NL-16-018, Transmittal 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report: Difference between revisions

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                                                                                                                                       $] O              C ItI                W  It Single Positiv    Test Form (version 1.6.0 - De;emnber 19, 2014)                                                                                          NRC Form 890 (12/2014)


              .
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* lc Ino" e                                  Estimatad  borden par  response  to comply  with this cotiection required request in 30 under 10  CFRminutes, 26.717. This The e d)Mu7oe5fo m .fedfo tne
* lc Ino" e                                  Estimatad  borden par  response  to comply  with this cotiection required request in 30 under 10  CFRminutes, 26.717. This The e d)Mu7oe5fo m .fedfo tne

Latest revision as of 05:52, 5 February 2020

Transmittal 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report
ML16053A236
Person / Time
Site: Indian Point  Entergy icon.png
Issue date: 02/12/2016
From: Coyle L
Entergy Nuclear Northeast
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
NL-16-018
Download: ML16053A236 (19)


Text

a Entergy Entercav Nuclear Northeast Indian Point Energy Center 450 Broadway, GSB P.O. Box 249 Buchanan, NY 10511-0249 Tel 9142546700 Lawrence Coyle Site Vice President NL-16-018 February 12, 2016 U.S. Nuclear Regulatory Commission Document Control Desk 11545 Rockville Pike, "IWFN-2 F1 Rockville, MD 20852-2738

Subject:

2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report Indian Point Energy Center Docket Nos. 50-247, 50-286 License Nos. DPR-26, DPR-64

Dear Sir or Madam:

This letter transmits Indian Point Energy Center (IPEC) Fitness for Duty (FFD) Program Performance data for the period January 1, 2015 through December 31, 2015 in accordance with the requirements of 10 CFR 26.717(e). Included is also the Fatigue Management Program data in accordance with 10 CFR 26.203(e).

There are no new commitments contained in this letter. If you have any questions or require additional information, please contact Mr. Robert Walpole, Regulatory Assurance Manager at (914) 254-6710.

Sincerely,

Enclosure:

1. 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report 7..-I

NL-1 6-018 Docket Nos. 50-247, 50-286 Page 2 of 2 cc: Mr. Daniel H. Dorman, Regional Administrator, NRC Region 1 Mr. Douglas Pickett, Senior Project Manager, NRC NRR DORL IPEC NRC Resident Inspector's Office Mrs. Bridget Frymire, New York State Department of Public Service Mr. John B. Rhodes, President and CEO, NYSERDA Mr. Paul Harris, NRC NSIR DSP SPSB

ENCLOSURE 1 TO NL-16-018 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report ENTERGY NUCLEAR OPERATIONS, INC.

INDIAN POINT NUCLEAR GENERATING UNIT NOS. 2 and 3 DOCKET NOS. 50-247 and 50-286

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Estimated burden per response to comply with this collection request is 114 hours0.00132 days <br />0.0317 hours <br />1.884921e-4 weeks <br />4.3377e-5 months <br />. This form is a voluntary means of reporting the information required under 10 CFR 26.717. The information is required by NRC to obtain 0n an annual basis sodespecific fitness-for-duty (FF0) program performance data on drug and alcohol programrs from licensees and other entites. Send comments regarding burden estimaoteto the FOIA, privacy and Information Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission. Washington DC 20555-0001. or by e-mail to Infocollecto.Resource@NRC.son, and tc the Desk Officer. Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Offce ot Management and Budget, washington DC 20503. If a means used to imepose information collection does not display a currently nalhd0MB control number, the NRC may not conduct or sponsor, and a personai not required to respond to, the information collection.

1) All fields required unless marked 'optionar"
2) Use of Adobe Reenter 8 orIlter Is required
3) Mouse over fields for addltional Information D-'Submission Update Select Facility Periodof Report Ilndian Point [5D-247; 50-286]

J120161 Tfob l*.nndi,,.td in tha c'*andkar Year Total Number of Tests Conducted Total Number of Positive, Adulterated, Reason For Testing Licensee Employees ContractorsNendors Substituted, and Refusal to Test Results Random [III 21J 1 " I6 Post-Event o I ° Z

[I o Total(Calculated) 1h61I [X62 ZI3I FFD ProgramRandom Testing Population and Rate Average number of Average number of Total size of the random testing pool Annual random testing percentage licensee employees contractors/vendors throughout the period (Calculated) achieved for the testing pool 1,°D1 4831 '17 53.71 Laboratory Testing Does your program use aI Licensee Testing Facility? No (Yes/No)

Identity your HHS-Certifled Laboratory(ies) QUEST DIAGNOSTIC LABORATORIES Identity your Blind Performance Test Sample supplier(s) [ELSOHLY LABORATORIES, INCORPORATED 1 Substances Tested Did your program only test for NRC-required substances lle Does yoUrinProgram conduct LOD/testing Yes ANŽDat the NRC-specitied minimum cutoff levels? (Yes I No) permitted in26.163(a)(2)? (Yes INo)

Substance Use Only NRC Cutoff Initial Confirmatory LOD Testing? Comment Levels? (Yes I No) Cutoff Cutoff (Yes / No) (Optional)

Alcohol[ ~ I j]

Cocaine Yes [e Marijuana Yes [Yes Amphetamines Yes iIIZYes Opiates [Yles__________ _____Yes_________

PPYes IYes__

Annual Report Form (version 1.6.0 - December 19, 2014) - Page 1 of 2 - NRC Form 891 (12/2014)

Substances Tested - continued Summary of Management Actions - 26.71 7(b)(8)

Summarize actions implemented to improve FF0 program performance. As applicable, reference in the topic description audit reports, 30-day reports, and/or corrective action reports. If reporting information on more than three topics, select 'Others" for Topic 3 to report any additional topics.

Topic 1 Please Select}

Person(s) Responsible for Information Provided Person 1 (required):

~~IIIIZCoordi11111r kpettus@entergy~com First Name Last Name Position Title Company Email Address Person 2 (optional):

ZX

~Im Awgriffl @entergy.com First Name Last Name Position Title Company Email Address Final Step (Required).- NRC will consider this form authentic in accordance with 26.11 only when the "Validate & Lock" button has been selected and all errors (iLe.,those highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successfully L i ]

completed and the form is ready for submission.

Form Locked on:l eb22016at1:2O:02 PM I Annual Report Form (version 1.6.0 - December 19, 2014) - Page 2 of 2 - NRC Form 891 (1212014)

I *-. - S .~- 0 S -

2l Entr*esleason,. fieds aeto-pepaigIrnfmoaeun, In o~ter as~de Estimated burden per response to comoplywith thio collection request is 30 mnruntes. Thos

,1) Mooae ov, ernet fleld. to vke. .dddnl les~et,.ee,'m~ toermis a voluntary macno of reporting thre information required uoder t0 CFR 26.717. The informshlon is required by NRC to obtain On an aennul bosi site specilic tlthess-for-rtuf 41Uxe of AdOtr ReaderS or lak, A.required [FFD) program performance date ott drug and alcohol programis from licensees and otiem entitles. Send comments regarding burden estimate to tire FOIA, Privacy and Information S1) A~ll1114required esc roepfleaeeked 'ogtgeno Collection Biranch (T5-F53), U.S. Noclear Regulatory Commission, Wastrmgtoo DC 20555-0001,or by e-mail to intocotiecls Rcsocrre@NRC coov and to tihe Desk Offcer Oftice of Information cod Reoulatory Affairs, NEOti-1020, (3150-0146). Office o0 Managiement aod tiudget, Washington DC 20503. lIfe meaos used to impoose otformation colleotion doeo net display a currentgy oalid 0MB control nomber, tire NRC may not 0onducl or sponsor, and a person is not required to respond to, the information collection.

Select Facility Indian Point [50-247; 50-286} J Dafe of Collecfion[01425 (mm/do/yyyy)

Reason for Testing - 26.71 7(b)(5) Pre-Access Testiing Reason (optional) Pleasei elaboratei (optional)

Initial Authorization Dilute Sample-LOD testing required Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

?.onracorndor [Yen Labor Category - 26.71 7(b)(3)

Faiity Supot is thits a 24-Hour Reporting Event (Yesdtio)? - 26.715(b) [No[

Refusal- 26,717(b)(7) & 26.75 Was this collection refused (Yes I No)? Fi77o7]

Teat Results - 26.717(b)(4)

Test Validity Was LOD testing conducted Cr'es ( No) - 26,163(a)(2)?

Dilute ] Yeis Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ]Ifn Was dhis collect ion observed (Yes/No)? - 26.71 7(b)(7( & 26.75 I ]

Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Manruan

.. ] [Please Select IPlease Select Use NRC Cutoff (Yes / No)'? li Subversion Attempts - 26.717(b)(7) and 26.75()5 Did this collection involve a subversion attempt (Yes/No)? ]No Meneoemnent Actions -26.71 71b1181 & 26.75 Roason for the Action IFirstdrug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specitic Sanction Applied 2- Year Denial Person(s) Responsible for Information Provided Person I (required):

Kly PetlsoIed cesScrtyCodiao tikpettos@entergy.com First Name Last Name Position Title Company Email Address Person 2 (optional):

~ ~ mgritit@entergn.com First Name Last Name Position Title Company Email Address Fital Steg, (Required). NRC mill consider this fo~rmcuthenticin accordance wfth 26,11 only ewhenthe "Validate &Lock" batten is clicked and all errors (highlighted in red) hrane been corrected. The "Validate &Lock" button mill change to "Locked" after the data validasion process has been successfully completed indicahlogthe form Is ready for submission.

Form Locked on:[~b22016at 12:4941 M] ISaet aa C Pri ext Single Posihtive Test Form (version 1.6.0 - December 195,2014) NRC Form 690 (12/2014)

0 - ~ S -

p 1)All asia. rsqr*ssi eee.ptfiles. ,eae~ ~ APPROVED BY0MB:CLEARANCE NO.3150-0148 EXPIRES: 1113012017 2)Enele in aser filds aaa.eedas ,nafonsn abfeld.

o,, Estlmated burden per response to comply Withthlis totlection request in 30 ninutes. This

3) Maoase ovar fa,,m 051*d to vhJe adtltlaesj inisn,,a~sn form is a voluntary means of reporting the infonmation reqoired under 10 CFR 26,7t7, The intonmation is required by NRC to obtain On an annual basis site speific fitness-for-duty
4) tUse ot Adoh ReadrS arlatar1. rsq.*red (FFD0

) prognrm performance data on drua end alcohol progeras barnmlcensees end other r-] Submission rm Delete enhties. Send comments regsrding borden estiorste to the FOIA, Privacy and Informration Coilevo~on Branch (Tt-F53), U.S. Noclear Regulatory Cornmission. Washgtoono DC L Update L_ Sub mission 25055-0OS1, Or by e-mailto infeoooltct Reswocree@NPC eon, end to the Desk Officer, Office ot Information and Regulatory Affairs, NEOE-1020, (3150-0146). Office of Management and Budget, Whashington DC 25503. Ifs ormeasuoed to impose information collection does not display a currently valid DMB control number, the NRC may not condoct or sponsor, endsapemsonis not required to respond to, the information collection.

Select Facility Indian Point [50-247; 50-2861 (mmldd/yyyy)Oe[of~leji~n0120205 j Reason for Test ing - 2671 7(b)(5) Please elaborate (optional)

Rand I Employment Type - 26.71 7(b)(3) Outage Worker (optional) ?

CotatrNendor I No LaborCategory- 26.717(b)(3)

Faiity Supot Is this a 24-Hour Reporting Event (YeseJro)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was thls collection refused (Yes I No)?' [~II Test Results - 26.71 7(b)(4)

Test Validity Toot Type(s) for Result(s) Reported - 20.717(b)(2) Drug Tooting Drug Only] dn Was this collection observed (Yes/No)? - 26.71 7(b)(7) & 26.75 [ L i Substance - 26,717(b)(2) & (b)(6) Additional Substance (as applicable)

Additional Substance (as applicable)

Marijun

.. Please Select [Please Select]

Use NRC Cutoff (Yes / No)?Ye Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection inoolve a subversion attempt (Yes/No)? Eioi l ]

Manasoement Actions - 26.7171b1181 & 26.75 Reason for the Action Frtdrug or alcohol positive Sanction Applied (NRC Minimum or Ucensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Person(s) Responsible for Information Provided Ferson 1 (required)l:

First Name Last Name Positioo Title Company Email Address emaon 2 (optional):

I~aye GrffinSupervisor, Aceess/Fithess for Dory mawgiffl

@entergy.com First Name Last Name Position Tite Company Email Address Final Step (Reqsdrsd.-NRC millconsider this formauthentic in accordance with 26.1: only whrenthe "ValIdate & Lock"button is clickedand allerrors (highlightedinred) have been corrected. The "Vatidate &Loch" bottonmill change to "Locked" alter the dats validationprocess boobeen successiully compfeted indicatingthe foes Isready forsubmisaion.

Form Locked on:[~ebj201 2o j50: PM Ia

$] O C ItI W It Single Positiv Test Form (version 1.6.0 - De;emnber 19, 2014) NRC Form 890 (12/2014)

2)Entedesinote aeld =tut~ pua

  • lc Ino" e Estimatad borden par response to comply with this cotiection required request in 30 under 10 CFRminutes, 26.717. This The e d)Mu7oe5fo m .fedfo tne
  • noffm form is a volunfary means of reportng the information
3) Maaeinformanon in required by NRC to obtain on an annoal basis site specdioi fithess-for-duty
4) U alAdeh.e ReaderS8 rae
  • l (FFD) program performance data on drug and alcohol programs from licensees and othar rDelete J]Submission Deoeentitee. Sand comments regarding borden estimate to the FOIA, Privacy and information CollectionBranch (T5-F53). U.S. Nuclear Regulatory Commission. Washington DC Lipdta t.J Sumsin20555-0001, Or by e-mail fo Infovollects ResouorcetiNRC noov and to the Desk Officer, Office of information and Regulatory Affairs, INEOB-I(020, (3150-0140), Office 01 Uini ue Reference ID (Licensee Supplied) Management and Budget, Washington DC 20503. ifta means used to impose information SIPEC-2015-003 collection does not display a currently valid 0MB control number, the NRC may not condoci I or sponsor, and a person is net required to resprmd to, the information collection.

Select Facility Dt fCleto ~

Indian Point (50-247; 50-286] DtofCleto(mm/dd/yyyy) 02/25 n Reason fot' Testing - 26.717(b)(5) Pre-Access Testing Reason (optiocnal) Please elaborate (optional)

Reinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3) Outage Worker (optional)?

Contract~orenmor JYes Labor Categoty - 26.71 7(b)(3)

Maintenance (general facility)

Is tihis a 24-Hour Reporting Event (Yeais/Na)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection ref used (Yes I No)? ~ iiI Test Results - 26,717)b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26.717(b)(2) DwugTesting Drug Only [1I iIIIe Was this collection observed (Yes/No)? -26.717(b)(7) & 26.75[ iI]

Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marijuana ] Please Select IPlease Select Use NRC Cutoff (Yes / No)? ~ I Subversion Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? E~o ]

Manaoement Actions - 26.717(b1181 & 26.75 Reason for the Action First drug or alcohol positive Sancton Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied J3- Year Denial Person 1 (required).

JKelly F~~ I~ IIIIIIIJ~ Jed *esSc*Cori~o hpettus~entergy.c..

First Name Last Name Position Titie Company Email Address Pemson 2 (optional):

Wayn Grffi Sprvisor, Access/Fcithess fortDuly wrl tt@entergy.com m ffl First Name Last Name Position Title Company Email Address Final Step (Requied).-NRC mill consider this form authentic in accordance mith 20.11 only when the 'Validate & Lock' button is clicked and all erroms(highlighted in red) sane been corrected. The =Validate &Lank' hutton mill change to 'Locked' after the data validation process hon been suocessfully completed indicasing the form is ready for submission.

Form Locked On:[geb2,216 at 122:31 PM J ~ Q~~I PCfhqtr Single Poesitve Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

~tEetelea besome flaklaaate-pepudat. Intonneden In oEarlblde Enanmated burden per fornmitoa voluntary response means to comply of reportina with thin collection the information raquired request inCFR under 10 30 minutes.

26.717. This The

[7J

.1)Moos.evertenon 4)1.1.. Submission fieldsto 11rlewaddnlanaIlnfo.ene~on m

ofAdobeReaderSOrlater Delete in r.qair.d intormchonc in required by NRC to obtain on an annual basis site opecilto fitoess-tor-duty (FFD1 program performance data on drug and alcohol programs from linennees and other entities. Send commenta regarding borden estimate to the FOIA, Privacy and Intormation Collectimn Branch (TrS-F53), U.S. Nuclear Reeulatory Commission, mashington DC Update [] Sub mission 20555-0001, or by e-mail to Intocotllets Resocrco@NRC noocend to the Dank Dfinner, Ottice of Informoation and Reaulatory Attairs, NEOB--tO20. (3150-Ol4e), Omfie of Manaaemnent and Budget, Washington DC 20003. Itoa means uned to impose inforrration uollectiondoen not display a currently valid 0MB uonnholnuomber,the NRC may not conduct or sponsor, anoda person in not required to respond to. the information collection.

Select Facility Indian Point [50-247; 50-286] (mm/dd/yyyy)D ef~lcin02/23/2015 ]

Reason for Testing - 26.71 7(b)(5) Pro-Access Testing Reason (ootio onall Please elaborate (optional) iupdate Authorization Employment Type - 26,71 7(b)(3) Outage Worker (optional)?

IYes Labor Category - 26.71 7(b)(3)

IMaintenance (general facility)

Is this a 24-Hour Reporting Event (Yena/o)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Walsthis collection refused (Yes / No)? [

Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ] Urine Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.75 i I Substance - 26.71 7(b)(2) & (b:)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marijuana ] Please Select IPlease Select Use NRC Ocutoff (Yes / No)? EI~

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~ ~IoI Manaoement Actions - 26.7171b1181 & 26.75 Reason for the Action IFirst drug or alcohtol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Peran~s)Resonsile fr Iformt~onProide Person 1 (required):

Kelly I efs)ed A~essencudWCoordminao Z kpe~us@entergy ....

First Name Last Name Position Title Compeny Email Address Person 2 (optional):

First Name Last Name Position Titie Company Email Address FinalStep (Requied). NRC will consider thus fony authentic in accordance with 26,11 only when the "Velidate &Look" bucone moclicked and all erroms(highlighted in red) have been corrected. The "Validate &Lock" sctore will chenge to "Locked" atier the data validation process has bees successfully completed indicating the form inready tor nubminnion.

Foro Locked on:le2 ~2o16Nt2:S3:PM fSWI GS P ~ R p~

Single Positive Test Forrm (version 1.6.0 - December 19, 2014) NRC Form 8980(12/2014)

1)iAll field. required except those. narked "oadiorr APPROVEDBY0MB: CLEARANCE NO.3165-0146 EXPIRES-1113012017

3) Eared., in soe.a hr.*d aeto-popoiaf. iftn.Uonar in ofir fel~d. Estimated harden per response to comrply oith this collectioe request is 35 minutes, This 3)Mose. ovearten, hieds to view addtlonalbd onnfa form is a volantaty means of reporting the information required under 10 CFR 30.717. The information is required by NRC to obtain on ao annual basis site specitic fithess-for-duty
4) U.. of Adobe R..der l or-lI. isqrd.-.de (FF0) program performance dote on drag and alcohol prograns from licensees and other

-- ]Submission L DebISlete entities. Send comments regarding burden estimate to the FOIA, Pdnvacy and Information Collection Branch (TS-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to Infucolleoto Resoaroae@NRC 000 and to the Desk Officer, Office 01 information and Regulatory Affairs, NEOB-It020, (3150-0146), Office ol Managemert and Budget, hWashingtonDC 20503. Itoa means used to impone information IPE-215-005 collection dues nor display a currently ualid 0MB contro number, the NRC may nut conducl or sponsor, and a person is not required to respond to. the information collection.

Select Facility ininPoint [027 026 ](mm/d/~yyyy)Da f~lefn02/23/2015 Reason for Testing.- 26.717(b)(5) Pro-Access Testir10Reason (optional) Please elaborate (optional)

Inilial Authorization Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

CotacoNendor] Y~es ]

Labor Category- 26.717(b)(3)

Maintenance (general facility)

Is this a 24-Hour Reporting Event (Yes/No)? - 26.719(b) No Refusal- 26.71 7(b)(7) & 26.75 Was this collection refused (Yes / No)? [*Ii Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26 717(b)(2) Drag Testing Drug Only un Was this collection observerd (Yes /No)? - 26 717(b)(7) & 26.75 [Zi Substance - 26.71 7(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marilun

.. ] Pleese Select 1Please Select Use NRC Cubtof (Yes ( No)? EI Subversion Attempts - 26.717(b)(7) and 26.75(b)

Didthis collechion inyolye a sub version attempt (Yes/No)? Eiliol Manaoement Actions - 26.717(b11t81 & 26.75 Reason for the Action First drug or alcohol positilye Sanction Applied (NRC Minimum or Licensee Administrated)

Licenses Administrated]

Specitic Sanction Applied 3- Year Deniali Persn~s)Resonsile or iformtio Proide person 1 (required):

ely Pettus Led cesScrt oriao kpettus@entergy~corn First Name Last Name Position Title Company Email Address Person 2 loptional):

First Name Last Name Position Titie Company Email Address Final Step (Requtred) -NRC wdilconsider this form authentic in eccordance with26, ft only when the "Validate & Lock" button is clicked and all errors (highlighted in red) hone been rorrected. The "Validate &Loch" button mill change to =Locked"offerthe data validation process hos been surcessfolly completed indicating the form is ready for submission.

Form Locked On:[Feb 2, 2016 at 12:55.12 PM ]a to ocI P Pt!R~g t Single Positive Test Forms (version 1.6.0 - December 19, 2014) NRC Fotnm 800 (12/2014)

  • 1)Affff-alda
2) *sne ineaqu/ved esap a... #eisi
  • gefd 'opfftptr

/Mba.

eastopopuabit .* . in.o6,e - ArrP vtUVP.

Estiniated U per burden UGtAANUL*

MB:response NV. J1WiO-r*tO to compty P3.Pces:

with this collection request 1llgo-tal,This Is 30 nrdnotas.

3J6I..oae ovaver fon~ita1fed=t

  • I.o eo trm wsanvcluntary means of reportlng the informationt reqoired under 10 CFR 26.717. Th.

i reuird b NR toobtain no an annoal basis sit, specific ftoleos-for-ttut3 nforat~n

4) Uae d4Adobe.
  • 8 orae/ retl (FFD)progianh performance data on ding and alcohoi progranms trots tlcesees and ottel r" umsin
  • Delet en~tits., Send commnentsregarding borden estinate to the FOIA, privacy and Infonmation

[] i~*~

L.Upae 6

J Submission oflection B.anch (TS-F53), U.S. Nuclear Regulatory Conmislsion, Washington DC 20555-0051. on by e-mail to Infouoilects Rasouorce*;NRfC aov, and tO the Dash Officer Office ot Intonnation and RegulatOry Affairs, NEOB-1020, (3150-0148), Office o UniueRe fereDnceI/ieseeSuppiedL Management and Budget, Washington DC 20503. If a means used to impose information IPEC-2015-006 I collecton does not display a corrently valid OMB control nomber, the NRC may not conduc" I or sponsor, and a parson is not required to respond to, the information collection.

Select Facility Dt fCleto (mmldd/yy) I°2 °1 lndian Point [50-247; 50-286]

Reason for Testing - 26.717(b)(5) Pro-Access Testing Reason (optional) Please elaborate (optional)

Pr-Acss]

Initial Authordzation Employment Type - 26.717(b)(3) DOtage Worker (optional)?

IYes Labor Category -20.71 7(b)(3)

Mainenance(gerlfclit) is this a 24-Hour Reporting Event (Yes/No)? -26.71 9(b) N Refusal- 26.71 7(b)(7) & 26.75 Was this collection refused (Yes / No)? j j Teat Results - 26.717(b)(4)

Test Validity Test Type(s) fur Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ]Irn Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.75[ Il Substance - 26.717(b)(2) & (b)(6)( Additional Substance (as applicable)

Additional Substance (as applicable)

Marijuana I Please Select] IPlease Select]

Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~ j~oj Manaoement Actions - 26.7171b1181 & 20.75 Reason for the Action IFtrst drug or alcohol positive Sancton Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated]

Specific Sanction Applied 3- Year Denial Person(s) Responsible fur Information Provided Person 1 (required):

Kel I IIIy I [Pettso]Ied ces tecort r Iketts@entergyi.c..

borint First Name Last Name Position Title Company Email Address Person 2 (optional):

Wayne [Gfi IsprioAcs/~s ut mogriffi@entergy.com First Name Last Name Position Title Company Email Address Final Step (Required) - NRCmrilconsider this formauthentic in accordance with26.11onlywhen thre"Validate& Lock"bottonis clickedand allerrors (highlighted red) base been in corrected. The "Validate & Loch" botton mitlchange to "Locked' offer the data oalidatinn process has been successfolly completed indicating the form is ready for submission.

FormLocke OnJle ,16 s 2~:d:4PM SI A gIP lh R f Single Posibive Test Foro (versionl 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

I1) AMl1154 requared except tho. semrked eeeln*r IAPPROVEBYOMB: CLEARANCENO. 3110-0146 EXPIRES. 1113012017 EmresI soearv,. nds .ot-eata fonf o in.n*le In ew ie Estiromtedborden per response to complyise thiescotiectionlrequest i. 30 minutes. Thin form in a voluntary means of reportin tire informration reqoired onder itt CFR 26.717. The

3) M~eoo..as, on Cold CerV. odtsuleoelIdoee intormraton is reqoired by NRC to obtain on an annual basin tedspecrfic tibress-for-duty (FF0) program performance data on drog and alcohol prograrns fronmlicensees ond other LI Submmsson elete enttities. Send comrrents regarding burden estimate to tihe FOIA, Privacy and lnfornmationr Cotiection Branch (TS-F53), U.S. Nuclear Regolatoty Comnmissionn Washington DC 205555-0001, or by e-nrintto Infcocttct Rnsoorco46NRC goy. and to tire Desk Officer.

Office of Intnrnation and Regulatnry Affairs. NEOti-t020, (3150-0146t). Office of Management and Budget, Washington DC 20503. Itoa means osed to impnse information collection does not display a currenlty valid OMti control nomber, the NRC may not conduct or sponsor, and a person in not reqoiredto respond to, tireinformation colleobon.

Select Facility lndian Point [50-247; 50-286]

Date of Collection o1?25mldyy)

Reason for Testing - 26.717(b)(5) Pro-Access Testing Reasont (optionral) Please elaborate (optional)

I'nitial Authlorizabion Observed collection- applicant returming to indostry from positive test in 2008 Employment Type - 26.717(b)(3) Outage Workrer (optional)?

Yes Labor Category- 26,717(b)(3)

Is this a 24-Hour Reporting Event (Yes/No)?- 26.7198(b) N Refusal- 26.717(b)(7) & 26.75 Was this collechion refused (Yes /No)? EiI Test Results - 26 717(b)(4)

Test Validityj Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing IDrug Only I

[Urine Was tils collection observed (Yes /No)?- 26.717()(7)) & 26.75 [II Substance- 26.717(b)(2) & (b)(6) AdditionalSubstance (as applicable) Additional Substance (as applicable)

Marijuanao Please Select IPlease Select Use NRC Cutoff (Yes ( No)? *e Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involveta subversion attempt (Yes/No)? [liNo Manaoement Actions - 26 717)b*(8t) & 26.75 Reason for the Action Second drug or alcohol posihive Sanction Applied (NRC Minimum or Licensee Administrated)

SLicensee Administrated Specific Sanction Applied Perm..anet Denial Person(s) Responsible fur Information Pro vided Person 1 (required):

Iey Pettun [La.Acs eut orieo kpettusl~entergy c..m First Name Last Name Position Titte Company Email Address Person 2 (optional):

Wayne ]Griffin Supervisor, Access/Fitoess for Duty m grittt@entergyp.com First Name Last Name Position Title Company Email Address Fliraf Step (Reqcrlrerft .NRC mill consider this form aothestic in acoordance with 20.11 only when the "Validate & Lock"botton in clicked and all errors (highlighted in red) have been corrected. The "Validate & Lonk" batten mill change to "Lonked' afte the data validation process ban been nuccessfollycompleted indicating the form in ready for nubminnion.

Form Loced on:[Fb2 216st11: :,.7P~ Saet I.c ItthsRI Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

3) tne/

o e hed . -auto-pp . /non h, blohrfed Etiroated burden par responso to comrply witthghiscotention retprest in 30 monutes. Ttis

3) Muse toview ver ormfle~=
  • *farm is a votontary means of reporting the inrformtion required under 10 CFR 28.717. The intormnatio asroqoired by NRC to obtain on an annual boois alto specific flthna-t*por-doty
4) Uaa of Adobe Raedw58 rltrisnqf~ (FFD) program performanoe data on drag and alcohol programsnrombolcensees and other

[]Sbiso r' Delate entitaes Sand commants regarding burden astirmateto ithe FOIA, Privacy and Intornation Updae I SumisionCatiaccon Branoh (TS-F53), U.S. Nuolear Regulatory Commissioan. Washrington DC Submission05g55000o , or by a-madl to letorolaeto Ranuorrai5NRC ga and to gre DankDttrer, UnqeRfrneI ~cne upid Dffioe ot Information and Regulatory Affairs. NEOB-1020, (3150-0146), Dffioe at Monagoment and Budget. Washington DC 20503. Itoa meant used to impono informalton IIPEC-21 - 2008 5 8cotaecton daes not disploy a currantly nalid DM2 control numbter. tra NRC map rot conduct or sponsor, and a person lb not raquired to raspond to, uheintormation collaction.

Select Faciliy Indian Point [50-247; 50-286] Date of Collection Fo31021(mdyy)

Reason for Testinrg- 26.717(b)(5) p*lease elaborate (optional)

Employment Type - 26.717(b)(3) COurtage Worker (optional)?

Labor Cse*gory - 26.71 7(b)(3)

Is it/isea24-Hour Reporting Event (Vesfido)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? E II Test Results - 26.717(b:)(4)

Test Validity Test Type(s) fot Result(s) Reported - 26.717(b)(2)

Drug only ] l I~no Drug Testing I]

Was ft/is collection observed (Yes / No.)? -26.71 7(b)(7) & 26.75 [ II Substance - 26.717(b)(2) & (b)(6) Addi/tiona/ Substance (as app//cable) Additional Substance (as applicable)

Marijuana ] Please SelectI [Please Select Use NRC Cutoff (Yes I No)?

Sube-ers/on Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? o Manaoement Actions.- 26.7171b118) & 26.75 Reason for the Action First drug or alcohol positive I Sanction Applied (NRCMinimum or Licensee Administrated)

Licensee Administrated]

Specttlc Sanction Applied 3- Year Denial Person(s) Responsible for Information Provided Parson t (required):

Kel ZIyI I] IPatton ] ~a.Acs eut oriao hpettusgentergy ....

First Name Last Name Position Title Company Email Address Parson 2 (optional):

First Name Last Name Position Ttite Company Email Address Float $tap tRaquelre. NRC milhconsider this form authoenti In accordanrcengrt 26 11tonly whmen the "Valdate &Lock" boston aschockedand all errors (highilghted in redl have bean corrected, Tho "Validate &Loch" button will change to "Locked" altar the data validation process has boon succestoully completed indicating the term ia ready far submission.

Single Positive Teat Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

P 3U *00 - - P ~*-.. S -

S I tiM ff.at. ,50t*Sd aweaptus... resotradolaeone IA~~D BY0MB:CLEARANCE NO.31504148 EXPIRES: 1113012011 2)Enarlesisnseen. fil~ds .ada-paplat tarsrnneton In o~ers fieds Etiemated burden per torm is a voluntary response mreans to comply of reporting wdtr this collection tre intormalton required request is CFR under 10 30 mirnutes.

26.717. This The

3) MOS o o'.r formnfields to viassrsdditionallrdInmrnUonr intormnation is required by NRC to obtaun on an annual basis site specilic ftloess-for-doty 4)11U.of Adobe Reedsr Dor tldr Is reqaal'red (FF0) program pertornmance date onr drug and alcohol programs frem licensees end other entlies. Send comnmentsregardong burden estimate to the FOiA, Pdivaey and Intermatiun

[* Submiss ion [r1 Delete LiUpdate 1-i Submission Coilection Branch 1T5-F53), U.S. Nuciear Reguistory Conorsosien, Washington DC 20555-S0S1, or by e-rmadlto Infoculollctsesnoureo@NRC non. anid to the Desli Otffier, UnqeRfrneI ~cne upid 0010e of etnformaton end Reguiatory Affairs, NEOB-t020, (3150-014e), Ofmen ot Mlanagenrantand Budeet, Washington DC 20503. if e mer.s coed to impose interormton ceiiectacndues riot dispiay a corrently vailid 0MB controi number, the NRC may not conduct SelEC-2015-I1t9 or sponsor, aod e person in cot required to respond to, the inforrmatoe cotlnotion.

Dale of Collection Indian Point [50-247; 50-286] (mm/dd/ I°1°yy)

Reason for Testing - 26.71 7(b)(5) Please elaborate (optional)

Employment Type- 28.71 7(b)(3) Outage Worker (optional)?

Licensee Employee I [leaeSaleti]

Labor Category- 28.71 7(b)(3) Please elaborate Supervsor J Maintenance supervisor Irorking nightefortireoutage) masnuitfed at OreFPEC SOCAaccess facility,whichis outsidethe I pr'otectedore,,to reportto the Access facidity tona randem Fitness-Fvc-Outy (FFD)test. A toot teraicohol resulted in a confirmed Is this a 24-Hour Reporting Event (Yeaftrfo)? - 26.719(b) Ys Reactor Rlant Ecent NotifucaltonWolrticheet EN # 50879 won completed to docomant nofification.

Refusal- 26.717(b)(7) & 28.75 Was this collection refused (Yes I No)? o Test Results - 26.71 7(b)(4)

Test Validity No Aplicbe ]

Test Type(s) for Result(s) Reported - 26,717(b)(2)

Alcohol Testing Alcohol Only]

Substance- 26.717(b)(2) & (b)(6)

Alcohol]

What 28.103 BAC level mao exceeded?

0.04 or greaterJ Subversion Attempts - 26.717(b)(7) and 28.75(b)

Did ltins collection involve a subversion attempt (Yes/No)? o Manaaement Actions - 26.71 71b118'& 28.75 Reason for the Action IFirstdrug or alcohol positive Sanction Applied (NRC Minimum or Liceesee Administrated)

NRC Minimum]

Specific Sanction Applied 14- Day Denial Person(s) Responsible for Information Provided parson 1 {required):

First Name Last Name Posdtion Title Company Email Address Person 2 (optionall:

First Narse Lost Name Position Title Company Email Address Flnal Slep IRaqol~re*g NRC wetl consider this term authentbc in accordance mrlt 24 11tonly when the "Valotate& Lock" button is clickled end all enrors Ihighldightedsinred)have beer corrected. The "Validate &Lock" button will change to "Locked"alter the data validation process huo been successfully completed indicticongthle tonrmis ready for submission.

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 8t90 11212014)

D S.. ~0 - ~ * -

k. a -

I 2)1)AM field. req~d excafitlAb,. mwte.d ~apemaf ErmeesaIn some flaldaauel.pepalat. le *sue In eMhr field.

IAPPR(2~~W Estimated BYOM9~CLEARANCE NO.31000146 EXPIRESI1113012017 boorm le n borden otuntary per response meons to cormply of reportng with this collection the infonmation required request uoder 10is CFR 30 minutes.

20.717. This The

3) Moue..everibeefield. to sleerwddtdonellinaoms.the ntonnetino is required by NRC to obtain on en anneal basis site seii ios-o-it
4) (Me ot Adobe Reud.5er oerIa Is req.*red fFFD) program perfonmnance data no drug end alcohol progranms horomcnesn te

[] Submission m-' Delete nntities. Send comments regarding burden estimate to the FOIA, Privnacyand Information Collection Branch (T5-F53), U.S. Nuclear Regolatory Commission, Wenhingtnn DC Update LJ1 Submission OO555-000t, or by e-mailto lntfonlaot Ree.~ourgdNRC eon and to the Desk Officer, 310ce 0f Inotmnation end Regulatory Affairs, NEOB-t020. (3155-0148), Office 01 hlanegamentand Budget, Washington DC 25503. Ifta means coed to impose Information collection does not display e currently nalid 0MB control nuomber,the NRC may not condedl iff or sponsor, anode peosno is net required to respond to. the intormatinoncollectnon.

Select Facility Dateof Collection -

Indian Point [50-247; 50-286] (nmm/ddlyyyy) L°*4r21s Reason for Testing - 26.717(b)(5) For Cause Testing Reason Please elaborate (optional)

IPhysical Condition/Smell of Alcohol Employment Type - 26,71 7(b)(3) Outage Worker (optional)?

Licensee Employee INo Labor Category- 26.717(b)(3)

Is this a 24-Hour Reporting Event (Yes/Ndo)? - 26.719(b) N Refusal- 26717(b)(7) & 26.75 Was this collection refused (Yes / No)? 1 7 Test Results - 26.71 7(b)(4)

Test Validity Not Applicable Test Type(s) for Restilt(s) Reported.- 26.717(b)(2) Alcohol Testing Alcohol Only I ~i iiIth]

Substance - 26.717(b)(2) & (b)(6)

IAlcohol SWat 26.103 BAC level was exceeded?

0.04 or greeter ]

Subversion Attempts - 26.71 7(b))7) and 26.75(b)

Did this collection innolve a subversion attempt (Yes/No)? o ManaoementActions - 26.71 71b1168& 26.75 Reason for the Action Frtdrug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s) Responsible for Information Provided Person 1 Iroeuired):

Kelly ll 1I I [Pettus ] ~aAcs eurt oriao kpettos@eotergy .com First Name Last Name Position Title Company Email Address Person 2 loptionall:

Wye X I II I Z J [Gi Eup rviorccess/i1toess tor Duty mgrifft@entorgy.com First Name Lest Name Position Titie Company Email Addrtiss FinalStep Iltequltecl)NRCmillconsider this term authenticin accordance woth26 It onlywhen the "Validate &LOnik"button is duicked and all errors (highllighted in red) haoe bees corrected. The "Validate & Lock"hotton mill change te "Locked" offerthe datevalidationprocess has been successfully completed indicatingthetormis ready tor submission.

Form Locked On: Feb 2,2016 at 1:54 MSw1 oa C PbttI p~

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 6901(1212014)

3 mU S - - S - 3~ - *~SS 0 -

I i~AM0.11. re sIredexeaetthea. mw*eal'eatleaaj APPRO~~~ BYOMBrCLEARANCE NO.3180.0144 EXPIRESI 1113012017 Zt Ern~sto, nsameBald.aute-popail. h*eas In oeri~ ffld. Eotroatet burden per response to comply wi-th ttos cotiection rerpuest is 30 esnutes. Thur

3) Nosa.en. tore is a votontary nmeas of reporting the information rempiredander 10 CFR 26.717. Tha oter m fiald. ts view .duleln.I lefne~inmfo infonnation ie reqoired by NRC to obtain on an annual basis site spocific henna-for-dots
4) Use oefAdobe Read.5er tS. Ir.erl reqldred (FFD) program performance data Onodrug and alcohol progranms broo lcensees and otee

'-]Submission r'- Delete entities, Send comments regarding borden estimate to the FOIA, Privacy anid Information Collection Branch (T5-F53), U.S. Nocdesr Regulatory Commission. Washington DC U Update L_ Submission 20555-000t,or by e-rnail to Infocollects Resoorce@NRC gnu, and to the Desk Officer Dfi~ce ot Intornmation and Regolatomy Affairs, NEOB-1020. (3150-0146), Officeo UnqeReference ID (Licensee Supplied) Management and Budget. Washington DC 20503. Itsa means used to inmposeinformation IPEC-015-11 cllector does not display a corrently natid DMB control nurmber, the NRC masynot condoc or sponsor, and a porson is not reqbired to respond to. the intormation colleciton.

Select Facility lIrdiarn Point [50-247; 50-286] Date of Collection 4/125(mdyy)

Reason for Testirng. 26.71 7(b)(5) Please elaborate (ophionail)

Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

Licenses Employee [SINO I Labor Category- 26.71 7(b)(3)

Is thIs a 24-Hour Reporting Enent (Yes/No)? -26.71 9(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes I No)? EI~oI]

Test Results - 26.71 7(b)(4)

Tent Validity Test Type(s) for Resuit(s) Reported - 26.717(b)(2) Drug Testing IDrug Only [I I Idne Waatitis collection observed (Yee/No)? -26.717(b)(7) &26.75 No Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable)

Additional Substance (as applicable)

Cocaine ] Please sele] Please. Select Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? [I j~o Manaoement Actions - 26.717(b51181 & 26.75 Reason for the Action First drug or alcohol positiveJ Sanction Applied (NRC Mirnimum or Uicensee Administrated)

INRc Minimum I Specitic Sanction Applied 114- Day Denial Person(s) Responsible fur Information Provided Person 1 (required):

First Name Last Name Positon Title Company Email Address Person 2 (opuonal):

WaynmeI I~rfi Superor, Accesol/Ftiess forDuty]wntnteaco First Name Last Name Position Titie Company Email Address FinalStep (Rempoimed) NRC will consider this tore authenhic in accordance rat 26.11 onlywdhenthe "Vanidate& Lock" button is sticked and all errors (highdlghted in red) have bees corrected. The "Validate & Lock" button mill change to "Locked" atter the data validation process hon bees succnetsouly completed indicating the torm is reerdi tor submission.

Single Positive Test Form (version 1.6.0 - December 19. 2014) NRC Form 890 (12/2014)

0 - I~~*-e. S -

L. . I 5 I ~ All 0.14. requiredesoept~ flee*.d a~aeaf F~P!ROWO BY0MB:CLEARANCE NO.31804146 EXPIRES: ~"-~'!

3) rdm01..in 0.n * .uteld

-papuite Iefbnmsaln in elba fields Estimated burden par form is a voluntary respunse means to comply of reporlbng with this collection tre intormation required request is CFR undar 10 30 minotes.

26.717. ThiO The

3) Me.,.. over fansfies to s'aeadlaew lnte*eemegan information is required by NRC to obtain onl an annual baumsadte specoic Itness-for-dutl
4) Iteae (Adahe ReaderS or lade, I. requied (FFD) program performance data on drug and alcohol prograns from licensees and ogree entitiea. Sand cumments regarding burden estimate to gre FOIA, Pdvacy and Informatior L SUpdateOf LJ Submissio Collection Branch (T5-F53). U.S. Nuclear Regulatory Comnisalon, Washington O(

20555-0001,Or by e-mailto Intorellects Resource@NRoov n, and to gre Dank Officer Office of information and Regulatory Affairs. NEOB-t020. (3150-0146), Officeo Managemant and Budget, Washington DC 20503. It a means uoed to impose informatior IPC-015012 collection doan not display a corrantly valid 0MB control number. gre NRC may nat candor or sponsor. and a person is not required to respond to. gre intormrationcollection.

Select Facility Indian Point [50-247; 50-286]

_______Date of Collection (mm/dd/yyyy) 0/2/2 15 Reason for Testing - 26.71 7(b)(5) pPlease elaborate on the reason for tooting (optional)

Foloup [

Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

Licensee Employee I Labor Category - 26.71 7(b)(3) is this a 24-Hour Reporting Event (Yes/No) ? - 26.719(b) N Refusal- 26.717(bi)(7) & 26.75 Was grincollection refused (Yes I No)? [

Teat Resuits - 26.717(b)(4)

Test Validity Was LOD testing conducted (Yes / No) - 26.163(a)(2)?

Dilue ] le Test Type(s) for Result~s) Repotted - 26.717(b)(2) Drug Tooting Drug Only ] Iri IIeI Was this coiiection observed (Yes /No)? - 26.717(b)(7) &26.75 I II Substance - 26.717(ti)(2) & (b)(6) Additional Substance (as applicabie)

Additional Substance (as appilicable)

Cocaine ] Please Select Iplease Select Use NRC Cutoff (Yes I No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~Io Manaoement Actions - 26.717lbll8l & 26.75 Reason for the Action Second drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Speobic Sanction Applied Permanent DenialJ Person(s) Responsible for Information Provided Person I (required):

First Name Last Name Position Title Company Email Address Person 2 (optional):

Wan rfi Suerisr AccessiFitnass forDuty orgrifft@antergy.com First Name Last Name Position Titie Company Email Address Final Steop (Required). NRC will consider this form autrantic in accordance withi20.It only when gre "Validate & Locti hutton asclicked and all errors (hightighted in red) have been corrected. The "Vairdate & Loch" button will change to 'Locked" alter gre data validation process has been successfully completed indicating the form is ready for submission.

Formo Locied On:[Feb2, 2016 at 1:00:23 PM S]~OLc C ~OtSO~

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 690 (1212014)

2) Fleanehi sxeni 1j BEnat. qim filde ensapi ene. maxau au opopuiai opw leinaeo In oerl dfele Etmimated bnurdenper response tn comply with this cotienhnunrequest is 30 minutes. This torm is 8 voluntary means of reporting the infornmaion required under 10 CFR 26.717. The
3) Moo.se ver Ia.,, fied.s to s w eds'di~lbon aadie informartionis required hy NRC to obtitin en on annual basise site specific fitess-tor-dudy
4) IP~a Adobe Roeder# a, trlaer I reqetrad (FF0) pruogrm pertormance dot. on drug end olcohol pregrams from licensees and nther i- Delete entites. Send cnmments megardngburden estimote to the FOIA, Privocy end Intormotion

-]Submission COtetion Branch (TS-F53). U.S. Nuctear Regulotory Comnussinon Washington DC 20555-0001 Omby n-maelto InftooclctoOs ResoacNRC cco, ond to the Desk Othcer, Office ut Intormation and Regulatory Affoirs, NEOe-1020, t3t50-0146), Offie ot Managtement and Budget, Washington DC 20503. Itoa means used to impose inforination colleotlon dues not display a currently oalid 0MB control number, the NRC moy net conduct mrsponsor, and a person is not required to respond to, the information collec~on.

Select Facility Date of CollectiOnmmeyyy 11/3/05I Indian Point [50-247; 50-286]

Reason for Tasting - 26.71 7(b)(5) Please elaborate (optional)

Employment Type - 26.717(b)(3) Outage Worker (optional)?

LicenseEmployeeI [No]

Labor Category- 26.717(b)(3)

Is thils a 24-liour Reporting Event (Yes/No)?- 26.715(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes I No)? E ii Test Results - 26.71 7(b)(4)

Test Validity Test Typo(s) for Result(s) Reported - 26.717(bi)(2) Drug Testinrg IDrug Only [Iunai Was this collection observeti (Yes/No)? - 26.71 7(b)(7) & 26.75 I I]

Substance - 26.71 7(b)(2) & (b:)(6) Additiltonal Substance (as applicable) Atditiltonal Substance (aS applicable)

Marijuana ] Please Select IPlease Select]

Use NRC Cutoff (Yes / No)? E i Subversion Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? [NIo ~ i Maneaement Actions - 26.71 71b)I8/ & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licenses Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s) Responsible fur Information Provideti Person 1 trequired):

First Name Last Name Position Title Company Email Address t

Person 2 (op ionll):

Wayn GrifinSupervisor. Acceos/Fitness ler Duty wgrlffl@entergy.com First Name Last Name Position Bite Company Email Address Final Stop (Raquirsd) - NRC sill consider this leon authentic in eccordenco with 26 t11only when the "Validate &Lock" button is clicked ond all errors (highlighted In red) have been corrected. The "Validate & Lock" button will change to "Locked"alter the data volidaiton process has boon successfully compyleted indicating the forin is ready for submission.

Form Locked On:[Feb 2, 2016 at 1:12:43 PM S] o o*PCP*tIes 1a Single Positive Test Fors (version 1.6.0 - December 19, 2014) NRC Form 890 (1212014)

a Entergy Entercav Nuclear Northeast Indian Point Energy Center 450 Broadway, GSB P.O. Box 249 Buchanan, NY 10511-0249 Tel 9142546700 Lawrence Coyle Site Vice President NL-16-018 February 12, 2016 U.S. Nuclear Regulatory Commission Document Control Desk 11545 Rockville Pike, "IWFN-2 F1 Rockville, MD 20852-2738

Subject:

2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report Indian Point Energy Center Docket Nos. 50-247, 50-286 License Nos. DPR-26, DPR-64

Dear Sir or Madam:

This letter transmits Indian Point Energy Center (IPEC) Fitness for Duty (FFD) Program Performance data for the period January 1, 2015 through December 31, 2015 in accordance with the requirements of 10 CFR 26.717(e). Included is also the Fatigue Management Program data in accordance with 10 CFR 26.203(e).

There are no new commitments contained in this letter. If you have any questions or require additional information, please contact Mr. Robert Walpole, Regulatory Assurance Manager at (914) 254-6710.

Sincerely,

Enclosure:

1. 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report 7..-I

NL-1 6-018 Docket Nos. 50-247, 50-286 Page 2 of 2 cc: Mr. Daniel H. Dorman, Regional Administrator, NRC Region 1 Mr. Douglas Pickett, Senior Project Manager, NRC NRR DORL IPEC NRC Resident Inspector's Office Mrs. Bridget Frymire, New York State Department of Public Service Mr. John B. Rhodes, President and CEO, NYSERDA Mr. Paul Harris, NRC NSIR DSP SPSB

ENCLOSURE 1 TO NL-16-018 2015 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report ENTERGY NUCLEAR OPERATIONS, INC.

INDIAN POINT NUCLEAR GENERATING UNIT NOS. 2 and 3 DOCKET NOS. 50-247 and 50-286

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Estimated burden per response to comply with this collection request is 114 hours0.00132 days <br />0.0317 hours <br />1.884921e-4 weeks <br />4.3377e-5 months <br />. This form is a voluntary means of reporting the information required under 10 CFR 26.717. The information is required by NRC to obtain 0n an annual basis sodespecific fitness-for-duty (FF0) program performance data on drug and alcohol programrs from licensees and other entites. Send comments regarding burden estimaoteto the FOIA, privacy and Information Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission. Washington DC 20555-0001. or by e-mail to Infocollecto.Resource@NRC.son, and tc the Desk Officer. Office of Information and Regulatory Affairs, NEOB-1020, (3150-0146), Offce ot Management and Budget, washington DC 20503. If a means used to imepose information collection does not display a currently nalhd0MB control number, the NRC may not conduct or sponsor, and a personai not required to respond to, the information collection.

1) All fields required unless marked 'optionar"
2) Use of Adobe Reenter 8 orIlter Is required
3) Mouse over fields for addltional Information D-'Submission Update Select Facility Periodof Report Ilndian Point [5D-247; 50-286]

J120161 Tfob l*.nndi,,.td in tha c'*andkar Year Total Number of Tests Conducted Total Number of Positive, Adulterated, Reason For Testing Licensee Employees ContractorsNendors Substituted, and Refusal to Test Results Random [III 21J 1 " I6 Post-Event o I ° Z

[I o Total(Calculated) 1h61I [X62 ZI3I FFD ProgramRandom Testing Population and Rate Average number of Average number of Total size of the random testing pool Annual random testing percentage licensee employees contractors/vendors throughout the period (Calculated) achieved for the testing pool 1,°D1 4831 '17 53.71 Laboratory Testing Does your program use aI Licensee Testing Facility? No (Yes/No)

Identity your HHS-Certifled Laboratory(ies) QUEST DIAGNOSTIC LABORATORIES Identity your Blind Performance Test Sample supplier(s) [ELSOHLY LABORATORIES, INCORPORATED 1 Substances Tested Did your program only test for NRC-required substances lle Does yoUrinProgram conduct LOD/testing Yes ANŽDat the NRC-specitied minimum cutoff levels? (Yes I No) permitted in26.163(a)(2)? (Yes INo)

Substance Use Only NRC Cutoff Initial Confirmatory LOD Testing? Comment Levels? (Yes I No) Cutoff Cutoff (Yes / No) (Optional)

Alcohol[ ~ I j]

Cocaine Yes [e Marijuana Yes [Yes Amphetamines Yes iIIZYes Opiates [Yles__________ _____Yes_________

PPYes IYes__

Annual Report Form (version 1.6.0 - December 19, 2014) - Page 1 of 2 - NRC Form 891 (12/2014)

Substances Tested - continued Summary of Management Actions - 26.71 7(b)(8)

Summarize actions implemented to improve FF0 program performance. As applicable, reference in the topic description audit reports, 30-day reports, and/or corrective action reports. If reporting information on more than three topics, select 'Others" for Topic 3 to report any additional topics.

Topic 1 Please Select}

Person(s) Responsible for Information Provided Person 1 (required):

~~IIIIZCoordi11111r kpettus@entergy~com First Name Last Name Position Title Company Email Address Person 2 (optional):

ZX

~Im Awgriffl @entergy.com First Name Last Name Position Title Company Email Address Final Step (Required).- NRC will consider this form authentic in accordance with 26.11 only when the "Validate & Lock" button has been selected and all errors (iLe.,those highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successfully L i ]

completed and the form is ready for submission.

Form Locked on:l eb22016at1:2O:02 PM I Annual Report Form (version 1.6.0 - December 19, 2014) - Page 2 of 2 - NRC Form 891 (1212014)

I *-. - S .~- 0 S -

2l Entr*esleason,. fieds aeto-pepaigIrnfmoaeun, In o~ter as~de Estimated burden per response to comoplywith thio collection request is 30 mnruntes. Thos

,1) Mooae ov, ernet fleld. to vke. .dddnl les~et,.ee,'m~ toermis a voluntary macno of reporting thre information required uoder t0 CFR 26.717. The informshlon is required by NRC to obtain On an aennul bosi site specilic tlthess-for-rtuf 41Uxe of AdOtr ReaderS or lak, A.required [FFD) program performance date ott drug and alcohol programis from licensees and otiem entitles. Send comments regarding burden estimate to tire FOIA, Privacy and Information S1) A~ll1114required esc roepfleaeeked 'ogtgeno Collection Biranch (T5-F53), U.S. Noclear Regulatory Commission, Wastrmgtoo DC 20555-0001,or by e-mail to intocotiecls Rcsocrre@NRC coov and to tihe Desk Offcer Oftice of Information cod Reoulatory Affairs, NEOti-1020, (3150-0146). Office o0 Managiement aod tiudget, Washington DC 20503. lIfe meaos used to impoose otformation colleotion doeo net display a currentgy oalid 0MB control nomber, tire NRC may not 0onducl or sponsor, and a person is not required to respond to, the information collection.

Select Facility Indian Point [50-247; 50-286} J Dafe of Collecfion[01425 (mm/do/yyyy)

Reason for Testing - 26.71 7(b)(5) Pre-Access Testiing Reason (optional) Pleasei elaboratei (optional)

Initial Authorization Dilute Sample-LOD testing required Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

?.onracorndor [Yen Labor Category - 26.71 7(b)(3)

Faiity Supot is thits a 24-Hour Reporting Event (Yesdtio)? - 26.715(b) [No[

Refusal- 26,717(b)(7) & 26.75 Was this collection refused (Yes I No)? Fi77o7]

Teat Results - 26.717(b)(4)

Test Validity Was LOD testing conducted Cr'es ( No) - 26,163(a)(2)?

Dilute ] Yeis Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ]Ifn Was dhis collect ion observed (Yes/No)? - 26.71 7(b)(7( & 26.75 I ]

Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Manruan

.. ] [Please Select IPlease Select Use NRC Cutoff (Yes / No)'? li Subversion Attempts - 26.717(b)(7) and 26.75()5 Did this collection involve a subversion attempt (Yes/No)? ]No Meneoemnent Actions -26.71 71b1181 & 26.75 Roason for the Action IFirstdrug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specitic Sanction Applied 2- Year Denial Person(s) Responsible for Information Provided Person I (required):

Kly PetlsoIed cesScrtyCodiao tikpettos@entergy.com First Name Last Name Position Title Company Email Address Person 2 (optional):

~ ~ mgritit@entergn.com First Name Last Name Position Title Company Email Address Fital Steg, (Required). NRC mill consider this fo~rmcuthenticin accordance wfth 26,11 only ewhenthe "Validate &Lock" batten is clicked and all errors (highlighted in red) hrane been corrected. The "Validate &Lock" button mill change to "Locked" after the data validasion process has been successfully completed indicahlogthe form Is ready for submission.

Form Locked on:[~b22016at 12:4941 M] ISaet aa C Pri ext Single Posihtive Test Form (version 1.6.0 - December 195,2014) NRC Form 690 (12/2014)

0 - ~ S -

p 1)All asia. rsqr*ssi eee.ptfiles. ,eae~ ~ APPROVED BY0MB:CLEARANCE NO.3150-0148 EXPIRES: 1113012017 2)Enele in aser filds aaa.eedas ,nafonsn abfeld.

o,, Estlmated burden per response to comply Withthlis totlection request in 30 ninutes. This

3) Maoase ovar fa,,m 051*d to vhJe adtltlaesj inisn,,a~sn form is a voluntary means of reporting the infonmation reqoired under 10 CFR 26,7t7, The intonmation is required by NRC to obtain On an annual basis site speific fitness-for-duty
4) tUse ot Adoh ReadrS arlatar1. rsq.*red (FFD0

) prognrm performance data on drua end alcohol progeras barnmlcensees end other r-] Submission rm Delete enhties. Send comments regsrding borden estiorste to the FOIA, Privacy and Informration Coilevo~on Branch (Tt-F53), U.S. Noclear Regulatory Cornmission. Washgtoono DC L Update L_ Sub mission 25055-0OS1, Or by e-mailto infeoooltct Reswocree@NPC eon, end to the Desk Officer, Office ot Information and Regulatory Affairs, NEOE-1020, (3150-0146). Office of Management and Budget, Whashington DC 25503. Ifs ormeasuoed to impose information collection does not display a currently valid DMB control number, the NRC may not condoct or sponsor, endsapemsonis not required to respond to, the information collection.

Select Facility Indian Point [50-247; 50-2861 (mmldd/yyyy)Oe[of~leji~n0120205 j Reason for Test ing - 2671 7(b)(5) Please elaborate (optional)

Rand I Employment Type - 26.71 7(b)(3) Outage Worker (optional) ?

CotatrNendor I No LaborCategory- 26.717(b)(3)

Faiity Supot Is this a 24-Hour Reporting Event (YeseJro)? - 26.719(b) No Refusal- 26.717(b)(7) & 26.75 Was thls collection refused (Yes I No)?' [~II Test Results - 26.71 7(b)(4)

Test Validity Toot Type(s) for Result(s) Reported - 20.717(b)(2) Drug Tooting Drug Only] dn Was this collection observed (Yes/No)? - 26.71 7(b)(7) & 26.75 [ L i Substance - 26,717(b)(2) & (b)(6) Additional Substance (as applicable)

Additional Substance (as applicable)

Marijun

.. Please Select [Please Select]

Use NRC Cutoff (Yes / No)?Ye Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection inoolve a subversion attempt (Yes/No)? Eioi l ]

Manasoement Actions - 26.7171b1181 & 26.75 Reason for the Action Frtdrug or alcohol positive Sanction Applied (NRC Minimum or Ucensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Person(s) Responsible for Information Provided Ferson 1 (required)l:

First Name Last Name Positioo Title Company Email Address emaon 2 (optional):

I~aye GrffinSupervisor, Aceess/Fithess for Dory mawgiffl

@entergy.com First Name Last Name Position Tite Company Email Address Final Step (Reqsdrsd.-NRC millconsider this formauthentic in accordance with 26.1: only whrenthe "ValIdate & Lock"button is clickedand allerrors (highlightedinred) have been corrected. The "Vatidate &Loch" bottonmill change to "Locked" alter the dats validationprocess boobeen successiully compfeted indicatingthe foes Isready forsubmisaion.

Form Locked on:[~ebj201 2o j50: PM Ia

$] O C ItI W It Single Positiv Test Form (version 1.6.0 - De;emnber 19, 2014) NRC Form 890 (12/2014)

2)Entedesinote aeld =tut~ pua

  • lc Ino" e Estimatad borden par response to comply with this cotiection required request in 30 under 10 CFRminutes, 26.717. This The e d)Mu7oe5fo m .fedfo tne
  • noffm form is a volunfary means of reportng the information
3) Maaeinformanon in required by NRC to obtain on an annoal basis site specdioi fithess-for-duty
4) U alAdeh.e ReaderS8 rae
  • l (FFD) program performance data on drug and alcohol programs from licensees and othar rDelete J]Submission Deoeentitee. Sand comments regarding borden estimate to the FOIA, Privacy and information CollectionBranch (T5-F53). U.S. Nuclear Regulatory Commission. Washington DC Lipdta t.J Sumsin20555-0001, Or by e-mail fo Infovollects ResouorcetiNRC noov and to the Desk Officer, Office of information and Regulatory Affairs, INEOB-I(020, (3150-0140), Office 01 Uini ue Reference ID (Licensee Supplied) Management and Budget, Washington DC 20503. ifta means used to impose information SIPEC-2015-003 collection does not display a currently valid 0MB control number, the NRC may not condoci I or sponsor, and a person is net required to resprmd to, the information collection.

Select Facility Dt fCleto ~

Indian Point (50-247; 50-286] DtofCleto(mm/dd/yyyy) 02/25 n Reason fot' Testing - 26.717(b)(5) Pre-Access Testing Reason (optiocnal) Please elaborate (optional)

Reinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3) Outage Worker (optional)?

Contract~orenmor JYes Labor Categoty - 26.71 7(b)(3)

Maintenance (general facility)

Is tihis a 24-Hour Reporting Event (Yeais/Na)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection ref used (Yes I No)? ~ iiI Test Results - 26,717)b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26.717(b)(2) DwugTesting Drug Only [1I iIIIe Was this collection observed (Yes/No)? -26.717(b)(7) & 26.75[ iI]

Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marijuana ] Please Select IPlease Select Use NRC Cutoff (Yes / No)? ~ I Subversion Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? E~o ]

Manaoement Actions - 26.717(b1181 & 26.75 Reason for the Action First drug or alcohol positive Sancton Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied J3- Year Denial Person 1 (required).

JKelly F~~ I~ IIIIIIIJ~ Jed *esSc*Cori~o hpettus~entergy.c..

First Name Last Name Position Titie Company Email Address Pemson 2 (optional):

Wayn Grffi Sprvisor, Access/Fcithess fortDuly wrl tt@entergy.com m ffl First Name Last Name Position Title Company Email Address Final Step (Requied).-NRC mill consider this form authentic in accordance mith 20.11 only when the 'Validate & Lock' button is clicked and all erroms(highlighted in red) sane been corrected. The =Validate &Lank' hutton mill change to 'Locked' after the data validation process hon been suocessfully completed indicasing the form is ready for submission.

Form Locked On:[geb2,216 at 122:31 PM J ~ Q~~I PCfhqtr Single Poesitve Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

~tEetelea besome flaklaaate-pepudat. Intonneden In oEarlblde Enanmated burden per fornmitoa voluntary response means to comply of reportina with thin collection the information raquired request inCFR under 10 30 minutes.

26.717. This The

[7J

.1)Moos.evertenon 4)1.1.. Submission fieldsto 11rlewaddnlanaIlnfo.ene~on m

ofAdobeReaderSOrlater Delete in r.qair.d intormchonc in required by NRC to obtain on an annual basis site opecilto fitoess-tor-duty (FFD1 program performance data on drug and alcohol programs from linennees and other entities. Send commenta regarding borden estimate to the FOIA, Privacy and Intormation Collectimn Branch (TrS-F53), U.S. Nuclear Reeulatory Commission, mashington DC Update [] Sub mission 20555-0001, or by e-mail to Intocotllets Resocrco@NRC noocend to the Dank Dfinner, Ottice of Informoation and Reaulatory Attairs, NEOB--tO20. (3150-Ol4e), Omfie of Manaaemnent and Budget, Washington DC 20003. Itoa means uned to impose inforrration uollectiondoen not display a currently valid 0MB uonnholnuomber,the NRC may not conduct or sponsor, anoda person in not required to respond to. the information collection.

Select Facility Indian Point [50-247; 50-286] (mm/dd/yyyy)D ef~lcin02/23/2015 ]

Reason for Testing - 26.71 7(b)(5) Pro-Access Testing Reason (ootio onall Please elaborate (optional) iupdate Authorization Employment Type - 26,71 7(b)(3) Outage Worker (optional)?

IYes Labor Category - 26.71 7(b)(3)

IMaintenance (general facility)

Is this a 24-Hour Reporting Event (Yena/o)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Walsthis collection refused (Yes / No)? [

Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ] Urine Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.75 i I Substance - 26.71 7(b)(2) & (b:)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marijuana ] Please Select IPlease Select Use NRC Ocutoff (Yes / No)? EI~

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~ ~IoI Manaoement Actions - 26.7171b1181 & 26.75 Reason for the Action IFirst drug or alcohtol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Specific Sanction Applied 3- Year Denial Peran~s)Resonsile fr Iformt~onProide Person 1 (required):

Kelly I efs)ed A~essencudWCoordminao Z kpe~us@entergy ....

First Name Last Name Position Title Compeny Email Address Person 2 (optional):

First Name Last Name Position Titie Company Email Address FinalStep (Requied). NRC will consider thus fony authentic in accordance with 26,11 only when the "Velidate &Look" bucone moclicked and all erroms(highlighted in red) have been corrected. The "Validate &Lock" sctore will chenge to "Locked" atier the data validation process has bees successfully completed indicating the form inready tor nubminnion.

Foro Locked on:le2 ~2o16Nt2:S3:PM fSWI GS P ~ R p~

Single Positive Test Forrm (version 1.6.0 - December 19, 2014) NRC Form 8980(12/2014)

1)iAll field. required except those. narked "oadiorr APPROVEDBY0MB: CLEARANCE NO.3165-0146 EXPIRES-1113012017

3) Eared., in soe.a hr.*d aeto-popoiaf. iftn.Uonar in ofir fel~d. Estimated harden per response to comrply oith this collectioe request is 35 minutes, This 3)Mose. ovearten, hieds to view addtlonalbd onnfa form is a volantaty means of reporting the information required under 10 CFR 30.717. The information is required by NRC to obtain on ao annual basis site specitic fithess-for-duty
4) U.. of Adobe R..der l or-lI. isqrd.-.de (FF0) program performance dote on drag and alcohol prograns from licensees and other

-- ]Submission L DebISlete entities. Send comments regarding burden estimate to the FOIA, Pdnvacy and Information Collection Branch (TS-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to Infucolleoto Resoaroae@NRC 000 and to the Desk Officer, Office 01 information and Regulatory Affairs, NEOB-It020, (3150-0146), Office ol Managemert and Budget, hWashingtonDC 20503. Itoa means used to impone information IPE-215-005 collection dues nor display a currently ualid 0MB contro number, the NRC may nut conducl or sponsor, and a person is not required to respond to. the information collection.

Select Facility ininPoint [027 026 ](mm/d/~yyyy)Da f~lefn02/23/2015 Reason for Testing.- 26.717(b)(5) Pro-Access Testir10Reason (optional) Please elaborate (optional)

Inilial Authorization Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

CotacoNendor] Y~es ]

Labor Category- 26.717(b)(3)

Maintenance (general facility)

Is this a 24-Hour Reporting Event (Yes/No)? - 26.719(b) No Refusal- 26.71 7(b)(7) & 26.75 Was this collection refused (Yes / No)? [*Ii Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported - 26 717(b)(2) Drag Testing Drug Only un Was this collection observerd (Yes /No)? - 26 717(b)(7) & 26.75 [Zi Substance - 26.71 7(b)(2) & (b)(6) Additional Substance (as applicable) Additional Substance (as applicable)

Marilun

.. ] Pleese Select 1Please Select Use NRC Cubtof (Yes ( No)? EI Subversion Attempts - 26.717(b)(7) and 26.75(b)

Didthis collechion inyolye a sub version attempt (Yes/No)? Eiliol Manaoement Actions - 26.717(b11t81 & 26.75 Reason for the Action First drug or alcohol positilye Sanction Applied (NRC Minimum or Licensee Administrated)

Licenses Administrated]

Specitic Sanction Applied 3- Year Deniali Persn~s)Resonsile or iformtio Proide person 1 (required):

ely Pettus Led cesScrt oriao kpettus@entergy~corn First Name Last Name Position Title Company Email Address Person 2 loptional):

First Name Last Name Position Titie Company Email Address Final Step (Requtred) -NRC wdilconsider this form authentic in eccordance with26, ft only when the "Validate & Lock" button is clicked and all errors (highlighted in red) hone been rorrected. The "Validate &Loch" button mill change to =Locked"offerthe data validation process hos been surcessfolly completed indicating the form is ready for submission.

Form Locked On:[Feb 2, 2016 at 12:55.12 PM ]a to ocI P Pt!R~g t Single Positive Test Forms (version 1.6.0 - December 19, 2014) NRC Fotnm 800 (12/2014)

  • 1)Affff-alda
2) *sne ineaqu/ved esap a... #eisi
  • gefd 'opfftptr

/Mba.

eastopopuabit .* . in.o6,e - ArrP vtUVP.

Estiniated U per burden UGtAANUL*

MB:response NV. J1WiO-r*tO to compty P3.Pces:

with this collection request 1llgo-tal,This Is 30 nrdnotas.

3J6I..oae ovaver fon~ita1fed=t

  • I.o eo trm wsanvcluntary means of reportlng the informationt reqoired under 10 CFR 26.717. Th.

i reuird b NR toobtain no an annoal basis sit, specific ftoleos-for-ttut3 nforat~n

4) Uae d4Adobe.
  • 8 orae/ retl (FFD)progianh performance data on ding and alcohoi progranms trots tlcesees and ottel r" umsin
  • Delet en~tits., Send commnentsregarding borden estinate to the FOIA, privacy and Infonmation

[] i~*~

L.Upae 6

J Submission oflection B.anch (TS-F53), U.S. Nuclear Regulatory Conmislsion, Washington DC 20555-0051. on by e-mail to Infouoilects Rasouorce*;NRfC aov, and tO the Dash Officer Office ot Intonnation and RegulatOry Affairs, NEOB-1020, (3150-0148), Office o UniueRe fereDnceI/ieseeSuppiedL Management and Budget, Washington DC 20503. If a means used to impose information IPEC-2015-006 I collecton does not display a corrently valid OMB control nomber, the NRC may not conduc" I or sponsor, and a parson is not required to respond to, the information collection.

Select Facility Dt fCleto (mmldd/yy) I°2 °1 lndian Point [50-247; 50-286]

Reason for Testing - 26.717(b)(5) Pro-Access Testing Reason (optional) Please elaborate (optional)

Pr-Acss]

Initial Authordzation Employment Type - 26.717(b)(3) DOtage Worker (optional)?

IYes Labor Category -20.71 7(b)(3)

Mainenance(gerlfclit) is this a 24-Hour Reporting Event (Yes/No)? -26.71 9(b) N Refusal- 26.71 7(b)(7) & 26.75 Was this collection refused (Yes / No)? j j Teat Results - 26.717(b)(4)

Test Validity Test Type(s) fur Result(s) Reported - 26.717(b)(2) Drug Testing Drug Only ]Irn Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.75[ Il Substance - 26.717(b)(2) & (b)(6)( Additional Substance (as applicable)

Additional Substance (as applicable)

Marijuana I Please Select] IPlease Select]

Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~ j~oj Manaoement Actions - 26.7171b1181 & 20.75 Reason for the Action IFtrst drug or alcohol positive Sancton Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated]

Specific Sanction Applied 3- Year Denial Person(s) Responsible fur Information Provided Person 1 (required):

Kel I IIIy I [Pettso]Ied ces tecort r Iketts@entergyi.c..

borint First Name Last Name Position Title Company Email Address Person 2 (optional):

Wayne [Gfi IsprioAcs/~s ut mogriffi@entergy.com First Name Last Name Position Title Company Email Address Final Step (Required) - NRCmrilconsider this formauthentic in accordance with26.11onlywhen thre"Validate& Lock"bottonis clickedand allerrors (highlighted red) base been in corrected. The "Validate & Loch" botton mitlchange to "Locked' offer the data oalidatinn process has been successfolly completed indicating the form is ready for submission.

FormLocke OnJle ,16 s 2~:d:4PM SI A gIP lh R f Single Posibive Test Foro (versionl 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

I1) AMl1154 requared except tho. semrked eeeln*r IAPPROVEBYOMB: CLEARANCENO. 3110-0146 EXPIRES. 1113012017 EmresI soearv,. nds .ot-eata fonf o in.n*le In ew ie Estiromtedborden per response to complyise thiescotiectionlrequest i. 30 minutes. Thin form in a voluntary means of reportin tire informration reqoired onder itt CFR 26.717. The

3) M~eoo..as, on Cold CerV. odtsuleoelIdoee intormraton is reqoired by NRC to obtain on an annual basin tedspecrfic tibress-for-duty (FF0) program performance data on drog and alcohol prograrns fronmlicensees ond other LI Submmsson elete enttities. Send comrrents regarding burden estimate to tihe FOIA, Privacy and lnfornmationr Cotiection Branch (TS-F53), U.S. Nuclear Regolatoty Comnmissionn Washington DC 205555-0001, or by e-nrintto Infcocttct Rnsoorco46NRC goy. and to tire Desk Officer.

Office of Intnrnation and Regulatnry Affairs. NEOti-t020, (3150-0146t). Office of Management and Budget, Washington DC 20503. Itoa means osed to impnse information collection does not display a currenlty valid OMti control nomber, the NRC may not conduct or sponsor, and a person in not reqoiredto respond to, tireinformation colleobon.

Select Facility lndian Point [50-247; 50-286]

Date of Collection o1?25mldyy)

Reason for Testing - 26.717(b)(5) Pro-Access Testing Reasont (optionral) Please elaborate (optional)

I'nitial Authlorizabion Observed collection- applicant returming to indostry from positive test in 2008 Employment Type - 26.717(b)(3) Outage Workrer (optional)?

Yes Labor Category- 26,717(b)(3)

Is this a 24-Hour Reporting Event (Yes/No)?- 26.7198(b) N Refusal- 26.717(b)(7) & 26.75 Was this collechion refused (Yes /No)? EiI Test Results - 26 717(b)(4)

Test Validityj Test Type(s) for Result(s) Reported - 26.717(b)(2) Drug Testing IDrug Only I

[Urine Was tils collection observed (Yes /No)?- 26.717()(7)) & 26.75 [II Substance- 26.717(b)(2) & (b)(6) AdditionalSubstance (as applicable) Additional Substance (as applicable)

Marijuanao Please Select IPlease Select Use NRC Cutoff (Yes ( No)? *e Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involveta subversion attempt (Yes/No)? [liNo Manaoement Actions - 26 717)b*(8t) & 26.75 Reason for the Action Second drug or alcohol posihive Sanction Applied (NRC Minimum or Licensee Administrated)

SLicensee Administrated Specific Sanction Applied Perm..anet Denial Person(s) Responsible fur Information Pro vided Person 1 (required):

Iey Pettun [La.Acs eut orieo kpettusl~entergy c..m First Name Last Name Position Titte Company Email Address Person 2 (optional):

Wayne ]Griffin Supervisor, Access/Fitoess for Duty m grittt@entergyp.com First Name Last Name Position Title Company Email Address Fliraf Step (Reqcrlrerft .NRC mill consider this form aothestic in acoordance with 20.11 only when the "Validate & Lock"botton in clicked and all errors (highlighted in red) have been corrected. The "Validate & Lonk" batten mill change to "Lonked' afte the data validation process ban been nuccessfollycompleted indicating the form in ready for nubminnion.

Form Loced on:[Fb2 216st11: :,.7P~ Saet I.c ItthsRI Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

3) tne/

o e hed . -auto-pp . /non h, blohrfed Etiroated burden par responso to comrply witthghiscotention retprest in 30 monutes. Ttis

3) Muse toview ver ormfle~=
  • *farm is a votontary means of reporting the inrformtion required under 10 CFR 28.717. The intormnatio asroqoired by NRC to obtain on an annual boois alto specific flthna-t*por-doty
4) Uaa of Adobe Raedw58 rltrisnqf~ (FFD) program performanoe data on drag and alcohol programsnrombolcensees and other

[]Sbiso r' Delate entitaes Sand commants regarding burden astirmateto ithe FOIA, Privacy and Intornation Updae I SumisionCatiaccon Branoh (TS-F53), U.S. Nuolear Regulatory Commissioan. Washrington DC Submission05g55000o , or by a-madl to letorolaeto Ranuorrai5NRC ga and to gre DankDttrer, UnqeRfrneI ~cne upid Dffioe ot Information and Regulatory Affairs. NEOB-1020, (3150-0146), Dffioe at Monagoment and Budget. Washington DC 20503. Itoa meant used to impono informalton IIPEC-21 - 2008 5 8cotaecton daes not disploy a currantly nalid DM2 control numbter. tra NRC map rot conduct or sponsor, and a person lb not raquired to raspond to, uheintormation collaction.

Select Faciliy Indian Point [50-247; 50-286] Date of Collection Fo31021(mdyy)

Reason for Testinrg- 26.717(b)(5) p*lease elaborate (optional)

Employment Type - 26.717(b)(3) COurtage Worker (optional)?

Labor Cse*gory - 26.71 7(b)(3)

Is it/isea24-Hour Reporting Event (Vesfido)? - 26.719(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? E II Test Results - 26.717(b:)(4)

Test Validity Test Type(s) fot Result(s) Reported - 26.717(b)(2)

Drug only ] l I~no Drug Testing I]

Was ft/is collection observed (Yes / No.)? -26.71 7(b)(7) & 26.75 [ II Substance - 26.717(b)(2) & (b)(6) Addi/tiona/ Substance (as app//cable) Additional Substance (as applicable)

Marijuana ] Please SelectI [Please Select Use NRC Cutoff (Yes I No)?

Sube-ers/on Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? o Manaoement Actions.- 26.7171b118) & 26.75 Reason for the Action First drug or alcohol positive I Sanction Applied (NRCMinimum or Licensee Administrated)

Licensee Administrated]

Specttlc Sanction Applied 3- Year Denial Person(s) Responsible for Information Provided Parson t (required):

Kel ZIyI I] IPatton ] ~a.Acs eut oriao hpettusgentergy ....

First Name Last Name Position Title Company Email Address Parson 2 (optional):

First Name Last Name Position Ttite Company Email Address Float $tap tRaquelre. NRC milhconsider this form authoenti In accordanrcengrt 26 11tonly whmen the "Valdate &Lock" boston aschockedand all errors (highilghted in redl have bean corrected, Tho "Validate &Loch" button will change to "Locked" altar the data validation process has boon succestoully completed indicating the term ia ready far submission.

Single Positive Teat Form (version 1.6.0 - December 19, 2014) NRC Form 890 (12/2014)

P 3U *00 - - P ~*-.. S -

S I tiM ff.at. ,50t*Sd aweaptus... resotradolaeone IA~~D BY0MB:CLEARANCE NO.31504148 EXPIRES: 1113012011 2)Enarlesisnseen. fil~ds .ada-paplat tarsrnneton In o~ers fieds Etiemated burden per torm is a voluntary response mreans to comply of reporting wdtr this collection tre intormalton required request is CFR under 10 30 mirnutes.

26.717. This The

3) MOS o o'.r formnfields to viassrsdditionallrdInmrnUonr intormnation is required by NRC to obtaun on an annual basis site specilic ftloess-for-doty 4)11U.of Adobe Reedsr Dor tldr Is reqaal'red (FF0) program pertornmance date onr drug and alcohol programs frem licensees end other entlies. Send comnmentsregardong burden estimate to the FOiA, Pdivaey and Intermatiun

[* Submiss ion [r1 Delete LiUpdate 1-i Submission Coilection Branch 1T5-F53), U.S. Nuciear Reguistory Conorsosien, Washington DC 20555-S0S1, or by e-rmadlto Infoculollctsesnoureo@NRC non. anid to the Desli Otffier, UnqeRfrneI ~cne upid 0010e of etnformaton end Reguiatory Affairs, NEOB-t020, (3150-014e), Ofmen ot Mlanagenrantand Budeet, Washington DC 20503. if e mer.s coed to impose interormton ceiiectacndues riot dispiay a corrently vailid 0MB controi number, the NRC may not conduct SelEC-2015-I1t9 or sponsor, aod e person in cot required to respond to, the inforrmatoe cotlnotion.

Dale of Collection Indian Point [50-247; 50-286] (mm/dd/ I°1°yy)

Reason for Testing - 26.71 7(b)(5) Please elaborate (optional)

Employment Type- 28.71 7(b)(3) Outage Worker (optional)?

Licensee Employee I [leaeSaleti]

Labor Category- 28.71 7(b)(3) Please elaborate Supervsor J Maintenance supervisor Irorking nightefortireoutage) masnuitfed at OreFPEC SOCAaccess facility,whichis outsidethe I pr'otectedore,,to reportto the Access facidity tona randem Fitness-Fvc-Outy (FFD)test. A toot teraicohol resulted in a confirmed Is this a 24-Hour Reporting Event (Yeaftrfo)? - 26.719(b) Ys Reactor Rlant Ecent NotifucaltonWolrticheet EN # 50879 won completed to docomant nofification.

Refusal- 26.717(b)(7) & 28.75 Was this collection refused (Yes I No)? o Test Results - 26.71 7(b)(4)

Test Validity No Aplicbe ]

Test Type(s) for Result(s) Reported - 26,717(b)(2)

Alcohol Testing Alcohol Only]

Substance- 26.717(b)(2) & (b)(6)

Alcohol]

What 28.103 BAC level mao exceeded?

0.04 or greaterJ Subversion Attempts - 26.717(b)(7) and 28.75(b)

Did ltins collection involve a subversion attempt (Yes/No)? o Manaaement Actions - 26.71 71b118'& 28.75 Reason for the Action IFirstdrug or alcohol positive Sanction Applied (NRC Minimum or Liceesee Administrated)

NRC Minimum]

Specific Sanction Applied 14- Day Denial Person(s) Responsible for Information Provided parson 1 {required):

First Name Last Name Posdtion Title Company Email Address Person 2 (optionall:

First Narse Lost Name Position Title Company Email Address Flnal Slep IRaqol~re*g NRC wetl consider this term authentbc in accordance mrlt 24 11tonly when the "Valotate& Lock" button is clickled end all enrors Ihighldightedsinred)have beer corrected. The "Validate &Lock" button will change to "Locked"alter the data validation process huo been successfully completed indicticongthle tonrmis ready for submission.

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 8t90 11212014)

D S.. ~0 - ~ * -

k. a -

I 2)1)AM field. req~d excafitlAb,. mwte.d ~apemaf ErmeesaIn some flaldaauel.pepalat. le *sue In eMhr field.

IAPPR(2~~W Estimated BYOM9~CLEARANCE NO.31000146 EXPIRESI1113012017 boorm le n borden otuntary per response meons to cormply of reportng with this collection the infonmation required request uoder 10is CFR 30 minutes.

20.717. This The

3) Moue..everibeefield. to sleerwddtdonellinaoms.the ntonnetino is required by NRC to obtain on en anneal basis site seii ios-o-it
4) (Me ot Adobe Reud.5er oerIa Is req.*red fFFD) program perfonmnance data no drug end alcohol progranms horomcnesn te

[] Submission m-' Delete nntities. Send comments regarding burden estimate to the FOIA, Privnacyand Information Collection Branch (T5-F53), U.S. Nuclear Regolatory Commission, Wenhingtnn DC Update LJ1 Submission OO555-000t, or by e-mailto lntfonlaot Ree.~ourgdNRC eon and to the Desk Officer, 310ce 0f Inotmnation end Regulatory Affairs, NEOB-t020. (3155-0148), Office 01 hlanegamentand Budget, Washington DC 25503. Ifta means coed to impose Information collection does not display e currently nalid 0MB control nuomber,the NRC may not condedl iff or sponsor, anode peosno is net required to respond to. the intormatinoncollectnon.

Select Facility Dateof Collection -

Indian Point [50-247; 50-286] (nmm/ddlyyyy) L°*4r21s Reason for Testing - 26.717(b)(5) For Cause Testing Reason Please elaborate (optional)

IPhysical Condition/Smell of Alcohol Employment Type - 26,71 7(b)(3) Outage Worker (optional)?

Licensee Employee INo Labor Category- 26.717(b)(3)

Is this a 24-Hour Reporting Event (Yes/Ndo)? - 26.719(b) N Refusal- 26717(b)(7) & 26.75 Was this collection refused (Yes / No)? 1 7 Test Results - 26.71 7(b)(4)

Test Validity Not Applicable Test Type(s) for Restilt(s) Reported.- 26.717(b)(2) Alcohol Testing Alcohol Only I ~i iiIth]

Substance - 26.717(b)(2) & (b)(6)

IAlcohol SWat 26.103 BAC level was exceeded?

0.04 or greeter ]

Subversion Attempts - 26.71 7(b))7) and 26.75(b)

Did this collection innolve a subversion attempt (Yes/No)? o ManaoementActions - 26.71 71b1168& 26.75 Reason for the Action Frtdrug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s) Responsible for Information Provided Person 1 Iroeuired):

Kelly ll 1I I [Pettus ] ~aAcs eurt oriao kpettos@eotergy .com First Name Last Name Position Title Company Email Address Person 2 loptionall:

Wye X I II I Z J [Gi Eup rviorccess/i1toess tor Duty mgrifft@entorgy.com First Name Lest Name Position Titie Company Email Addrtiss FinalStep Iltequltecl)NRCmillconsider this term authenticin accordance woth26 It onlywhen the "Validate &LOnik"button is duicked and all errors (highllighted in red) haoe bees corrected. The "Validate & Lock"hotton mill change te "Locked" offerthe datevalidationprocess has been successfully completed indicatingthetormis ready tor submission.

Form Locked On: Feb 2,2016 at 1:54 MSw1 oa C PbttI p~

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 6901(1212014)

3 mU S - - S - 3~ - *~SS 0 -

I i~AM0.11. re sIredexeaetthea. mw*eal'eatleaaj APPRO~~~ BYOMBrCLEARANCE NO.3180.0144 EXPIRESI 1113012017 Zt Ern~sto, nsameBald.aute-popail. h*eas In oeri~ ffld. Eotroatet burden per response to comply wi-th ttos cotiection rerpuest is 30 esnutes. Thur

3) Nosa.en. tore is a votontary nmeas of reporting the information rempiredander 10 CFR 26.717. Tha oter m fiald. ts view .duleln.I lefne~inmfo infonnation ie reqoired by NRC to obtain on an annual basis site spocific henna-for-dots
4) Use oefAdobe Read.5er tS. Ir.erl reqldred (FFD) program performance data Onodrug and alcohol progranms broo lcensees and otee

'-]Submission r'- Delete entities, Send comments regarding borden estimate to the FOIA, Privacy anid Information Collection Branch (T5-F53), U.S. Nocdesr Regulatory Commission. Washington DC U Update L_ Submission 20555-000t,or by e-rnail to Infocollects Resoorce@NRC gnu, and to the Desk Officer Dfi~ce ot Intornmation and Regolatomy Affairs, NEOB-1020. (3150-0146), Officeo UnqeReference ID (Licensee Supplied) Management and Budget. Washington DC 20503. Itsa means used to inmposeinformation IPEC-015-11 cllector does not display a corrently natid DMB control nurmber, the NRC masynot condoc or sponsor, and a porson is not reqbired to respond to. the intormation colleciton.

Select Facility lIrdiarn Point [50-247; 50-286] Date of Collection 4/125(mdyy)

Reason for Testirng. 26.71 7(b)(5) Please elaborate (ophionail)

Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

Licenses Employee [SINO I Labor Category- 26.71 7(b)(3)

Is thIs a 24-Hour Reporting Enent (Yes/No)? -26.71 9(b) No Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes I No)? EI~oI]

Test Results - 26.71 7(b)(4)

Tent Validity Test Type(s) for Resuit(s) Reported - 26.717(b)(2) Drug Testing IDrug Only [I I Idne Waatitis collection observed (Yee/No)? -26.717(b)(7) &26.75 No Substance - 26.717(b)(2) & (b)(6) Additional Substance (as applicable)

Additional Substance (as applicable)

Cocaine ] Please sele] Please. Select Use NRC Cutoff (Yes / No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? [I j~o Manaoement Actions - 26.717(b51181 & 26.75 Reason for the Action First drug or alcohol positiveJ Sanction Applied (NRC Mirnimum or Uicensee Administrated)

INRc Minimum I Specitic Sanction Applied 114- Day Denial Person(s) Responsible fur Information Provided Person 1 (required):

First Name Last Name Positon Title Company Email Address Person 2 (opuonal):

WaynmeI I~rfi Superor, Accesol/Ftiess forDuty]wntnteaco First Name Last Name Position Titie Company Email Address FinalStep (Rempoimed) NRC will consider this tore authenhic in accordance rat 26.11 onlywdhenthe "Vanidate& Lock" button is sticked and all errors (highdlghted in red) have bees corrected. The "Validate & Lock" button mill change to "Locked" atter the data validation process hon bees succnetsouly completed indicating the torm is reerdi tor submission.

Single Positive Test Form (version 1.6.0 - December 19. 2014) NRC Form 890 (12/2014)

0 - I~~*-e. S -

L. . I 5 I ~ All 0.14. requiredesoept~ flee*.d a~aeaf F~P!ROWO BY0MB:CLEARANCE NO.31804146 EXPIRES: ~"-~'!

3) rdm01..in 0.n * .uteld

-papuite Iefbnmsaln in elba fields Estimated burden par form is a voluntary respunse means to comply of reporlbng with this collection tre intormation required request is CFR undar 10 30 minotes.

26.717. ThiO The

3) Me.,.. over fansfies to s'aeadlaew lnte*eemegan information is required by NRC to obtain onl an annual baumsadte specoic Itness-for-dutl
4) Iteae (Adahe ReaderS or lade, I. requied (FFD) program performance data on drug and alcohol prograns from licensees and ogree entitiea. Sand cumments regarding burden estimate to gre FOIA, Pdvacy and Informatior L SUpdateOf LJ Submissio Collection Branch (T5-F53). U.S. Nuclear Regulatory Comnisalon, Washington O(

20555-0001,Or by e-mailto Intorellects Resource@NRoov n, and to gre Dank Officer Office of information and Regulatory Affairs. NEOB-t020. (3150-0146), Officeo Managemant and Budget, Washington DC 20503. It a means uoed to impose informatior IPC-015012 collection doan not display a corrantly valid 0MB control number. gre NRC may nat candor or sponsor. and a person is not required to respond to. gre intormrationcollection.

Select Facility Indian Point [50-247; 50-286]

_______Date of Collection (mm/dd/yyyy) 0/2/2 15 Reason for Testing - 26.71 7(b)(5) pPlease elaborate on the reason for tooting (optional)

Foloup [

Employment Type - 26.71 7(b)(3) Outage Worker (optional)?

Licensee Employee I Labor Category - 26.71 7(b)(3) is this a 24-Hour Reporting Event (Yes/No) ? - 26.719(b) N Refusal- 26.717(bi)(7) & 26.75 Was grincollection refused (Yes I No)? [

Teat Resuits - 26.717(b)(4)

Test Validity Was LOD testing conducted (Yes / No) - 26.163(a)(2)?

Dilue ] le Test Type(s) for Result~s) Repotted - 26.717(b)(2) Drug Tooting Drug Only ] Iri IIeI Was this coiiection observed (Yes /No)? - 26.717(b)(7) &26.75 I II Substance - 26.717(ti)(2) & (b)(6) Additional Substance (as applicabie)

Additional Substance (as appilicable)

Cocaine ] Please Select Iplease Select Use NRC Cutoff (Yes I No)?

Subversion Attempts - 26.717(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? I~Io Manaoement Actions - 26.717lbll8l & 26.75 Reason for the Action Second drug or alcohol positive Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Speobic Sanction Applied Permanent DenialJ Person(s) Responsible for Information Provided Person I (required):

First Name Last Name Position Title Company Email Address Person 2 (optional):

Wan rfi Suerisr AccessiFitnass forDuty orgrifft@antergy.com First Name Last Name Position Titie Company Email Address Final Steop (Required). NRC will consider this form autrantic in accordance withi20.It only when gre "Validate & Locti hutton asclicked and all errors (hightighted in red) have been corrected. The "Vairdate & Loch" button will change to 'Locked" alter gre data validation process has been successfully completed indicating the form is ready for submission.

Formo Locied On:[Feb2, 2016 at 1:00:23 PM S]~OLc C ~OtSO~

Single Positive Test Form (version 1.6.0 - December 19, 2014) NRC Form 690 (1212014)

2) Fleanehi sxeni 1j BEnat. qim filde ensapi ene. maxau au opopuiai opw leinaeo In oerl dfele Etmimated bnurdenper response tn comply with this cotienhnunrequest is 30 minutes. This torm is 8 voluntary means of reporting the infornmaion required under 10 CFR 26.717. The
3) Moo.se ver Ia.,, fied.s to s w eds'di~lbon aadie informartionis required hy NRC to obtitin en on annual basise site specific fitess-tor-dudy
4) IP~a Adobe Roeder# a, trlaer I reqetrad (FF0) pruogrm pertormance dot. on drug end olcohol pregrams from licensees and nther i- Delete entites. Send cnmments megardngburden estimote to the FOIA, Privocy end Intormotion

-]Submission COtetion Branch (TS-F53). U.S. Nuctear Regulotory Comnussinon Washington DC 20555-0001 Omby n-maelto InftooclctoOs ResoacNRC cco, ond to the Desk Othcer, Office ut Intormation and Regulatory Affoirs, NEOe-1020, t3t50-0146), Offie ot Managtement and Budget, Washington DC 20503. Itoa means used to impose inforination colleotlon dues not display a currently oalid 0MB control number, the NRC moy net conduct mrsponsor, and a person is not required to respond to, the information collec~on.

Select Facility Date of CollectiOnmmeyyy 11/3/05I Indian Point [50-247; 50-286]

Reason for Tasting - 26.71 7(b)(5) Please elaborate (optional)

Employment Type - 26.717(b)(3) Outage Worker (optional)?

LicenseEmployeeI [No]

Labor Category- 26.717(b)(3)

Is thils a 24-liour Reporting Event (Yes/No)?- 26.715(b) N Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes I No)? E ii Test Results - 26.71 7(b)(4)

Test Validity Test Typo(s) for Result(s) Reported - 26.717(bi)(2) Drug Testinrg IDrug Only [Iunai Was this collection observeti (Yes/No)? - 26.71 7(b)(7) & 26.75 I I]

Substance - 26.71 7(b)(2) & (b:)(6) Additiltonal Substance (as applicable) Atditiltonal Substance (aS applicable)

Marijuana ] Please Select IPlease Select]

Use NRC Cutoff (Yes / No)? E i Subversion Attempts - 26.71 7(b)(7) and 26.75(b)

Did this collection involve a subversion attempt (Yes/No)? [NIo ~ i Maneaement Actions - 26.71 71b)I8/ & 26.75 Reason for the Action First drug or alcohol positive Sanction Applied (NRC Minimum or Licenses Administrated)

NRC Minimum Specific Sanction Applied 14- Day Denial Person(s) Responsible fur Information Provideti Person 1 trequired):

First Name Last Name Position Title Company Email Address t

Person 2 (op ionll):

Wayn GrifinSupervisor. Acceos/Fitness ler Duty wgrlffl@entergy.com First Name Last Name Position Bite Company Email Address Final Stop (Raquirsd) - NRC sill consider this leon authentic in eccordenco with 26 t11only when the "Validate &Lock" button is clicked ond all errors (highlighted In red) have been corrected. The "Validate & Lock" button will change to "Locked"alter the data volidaiton process has boon successfully compyleted indicating the forin is ready for submission.

Form Locked On:[Feb 2, 2016 at 1:12:43 PM S] o o*PCP*tIes 1a Single Positive Test Fors (version 1.6.0 - December 19, 2014) NRC Form 890 (1212014)