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{{#Wiki_filter:EXAM ASSIGNMENT TICKLER Chief:              John Kirkland                            Facility:        PV                Date of Written Exam:                5/12/2022 U/I:                                                Start of Op Test:      5/2/2022                      End of Op Test:              5/6/2022 Written Exam Developed By:              NRC    /  Facility                  Operating Test Developed By:          NRC      /  Facility Due Date                                Description                          Date Complete    Initials                        Notes For NRC prepared exams, arrangements made 8/30/2021  Examination administration date confirmed                          7/13/2021                for the facility to submit reference materials 10/4/2021  NRC examiners and facility contact assigned                        7/13/2021 10/4/2021  Facility contact briefed on security and other requirements        7/13/2021 10/4/2021  Reference material due for NRC prepared exams                      11/22/2021                ES-201 Att-3 10/4/2021  Corporate Notification Letter sent                                  7/14/2021                ES-201 Att-4 produced by CE NRC developed written examination outline sent to facility 10/18/2021 contact                                                            7/13/2021                ES-401-1/2 and ES-401-3 11/29/2021  Operating test outline(s) and other checklists due                11/22/2021                ES-201-2, 201-3, 301-1, 301-2, 301-5, D-1 Operating test outline(s) reviewed by NRC and feedback 12/13/2021 provided to facility licensee                                      11/29/2021                ES-201-2 signed by CE & BC Proposed exams, outlines, supporting documentation, and                                      Exams prepared by the NRC are approved by 2/14/2022 reference materials due.                                            2/24/2022                BC and forwarded for facility licensee review 2/21/2022  Peer review of written exam complete                                  N/A          N/A    Document review on ES-401-9 3/14/2022  Written exam and operating test reviews completed                  3/10/2022                Document review on ES-401-9 3/28/2022  Feedback approved by Branch Chief                                  3/10/2022 Examination review results discussed between NRC and facility 3/28/2022 licensee                                                            3/30/2022 4/4/2022  Preliminary license applications & waiver/excusal requests due      4/4/2022                NRC Forms 398/396 3/28/2022  On-site validation & 10% audit of license applications              3/28/2022 4/11/2022  Preliminary license applications and waivers reviewed                4/4/2022 4/18/2022  Final license applications & waiver/excusal requests due            4/14/2022                ES-201-4 prepared by LA 4/25/2022  Written exams and operating tests approved by Branch Chief          4/12/2022 4/25/2022  Request facility licensee management feedback on the exam              N/A          N/A Final applications reviewed and audited; exam approval and                                  LA produces / BC signs Exam Approval Letter 4/25/2022 waiver/excusal letters sent                                        4/14/2022                (ES-201 Att-5)
Proctoring/written exam administration guidelines reviewed with 4/25/2022 facility licensee                                                    5/5/2022 4/25/2022  Approved scenarios and JPMs distributed to examiners                4/25/2022 5/2/2022  Administer Operating Test                                            5/2/2022 5/13/2022  Examiner's document op test results on ES 303's                    5/13/2022 6/1/2022  Post exam comments and graded exams received                        5/19/2022                ES-403-1 to BC Post exam written comments reviewed and incorporated and 6/9/2022 NRC grading completed                                              5/20/2022 Post exam operating test comments reviewed and ES-303-1 6/9/2022 updated                                                            2/21/2022 Chief examiner review of operating test and/or written exam 6/16/2022 grading completed                                                  5/22/2022                Signed ES 303's to BC 6/23/2022  Branch Chief review of exam results completed                      5/23/2022 6/30/2022  Waivers/deferrals reviewed for impact on licensing decision        5/23/2022 License/Proposed Denial letters mailed; Facility notified of 6/30/2022 results                                                              6/1/2022 6/30/2022  RPS/IP number of examinees updated                                  5/24/2022                print Report-21 7/21/2022  Final Denial Letters mailed (if no request for informal review)        N/A          N/A    21 days after proposed denial letters mailed.
7/28/2022  Examination Report Issued                                          6/27/2022                produced by CE 8/4/2022  Ref Mat'l Returned after Final Resolution of Appeals                  N/A          N/A 9/1/2022  SUNSI checklist complete and exam docs to ADAMS                    6/27/2022                SUNSI checklist to LA Replaces NUREG-1021, Revision 11, Forms ES-201-1 and ES-501-1 Rev. 9
 
password es1021 Form 2.3-1 Examination Outline Quality Checklist Facility: PVNGS                                              I Date of Examination:                        5/2/2022 (Y)es / (N)o Item                                      Task Description a              b*            c#
z      The outline was systematically and randomly prepared in accordance with the w      instructions in Section B of ES-4.1, and all knowledge and ability (KIA) categories                            JR I-I-    are aoorooriatelv sampled                                                                                                                  'fl'--
c2    The outline does not overemphasize any systems, evolutions, or generic topics                                  JR              AM 4£--
s      Justifications for deselected or rejected KIA statements are acceptable.                                      JR              AM ~
Using Form 3.4-1, Events and Evolutions Checklist, verify that the proposed scenario sets cover the required number of normal evolutions, reactivity evolutions, instrument and component failures, manual control evolutions,                                      JR              AM 0:::  technical specifications, and major transients.                                                                                          .p.-
0      There are enough scenarios (and spares) for the projected number and mix of
    ~      applicants in accordance with the expected crew composition and rotation schedule without compromising exam integrity. Ensure that scenarios will not be                              JR              AM
    ~      repeated on subseQuent davs.                                                                                                              of"--
ci5    Ensure that all scenarios are new or significantly modified in accordance with ES-3.4 and that no scenarios are duplicated from the aoolicants' audit test(s).                                JR"              AM" ~
To the extent possible, assess whether the outline(s) conforms with the qualitative and auantitative simulator set criteria specified on Form 2.3-2.                                              JR              AM .p-Verify that the control room and in-plant systems outline meets the criteria specified in the instructions on Form 3.2-2 and that no tasks are duplicated from the aoolicant's audit test(s).
JR"              AM"        .p-en      Verify that the administrative outline meets the criteria specified in the instructions
    ~                                                                                                                                    AMA a..
    ....,  on Form 3.2-1 and that no tasks are duplicated from the aoolicant's audit test(s).                          JR"                          ~
Determine whether the number of job performance measures (JPMs) and JPM types is sufficient for the projected number and mix of applicants and ensure that                            JR              AM no items are duplicated on subseQuent davs.                                                                                              ~
Assess whether the appropriate exam sections cover plant-specific priorities (includina probabilistic risk assessment and individual plant examination insiahts).                          JR              AM          ,p:--
Assess whether the 10 CFR 55.41, 10 CFR 55.43, and 10 CFR 55.45 sampling is
    ....J  aoorooriate .                                                                                                JR              AM          ifL-ciw    Check whether KIA importance ratings (except for plant-specific priorities) are greater than or equal to 2.5.                                                                                JR              AM          ..pt z      Check for duplication and overlap across the exam and with the last two NRC w                                                                                                                    JR              AM #-
C)      exams.
Check the entire exam for balance of ~overage.                                                                JR            AM          #-
Assess whether the exam fits the appropriate job level (reactor operator or senior reactor operator).                                                                                            JR              AM          ,p--
Printed Name I Signature                                                      Date Dlgltally signed by John Rodgers
: a. Author                            John Rodgers                                DN:rn=John Rodgers, o-Exi.m Group, ou-9618, emalf=john.rodge~aps:.com. c=US Date: 2021.11 .1711:35:19-07'00' O)gltally signed by ~  n Mar:sh
: b. Facility Reviewer(*)              Allen Marsh                                ON: cn=Alen MaM, o-PVNGS,o~ratians,<ll!maif=a1len.mar:sh@aps.com. e=US Date: 2021.11.1913:35:S-4-07'00' C.      NRC Reviewer (#)              j Q~ "-    \L,,~ \a"'ol ;</lL ~                                                l'l-/ I      /z.J NRC Chief Examiner                      Jo"-V\.    \( ,~ k_  I 11 ... cl{W ~ 11-/t /21 NRC Supervisor                                                          u
* The facility licensee signature is not applicable for NRC developed tests
# An independent NRC reviewer performs the steps in column "c" . This may be the NRC Chief Examiner if he/she did not develop the outline under review "The audit exam has not yet been developed but the instructions on the referenced forms and NUREG 1021 sections have been met
 
Form 2.3-2 Operating Test Quality Checklist Facility: PVNGS                          I Date of Examination:    5/2/2022              I Operating Test Number: 2022 (Y)es/ (N)o General Criteria a      b*      c#
y      y
: a. The operating test meets the criteria on the associated test outline                                                    1
: b. There are enough test items so that test items will not be repeated on more than 1 day of the            y      y operating test                                                                                                          y C. The operating test does not duplicate items from the applicant's audit test(s)                          y      y        y
: d. Overlap with the written examination and between different part of the operating test is minimized      y      y
                                                                                                                              'I y      y
: e. It appears that the operating test will differentiate between competent and less-than-competent applicants at the designated license level y
Walkthrough Criteria Each job performance measure (JPM) includes the following, as applicable:                                      y      y
                                                                                                                              '--(
* Task standard
* Initial conditions
* Initiating cues
* References and tools, including associated procedures
* Reasonable and validated time limits (average time allowed for completion) and specific designation if the facility licensee deems it to be time critical
* Specific designation if it meets the criteria of alternate path
* Operationally important specific performance criteria that include the following:
            -    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 JPM task standard
            -    Identification of critical steps and their associated performance standards
            -    Restrictions on the sequence of steps, if applicable
: b. Ensure that any changes from the previously approved JPM outlines (Forms 3.2-1 and 3.2-2)                y      y    'f have not caused the test to deviate from any of the acceptance criteria (e.g., item distribution, bank use, repetition from the last two NRC examinations) specified on those forms Simulator Scenario Set Criteria for Scenario Numbers: 2 / 4 / 3 (1 Is the spare)
QUALITATIVE ATTRIBUTES
: 1. The initial conditions are realistic in that some equipment and/or instrumentation may be out of          y      y      'I service, but it does not cue the operators into expected events
: 2. The scenarios consist mostly of related events                                                            y      y      y y      y
: 3. Each event description consists of the following:
* The point in the scenario when it is to be initiated
                                                                                                                              'I
* 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)
 
(Y)es/(N)o QUALITATIVE ATTRIBUTES continued a        b*      elf.
: 4. The events are valid with regard to physics and thermodynamics                                        y        y      y
: 5. The sequencing and timing of events is reasonable and allows the examination team to observe          y          y and evaluate applicant performance                                                                                      y
: 6. If time compression techniques are used, the scenario summary clearly so indicates. Operators          y        y have sufficient time to carry out expected activities without undue time constraints. Cues are                          y given.
: 7. The simulator modeling is not altered                                                                  y        y      y
: 8. The scenarios have been validated. Pursuant to 10 CFR 55.46(d), any open simulator                    y        y performance deficiencies or deviations from the referenced plant have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.
y
: 9. Scenarios are new or significantly modified in accordance with ES-3.4                                  y        y      '(
: 10. Scenarios (as grouped) allow each applicant to be significantly involved in the minimum number          y        y of transients, events, and evolutions specified on the version Form 3.4-1 submitted with the                            y scenario set 11 . Applicants are evaluated on a similar number of pre-identified critical tasks across scenarios,        y        y when possible                                                                                                          y
: 12. The level of difficulty is appropriate to support licensing decisions for each crew position            y        y      y Actual Attributes by        (Y)es/ (N)o TARGET QUANTITATIVE ATTRIBUTES per Scenario (See ES-3.4)                            Scenario No.
2 I 41 3 / 1 (spare)  a        b*      elf.
: 1. Malfunctions after emergency operating procedure (EOP) entry (1-2)                  1/3/3/2          y        y      y
: 2. Abnormal events (2-4)                                                                4/3/3/3          y        y      y
: 3. Major transients (1-2)                                                              1/1/1/1          y        y      '(
: 4. EOPs entered/requiring substantive actions (1-2)                                    1/1/1/1          y        y      y
: 5. Entry into a contingency EOP with substantive actions (~ 1 per                                        y        y scenario set, set is the entire set of scenarios prepared for the                    0/1/1/0                            y scheduled exam)
: 6. Pre-identified critical tasks (~ 2)                                                  3/2/2/2          y        y      y Date Pointed Name/-    ~                  ~
: a. Author                                            John Rodgers I                                        4/5/2022
: b. Facility Reviewer (*)                              Allen Marsh I
                                                                          / J6/-c>-:r7X                      4/5/2022
: c. NRC Reviewer (#)
JohV\    IL,rk..la~cl 1-:J)J.[ rfl .:::--.:..~        4(12 /z. 2..
NRC Chief Examiner                                      Jc),-w1    \l 1rkla,0/4,ir~                              4Jr2.. /2,2.
NRC Supervisor                                  &#xb5;t~{htr Ge.1)-\o,~              ~/4L"1f-kfa..JfI ~ic/      ,
                                                                                                                    ~/;di ~
J,,J      ,,, ,,
* The facility licensee signature is not applicable for NRC developed tests
# An independent NRC reviewer performs the steps in column "c". This may be the NRC Chief Examiner if he/she did not develop the etltline under review
 
Form 2.3-4 Written Examination Quality Checklist Facility: PVNGS                        Date of Exam: 512/2022                      Exam Level:          RO
                                                                                                                  ~      SRO~
(Y)es I (N)o Item Description a      b*      c#
y      y
: 1. Questions and answers are technically accurate and applicable to the facility. Each question includes a technical reference.                                                                                              y
: 2. a. All questions reference NRC knowledge and abilities (K/As) requirements.                                y      y
: b. Facility learning objectives are referenced as available.
: c. All questions include an explanation of the correct answer and a distractor analysis.
y
: 3. Senior reactor operator (SRO) questions test at the SRO license level.                                      y      y      y
: 4. The sampling process was random and systematic. (If more than four reactor operator (RO) or two            y      y SRO questions were repeated from the last two NRC licensing exams, including full (100-question) retake examinations, consult the NRC Office of Nuclear Reactor Regulation operator licensing program office.)                                                                                                          ~
: 5. Question duplication from the licensee screening/audit exam was controlled as indicated below              y      y (check the item that applies) and appears appropriate:
_ The audit exam was systematically and randomly developed
_ The audit exam was completed before the license exam was started
                                                                                                                                  '(
_ The examinations were developed independently
_X_ The licensee certifies that there is no duplication
_ Other (explain):
: 6. Bank use meets limits (no more than 75% from the bank, at least          Bank      Modified      New    y      y 10% new (at the comprehension/analysis level), and the rest new or modified); enter the actual RO/SRO-only questions distribution >        16/6          7/3        52 / 16 y
: 7. Between 38 and 45 questions of the question on the RO exam and                                              y      y Memory              CIA at least 13 of the questions on the SRO-only portion of the exam are written at the comprehension/analysis level; enter the actual RO/SRO-only question distribution >                                            31 / 10          44/ 15                  1 y      y
: 8. References/handouts provided do not give away answers or aid in the elimination of distractors.                            'I
: 9. Question content conforms to specific KIA statements in the previously approved examination outline          y      y and is appropriate for the KIA statements' assigned tier; deviations are justified.                                        y
: 10. Question psychometric quality and format meet the instructions and guidelines in ES-4.2.                      y      y      y.
: 11. The exam contains the required number of one-point, multiple-choice items; the total is correct and          y      y agrees with the value on the cover sheet.                                                                                  'I Primed N,me / Sigoature          ~                        Date        (
: a. Author                                            John Rodgers I  ~                                      4/5/2022
: b. Facility Reviewer(*)                                Allen Marsh
                                                                      '/~&#xa3;<_                                      4/5/2022
: c. NRC Reviewer(#)
JC> hV\ ll ,~k.\aV\d          I ~~-->2/    -            '
4/12/?2.
NRC Chief Examiner                            Jotivt ll 1,1'.Jd"'d U::;;/V-()                      :><
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                                                                                                            - ,. 4)12'2 2-NRC Supervisor                                J..l~dih-t, Gt~i~            I if/ 1aYb5f.S//1ffe1//          -,    <f/J;i/4:J-
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* The facility licensee signature is not applicable for NRC developed tests
# An independent NRC reviewer performs the steps in column "c". This may be the NRC Chief Examiner if he/she did not develop the 8l:ltline under review
 
Form 3.4-1 Events and Evolutions Checklist (Based on running Scenarios 2/4/3)
Facility: PVNGS                        Date of Exam: 5/2/2022                                    Operating Test Number: 2022 E                                                      Scenarios A        V                                                                                                    M P        E                                                                                                      I P        N            1                  2                  3                  4              T              N L        T                                                                                      O              I I                                                                                              T              M C        T        POSITION        POSITION            POSITION            POSITION            A              U A        Y      S    A    B    S      A      B    S      A      B    S      A      B      L              M N        P      R    T    O    R      T    O    R      T      O    R      T      O RO    SRO-I SRO-U T        E      O    C    P    O      C      P    O    C        P    O    C        P RX                                                                                        0      1      1      0 R1    NOR                                  1                          1                          2      1      1      1 2,3,4,7 I/C                                3,4,5                      3,4,5
                                                                                              ,8    11      4      4      2 RX+NOR MAJ                                    6                          6                  5      3      2      2      1
  +I/C  Man. Ctrl.                          4,5                        4,5                2,4,7    7      1      1      0 13    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R2    NOR                                                                        1              1      1      1      1 I/C                                      2,3,4,7                        3,4,6,8          8      4      4      2 RX+NOR MAJ                                            6                              5              2      2      2      1
  +I/C  Man. Ctrl.                                4,6,7                            4              4      1      1      0 9    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R3    NOR                                  1                          1                          2      1      1      1 I/C                                3,4,5                      3,4,5                        6      4      4      2 RX+NOR MAJ                                    6                          6                          2      2      2      1
  +I/C Man. Ctrl.                          4,5                        4,5                        4      1      1      0 8    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R4    NOR                                                    2                                  1      1      1      1 3,4,5,8 I/C                                      2,3,4,7
                                                                  ,9                                9      4      4      2 RX+NOR MAJ                                            6          6                                  2      2      2      1
  +I/C  Man. Ctrl.                                4,6,7        4,5                                5      1      1      0 10    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R5    NOR                                  1                                                    1      1      1      1 2,3,4,7 I/C                                3,4,5
                                                                                              ,8    8      4      4      2 RX+NOR MAJ                                    6                                              5      2      2      2      1
  +I/C  Man. Ctrl.                          4,5                                          2,4,7    5      1      1      0 9    TS                                                                                        0      0      2      2
 
Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS                        Date of Exam: 5/2/2022                                  Operating Test Number: 2022 E                                                      Scenarios A        V                                                                                                    M P        E                                                                                                    I P        N            1                2                  3                  4              T              N L        T                                                                                    O              I I                                                                                            T              M C        T        POSITION        POSITION          POSITION            POSITION            A              U A        Y      S    A    B    S    A      B    S      A      B    S      A      B      L              M N        P      R    T    O    R    T      O    R      T      O    R      T      O RO    SRO-I SRO-U T        E      O    C    P    O    C      P    O    C        P    O    C        P RX                                                                                        0      1      1      0 R6    NOR                                                                        1              1      1      1      1 I/C                                    2,3,4,7                        3,4,6,8          8      4      4      2 RX+NOR MAJ                                          6                              5              2      2      2      1
  +I/C  Man. Ctrl.                              4,6,7                            4              4      1      1      0 9    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R7    NOR                                                            1          1              2      1      1      1 I/C                                                          3,4,5      3,4,6,8          7      4      4      2 RX+NOR MAJ                                                              6          5              2      2      2      1
  +I/C  Man. Ctrl.                                                    4,5          4              3      1      1      0 9    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R8    NOR                                                    2                                  1      1      1      1 3,4,5,8                    2,3,4,7 I/C                                                    ,9                          ,8    10      4      4      2 RX+NOR MAJ                                                      6                          5      2      2      2      1
  +I/C Man. Ctrl.                                            4,5                        2,4,7    5      1      1      0 11    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R9    NOR                                                                        1              1      1      1      1 I/C                                    2,3,4,7                        3,4,6,8          8      4      4      2 RX+NOR MAJ                                          6                              5              2      2      2      1
  +I/C  Man. Ctrl.                              4,6,7                            4              4      1      1      0 9    TS                                                                                        0      0      2      2 RX                                                                                        0      1      1      0 R10    NOR                                                    2                                  1      1      1      1 3,4,5,8                    2,3,4,7 I/C                                                    ,9                          ,8    10      4      4      2 RX+NOR MAJ                                                      6                          5      2      2      2      1
  +I/C  Man. Ctrl.                                            4,5                        2,4,7    5      1      1      0 11    TS                                                                                        0      0      2      2
 
Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS                        Date of Exam: 5/2/2022                          Operating Test Number: 2022 E                                                  Scenarios A        V                                                                                            M P        E                                                                                            I P        N            1                2                3                4          T              N L        T                                                                            O              I I                                                                                    T              M C        T        POSITION        POSITION          POSITION          POSITION      A              U A        Y      S    A    B    S      A    B    S    A    B      S    A    B    L              M N        P      R    T    O    R      T    O    R      T    O    R    T    O RO    SRO-I SRO-U T        E      O    C    P    O      C    P    O      C    P    O    C    P RX                                                                                0      1      1      0 I1    NOR                                1                                            1      1      1      1 3,4,5,8            2,3,4,6 I/C                              3,4,5
                                                        ,9              ,7,8            14      4      4      2 RX+NOR MAJ                                    6          6                  5              3      2      2      1
  +I/C  Man. Ctrl.                        4,5                                            2      1      1      0 15    TS                                            2,4                3,4              4      0      2      2
 
Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS                          Date of Exam: 5/2/2022                            Operating Test Number: 2022 E                                                    Scenarios A        V                                                                                              M P        E                                                                                              I P        N            1                  2                3                  4          T              N L        T                                                                              O              I I                                                                                      T              M C        T        POSITION          POSITION          POSITION          POSITION      A              U A        Y      S    A    B    S    A    B    S    A      B      S    A    B    L              M N        P      R    T    O    R      T    O    R      T    O      R    T    O RO    SRO-I SRO-U T        E      O    C    P    O      C    P    O      C      P    O    C    P RX                                                                                  0      1      1      0 U1    NOR                                                                                0      1      1      1 2,3,4,5                              2,3,4,6 I/C                          ,7                                  ,7,8            11      4      4      2 RX+NOR MAJ                              6                                    5              2      2      2      1
  +I/C  Man. Ctrl.                                                                          0      1      1      0 11    TS                          2,4                                  3,4              4      0      2      2 RX                                                                                  0      1      1      0 U2    NOR                                                                                0      1      1      1 2,3,4,5          3,4,5,8 I/C                          ,7                ,9                                10      4      4      2 RX+NOR MAJ                              6                6                                  2      2      2      1
  +I/C  Man. Ctrl.                                                                          0      1      1      0 10    TS                          2,4              2,4                                  4      0      2      2 RX                                                                                  0      1      1      0 U3    NOR                                                                                0      1      1      1 2,3,4,5                              2,3,4,6 I/C                          ,7                                  ,7,8            11      4      4      2 RX+NOR MAJ                              6                                    5              2      2      2      1
  +I/C  Man. Ctrl.                                                                          0      1      1      0 11    TS                          2,4                                  3,4              4      0      2      2 RX                                                                                  0      1      1      0 U4    NOR                                                                                0      1      1      1 3,4,5,8            2,3,4,6 I/C                                            ,9                ,7,8            11      4      4      2 RX+NOR MAJ                                                6                  5              2      2      2      1
  +I/C  Man. Ctrl.                                                                          0      1      1      0 11    TS                                            2,4                3,4              4      0      2      2 RX                                                                                  0      1      1      0 U5    NOR                                                          1                      1      1      1      1 2,3,4,5 I/C                          ,7 3,4,5                    8      4      4      2 RX+NOR MAJ                              6                              6                      2      2      2      1
  +I/C  Man. Ctrl.                                                  4,5                    2      1      1      0 9    TS                          2,4                                                    2      0      2      2
 
0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5  3  0.5 0.5  5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1  0.5 0.5  1 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5  2  0.5 0.5  3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5  3  0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  4  0.5  5  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5 0.5 0.5 0.5  5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  1 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5  3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5
 
0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5  4  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5 0.5  5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5  3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5  4  0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  3  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5 0.5  5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5  1 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5  3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5
 
0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  3  0.5  5  0.5 0.5  6  0.5 0.5 0.5 0.5 0.5 0.5  1  0.5  1  0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5  2  0.5 0.5
 
0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5 0.5 0.5 0.5  6  0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5  5  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5 0.5 0.5 0.5  6  0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5  6  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5  5  0.5 0.5 0.5 0.5  3  0.5 0.5 0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5  1  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5  2  0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5
 
IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4
                                                            # Candidates Exam          Site / Docket # / Insp Rpt #              RO LSRO SROI SROU    Type  Exam Author Chief Examiner Examiners Assigned Week 05/01/2022    Palo Verde / 05000528, 05000529, 05000530 10    0    1    5 FB-OR-      NFF    Kirkland, John Bergeon,Bryan
              / 2022301                                                    INITIAL                            Clayton,Kelly CAC #: 000500                                                LICENSE                            Doyle,Matthew EXAM                              Hernandez,Nick ADMINIS                            Kirkland,John TRATION                            Osterholtz,Clyde (EXAD)                            You,David Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM                                                                                                            Page 1 of 4
 
IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Date                                  RO  SROI SROU LSRO  Total 05/2022                                            10    1    5    0    16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM                                                                  Page 2 of 4
 
IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Site                                  RO  SROI SROU LSRO  Total Palo Verde                                        10    1    5    0    16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM                                                                  Page 3 of 4
 
IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Region                                RO  SROI SROU LSRO  Total Region 4                                          10    1    5    0    16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM                                                                  Page 4 of 4
 
Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination
( 1) Pre-Examination I acknowledge that I have acquired specialized know ledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 the comp letion of examination administration, except as specifically not ed below or authorized by the NRC. Furthermore, I am aware of the physi ca l 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 enforcement action by the NRC against m e or the faci lity licensee, or both. I wi ll immediately report to facility licensee management or the NRC chief examination any indication or suggestions that examination security may have been compromised.
(2) Post-Examination To t he best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered into this examination security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who we re administered these licensing examinations, except as specifically noted below or authorized by the NRC.
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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge that I have acquired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 the completion of examination administration, except as specifically noted below or authorized by the NRC. Furthermore, I am aware of the physical security measures and requ irements (as documented in the facility licensee's procedures) and understand that violation of the conditions of t his agreement may result in cancellation of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management or the NRC chief examination any indication 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 NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From t he date that I entered into this exam ination 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 examinat ions, except as specifically noted below or authorized by the NRC.
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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons w ho have not been authorized by the NRC chief examiner. I understand t hat I am not to instruct, evaluate, or provide perfo rmance feedback t o those applicants scheduled to be administered these licensing exam inations from this date until the completion of examination administration, except as specifically noted below or authorized by t he NRC. Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand th at violation of the conditions of this agreement may result in cancellat ion of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management o r the NRC chief examination any indication o r suggestions t hat 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 NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered into this examination security agre ement until the complet ion 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 or authorized by the NRC.
Print Name                    Job Title                Signature (1)          Date                                            Note
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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Exam ination I acknowledge that I have acquired specialized knowledge abo ut the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 th e completion of examination administ ration, except as specifically noted below or authorized by t he NRC. Furthermore, I am aware of the physical security measures and requirements (as documented in t he facility licensee's procedures) and understand that violation of the conditions of t his agree ment may result in cancellation of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management or the NRC chief examination any indication 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 info rmation concerning the NRC licensing examinations scheduled to be administered from May 2, 2022 t hrough May 12, 2022. From the date that I entered into t his examination 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 not ed below or authorized by the NRC.
Print Name                      Job Title
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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial Licen se Examination (1) Pre-Examination I acknowledge that I have acq uired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) lice nsing examination scheduled for May 2, 2022 through May 12, 2022, as of the d ate o f my signature. That I will not knowingly divulge any informat ion about t hese examinat ions to any persons who have not been authorized by the NRC chief exam iner. I u ndersta nd that I am not to instruct, evaluate, or provide performance feedback to those applicants sched uled to be administered these lice nsing exa minations from t his date until the co mpletion of examination administration, except as specifica lly noted below or authorized by t he NRC. Furthermore, I am aware of the physica l security measures and req uirements (as docum ented in the facility lice nsee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the exam inations, and enforcem ent action by the NRC against me or the faci lity licensee, or both. I w ill immediately repo rt to facility lice nsee management or the NRC ch ief examination any indication or suggestions that examination security may have been com promised.
(2) Post-Examination To t he best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing exam inations scheduled to be ad ministered from May 2, 2022 through May 12, 2022 . From the date that I entered into this examination security agreement until the co mplet ion of exa mination administration, I did not instruct, evaluate, or provide performance feedback to those applica nts who we re administered th ese licens ing examinations, except as specifica lly noted below or aut horized by the NRC.
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Form 1.3-1 Examination Security Agreement- 2022 PVNGS NRC Initial License Examination (1) Pre-Exa mination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regu latory Commission (NRC) licensing examination scheduled fo r May 2, 2022 through May 12, 2022, as of the date of my signature. That I will not knowingly divulge any informat ion about these examinations to any persons who have not been authorized by t he NRC chief examiner. I understa nd that I am not to instruct, evaluat e, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until the completion of examination administration, except as specifically noted below or authorized by the NRC. Furthermore, I am aware of t he physical security measures and require ments (as documented in the facility licensee' s procedures) and understand tha t violation of the conditions of this agreement may resu lt in cancellation of the examinatio ns, and enforcement action by the NRC aga inst me or the faci lity licensee, or both. I will immediately report to facility licensee manage ment or the NRC chief examination any indication or suggestions t hat 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 NRC licensi ng examinations scheduled to be adm inistered from May 2, 2022 through May 12, 2022. From the date t hat I entered into this examination 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 or authorized by t he NRC.
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1 Notes:
 
Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge t hat I have acquired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 t hrough May 12, 2022, as of the date of my signature. That I wi ll not knowingly divulge any information about these exami nations to any persons who have not been aut horized by the NRC chief examiner. I understa nd t hat I am not to instruct, evaluate, or provide performance feedback to t hose applicants scheduled t o be administered t hese licensing exami nations from this date unt il t he complet ion of examination administrat ion, except as specifica lly noted below or authorized by t he NRC. Furthermore, I am aware of t he physical security measures and requirements (as documented in the facility licensee's proced ures) and understand t hat violation of t he condit ions of this agreement may resu lt in ca ncellation of the exam inat ions, and enforcement action by t he NRC against m e or t he facility licensee, o r both. I w ill immediately report to facility licensee m anagement or the NRC chief examination any indication or suggestions t hat examination security may have been compromised.
(2) Post-Examination To the best of my knowledge, I did not divulge to any unaut horized persons any information concerning t he NRC licensing examinat ions scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered int o this examination security agreement until the completion of exam ination administration, I did not instruct, evaluate, or provide perfo rmance feedback t o t hose applicants w ho were administered t hese licensing examinations, except as specifically noted below or aut horized by the NRC.
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Latest revision as of 09:14, 29 June 2022

PV-2022-05-Public Forms
ML22178A177
Person / Time
Site: Palo Verde  Arizona Public Service icon.png
Issue date: 04/12/2022
From: Heather Gepford
NRC/RGN-IV/DORS/OB
To:
Arizona Public Service Co
References
Download: ML22178A177 (25)


Text

EXAM ASSIGNMENT TICKLER Chief: John Kirkland Facility: PV Date of Written Exam: 5/12/2022 U/I: Start of Op Test: 5/2/2022 End of Op Test: 5/6/2022 Written Exam Developed By: NRC / Facility Operating Test Developed By: NRC / Facility Due Date Description Date Complete Initials Notes For NRC prepared exams, arrangements made 8/30/2021 Examination administration date confirmed 7/13/2021 for the facility to submit reference materials 10/4/2021 NRC examiners and facility contact assigned 7/13/2021 10/4/2021 Facility contact briefed on security and other requirements 7/13/2021 10/4/2021 Reference material due for NRC prepared exams 11/22/2021 ES-201 Att-3 10/4/2021 Corporate Notification Letter sent 7/14/2021 ES-201 Att-4 produced by CE NRC developed written examination outline sent to facility 10/18/2021 contact 7/13/2021 ES-401-1/2 and ES-401-3 11/29/2021 Operating test outline(s) and other checklists due 11/22/2021 ES-201-2, 201-3, 301-1, 301-2, 301-5, D-1 Operating test outline(s) reviewed by NRC and feedback 12/13/2021 provided to facility licensee 11/29/2021 ES-201-2 signed by CE & BC Proposed exams, outlines, supporting documentation, and Exams prepared by the NRC are approved by 2/14/2022 reference materials due. 2/24/2022 BC and forwarded for facility licensee review 2/21/2022 Peer review of written exam complete N/A N/A Document review on ES-401-9 3/14/2022 Written exam and operating test reviews completed 3/10/2022 Document review on ES-401-9 3/28/2022 Feedback approved by Branch Chief 3/10/2022 Examination review results discussed between NRC and facility 3/28/2022 licensee 3/30/2022 4/4/2022 Preliminary license applications & waiver/excusal requests due 4/4/2022 NRC Forms 398/396 3/28/2022 On-site validation & 10% audit of license applications 3/28/2022 4/11/2022 Preliminary license applications and waivers reviewed 4/4/2022 4/18/2022 Final license applications & waiver/excusal requests due 4/14/2022 ES-201-4 prepared by LA 4/25/2022 Written exams and operating tests approved by Branch Chief 4/12/2022 4/25/2022 Request facility licensee management feedback on the exam N/A N/A Final applications reviewed and audited; exam approval and LA produces / BC signs Exam Approval Letter 4/25/2022 waiver/excusal letters sent 4/14/2022 (ES-201 Att-5)

Proctoring/written exam administration guidelines reviewed with 4/25/2022 facility licensee 5/5/2022 4/25/2022 Approved scenarios and JPMs distributed to examiners 4/25/2022 5/2/2022 Administer Operating Test 5/2/2022 5/13/2022 Examiner's document op test results on ES 303's 5/13/2022 6/1/2022 Post exam comments and graded exams received 5/19/2022 ES-403-1 to BC Post exam written comments reviewed and incorporated and 6/9/2022 NRC grading completed 5/20/2022 Post exam operating test comments reviewed and ES-303-1 6/9/2022 updated 2/21/2022 Chief examiner review of operating test and/or written exam 6/16/2022 grading completed 5/22/2022 Signed ES 303's to BC 6/23/2022 Branch Chief review of exam results completed 5/23/2022 6/30/2022 Waivers/deferrals reviewed for impact on licensing decision 5/23/2022 License/Proposed Denial letters mailed; Facility notified of 6/30/2022 results 6/1/2022 6/30/2022 RPS/IP number of examinees updated 5/24/2022 print Report-21 7/21/2022 Final Denial Letters mailed (if no request for informal review) N/A N/A 21 days after proposed denial letters mailed.

7/28/2022 Examination Report Issued 6/27/2022 produced by CE 8/4/2022 Ref Mat'l Returned after Final Resolution of Appeals N/A N/A 9/1/2022 SUNSI checklist complete and exam docs to ADAMS 6/27/2022 SUNSI checklist to LA Replaces NUREG-1021, Revision 11, Forms ES-201-1 and ES-501-1 Rev. 9

password es1021 Form 2.3-1 Examination Outline Quality Checklist Facility: PVNGS I Date of Examination: 5/2/2022 (Y)es / (N)o Item Task Description a b* c#

z The outline was systematically and randomly prepared in accordance with the w instructions in Section B of ES-4.1, and all knowledge and ability (KIA) categories JR I-I- are aoorooriatelv sampled 'fl'--

c2 The outline does not overemphasize any systems, evolutions, or generic topics JR AM 4£--

s Justifications for deselected or rejected KIA statements are acceptable. JR AM ~

Using Form 3.4-1, Events and Evolutions Checklist, verify that the proposed scenario sets cover the required number of normal evolutions, reactivity evolutions, instrument and component failures, manual control evolutions, JR AM 0::: technical specifications, and major transients. .p.-

0 There are enough scenarios (and spares) for the projected number and mix of

~ applicants in accordance with the expected crew composition and rotation schedule without compromising exam integrity. Ensure that scenarios will not be JR AM

~ repeated on subseQuent davs. of"--

ci5 Ensure that all scenarios are new or significantly modified in accordance with ES-3.4 and that no scenarios are duplicated from the aoolicants' audit test(s). JR" AM" ~

To the extent possible, assess whether the outline(s) conforms with the qualitative and auantitative simulator set criteria specified on Form 2.3-2. JR AM .p-Verify that the control room and in-plant systems outline meets the criteria specified in the instructions on Form 3.2-2 and that no tasks are duplicated from the aoolicant's audit test(s).

JR" AM" .p-en Verify that the administrative outline meets the criteria specified in the instructions

~ AMA a..

...., on Form 3.2-1 and that no tasks are duplicated from the aoolicant's audit test(s). JR" ~

Determine whether the number of job performance measures (JPMs) and JPM types is sufficient for the projected number and mix of applicants and ensure that JR AM no items are duplicated on subseQuent davs. ~

Assess whether the appropriate exam sections cover plant-specific priorities (includina probabilistic risk assessment and individual plant examination insiahts). JR AM ,p:--

Assess whether the 10 CFR 55.41, 10 CFR 55.43, and 10 CFR 55.45 sampling is

....J aoorooriate . JR AM ifL-ciw Check whether KIA importance ratings (except for plant-specific priorities) are greater than or equal to 2.5. JR AM ..pt z Check for duplication and overlap across the exam and with the last two NRC w JR AM #-

C) exams.

Check the entire exam for balance of ~overage. JR AM #-

Assess whether the exam fits the appropriate job level (reactor operator or senior reactor operator). JR AM ,p--

Printed Name I Signature Date Dlgltally signed by John Rodgers

a. Author John Rodgers DN:rn=John Rodgers, o-Exi.m Group, ou-9618, emalf=john.rodge~aps:.com. c=US Date: 2021.11 .1711:35:19-07'00' O)gltally signed by ~ n Mar:sh
b. Facility Reviewer(*) Allen Marsh ON: cn=Alen MaM, o-PVNGS,o~ratians,<ll!maif=a1len.mar:sh@aps.com. e=US Date: 2021.11.1913:35:S-4-07'00' C. NRC Reviewer (#) j Q~ "- \L,,~ \a"'ol ;</lL ~ l'l-/ I /z.J NRC Chief Examiner Jo"-V\. \( ,~ k_ I 11 ... cl{W ~ 11-/t /21 NRC Supervisor u
  • The facility licensee signature is not applicable for NRC developed tests
  1. An independent NRC reviewer performs the steps in column "c" . This may be the NRC Chief Examiner if he/she did not develop the outline under review "The audit exam has not yet been developed but the instructions on the referenced forms and NUREG 1021 sections have been met

Form 2.3-2 Operating Test Quality Checklist Facility: PVNGS I Date of Examination: 5/2/2022 I Operating Test Number: 2022 (Y)es/ (N)o General Criteria a b* c#

y y

a. The operating test meets the criteria on the associated test outline 1
b. There are enough test items so that test items will not be repeated on more than 1 day of the y y operating test y C. The operating test does not duplicate items from the applicant's audit test(s) y y y
d. Overlap with the written examination and between different part of the operating test is minimized y y

'I y y

e. It appears that the operating test will differentiate between competent and less-than-competent applicants at the designated license level y

Walkthrough Criteria Each job performance measure (JPM) includes the following, as applicable: y y

'--(

  • Task standard
  • Initial conditions
  • Initiating cues
  • References and tools, including associated procedures
  • Reasonable and validated time limits (average time allowed for completion) and specific designation if the facility licensee deems it to be time critical
  • Specific designation if it meets the criteria of alternate path
  • Operationally important specific performance criteria that include the following:

- 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 JPM task standard

- Identification of critical steps and their associated performance standards

- Restrictions on the sequence of steps, if applicable

b. Ensure that any changes from the previously approved JPM outlines (Forms 3.2-1 and 3.2-2) y y 'f have not caused the test to deviate from any of the acceptance criteria (e.g., item distribution, bank use, repetition from the last two NRC examinations) specified on those forms Simulator Scenario Set Criteria for Scenario Numbers: 2 / 4 / 3 (1 Is the spare)

QUALITATIVE ATTRIBUTES

1. The initial conditions are realistic in that some equipment and/or instrumentation may be out of y y 'I service, but it does not cue the operators into expected events
2. The scenarios consist mostly of related events y y y y y
3. Each event description consists of the following:
  • The point in the scenario when it is to be initiated

'I

  • 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)

(Y)es/(N)o QUALITATIVE ATTRIBUTES continued a b* elf.

4. The events are valid with regard to physics and thermodynamics y y y
5. The sequencing and timing of events is reasonable and allows the examination team to observe y y and evaluate applicant performance y
6. If time compression techniques are used, the scenario summary clearly so indicates. Operators y y have sufficient time to carry out expected activities without undue time constraints. Cues are y given.
7. The simulator modeling is not altered y y y
8. The scenarios have been validated. Pursuant to 10 CFR 55.46(d), any open simulator y y performance deficiencies or deviations from the referenced plant have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

y

9. Scenarios are new or significantly modified in accordance with ES-3.4 y y '(
10. Scenarios (as grouped) allow each applicant to be significantly involved in the minimum number y y of transients, events, and evolutions specified on the version Form 3.4-1 submitted with the y scenario set 11 . Applicants are evaluated on a similar number of pre-identified critical tasks across scenarios, y y when possible y
12. The level of difficulty is appropriate to support licensing decisions for each crew position y y y Actual Attributes by (Y)es/ (N)o TARGET QUANTITATIVE ATTRIBUTES per Scenario (See ES-3.4) Scenario No.

2 I 41 3 / 1 (spare) a b* elf.

1. Malfunctions after emergency operating procedure (EOP) entry (1-2) 1/3/3/2 y y y
2. Abnormal events (2-4) 4/3/3/3 y y y
3. Major transients (1-2) 1/1/1/1 y y '(
4. EOPs entered/requiring substantive actions (1-2) 1/1/1/1 y y y
5. Entry into a contingency EOP with substantive actions (~ 1 per y y scenario set, set is the entire set of scenarios prepared for the 0/1/1/0 y scheduled exam)
6. Pre-identified critical tasks (~ 2) 3/2/2/2 y y y Date Pointed Name/- ~ ~
a. Author John Rodgers I 4/5/2022
b. Facility Reviewer (*) Allen Marsh I

/ J6/-c>-:r7X 4/5/2022

c. NRC Reviewer (#)

JohV\ IL,rk..la~cl 1-:J)J.[ rfl .:::--.:..~ 4(12 /z. 2..

NRC Chief Examiner Jc),-w1 \l 1rkla,0/4,ir~ 4Jr2.. /2,2.

NRC Supervisor µt~{htr Ge.1)-\o,~ ~/4L"1f-kfa..JfI ~ic/ ,

~/;di ~

J,,J ,,, ,,

  • The facility licensee signature is not applicable for NRC developed tests
  1. An independent NRC reviewer performs the steps in column "c". This may be the NRC Chief Examiner if he/she did not develop the etltline under review

Form 2.3-4 Written Examination Quality Checklist Facility: PVNGS Date of Exam: 512/2022 Exam Level: RO

~ SRO~

(Y)es I (N)o Item Description a b* c#

y y

1. Questions and answers are technically accurate and applicable to the facility. Each question includes a technical reference. y
2. a. All questions reference NRC knowledge and abilities (K/As) requirements. y y
b. Facility learning objectives are referenced as available.
c. All questions include an explanation of the correct answer and a distractor analysis.

y

3. Senior reactor operator (SRO) questions test at the SRO license level. y y y
4. The sampling process was random and systematic. (If more than four reactor operator (RO) or two y y SRO questions were repeated from the last two NRC licensing exams, including full (100-question) retake examinations, consult the NRC Office of Nuclear Reactor Regulation operator licensing program office.) ~
5. Question duplication from the licensee screening/audit exam was controlled as indicated below y y (check the item that applies) and appears appropriate:

_ The audit exam was systematically and randomly developed

_ The audit exam was completed before the license exam was started

'(

_ The examinations were developed independently

_X_ The licensee certifies that there is no duplication

_ Other (explain):

6. Bank use meets limits (no more than 75% from the bank, at least Bank Modified New y y 10% new (at the comprehension/analysis level), and the rest new or modified); enter the actual RO/SRO-only questions distribution > 16/6 7/3 52 / 16 y
7. Between 38 and 45 questions of the question on the RO exam and y y Memory CIA at least 13 of the questions on the SRO-only portion of the exam are written at the comprehension/analysis level; enter the actual RO/SRO-only question distribution > 31 / 10 44/ 15 1 y y
8. References/handouts provided do not give away answers or aid in the elimination of distractors. 'I
9. Question content conforms to specific KIA statements in the previously approved examination outline y y and is appropriate for the KIA statements' assigned tier; deviations are justified. y
10. Question psychometric quality and format meet the instructions and guidelines in ES-4.2. y y y.
11. The exam contains the required number of one-point, multiple-choice items; the total is correct and y y agrees with the value on the cover sheet. 'I Primed N,me / Sigoature ~ Date (
a. Author John Rodgers I ~ 4/5/2022
b. Facility Reviewer(*) Allen Marsh

'/~£<_ 4/5/2022

c. NRC Reviewer(#)

JC> hV\ ll ,~k.\aV\d I ~~-->2/ - '

4/12/?2.

NRC Chief Examiner Jotivt ll 1,1'.Jd"'d U::;;/V-()  :><

I

- ,. 4)12'2 2-NRC Supervisor J..l~dih-t, Gt~i~ I if/ 1aYb5f.S//1ffe1// -, <f/J;i/4:J-

-;p / If

  • The facility licensee signature is not applicable for NRC developed tests
  1. An independent NRC reviewer performs the steps in column "c". This may be the NRC Chief Examiner if he/she did not develop the 8l:ltline under review

Form 3.4-1 Events and Evolutions Checklist (Based on running Scenarios 2/4/3)

Facility: PVNGS Date of Exam: 5/2/2022 Operating Test Number: 2022 E Scenarios A V M P E I P N 1 2 3 4 T N L T O I I T M C T POSITION POSITION POSITION POSITION A U A Y S A B S A B S A B S A B L M N P R T O R T O R T O R T O RO SRO-I SRO-U T E O C P O C P O C P O C P RX 0 1 1 0 R1 NOR 1 1 2 1 1 1 2,3,4,7 I/C 3,4,5 3,4,5

,8 11 4 4 2 RX+NOR MAJ 6 6 5 3 2 2 1

+I/C Man. Ctrl. 4,5 4,5 2,4,7 7 1 1 0 13 TS 0 0 2 2 RX 0 1 1 0 R2 NOR 1 1 1 1 1 I/C 2,3,4,7 3,4,6,8 8 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,6,7 4 4 1 1 0 9 TS 0 0 2 2 RX 0 1 1 0 R3 NOR 1 1 2 1 1 1 I/C 3,4,5 3,4,5 6 4 4 2 RX+NOR MAJ 6 6 2 2 2 1

+I/C Man. Ctrl. 4,5 4,5 4 1 1 0 8 TS 0 0 2 2 RX 0 1 1 0 R4 NOR 2 1 1 1 1 3,4,5,8 I/C 2,3,4,7

,9 9 4 4 2 RX+NOR MAJ 6 6 2 2 2 1

+I/C Man. Ctrl. 4,6,7 4,5 5 1 1 0 10 TS 0 0 2 2 RX 0 1 1 0 R5 NOR 1 1 1 1 1 2,3,4,7 I/C 3,4,5

,8 8 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,5 2,4,7 5 1 1 0 9 TS 0 0 2 2

Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS Date of Exam: 5/2/2022 Operating Test Number: 2022 E Scenarios A V M P E I P N 1 2 3 4 T N L T O I I T M C T POSITION POSITION POSITION POSITION A U A Y S A B S A B S A B S A B L M N P R T O R T O R T O R T O RO SRO-I SRO-U T E O C P O C P O C P O C P RX 0 1 1 0 R6 NOR 1 1 1 1 1 I/C 2,3,4,7 3,4,6,8 8 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,6,7 4 4 1 1 0 9 TS 0 0 2 2 RX 0 1 1 0 R7 NOR 1 1 2 1 1 1 I/C 3,4,5 3,4,6,8 7 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,5 4 3 1 1 0 9 TS 0 0 2 2 RX 0 1 1 0 R8 NOR 2 1 1 1 1 3,4,5,8 2,3,4,7 I/C ,9 ,8 10 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,5 2,4,7 5 1 1 0 11 TS 0 0 2 2 RX 0 1 1 0 R9 NOR 1 1 1 1 1 I/C 2,3,4,7 3,4,6,8 8 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,6,7 4 4 1 1 0 9 TS 0 0 2 2 RX 0 1 1 0 R10 NOR 2 1 1 1 1 3,4,5,8 2,3,4,7 I/C ,9 ,8 10 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 4,5 2,4,7 5 1 1 0 11 TS 0 0 2 2

Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS Date of Exam: 5/2/2022 Operating Test Number: 2022 E Scenarios A V M P E I P N 1 2 3 4 T N L T O I I T M C T POSITION POSITION POSITION POSITION A U A Y S A B S A B S A B S A B L M N P R T O R T O R T O R T O RO SRO-I SRO-U T E O C P O C P O C P O C P RX 0 1 1 0 I1 NOR 1 1 1 1 1 3,4,5,8 2,3,4,6 I/C 3,4,5

,9 ,7,8 14 4 4 2 RX+NOR MAJ 6 6 5 3 2 2 1

+I/C Man. Ctrl. 4,5 2 1 1 0 15 TS 2,4 3,4 4 0 2 2

Form 3.4-1 Events and Evolutions Checklist Facility: PVNGS Date of Exam: 5/2/2022 Operating Test Number: 2022 E Scenarios A V M P E I P N 1 2 3 4 T N L T O I I T M C T POSITION POSITION POSITION POSITION A U A Y S A B S A B S A B S A B L M N P R T O R T O R T O R T O RO SRO-I SRO-U T E O C P O C P O C P O C P RX 0 1 1 0 U1 NOR 0 1 1 1 2,3,4,5 2,3,4,6 I/C ,7 ,7,8 11 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 0 1 1 0 11 TS 2,4 3,4 4 0 2 2 RX 0 1 1 0 U2 NOR 0 1 1 1 2,3,4,5 3,4,5,8 I/C ,7 ,9 10 4 4 2 RX+NOR MAJ 6 6 2 2 2 1

+I/C Man. Ctrl. 0 1 1 0 10 TS 2,4 2,4 4 0 2 2 RX 0 1 1 0 U3 NOR 0 1 1 1 2,3,4,5 2,3,4,6 I/C ,7 ,7,8 11 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 0 1 1 0 11 TS 2,4 3,4 4 0 2 2 RX 0 1 1 0 U4 NOR 0 1 1 1 3,4,5,8 2,3,4,6 I/C ,9 ,7,8 11 4 4 2 RX+NOR MAJ 6 5 2 2 2 1

+I/C Man. Ctrl. 0 1 1 0 11 TS 2,4 3,4 4 0 2 2 RX 0 1 1 0 U5 NOR 1 1 1 1 1 2,3,4,5 I/C ,7 3,4,5 8 4 4 2 RX+NOR MAJ 6 6 2 2 2 1

+I/C Man. Ctrl. 4,5 2 1 1 0 9 TS 2,4 2 0 2 2

0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 3 0.5 0.5 5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 1 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 2 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 4 0.5 5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5

0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 4 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 4 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5

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0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 0.5 6 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 0.5 6 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 6 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 5 0.5 0.5 0.5 0.5 3 0.5 0.5 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 1 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 2 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5

IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4

  1. Candidates Exam Site / Docket # / Insp Rpt # RO LSRO SROI SROU Type Exam Author Chief Examiner Examiners Assigned Week 05/01/2022 Palo Verde / 05000528, 05000529, 05000530 10 0 1 5 FB-OR- NFF Kirkland, John Bergeon,Bryan

/ 2022301 INITIAL Clayton,Kelly CAC #: 000500 LICENSE Doyle,Matthew EXAM Hernandez,Nick ADMINIS Kirkland,John TRATION Osterholtz,Clyde (EXAD) You,David Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM Page 1 of 4

IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Date RO SROI SROU LSRO Total 05/2022 10 1 5 0 16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM Page 2 of 4

IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Site RO SROI SROU LSRO Total Palo Verde 10 1 5 0 16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM Page 3 of 4

IP 21 Operator Licensing Exam Schedule From 05/01/2022 to 05/07/2022 Phase Code: 2 - Construction, 5 - Operational Region: 4 Summary by Region RO SROI SROU LSRO Total Region 4 10 1 5 0 16 Sites: ANO, CALL, CNS, CP, DIAB, GG, PALO, RBS, STP, WAT, WC, WNP Orgs: ALL Exam Author: ALL Activity Codes: EXAD, NEXAD, NOV, OV 5/24/2022 3:05:18 PM Page 4 of 4

Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination

( 1) Pre-Examination I acknowledge that I have acquired specialized know ledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 the comp letion of examination administration, except as specifically not ed below or authorized by the NRC. Furthermore, I am aware of the physi ca l 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 enforcement action by the NRC against m e or the faci lity licensee, or both. I wi ll immediately report to facility licensee management or the NRC chief examination any indication or suggestions that examination security may have been compromised.

(2) Post-Examination To t he best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered into this examination security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who we re administered these licensing examinations, except as specifically noted below or authorized by the NRC.

Print Name Job Title Date Note

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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge that I have acquired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 the completion of examination administration, except as specifically noted below or authorized by the NRC. Furthermore, I am aware of the physical security measures and requ irements (as documented in the facility licensee's procedures) and understand that violation of the conditions of t his agreement may result in cancellation of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management or the NRC chief examination any indication 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 NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From t he date that I entered into this exam ination 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 examinat ions, except as specifically noted below or authorized by the NRC.

Print Name Job Title Date Signature (2) Date Note

1. D~V)/\) C.\CINELL\ 11. ~ Z \

2.

3.

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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I w ill not knowingly divulge any information about these examinations to any persons w ho have not been authorized by the NRC chief examiner. I understand t hat I am not to instruct, evaluate, or provide perfo rmance feedback t o those applicants scheduled to be administered these licensing exam inations from this date until the completion of examination administration, except as specifically noted below or authorized by t he NRC. Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand th at violation of the conditions of this agreement may result in cancellat ion of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management o r the NRC chief examination any indication o r suggestions t hat 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 NRC licensing examinations scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered into this examination security agre ement until the complet ion 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 or authorized by the NRC.

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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Exam ination I acknowledge that I have acquired specialized knowledge abo ut the U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 through May 12, 2022, as of the date of my signature. That I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC 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 th e completion of examination administ ration, except as specifically noted below or authorized by t he NRC. Furthermore, I am aware of the physical security measures and requirements (as documented in t he facility licensee's procedures) and understand that violation of the conditions of t his agree ment may result in cancellation of the examinations, and enforcement action by the NRC against me or the facility licensee, or both. I will immediately report to facility licensee management or the NRC chief examination any indication 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 info rmation concerning the NRC licensing examinations scheduled to be administered from May 2, 2022 t hrough May 12, 2022. From the date that I entered into t his examination 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 not ed below or authorized by the NRC.

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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial Licen se Examination (1) Pre-Examination I acknowledge that I have acq uired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) lice nsing examination scheduled for May 2, 2022 through May 12, 2022, as of the d ate o f my signature. That I will not knowingly divulge any informat ion about t hese examinat ions to any persons who have not been authorized by the NRC chief exam iner. I u ndersta nd that I am not to instruct, evaluate, or provide performance feedback to those applicants sched uled to be administered these lice nsing exa minations from t his date until the co mpletion of examination administration, except as specifica lly noted below or authorized by t he NRC. Furthermore, I am aware of the physica l security measures and req uirements (as docum ented in the facility lice nsee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the exam inations, and enforcem ent action by the NRC against me or the faci lity licensee, or both. I w ill immediately repo rt to facility lice nsee management or the NRC ch ief examination any indication or suggestions that examination security may have been com promised.

(2) Post-Examination To t he best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing exam inations scheduled to be ad ministered from May 2, 2022 through May 12, 2022 . From the date that I entered into this examination security agreement until the co mplet ion of exa mination administration, I did not instruct, evaluate, or provide performance feedback to those applica nts who we re administered th ese licens ing examinations, except as specifica lly noted below or aut horized by the NRC.

Print Name Job Title Signature (1) Date Signature (2) Date Note 1.

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Form 1.3-1 Examination Security Agreement- 2022 PVNGS NRC Initial License Examination (1) Pre-Exa mination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regu latory Commission (NRC) licensing examination scheduled fo r May 2, 2022 through May 12, 2022, as of the date of my signature. That I will not knowingly divulge any informat ion about these examinations to any persons who have not been authorized by t he NRC chief examiner. I understa nd that I am not to instruct, evaluat e, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until the completion of examination administration, except as specifically noted below or authorized by the NRC. Furthermore, I am aware of t he physical security measures and require ments (as documented in the facility licensee' s procedures) and understand tha t violation of the conditions of this agreement may resu lt in cancellation of the examinatio ns, and enforcement action by the NRC aga inst me or the faci lity licensee, or both. I will immediately report to facility licensee manage ment or the NRC chief examination any indication or suggestions t hat 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 NRC licensi ng examinations scheduled to be adm inistered from May 2, 2022 through May 12, 2022. From the date t hat I entered into this examination 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 or authorized by t he NRC.

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Form 1.3-1 Examination Security Agreement - 2022 PVNGS NRC Initial License Examination (1) Pre-Examination I acknowledge t hat I have acquired specialized knowledge about t he U.S. Nuclear Regulatory Commission (NRC) licensing examination scheduled for May 2, 2022 t hrough May 12, 2022, as of the date of my signature. That I wi ll not knowingly divulge any information about these exami nations to any persons who have not been aut horized by the NRC chief examiner. I understa nd t hat I am not to instruct, evaluate, or provide performance feedback to t hose applicants scheduled t o be administered t hese licensing exami nations from this date unt il t he complet ion of examination administrat ion, except as specifica lly noted below or authorized by t he NRC. Furthermore, I am aware of t he physical security measures and requirements (as documented in the facility licensee's proced ures) and understand t hat violation of t he condit ions of this agreement may resu lt in ca ncellation of the exam inat ions, and enforcement action by t he NRC against m e or t he facility licensee, o r both. I w ill immediately report to facility licensee m anagement or the NRC chief examination any indication or suggestions t hat examination security may have been compromised.

(2) Post-Examination To the best of my knowledge, I did not divulge to any unaut horized persons any information concerning t he NRC licensing examinat ions scheduled to be administered from May 2, 2022 through May 12, 2022. From the date that I entered int o this examination security agreement until the completion of exam ination administration, I did not instruct, evaluate, or provide perfo rmance feedback t o t hose applicants w ho were administered t hese licensing examinations, except as specifically noted below or aut horized by the NRC.

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