ML20057C818

Single Positive Test Form Collected on 02/06/2019

ML20057C818
Person / Time
Site:	Palisades
Issue date:	02/24/2020
From:	Summers S Entergy Nuclear Operations
To:	Office of Nuclear Security and Incident Response
Shared Package
ML20057C816	List: ML20057C817 ML20057C818 ML20057C819 ML20057C822 ML20057C824 ML20057C826 ML20057C828 ML20057C829
References
PAL-2019-02
Download: ML20057C818 (1)

Text

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FFD Program Performance Data Repori*t'g System

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NRC For*n 890 S1'lg e Pos '1ve Tesr For "'

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1) All fittlds required except those marlced *optionar

2) Entries In some fields auto-populate lnfonnation in other fields JJ Mouse over form fields to view additional Information 4} Use of Adobe Ruder a or later ls requfred D

Submission Update Uni ue Reference ID Licensee Su lied PAL-2019-02 Facility

!Palisades (50-255}

APPROVED BY 0MB: CLEARANCE NO. 3150-014' EXPIRES: 04/30/2021 Eslimated burden per response to compty 'Mth this colection request is 30 ninutes. This form Is a votunta,y means oheporting the informalion required under 10 CFR 2fi.417(b)(2) and 26.717 The information is required by NRC to obtain on an annual basis site specific fitness-for-duly (FFO) program performance data on drug and alcohol programs from licensees and other entities Send comments regarding burden estimate lo the FOIA Privacy and Information Collection Bfanch (T5-F53). U.S. Nuclear Regulatory Comrrission, Washington DC 20555-0001, or by e-mail to ~

Rs&9:urcc@NRC goy and to the Desk Officer, Office of Information and Regulatory Affairs. NEOB-1020. (31SO-OU6). Office of Management and Budget, Washington DC 20503 If a means used to impose infonnation collection does not d"isplay a currently va6d 0MB control number. the NRC may not conduct or sponsor, and a perun is not reqwred to respond to, the infonnation collection Date of Collect/on I 02/06/2019 j (mm/ddlyyyy)

Reason for Testing

• 26. 717(b)(5)

IPr~Access Pre-Access Testing Reason (optional)

Please elaborate (optional)

Employment Type 717(b)(3)

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

!security j 1nitial Authorization Outage Worker (optional)?

jNo Is this a 24-hour reportable event unoor 26.719(b)? ~

Was this collection refused? - 26.717(b)(7) & 26 75 ~

Test Results

• 26 717(b)(4)

Test Type(s) for Result(s) Reported - 26.717(b)(2)

!Alcohol Only ENTERGY NEW HIRE FOR SECURITY.

Substance

• 26.717(b)(2) & (b)(6)

Alcohol Specimen Tested

!Breath

'Mtat 26.103 BAC level was exceeded?

jo.04 or greater Subversion Attempt-Oid th,s co\\lect,on involve a subversion attempt? - 26.717(b)(7) and 26.75(b) l~ __ N_o _

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Management Actions - 26.717(b)(8) & 26.75 Reason fo, the Action I

First drug o, alcohol posftive Sanction Applied (NRC Minimum o, Licensee Administrated) lucensee Administrated Specific Sanction Applied j1-Year Denial Person(s) Responsible for Information Provided Person 1 (required):

Lls_co_n __ ~~-:7'------'l lsummers I

IAA/FFO SupeMSor I ssumme1@enlergy.com First Name

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Company Ema1I Address Person 2 (optional):

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Firs, Name Last Name Position Title Company Email Address Final Step (Required)* NRC will consider lhis form authentic in accordancewilh 10 CFR 26.11 only when lhe Vatidate & Lock* button is clicked and all errors (highlighted in red) have been corrected. The Vahdate & Lock* button will change to *Locked* after the data validation process has been successfully com~eted Indicating the form is ready for submission Form Locked an,!Feb 24. 2020 at 3:34:44 PM Smgle Pos1bve Test Fann (version 1 8.0 -April 2018)

I Save to Local PC 11 Print this Report I NRC Fann 890 (12/2014)