ML15348A168

2015 Fermi Power Plant Initial License Examination Forms ES-201-3

ML15348A168
Person / Time
Site:	Fermi
Issue date:	10/13/2015
From:	Operations Branch III
To:	Detroit Edison, Co
Shared Package
ML15268A032	List: ML15282A474 ML15287A289 ML15287A293 ML15287A295 ML15287A303 ML15287A334 ML15287A338 ML15348A168
References
Download: ML15348A168 (5)

Text

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ES-201 Examination Security Agreement ES-201-3

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 08/24/15-08/28/15 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner.

I understand that I am not to instruct, ~valua~ e , or provid ~ performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facil ity licensee's procedures) and understand that violation of the conditions of th is agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC ch ief examiner any indications or suggestions that examination security may have been comprom ised .

2. Post-Examination To the best of my knowledge , I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 8/24/15. From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

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ES 201 , Page 27 of 28

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

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/24/2015 as of the date of my signature. I agree that I will riot 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 admin istered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g ., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC ch ief examiner any indications or suggestions that examination security may have been comprom ised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concern ing the NRC licensing examinations administered during the week(s) of '1/4,Y,;-- . From the date that I entered into this security agreement until the completion of exam ination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE NOTE

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NOTES :

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ES-201 , Page 27 of 28

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~01S' ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/z'i/tS. as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications 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 administered during the week(s) of ~r<* From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate , or pr id performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC .

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE

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ill/IT ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination I acknowledge that I have acqui red specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/24/2015 as of the date of my signature . I agree that I will not knowing ly 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 completion of examination administration . except as specifically noted below and authorized by the NRC (e.g. , acting as a simulator booth operato r or communicator is acceptaole if the individual does not select the training content or provide direct or indirect feedback). Fu rthermore, I am aware of the physical secunty measures and requirements (as documented in the facility licensee 's procedures) and understand that violation of the conditions of this agreement may result in can cellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications 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 administered during the week(s) of 8/24/2015 . From the date that I entered mto this security agreement until the completion of examination administration, I did not instruct, evaluate. or provide performance feedback to those applicants who were administered these licensing examinations , except as specifically noted below and authorized by the NRC.

SIGNATURE (2) DATE NOTE

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• Examinat ion ~urity A~~- - -*---- __ __._ _ _ ___:.,.:.S!:!t!.&'ow.1a1~;.c;..u*-.i..;\ .1li'

1. Pre-Exnmlnath;in I acknowledge r:al I have aCQul'ad L~cc1al 1Ze<.I kno >ied9e aoout ll'e NRC l!CttMlf <!tamur 1011s S(;ne..ltlied for !i".e wtoek(sl cl _ 31241201~ as ot ltte dale of my !IJ9nalure I agree 1i1at I w*ll ~ot knowingly d ulge arr/ 1nformal1Qn abcul lhe~e e~am atit>n !O any oer$0ns who have nol betn authoffilled by

• e NRC chiet exa ner I um1ersland t~a1 I am not re i0$fl\JCt. l\Ja'.e. or provl::e _rtorrr~e feedback to those <1pp ~ s scheduled to oe administered these ~cens*ng ami ior*s from *t*1s ctat un111 comp!etJon cl exam alion adrnll'lls!ril 11 except a'$ specifically noted heklw 8nd authorized 1))1 the NRC (e g .. acting as a simulaJ01 tiootl* ope/Hlor or comrnurirotor 1s B!'.oepla le if ti:le' i.dlvldual doe!! ot select the :l'\'l!Omg coment or providB dJ<ecl or indirect le8dback.). Furlt1enrore, I an1 fNI: a of th& ~hys1cal security mea5l.lfc arid 1eQIJi1.emen1$ {* s documen!ed rn 1he fai;~lly riceflSee's prO(;e!J:ures) and underslal'!d thel violattan of the col'ld,1ions of lhis ement may result tfl oMalJ!a el tl'e ;.xamltWllons andior an en!ol'Cem nt acikin aga1nsl me 01 tt-e tadllly licensee. I Will lmmed a~~ly lt!O>)rt le tlllC!lily -nanagem"'11 or th NRC c iel eJ<amlTl8t an( indir.a!ioM o< suggesfo s thal examination secllfity may hcve been comnromised.

2. Post-Ei:ami!l!llion lo lhb best ot n.y ' now!adge I :l*tl .,ot drJul:;w to ant urauttorried persons any nfoi111011on cnnce"~*ng the N'lC llcens1119 axaminatMlns admlntS~1 ed dUJlng lhe'weei< jst of _8g~..Q1~ . From ti>'l dale !hal I entered 111to *, is saGt.1111}1 agreement u~hl lhe oomptetloo o' P.xarninallon a~i1ust1aoon, I did n<>t lllstrucl, evaluate. or fltlw1de pet cnnan..o., fP.P.rlback kl .ose apphcsnt.s *no '""e ad1111!1istared these licensing exa711nations. e*cepl as speciflcaly noted

) b low an autl\ori:!ed by tit NRC PRINTED NAME DATE NOTE

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ES-201 Examination Security Agreement ES-201-3

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 08/24/15-08/28/15 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner.

I understand that I am not to instruct, ~valua~ e , or provid ~ performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facil ity licensee's procedures) and understand that violation of the conditions of th is agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC ch ief examiner any indications or suggestions that examination security may have been comprom ised .

2. Post-Examination To the best of my knowledge , I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 8/24/15. From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

..;..u........._-=.;......._" " " ' " ' - ' - - - - - - l l' J § !Pfl l ..JVIVS:I Vl? lJ r:... ,nl*I V lf !J V'f l h H /IJ // /5/ /~- -!1..LLJJ_s:,_

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NOTES:

ES 201 , Page 27 of 28

i IL.<:> -

"LOI~

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

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/24/2015 as of the date of my signature. I agree that I will riot 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 admin istered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g ., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC ch ief examiner any indications or suggestions that examination security may have been comprom ised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concern ing the NRC licensing examinations administered during the week(s) of '1/4,Y,;-- . From the date that I entered into this security agreement until the completion of exam ination administration , I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE NOTE

1. iJ. L .&4,ec_,t; L/{)6  ?)~

2. ?00-.rc. [l: ,'""'-tv.:icx,uc,.v- . C,e_ ~  :::?t~ -

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NOTES :

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ES-201 , Page 27 of 28

JL.0

~01S' ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/z'i/tS. as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration , except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback) . Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications 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 administered during the week(s) of ~r<* From the date that I entered into this security agreement until the completion of examination administration , I did not instruct, evaluate , or pr id performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC .

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE

• 1 :---P, £.~ ~1e L~O 6-*ry-*> ~ r--A.- _ff2_

LNO I~_@_

~: };::: N~~=~ ~

t..-JJ-15

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NOTES:

CD ~1a.,.~p oFF VJ'- t*,..JfJL R~Qtlll-57

,,11,, toNFIM4'floN ( ~rr.fcllt!t:>)

11...<> 2,.(")/.,

ill/IT ES-201 Examination Security Agreement Form ES-201-3

1. Pre-Examination I acknowledge that I have acqui red specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 8/24/2015 as of the date of my signature . I agree that I will not knowing ly 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 completion of examination administration . except as specifically noted below and authorized by the NRC (e.g. , acting as a simulator booth operato r or communicator is acceptaole if the individual does not select the training content or provide direct or indirect feedback). Fu rthermore, I am aware of the physical secunty measures and requirements (as documented in the facility licensee 's procedures) and understand that violation of the conditions of this agreement may result in can cellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications 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 administered during the week(s) of 8/24/2015 . From the date that I entered mto this security agreement until the completion of examination administration, I did not instruct, evaluate. or provide performance feedback to those applicants who were administered these licensing examinations , except as specifically noted below and authorized by the NRC.

SIGNATURE (2) DATE NOTE

4. ~~

~~PTtj;;;f{:;, -* --~o,":!..LJll O?s F£i !eLA.ft!'<£t.. ~-

&

~ ~:s - -4. .pt¢; ~

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NOTES:

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• Examinat ion ~urity A~~- - -*---- __ __._ _ _ ___:.,.:.S!:!t!.&'ow.1a1~;.c;..u*-.i..;\ .1li'

1. Pre-Exnmlnath;in I acknowledge r:al I have aCQul'ad L~cc1al 1Ze<.I kno >ied9e aoout ll'e NRC l!CttMlf <!tamur 1011s S(;ne..ltlied for !i".e wtoek(sl cl _ 31241201~ as ot ltte dale of my !IJ9nalure I agree 1i1at I w*ll ~ot knowingly d ulge arr/ 1nformal1Qn abcul lhe~e e~am atit>n !O any oer$0ns who have nol betn authoffilled by

• e NRC chiet exa ner I um1ersland t~a1 I am not re i0$fl\JCt. l\Ja'.e. or provl::e _rtorrr~e feedback to those <1pp ~ s scheduled to oe administered these ~cens*ng ami ior*s from *t*1s ctat un111 comp!etJon cl exam alion adrnll'lls!ril 11 except a'$ specifically noted heklw 8nd authorized 1))1 the NRC (e g .. acting as a simulaJ01 tiootl* ope/Hlor or comrnurirotor 1s B!'.oepla le if ti:le' i.dlvldual doe!! ot select the :l'\'l!Omg coment or providB dJ<ecl or indirect le8dback.). Furlt1enrore, I an1 fNI: a of th& ~hys1cal security mea5l.lfc arid 1eQIJi1.emen1$ {* s documen!ed rn 1he fai;~lly riceflSee's prO(;e!J:ures) and underslal'!d thel violattan of the col'ld,1ions of lhis ement may result tfl oMalJ!a el tl'e ;.xamltWllons andior an en!ol'Cem nt acikin aga1nsl me 01 tt-e tadllly licensee. I Will lmmed a~~ly lt!O>)rt le tlllC!lily -nanagem"'11 or th NRC c iel eJ<amlTl8t an( indir.a!ioM o< suggesfo s thal examination secllfity may hcve been comnromised.

2. Post-Ei:ami!l!llion lo lhb best ot n.y ' now!adge I :l*tl .,ot drJul:;w to ant urauttorried persons any nfoi111011on cnnce"~*ng the N'lC llcens1119 axaminatMlns admlntS~1 ed dUJlng lhe'weei< jst of _8g~..Q1~ . From ti>'l dale !hal I entered 111to *, is saGt.1111}1 agreement u~hl lhe oomptetloo o' P.xarninallon a~i1ust1aoon, I did n<>t lllstrucl, evaluate. or fltlw1de pet cnnan..o., fP.P.rlback kl .ose apphcsnt.s *no '""e ad1111!1istared these licensing exa711nations. e*cepl as speciflcaly noted

) b low an autl\ori:!ed by tit NRC PRINTED NAME DATE NOTE

~=--~--

1 4tJa;.:-l.J.':.G.-r./r..

2~ ~:i~%V 3 .~ :;

4 ________ _

5-~-----

G.

a7 --_ - --_-______

9.

10 _ _ __

, 1 ----~---- -~-~p----*** -----

12 - - - - * - *- -**-* .. --- **-*--------

13 - --*- - - -- --

t4

• !i _ _ __ __ _ __ _