ML14162A327

Single Positive Test Form Collected on 02/10/2014

ML14162A327
Person / Time
Site:	Seabrook
Issue date:	06/11/2014
From:	NextEra Energy Seabrook
To:	Document Control Desk, Office of Nuclear Security and Incident Response
Paul Harris - 287-9294
References
Download: ML14162A327 (1)

Text

Select Facility Seabrook [50-443]

Reason for Testing - 26.717(b)(5)

Pre-Access Pre-Access Testing Reason (optional)

Initial Authorization Please elaborate (optional)

Employment Type - 26.717(b)(3)

Contractor/Vendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?

Test Results - 26.717(b)(4)

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

Drug Only Drug Testing Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.75 Marijuana Substance - 26.717(b)(2) & (b)(6)Additional Substance (as applicable)Additional Substance (as applicable)

Please Select Please Select Use NRC Cutoff (Yes / No)?

Yes Management Actions

- 26.717(b)(8) & 26.75 Specific Sanction Applied 5- Year Denial Save to Local PC Print this Report Unique Reference Number (Licensee Supplied) 991141E Note: 1) All fields are required except those marked 'optional'.

2) Entries in some form fields may result in information being auto-populated into other form fields.

3) Use Adobe Reader 8 or later for this form to work properly.

4) Hold your mouse over a form field to view additional information.

Is this a 24-Hour Reporting Event (Yes/No)? - 26.719(b)No No No Date of Collection (mm/dd/yyyy) 02/10/2014 Submission Update Person(s) Responsible for Information Provided Company Email Address stella.dumais@fpl.com First Name Stella Position Title A ccess/Fitness For Duty Supv Position Title A A/FFD Program Manager First Name David Last Name Bonthron Last Name Dumais Company Email Address david.bonthron@fpl.com Person 1 (required):

Person 2 (optional):

Single Positive Test Form (version 1.5.0 - January 1, 2014)

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 (i.e., those highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data valid ation process has been successfully completed and the form is ready for submission.

LockedForm Locked On:Jun 11, 2014 at 8:42:19 AM Reason for the Action First drug or alcohol positive Did this collection involve a subversion attempt (Yes/No)?

No Subversion Attempts

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

Sanction Applied (NRC Minimum or Licensee Administrated)

Licensee Administrated Delete Submission FFD Program Performance Data Reporting System Single Positive Test Form (EIE General Submission Portal)