ML13127A274

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SONGS - 2012-11-Public Forms
ML13127A274
Person / Time
Site: San Onofre  Southern California Edison icon.png
Issue date: 10/25/2012
From: Rodgers J
Southern California Edison Co
To:
Operations Branch IV
laura hurley
References
50-361/12-011, 50-362/12-011
Download: ML13127A274 (18)
v • d • e


Text

08DI202 -INITIAL OPERATOR LICENSING PROCESS EXAM ASSIGNMENT TICKLER Chief: Start of Op Test: Written Exam::;", _. By: NRC I !:acility Duepate "'...."'.......,," 4/13/2012 Written Exam & Op Test Dates Confirmed 6/812012 NRC Examiners

& Facility Contact Assigned 6/8/2012 Facility Contact Briefed on Security & Other Req's 618/2012 Corporate Notification Letter sent 7/1312012 Reference material due (if NRC authored) 7127/2012 Integrated exam outlines due 8/312012 Outlines reviewed by CE; feedback approved by BC 8/3/2012 Feedback on integrated outlines provided to facility*

8/2412012 DRAFT exam I docs I support reference material due 91712012 Peer review of written exam complete 91712012 Preliminary license applications due 9/1412012 Preliminary license applications and waivers reviewed 9/14/2012 DRAFT exam reviewed by CE; feedback approved by BC 9/14/2012 Feedback on DRAFT exam provided to facility 9/10/2012 On-site validation

& 10% audit of license applications 9/28/2012 Final applications due & List of Applicants prepared 10/5/2012 Final applications approved &waiver letters sent 10/5/2012 Branch Chief approves FINAL exam (Written & Op Test) Date of Written Exam: End of Op Test: :::...... " ......:!:I Test ..... By: NRC I Facility Date ..........

1'........

Initials Notes ,1. IES-201 Att-4 produced by CE IES-201 Att-3 ES-201-2 signed by CE &BC 9/7/11., ift-INRC Forms 398/396 K' ES-201-4 prepared by LA /(') k LA produces I BC signs Exam Approval Letter (ES-201 Att-5) 10/5/2012 Proctoringiwritten exam admin guidelines reviewed wI facility '1/1 J/1 "l,... 10/5/2012 Exam material to exam team 10/12/2012 Administer Operating Test 11/112012 Facility post-exam documentation due 11/1..) /"",

  • 11/1/2012 NRC written exam grading completed ES-403-1 to BC 10/3012012 Examiner's document op test results on ES 303's 11/812012 Chief Examiner review of written exam &op test completed Signed ES 303's to BC 11/15/2012 Branch Chief review of exam results completed 1112212012 WClIVtH "H"..f", ,g", reviewed for impact on licensing decision 11/2212012 License/Denialletters mailed; Facility notified of results 11/22/2012 RPSIIP number of examinees Updated II/1,1.;/1"[,,,. print Report-21 12/6/2012 1"I111/1I)J t,. Iproduced by CE 12/1312012 I SUNSI checklist complete and exam docs to ADAMS 1.5"/(/{I k SUNSI checklist to LA 12/20/2012 Ref Mat'l Returned after Final Resolution of Appeals Replaces NUREG-1021, Revision 9, Supp 1, Forms ES-201-1 and ES-501-1

--Examination Outline Quality Checklist Form ES-201-2 Facility:

SONGS 2 and Date of Examination:

10/12112 Item Task Description

1. W R I i a. b. Verify that the outline(s) fit(s) the appropriate model, in accordance with ES-401. Assess whether the outline was systematically and randomly prepared in accordance with I T T E N 2. 0 R 3. W A -K T I , H Section 0.1 of ES-401 and whether all KIA categories are appropriately sampled. c. Assess whether the outline over-emphaSizes any systems, evolutions, or generic topics. d. Assess whether the justifications for deselected or rejected KIA statements are appropriate.
a. Using Form ES-301-5, verify that the proposed scenario sets cover the required number of normal evolutions, instrument and component failures, technical specifications, and major transients.
b. Assess whether there are enough scenario sets (and spares) to test the projected number and mix of applicants in accordance with the expected crew composition and rotation schedule without compromising exam integrity, and ensure that each applicant can be tested using at least one new or significantly modified scenariO, that no scenarios are duplicated from the applicants' audit test(s), and that scenarios will not be repeated on subsequent days. c. To the extent possible, assess whether the outline(s) conform(s) with the qualitative and quantitative criteria specified on Form ES*301-4 and described in Appendix D. a Verify that the systems walk-through outline meets the criteria specified on Form ES-301-2:

(1) the outline(s) contain(s) the required number of control room and in-plant tasks distributed among the safety functions as specified on the form Initials a b* c# A }(<"" <Jvw A 4 Pr-! 4wv A-Ar k ' I (2) task repetition from the last two NRC examinations is within the limits specified on the form I J.t"'A.I i :3) no tasks are duplicated from the applicants' alldit test(s) It.<;I .....V! It"': "--1 1 (4:, 'ihe number of new or modified tasks meets 0:' exceeds th"Hnjn:'TUms specified on ihe fom! ' : , J(J..,. II 1 trl-,e number of alternate path, low-poVv"" emergency.

and 1-1(;,", tasks meet the <.::riteria ! . t l I' on the form. ! i ---11 I!j b. \ 'Cilly that the administ'atlve outlH1e meeh the criteria specified on Form ES-301-1 : ": 0" ! (i) lhe tasks are distributed among the topics as specified on tt.£> form Jt AA I Ii ! U i 'it least one task is new or significantlY modified ms 1"'Ir.'Vl tt-I /t-l, G no more than task is repeated from the last two NRC

-

H 4. G E N E R A L I c.

and mix W !I a. I b. I c. I d. I e. f. Assess whether plant-specific priorities (including PRA and IPE insights) are covered in the appropriate exam sections.

Assess whether the 10 CFR 55.41/43 and 55.45 sampling is appropriate.

Ensure that KIA importance ratings (except for plant-specific priorities) are at least 2.5. Check for duplication and overlap among exam sections.

Check the entire exam for balance of coverage.

Assess whether the exam fits the appropriate job level (RO or SRO). '1Q7. Printed

a. John Rodaers I ..dill ".. .ll_.1l. ::J A.L. b. Facility Reviewer (0) 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 SONGS NRC 2012 ES-201-2 Exam Outline Quality Checklist Rev a.doca I ES-401 Written Examination Quality Checklist Form ES-401-6 Facility:

SONGS 2/3 Date of Exam: 10/25/2012 Exam Level: RO CZl SRO 0' 1. 2. 3. 4. 5. 6. Item Description Questions and answers are technically accurate and applicable to the facility.

a. NRC KiAs are referenced for all questions.
b.

obiectives are referenced as available.

SRO Questions are appropriate in accordance with Section D.2.d of ES-401 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), Question duplication from the license screeninglaudit exam was controlled 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 the examinations were developed independently; or 7 the licensee certifies that there is no duplication; or _ other (explain)

Bank Modified New Initial '.' " Ir 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 question distribution( s) at right. 26/6 410 45/19 .Jtn 7. 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 KiAs support the higher cognitive levels; enter the actual RO I SRO question distribution(s) at right. Memory 8. Referenceslhandouts provided do not give away answers or aid in the elimination of distractors.

9. Question content conforms with specific KiA statements in the previously approved 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. 11. The exam contains the required number of one-point, multiple choice items; the total is correct and agrees with the value on the cover sheet. CIA 42/19 Printed Name I Signature n a UN
a. Author b. Facility Reviewer (..) c. NRC Chief Examiner (#) d. NRC Regional Supervisor Note: .. The facility reviewer's initialslsignature are not applicable for NRC-developed examinCjtions.
  1. Independent NRC reviewer initial items in Column "CO; chief examiner concurrence required.

v Date Operating Test Quality Checklist Form ES-301-3 Facili SONGS Date of Examination:

Test Number: Initials 1. General Criteria a. There is no day-to-day repetition between this and other operating tests to be durin this test shall not du licate items from the a licants' audit test s. see Section D.1.a. Overlap with the written examination and between different parts of the operating test is acce table It appears that the operating test will differentiate between competent and a licants at the desi nated license 2. Walk-Throu h Criteria Each JPM includes the following, as initial initiating references and tools, including associated reasonable and validated time limits (average time allowed for completion) and deSignation if deemed to be time-critical by the facility operationally important specific performance criteria that . 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 se uence of ste s, if a licable Ensure that any changes from the previously approved systems and administrative outlines (Forms ES-301-1 and 2) have not caused the test to deviate from any of the criteria (e.g., item distribution, bank use, repetition from the last 2 NRC examinations) on those forms and Form

3. Simulator Criteria The associated simulator operating tests (scenario sets) have been reviewed in accordance Form ES-301-4 and a cop is
a. Author b. Facility Reviewer(*)
c. NRC Chief Examiner d. NRC Ie* The facility signature is not applicable for NRC-developed # Independent NRC reviewer initial items in Column "c"; chief examiner concurrence r Date ES-301 Simulator Scenario Quality Checklist Form ES*301*4 I Facility:

SONGS 2 &3 Date of Exam: 10/12112 Scenario Numbers: 112131415/6 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 }A of service, but it does not cue the operators into expected events. 2. The scenarios consist mostly of related events. 3. Each event description consists of

  • the point in the scenario when it is to be initiated 9* the malfunction{s) that are entered to initiate the event fz,u JJ* 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 fh without a credible preceding incident such as a seismic event J 5. The events are valid with regard to physics and thermodynamics. f1 6. Sequencing and timing of events is reasonable, and allows the examination team to obtain ict complete evaluation results commensurate with the scenario objectives.
7. If time compression techniques are used, the scenario summary clearly so indicates. J: Operators have sufficient time to carry out expected activities without undue time constraints.

If Cues are given. S. The Simulator modeling is not altered. {z.v 9. The scenarios have been validated.

Pursuant to 10 CFR 55.46(d), any open Simulator performance deficiencies or deviations from the referenced plant have been evaluated i>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. II-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 (L If (submit the form along with the simulator scenarios).
12. Each applicant will be significantly involved in the minimum number of transients and events 1w CC It specified on Form E5-301-5 (submit the form with the simulator scenarios).
13. The level of difficulty is appropriate to support licensing decisions for each crew position. Ii Target Quantitative Attributes (Per Scenario; See Section D.S.d) Actual Attributes 1 2 3 4 5 6 1. Total malfunctions (5-S) 9 9 6 9 7 9 2. Malfunctions after EOPentry (1-2) 5 3 2 3 3 5 3. Abnormal events (2-4) 4 4 3 3 4 4 4. Major transients (1-2) 2 1 1 1 2 2 5. EOPs entered/requiring substantive actions (1-2) 2 2 2 2 3 2 6. EOP contingencies requiring substantive actions (0-2) 1 0 0 0 1 0 7. Critical tasks (2-3) 3 2 4 2 4 4 ES-403 Written Examination Grading Form Quality Exam Level: RO [2J Initials b trJ Facilit: SONGS 2/3 Date of Exam: 10/24/12 Item Descn tion 1. Answer key changes and question deletions and Applicants' scores checked for addition reviewers s at check> 25% of Grading for all borderline cases (80 +/-2% overall and 70 or 80, i tv/ANJ,4 as a licable, +/-4% on the SRO-onl reviewed in detail All other failing examinations checked to ensure that grades 1\;/1'4 N/A are 'ustified "lft Performance on missed questions checked for deficiencies and wording problems; evaluate ltJof uestions missed b half or more of the applicants Printed Name/Signature L. Date a.

t;v£?ef> b. Facility I!LItLI"L

c. NRC Chief Examiner ItAld. NRC Supervisor

(*) ("') The facility reviewer's signature is not applicable for examinations graded by the NRC; two inde endent NRC reviews are re uired.

Page 1 of4 Operator Licensing Exam Schedule 05/07/2013 09:22:56 From 10/01/2012 To 1213112012 Report 21 Region: 4 Phase Code: Operating Reactors (5) [ Exam Week I[Siie/i)oCketUNc:i}lnsp Rpt IL # Candidates )L Type ,[Exam Author,L Chief Examiner)L Examiners Assigned I 10115/2012 San Onofre 1 05000361/2012301 RO 4 SROI -5 Admin FFF APGER, GABRIEL W. APGER, GABRIEL W. TAC #: X02494 SROU -BLOODGOOD, MICHAEL R. BUCHANAN, THERESA D. GARCHOW, STEPHEN M. HERNANDEZ, NICHOLAS A. OSTERHOLTZ, CLYDE C. 10/15/2012 San Onofre / 05000362 / 2012301 RO-4 SROI-4 Admin FFF APGER, GABRIEL W. APGER, GABRIEL W. TAC #: X02495 BLOODGOOD, MICHAEL R. BUCHANAN, THERESA D. GARCHOW, STEPHEN M. HERNANDEZ, NICHOLAS A. OSTERHOL TZ, CLYDE C. 10/22/2012 San Onofre 105000361 Doc FFF APGER, GABRIEL W. APGER, GABRIEL W. TAC #: BLOODGOOD, MICHAEL R. BUCHANAN, THERESA D. GARCHOW, STEPHEN M. HERNANDEZ, NICHOLAS A. OSTERHOLTZ, CLYDE C. 10/22/2012 San Onofre Doc FFF APGER, GABRIEL W. APGER. GABRIEL W. T AC #: BLOODGOOD.

MICHAEL R. BUCHANAN.

THERESA D. GARCHOW. STEPHEN M. HERNANDEZ, NICHOLAS A. OSTERHOL TZ, CLYDE C. Sites: SANO Orgs: 4620 Exam Author: ALL Page 2 of4 Operator Licensing Exam Schedule 05107/2013 09:22:56 From 10/01/2012 To 1213112012 Report 21 Region: 4 Phase Code: Operating Reactors (5) [SumrrulryByDatel 10/2012 SANO* San Onofre RO -8 SROI-9 SROU-4 LSRO-O Total for San Onofre: 21 Sites: SANO Orgs: 4620 Exam Author: ALL Page 3 of4 Operator licensing Exam Schedule 05107/2013 09:22:56 From 10/01/2012 To 1213112012 Report 21 Region: 4 Phase Code: Operating Reactors (5) l Summary By Site I SANO

  • San Onofre RO*8 SROI* 9 SROU*4 LSRO* 0 Total for San Onofre: 21 Sites: SANO Orgs: 4620 Exam Author: ALL Page 4 of4 Operator Licensing Exam Schedule 05107/2013 09:22:56 From 10/01/2012 To 12/31/2012 Report Region: 4 Phase Code: Operating Reactors lfu!:mmaryByRegion
J Region RO-8 SROI-9 SROU-4 LSRO 0 Total for Region 4: Sites: SANO Orgs: Exam Author: ALL 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 October 8,15 and 22, 2012 as of the date of my signature.

I agree that J will not knowingly divulge any information about these examinations to any persons who have not been authorized by NRC. 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 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 NRC 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 October 8,15 and 22, 2012. 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 NRC. PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATLJrE (1) DATE DATE NOTE 1 . \l'QttN {20t-z.-/3,j(

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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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 durinQ the week(s) of October 8,15 and 22, 2012. From the date that I entered into this security agreement until the completion of examination administration, I did not evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by NRC. PRINTED NAME JOB TITLE / RESPONSIBILITY 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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC any indications or suggestions that examination security may have been compromised.

2.

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 October 8,15 and 22, 2012. 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 NRC. DATE DATE NOTE PRINTED NAME JOB TITLE I RESPONSIBILITY

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  • b* II # II (I) 41 '1Mro vW Vll\r-ES-201 Examination Security Agreement Form ES-201-3 1. Pre-Examination f acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 October 8,15 and 22,2012. 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 NRC. PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE 1. 50<

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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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 October 8,15 and 22, 2012. 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 NRC. PRINTED NAME JOB TITLE / RESPONSIBILITY SIGN]: (1) DATE DATE NO, TE 1. ]0 flM-J M f'VA

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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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 October8,15 and 22,2012. 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 NRC. PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1) DATE DATE NOTE CI2S "f1?/IV (o*"U/-1'V

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Vl1Y 'ViA tMttktL 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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 October 8,15 and 22, 2012. 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 NRC. PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 1. 1'q! /JII\. (,..n VeL; 2.
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I ES-201 Examination Security t\greement 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 October 8,15 and 22, 2012 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 NRC. 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 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 NRC 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 October 8,15 and 22, 2012. From the date that I entered into this security agreement untif 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 NRC. PRINTED NAME DME DMENmE / 9-1"'-/0 .1.11. tv (,), I X ......

I * ...........

f YC'....... ....,

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2. ( ::sQ.c.o;S , == /ojrl1/n-erJ!iJk3. ____ 4. ____ 5. ______________________________________

_ 6. _______________________________________

_ 7. ____ 8. ____ 9. ___________________________________

_ NOTES: (t)

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