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{{#Wiki_filter:2012 D. C. COOK NUCLEAR INITIAL LICENSE ADMINISTRATIVE ES-201 Examination Preparation Checklist Form ES-201-1 Facility:
{{#Wiki_filter:2012 D. C. COOK NUCLEAR PLANT INITIAL LICENSE EXAMINATION ADMINISTRATIVE FILES
D. C. COOK Date of Examination:
 
7/23/12 Developed by: Written -Facility
ES-201                                     Examination Preparation Checklist                                   Form ES-201-1 Facility:       D. C. COOK                                   Date of Examination:         7/23/12 Developed by: Written - Facility
* NRC /I Operating  
* NRC         /I Operating - Facility
-Facility
* NRC Chief Target Task Description (Reference)                                       Examiner's Date*
* NRC Chief Target Date* Task Description (Reference)
Initials
Examiner's Initials -180 1. Examination administration date confirmed (C.1.a; C.2.a and b) 11""lt.. iif,( -120 2. NRC examiners and facility contact assigned (C.1.d; C.2.e) IIII/It. -120 3. Facility contact briefed on security and other requirements (C.2.c) IllfHL -120 4. Corporate notification letter sent (C.2.d) llrfllt [-90] [S. Reference material due (C.1.e; C.3.c; Attachment 2)] I1.A CIJi,t 6. Integrated examination outline(s) due, including Forms ES-201-2, ES-201-3, {-7S} 301-1, ES-301-2, ES-301-S, ES-D-1's, ES-401-1/2.
: 1. Examination administration date confirmed (C.1.a; C.2.a and b)
ES-401-3, and ES-401-4, as applicable (C.1.e and f; C.3.d) '-Ilft/{ct CIM {-70} {7. 8. Examination outline(s) reviewed by NRC and feedback provided to facility licensee (C.2.h; C.3.e)} Proposed examinations (including written, walk-through JPMs, and scenarios, as C({Z1{tZ {-45}
    -180 11""lt.. iif,(
supporting do..§mentation (including S-301-S>(S-301-6, and S-401-6, and any Form ES-20i-3 updates).
: 2. NRC examiners and facility contact assigned (C.1.d; C.2.e)
and reference materials due (C. i.e, f, 9 and h; C.3.d) -30 9. Preliminary license applications (NRC Form 398's) due (C.i.1; C.2.g; ES-202) (P(ZZ/tl.. -14 10. Final license applications due and Form ES-201-4 prepared (C.1.1; C.2.i; 202) 1-1,,(,z -14 11. Examination approved by NRC supervisor for facility licensee review (C.2.h; C.3.f) (,/1./12.
    -120                                                                                                    IIII/It. ~
CUt -14 12. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g) 4n -7 13. 14. Written examinations and operating tests approved by NRC supervisor (C.2.i; C.3.h) Final applications reviewed; 1 or 2 (if >10) applications audited to confirm 'Ht?'lll -7 qualifications I eligibility; and examination approval and waiver letters sent (C.2.i; Attachment 4; ES-202, C.2.e; ES-204) :Hi1-flt -7 15. Proctoringlwritten exam administration guidelines reviewed with facility licensee (C.3.k) (,{zq/lt -7 16. Approved scenarios, job performance measures, and questions distributed to NRC examiners (C.3.i) -:NfII{tZ.
    -120         3. Facility contact briefed on security and other requirements (C.2.c)
* Target dates are generally based on facility-prepared examinations and are keyed to the examination date identified the corporate notification letter. They are for planning purposes and may be adjusted on a case-by-case basis coordination with the facility
IllfHL ~
[Applies only] {Does not apply} to examinations prepared by the
    -120
* *
: 4. Corporate notification letter sent (C.2.d) llrfllt ~
* 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 7:2-7-. 2as of the date of my signature.
[-90]
I agree that I will not knowingly divulge any information about these examinations to any persons who have not been uthorized by the NRC chief examiner.
[S.
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).
6.
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.
Reference material due (C.1.e; C.3.c; Attachment 2)]
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
Integrated examination outline(s) due, including Forms ES-201-2, ES-201-3, ES I1.A    CIJi,t 301-1, ES-301-2, ES-301-S, ES-D-1's, ES-401-1/2. ES-401-3, and ES-401-4, as
: 2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) 0 -' 3 It.. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or rovide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC. JOB TITLE! RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 1. jf"f'VYI<...,  
{-7S}
-61 .5.,-h).-..
applicable (C.1.e and f; C.3.d)                                                       '-Ilft/{ct   CIM
2..  
{7. Examination outline(s) reviewed by NRC and feedback provided to facility
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{-70}            licensee (C.2.h; C.3.e)}                                                               C({Z1{tZ    ~
: 10.
: 8. Proposed examinations (including written, walk-through JPMs, and scenarios, as
U/c)t 12. /. . . .'ZI* n..13. ;n;;:
                      ~Plicable). supporting do..&sect;mentation (including Forms~S-301-3.~S-301-4,
1'-'1-11-/
{-45}              S-301-S>(S-301-6, and S-401-6, and any Form ES-20i-3 updates). and reference materials due (C. i.e, f, 9 and h; C.3.d)
: 14.
                                                                                                              ~/l/Irz ~
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      -30         9. Preliminary license applications (NRC Form 398's) due (C.i.1; C.2.g; ES-202)
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: 10. Final license applications due and Form ES-201-4 prepared (C.1.1; C.2.i; ES
* *
      -14              202)                                                                                   1-1,,(,z     ~
* 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 of the date of my signature.
: 11. Examination approved by NRC supervisor for facility licensee review
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.
      -14              (C.2.h; C.3.f)                                                                         (,/1./12. CUt
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).
      -14
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. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g)
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
{,IZI1~" 4n
: 2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s)
: 13. Written examinations and operating tests approved by NRC supervisor
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 NRO. PRINTED NAME JOB TITLE / RESPONSIBILITY
      -7              (C.2.i; C.3.h)                                                                           'Ht?'lll ~
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: 14. Final applications reviewed; 1 or 2 (if >10) applications audited to confirm qualifications I eligibility; and examination approval and waiver letters sent (C.2.i;
__ 4. lP. '<VI*"" "i Sn-s . .5 '12 5 . .5'rAl-lt&#xa3;t N*6v> {!LL,
      -7 Attachment 4; ES-202, C.2.e; ES-204)                                                   :Hi1-flt ~
_ -I
: 15. Proctoringlwritten exam administration guidelines reviewed with facility licensee
: 6. -;O;,'fC!
      -7              (C.3.k)                                                                                 (,{zq/lt ~
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: 16. Approved scenarios, job performance measures, and questions distributed to
: 7. Z!?&inr ir4;-;JAJ  
      -7              NRC examiners (C.3.i)                                                                   -:NfII{tZ. ~
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* Target dates are generally based on facility-prepared examinations and are keyed to the examination date identified in the corporate notification letter. They are for planning purposes and may be adjusted on a case-by-case basis in coordination with the facility licensee.
: 8.
[Applies only] {Does not apply} to examinations prepared by the NRC.
i.o I 1>
* ES-201
S:/"'/L -\'L 9.
* Examination Security Agreement
C:='Q>r\C RO / DSHIF, S'IO'l?-
* Form ES*201*3
17* 1"2.. 10. furl'''1V )
: 1.       pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 7:2 .           2as 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 uthorized 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.
&g i("(""...,e (rqL(),
: 2.       Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) 0 ~ - ' 3 It.. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or rovide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
g-/64'C 11. j ILe Se &..r s -"f.i1-J::l7' i 12. Ij,..l'f;k
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* ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekes) oh-11'" 9/siJlas of the date of my signature.
: 10. ~r'i,e1        U/c)t 11f!~
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.
      ;n;;:                                                                                                ~~-                                    .'ZI* n..
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.
We== 2t ~                          ~n-/~
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
: 12. /.           .                                                                                        . ~I
: 2. Post-Examination To the best of my knowledge I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the weekes) of 712:1 -Bb It:+-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. DATE PRINTED NAME JOB TITLE / RESPONSIBILITY
      $~.'"
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* ES-201
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* Examination Security Agreement                                               Form ES*201*3
I J.. NOTES: r (j) >l9 NAi l.i :If q -A1TA Cj-/ eo c..o Pi D F fAG!C 3 F"f! 01 DATE NOTE
                                                                                                                                                                *
,. ES-201, Page 27 of 28
: 1.       Pre*Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of         7-:J~ -q/Jk~as    of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
* *
: 2.       Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of7/z.p-ll~lrz'\ 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 NRO.
* 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) of7..jJ..tJfs//las of the date of my signature.
PRINTED NAME           JOB TITLE / RESPONSIBILITY                                                                               DATE NOTE
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. ~-cl+ N\~k"                    ~() f il Sh:,~                                                        519hz                            tV&-q-~
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).
7(f.1 2.
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.
3.
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
j'ECf t6~Los
: 2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 7/z!,
        .n.-:;     f~
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 / RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 1.j)w,O She\0.0"> A"*c> 010';' -" 9* 6 -I'l.. 2. :7.cdt t..laf..
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_______ ES*201 Stlcurity Agreement Form ES-201-3 1. Pre-Examination d I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekes) of 7.rz.'7 2.as of the date of my signature.
                                        "i      Sn- s
I agree that I will not knowingly divulge any information about these examinations to any persons who have not been uthorized by the NRC chief examiner.
                                          --I'RA./ I AdrniCl
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.
                                                                  .                                              .5 '12
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 5-lo-tl Cb,.rtr~    l.Z.
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..::k-~
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
: 7. Z!?&inr ir4;-;JAJ               ..pvs TI2.~ of'S                                                     '5' -ID' ti-                       --.%.l.2.l!..1:.:.
: 2. Post*Examination To the best of my know edge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) ofi;';.-::'--
: 8. ~DfI..c;..J ~&rU.b'1~                i.o I 1> s,.,~'\                                                  S:/"'/L                           ~ -\'L
9 0:. 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. * ;;, ..o , $,!!We 9. t!)1r Sy'S+/-.e"!.fS'  ct..."tg r 5.,,-( ,.."",,04" of> ::::"lS<<]l'-}CQI VV,}lr '-'-7
: 9. ~V~(\          C:='Q>r\C           RO / DSHIF,                                                                                             'i?~ 17* 1"2..
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JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE _________ ii1iKG
: 12. ~ Ij,..l'f;k                       1f~'''''''D''' 6e~                                                  ;-I'/./7-_..2.bLL2
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_____ _ M-Il ______ Cl)'P'Y ftije I ttl-tf ES-201, Page 27 of 28 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 7-:T:? -t?P/;cias of the date of my signature.
NOTES:
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.
fR> >IllNA,..lAl(E it=-? - ~C);:        ArrACHeO       coN   OF     Fl411e 2. t:oR   >~,JATV~e (2)         #
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).
faje       1- )- If ES-201, Page 27 of 28
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.
* ES-201
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
* Examination Security Agreement                                           Form ES-201-3
: 2. Post-Examination To the best of my I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 19-i/*f-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 NRO. PRINTED NAME JOB TITLE / RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE 1.
                                                                                                                                                                *
Ra j 0 if'e 2. :>tkf
: 1.       Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekes) oh-11'"               9/siJlas   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.
\!::o Z'D -ft.:....-
: 2.       Post-Examination To the best of my knowledge I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the weekes) of 712:1 -     Bb It:+- 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.
_______ 3. s......$ -..J JllQI'>f"A p.. .No"'!'F == .jf&#xa3;" 4. 1'0:&#xa3;\ i<vl+to SeD Jsm n-sb\*h .. K. S '2 e
PRINTED NAME                 JOB TITLE / RESPONSIBILITY                                                   DATE                          DATE NOTE
: 5. $rAl-iut Ai*&#xa2;lvS jSgQ / b-SHR'"C -/;z..... "...:'J'aLr"-vL..
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: 6. -ranyc< off-fRA.! I Adm;/} _ :5.JD-fZ _______ 7. Zl'.?J'52lr tit.:t",,&#xa5;iJ Di'S ".
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____10. ____ 11. ____ 12. ____ 13. ____ 14. ____ 15. ____ NOTES: coV'l ES-201, Page 27 of 28 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) 9/WZas of the date of my signature.
                                                                                                                .fprQt.
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.
                                                                                                                ~                                  ~\2.-
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.
: 5.                                       \         c)n..-   o,...r                                             ~?..                                8-S,,\~
I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
~:                                        p:z!cVt~~tr                                                            .;' (~I n,                       Y~i-(f.;(v 1__
: 2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of -)12.. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC. PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) SIGNATURE (2) DATE NOTE 6. !Ufl9kb SV P U?:'0= 7.
: 8. AI", Ho.x+                           $h. .. I_fttW",,,t                                                                                   ~        __
____ 8. Alvt ko.-\-+/-
: 9. J{V$$GL( ,J"p("",                     TVA C"rlf DilA ~&#xa3;                                                                            eo Cct"f ~~
Yls'i\'l..
10.~,N ~                                v)\J\T       Sl./fUv\ S..,1t.,                                                                           ~_ _
___----,:=-_
: 11. AJril.. lJ,n.! ~""V\                  <'..... "jarla'( SvPPUl
: 9. f(V$$GLt Jee(;", TvA U S"f,;ftl ,.", (7,..,. 5
: 12. n~-.. fOJtk~,,~(rWctIHI CZ=J.R1f:,i<.                                                                                                               1._ _
: 10. ____ 11. ____ 12. ____ 1 ____ ._----------------------------------------15. ____ NOTES:
13.:fu!orHt ~IC,*.-                     g~rpfZ a~"flZ)j!                                                                                                  I~
P"te 01 ES-201, Page 27 of 28 ES-403 Written Examination Grading Form Quality Date of Exam: 2(112 Exam Level: R Initials Item Descri tion 1. Answer key changes and question deletions justified and documented Applicants' scores checked for addition errors reviewers s ot check> 25% of examinations Grading for all borderline cases (80 +/-2% overall and 70 or 80, as a licable, +/-4% on the SRO-onl reviewed in detail All other failing examinations checked to ensure that grades are 'ustified Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of uestions missed b half or more of the a licants Printed Date WERI< / a. Grader b. Facility Reviewer(*)
: 14. oE!l.ll.. Irc/Sh=                     ?-:~b,c~(/t>"0h;.C                                                                                                __
: c. NRC Chief Examiner (*) d. NRC Supervisor
15, b....,. "'-I L",s. ci <he-           ~.b.i.u _ JU' !=~.-"-                                                                                    I   J.. _ _
(*) . The facility reviewer'S signature is not appli able for examinations graded by the NRC; two inde endent NRC reviews are re uired. ES-403, Page 6 of 6 
r A,.
,.,... INDIANA "".. MleHIGAN A unit of American Electric AUG 08 lOU August 8,2012 U. S. Nuclear Regulatory Commission Attn: Mr. Carl J. Moore Region III Examiner 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Donald C. Cook Nuclear Plant Units 1 and 2 Written Examination Results The written portion of the Nuclear Regulatory Commission License Examination was administered on August 3, 2012, at the Donald C. Cook Nuclear Plant (CNP). In accordance with NUREG 1021, Operator Licensing Examination Standards for Power Reactors, CNP is submitting the following exam materials:
NOTES:           ""7.;j (j)   >l9 NAil.i R~ :If q       - ~e A1TA Cj-/ eo             c..o Pi   DF    fAG!C 3 F"f! ~ 01 1 ES-201, Page 27 of 28
* 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) of7..jJ.. tJfs//las of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
: 2.       Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 7/z!, -8/~M* 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 / RESPONSIBILITY                   SIGNATURE (1)             DATE         SIGNATURE (2)       DATE NOTE 1.j)w,O She\0.0">                     A" c> ~~.,., 010';' -"                                                                                 9* 6 - I'l..
: 2. :7.cdt t..laf ..~                1~~,,,;~7I!AIdlJ..t'V-                                                                                    ;~"":
3.&,< XC' 2:>&'-L               z:A;snu,mJ1: f-n:.&/!?rH(,                                                                                 ffj t~-.l ~1C~~                                                                                                                                  ~~7.
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8.
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: 9.                       tolftH)   ~S3guCntL /ntA,wI;l6
: 10.                                                 '                                                                                       _ _ __
: 11.                                                                                                                                         _ _ __
: 12.                                                                                                                                         _ _ __
: 13.                                                                                                                                         _ _ __
: 14.                                                                                                                                         _ _ __
: 15.                                                                                                                                         _ _ __
NOTES:
1"1- '1 "f tf ES-201, Page 27 of 28
 
ES*201                                                                        Examin~tio!Stlcurity Agreement                                           Form ES-201-3
: 1.           Pre-Examination d
I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekes) of 7.rz.'7                             2.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 uthorized 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 did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) ofi;';.-::'-- 9 ~ 0:. 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.
JOB TITLE I RESPONSIBILITY                                                  DATE          SIGNATURE (2)        DATE NOTE
                                                                                                        *=".~-I
~: ii1iKG fi;t\~RAv              ~
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                        *
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                                                                                                                      "'-'~h.
M-Il
                                                                                                                                                            ====
                                                                                                                                                            -------
______
______
Cl)'P'Y ftije I    ttl- tf ES-201, Page 27 of 28
 
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 7-:T:?        -t?P/;cias  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~dge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 19        -i/*f- 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 NRO.
PRINTED NAME              JOB TITLE / RESPONSIBILITY                                                DATE        SIGNATURE (2)    DATE NOTE
: 1. ;)~US+/- ~';.\~S
:>tkf ~QeJ:J.e~
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                                      \!::o Z'D S;~'l.~
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                                                                                                                      '2                      I!::!.:r~
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: 8. --.iLJ 0 llt:::...J ~ 'I.m::.::      2.0 I J) Stf l ( : r                                              s;.{o-I L 9.
: 10. DOt\WQt(\ O;;;;"Q:In&'\            Ro I    D&HIPT                                ."..                   5-/ 0.11-=============== ____    _ _ __
: 11.                                                                                                                                          _ _ __
: 12.                                                                                                                                          _ _ __
: 13.                                                                                                                                          _ _ __
: 14.                                                                                                                                          _ _ __
: 15.                                                                                                                                           _ _ __
NOTES:
coV'l r~l;tf ES-201, Page 27 of 28
 
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)            oh-21~ 9/WZas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
: 2.        Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 7~ - g}~ )12.. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
PRINTED NAME              JOB TITLE I RESPONSIBILITY                  SIGNATURE (1)                              SIGNATURE (2)    DATE NOTE
: 6.  !Ufl9kb ~WlI~'V                ~ SVPU?:'0=                          ~:."                            ~y~lr2.-
: 7. th:+/-~k----                      ~fC\f' ~r*                                                            S/!.~b'l                          ____
: 8. Alvt    ko.-\-+/-                  Sh."'.f.t,,~,.rt                                                      Yls'i\'l.. ---..~_ _ _----,:=-_
: 9. f(V$$GLt 10.
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_ _ __
: 11.                                                                                                                                          _ _ __
: 12.                                                                                                                                          _ _ __
1                                                                                                                                            _ _ __
15.. _ - - - - - - -            --------------------------------- -                                                                        __  -__ -
NOTES:
                                                                                                                                                  ~Df"'-4 P"te          01 t/
ES-201, Page 27 of 28
 
ES-403                            Written Examination Grading                      Form ES-403-1 Quality Checklist Date of Exam:            2(112 Exam Level: R Initials Item Descri tion 1.
: 2. Answer key changes and question deletions justified and documented
: 3. Applicants' scores checked for addition errors reviewers s ot check> 25% of examinations
: 4. Grading for all borderline cases (80 +/-2% overall and 70 or 80, as a licable, +/-4% on the SRO-onl reviewed in detail
: 5. All other failing examinations checked to ensure that grades are 'ustified
: 6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of uestions missed b half or more of the a licants Printed Name/Signature                            Date
: a. Grader                        l~D WERI< /          -P.JAJc                        0/1-/11
: b. Facility Reviewer(*)                                                              f-f-/2
: c. NRC Chief Examiner (*)                                                            ~It"ltz.
: d. NRC Supervisor (*)                                                                t>jrj;2
                                                                                            .
(*)    The facility reviewer'S signature is not appli able for examinations graded by the NRC; two inde endent NRC reviews are re uired.
ES-403, Page 6 of 6
 
                                                                  ,.,... INDIANA
                                                                  "".. MleHIGAN POWER'"
Aunit ofAmerican Electric Power AUG 08 lOU August 8,2012 U. S. Nuclear Regulatory Commission Attn: Mr. Carl J. Moore Region III Examiner 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Donald C. Cook Nuclear Plant Units 1 and 2 Written Examination Results The written portion of the Nuclear Regulatory Commission License Examination was administered on August 3, 2012, at the Donald C. Cook Nuclear Plant (CNP). In accordance with NUREG 1021, Operator Licensing Examination Standards for Power Reactors, CNP is submitting the following exam materials:
* Form ES-403-1, Written Exam Grading QA Checklist
* Form ES-403-1, Written Exam Grading QA Checklist
* Applicant answer sheets and examination cover sheets
* Applicant answer sheets and examination cover sheets

Revision as of 23:58, 11 November 2019

2012 Donald C. Cook Nuclear Power Plant Initial License Examination Administrative Files
ML12250A007
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Site: Cook  American Electric Power icon.png
Issue date: 07/23/2012
From:
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To:
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Text

2012 D. C. COOK NUCLEAR PLANT INITIAL LICENSE EXAMINATION ADMINISTRATIVE FILES

ES-201 Examination Preparation Checklist Form ES-201-1 Facility: D. C. COOK Date of Examination: 7/23/12 Developed by: Written - Facility

  • NRC /I Operating - Facility
  • NRC Chief Target Task Description (Reference) Examiner's Date*

Initials

1. Examination administration date confirmed (C.1.a; C.2.a and b)

-180 11""lt.. iif,(

2. NRC examiners and facility contact assigned (C.1.d; C.2.e)

-120 IIII/It. ~

-120 3. Facility contact briefed on security and other requirements (C.2.c)

IllfHL ~

-120

4. Corporate notification letter sent (C.2.d) llrfllt ~

[-90]

[S.

6.

Reference material due (C.1.e; C.3.c; Attachment 2)]

Integrated examination outline(s) due, including Forms ES-201-2, ES-201-3, ES I1.A CIJi,t 301-1, ES-301-2, ES-301-S, ES-D-1's, ES-401-1/2. ES-401-3, and ES-401-4, as

{-7S}

applicable (C.1.e and f; C.3.d) '-Ilft/{ct CIM

{7. Examination outline(s) reviewed by NRC and feedback provided to facility

{-70} licensee (C.2.h; C.3.e)} C({Z1{tZ ~

8. Proposed examinations (including written, walk-through JPMs, and scenarios, as

~Plicable). supporting do..§mentation (including Forms~S-301-3.~S-301-4,

{-45} S-301-S>(S-301-6, and S-401-6, and any Form ES-20i-3 updates). and reference materials due (C. i.e, f, 9 and h; C.3.d)

~/l/Irz ~

-30 9. Preliminary license applications (NRC Form 398's) due (C.i.1; C.2.g; ES-202)

(P(ZZ/tl.. ~

10. Final license applications due and Form ES-201-4 prepared (C.1.1; C.2.i; ES

-14 202) 1-1,,(,z ~

11. Examination approved by NRC supervisor for facility licensee review

-14 (C.2.h; C.3.f) (,/1./12. CUt

-14

12. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g)

{,IZI1~" 4n

13. Written examinations and operating tests approved by NRC supervisor

-7 (C.2.i; C.3.h) 'Ht?'lll ~

14. Final applications reviewed; 1 or 2 (if >10) applications audited to confirm qualifications I eligibility; and examination approval and waiver letters sent (C.2.i;

-7 Attachment 4; ES-202, C.2.e; ES-204) :Hi1-flt ~

15. Proctoringlwritten exam administration guidelines reviewed with facility licensee

-7 (C.3.k) (,{zq/lt ~

16. Approved scenarios, job performance measures, and questions distributed to

-7 NRC examiners (C.3.i) -:NfII{tZ. ~

  • Target dates are generally based on facility-prepared examinations and are keyed to the examination date identified in the corporate notification letter. They are for planning purposes and may be adjusted on a case-by-case basis in coordination with the facility licensee.

[Applies only] {Does not apply} to examinations prepared by the NRC.

  • 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 7:2 . 2as 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 uthorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) 0 ~ - ' 3 It.. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or rovide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

JOB TITLE! RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE

1. jf"f'VYI<..., S"'"U~ -61 ~ ~6 ~ .5.,-h).-.. ~/11,~

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15. A Q1.. 'FIMN<fl SHIPe NOTES:

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ES-201, Page 27 of 28

...-

  • 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 7-:J~ -q/Jk~as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of7/z.p-ll~lrz'\ 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 NRO.

PRINTED NAME JOB TITLE / RESPONSIBILITY DATE NOTE

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15. t'1.C/"""oL( tJd0h ii24 (i skCft ,,"*IS:/'L ~'tf.L="

NOTES:

fR> >IllNA,..lAl(E it=-? - ~C);: ArrACHeO coN OF Fl411e 2. t:oR >~,JATV~e (2) #

faje 1- )- If ES-201, Page 27 of 28

  • 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 weekes) oh-11'" 9/siJlas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the weekes) of 712:1 - Bb It:+- 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 / RESPONSIBILITY DATE DATE NOTE

1. M-H!?~ ESS to.. OP(7 "5u~\JUi.ofl.. S'-I'S-i:2._~--;;:="7"--r-"r--
2. Sq.....,:$. I c..~ I UN , ! S4?i.I!..N , $(;>::R. 5'"-l'f-p... ,.

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NOTES: ""7.;j (j) >l9 NAil.i R~ :If q - ~e A1TA Cj-/ eo c..o Pi DF fAG!C 3 F"f! ~ 01 1 ES-201, Page 27 of 28

  • 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) of7..jJ.. tJfs//las of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 7/z!, -8/~M* 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 / RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 1.j)w,O She\0.0"> A" c> ~~.,., 010';' -" 9* 6 - I'l..

2. :7.cdt t..laf ..~ 1~~,,,;~7I!AIdlJ..t'V-  ;~"":

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10. ' _ _ __
11. _ _ __
12. _ _ __
13. _ _ __
14. _ _ __
15. _ _ __

NOTES:

1"1- '1 "f tf ES-201, Page 27 of 28

ES*201 Examin~tio!1 Stlcurity Agreement Form ES-201-3

1. Pre-Examination d

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the weekes) of 7.rz.'7 2.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 uthorized 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 did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) ofi;';.-::'-- 9 ~ 0:. 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.

JOB TITLE I RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE

  • =".~-I

~: ii1iKG fi;t\~RAv ~

Slmu-ItL-~(' -<sf ~

.$\ M,,)I..A-"T se. t;;tJ~ .

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

1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 7-:T:? -t?P/;cias 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~dge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 19 -i/*f- 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 NRO.

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coV'l r~l;tf ES-201, Page 27 of 28

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) oh-21~ 9/WZas of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of 7~ - g}~ )12.. 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.

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ES-201, Page 27 of 28

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Date of Exam: 2(112 Exam Level: R Initials Item Descri tion 1.

2. Answer key changes and question deletions justified and documented
3. Applicants' scores checked for addition errors reviewers s ot check> 25% of examinations
4. Grading for all borderline cases (80 +/-2% overall and 70 or 80, as a licable, +/-4% on the SRO-onl reviewed in detail
5. All other failing examinations checked to ensure that grades are 'ustified
6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of uestions missed b half or more of the a licants Printed Name/Signature Date
a. Grader l~D WERI< / -P.JAJc 0/1-/11
b. Facility Reviewer(*) f-f-/2
c. NRC Chief Examiner (*) ~It"ltz.
d. NRC Supervisor (*) t>jrj;2

.

(*) The facility reviewer'S signature is not appli able for examinations graded by the NRC; two inde endent NRC reviews are re uired.

ES-403, Page 6 of 6

,.,... INDIANA

"".. MleHIGAN POWER'"

Aunit ofAmerican Electric Power AUG 08 lOU August 8,2012 U. S. Nuclear Regulatory Commission Attn: Mr. Carl J. Moore Region III Examiner 2443 Warrenville Road, Suite 210 Lisle, Illinois 60532-4352 Donald C. Cook Nuclear Plant Units 1 and 2 Written Examination Results The written portion of the Nuclear Regulatory Commission License Examination was administered on August 3, 2012, at the Donald C. Cook Nuclear Plant (CNP). In accordance with NUREG 1021, Operator Licensing Examination Standards for Power Reactors, CNP is submitting the following exam materials:

  • Applicant answer sheets and examination cover sheets
  • Master exam and answer key
  • Applicant questions/clat"i'fications
  • Post-exam applicant comments
  • Seating chart
  • Exam analYSis information
  • Exam security agreement If you have any comments or concerns, please contact Ted Werk or Steve Pettinger at (269) 465-5901, extension 3738/3707, or myself at (269) 466-3407.

Brian E. Evans Operations Training Manager TCW Enclosures