ML17156A791

2016 Monticello Nuclear Generating Plant Initial Licensed Examination ES-203-1 - Examination Security Agreement

ML17156A791
Person / Time
Site:	Monticello
Issue date:	02/17/2017
From:	Reeser D W NRC/RGN-III/DRS/OLB
To:	Nuclear Management Co
Reeser, David
Shared Package
ML15274A427	List: IR 05000263/2016301 ML17156A053 ML17156A055 ML17156A791 ML17156A796 ML17157B719
References
Download: ML17156A791 (11)

Text

Form ES-201-3, "Examination Security Agreements" OF-1071--ev. 2 FP-T-SAT-71 * '(l Xcel Energy* 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) I acknowledge that I have acquired specialized knowledge about the 2016 MNGP ILT NRC examination(s) scheduled for the date(s) of 11/14/2016 -11/18/2016 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 , did not divulge to any unauthorized persons any information concerning the examinations administered during the date(s) of II . From the date that I entered into this security agreement until the completion of examination administration, I d d not instruct, evaluate, or provide performance feedback to those individuals who were administered these examinations. PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE 1. 7?&-,1(@ ----2. r-ftip !M? / 1 3. ..._ "'f i111*' Cr f i:k he.l{ 6J8/& . _)l II' (t .J./_ (Jf. I 1-" .J,,-.,J_, 14. 4. -Hf --5. p5u,a;l+11c-t, ---6. f t: :t c r;,, r-1 fl) It* J)4.( 6/1 (,k. !"tfll\ 8-m16 7. ---Retention: Life of Plant RECE\\f ED f£0 t 7 10f1 Retain in: Exam File QF-107Htlv. 2 FP-T-SAT-71

• of 2 (t Xcel Energy-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. PRINTED NAME 8. du/1 9. Sue <*.n 10. 11. 12. 13. 14. 15. NOTES: Retention: Life of Plant Retain in: Exam File JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE '/ / ///;?/ ';{.

• * ** 2 FP-T-SAT-71 ! Pa--e""I of 2 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 L Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements} I acknowledge that I have acquired specialized knowledge about the 2016 MNGP ILT NRC examination(s) scheduled for the date(s) of 11/1412016-11/18/2016 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 , I id not divulge to any unauthorized persons any information concerning the examinations administered during the date(s) of -II. '/ . From the date that I entered into this security agreement until the completion of examination administration, diCi not i struct, evaluate, or provide performance feedback to those individuals who were administered these examinations. Retention: Life of Plant Retain in: Exam File S*-1111.Jr,,sL DATE s:1z .. r:fti.fi j;j;,,-=vu------1'if It* S/1VJ6 #----DATE NOTE :::-£-/?> ------./ ll/!tf /'1 -*'

• *

• 2 FP-T-SAT-71 Pa "e'1 of 2 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) I acknowledge that I have acquired specialized knowledge about the 2016 MNGP IL T NRC examination(s) scheduled for the date(s) of 11/14/2016 -11/18/2016 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 ledge I id not divulge to any unauthorized persons any information concerning the examinations administered during the date(s) of '/, .. II '° . From the date that I entered into this security agreement until the completion of examination administration, d. not in truct, evaluate, or provide performance feedback to those individuals who were administered these examinations. PRINTED NAME 1. /ffampw 2. *Plfmw 3. fU.lkhtll 4. }u'fl }'wbn9k 5. /116'A1.;;b ,' C Son} Retention: Life of Plant Retain in: Exam File DATE NOTE 11/r..I .. -!!.ftllL',P -

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

• Page 1 of 2 '(l 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 acknowledge that I have acquired specialized knowledge about the 2016 MNGP ILT NRC examination scheduled for the date(s) of 11/14/2016-11/18/2016 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 m know! d e, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of //,I'/, Ju --// I. . From the date that I entered into this security agreement until the completion of this examination administra 10 , I did n t 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 DATE NOTE PG1'i$ S<.o 10 *'5-1(, S c<Yl\ Vcl\NQ 7(2..-u IZ{Tltb t r.-1 ""4) -:;(lo /, I 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 2 of 2 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. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. NOTES: PRINTED NAME Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY SIGNATURE (1) Form retained in accordance with record retention schedule identified in FP-G-RM-01. DATE SIGNATURE (2) DATE NOTE

• QF-1071-02, Rev. 2 (FP-T-SAT-71) *

• Page 1 of 2. 'ft 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 acknowledge that I have acquired specialized knowledge about the 2016 MNGP IL T NRC examination scheduled for the date(s) of 11/14/2016-11/18/2016 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 kno le e, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of ' -II I I . From the date that I entered into this security agreement until the completion of this examination administra ion, I did ot 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 SIGN:c DATE NOTE 1#1-_z_ _;;--. V:nc.l.. IZ./S-//c. J,J(1Q V\)WJN S\20 \). Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071,Rev. 2 (FP-T-SAT-71) * '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. NAME .__ NOTES: Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

• 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 acknowledge that I have acquired specialized knowledge about the 2016 MNGP ILT NRC examination scheduled for the date(s) of 11/14/2016-11/18/2016 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. , I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of II . 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 SIGNATURE (1) DATE NOTE (ovM rc. tfuL U:.-s-/(.0 t"0!ta/1b 0.,' "-+t.c\ Kov9.neA to/13/11, //,2*.fk __ # 1i_i-1ft/, --' "< Vl"\ ...\ vvi.olf Ro /#ftfr;, 1t/JW4:---; I H E:1,..lo f2-o I b fiA-+/- fl*Z/*16_ Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071--ev. 2 (FP-T-SAT-71)

• 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 5. "fiZ4v.J:;s 6&ucfPl\)15@:'<'. 6. Tuv /f,L.L 7. (A-veL s. 9. i,. f c>pV>-=-10. Je,rv' S,',..p.so"-' / I 11 . Gev"'1d 12. 13. bc1es+ cJc..se 14. f(qeNtCr 15. NOTES: Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY Ao SIGNATURE (1) Form retained in accordance with record retention schedule identified in FP-G-RM-01. DATE --1LhJt r.. (o

• IO/lif/6 10/,i{it /o-1°1-1r. Jo -¥t6 11/ I'// JO I I ......... _ DATE NOTE 11/z./a, __ /( 1/t/7 uh.tA __ --'1!z ii 16