ML100601283

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2009 Fitness for Duty Program Performance Data
ML100601283
Person / Time
Site: Ginna Constellation icon.png
Issue date: 02/25/2010
From: Palmer E
Constellation Energy Group, Ginna
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML100601283 (36)
v • d • e


Text

Eugene F. Palmer R.E. Ginna Nuclear Power Plant, LLC Director - Security 1503 Lake Road Ontario, New York 14519-9364 585.771.5223 Gene.Palmer@cengllc.com CENG.

a joint ven tur-e of Eneorgr ,*,e~

Constellation.

February 25, 2010 U. S. Nuclear Regulatory Commission Washington, DC 20555 ATTENTION: Document Control Desk

SUBJECT:

R.E. Ginna Nuclear Power Plant Docket No. 50-244 2009 Fitness for Duty Pro2ram Performance Data In accordance with the requirements set forth in 10 CFR 26.203 (e) and 26.717, R.E. Ginna Nuclear Power Plant, LLC has compiled and is submitting the enclosed annual 2009 Fitness for Duty (FFD) Program Performance Data covering the period January 1, 2009 through December 31, 2009.

Should you have any questions regarding the information in this submittal, please contact Mr. Thomas Harding at (585) 771-5219.

Very truly yours, Eugene F. Palmer

Attachment:

2009 Fitness for Duty Program Performance Data cc: S. J. Collins, NRC D. V. Pickett, NRC Resident Inspector, NRC W./PL/N RC-/ 00 Z,?659`

ATTACHMENT 2009 FITNESS FOR DUTY PROGRAM PERFORMANCE DATA

NRC FFD Program Performance Data Reporting System Oln"eHe~l Annual Reporting Form for Drug and Alcohol Tests Note:

1) All fields requiredexcept those marked 'optional'.
2) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Period of report R.E. Ginna 2009I FFD Program Random Testing Population.

Average number of licensee employees Average number of contractors/vendors Total size of the random testing pool subject to Part 26 throughout the period subject to Part 26 throughout the period throughout the period (Calculated) 484 1 1964 1480 Pre-Access Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees) (Contractors/Vendors) substituted, and refusal to test results 1,244 26 Followup Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees) (ContractorsNendors) substituted, and refusal to test results 143 93 F2 For Cause Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees) (Contractors/Vendors) substituted, and refusal to test results 116 1 2 Random Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, Annual random testing percentage (Licensee Employees) (ContractorsNendors) substituted, and refusal to test results achieved for the testing pool 247 248 0 F52.4 Post-Event Tests Conducted Throughout the Period Total number of tests conducted Total number of tests conducted Total number of positive, adulterated, (Licensee Employees) (ContractorsNendors) substituted, and refusal to test results 0 13 O 0

Other Tests Conducted Throughout the Period Total number of tests conducted Totalnumber of tests conducted Total number of positive, adulterated, (Licensee Employees) (ContractorsNendors) substituted, and refusal to test results 0 1 o SubstancesTested Did your program only test for NRC-required substances AND at the NRC-specified minimum cutoff levels? (Yes / No) INo Substance Use Only NRC Cutoff Initial Confirmatory LOD Testing? Comment Levels? (Yes / No) Cutoff Cutoff (Yes / No) (Optional)

Alcohol - Yes Not ApplicableL See narrative comment Testing conducted in accordance with 10 lCocaine IYes -1 Yes CFR 26.163(a)(2)(ii)

ICa~tIj iy tU~U l.tUfl I]I OtA..I UOGIIL VVILI I IV ICFR 26.1 63(a)(2)(ii)

Do you want to add additional substances? (Yes / No) No How many additional substances do you want to add? (up to 6)

Narrative(as applicable)

If reporting information on more than three narrative topics, select "Other(s)" for the Narrative Topic 3 to report any additional narrative topics. List each additional narrative topic title to be addressed in the "Please Elaborate" box. Ensure that each topic is identified and discussed in the "Narrative text" box that appears to the right of the Narrative Topic 3.

Narrative Topic 1 Narrative Text Policies and Procedures ANY reading of equal or greater than 0.01% BAC requires:

1. Individual is prohibited from performing duties
2. Perform additional testing until BAC shows a downward trend.
3. The sponsor or Access Requestor is notified and asked ifthere is a continued need to have UAA/UA.

r7 Add an additional Narrative Topic This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document L~~~to~~ocalI,§P Oeboft to NRIC ~hti~p Annual Test Results Form version 1.1.16

NRC FFD Program Performance Data Reporting System 10 CFR Part 26, Subpart I - Managing Fatigue Annual Fatigue Reporting Form Seled Facility

[R.E.GJ.... 7 Peio f" I' Uod:

Us, AdobeReader 9.3 for this form towor. pwopetv.

Was this faclity Inan outage for aoy part of the Didany single site outage last mor than 60 Did any of the first60 days of an outage occur Did any of the outagedays afterday 60 occur reportingperiod? (Yes INo) days in total? (Yes I No) dudng the reporlingperiod?(YesI NO) during the reporfingperdod? (Yes I No)

Yes S y ISummary of Waiver issuance- 26.203(e)(7)Fi-ii I I No~

-° F Yes_ No Nomber of WalveroIssued (Waroe: Evrlreni10wal.eIssurebed.

N pleaseot.,r . aluoe(e.g.. 0) 10artoIa.on 000 e. rmcello In rob .ohte]

Operacfing or 00n'sle-daoolrrgof Performinghealthrdhysicsorf performidng dutiesofia firebrigade Pedoenrongerainoaos or Pedfoortiogosawdycldobs.as Operating Outage Oans2 ' omrbl~odo tire operationsof syslerrrs.ns chremistryduties. ns described emober, mo as desoribedIn nailsdiertnofo mainratenance. describedIn o. Total Tob tald' Tr~

WorkrHourConroflos descrtibadin 26.41(a)(l) 26.4(a)(2) 26.4(a)(3) on describedIn 26.4(aX4) 26,11(a)(5) (days 1-60) .(idlerltay 60)I~

Oorrstlioaq (days 140)tin (01101.60) Operating (daysi-SO) (otra 6 rnri DOutage outage days 1460) -,(aft r day SO) ~

0prt dayn1-ee) (afterday 0 2 010Oaan a (days 146) 006

'Outage jailnr day 60)

(Calcutated) (Cloolfr)kaodir Clrlrr Hoss ce~eded2016 Irk ra in any 24ireperiod Fo__ 1o__1 . i W I (o( 1 F 1.

Exoteoded 72 wori his in mny I dayperiod El--] F]-- Fo Fo 16 01 1l] Fl] El El] El__ ] Fo erab R(

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Average oflos doesaI dayoff We -00kElE ]

bnlom Average ofleaw doens for10-h-oshift.li 2 days off perwoeik E ]- 0lII] Fl] l Days Off Avraogeoflenstran 2.5daysoff peerseni PeirShift Cycle for 12-ioroishifts Eli]o 26,205(d)(53) Avraonge offossthan 2 days09fporonnk ---- 1a for 12-boor-inron-a.. sthifts -o L-7L Averageo1lensthean3 riaysonff perwveak r i j1 for 12-hoursecurrityshifts - -___1_ F0. - .

Off poniod26.205.(d)(4) n~unDays l z. - 0 for Ouotage _______________

Actfiftl~o(daringfirst Less thanI dayoff pere7-dayperiodfor 5:odays ofoutage) madintenanceperonarnel 2&205.(dXd5 [-

2620)1 .Ls- than4 dlaysoff per saccessive IS-day C-(7 Period forscournty p-rano rind l El]26120El5ll.(dX5) - E l] El _ _ ll .lL OF29)55 aE I -__ ]~ ]

- NOTE:For individualsperorleming fire brigadeduies and other dutie, please count them only under ihe fire brigade colurmr.Do not double countthese Idbdoas.

Distributionof Waivers for Individualsin Each Category- 26.203(e)(1)(iii) Summary of CorrectiveAction - 26.203(e)(2) (asapplicable)]

Number of Employ.os Issued Waives

[Nore: Even 11nowaIvers were issued fora given eolumn. please eoter a value (e.g.. 0) in r least 000 orfthe cells in the corlum] Analynisof WaiverAssessment Data: J-I 5.00r.*r0,M NoWair reitroed duringrfor rrgssio perad.

Ope*Ltingor o-sh performng heath Pedroming duaies of0a PnerornigmaLtenanPe omsng securty deoeransof physc or chemistry ft brigadpe nmmpe cs or onsita dkectLtg of duties as described ig Nuamber ssemsas daties as describod Is describedIn maintenance as 26.4 (a)(3 ) described In 26 .4 )0541 26 .4((a55 fdWaive s desrie hoins26.4(a)(1) d system , as 26.4(aX2 )

E=II E=l m= Analysisof FatigueAssessment Data: l new -

D. dasnon) 3 I] 11 1I or Fatige-As c

.essmao rplerrd rofrol drloinngrfos peried. .s tr.1 of. pfrc- drrg sodaotobt trt.

4,I I I 5 F_--_1 F----i I F----i

Hours 26.205(dX1) z.add263 honto ny 48 he period h.l F~~

Fo -1 0 I ,~- .. I .. I -1 EZHEZK t t-~ I. I

~I: ...-. f-v --- T o Exceeded 72 workIo in any 7 day period O- F RE-] Z FO----] 110-1 FO O E= EI R1 26.205(dX2) pras(or Lross 8hr breakooounmondating rethan 3r4nffo hAIn__ erany o9 d___y_

fveragoof les than I day ofl per weak period__

Fo-1 fma k=~

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h50Sono or 04boaor shift.  : ~Ei]IJ ________LJ Fi~

Days off ParShift~

cycle 26-205(d)(3) koosoge ofloss or 112-Itour tlhon2.days rnainterranceshift allpor week l ______ _____L...

E ]-'- _____ ______[______ _____

.4] E 5500060 of Insthtm ar 2-hournodYshil 3 idaynoff p" eoek lEl '1~ iiii:

Min..... Days for Outagoe fo ta.

period Lossthon26.205.()(4) 3 days off per seaeonnlon 05400sy . ... [ _ _ _ _ _ _

ActitieS (during fost Leso than day-off per T-dayperiod for 'l:]

60day. of 00106) ean~fternwim peronnerrl 26.205.(dX4) [o __________

26.205(,d5) Loss ;tan 4 05ay pot s .o5-day doff periodfor ctall pernonnl222"05(.15) .. __ ._-_-+

Toa ElF00 l 0 El EC=

'NOTE.Formandualdolperforming rie brigade0utiesand othrerdulinn,please coun0thornoulyunderthe000e1b0i0ad cofonro.Do nordoublecount100 thew ldh~alt.

Distributionof Waivers for Individualsin Each Category- 26.203(e)(1)(iii) I Summary of CorrectiveAction - 26.203(e)(2) (asapplicable)I Number of Employees Issed Waivets

[Note: Even lion waivers were issued fera given column, please enter a value (eg.. O) nat least oe of the cells in the colmunn AnalysisofWalverAssessmeont Data: I I- 00.00Coe I

50N0. rviono during0510Teonmg pi10.

Operatingor e-ste Perfrmin health Perforodng 00ti000f0 Perforning mnaintenaonc p directingof wfaa ciy th ,110 of physlenor chemistry 000ebrigade 00050000 or onafte0d0r1cting of duie P, 011 9 0a00sriedI Noonlooa of Wd.Ur n 0000.y.rodescthribe In described In rarintenoneen do s Ostbd1 describedIn 26.4(a)(1) 26.4(052) 26A.4(e3) describedin 260102X4) 56425 Ana0p0.01o F.UgonA.--noero Dafota1:0 ~oos 0-eo1goAoseoent o-ooepord drirgthi, ri-vengpeo~dsoaeWel nf, po.vodosged kl l lott 4

7 n m nr CovnclusonsO: -toa000 es Wot hosrs b- ors l-o,e b.-ee edgooively ielcod e otv Io-dod 10 h on1 00w0 -n00vood by hommo perfeeoee buo. I.-t sohowot isoor rnr rna rnrnr Summaryand Status of CorreetireActions: tIo lo-00 ),0oe IsudMorn 2F r n uso r0n n r Onenookho-s deionn .c-ond driog theepeeiog periodoithin1e IEeepceoreekig sy"-p.

(9) dayperiod.The vinlafli- -,

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  • a 0- X NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:
1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 11925 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 104/23/00 IR.E. Ginna Reason for Testing - 26.717(b)(5) Please elaborate on the reason for testing (optional)

Followup MRO requirement after a Determination of Pitnocc fMr nrinr mnriuinn joico a Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) AdditionalSubstance (as applicable) Additional Substance (as applicable)

IPlease Select Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)I~es Use NRC Cutoff(Yes / No)l Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors

[]

Refusal to Cooperate Other 1-1 17 ManagementActions - 26.717(b)(8)

Disciplinary Action II er Denia Z IZ Reason(s) for the Action (select all that apply):

[] MRO Confirmation [] First drug or alcohol positive lJ Resignation/Withdrawal r7 Subversion [] Subsequent positive test result from testing E1 Misuse E Violation of 5-hour abstinence rule Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 Save~to Local PC, Send ~ep6Wto NRC S*Print this eot Single Positive Test Form version 1.1.26

Elcro i 0n -:~,Ecag NRC FFD Program Performance Data Reporting System Single Positive Test Form [ýý hl ýbp`Z Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use tSingle Form 2009 12001 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 4272009 j R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable) lCocaine Please Select I Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)Y Use NRC Cutoff (Yes / No)m Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 17 Refusal to Cooperate Other El nl Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial 71 Reason(s) for the Action (select all that apply):

[] MRO Confirmation [ First drug or alcohol positive Ml Resignation/Withdrawal r- Subversion El Subsequent positive test result from testing Fl Misuse El Violation of 5-hour abstinence rule El Other:

17 Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Clickto Digitally Sign This Document Sav t PcalK F Send Reportito NRC'.- PSintFthisvRepor Single Positive Test Formversion 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12002 being auto-populated into other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) [4/27/209 JR.E. Ginna Reason for Testing - 26,717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access I Initial Authorization Employment Type - 26.717(b)(3) lContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) AdditionalSubstance (as applicable) lCocaine UMarijuana I Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No)lYes Use NRC Cutoff (Yes / No)[

Is this a 24-HourReportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 13 1`

Refusal to Cooperate Other 7l E]

Management Actions - 26.717(b)(8)

Disciplinary Action 1-Yer DeniaZ Reason(s) for the Action (select all that apply):

'R MRO Confirmation [ First drug or alcohol positive El Resignation/Withdrawal El Subversion nl Subsequent positive test result from testing 17 Misuse El Violation of 5-hour abstinence rule E] Other:

Rl Sale, Use or Possession in PA-This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right--clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

[ ýratq,100!, [-Send Repor to NRC Print this.Report Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

  • 1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12062 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 05/1 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IReinstatement (Between 6 and 30 days)

Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

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

Test Results - 26.717(b)(4)

Test Validity FNot Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes / No)?- 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

IPlease Select I IPlease Select Use NRC Cutoff (Yes I No) Yes Use NRC Cutoff (Yes / No)[Ys Use NRC Cutoff (Yes I No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors

]l El Refusal to Cooperate Other 17 Ml ManagementActions - 26.717(b)(8)

Disciplinary Action 1- Year Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation Ig First drug or alcohol positive El El Resignation/Withdrawal Fl Subversion Subsequent positive test result from testing

[3 Misuse El Violation of 5-hour abstinence rule El Other:

Ml Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document SaeoLcalPC1 SSendRep6rtot NRC PrintthisRkeport]

Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12244 1 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

[R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Finitial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes No)? - 26.717(b)(7) & 26.1 No Substance- 26.717(b)(2) & (b)(4) Additional Substance (as applicable) AdditionalSubstance (as applicable) 1Cocaine IPlease Select Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)[e ] Use NRC Cutoff (Yes / No) i Is this a 24-HourReportable Event (Yes/No)?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors R C Refusal to Cooperate Other 11 r]

Management Actions - 26.717(b)(8)

Disciplinary Action F1- Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation fK First drug or alcohol positive Resignation/Withdrawal 17 Subversion E3 1-1 Subsequent positive test result from testing

[3 Misuse [ Violation of 5-hour abstinence rule Other:

jJ Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Savto Lo~Ical 1,,-Send Reporitto NRC PrintSthis P oRepo1ort Single Positive Test Formversion 1.1.26

Elcroi Ino' xcag NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcep t those marked 'optional'.

Sing 2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12349 being auto-populated into othe r form fields.

3) Use Adobe Reader 9.3 to en:sure this form works properly.

Select Facility 8/10/200 Date of Collection (mm/ddlyyyy)

IR.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access lReinstatement (Between 31 and 365 days)' j 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 Drug Testing Drug Only Urine Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

IMarijuana ZX IPlease Select I Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 1-Refusal to Cooperate Other 1- El Management Actions - 26.717(b)(8)

Disciplinary Action 1- Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation [] First drug or alcohol positive El Resignation/Withdrawal E7 Subversion El Subsequent positive test result from testing 17 Misuse E] Violation of 5-hour abstinence rule El Other:

E3 Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Sav3toLocalP I Send Reportto NRC. PrintSthis Report Single Positive Test Formversion1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12426 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

[Pre-Access SUpdate Authorization Employment Type - 26,717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? [o Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance- 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

IMarijuana 77 Please Select Use NRC Cutoff (Yes / No)o Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes/ No)m Initial Cutoff 50 Confirmatory Cutoff 15 Is this a 24-Hour Reportable Event (Yes / No)?- 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 1-Refusal to Cooperate Other El 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1 -Year Denial ZI Reason(s) for the Action (select all that apply):

R MRO Confirmation Z First drug or alcohol positive El Resignation/Withdrawal

[] Subversion El Subsequent positive test result from testing r- Misuse E] Violation of 5-hour abstinence rule [] Other: Please elaborate El Sale, Use or Possession in PA Sample was found positive at LOD.

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

-,SendRepoitto NRC, Pr -7tusReot

ýý avetoýca Single Positive Test Form version 1.1.26

I UnI- N-1 io 't-.

Elcro i InorS 0l 0> *n NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12434 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 08/ j R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access lnitial Authorization Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3) Please elaborate (optional)

FOther Siemens Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Ivalid Test Type(s) for Result(s) Reported Drug Testing Drug Only lUrine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) AdditionalSubstance (as applicable)

ICocaine 77 7 Please Select IPlease Select Use NRC Cutoff (Yes / No)Ye ]

Use NRC Cutoff (Yes / No) Iis Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El El Refusal to Cooperate Other Ml 1-Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation [ First drug or alcohol positive El Resignation/Nithdrawal El Subversion El Subsequent positive test result from testing El Misuse El Violation of 5-hour abstinence rule El Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 4eto o!l7R, I Send Reipor toNRC ['Print this Report*

Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form 1 ,Onhnei0elR]

Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12481 being auto-populatedinto other form fields.
3) Use Adobe Reader9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 0/I2009 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

[Pre-Access [Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendcor Labor Category - 26.717(b)(3) Please elaborate (optional)

Other Office Works furniture delivery and set-up1 Refusal- 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes / No)?- 26.717(b)(7) & 26.1 f~o Z Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

MarijuanaC f so Please Sele s ]

Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No)Ie Use NRC Cutoff (Yes / No)l Is this a 24-HourReportable Event (Yes / No)? - 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El El Refusal to Cooperate Other El El Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Z Reason(s) for the Action (select all that apply):

[] MRO Confirmation [K First drug or alcohol positive [] Resignation/Withdrawal E3 Subversion El Subsequent positive test result from testing

[E Misuse E] Violation of 5-hour abstinence rule El Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Save._t6.lLo.c4I',PC,* [Send Repo rt to *NRCQ, this Report, gPrint Single Positive Test Formversion1.1.26

Prtctn Pepl and

'-rnn th 0 0 0

  • NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:
1) All fields are required except those marked 'optional"
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12482 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility

[R.E. Ginna Date of Collection (mm/dd/yyyy) 84200 I Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing IDrug Only Urine Was this collection observed (Yes/No)?-26.717(b)(7) & 26.1 Substance- 26.717(b)(2) &(b)(4) Additional Substance(as applicable) Additional Substance (as applicable) lCocaine IMarijuana I Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes I No)[s Use NRC Cutoff (Yes / No)I I Is this a 24-Hour Reportable Event (Yes /No)?- 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El El Refusal to Cooperate Other 11 El ManagementActions - 26.717(b)(8)

Disciplinary Action 11-Year Denial7 I

Reason(s) for the Action (select all that apply):

0 MRO Confirmation [] First drug or alcohol positive Ml Resignation/Withdrawal 17 Subversion El Subsequent positive test result from testing 1` Misuse El Violation of 5-hour abstinence rule El Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

[ SaveIP Send"Rep°4fto7NRC Print thiý Report Single Positive Test Form version 1.1.26

U'r tciq P- le ai i heE-wr-nm U..R Elcroi S n 0, Ex NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional"
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12494 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility R.E. Ginna Date of Collection (mm/dd/yyyy) 8/20009 Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3) iContractorNendor 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 F

Test Type(s) for Result(s) Reported Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

Use NRC Cutoff (Yes / No)l Use NRC Cutoff (Yes / No)l Use NRC Cutoff (Yes / No)l Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Please elaborate on the choice(s) selected:

El Refused to take drug and alcohol test Refusal to Cooperate Other N] 17 ManagementActions - 26.717(b)(8)

Disciplinary Action jermanent Denial 7 Reason(s) for the Action (select all that apply):

El MRO Confirmation El First drug or alcohol positive Resignation/Withdrawal El Subversion El Second drug or alcohol positive Subsequent positive test result from testing El Misuse El Violation of 5-hour abstinence rule Other: Please elaborate El Sale, Use or Possession in PA Permanently denied due to refusing to take the drug and alcohol test. He appealed but the appeal was upheld because he had refused to take the druc and alcohol test, which is a reouirement to obtain unescorted access.0 This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Sendieport Ocl to NRC] Reo rt S eiPTrinti Single Positive Test Formn version1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional"
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12495 being auto-populated into other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 8/2/009 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

I I Use NRC Cutoff (Yes / No)I Use NRC Cutoff (Yes / No)l Use NRC Cutoff (Yes / No)t IZ Is this a 24-Hour Reportable Event (Yes/No)?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Please elaborate on the choice(s) selected:

Li Refused to take drug and alcohol test Refusal to Cooperate Other

[] 17 ManagementActions - 26.717(b)(8)

Disciplinary Action Permanent Denial Reason(s) for the Action (select all that apply):

E] MRO Confirmation El First drug or alcohol positive El Resignation/Withdrawal rl Subversion El Second drug or alcohol positive El Subsequent positive test result from testing Ml Misuse E] Violation of 5-hour abstinence rule [] Other: Please elaborate

[] Sale, Use or Possession in PA Permanently denied due to refusing to take the drug and alcohol test..

This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be ,

performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document P~toWLo66I:P Send Report to NRC 1P.Print this'Report Single Positive Test Forn version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form -ilie eljn Note:

1) All fields are requiredexcept those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12533 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility R.E. Ginna Date of Collection (mm/dd/yyyy) 832009 I Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IReinstatement (Between 31 and 365 days) I Employment Type - 26.717(b)(3)

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

HP/RP 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 Drug Testing IDrug Only Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) &(b)(4) Additional Substance (as applicable) Additional Substance (as applicable) lCocaine IPlease Select Use NRC Cutoff (Yes / No)[Ys Use NRC Cutoff (Yes / No)Y Use NRC Cutoff (Yes / No)l Is this a 24-HourReportable Event (Yes /No)? - 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 1-Refusal to Cooperate Other 7l F7 Management Actions - 26.717(b)(8)

Disciplinary Action S1-year Denial Reason(s) for the Action (select all that apply):

9 MRO Confirmation [] First drug or alcohol positive El Resignation/Withdrawal El Subversion El Subsequent positive test result from testing Ml Misuse E] Violation of 5-hour abstinence rule El Other:

C] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1,"SavejtoLocal, ISend Report to NRC this Repo1 trint Single Positive Test Formversion1.1.26

Elcro i 11x In ' h NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional' Optional Reference Number for Licensee Use ISingle Form 2009 12625

] 2) Entries in some form fields may result in information being auto-populatedinto other form fields.

3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 832009 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Update Authorization -

Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?No Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Testing IDrug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

IMarijuana I [PleaseSelect Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)m Is this a 24-HourReportable Event (Yes / No)? - 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 17 Refusal to Cooperate Other 1- 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

[] MRO Confirmation ZJ First drug or alcohol positive 13 Resignation/Withdrawal Ml Subversion El Subsequent positive test result from testing Ml Misuse E] Violation of 5-hour abstinence rule 17 Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document SaetoLocalC <,Send Repor*ttoiNRC 1P~rint thig Reort Single Positive Test Form version 1.1.26

-1' .- LSt, S--

0ul a

  • e mto NRC FFD Program Performance Data Reporting System Single Positive Test Form IRK', 7--

Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12770a I being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

IR.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Ilnitial Authorization Employment Type - 26.717(b)(3)

IContractorNendor Labor Category - 26.717(b)(3)

FMaintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)? O Test Results - 26.717(b)(4)

Test Validity valid Test Type(s) for Result(s) Reported Drug Testing

[Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) AdditionalSubstance (as applicable)

Please Select I Please Select Please Select Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No) I I Use NRC Cutoff (Yes / No) Yes Is this a 24-HourReportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 17 17 Refusal to Cooperate Other I- rJ Management Actions - 26.717(b)(8)

Disciplinary Action Please elaborate I temp 102. Sent to the lab with a result of negative. 2nd sample is on report Single Form 2009 7Sample I ther as a refusal to test.

Reason(s) for the Action (select all that apply): 12770b El MRO Confirmation [K First drug or alcohol positive El Resignation/Withdrawal Ml Subversion El Subsequent positive test result from testing r] Misuse E] Violation of 5-hour abstineno a rule El Other:

E] Sale, Use or Possession in P'A This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document Seri&Riepoit46NRC I- alýoio-ý6 1ýý SirintostivtTetsormverio 1,.2 Single Positive Test FormversIon1.1.26

Prtetiig Pepl a-i d th Ejv -oze U..R N-1 0 *.,.0 Electronic In AXca NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcep t those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12770b being auto-populated into othe r form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

R.E. Ginna Reason for Testing - 26.717(b)(5) For Cause Testing Reason (optional) Please elaborate (optional)

For Cause FSuspect I Original sample temp (pre-access) was 102.

qsza ;innl *Fnrm "')nOQ 1 ?77fln a Employment Type - 26.717(b)(3)

ContractorNendor Labor Category- 26.717(b)(3)

Maintenance (Craft)

Refusal - 26.717(b)(7) & 26.75 Was this collection refused (Yes / No)?Yes Test Results - 26.717(b)(4)

Test Validity Test Type(s) for Result(s) Reported Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance(as applicable) Additional Substance (as applicable)

I I Use NRC Cutoff (Yes / No)I Use NRC Cutoff (Yes / No)l Use NRC Cutoff (Yes / No)l Is this a 24-HourReportable Event (Yes /INo)?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Please elaborate on the choice(s) selected:

U] Refused to take drug and alcohol test Refusal to Cooperate Other Rl 1-Management Actions - 26.717(b)(8)

Disciplinary Action Permanenteial Reason(s) for the Action (select all that apply):

E] MRO Confirmation E] First drug or alcohol positive El Resignation/Withdrawal 1- Subversion El Second drug or alcohol positive El Subsequent positive test result from testing El Misuse E] Violation of 5-hour abstinence rule Other: Please elaborate

[] Sale, Use or Possession in PA Donor was in the FFD waiting area with numerous other people when he got up and left. His employer was notified after he wasn't found in the building and confirmed he had aone home. claimina his doo was hit bv a car. A This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I 6v~oLocalPw 11Send Reporto1-NRC] Print this Repor Single Positive Test Form version 1.1.26

ec le an'hejJ'nnn U.S.NR NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional"
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12824 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3)

[ContractorNendor Labor Category - 26.717(b)(3)

FMaintenance (Craft)

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

Test Results - 26.717(b)(4)

Test Validity alid Test Type(s) for Result(s) Reported Drug Testing FDrug Only Urine Was this collection observed (Yes/ No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable) uMarijuana j Please Select ] Please Select Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)[Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 1` 1-Refusal to Cooperate Other 1- 17 ManagementActions - 26.717(b)(8)

Disciplinary Action I -Year Denial Z Z Reason(s) for the Action (select all that apply):

[ MRO Confirmation [ First drug or alcohol positive Resignation/Withdrawal El Subversion Subsequent positive test result from testing 1` Misuse El Violation of 5-hour abstinence rule Other:

Ml Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I @ay ito.Local. C LSend, Report to NRCI Prointvthis.FRepo1rt.

Single Positive Test Formversion T.1.26

Eletrni Ini A 147---a g NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 12837 being auto-populatedinto other form fields.
3) Use Adobe Reader9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 9/42009 1R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional) 1Pre-Access IReinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes/No)?-26.717(b)(7) & 26.1 No Substance- 26.717(b)(2) &(b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

Cocaine I Please Select Please Select Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour ReportableEvent (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

'If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 17 El Refusal to Cooperate Other 1- 1l Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation [] First drug or alcohol positive El Resignation/Withdrawal El Subversion [] Subsequent positive test result from testing El Misuse El Violation of 5-hour abstinence rule E] Other:

Ml Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

~tLocal-,C [Sen~l.Reoortt&INRC Print this ReP-rt Single Positive Test Form version 1.1.26

etti *'i eaI the Emioine 0 0 *R NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 12957 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)090/2009 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IReinstatement (Between 31 and 365 days)

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)?NO Test Results - 26.717(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) AdditionalSubstance (as applicable)

!cocaine Please Select 7 IPlease Select Use NRC Cutoff (Yes / No)Ies Use NRC Cutoff (Yes I No)e Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El F1 Refusal to Cooperate Other 1- nl ManagementActions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

El MRO Confirmation fK First drug or alcohol positive 11 Resignation/Withdrawal El Subversion El Subsequent positive test result from testing El Misuse E] Violation of 5-hour abstinence rule El Other:

[] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by'right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1.Sýto-Local P I:Send Repprtto.RC i".p-nt'.thisIRepo rt J Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13112 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 9/0/00 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IReinstatement (Between 31 and 365 days) I Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) AdditionalSubstance (as applicable) Additional Substance (as applicable) iMarijuana [Please Select [Please Select Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) IIs Use NRC Cutoff (Yes I No) Yes Is this a 24-Hour Reportable Event (Yes/No)? -26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 17 El Refusal to Cooperate Other El 17 ManagementActions - 26.717(b)(8)

Disciplinary Action 1-Year Denial Reason(s) for the Action (select all that apply):

gj MRO Confirmation [] First drug or alcohol positive El Resignation/Withdrawal El Subversion El Subsequent positive test result from testing El Misuse El Violation of 5-hour abstinence rule 17 Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document I Svo Lool. Send Re*ort toNRc rint thiskRelobirt Single Positive Test Form version 1.1.26

k , - - 1,, i-ý Elcroi Sn xchng NRC FFD Program Performance Data Reporting System Single Positive Test Form  : ý,H Pý hithe Note:

1) All fields are required except those marked 'optional',
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13376a being auto-populated into other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

JR.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access FUpdate Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Substituted I Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

INot applicable Please Select Please Select Use NRC Cutoff (Yes I No)e Use NRC Cutoff (Yes / No)Ie Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No) ?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Please elaborate on the choice(s) selected:

il Initial sample temp was 84.5 and laboratory results were negative. 2nd sample was Other observed and positive for cocaine. See report 13376b. A wet spot was observed at the Refusal to Cooperate 171 0 back of the donors knee area Management Actions - 26.717(b)(8)

Disciplinary Action Reason(s) for the Action (select all that apply):

IR MRO Confirmation El First drug or alcohol positive 1- Resignation/Withdrawal 9 Subversion - Second drug or alcohol positive [] Subsequent positive test result from testing M Misuse [] Violation of 5-hour abstinence rule M Other:

M Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

-S ye ' LcalP~ Siend'Reporftt NR6 IPin thi ep Single Positive Test Form version 1.1.26

'12 rC, Pep -,ii th z i7ozie Elcroi Inf F"' 01 0~ S-.ca NRC FFD Program Performance Data Reporting System Single Positive Test Form ýielp Note:

1) All fields are required except those marked 'optional"
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13376b being auto-populatedinto other form fields.
3) Use Adobe Reader9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 09/1/2009 R.E. Ginna Reason for Testing - 26.717(b)(5) For Cause Testing Reason (optional) Please elaborate (optional)

For Cause LOw Temperature Temp on 1st sample was 84.5.

Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Yes Substance- 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable) lCocaine I IPlease Select I Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) ll Is this a 24-HourReportable Event (Yes / No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

Ifnot a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Please elaborate on the choice(s) selected:

I I-i Initial sample temp was 84.5 and laboratory results were negative. 2nd sample was observed and positive for cocaine. A wet spot was observed at the back of the donors Refusal to Cooperate Other El 171 knee area Management Actions - 26.717(b)(8)

Disciplinary Action Please tlaborate Ither This wa. s his 1st positive, but the denial was permanent based on the substituted sample he initially I. See report 13376a.

Reason(s) for the Action (select all that apply): I 9 MRO Confirmation [] First drug or alcohol positive E] Resignation/Withdrawal Ml Subversion E] Subsequent positive test result from testing Ml Misuse [ Violation of 5-hour abstinencae rule 1- Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by dight--clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1ýsaVeto:Local pc ISenqd oFrt 6NRC Print this Report Single Positive Test Form version 1.1.26

Prtctq Pepl aud the Evvioi U.S.NR0 va.

NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional'*
2) Entriesin some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13460 being auto-populatedinto other form fields.
3) Use Adobe Reader9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 110/520 JR.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IReinstatement (Between 31 and 365 days)

Employment Type - 26.717(b)(3)

ContractorNendor 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 Fvalid Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable) 1Cocaine 777 Please Select Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)[

Is this a 24-Hour Reportable Event (Yes /No)?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El El Refusal to Cooperate Other 17 Ml ManagementActions - 26.717(b)(8)

Disciplinary Action 1- Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation JR First drug or alcohol positive El Resignation/Withdrawal rl Subversion E] Subsequent positive test result from testing E7 Misuse E] Violation of 5-hour abstinence rule E] Other:

Ml Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removirg your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document F V616oLoca:FF& ISeind, F~epo~q7 [Print this Report ]

Single Positive Test Form version 1.1.26

Prtciz - -,ýq a- i t7 jz roii.z

) .. R Un- S- - -

Elcro i ln 0:'Ih -g NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13572 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 1 JR.E. Ginna I Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Initial Authorization Employment Type - 26.717(b)(3)

[ContractorNendor 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 Not Applicable Test Type(s) for Result(s) Reported FAlcohol Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 No Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

Alcohol Please Select Please Select Use NRC Cutoff (Yes / No) Use NRC Cutoff (Yes / No)es *] Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)?- 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Refusal to Cooperate Other ManagementActions - 26.717(b)(8)

Disciplinary Action I1-Year Denial Reason(s) for the Action (select all that apply):

F1 MRO Confirmation Z First drug or alcohol positive El Resignation/Withdrawal Ml Subversion El Subsequent positive test result from testing E] Misuse E] Violation of 5-hour abstinence rule El Other:

[3 Sale, Use or Possession in PA Tis reotms edgitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be promdwhen the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1 Z6ve-to'Loal PC 1'-Send Repýr to NRC I..lPrint tP ie sF Single Positive Test Formn version 1.1.26

Pr tci~z Pepl a ti d th -ivi-w U.S.N-Elcroi InST' K, *~kca NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13573 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access IInitial Authorization Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3)

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

Test Results - 26.717(b)(4)

Test Validity Not Applicable Test Type(s) for Result(s) Reported Alcohol Testing Alcohol Only SBreath Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

IPlease Select I IPlease Select Use NRC Cutoff (Yes / No)[Yes Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No) Yes Is this a 24-HourReportable Event (Yes / No)?- 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

Ifthis result relates to a subversion attempt, select one or more of the following choices as applicable.

Ifnot a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors Ml El Refusal to Cooperate Other El .El Management Actions - 26.717(b)(8)

Disciplinary Action 1-Year Denial i Reason(s) for the Action (select all that apply):

[] MRO Confirmation [9 First drug or alcohol positive El Resignation/Withdrawal E] Subversion 171Subsequent El positive test result from testing El Misuse E] Violation of 5-hour abstinence rule Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document oLoca-PcO Send- Rep~t'to NIRC Prntthis'R~p6itr Single Positive Test Form version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form t6olinFeep Note:

1) All fields are required except those marked 'optional'
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 13574 being auto-populated into other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy)

R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional) 11Pre-Access [Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Not Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

UAlcChol (Ys/No Ie Please Select I Please Select Use NRC Cutoff (Yes / No)Ye ]

Use NRC Cutoff (Yes / No) Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 1- El Refusal to Cooperate Other 1` El Management Actions - 26.717(b)(8)

Disciplinary Action FI- Year Denial ZZ Reason(s) for the Action (select all that apply):

[] MRO Confirmation 0 First drug or alcohol positive 11 Resignation/Withdrawal 1- Subversion 13 Subsequent positive test result from testing 1- Misuse Cl Violation of 5-hour abstinence rule 17 Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

.~tjoclO

ýen,:,pýt 1,RC, SirintostivtTeisormveeioo1rt2 Single Positive Test Form~

version 1.1.26

NRC FFD Program Performance Data Reporting System Single Positive Test Form ~Onhin&Help~'i L~ZL~~~J Note:

1) All fields are required except those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 13604 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 1/1/2009 R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access Ilnitial Authorization 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 I Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 No Substance- 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

Please Select MarijuanaCf e I Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)!

Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors 11 El Refusal to Cooperate Other 1- El ManagementActions - 26.717(b)(8)

Disciplinary Action 1- Year Denial Reason(s) for the Action (select all that apply):

9 MRO Confirmation 10 First drug or alcohol positive El Resignation/Withdrawal E3 Subversion El Subsequent positive test result from testing El Misuse E] Violation of 5-hour abstinence rule El Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

';Svet o~lPcto Sýend Report t NlRC thisormveeport..2Sinle osttv Single Positive Test Formversion1.1.26

PrUecii Pepe a~dtI iv?'ie

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`S1 ElcrncI NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13605 being auto-populatedinto other form fields.
3) Use Adobe Reader9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) 1 1R.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access [Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor LaborCategory - 26.717(b)(3)

FMaintenance (Craft)

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

Test Results - 26.71.7(b)(4)

Test Validity Valid Test Type(s) for Result(s) Reported Drug Testing Drug Only Urine Was this collection observed (Yes /No)? - 26.717(b)(7) & 26.1 Substance - 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

Marijuana Z Please Select7 7 Please Select Use NRC Cutoff (Yes / No) Yes Use NRC Cutoff (Yes/ No)le Z Use NRC Cutoff (Yes / No) Yes Is this a 24-Hour Reportable Event (Yes / No)?- 26.719(b) NO Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 17 Refusal to Cooperate Other 17 17 Management Actions - 26.717(b)(8)

Disciplinary Action 1-YerDenial Reason(s) for the Action (select all that apply):

EK MRO Confirmation 0 First drug or alcohol positive Resignation/Withdrawal 1` Subversion Subsequent positive test result from testing El Misuse E] Violation of 5-hour abstinence rule Other:

E] Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document 1`0ve o Lo.lPC ~Snd ReporqoNC tetiormvRripo1.r2 Sinlrinstiv Single Positive Test Formversion 1.1.26

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  • NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:
1) All fields are requiredexcept those marked 'optional'.
2) Entries in some form fields may result in information Optional Reference Number for Licensee Use Single Form 2009 13669 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility Date of Collection (mm/dd/yyyy) /

IR.E. Ginna Reason for Testing - 26.717(b)(5) Pre-Access Testing Reason (optional)

Pre-Access

[Initial Authorization Employment Type - 26.717(b)(3)

ContractorNendor 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 Drug Testing Drug Only Urine Was this collection observed (Yes / No)? - 26.717(b)(7) & 26.1 No Substance- 26.717(b)(2) &(b)(4) -AdditionalSubstance (as applicable) Additional Substance (as applicable)

MarijuanaC Please Select ]

Use NRC Cutoff (Yes / No)le Use NRC Cutoff (Yes / No) Use NRC Cutoff (Yes / No)m Is this a 24-Hour Reportable Event (Yes/No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors El 1l Refusal to Cooperate Other 17 In Management Actions - 26.717(b)(8)

Disciplinary Action 1- Year Denial Reason(s) for the Action (select all that apply):

R MRO Confirmation Rl First drug or alcohol positive El ResignationAWithdrawal E] Subversion El Subsequent positive test result from testing E] Misuse E] Violation of 5-hour abstinence rule E] Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved. After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document SendReportto NRC. . tkhs epr 1,to p'Loc~lP 1',-SýnqýiRelpok Single Positive Test Form version 1.1.26

Elcroi I Exchang Ma ii-NRC FFD Program Performance Data Reporting System Single Positive Test Form Note:

1) All fields are requiredexcept those marked 'optional',
2) Entriesin some form fields may result in information Optional Reference Number for Licensee Use ISingle Form 2009 13674 being auto-populatedinto other form fields.
3) Use Adobe Reader 9.3 to ensure this form works properly.

Select Facility FR.E. Ginna Date of Collection (mm/dd/yyyy) 1 2/14200 Reason for Testing - 26.717(b)(5) Please elaborate on the reason for testing (optional)

Followup Determination of Fitness requirement from tha RAPn ý.ttr All I n v,nr~nwn- 21 Employment Type - 26.717(b)(3)

ContractorNendor Labor Category - 26.717(b)(3) Please elaborate (optional)

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

Test Results - 26.717(b)(4)

Test Validity FNot Applicable Test Type(s) for Result(s) Reported Alcohol Only Was this collection observed (Yes/No)? - 26.717(b)(7) & 26.1 No Substance- 26.717(b)(2) & (b)(4) Additional Substance (as applicable) Additional Substance (as applicable)

[Please Select IPlease Select' I Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)e Use NRC Cutoff (Yes / No)[Yes Is this a 24-Hour Reportable Event (Yes /No)? - 26.719(b) No Subversion Attempts - 26.717(b)(7) and 26.75(b)

If this result relates to a subversion attempt, select one or more of the following choices as applicable.

If not a subversion attempt, do not select any of the four boxes.

Physical Evidence Observed Actions/Behaviors F1 17 Refusal to Cooperate Other ManagementActions - 26.717(b)(8)

Disciplinary Action, I -Year Denial Reason(s) for the Action (select all that apply):

17 MRO Confirmation gl First drug or alcohol positive El Resignation/Withdrawal El Subversion El Subsequent positive test result from testing

[7 Misuse E] Violation of 5-hour abstinence rule El Other:

El Sale, Use or Possession in PA This report must be digitally signed before it can be sent to NRC. Click on the empty box below to sign this report. A data validation check will be performed when the user digitally signs the form. Any entries needing correction will be highlighted in red and the form cannot be signed until all errors have been resolved, After the report has been digitally signed, changes only can be made to the form by first removing your signature by right-clicking the signature box and selecting "Clear Signature".

Click to Digitally Sign This Document

~toLo~RC Send~epbifr I~RC, Pritlthistiv T FR Single Positive Test Formversion1.1.26

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