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| issue date = 08/22/2014
| issue date = 08/22/2014
| title = 2014 Prairie Island Nuclear Generating Plant Initial License Examination Form ES-201-3
| title = 2014 Prairie Island Nuclear Generating Plant Initial License Examination Form ES-201-3
| author name = Bielby M E
| author name = Bielby M
| author affiliation = NRC/RGN-III/DRS/OLB
| author affiliation = NRC/RGN-III/DRS/OLB
| addressee name =  
| addressee name =  
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=Text=
=Text=
{{#Wiki_filter:(l Xcel Energy NOV 0 3 2014 Regional Administrator, Region Ill US Nuclear Regulatory Commission 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Prairie Island Nuclear Generating Plant Units 1 and 2 Dockets 50-282 and 50-306 Renewed License Nos. DPR-42 and DPR-60 L-Pl-14-110 NUREG-1021 2014 Initial Operator Licensing Examination Security Agreement Forms Pursuant to NUREG-1021, Revision 9, Supplement 1, Operator Licensing Examination Standards for Power Reactors, section ES-501, Initial Post Examination Activities, the facility licensee must submit the original examination security agreement forms to the NRC's regional office for retention after the examinations are complete. Northern States Power Company, a Minnesota corporation, doing business as Xcel Energy (hereafter "NSPM"), submits the original signed examination security agreements as Enclosure 1. Summary of Commitments This letter contains no new commitments and no revisions to existing commitments. ' /) / ';,, /tu Kevin Davison Site Vice President, Prairie Island Nuclear Generating Plant Northern States Power Company -Minnesota Enclosures (1) cc: Mike Bielby, US NRC Region Ill, with enclosure Hironori Peterson, US NRC Region Ill, without enclosure 1717 Wakonade Drive East o Welch, Minnesota 55089-9642 Telephone: 651.388.1121 ' m::CEIVEO 0 4 2014 QF-1071-01, Rev. 2 (FP-T-SAT-71) MASTER SECURITY AGREEMENT I (l Xcel Energy-Page 1 of 2 The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment. 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) I acknowledge that I have acquired specialized knowledge about the .2oi4 u_r tJ&#xa3;'-examination(s) scheduled for the date(s) of 'iS/t.Jh4 -1?/it/1'1 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised. 2. Post-Examination To the best of my , ,1 did not divulge to any unauthorized any inf?rmation concern!ng the exami.nations during the date(s) of 15 L/ /lt -./r-, 1'f . From the date that I entered into this security agreement until the completion of exam1nat1on administration, I did not in *truct, evaluate, or provide performance feedback to those individuals who were administered these examinations. PRINTED NAME 1. SA120\S 1) 2. f a.eo (j;;, urtJ\ 3. -z;iAv?s C *. 1,1,.zer 4. H tlftM' .pii-7U?f!J 5. ,,Yl !1 scsn e.v 0 + I, I . l. 6. \!Jhi'\-Sor, 1. An+/-hooj Snort Retention: Life of Plant Retain in: Exam File JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE oPS Ir' ;WJCJtYr"L 101.1)1 *(1>/1<< / I , DP> IA!8r&#xa3;JHM =:= _ &#xa3;1-0; --&#xa3; /J _ , .* /:ft ttl 0f ,._'?. </-11fy --; -f J/L N.* O gA-b'f. /ti </\t,..,\ \' i ._, Ill"*! --s i V'r1 TPb+er 11-1/-/3 &#xa3;\ /
{{#Wiki_filter:(l     Xcel Energy NOV 0 3 2014                                                           L-Pl-14-110 NUREG-1021 Regional Administrator, Region Ill US Nuclear Regulatory Commission 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Prairie Island Nuclear Generating Plant Units 1 and 2 Dockets 50-282 and 50-306 Renewed License Nos. DPR-42 and DPR-60 2014 Initial Operator Licensing Examination Security Agreement Forms Pursuant to NUREG-1021, Revision 9, Supplement 1, Operator Licensing Examination Standards for Power Reactors, section ES-501 , Initial Post Examination Activities, the facility licensee must submit the original examination security agreement forms to the NRC's regional office for retention after the examinations are complete.
QF-1071-01, Rev. 2 (FP-T-SAT-71) [ ll Xcel Energy-MASTER SECURITY AGREEMENT Pcige 2 of 2 The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment. PRINTED NAME JOB. T. ITLE I RESPONSIBILITY SIG. NATURE (1) DATE (2) :: 10.. M1c.Jiolt1t\ A.bvie11 {')fJ L'-7! __ 'i/z/t'f ___ _ "'-!Kl..J.... "i . !_ (l.[)(\ -.. ' ' /-.-t. (\ ,"'""/ );&#xa3;\.. ____ L_ ______ _ c1 , scov , D'* ,, , ., w' / l:CL+'-:,1, KG r: il 1, "l' __ 12. 13. 14. 15. 16. 17. 18. 19. 20. NOTES: Retention: Life of Plant Retain in: Exam File DATE NOTE g-fts-/ty <J/t5/i'
Northern States Power Company, a Minnesota corporation, doing business as Xcel Energy (hereafter "NSPM"), submits the original signed examination security agreements as Enclosure 1.
')(1&deg;! QF-1071-02, Rev. 2 (FP-T-SAT-71) Page 1 ot-r' <JP I fl Xcel Energy-I LIMITED SECURITY AGREEMENT I The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) I that I have acquired specialized knowledge about the .;}oi'i il:r rJ\l<.. examination scheduled for the date(s) of 'iiL\h'l
Summary of Commitments This letter contains no new commitments and no revisions to existing commitments.
* 111 as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor .. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised. 2. Post-Examination 1. 2. 3. 4. To the best f y kn wledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of <t 14. -'l 6 . From the date that I entered into this security agreement until the completion of this examination administrati n, I did. not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination. Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me. PRINTED NAME JOB TITLE I RESPONSIBILITY DATE ./\SIGNA/lfE (2) DATE NOTE "s *41 -r , / C....11. 'i-<....v 1..-S' ') / 5:r} I , Ut,.. J,, LI\, V:; /"J...., 2'-r (JI 't -fc;._ _ _, /Z ).,<.pl </ ' 1/// r/ I r '* --J ___ (l 1) 9_),_.JLf Kr, y /, uhJ HWI I \_o..,0.r-Q.... 0-\,.)J\. \,(.. Lto t/cu1 fJ --f5ttcH S:S' ;;;;: 2ccv---Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
                  /)
QF-1071-02, Rev. 2 (FP-T-SAT-71) I fl Xcel Energy-LIMITED SECURITY AGREEMENT 'flJ' Page 2 pl The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. 5. 6. 7. 8. 9. 10. PRINTED NAME f \*hAtt---::') fN'v-\ l-------------:-7 f)g..vc.(. lYL1t5l-, Jc.-e.. t1((1'k /..17oj.brvcl >c<.+/-en-e )vi,ra, ff> :t>1.'i3s . 11. -\ " \,.-.... )( ... \?)' JOB TITLE I RESPONSIBILITY LRn Lf_o ,,;* J.-"'-Sf-r'-"-<-J-.:,..,,.,.-5,;Vf SIGNATURE (2) W'f= ,&#xa2; ''" 7 \__ I? SIGNATURE (1) ( (\ . DATE I7. i!fi!? ,, &#xa3;M . s s/ s*-r1t zi: ... '3/'>/tl no 1/->f1q /lj/L-DATE NOTE -qf11/rf r/rt/1t I v/:J/; I/ t..:::.L:.-' --,, , , MS 'xf "ii: 13, 0te '"''' 3,ll 1'/ 0= 14 * , . <" _,, ,. (,?A ,.., ' / * //,/ /,?i ?-1 12. JJD.N 'ffi_W * / \-;1\)-'\{l;_t<;,., ..::.LHt::C'-\L\.;..J *";t1 15. -J"eU Vvt o..A.. 16. t /,.t :7 C/ t" A r<) r._., 17. /Vt c\;,,ohs /V]oocly 18. R.oss 1Y,; of!t 19. .. 20. .Jo.soi-\ &#xa3;-tv-;t. NOTES: Retention: Life of plant Retain in: Exam file 55 Ro ,..., <' >.) Ofs lt--1J6 I 1rw 6-P ;;JJ < :I/V::::r* 55 ;l_>TA r---* -t)l.....,_..I c..------=-Form retained in accordance with record retention schedule identified in FP-G-RM-01. 1-/ I /,J ,ll .l.... *, "-'-L -_._fl-I i/;11 \ q;!t,A*L{_ '1/i<J(1 'i o/-z."111:{
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QF-1071-02, Rev. 2 (FP-T-SAT-71) ef2 I (l Xcel Energy-I LIMITED secURllY AGREEMENT [ The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment 5. 6. 7. 8. 9. 10. PRINTED NAME :612..vc_(, fu_.Ll,sz.: !1i&!'K J..(7esbrrd... . }Vfl(1q U J, J.LL .. <J r o,,," V\G<.,..., f>, bu...s JOB TITLE I RESPONSIBILITY LRn L2-D DATE SIGNATURE (2) $/1:4 see. ')X'e'.'I\ e...;> z../2-1/tf see ?r-e-nc,,;,'> ec..se.... f;M prs'{10-is ?&deg;''.J..,_ s S' I St.ft ;Jbb_i.&#xa3;._ "3/8/!'( See. ?re.--J 1c:>->S ec--se.... 11. \. 'l l tl 0 --* ;...... 1 .:.rs " se.:: 16. 12. VwvtJ. ffi=E'P l\JJS f&$C5a7' 13. 3\eph0Y\ Se.;l1L!ifv\ef SIV\. 14. / \J'l\.A<2.<-E<;. Rei :3iu//o/ See 1s. Jeif 1h;.1Mo.....__ ss <fa>>Lf;;>(
      /
* KO -*see. 1.:.-.;\ see. &#xa5;' re \,(( 0-.) ec.-See i''6i lo-.> f?O..'J-'L 17. N ('tl.rto\.._5 Mooay SS 18. Ross /17 u. . 19. 20. 5t-v-;l'.. m/rtP 'I/ J;,;.,--SS 5TI\ 4/z,/11 Ots lr-rJ6 See ere" lo..>S ftA.Sk NOTES: Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01. DATE NOTE 'l'/r;{N' -g-z.a-f'f Rev. 2 ff P-T-SAT-71 MASTER SECURITY AGREEMENT 4 a.I' sc;1:11i'-' 1of1*1 *F. --The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary *and Secondary Containment. 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) 'X Ji -s/20 11-1 s l(l 1'i I acknowledgi:!'tha I specialized knowledge about the 2014 NRC IL T EXAM examination(s) scheduled for the date(s) of 8/4/2014 e/2atzr 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 an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised. 2. Post-Examination the date(s) of :r:\l.u,J -\"?\ 1y . From the date that I entered into this secu ity agreeme t until the completion of ex
Kevin Davison Site Vice President, Prairie Island Nuclear Generating Plant Northern States Power Company - Minnesota Enclosures (1) cc:       Mike Bielby, US NRC Region Ill , with enclosure Hironori Peterson, US NRC Region Ill, without enclosure
* a 10 To the best of my knowle,ge, I did not divulge to any unauthorized persons any the examinations administere. d during administration, I did not instruct', evaluate, or provide performance feedback to tho e individual who were administered PRINTED NAME JOB TITLE I RESPONSIBILITY 1. J A th "'(J.f Ce.*c ('.hetil.,/d,;<</, /.Jew f 2. C_ '-r tJ .. ..,-tJ.C.. / \>o 1-.,\ \'>'" L-3. 4. 5. 6. 7. Retention: Life of Plant Retain in: Exam File .. 3/5/1i f NOTE -a/Zi;/1( --
                                                                                ' m::CEIVEO ~mv 0 4 2014 1717 Wakonade Drive East o Welch , Minnesota 55089-9642 Telephone: 651 .388.1121
QF-1071-02, Rev. 2 (FP-T-SAT-71) S..,, Page ""1-f'o'l+-f..:;;2"-* lio \ l "i 1' of IP '&deg; (t Xcel Energy* LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) I I have acquired specialized knowledge about the 2o ''1 t L-''f examination scheduled for the date(s) of bf.., I 1 i.i -S/llS' I 1:t as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor .. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised. 2. Post-Examination 1. 2. 3. 4. To the best o my know edfle, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of a t.t/i'i -8 ;'( / 1'-f
 
* From the date that I entered into this security agreement until the completion of this examination administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination. Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me. PRINTED NAME m&deg;'rk H&deg;'(e n f(, tJ, 4-ei m . l11 Mn*-' Jf::v1,.J .1YI I/ JOB TITLE I RESPONSIBILITY DATE Lt?0id Ro fo C: ::;7 4*ZI-ttf _5' -;-r.::-v* _, r *' ' -1::./ '===== *---*-----------* r* *'.*?"J ./ g.z")-1<{ _ <2/ o..ktiz. ... I-'l'<fl..v(.:l'-1, Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
QF-1071-01, Rev. 2 (FP-T-SAT-71)                                                                                                                       Page 1 of 2 (l Xcel Energy-                                                                 MASTER SECURITY AGREEMENT                                                                    I The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.
QF-1071-02, Rev. 2 (FP-T-SAT-71) Page-% of 2 s.,,1 (, c;, fl Xcel Energy-LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. PRINTED NAME c* C: 5. 0c..tirr-t<.f' 6. 7. 8. 9. 10. j S"le: e.r=J l:)Ud. \ """ *]<)Sor'\ fo ,.,.. ,/r c1 ,.J Eke b-S /' ;; .'.J I"""-Lc.-i-\J""{..-r-' t1 fJti 11. ""J*;_;f 7 sC::l'*'':\. 12. Pect..r\. 13. -;-;;J ,J :5 fr'a,1 ;-1 14. \L-sf ;;t 1&#xa3;. <oil .-: 15. __ <;j-rul ljgMjt 16. -* I .... f-17. Ctl\LV 612-E.6.Sol\I 18. 1J;o,../ 19. /111 ;c_.,t:: /5/z.W 20. 1'-A:tY<.*4fr/!,.,.,: L NOTES: Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY USD MJF l<o /... 1::'71,!J ,!( 0 5"_5 LW kv --------1 ) / ,&#xa2;? '* / .('_ "1u7' /) C.) I Leo..cO --g O :51/l {/ * /A .. /r1 <; lr-<AC lo.-.-Ot1 s -1 rt...u ) ... /,,. AH_v\".sc,r 71 ). vu +r"' ch r _,..., J, ../-, _/.-/tJf ,...., c' 1 0 J..-' / -::Z:,.r_,? vt. c-h / w<< ae.---. , -.,.,------,-,.......... Form retained in accordance with record retention schedule identified in FP-G-RM-01. DATE DATE NOTE h'f ..,,/ I g!'--t;/lt ff /'r/!'1 .JJ.jjfJ'f_ CJ-12*/i-/ .....____, '1-f,2.-!'f --;_off/; I_ " I" --.t?i t/ =----ff;/,,/,"' ',./ .,.._., 8/ ''i [ii./ __ rhl/I/ __}}
: 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)
I acknowledge that I have acquired specialized knowledge about the .2oi4 u_r tJ&#xa3;'- examination(s) scheduled for the date(s) of
  'iS/t.Jh4 - 1?/it /1'1 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Post-Examination To the best of           my   nowl~~~ , ,1 did not divulge to any unauthorized p~rson~ any inf?rmation concern!ng the exami.nations adn:i in i~tered during the date(s) of 15 L/ /lt - ./r-, 1'f                 . From the date that I entered into this security agreement until the completion of exam1nat1on administration, I did not in *truct, evaluate, or provide performance feedback to those individuals who were administered these examinations.
PRINTED NAME               JOB TITLE/ RESPONSIBILITY                    SIGNATURE (1)              DATE                                DATE          NOTE
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Retention: Life of Plant Retain in: Exam File
 
QF-1071-01, Rev. 2 (FP-T-SAT-71)
[ll XcelEnergy-                                                                MASTER SECURITY AGREEMENT Pcige 2 of 2 The Secondary and        Master Security      Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary Containment.
PRINTED NAME              JOB .T. ITLE I RESPONSIBILITY              SIG
                                                                                          . NATURE (1)             DATE        n~~T~~; (2)
:: Je.t.r;,:e~;~                            S~~.'A~, ~"t~-.c                      ~'f ?1*h~ ~~~
DATE      NOTE g-fts-/ty
                                                                                                                                                  <J/t5/i'i 10..         M1c.Jiolt1t\ A.bvie11        {')fJ i~J~JXulfTUl                    L'-7!              _          'i/z/t'f _/ _._~__,,.,..
~N~ c1 ,~,,i , scov , D'* ,, ~ ,*-y~., w'
  "'-!Kl..J.... "i .           ~- !_          ( l . [)(\ -
                                                                  ~ / l :CL+'-
                                                              .. ' ' /-.- t.     (\  ' *~ r: il ~sv* __
                                                                                                ,"'"" /  );&#xa3;\ . .          __ _ _L__ _ _ _ _ _ _ ~!sir
:,1 , KG            1,"l' 12.
13.
14.
15.
16.
17.
18.
19.
20.
NOTES:
Retention: Life of Plant Retain in: Exam File
 
10/~Jiif
                                                                                                                                                                            ')(1&deg;!
QF-1071-02, Rev. 2 (FP-T-SAT-71)                                                                                                                        Page 1      ot-r'<JP I fl Xcel Energy- I                                                                   LIMITED SECURITY AGREEMENT                                                                    I The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.
: 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)
I ~ckno~led~e that I have acquired specialized knowledge about the .;}oi'i il:r rJ\l<..                     examination scheduled for the date(s) of
      'iiL\h'l * ~li'il 111          as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.
Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Post-Examination To the best f y kn wledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of ~ <t 14. - 'l 6                          . From the date that I entered into this security agreement until the completion of this examination administrati n, I did. not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.
Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.
PRINTED NAME                      JOB TITLE I RESPONSIBILITY                                          DATE        ./\SIGNA/ l fE (2)      DATE          NOTE
: 1.   "s *41 I ,        -
Ut,.. r , //"J....,
J,, LI\, V:;            C....11. 'i-<....v 1..- S' ') / 5:r}
2'-r ~it (JI 't .ff~/ -fc;.__ _,      /Z ).,<.pl </
1///y /,r/uhJ  I                                      (l 1)
                                                                                          ~ ;~--:-,                                  f, ~~
                                                                                                                                  ~--;;,
9_),_.JLf
                                                                                                                  ;;;;: 2 c cv-
: 2.         Kr,                  r                              J___
I
          \_o..,0.r-Q.... 0-\,.)J\.\,(.                        Lto                                              HWI 9 -~-f'f
                                                                                        *r;~
: 3.                                                                                                                                                                    --
: 4.      t/cu1fJ f5ttcH                                    S:S'                                                                                      '1_~ - -
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
 
                                                                                                                                                                                                        , ,., .~
pl
                                                                                                                                                                                                  'flJ' QF-1071-02, Rev. 2 (FP-T-SAT-71)                                                                                                                                            Page 2          of~(::>
I fl Xcel Energy-                                                                             LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.
PRINTED NAME                                JOB TITLE I RESPONSIBILITY               SIGNATURE (1)              DATE                  SIGNATURE (2)         DATE            NOTE
                                                                                                                                                            'f=
f
( (\ )\/~*-
* 1/~111~ -
                                                                                                                              ,_~ I?W<~-=
: 5.            \ *hAtt--- ::') fN'v- \
l ---- - - - - - ----:-7  L Rn                                                    .
7 \ __
                                                                                                ~~!<>Phi~
: 6.      f)g..vc.(. lYL1t5l-L f_o                            ,&#xa2;    ''"
qf11/rf
: 7.          Jc.-e..      ~Wl..e<...v'\                     J.-"'-Sf-r'-"-<- J-.:,..,,.,.-                                                                              r/rt/1t 8.
9.
t1((1'k /..17oj.brvcl
          >c<. +/-en-e )vi,ra, ff>
5,;Vf
                                                                      &#xa3;M .
I            7
                                                                                              ~/- ~*~\ .~0- 0?1J;~ ~ ~~L~&
                                                                                                                            . i!fi!? /~ ,,                                 <tfzofl~
                                                                                                                                                                            !c(j/r~
: 10.       rJl\*\-h~..-. ~ :t>1.'i3s .                           s s/ s*-r1t                                zi:. .L~.-       '3/'> /tl ~:p;t'J                              I v/:J/;     I/
t..:::.L:.- ' --
11.
12.
13, 14 *
            -\ " \,.-.... )(... \? ) '
JJD.N 0te
                          ,~J 'ffi_W
                      '~""" Sz,1~, '"''' MSS~J\/&~a-1
          / \-;1\) -'\{l;_t <;,.,
                                      ..::. LHt::C '-
no
(,?A
                                                                      \L\.;..J
                                                                                                              ~
                                                                                                                              'xf0=
1/->f1q 3,ll
                                                                                                                                ,.., '   /
1'/
                                                                                                                                ..>/?~ *";t1
                                                                                                                                                ~ r~1i1
                                                                                                                                                        /lj / L-
                                                                                                                                                    * //,/  /,?i
                                                                                                                                                ~'f_,/{. /c~- *(/'\J
                                                                                                                                                                        ?-1 "ii:
B/~..,9//r.y
: 15.  -J"eU I ~\,\ Vvt o..A..                                       55                        r---* -                                                                    ~                -
: 16.     t /,.t C/ t " r <) r._.,
:7              A                                  Ro                          t)l.....,_..Ic..------=-      1-/ I ~1 / ,J
_. _ fl -I
                                                                                                                                                  ,ll .l....
                                                                                                                                                ~c""'-
Z.;;._
l** ----
                                                                                                                                                                  "-'-L-     q;!t,A*L{_
i/;11 ~
: 17.    /V tc\;,,ohs            / V] oocly                          >.)                                                                                                  '1/i<J(1'i
: 18. R.oss ~o !J                                          Ofs lt--1J6 ~*
I                                                                                                            ~
      . 1Y,;
1~tllft1i/ .~            of!t
                                                                                                                              ~~: a4t1::2~\\
: 19.                     15.t~C                          1rw6-P ;;JJ <:I/V::::r*
: 20.   .Jo.soi-\ &#xa3;-tv-;t. ~{~...d                          55 ;l_>TA                                                                                                      o/-z."111:{
NOTES:
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
 
QF-1071-02, Rev. 2 (FP-T-SAT-71)                                                                                                                  Page~  ef2 <E.1>\0 1i... \\~
                                                                                                                                                        ~ ""~
I(l XcelEnergy- I                                                    LIMITED secURllY AGREEMENT                                                                    [
The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment PRINTED NAME                  JOB TITLE I RESPONSIBILITY                        DATE            SIGNATURE (2)                      DATE    NOTE
: 5.         ~ll..-~fNV-\                    LRn                                            $/1:4        see. ')X'e'.'I\ e...; > ~)O..'\~
: 6.     :612..vc_(, fu_.Ll,sz.:                L2-D                                        z../2-1/tf    see    ?r-e-nc,,;, '>    e c..se....
                                            ~S?he                      ~. i4i~~
: 7.       Jee..~                                                                                                                                'l'/r;{N'
: 8.      !1i&!'K J..(7esbrrd...
: 9.      .~~.oe. }Vfl(1q J,             U          f;M                ...,~(/j,3~ ~<!_ p rs'{ 10-is                              ? &deg;''.J..,_
10.
              .LL            .. <J rJ o,,," V\G<.,..., f>, bu...s        s S'I St.ft              ;Jbb_i.&#xa3;._          "3/8/!'(      See. ? re.--J 1c:>->S ec--se....
: 11.      \.
                      'l 1 .:.rs "
l                tl 0                                                  se.::  ':>f'e.~ 1 0*~~  yi c~", ~
: 12. VwvtJ.                 ffi=E'P        l\JJS f&$C5a7'                                            *see. ? c~ " 1.:.-.;\  y;>u.~IL
: 13. 3\eph0Y\ Se.;l1L!ifv\ef                      SIV\.                                                see. ?r e-<1~..:i.s    pCA.~e..
                                          <--~~----------~~~-
: 14.   / \J'l\.A<2.<-E<;.     Sc..t-1tc~          Rei                  ~                  :3iu//o/ See        ~"'o>?'i po-y~.
1s. Jeif 1h;.1Mo.....__                            ss                    <fa>>Lf;;>(        *            ~    &#xa5;' re \,(( 0-.) ~ ec.-  '}~*
: 16.     ~~qd ~~:-5c>-"1                            KO                    ~L            -    '-//'-/It~  See i'' 6i lo-.> f?O..'J-'L
: 17. N ('tl.rto\.._5 Mooay                      SS                  ~~11 Ross ~olJ                                lr-rJ6  ~*            ~ .~/J1 ~                                                              ~
18.
19.
      /17
{blf1!t&#xa5;~#K
: u. .                  Ots m/rtP  'I/  J;,;.,--      ~                    -&#xa5;/nil'/~                                          -g-z.a-f'f
: 20. Jo.so~ 5t-v-;l'.. ~(.ot~            SS        5TI\            a@&#xa3;.&#xa3;'tlv~i-.~ 4/z,/11            See    ere"lo..>S        ftA.Sk NOTES:
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
 
Rev. 2 ff P-T-SAT-71
                                                                                                                                                  ?o.s~ 4 a.I' ~ sc;1:11i'-'
                                                                                                                                                  *F.    -1of1*
                                                                                                                                                            -    1 MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary
*and Secondary Containment.
: 1. Pre-Examination (Review FP-T-SAT-71 , Attachment 1 for pre-job briefing requirements)
                    'X Ji -s/20        l(l 11-1 s 1'i I acknowledgi:!'tha I hav~~acquired specialized knowledge about the 2014 NRC ILT EXAM                      examination(s) scheduled for the date(s) of 8/4/2014 -=..B.l~ e/2atzr ~as of the date of my signature. I agree that I wil l not knowingly divulge any information about these examinations to any -
persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration . I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Post-Examination To the best of my knowle,ge, I did not divulge to any unauthorized persons any i~ormation c~cerning the examinations adm inistere.d during the date(s) of :r:\l.u,J - ~ \"?\      1y        . From the date that I entered into this secu ity agreeme t until the completion of ex
* a 10 administration , I did not instruct', evaluate, or provide performance feedback to tho e individual who were administered            ~nations.
PRINTED NAME                    JOB TITLE I RESPONSIBILITY                                                                                        NOTE
: 1. J e~ A th "'(J.f                    Ce.*c ('.hetil.,/d,;<</, /.Jew f                                      .i . '~w 3 /5/1    ~      f &#xa5;4              -a/Zi;/1( - -
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* lio \ l "i 1' of IP      '&deg; (t Xcel Energy*                                                                LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.
: 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)
I ac~n9wledge t~at I have acquired specialized knowledge about the 2o ''1 t L-''f *"'~'-                     examination scheduled for the date(s) of bf.., I1i.i - S/llS' I1:t as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.
Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Post-Examination To the best o my know edfle, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of        a  t.t/i'i - 8 ;'( / 1'-f
* From the date that I entered into this security agreement until the completion of this examination administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.
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PRINTED NAME                      JOB TITLE I RESPONSIBILITY ~:N~                                      DATE
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fl Xcel Energy-                                                                            LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.
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NOTES:
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.}}

Latest revision as of 07:58, 25 February 2020

2014 Prairie Island Nuclear Generating Plant Initial License Examination Form ES-201-3
ML15128A227
Person / Time
Site: Prairie Island  Xcel Energy icon.png
Issue date: 08/22/2014
From: Bielby M
NRC/RGN-III/DRS/OLB
To:
Northern States Power Co
Shared Package
ML13093A444 List:
References
Download: ML15128A227 (9)


Text

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

Northern States Power Company, a Minnesota corporation, doing business as Xcel Energy (hereafter "NSPM"), submits the original signed examination security agreements as Enclosure 1.

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

/)

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/

Kevin Davison Site Vice President, Prairie Island Nuclear Generating Plant Northern States Power Company - Minnesota Enclosures (1) cc: Mike Bielby, US NRC Region Ill , with enclosure Hironori Peterson, US NRC Region Ill, without enclosure

' m::CEIVEO ~mv 0 4 2014 1717 Wakonade Drive East o Welch , Minnesota 55089-9642 Telephone: 651 .388.1121

QF-1071-01, Rev. 2 (FP-T-SAT-71) Page 1 of 2 (l Xcel Energy- MASTER SECURITY AGREEMENT I The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

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

I acknowledge that I have acquired specialized knowledge about the .2oi4 u_r tJ£'- examination(s) scheduled for the date(s) of

'iS/t.Jh4 - 1?/it /1'1 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my nowl~~~ , ,1 did not divulge to any unauthorized p~rson~ any inf?rmation concern!ng the exami.nations adn:i in i~tered during the date(s) of 15 L/ /lt - ./r-, 1'f . From the date that I entered into this security agreement until the completion of exam1nat1on administration, I did not in *truct, evaluate, or provide performance feedback to those individuals who were administered these examinations.

PRINTED NAME JOB TITLE/ RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE

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[ll XcelEnergy- MASTER SECURITY AGREEMENT Pcige 2 of 2 The Secondary and Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary Containment.

PRINTED NAME JOB .T. ITLE I RESPONSIBILITY SIG

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QF-1071-02, Rev. 2 (FP-T-SAT-71) Page 1 ot-r'<JP I fl Xcel Energy- I LIMITED SECURITY AGREEMENT I The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

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

I ~ckno~led~e that I have acquired specialized knowledge about the .;}oi'i il:r rJ\l<.. examination scheduled for the date(s) of

'iiL\h'l * ~li'il 111 as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.

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2. Post-Examination To the best f y kn wledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of ~ <t 14. - 'l 6 . From the date that I entered into this security agreement until the completion of this examination administrati n, I did. not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE ./\SIGNA/ l fE (2) DATE NOTE

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I fl Xcel Energy- LIMITED SECURITY AGREEMENT The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

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- 1 MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary

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

'X Ji -s/20 l(l 11-1 s 1'i I acknowledgi:!'tha I hav~~acquired specialized knowledge about the 2014 NRC ILT EXAM examination(s) scheduled for the date(s) of 8/4/2014 -=..B.l~ e/2atzr ~as of the date of my signature. I agree that I wil l not knowingly divulge any information about these examinations to any -

persons who have not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration . I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowle,ge, I did not divulge to any unauthorized persons any i~ormation c~cerning the examinations adm inistere.d during the date(s) of :r:\l.u,J - ~ \"?\ 1y . From the date that I entered into this secu ity agreeme t until the completion of ex
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1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I ac~n9wledge t~at I have acquired specialized knowledge about the 2o 1 t L-f *"'~'- examination scheduled for the date(s) of bf.., I1i.i - S/llS' I1:t as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.

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2. Post-Examination To the best o my know edfle, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of a t.t/i'i - 8 ;'( / 1'-f
  • From the date that I entered into this security agreement until the completion of this examination administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.

PRINTED NAME JOB TITLE I RESPONSIBILITY ~:N~ DATE

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