Latest revision as of 21:13, 30 October 2019

Text

2016 Byron Nuclear Station Initial License Examination Form ES-201-3
	ML16117A578
Person / Time
Site:	Byron
Issue date:	03/23/2016
From:	Bielby M; Operations Branch III
To:	; Exelon Generation Co
References
	Download: ML16117A578 (3)
	v • d • e

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

1. Pre-Examination ¥~za>;6 _

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 1./2-VZol' 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 knowl~dg~, l did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 1/rt. .Y~/2~'"f=rom the date that I entered into this se_c urity 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.

JOB TITLE I RESPONSIBILITY cz/;t"" A"~r /

~~

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11- ">>i<' ____:.__J"-=~~"fL!__ _ _

/~-;J../\ -----'-P~~~'lllU~-

J. - ?- !S"~~~+..:.~~--

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

1. Pre-Examination ~/11//zo/6-I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of '3/~ :s?'~11's 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 know.ledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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 DATE DATE NOTE

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NOTES:

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

1. Pre-Examination 3/ir/Z.;:tb -

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of :J/z >/Z&>I bas 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 know edge I 9id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of / f..-J rl(~~rom 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 1 . ~b tlJt~;e 2.l<?-iu1""' C4=1 s 3.*~

4:fi£1A ~

~- ~~~

7. f"'.ic.WJ\tbv.Ch 8 ~c.. ~I'~

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10._ _ _ __ _ _

11 ._ _ _ _ _ __ _

1~--------

13._ _ _ _ _ _ __

14._ _ _ _ _ _ __

15 ._ _ _ __ _ __

NOTES:

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

1. Pre-Examination ¥~za>;6 _

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 1./2-VZol' 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 knowl~dg~, l did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 1/rt. .Y~/2~'"f=rom the date that I entered into this se_c urity 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.

JOB TITLE I RESPONSIBILITY cz/;t"" A"~r /

~~

/I So avm [Off

/ O* 11-1;-~~~~~~;:::~~ ~---+'--

/p/1J /f_s"' ---',~~¥----"-'-'f'----

~ b; ), '2_!_/-~~~~"""""===-----

11- ">>i<' ____:.__J"-=~~"fL!__ _ _

/~-;J../\ -----'-P~~~'lllU~-

J. - ?- !S"~~~+..:.~~--

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

1. Pre-Examination ~/11//zo/6-I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of '3/~ :s?'~11's 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 know.ledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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 DATE DATE NOTE

1. l<Q:-1-~ K<e...., f**J ::):'T

2. OQ..("~ © *)..AJ:-..~

3. £..r...,, l;~~

4. 5h&...n.~ 1¥..c...ie1 5.3C.....,,j<t (,~n@v l

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10. ~r ~ L.

11. c.) ltJ. I ~

12. (...0

13. __r-------.....:...-=;.....;;..-

(~ /,..J<'

NOTES:

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

1. Pre-Examination 3/ir/Z.;:tb -

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of :J/z >/Z&>I bas 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 know edge I 9id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of / f..-J rl(~~rom 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 1 . ~b tlJt~;e 2.l<?-iu1""' C4=1 s 3.*~

4:fi£1A ~

~- ~~~

7. f"'.ic.WJ\tbv.Ch 8 ~c.. ~I'~

9: M/d7/Me .5'fk~()

10._ _ _ __ _ _

11 ._ _ _ _ _ __ _

1~--------

13._ _ _ _ _ _ __

14._ _ _ _ _ _ __

15 ._ _ _ __ _ __

NOTES:

@@ Line 15: / Line 15: @@
 =Text=
-{{#Wiki_filter:I ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination
+{{#Wiki_filter:I ES-201                                                         Examination Security Agreement                                                     Form ES-201-3
-_ I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 1./2-VZol' as of the date of my signature.
+: 1.         Pre-Examination                                                                                                                &#xa5;~za>;6    _
-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 acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of                 1./2-VZol' 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.
-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).
+: 2.         Post-Examination To the best of my knowl~dg~, l did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 1/rt. .Y~/2~'"f=rom the date that I entered into this se_c urity 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.
-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.
+JOB TITLE I RESPONSIBILITY cz/;t"" A"~r            /
-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 l did not divulge to any unauthorized persons any i nformat i on concerning the NRC licensing examinations administered during the week(s) of 1/rt .
+                                       /I So avm           [Off
-the date that I entered into this se_curity 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. JOB TITLE I RESPONSIBILITY cz/;t""
+                                                                                                               / O* 11-1;-~~~~~~;:::~~               ~---+'--
-/ avm [Off /I So /O* /p/1J /f_s"' b; ), 11-">>i<'
+                                                                                                              /p/1J /f_s"'  ---',~~&#xa5;----"-'-'f'----
-__ _ *J. -?-
+                                                                                                               ~ b; ), '2_!_/-~~~~"""""===-----
-ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination I acknow ledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of of the date of my signature.
+- ">>i<' ____:.__J"-=~~"fL!__ _ _
-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.
+                                                                                                                /~-;J../\ -----'-P~~~'lllU~-
-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).
+                                                                                                                *J. - ?- !S"~~~+..:.~~--
-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.
+ES-201                                                       Examination Security Agreement                                                 Form ES-201-3
-: 2. Post-Examination To the best of my know.ledg e , I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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 1.
+: 1.            Pre-Examination                                                                                                    ~/11//zo/6-I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of         '3/~ :s?'~11's   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.
-K<e...., f**J 2.
+: 2.             Post-Examination To the best of my know.ledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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.
-&#xa9;  "
+PRINTED NAME                 JOB TITLE I RESPONSIBILITY                                          DATE                               DATE       NOTE
-: 3. &#xa3;..r...,,
+: 1. l<Q:-1-~ K<e...., f**J             ::):'T
-: 4.
+: 2. OQ..("~ &#xa9; *)..AJ:-..~
-&#xa5;..c...ie1 5.3C.....,, j<t 6.
+: 3.     &#xa3;..r...,, l;~~
-f1 015 9 . .Yk,,(,,.., '-" ''1 ( I 10. L. 11. c.) ltJ. I 12. (...0 13. __ r----''---.....:...-=;.....;;..-
+: 4. 5h&...n.~ 1&#xa5;..c...ie1 5.3C.....,,j<t (,~n@v l
-NOTES: JOB TITLE I RESPONSIBILITY
+: 6. Ct.., c.r~ f1015
-::):'T /J50 ;'ft..o /,..J<' DATE DATE NOTE ES-201 Examination Security Agreement Form ES-20 1-3 1. Pre-Examination 3/ir/Z.;:tb
+  ~:t!f:tttf ~o=
--I ackno wl e d ge th a t I hav e acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) o f :J/z >/Z&>I b as of the date of my signature.
+                                             /J50 9 . .Yk,,(,,.., '-"  ''1 (   I            ;'ft..o
-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.
+: 10. ~r ~ L.
-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).
+: 11.        c.) ltJ. I ~
-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.
+: 12.                       (...0
-I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
+: 13. __r----''---.....:...-=;.....;;..-
-: 2. Post-Examination To the best of my k n o w edge I 9 i d n o t divulge to any unauthorized pe r sons a n y i n f o rm a t ion concerning the NRC licensing examinations administered during the week(s) o f / f..-J the date that I entered into this sec urit y 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 2.l<?-i u1""' C4=1 s 7. f"'.ic.WJ\tbv.Ch 8 9:
+(~       /,..J<'
-: 10. ______ _ 11. _______ _
+NOTES:
-: 13. _______ _ 14. _______ _ 15 .. _______ _ NOTES: JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 3 I 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 1./2-VZol' as of the date of my signature.
+ES-201                                                       Examination Security Agreement                                                 Form ES-201-3
-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.
+: 1.         Pre-Examination                                                                                                       3/ir/Z.;:tb -
-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).
+I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of :J/z >/Z&>I bas 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.
-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.
+: 2.         Post-Examination To the best of my know edge I 9id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of / f..-J rl(~~rom 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.
-I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
+PRINTED NAME               JOB TITLE I RESPONSIBILITY                   SIGNATURE (1)              DATE       SIGNATURE (2)            DATE      NOTE 1 . ~b tlJt~;e 2.l<?-iu1""'  C4=1 s 3.*~
-: 2. Post-Examination To the best of my l did not divulge to any unauthorized persons any i nformat i on concerning the NRC licensing examinations administered during the week(s) of 1/rt .
+:fi&#xa3;1A ~
-the date that I entered into this se_curity 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. JOB TITLE I RESPONSIBILITY cz/;t""
+  ~- ~~~
-/ avm [Off /I So /O* /p/1J /f_s"' b; ), 11-">>i<'
+: 7. f"'.ic.WJ\tbv.Ch 8 ~c.. ~I'~
-__ _ *J. -?-
+: M/d7/Me .5'fk~()
-ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination I acknow ledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 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 know.ledg e , I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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 1.
+._ _ _ __ _ __
-K<e...., f**J 2.
+NOTES:
-&#xa9;  "
-: 3. &#xa3;..r...,,
+I ES-201                                                         Examination Security Agreement                                                     Form ES-201-3
-: 4.
+: 1.         Pre-Examination                                                                                                                &#xa5;~za>;6    _
-&#xa5;..c...ie1 5.3C.....,, j<t 6.
+I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of                 1./2-VZol' 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.
-f1 015 9 . .Yk,,(,,.., '-" ''1 ( I 10. L. 11. c.) ltJ. I 12. (...0 13. __ r----''---.....:...-=;.....;;..-
+: 2.         Post-Examination To the best of my knowl~dg~, l did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 1/rt. .Y~/2~'"f=rom the date that I entered into this se_c urity 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.
-NOTES: JOB TITLE I RESPONSIBILITY
+JOB TITLE I RESPONSIBILITY cz/;t"" A"~r            /
-::):'T /J50 ;'ft..o /,..J<' DATE DATE NOTE ES-201 Examination Security Agreement Form ES-20 1-3 1. Pre-Examination 3/ir/Z.;:tb
+                                       ~~
--I ackno wl e d ge th a t I hav e acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) o f :J/z >/Z&>I b as of the date of my signature.
+                                       /I So avm           [Off
-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.
+                                                                                                               / O* 11-1;-~~~~~~;:::~~               ~---+'--
-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).
+                                                                                                              /p/1J /f_s"'  ---',~~&#xa5;----"-'-'f'----
-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.
+                                                                                                               ~ b; ), '2_!_/-~~~~"""""===-----
-I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
+- ">>i<' ____:.__J"-=~~"fL!__ _ _
-: 2. Post-Examination To the best of my k n o w edge I 9 i d n o t divulge to any unauthorized pe r sons a n y i n f o rm a t ion concerning the NRC licensing examinations administered during the week(s) o f / f..-J the date that I entered into this sec urit y 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 2.l<?-i u1""' C4=1 s 7. f"'.ic.WJ\tbv.Ch 8 9:
+                                                                                                                /~-;J../\ -----'-P~~~'lllU~-
-: 10. ______ _ 11. _______ _
+                                                                                                                *J. - ?- !S"~~~+..:.~~--
-: 13. _______ _ 14. _______ _ 15 .. _______ _ NOTES: JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 3}}
+ES-201                                                       Examination Security Agreement                                                 Form ES-201-3
+: 1.            Pre-Examination                                                                                                    ~/11//zo/6-I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of         '3/~ :s?'~11's   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 know.ledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of J/l'f-3fn11i,. 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                                          DATE                               DATE       NOTE
+: 1. l<Q:-1-~ K<e...., f**J             ::):'T
+: 2. OQ..("~ &#xa9; *)..AJ:-..~
+: 3.     &#xa3;..r...,, l;~~
+: 4. 5h&...n.~ 1&#xa5;..c...ie1 5.3C.....,,j<t (,~n@v l
+: 6. Ct.., c.r~ f1015
+  ~:t!f:tttf ~o=
+                                             /J50 9 . .Yk,,(,,.., '-"  ''1 (   I            ;'ft..o
+: 10. ~r ~ L.
+: 11.        c.) ltJ. I ~
+: 12.                       (...0
+: 13. __r----''---.....:...-=;.....;;..-
+(~       /,..J<'
+NOTES:
+ES-201                                                       Examination Security Agreement                                                 Form ES-201-3
+: 1.         Pre-Examination                                                                                                       3/ir/Z.;:tb -
+I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of :J/z >/Z&>I bas 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 know edge I 9id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of / f..-J rl(~~rom 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 1 . ~b tlJt~;e 2.l<?-iu1""'  C4=1 s 3.*~
+:fi&#xa3;1A ~
+  ~- ~~~
+: 7. f"'.ic.WJ\tbv.Ch 8 ~c.. ~I'~
+: M/d7/Me .5'fk~()
+._ _ _ __ _ _
+._ _ _ _ _ __ _
+~--------
+._ _ _ _ _ _ __
+._ _ _ _ _ _ __
+._ _ _ __ _ __
+NOTES:}}

ML16117A578: Difference between revisions

Latest revision as of 21:13, 30 October 2019

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ML16117A578: Difference between revisions

Latest revision as of 21:13, 30 October 2019

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