 2 R0-4 RX 2 1 1 1 0 Ox NOR 3 1 1 1 1 SRO-I 1/C 2,7, 4,5, 6 4 4 2 D

SRO-U 8 6 MAJ 5 3,7 3 2 2 1 D TS 0 2 2 Instructions:

1. Check the applicant level and enter the operating test number and Form ES-D-1 event numbers for each event type; TS are not applicable for RO applicants. ROs must serve in both the at-the-controls (ATC) and balance-of-plant (BOP) positions. Instant SROs (SRO-I) must serve in both the SRO and the ATC positions, including at least two instrument or component (1/C) malfunctions and one major transient, in the ATC position. If an SRO-I additionally serves in the BOP position, one 1/C malfunction can be credited toward the two 1/C malfunctions required for the ATC position.

2. Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.5.d) but must be significant per Section C.2.a of Appendix D. (*) Reactivity and normal evolutions may be replaced with additional 1/C malfunctions on a one-for-one basis.

3. Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirements specified for the applicant's license level in the right-hand columns.

4. For new reactor facility licensees that use the ATC operator primarily for monitoring plant parameters, the chief examiner may place SRO-I applicants in either the ATC or BOP position to best evaluate the SRO-I in manipulating plant controls.

ES-301 Transient and Event Checklist Form ES-301-5 IFacility: Millstone Unit 3 Date of Exam: 12/04/17 Operating Test No.: 2K17 I

A E Scenarios (Rev 1) p V p 1 2 3 (DELETED) 4 (SPARE) T M E

0 I L N CREW CREW POSITION CREW POSITION CREW POSITION T N I T POSITION I

C A A T s A B s A B s A B s A B M R T 0 R T 0 R T 0 R T 0 L u N y 0 C p 0 C p 0 C p 0 C p M(*)

T p E R I u RO RX 3 1)'1!>*: i~!F::s:*. P: *******:: 1 1 1 0 D NOR 2 1 1 1

-~:

SRO-I D

SRO-U 1/C 1,2 1 4 4 2 2,3 MAJ 5 3,7 2 2 1 Cle TS 1,2

!"'I'"°~- .;. ***** . . 2 0 2 2 RO RX 3 2 2 1 1 0 D

SRO-I NOR 1 1 1 1,2 1/C 1,2,6, 1 5 4 4 2 8

Ox SRO-U MAJ 5 3,7 3 2 2 1 D TS 1,2 2 0 2 2 RO RX 3 2 2 1 1 0 D

SRO-I NOR 0 1 1 1 D

SRO-U 1 1/C 1,2 1 3 4 4 2 MAJ 5 3,7 3 2 2 1 Cle TS 1,2 1,2 4 0 2 2 Instructions:

1. Check the applicant level and enter the operating test number and Form ES-D-1 event numbers for each event type; TS are not applicable for RO applicants. ROs must serve in both the at-the-controls (ATC) and balance-of-plant (BOP) positions. Instant SROs (SRO-I) must serve in both the SRO and the ATC positions, including at least two instrument or component (1/C) malfunctions and one major transient, in the ATC position. If an SRO-I additionally serves in the BOP position, one 1/C malfunction can be credited toward the two 1/C malfunctions required for the ATC position.

2. Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.5.d) but must be significant per Section C.2.a of Appendix D. (*) Reactivity and normal evolutions may be replaced with additional 1/C malfunctions on a one-for-one basis.

3. Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirements specified for the applicant's license level in the right-hand columns.

4. For new reactor facility licensees that use the ATC operator primarily for monitoring plant parameters, the chief examiner may place SRO-I applicants in either the ATC or BOP position to best evaluate the SRO-I in manipulating plant controls.

ES-301 Competencies Checklist Form ES-301-6 Facility: Millstone 3 Date of Examination: Week of 4 Dec 17 Operating Test No.: 2K17 APPLICANTS (Rev 1)

R0-1 xD R0-2,3 xD R0-4 xD RO D SRO-I D SRO-I D SRO-I D SRO-I D SRO-U D SRO-U D SRO-U D SRO-U D Competencies SCENARIO SCENARIO SCENARIO SCENARIO 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 ATC BOP BOP ATC BOP ATC InterpreUDiagnose 1,3,6, 1,3,7 2,7 2,5,6 2,7 2,5,6 8

Events and Conditions Comply with and 1,2,3, 1,3,4, 2,3,5, 2,3,5, 2,3,5 2,3,5, 4,5,6, 7 7,8 6,7 ,7,8 6,7 Use Procedures (1) 8 Operate Control 1,2,3, 1,3,4, 2,3,4, 2,3,5, 2,3,4 2,3,5, 4,5,6, 7 5,7,8 6,7 ,5,7, 6,7 Boards (2) 8 8 Communicate 1,2,3, 1,3,4, 2,3,4, 2,4,5, 2,3,4 2,4,5, 4,5,6, 7 5,7,8 6,7 ,5,7, 6,7 and Interact 8 8 Demonstrate Supervisory Ability (3)

Comply with and Use TS (3)

Notes:

( 1) Includes TS compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant. (This includes all rating factors for each competency.) (Forms ES 303 1 and ES 303 3 describe the competency rating factors.)

ES-301 Competencies Checklist Form ES-301-6 Facility: Millstone 3 Date of Examination: Week of 4 Dec 17 Operating Test No.: 2K17 APPLICANTS (Rev 1)

RO D RO D RO D RO D SR0-11,2 Ox SRO-I D SRO-I D SRO-I D SRO-U D SRO-U1 Ox SRO-U 2,3Dx SRO-U D Competencies SCENARIO SCENARIO SCENARIO SCENARIO 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 ATC SRO SRO SRO SRO BOP lnterpreUDiagnose 1,3,6, 1,2,3 1,2,4, 1,2,3, 1,2,4, 1,3,7 8 ,7 5,8 7 5,8 Events and Conditions Comply with and 1,2,3, 1,2,3 1,2,3, 1,2,3, 1,2,3, 1,2,3, 4,5,6, ,7 4,5,8 7 4,5,8 4,7 Use Procedures (1) 8 Operate Control 1,2,3, 1,2,3, 4,5,6, 4,7 Boards (2) 8 Communicate 1,2,3, 1,2,3 1,2,3, 1,2,3, 1,2,3, 1,2,3, 4,5,6, ,7 4,5,8 7 4,5,8 4,7 and Interact 8

Demonstrate 1,2,3 1,2,3, 1,2,3, 1,2,3,

,7 4,5,8 7 4,5,8 Supervisory Ability (3)

Comply with and 1,2 1,2 1,2 1,2 Use TS (3)

Notes:

( 1) Includes TS compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant. (This includes all rating factors for each competency.) (Forms ES 303 1 and ES 303 3 describe the competency rating factors.)

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Facility: .Mdls+oV\Q.. 3 Date of Exam: 11/11/, 1 Exam Level: RO Item Description Initials a b C

1. Clean answer sheets copied before grading

2. Proposed answer key changes and question deletions justified and documented (facility reviewer initials not required (N/R) if NO post-examination comments are submitted)

3. Applicants' scores checked for addition errors (reviewers spot check> 25% of examinations)

4. Grading for all borderline cases (80% +/-2% overall and 70% or I 80%, as applicable, +/-4% on the SRO-only exam) reviewed in N/12 tJf;c..

detail

5. All other failing examinations checked to ensure that grades N ll1 rJ / '/..

are justified //\ 1

6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of questions missed by one-half or more of the applicants Printed Name/Signature Date

a. Grader o \,ev t

-'-'--"-------+-=---f-#----,-'<--,,L:._,...c;;.--

,i/n/1, F *

b. Facility Reviewer(*) iZf3/!7

/2//ij/7

c. NRG Chief Examiner (*) 12.J~-/t7

,- )

(*) The facility reviewer's signature is not applicable for examinations graded by the NRG; two independent NRG reviews are required.

ES-403, Page 6 of 6