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Category:License-Fitness for Duty (FFD) Performance Report
MONTHYEARML23055B0462023-02-24024 February 2023 Annual Fitness for Duty Performance Data Report and Fatigue Management Program Data Report ML23055B0392023-02-24024 February 2023 Single Positive Test Form Collected on 07/19/2022 ML23055B0442023-02-24024 February 2023 Annual Report Form for Drug and Alcohol Tests for 2022 ML23055B0402023-02-24024 February 2023 Single Positive Test Form Collected on 08/17/2022 ML23055B0422023-02-24024 February 2023 Single Positive Test Form Collected on 3/21/2022 ML23055B0432023-02-24024 February 2023 Single Positive Test Form Collected on 1/24/2022 ML23055B0352023-02-24024 February 2023 Single Positive Test Form Collected on 01/18/2022 ML23055B0452023-02-24024 February 2023 Annual Fatigue Report Form for 2022 ML23055B0372023-02-24024 February 2023 Single Positive Test Form Collected on 04/11/2022 ML23055B0382023-02-24024 February 2023 Single Positive Test Form Collected on 06/1/2022 ML23055B0362023-02-24024 February 2023 Single Positive Test Form Collected on 03/24/2022 ML23055B0472023-02-24024 February 2023 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report Per 10 CFR 26.717(e) ML23055B0412023-02-24024 February 2023 Single Positive Test Form Collected on 11/9/2022 ML22056A2122022-02-28028 February 2022 Annual Fatigue Reporting Form for 2021 ML22056A2012022-02-25025 February 2022 Submittal of 2021 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report ML22056A2092022-02-23023 February 2022 Single Positive Test Form Collected on 02/24/2021 ML22056A2032022-02-23023 February 2022 Single Positive Test Form Collected on 03/02/2021 ML22056A2112022-02-23023 February 2022 Annual Reporting Form for Drug and Alcohol Tests for 2021 ML22056A2102022-02-23023 February 2022 Single Positive Test Form Collected on 08/31/2021 ML22056A2082022-02-23023 February 2022 Single Positive Test Form Collected on 10/26/2021 ML22056A2072022-02-23023 February 2022 Single Positive Test Form Collected on 12/14/2021 ML22056A2062022-02-23023 February 2022 Single Positive Test Form Collected on 10/28/2021 ML22056A2042022-02-23023 February 2022 Single Positive Test Form Collected on 05/12/2021 ML22056A2052022-02-23023 February 2022 Single Positive Test Form Collected on 08/16/2021 ML22056A2022022-02-23023 February 2022 Single Positive Test Form Collected on 04/05/2021 ML21049A0182021-02-18018 February 2021 Annual Fatigue Report Form for 2020 ML21049A0162021-02-18018 February 2021 Single Positive Test Form Collected on 10/26/2020 ML21049A0102021-02-18018 February 2021 Annual Report Form for Drug and Alcohol Tests for 2020 ML21049A0112021-02-18018 February 2021 Single Positive Test Form Collected on 04/20/2020 ML21049A0122021-02-18018 February 2021 Single Positive Test Form Collected on 05/13/2020 ML21049A0132021-02-18018 February 2021 Single Positive Test Form Collected on 05/13/2020 ML21049A0142021-02-18018 February 2021 Single Positive Test Form Collected on 05/27/2020 ML21049A0172021-02-18018 February 2021 Single Positive Test Form Collected on 11/16/2020 ML21049A0152021-02-18018 February 2021 Single Positive Test Form Collected on 07/14/2020 NL-21-010, Submittal of 2020 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report2021-02-17017 February 2021 Submittal of 2020 Annual Fitness for Duty Program Performance Data Report and Fatigue Management Program Data Report NL-20-052, Unsatisfactory 10 CFR 26 Fitness-For-Duty Blind Performance Testing Results2020-07-0707 July 2020 Unsatisfactory 10 CFR 26 Fitness-For-Duty Blind Performance Testing Results ML20057F4242020-02-26026 February 2020 Single Positive Test Form Collected on 3/12/2019 NL-20-020, Submittal of 2019 Annual Fitness for Duty Performance Data Report Update2020-02-26026 February 2020 Submittal of 2019 Annual Fitness for Duty Performance Data Report Update ML20042B6152020-02-11011 February 2020 Single Positive Test Form Collected on 4/24/2019 ML20042B6122020-02-11011 February 2020 Single Positive Test Form Collected on 3/8/2019 ML20042B6072020-02-11011 February 2020 Annual Report Form for Drug and Alcohol Tests for 2019 ML20042B6102020-02-11011 February 2020 Single Positive Test Form Collected on 3/8/2019 ML20042B6222020-02-11011 February 2020 Single Positive Test Form Collected on 9/9/2019 ML20042B6182020-02-11011 February 2020 Single Positive Test Form Collected on 8/12/2019 ML20042B6212020-02-11011 February 2020 Single Positive Test Form Collected on 3/12/2019 ML20042B6202020-02-11011 February 2020 Single Positive Test Form Collected on 09/23/2019 ML20042B6162020-02-11011 February 2020 Single Positive Test Form Collected on 7/8/2019 ML20042B6132020-02-11011 February 2020 Single Positive Test Form Collected on 03/13/2019 ML20042B6242020-02-11011 February 2020 Annual Fatigue Report Form for 2019 ML20042B6082020-02-11011 February 2020 Single Positive Test Form Collected on 01/08/2019 2023-02-24
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, l U.S.NRC \ FFD Program Performance Data Reporting System ' '-' NRC Form 890. Single Pos1t1ve Test Form l, 1, " '" " ,, ' l'r,,lt'I flll}: />c*oplc mu/ tltr I tu ,r""""' 111 1 E.11::_ C,eneral Submission Portal 1 1) All fields required except those marlutd 'optional' APPROVED BY 0MB: CLEAR A NCE NO. 3150-0146 EXPIRES: 11/3 0/2017 2) Entries in some fields auto-populate Information in other fields Estimated burden per response to comply with this collection request is 30 minutes. Th is 3) Mouse over fonn fields to view additional Information form is a voluntary means of reporting the information required under 10 CFR 26.717. The 4) Use of Adobe Reader 8 or l ater Is required information is required b y NRC to obtain on an annual basis site specific fitness-fo r-duty (F FO) program performance d a t a on drug and alcohol programs from licensees a nd other D Submission D ~~~e~~ssion entities. Send comments regarding burden estimate to the FOlA, Privacy and I nformation Update Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission , Washington DC 20555-0001, or by e-mail to l ofocollects R esou r ce@NB C g ov. and to the Desk Officer , Unique Reference ID (License Suoolied)
Office of Information and Regulat ory Affairs , NEOB-1 020 , (3150-01 4 6), O ffi ce of Management and Budget , Washington DC 20503. lf a means used to impose information IIPEC 2017-003 I collection does not display a currently valid 0MB control number , the NRC may not conduct or sponsor , and a pe r so n is not r equired to respond to, the information collectio n. Select Fac/1/ty I Indian Point (50-247; 50-286) I Date of Collec t/on I 02127 1 2017 I (mm/dd/yyyy)
Reason for Testing-26.717(b)(5)
Pre-Access Tes t ing Reason (optiona l) Please elaborate (optional)
I Pre-Access I I Initial Aut h orization I I I Employment Type -26.717(b)(3)
Outage Work e r (optional)?
ICo ntr actorNendor I Jves I Labor Category-26.717(b)(3)
I Maintenance (genera l facili t y) I Is this a 24-hour reporting event? -26. 719(b) Was this coll e ction refused? -26 717(b)(7)
& 26.75 T e st Results -26.717(b)(4) Test Type(s) for Result(s)
Reported -26.717(b)(2)
Drug Specimen Tested I Drug Only I I Urine I Test Validity l valid I Was this coll e ction observed?-26.717(b)(7)
& 26.75 How many substances were confi rm ed positive for this individua l? I 1 I Substance-26.717(b)(2)
& (b)(6) UseNRC Initial Confirmatory lim it of Cutoffs? Cutoff Cutoff Detection
!Marijuana I IGJ Subversion Attempt* Did this collection involve a subversion attempt?-26.717(b)(7) and 26.75(b) I No I Management Actions -26.7 1 7(b)(8) & 26.75 Reason fo r the Action I Fi r st drug or alcohol positive I Sanction App li ed (NRC Min i mum or Licensee Administrated) jLicensee Ad min istrated I Specific Sanction Applied 13-Yea r Denial I P e r s on(s) Responsible for Informat i on Pro vi ded P e r son 1 (required)
- I Kelly I !Pettus I lsr. Security Coordinator , Access/FFD I kpettus@entergy.com First Name L as t Name Position Title Com pan y Email Address Person 2 (optiona l): !Wayne I !Griffin I I su p erv isor , Access/FFD I wgriff1@entergy
.com F irst Name Last Name Position Title Company Email Address F i nal Step (R e qu ire d)* NRC will consider this form authentic in accordance with 1 O CFR 26.11 only when the -Validate
& Lock* button is clicked and al1 errors (highlighted in red) have been co rr ected. The "Validate
& L ock" button wilt change t o " Lock ed" after the data validatio n process h as been success fully com pl eted indicati n g the form i s ready for s ubmission. -FormlockedOn:jFeb15
, 2018at10: 11: 37AMI I Save to Loca l PC 1 1 P rint this Report I Single P ositive Test Form (v ersion 1.7.0-December 20 1 6) NRC Form 890 (12/2014)