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{{#Wiki_filter:ILO   j19     -
{{#Wiki_filter:ILO j19 -
Examination Security Agreement                                                                 Form ES-201-3 ES-201
ES-201 Examination Security Agreement Form ES-201-3
: 1.       Pre-Examination (NRC) licensing examinations scheduled for I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission 7/           '    as of the date of my signature. I agree     that   I will not knowingly   divulge     any information about these examinations to the week(s) of I understand      that  I am  not to  instruct,  evaluate, or provide performance any persons who have not been authorized by the NRC's chief examiner. I                                                                             of examination administration, feedback to those applicants scheduled to be administered             these licensing   examinations       from this date   until completion by the NRC   (e.g., acting as   a simulator     booth operator     or communicator   is acceptable if the individual except as specifically noted below and authorized                                                                            of the    physical security  measures and requirements does not select the training content or provide direct or indirect feedback). Furthermore, I am                     aware of the conditions    of this  agreement    may  result in cancellation of the (as documented in the facility licensee's procedures) and understand that violation immediately report to facility management or the NRC's chief examinations and/or an enforcement action against me or the               facility licensee. I will examiner any indications or suggestions that examination security may have been compromised.
: 1.
: 2.       Post-Examination concerning the NRC licensing examinations administered M To the best of my knowled e, I id not divulge to any unauthorized persons any information
Pre-Examination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of I
                                              -7   . From the date that I entered into this security agreement until the completion of examination administration, I did during the week(s) of            /
7 /
except as specifically not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, noted below and authorized           by the   NRC.
as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC's chief examiner any indications or suggestions that examination security may have been compromised.
SIGNATURE (1)                       DATE         SIGNATURE (2)             DATE       NOTE PRINTED NAME                        JOB TITLE/RESPONSIBILITY z
: 2.
                                                                                            -0,
Post-Examination M To the best of my knowled e, I id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of
: 4. N___Iee V                                                                                                      12-5-PJ 5.
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: 12. £T00-'   A-_______________L____
-7 From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
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PRINTED NAME JOB TITLE/RESPONSIBILITY SIGNATURE (1)
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DATE SIGNATURE (2)
NOTES:
DATE NOTE
1                       ~~~ES-201, Page 31 of 32                               / /       ~       +-
: 4.
-0, N___Iee z
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12-5-PJ V
: 12.  
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~~~ES-201, Page 31 of 32  
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ILO   . 19 °-           4 Examination Security Agreement                                                           Form ES-201-3 ES-201
ILO  
: 1.       Pre-Examination Commission (NRC) licensing examinations scheduled for I acknowledge that I h ve acquired specialized knowledge about the U.S. Nuclear Regulatory 02     as of the date of my signature. I agree that I will not     knowingly   divulge any information about these examinations to the week(s) of i; I understand   that I am   not to instruct, evaluate, or provide performance any persons who ave not been authorized by the NRC's chief examiner.
. 19 °-
feedback to those applicants scheduled to be administered these licensing       examinations     from   this date until completion of examination administration, by the NRC   (e.g., acting as   a simulator   booth   operator   or communicator is acceptable if the individual except as specifically noted below and authorized aware of the physical security measures and requirements does not select the training content or provide direct or indirect feedback). Furthermore, I am of this agreement may result in cancellation of the (as documented in the facility licensee's procedures) and understand that violation of the conditions I will immediately    report  to facility management or the NRC's chief examinations and/or an enforcement action against me or the facility licensee.
4 ES-201 Examination Security Agreement Form ES-201-3
examiner any indications or suggestions that examination security     may have   been compromised.
: 1.
: 2.       Post-Examination concerning the NRC licensing examinations administered M To the best of my knowledge, I did not divulge to any unauthorized persons any information                     until the completion of examination administration, I did
Pre-Examination I acknowledge that I h ve acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of i; 02 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who ave not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback).
                                      -iM . From the date that     I entered into this security agreement N during the week(s) of I /                                                                                                licensing examinations, except as specifically C not instruct, evaluate, or pro ide performance feedback to those applicants who were administered these noted below and authorized by the NRC.
Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC's chief examiner any indications or suggestions that examination security may have been compromised.
SIGNATURE (1)                     DATE       SIGNATURE (2)           DATE     NOTE PRINTED NAME                JOB TITLE/RESPONSIBILITY w2.
: 2.
Post-Examination M To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of I /
-iM From the date that I entered into this security agreement until the completion of examination administration, I did C
not instruct, evaluate, or pro ide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.
PRINTED NAME JOB TITLE/RESPONSIBILITY SIGNATURE (1)
DATE SIGNATURE (2)
DATE NOTE w2.
3.
3.
4.
4.
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Latest revision as of 09:35, 16 December 2024

2020 Fermi Retake Examination Form ES-201-3
ML20070J452
Person / Time
Site: Fermi 
Issue date: 02/27/2020
From: Chuck Zoia
NRC/RGN-III/DRS/OLB
To:
DTE Energy, Detroit Edison, Co
Zoia C
Shared Package
ML19303A625 List:
References
Download: ML20070J452 (2)
v • d • e


Text

ILO j19 -

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

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of I

7 /

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

2.

Post-Examination M To the best of my knowled e, I id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of

/

-7 From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE/RESPONSIBILITY SIGNATURE (1)

DATE SIGNATURE (2)

DATE NOTE

4.

-0, N___Iee z

5.

12-5-PJ V

12.

£T00-'

A-_______________L____

13.

j~eN-/\\

Le&c LhJ 3 U

&J6\\rr NOTES:

1

~~~ES-201, Page 31 of 32

/ /

~

+-

ILO

. 19 °-

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

1.

Pre-Examination I acknowledge that I h ve acquired specialized knowledge about the U.S. Nuclear Regulatory Commission (NRC) licensing examinations scheduled for the week(s) of i; 02 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who ave not been authorized by the NRC's chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback).

Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC's chief examiner any indications or suggestions that examination security may have been compromised.

2.

Post-Examination M To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered N during the week(s) of I /

-iM From the date that I entered into this security agreement until the completion of examination administration, I did C

not instruct, evaluate, or pro ide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE/RESPONSIBILITY SIGNATURE (1)

DATE SIGNATURE (2)

DATE NOTE w2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

NOTES:

ES-201, Page 31 of 32

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