ML14010A064

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Hope Creek - Final Qa/Related Forms (Folder 1)
ML14010A064
Person / Time
Site: Hope Creek PSEG icon.png
Issue date: 09/09/2013
From: Fish T H
Operations Branch I
To:
Public Service Enterprise Group
Jackson D E
Shared Package
ML13077A118 List:
References
TAC U01872
Download: ML14010A064 (12)
v • d • e


Text

ES-201 Examination Preparation Checklist Form ES-201-1 Facility:

Date of Examination:

9 Developed by: Written -Facility D NRC 1:/J. II Operating

-Facility 0 NRC¢ Target Chief Date* Task Description (Reference)

Examiner's Initials -180 1. Examination administration date confirmed (C.1.a; C.2.a and b) -rr--120 2. NRC examiners and facility contact assigned (C.1.d; C.2.e) -120 3. Facility contact briefed on security and other requirements (C.2.c) -(f' -120 4. Corporate notification letter sent (C.2.d) Tf [-90] [5. Reference material due (C.1.e; C.3.c; Attachment 2)] << {-75} 6. Integrated examination outline(s) due, including Forms ES-201-2, ES-201-3, ES-301-1, ES-301-2, ES-301-5, ES-D-1's, ES-401-1/2, ES-401-3, and Nf':\ ES-401-4, as applicable (C.1.e and f; C.3.d) {-70} {7. Examination outline(s}

reviewed by NRC and feedback provided to facility (\1'1\-licensee (C.2.h; C.3.e)} {-45} 8. Proposed examinations (including written, walk-through JPMs, and scenarios, as applicable), supporting documentation (including Forms Nl\ ES-301-3, ES-301-4, ES-301-5, ES-301-6, and ES-401-6, and any Form ES-201-3 updates), and reference materials due (C.1.e, f, g and h; C.3.d) -30 9. Preliminary license applications (NRC Form 398's) due (C.1.1; C.2.g; ff ES-202) -14 10. Final license applications due and Form ES-201-4 prepared (C.1.1; C.2.i; Tf ES-202) -14 11. Examination approved by NRC supervisor for facility licensee review IF (C.2.h; C.3.f) -14 12. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g) 1P -7 13. Written examinations and operating tests approved by NRC supervisor tf (C.2.i; C.3.h) -7 14. Final applications reviewed; 1 or 2 (if >10) applications audited to confirm Tf qualifications I eligibility; and examination approval and waiver letters sent (C.2.i; Attachment 4; ES-202, C.2.e; ES-204) -7 15. Proctoring/written exam administration guidelines reviewed -rP with facility licensee (C.3.k) -7 16. Approved scenarios, job performance measures, and questions tf distributed to NRC examiners (C.3.i)

  • Target dates are generally based on facility-prepared examinations and are keyed to the examination date identified in the corporate notification letter. They are for planning purposes and may be adjusted on a case-by-case basis in coordination with the facility licensee, [Applies only] {Does not apply} to examinations prepared by the NRC. ES-201, Page 24 of 27 ES-201 Examination Outline Quality Checklist Form ES-201-2 Facility:

Hope Creek Date of Examination:

8/19/2013-8/23/13 Initials Item Task Description a b* c# 1. a. Verify that the outline(s) fit(s) the appropriate model, in accordance with ES-401. a N/A (f w R b. Assess whether the outline was systematically and randomly prepared in accordance with N/A If"" I Section D.1 of ES-401 and whether all KIA categories are appropriately sampled. T rl N/A [f T c. Assess whether the outline over-emphasizes any systems, evolutions, or generic topics. E N/A rF N d. Assess whether the justifications for deselected or rejected KIA statements are appropriate.

2. Using Form ES-301-5, verify that the proposed scenario sets cover the required number N/A a. of normal evolutions, instrument and component failures, technical specifications, Tf" s and major transients.

I N/A M b. Assess whether there are enough scenario sets (and spares) to test the projected number u and mix of applicants in accordance with the expected crew composition and rotation schedule rr-L without compromising exam integrity, and ensure that each applicant can be tested using A at least one new or significantly modified scenario, that no scenarios are duplicated T from the applicants' audit test(s), and that scenarios will not be repeated on subsequent days. 0 To the extent possible, assess whether the outline(s) conform(s) with the qualitative N/A ff R c. and quantitative criteria specified on Form ES-301-4 and described in Appendix D. 3. a. Verify that the systems walk-through outline meets the criteria specified on Form ES-301-2:

N/A (1) the outline(s) contain(s) the required number of control room and in-plant tasks w distributed among the safety functions as specified on the form T\= I (2) task repetition from the last two NRC examinations is within the limits specified on the form T (3) no tasks are duplicated from the applicants' audit test(s) (4) the number of new or modified tasks meets or exceeds the minimums specified on the form (5) the number of alternate path, low-power, emergency, and RCA tasks meet the criteria on the form. b. Verify that the administrative outline meets the criteria specified on Form ES-301-1:

N/A (1) the tasks are distributed among the topics as specified on the form tr (2) at least one task is new or significantly modified (3) no more than one task is repeated from the last two NRC licensing examinations Determine if there are enough different outlines to test the projected number and mix N/A w c. of applicants and ensure that no items are duplicated on subsequent days. 4. Assess whether plant-specific priorities (including PRA and IPE insights) are covered N/A a. lt in the appropriate exam sections.

G N/A E b. Assess whether the 10 CFR 55.41/43 and 55.45 sampling is appropriate.

N Ensure that KIA importance ratings (except for plant-specific priorities) are at least 2.5. N/A \F E c. R d. Check for duplication and overlap among exam sections.

ItA N/A (\-A & 1\.:::: L Check the entire exam for balance of coverage.

N/A e. f. Assess whether the exam fits the appropriate job level (RO or SRO). N/A lf"" a. Author {]£?J ___ Printed Name/Signature rr.:te e.c{SJS b. Facility Reviewer(*)

c. NRC Chief Examiner (#) d. NRC Supervisor Note: # Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required. . Not applicable for NRC-prepared examination outlines

(\j (Cc_ I (+U D I T (1 f>1r>r-I o r-2-.

l LOT ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination 31JL'( I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of A 'VCr A.c \.-Sas of the date of my signature.

I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner.

I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback).

Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee.

I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of

':Lo !3:, From the date that I entered into this security agreement until the completion of examination administration, I rlid not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC. PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE 1 .

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ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of July & August 2013, as of the date of my signature.

I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner.

I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback).

Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee.

I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of July and August 2013 . From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC. PRINTED NAME JOB TITLE I RESPONSIBILITY
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<l/2.._,7, '"!:. fJzdts ES-301 Operating Test Quality Checklist Form ES-301-3 Facility:

Hope Creek Date of Examination:

8/19/13 Operating Test Number: 1 Initials 1. General Criteria a b* c# a. The operating test conforms with the previously approved outline; changes are consistent with G. N/A 1f sampling requirements (e.g., 10 CFR 55.45, operational importance, safety function distribution).

b. There is no day-to-day repetition between this and other operating tests to be administered 0... N/A \f during this examination.
c. The operating test shall not duplicate items from the applicants' audit test(s). (see Section D.1.a.) (;._ N/A 1f d. Overlap with the written examination and between different parts of the operating test is within N/A acceptable limits. e. It appears that the operating test will differentiate between competent and less-than-competent c"v N/A -zf' applicants at the designated license level. 2. Walk-Through Criteria ------a. Each JPM includes the following, as applicable: N/A . initial conditions

\Y . initiating cues . references and tools, including associated procedures . reasonable and validated time limits (average time allowed for completion) and specific designation if deemed to be time-critical by the facility licensee . operationally important specific performance criteria that include: -detailed expected actions with exact criteria and nomenclature

-system response and other examiner cues -statements describing important observations to be made by the applicant

-criteria for successful completion of the task -identification of critical steps and their associated performance standards

-restrictions on the sequence of steps, if applicable

b. Ensure that any changes from the previously approved systems and administrative walk-through N/A outlines (Forms ES-301-1 and 2) have not caused the test to deviate from any of the acceptance -rr criteria (e.g., item distribution, bank use, repetition from the last 2 NRC examinations) specified on those forms and Form ES-201-2.
3. Simulator Criteria ------The associated simulator operating tests (scenario sets) have been reviewed in accordance with N/A (f Form ES-301-4 and a copy is attached.
a. Author .

(_ H{219Dp.ji:Ja ab2ks Date b. Facility Reviewer(*)

__ N/A __ c. NRC Chief Examiner (#) ej_; 1-J_l:t 8'

d. NRC Supervisor NOTE: . The facility signature is not applicable for NRC-developed tests . # Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Facilty: Hope Creek Date of Exam: 8/19/13 Scenario Numbers: 1 /2/ 3 Operating Test No.: 1 QUALITATIVE ATTRIBUTES Initials a b* c# 1. The initial conditions are realistic, in that some equipment and/or instrumentation may be out (l, N/A of service, but it does not cue the operators into expected events. 2. The scenarios consist mostly of related events. a,_ N/A -(f 3. Each event description consists of N/A

  • the point in the scenario when it is to be initiated
  • the malfunction(s) that are entered to initiate the event
  • the symptoms/cues that will be visible to the crew
  • the expected operator actions (by shift position)
  • the event termination point (if applicable)
4. No more than one non-mechanistic failure (e.g., pipe break) is incorporated into the scenario Ct., N/A -c<& without a credible preceding incident such as a seismic event. 5. The events are valid with regard to physics and thermodynamics. (A, N/A 6. Sequencing and timing of events is reasonable, and allows the examination team to obtain &. N/A complete evaluation results commensurate with the scenario objectives.
7. If time compression techniques are used, the scenario summary clearly so indicates.

fA N/A Operators have sufficient time to carry out expected activities without undue time constraints. Cues are given. 8. The simulator modeling is not altered. ltl N/A 9. The scenarios have been validated.

Pursuant to 10 CFR 55.46(d), any open simulator

()_ N/A (f: performance deficiencies or deviations from the referenced plant have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

10. Every operator will be evaluated using at least one new or significantly modified scenario.

{A N/A All other scenarios have been altered in accordance with Section 0.5 of ES-301. 11. All individual operator competencies can be evaluated, as verified using Form ES-301-6 t.. N/A (submit the form along with the simulator scenarios).

12. Each applicant will be significantly involved in the minimum number of transients and events (). N/A specified on Form ES-301-5 (submit the form with the simulator scenarios).
13. The level of difficulty is appropriate to support licensing decisions for each crew position.

lA N/A Target Quantitative Attributes (Per Scenario; See Section D.S.d) Actual Attributes ------1. Total malfunctions (5-8) 71 7/8 &._ N/A 2. Malfunctions after EOP entry (1-2) 3/ 2/2 a,. N/A IU: 3. Abnormal events (2-4) 4/ 3 /4 Ot N/A 4. Major transients (1-2) 1/ 1 /1 e., N/A 5. EOPs entered/requiring substantive actions (1-2) 1/ 1 /1 (]<. N/A C(= 6. EOP contingencies requiring substantive actions (0-2) Of 1 /0 th. N/A -(f 7. Critical tasks (2-3) 2/ 3 /3 t1-, N/A 1-rf ES-301 Transient and Event Checklist Form ES-301-5 Facility:

Hope Creek Date of Exam: 8/19/13 Operating Test No.: 1 A E Scenarios p v 1 2 3 N/A T M p E 0 I L N CREW CREW CREW CREW T N I T POSITION POSITION POSITION POSITION A I c M s A B s A B s A B s A B L u A T R T 0 R T 0 R T 0 R T 0 M(*) N y 0 c p 0 c p 0 c p 0 c p T p R I u E RX 0 1 1 1 0 NOR 1 0 1 1 1 R0-1 1/C 3 4 4 4 2 MAJ 2 1 2 2 1 TS 0 0 0 2 2 RX 0 1 1 1 0 NOR 1 0 1 1 1 R0-2 1/C 3 4 4 4 2 MAJ 2 1 2 2 1 TS 0 0 0 2 2 RX 0 1 1 1 0 NOR 1 0 1 1 1 R0-3 1/C 3 4 4 4 2 MAJ 2 1 2 2 1 TS 0 0 0 2 2 RX 1 0 1 1 0 NOR 0 1 1 1 1 SR0-11 1/C 4 3 4 4 2 MAJ 2 1 2 2 1 TS 0 0 0 2 2 Instructions:

1. Check the applicant level and enter the operating test number and Form ES-D-1 event numbers for each event type; TS are not applicable for RO applicants.

ROs must serve in both the "at-the-controls (ATC)" and "balance-of-plant (BOP)" positions; Instant SROs must serve in both the SRO and the ATC positions, including at least two instrument or component (1/C) malfunctions and one major transient, in the ATC position.

If an Instant SRO additionally serves in the BOP position, one 1/C malfunction can be credited toward the two 1/C malfunctions required for the ATC position.

2. Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.5.d} but must be significant per Section C.2.a of Appendix D. (*)Reactivity and normal evolutions may be replaced with additional instrument or component malfunctions on a 1-for-1 basis. 3. Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirements specified for the applicant's license level in the right-hand columns.

ES-301 Transient and Event Checklist Form ES-301-5 Facility:

Hope Creek Date of Exam: 8/19/13 Operating Test No.: 1 A E Scenarios p v 1 2 3 N/A T M p E 0 I L N CREW CREW CREW CREW T N I T POSITION POSITION POSITION POSITION A I c M s A B s A B s A B s A B L u A T R T 0 R T 0 R T 0 R T 0 M(*) N y 0 c p 0 c p 0 c p 0 c p T p R I u E RX 1 0 1 1 1 0 NOR 0 1 1 1 1 1 SR0-12 1/C 4 3 7 4 4 2 MAJ 2 1 3 2 2 1 TS 0 0 0 0 2 2 RX 1 0 1 1 1 0 NOR 0 1 1 1 1 1 SR0-13 1/C 4 3 7 4 4 2 MAJ 2 1 3 2 2 1 TS 0 0 0 0 2 2 RX 1 1 2 1 1 0 NOR 1 0 1 1 1 1 SRO-U 1 1/C 7 2 9 4 4 2 MAJ 2 1 3 2 2 1 TS 2 0 2 0 2 2 Instructions:

3. Check the applicant level and enter the operating test number and Form ES-D-1 event numbers for each event type; TS are not applicable for RO applicants.

ROs must serve in both the "at-the-controls (ATC)" and "balance-of-plant (BOP)" positions; Instant SROs must serve in both the SRO and the ATC positions, including at least two instrument or component (1/C) malfunctions and one major transient, in the ATC position.

If an Instant SRO additionally serves in the BOP position, one 1/C malfunction can be credited toward the two 1/C malfunctions required for the ATC position.

4. Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.S.d) but must be significant per Section C.2.a of Appendix D. (*)Reactivity and normal evolutions may be replaced with additional instrument or component malfunctions on a 1-for-1 basis. 3. Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirements specified for the applicant's license level in the right-hand columns.

ES-301 Competencies Checklist Form ES-301-6 Facility:

Hope Creek Date of Examination:

8/19/13 Operating Test No.: 1 APPLICANTS (SRO) (ATC) (BOP) RO 0 RO X RO X RO D SR0-1 X SR0-1 X SR0-1 D SR0-1 D SRO-U X SRO-U D SRO-U D SRO-U D Competencies SCENARIO SCENARIO SCENARIO SCENARIO 1 2 3 1 2 3 1 2 3 Interpret/Diagnose 2-8 3-9 2-3,4,5 2,4-2,4, 1-8 1,3-3-Events and Conditions 10 ,8 8 6,8, 6,8-7,9-10 9 10 Comply With and 2-5 3-9 2-3,4,5 2,4-2,4, 1-8 1,3-3-Use Procedures (1) 10 ,8 8 6,8, 6,8-7,9-10 9 10 Operate Control N/A N/A N/A 3,4,5 2,4-2,4, 1-8 1,3-3-Boards (2) ,8 8 6,8, 6,8-7,9-10 9 10 Communicate 1-8 1-9 1-3,4,5 2-9 2-1-8 1-9 2-and Interact 10 6,7,8 10 10 Demonstrate 1-8 1-9 1-N/A N/A N/A N/A N/A N/A Supervisory Ability (3) 10 Comply With and 2,3 3,4 2,4, N/A N/A N/A N/A N/A N/A Use Tech. Specs. (3) 5 Notes: ( 1) Includes Technical Specification compliance for an RO. (2) Optional for an SRO-U. (3) Only applicable to SROs. Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-401 Written Examination Quality Checklist Facility:

Hope Creek Date of Exam: 8/19/13 Exam Level: RO X SRO D Item Description

1. Questions and answers are technically accurate and applicable to the facility.
2. a. b. NRC KJAs are referenced for all questions.

Facility learning objectives are referenced as available.

3. SRO questions are appropriate in accordance with Section D.2.d of ES-401 4. The sampling process was random and systematic (If more than 4 RO or 2 SRO questions were repeated from the last 2 NRC licensing exams, consult the NRR OL program office). 5. Question duplication from the license screening/audit exam was controUed
6. 7. 8. 9. 10. 11. a. Author as indicated below (check the item that applies) and appears appropriate:

_the audit exam was systematically and randomly developed; or _the audit exam was completed before the license exam was started; or x_ the examinations were developed independently; or _ the licensee certifies that there is no duplication; or _other (explain)

Bank use meets limits (no more than 75 percent from the bank, at least 10 percent new, and the rest new or modified);

enter the actual RO I SRO-only Bank Modified question distribution(s) at right. Between 50 and 60 percent of the questions on the RO exam are written at the comprehension/

analysis level; the SRO exam may exceed 60 percent if the randomly selected KJAs support the higher cognitive levels; enter the actual RO I SRO question distribution(s) at riqht. References/handouts provided do not give away answers or aid in the elimination of distractors.

51 6 Memory 31 Question content conforms with specific KJA statements in the previously approved examination outline and is appropriate for the tier to which they are assigned; deviations are justified.

Question psychometric quality and format meet the guidelines in ES Appendix B. The exam contains the required number of one-point, multiple choice items; the total is correct and aqrees with the value on the cover sheet. b. Facility Reviewer(*)

c. NRC Chief Examiner(#)
d. NRC Regional Supervisor New 18 C/A 44 Note:
  • The facility reviewer's initials/signature are not applicable for NRC-developed examinations.
  1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

Form ES-401-6 Initial a b* c# r-1 N/A If ()_ N/A

  • N/A N/A N/A v -rr:: N/A ( (f N/A N/A {f N/A N/A N/A '(f N/A Date 13/tl/'lt;;g.

ffff ES-401 Written Examination Quality Checklist Form ES-401-6 Facility:

Hope Creek Date of Exam: 8/19/13 Exam Level: RO D SROX Initial Item Description a b* c# 1. Questions and answers are technically accurate and applicable to the facility. N/A '(f' 2. a. NRC K/As are referenced for all questions.

t-N/A \:t b. Facility learning objectives are referenced as available.

3. SRO questions are appropriate in accordance with Section D.2.d of ES-401 N/A 4. The sampling process was random and systematic (If more than 4 RO or 2 SRO questions Cy \f were repeated from the last 2 NRC licensing exams, consult the NRR OL program office). 5. Question duplication from the license screening/audit exam was controlled N/A as indicated below (check the item that applies) and appears appropriate:

\f _the audit exam was systematically and randomly developed; or _the audit exam was completed before the license exam was started; or x._ the examinations were developed independently; or _the licensee certifies that there is no duplication; or _other (explain)

6. Bank use meets limits (no more than 75 percent Bank Modified New t N/A from the bank, at least 1 0 percent new, and the rest \r new or modified);

enter the actual RO I SRO-only 15 3 7 question distribution(s) at riqht. 7. Between 50 and 60 percent of the questions on the RO Memory CIA N/A '{f exam are written at the comprehension/

analysis level; the SRO exam may exceed 60 percent if the randomly 4 21 selected K/As support the higher cognitive levels; enter the actual RO I SRO question distribution(s) at right. 8. References/handouts provided do not give away answers N/A \f or aid in the elimination of distractors.

9. Question content conforms with specific KIA statements in the previously approved ()._ N/A \'f examination outline and is appropriate for the tier to which they are assigned; deviations are justified.
10. Question psychometric quality and format meet the guidelines in ES Appendix B. (/L N/A \Y 11. The exam contains the required number of one-point, multiple choice items; ()v N/A {( the total is correct and agrees with the value on the cover sheet. *
  • Printed Date a. Author --*

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jJ f.\.VPo* I b. Facility Reviewer(*)

ft c. NRC Chief Examiner(#)

d. NRC Regional Supervisor I Note:
  • The facility reviewer's initials/signature are not applicable for NRC-developed examinations.
  1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

ES-403 Written Examination Grading Quality Checklist Form ES-403-1 Facility:

l:+oP£ C..t't<i-k.

Date of Exam: '8' *'2..? Exam Level: Rqxj SROIX'i Initials Item Description a b c 1. Clean answer sheets copied before grading J/4-If' 2. Answer key changes and question deletions justified 1t1 Tf and documented s.J) 3. Applicants' scores checked for addition errors 11¥1 -rF (reviewers spot check> 25% of examinations) .S:.D 4. Grading for all borderline cases (80 +/-2% overall and 70 or 80, Tf as applicable, +/-4% on the SRO-only) reviewed in detail 5. All other failing examinations checked to ensure that grades 1/A (f are justified s.c 6. Performance on missed questions checked for training TF-deficiencies and wording problems; evaluate validity of questions missed by half or more of the applicants

>f) Printed Name/Signature Date a. Grader L ... 8*l..Clt*l3 ThoMAS *?* b. Facility Reviewer(*)

'i*N iJ-CJ. s -f'3 c. NRC Chief Examiner(*)

TotJ'O flS H f.,j o-J..d -;-.Ahl 'llb/ws , li1iJu . d ..) d. NRC Supervisor(*)

D:mea.lcl E. ,Ja 1/-U !/ ...........

(*) The facility reviewer's signature is not applicable for examinations graded by the NRC; two independent NRC reviews are required.

ES-403, Page 6 of 6

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