ML14118A405

Single Positive Test Form Collected on 03/14/2013

ML14118A405
Person / Time
Site:	Limerick
Issue date:	04/28/2014
From:	Exelon Generation Co
To:	Document Control Desk, Office of Nuclear Security and Incident Response
Paul Harris - 287-9294
References
Download: ML14118A405 (1)

Text

Please elaborate on the choice(s) selected:

The temperature of the specimen was 111 degrees.

NRC FFD Program Performance Data Reporting System Single Positive Test Form for the EIE General Submission Portal Select Facility Limerick [50-352; 50-353]

Reason for Testing - 26.717(b)(5)

Pre-Access Pre-Access Testing Reason (optional)

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

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

Use NRC Cutoff (Yes / No)?

Use NRC Cutoff (Yes / No)?

Use NRC Cutoff (Yes / No)?

Management Actions

- 26.717(b)(8) & 26.75 Specific Sanction Applied Permanent Denial Save to Local PC Print this Report Unique Reference Number (Licensee Supplied) 2013-LGS-105 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 Yes Date of Collection (mm/dd/yyyy) 03/14/2013 Submission Update Person(s) Responsible for Information Provided Company Email Address dolores.adams@exeloncorp.com First Name A dams Position Title Corp. FFD Analyst Position Title First Name Last Name Last Name Dolores Company Email Address Person 1 (required):

Person 2 (optional):

Single Positive Test Form version 1.4.0 - Oct 31, 2012 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.

Locked Form Locked On:

Ap r 28, 2014 at 12:32:21 PM Please explain the change(s) to the form correction required Reason for the Action Subversion attempt Refused to provide initial specimen Refused to provide second specimen Specimen characteristics (e.g., color, odor, precipitant)

Specimen temperature (out of range)

Invalid test result (initial specimen collected) - 26.185(f)

Specimen paraphernalia identified Did this collection involve a subversion attempt (Yes/No)?

Yes Subversion Attempts

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

Refused to follow directions Other Sanction Applied (NRC Minimum or Licensee Administrated)

NRC Minimum