ML031190525

RBS - Init Exam - 02/2003 - Public Forms

ML031190525
Person / Time
Site:	River Bend
Issue date:	02/22/2003
From:	NRC Region 4
To:	Entergy Operations
References
50-458/03-301 50-458/03-301
Download: ML031190525 (16)

Text

Operations Branch Assignment Check Sheet: as of: 5/21/2002

,1 (Includes ES-201-1 & ES-501-1 Rev. 8, Supplement 1 information)

Chief: M. Murphy Facility/Task: RB IN EX Task Start Date: 2/10/2003 ITEM DESCRIPTION DUE DATE INIT DATE 0 Exam/Inspection Schedule Agreement (C.1.a;C.2.a&b) Aug 14, 2002 ATG 5/21/2002 1 NRC Staff & Fac. Contact Assigned (C.1.c;C.2.e) Aug 14, 2002 ATG 5/21/2002 2 Facility contact briefed on security & other issues (C.2.c) Aug 14, 2002 - 7z 3 Corp. Notification Letter Sent (C.2.d) (Exams only) Aug 14, 2002B 3a Inspection Announcement Letter Sent (PIR & LORT if req'd) Dec 27, 2002 G H 4 Task Expectations, Issues, & Standards Discussed w/ BC Nov 12, 2002 A_- ,

5# [Reference Material Due (C.1.d;C.3.c)] Oct 13, 2002 ,v, ,,

6# Integrated Exam Outlines Due (C.1.d&e;C.3.d) Oct 13, 2002 > ________

7# Outlines reviewed by NRC & Feedback Sent (c.2.h;C.3.e) Oct 27, 2002 8Y Preliminary Applications Due (C.1.j;C.2.g;ES202) Jan 11, 2003 S '

9g Draft Exams wI Doc./Ref. Due (C.1 .d/e/fC.3.d) Dec 12, 2002 10' Peer Reviewer Initials As Reviewed All Parts* Dec 22, 2002 7 11' NRC Supervisor. Initials Approving for Fac. Rev. (C.2.h;C.3.f)* Dec 22, 2002 >

v- V 4 OS 12# Exams Reviewed wI Fac. (C.1.h;C.2.f&h;C.3.g) Dec 22, 2002 a;, e -

13# Final Appl. Due & Assign. Sheet Prepared (C.1.j;C.2.h;ES202) Jan 27, 2003 i 14# NRC Supervisor Approved Final Exams (C.2.i;C.3.h)* Feb 3, 2003 7 '/e/oS 15* Final Appl. Rec'd & Waivers Sent (C.2.g) Feb 3, 2003  ; y' / izh3 16s Proctor Rules Reviewed w/ Fac. & Written Authorized (C.3.k) Feb 3, 2003 ha ________

17 Exam/Insp Material to Team (C.3.i) Feb 3, 2003 ,b /3,'3 18# Fac. graded exam & Comments Rec'd Feb 22, 2003 19# INRC Written Grading Completed Feb 25, 2003 P?7 /

Examiners Finished Grading Op. Tests Feb 25, 2003 -/7fI j-NRC Ch. Ex. Review Completed Mar 7,2003 NRC BC Review Completed* Mar 8, 2003 - 0?,41/03 RPS/IP # Examinees Updated Before Report Issued Mar 13, 2003 #

.A lZ License/Denials Signed & Report Issued Mar 13, 2003  ;?F zz,,

Closed Out Apr 3, 2003 ~~'a/

, _. {

I /,

I~z He ilInspection Report Issued, Exam Package to OLA, Facility. Contact Notified of Results

1. Not required for inspections, except as noted.

• Note Supervisor/Peer initials required.

[] Required NRC-auth. exams only.

When complete, for exams, add to pkg & fwd copy to BC, for insp, fwd orig'I to BC.

Last revised 10/15/01 S:\DRS\OB\EXAMS\rb\2003 IN EX\exam assignment sheet.wpd r^ 7 1

ES-201 Examination Outline Form ES-201-2 Quality Checklist Facility River Bend Station Date of Examination: February 10, 2003 Initials Item Task Description

1. a. Verify that the outline(s) fit(s) the appropriate model per ES-401.

W b. Assess whether the outline was systematically and randomly prepared in accordance with R Section D.1 of ES-401 and whether all KIA categories are appropriately sampled.

T c. Assess whether the outline over-emphasizes any systems, evolutions, or generic topics.

T ~

E d. Assess whether the justifications for deselected or rejected K/A statements are appropriate.

N V

2. a. Using Form ES-301E-5, verify that the proposed scenario sets cover the required number of normal evolutions, instrument and component failures, and major transients.

S I b. Assess whether there are enough scenario sets (and spares} to test the projected number and M mix of applicants in accordance with the expected crew composition and rotation schedule without compromising exam integrity; ensure 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 scenarios will not be repeated over successive 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 inAppendix D. v 77, HA

3. a. Verify that:

q

'9 (1) the outline(s) contain(s) the required number of control room and in-plant tasks, W (2) no more than 30% of the test material is repeated from the last NRC examination, (3)^ no tasks are duplicated from the applicants' audit test(s), and T (4) no more than 80% of any operating test is taken directly from the licensee's exam banks.

b. Verify that:

(1) the tasks are distributed among the safety function groupings as specified in ES-301, (2) one task is conducted in a low-power or shutdown condition, (3) 40% of the tasks require the applicant to implement an alternate path procedure, (4) one in-plant task tests the applicant's response to an emergency or abnormal condition, and (5) the In-plant walk-through requires the applicant to enter the RCA.

c. Verify that the required administrative topics are covered, with emphasis on performance-based Ago "

activities. _ -

d. Determine if there are enough different outlines to test the projected number and mix of applicants and ensure that no items are duplicated on successive days.

4. a. Assess whether plant-specific priorities (including PRA and IPE insights) are covered in the appropriate exam section.

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

N R

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

e. Check the entire exam for balance of coverage.

f. Assess whether the exam fits the appropriate job level (W or SRO). ItI Printed Name / Sign _Date

a. Author: Roger Persons 10/7/02

b. Facility Reviewer(*): JoeyClark 47 10/7/02

c. NRC Chief Examiner(#): ti. A- l

d. NRC Supervisor: g ua oiL AT6 2S!4 /0O/Il70Z.

NOTE: Not applicable for NRC-developed examinations.

1. Independent NRC reviewer initial items in Column "c;" chief examiner concurrence required.

NUREG 1021 REVISION 8 SUPPLEMENT I

ES-401 Written Examination Form ES-401-7 Quality Checklist Facilitv ,1 eUD Si;ti*- itr I Date of Exam: Zt 4/Lo3 Exam Level: (&RO Initial 1 Item Description a WI c

.Questions and answers technically accurate and applicable to facility l . a. N RC K/lAs referenced for all questions S /

lb. Facility leamning oblectives referenced as available {

3. RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate / H per Section D.2.d of ES-401 r-l4. Question selection and duplication from the last two NRC licensing exams* _

appears consistent with a systematic sampans process _ ,

5. Question duplication from the license screeninglaudit exam was controlled as indicated below (check the item that apples) and appears appropriate:

the audit exam was systematically and randomly developed; or

_ t.he audit exam was completed before the license exam was started: or She examinations were developed independently; or the licensee certifies that there is no duplication; or other (explain)

6. Bank use meets limits (no more than 75 Bank Modified New percent from the bank at least 10 percent new, and the rest modified); enter the actual question 4 distribution at right 3.*'4

7. Between 50 and 60 percent of the questions on Memory C/A the exam (including 10 new questions) are written at the comprehenslonlanalsis level:

enter the actual question distribution at right 07

8. Referencesihandouts provided do not tive away answers

9. Question content conforms with specific K/A statements in the previously approved examination outine and is appropriate for the Tier to which they are assigned; deviations are jstified

10. Question epsychomeytRe quali and format meet ES, Apendix . guidelnes

11. The exam contains 100, one-poit, mu"bl choice Kom the total is correct and Go Printed Nar Diatue

a. Author e f a tl/tt> 0

b. Faciit~y RevWw 70ferEB/AD, -*I

c. NRC Chief Examiner (#) A-

d. NRC Regional Supervisor 1 07)/'

Note:

• The facility reviewer's inIbals/signature are not applicable for NRC developed examinations.

1. IndePendent NRC reviewer initial items in Column 'c; chief examiner concurrence required.

NUREG-1021, Revision8, Supplement 1 42 of 46

ES-401 Written Examination Form ES-401-7 Quality Checklist Facility Date of Exam: ExamLevel: RORO Initial Item Description a c

1. Questions and answers technically accurate and applicable to facility

2. a. NRC K/As referenced for all questions

b. Facility leaminc objectives referenced as available

3. RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate per Section D.2.d of ES-401

4. Question selection and duplication from the last two NRC licensing exams appears consistent with a systematic sampling process

5. Question duplication from the license screening/audit exam was controlled as indicated below (check the Item that applies) and appears appropriate:

the audit exam was systematically and randomly developed; or h audit exam was completed before the license exam was started; or Vthe examinations were developed independently; or the licensee certifies that there is no duplication; or other (explain)

6. Bank use meets limits (no more than 75 Bank Modified New percent from the bank at least 10 percent new, and the rest modified); enter the actual question distribution at right 4 _.l Z z V I

7. Between 50 and 60 percent of the questions on Memory C/A the exam (Including 10 new questions) are written at the comprehension/analysis level: I0l enter the actual question distribution at right '

8. References/handouts provided do not give away answers 1r

9. Question content conforms with specific K/A statements in the previously approved examination outline and is appropriate for the Tier to which they are assigned; deviations are istied

10. Queston psychometuic quality and format meet ES, Appendix B,guidelines

11. The exam contains 100, one-point, multiple choice items; the total is correct and agrees with value on cover sheet Printed Na Date

a. Author IR L /t

b. FacilityRevlwer(')

c. NRC Chief Examknerw() -M4A.Z'ki-/"

d. NRC Regional Supervisor 7 0 Note: The facility reviewer's initials/signature are not applicable for NRC-developed examinations.

1. Independent NRC reviewer initial items inColumn 'c:' chief examiner concurrence reuured.

NUREG-1021, Revision 8, Supplement 1 42 of 46

ES-301 Operating Test Quality Checklist Form ES-301-3 Facility: River Bend Station Date of Examination: 02/10/2002 - 02/22/2002 Initials

1. GENERAL CRITERIA a b*eC#

a. The operating test conforms with the previously approved outline; changes are consistent with sampling requirements (e.g., 10 CFR 55.45, operational importance, safety function distribution).

0-

b. There is no day-to-day repetition between this and other operating tests to be administered during this examination..AD

c. The operating test shall not duplicate items from the applicants' audit test(s)(see Section D. I .a). t  ;> I

d. Overlap with the written examination and between operating test categories is within acceptable limits.

e. It appears that the operating test will differentiate between competent and less-than-competent applicants /2 at the designated license level. rr

2. WALK-THROUGH (CATEGORY A & B) CRITERIA llll

a. Each JPM includes the following, as applicable:

initial conditions initiating cues references and tools including associated procedures reasonable and validated time limits (average time allowed for completion) and specific designation if deemed to be time critical by the facility licensee specific performance criteria that include:

-detailed expected actions with exact criteria and nomenclature

-system response and other examiner cues

-statements describing important observations to be made by the applicant

-criteria for successful completion of the task,

-identification of critical steps and their associated performance standards : aX

- restrictions on the sequence of steps, if applicable l__ ____

b. The prescripted questions in Category A are predominantly open reference and meet the criteria in *V Attachment 1 of ES-301. 1 ew

c. Repetition from operating tests used during the previous licensing examination is within acceptable limit jp 1 (30%/for the walk-through) and do not compromise test integrity. L

d. At least 20 percent of the IPMs on each test are now or significantly modified. t l 1

3. SIMULATOR (CATEGORY C) CRITERIA

a. The associated simulator operating tests (scenario sets) have been reviewed in accordance with Form ES-301-4 and a copy is attached.

R 1 L Printed t4Nanl A; ture Date

a. Author ORQGt, I 1 2

b. Facility Reviewer(*) A Q?,oe4e

c. NRC Chief Examiner(#) 9 -, /

d. NRC Supervisor A/T/

NOTE:

• The facility signature is not applicable for NRC-developed tests.

1. Independent NRC reviewer initial items in Column "c;" chief examiner concurrence required.

Revision 0 NUREG 1021, REVISION 8 SUPPLEMENT I

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Facility: RIVER BEND STATION Date of Exam: 02/10/2002 - 02/22/2002 Scenario Numbers: 1 / 2 / 3 / BU QUALITATIVE ATTRIBUTES Initials a b* c#

1. The initial conditions are realistic, in that some equipment and/or instrumentation may be out of service, but it does not cue the operators into expected events.

2. The scenarios consist mostly of related events. ll? S

3. Each event description consists of the point in the scenario when it is to be initiated the malfunction(s) that are entered to initiate the event

. the symptoms/cues that will be visible to the crew the expected operator actions (by shift position) the event termination point (if applicable) ____

4. No more than one non-mechanistic failure (e.g., pipe break) is incorporated into the scenario without a credible preceding incident such as a seismic event.

5. The events are valid with regard to physics and thermodynamics.

6. Sequencing and timing of events is reasonable, and allows the examination team to obtain complete evaluation results commensurate with the scenario objectives.

7. If time compression techniques are used, the scenario summary clearly so indicates. Operators have AhA T sufficient time to carry out expected activities without undue time constraints. Cues are given. I / am

8. The simulator modeling is not altered.

9. The scenarios have been validated. Any open simulator performance deficiencies have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

/1 6 Vi 7,

10. Every operator will be evaluated using at least one new or significantly modified scenario. All other scenarios have been altered in accordance with Section D.4 of ES-301.I.a

11. All individual operator competencies can be evaluated, as verified using Form ES-301-6 (submit the form along with the simulator scenarios).

12. Each applicant will be significantly involved in the minimum number of transients and events specified on Form ES-301-5 (submit the form with the simulator scenarios).

13. The level of difficulty is appropriate to support licensing decisions for each crew position.

TARGET QUANTITATIVE ATTRIBUTES 1 2 3 BU (PER SCENARIO; SEE SECTION D.4.D) Actual Attributes I. Total malfunctions (5-8) 8 i 6 / 8 / 7

2. Malfunctions after EOP entry (1-2) 2 / I / 2 / 1

3. Abnormal events (2-4) 2 /_ 2 / 3_ / 2

_e

4. Major transients (1-2) 1 / I / I / 1I

5. EOPs entered/requiring substantive actions (1-2) 2 / 2 / 1 / 2

6. EOP contingencies requiring substantive actions (0-2) 2 / 0 / ( / 1

7. Critical tasks (2-3) 3 / 2 / 2 / 3 Revision 0 NUREG 1021, REVISION 8 SUPPLEMENT I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evplution rin Scenario Number Ipype um er 1 1)

_ _ _ 1 _ _

Reactivity 1 Z 4 4 Z Normal 1 l I 1 RO Instrument/ 4 3 ,r ,3,4 4 3t3,o t5 Component ______ ' 5 Q8 Major 1 7 - 7 Reactivity 1 4 4 Normal 0 I l j As RO lstrumentI 2 3 , azl 1 4; Component _ _ f 1. L Major 1 1 j f 7 SRO-I Reactivity 0 Z 4- 4 Z Normal 1 1 I I J As SRO Instrument / 2 4*1, L~3~*)i 3,4 .'

Component _ _ _ I L M

Major 1 7 . 7 1

Reactivity 0 4-_ + -

Normal 1 l I SRO-U lustrumentl 2 , 4i, 4 St34 Maior 1 . S I L7 Instructions: (1) Enter the operating test number and Form ES-D-1 event numbers for each evolution type (2) Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3) Whenever Practical, both instrument and component malfunctions should be included; only those that req verifiable M ons that provide insight to the applicant s competence 9un toward t inimum requirement.

Author:

NRC Reviewer: I

.,O 'e, ,

25 of 26 NUREG-1021, Revision 8, Supplement 1

4 ES-301 Competencies Checklist Form ES-301-6 Applicant #1 Appkknt #2 Applicant

( ESRO-U R0 RO-JSRO-U RO/SRO-I RO-U Competencies m __ IARIO_Et - S ARl SNARIO 1 _2 3 4 _ _ _ 2 _ 3 4 1 2 3 4 Understand and Interpret A d; Zd. 4-Annunciators and Alarms _I_

Diagnose Events Z 2 . _ _ 4-and Conditions Understand Plant - 11 and System Response 0 __4 *1 Comply With and - - -a Use Procedures (1) -- I-74 Operate Control X _ 31 El Boards (2) 23 co Communicate and l

• 7*7 11- 1 Interact With the Crew __ 41 Demonstrate Supervisory $.. -.

Ability (3) - - - _

Comply With and 3 Use Tech. Specs. (3) - - -

Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's license type and enter oj or more event numbers that will allow the examiners to evaluate Reapplicabl for every applicant.

Author: I/a /crz NRC Reviewer: I1 I

7 , o1 NUREG-1021, Revision 8, Supplement 1 26 of 26

ES-301 Competencies Checklist Form ES-301-6 ipplacant#1 hplcaM t #2 Ap* 4nt #3 RO?3QJ SRO-U RORO- RORO-OLRO-U Competencies W SCENAtJ _ASC-ARI _S__AIO 1 1242 3 4 1 __2_ 3 1 2 3 4 Understand and Interpret T_ e) T 4-'7 -B VT 2A.

Annunciators and Alarms ----

Diagnose Events 2-7 7

-f 2 t- -

and Conditions 5_ - O:_

Understand Plant it-4 'I7 and System Response IS 4 Comply With and Z13 - OT- - - - -

Use Procedures (1) .8" 0'j,1 Operate Control Zo .4 1% - -

Boards (2) 45 Communicate and L 8 -*- _ II 3 (-8 _ _

Interact With the Crew (4 - 4-1 Demonstrate Supervisory --

Abilty (3)

Comply With and 4 Use Tech. Specs. (3) _

Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's license and enter 3xpe one or event numbers that will allow the examiners to evaluate ev a licable compet for very applicant Author: IZ./l)

I___ ?o NRC Reviewer: 3,21-/?z NUREG-1021, Revision 8, Supplement 1 26 of 26

ES-301 Competencies Checklist Form ES-301-6 pplicant #1 pplicant #2 Applican 01 RO-IlSRO-U R RO-I/SRO-U RO/SRO-I RO-U Competencies __ SC ENA _S O A NA 0

___2_3_4___ 1 2 3 4 1 2 4 1 2 3 4 Understand and Interpret 42 G1-1 .4)

Annunciators and Alarms Diagnose Events and Conditions z 1 '1 Understand Plant' .js-,

and System.Response Comply With and Use Procedures (1) -

Operate Control 2+

Boards (2) _7 Communicate and 11 Interact With the Crew 4- / (_

Demonstrate Supervisory Ability (3)

,-1 Comply With and .4?.

Use Tech. Specs. (3) _ - _ _ -

Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's Iii or more event numbers that will allow the examiners to evaluate Fncy for every applicant.

Author: w vr I -Z(/t.(

NRC Reviewer: -

v

-J.

,*-1 0

• e 3/o4I NUREG-1021, Revision 8, Supplement 1 26 of 26

ES-403 Written Examination Graing Form ES-403-1 Quality Checklist Faciitvy:q?;

,SrMr $TI471s -Dateof Exam: z/ I7/ZODS Exam Level: &SRO Initials Item Description a c

1. Clean answer sheets copied before gradi I

2. Answer key changes and question deletions justified and Gc documented  :'1L

3. Applicants' scores checked for addition errors (reviewers spot check > 25% of examinations) 75

4. Grading for all borderline cases (80% +/-2%) reviewed in  ;) b) A

5. All other failing examinations checked to ensure that grades \

are justified 5A

6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of questions missed b half or more of the applicants-Printed Name / Signature Date

a. Grader a.MQ3

b. Facility Reviewer(*) - 6> A/ -______

c. NRC Chief Examiner() ______

d. NRC Supervisor () /4k0

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

5 of 5 NUREG1021, Revision 8, Supplement 1 I -: . - I  :; r.

I . . 1I .1 I- Ir .

A

ES-403 Written Examination Grading Form ES-403-1

- Quality Checklist

~Faciitv:t2g pubq,

.- _. ..., -,_ ...... Ar, .- ..r *W.***

Ac in fate nf Fram 2//Z A-,

• f - _.fl F. fl ar *f

- - - _ Initials-Item Description a b C

1. Clean answer sheets copied before qradinq 3A

2. Answer key changes and question deletions justified anX

2. documented  : -

3. Applicants' scores checked fot addition errors (reviewers spot check > 25% of examinations)

4. Grading for all borderline cases (80% +1-2%) reviewed in detail l

5. All other failing examinations checked to ensure that grades are iustified

6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of Questions missed by half or more of the applicants Printed Name / Signature Date

a. Grader _____)) 0

b. Facility Reviewer(*) A g e (de6 1 _______

c. NRC Chief Examiner () - /

d. NRC Supervisor() __ O_ I

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

5 of 5 NUREG-1021, Revision 8, Supplement 1

Page l ot 4 Operator Licensing Exam Schedule 02Q2712003 13:33:11 From 10/01/2002 To 09/30=003 Report 21 Region: 4 Phase Code: 5 Operatlonal l Exam Week 11Site/Dockat Nof nsp Rpt # - t

• C:sndidd ITIrn II tl* W Fenm *I

• thetirbi tm .

Ferminr

. ....... . sA .,,,.,,. .El5 . 9 fl 01/21/2003 Rlver Bend /05000458/2003301 RO-6 SROI - 3 Prep MURPHY, MICHAEL E. MURPHY, MICHAEL E.

TAC #: X02241 SROU - 3 WERNER, G E.

02/1012003 River Bend /05000458 / 2003301 RO-4 SROI - 4 Admin MURPHY, MICHAEL E. MCKERNON, THOMAS 0.

TAC #: X02241 SROU - 4 MURPHY, MICHAEL E.

STETKA, THOMAS F.

WERNER, G E.

Sites: RBS Orgs:4620 Exam Author:ALL

-Page 2 of 4 Operator Licensing Exam Schedule 0212712003 13:33:11I Report21 From 10101t2002 To 09/30/2003 Region: 4 FPhase Code: 5 Operatlonal Summar By Date 01/2003 RBS - River Bend RO -6 SROI -3 SROU - 3 LSRO - 0 Total for River Bend: 12 0112003 RO -6 SROI -3 SROU - 3 LSRO - 0 Total for O1Q003:12 0212003 RBS - River Bend RO -4 SROI -4 SROU - 4 LSRO -0 Total for River Bend: 12 Sites: RBS Orgs 4620 Exam Author:ALL 77 .' '= - e. , -S7 ' . .

1 7! . V  :" . .' ...... I. -7, i : I':

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' j ' - I'l E Ir 'i- I l .' v :  : 1 ' '- I I ': It 1 :_ ' I '1 I7 ' ' '1E r.'

11 I '.: . I I

V]p4C I 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) or Z(WtbL03 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct. evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC.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 andlor an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of }row4rom the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATE1) DATE GNATUR DATENOTE

1. M tc, Og 4.

NOTEx-MAS I -/ADl7ag & / , 3

5. ~WhyFbC ZS /a C IF

6. Clev ~w~Rv"z~juS.

7. wm !M.~'£Si - Xj- 2, IW&

.'d Z -7 T a's 82 AoM~t~ Aiei

. #2'r-at .1 I1-46,13

-Z-A " 4&wm du

13. CFrF-OQZZTC ~~iAv p a 12 . .1 ItL-r -

14. D.a Ilqs X*orLo  ; nok A 4%-?-oZ  !/ 3

./r - - I I NOTES:

NUF *1021, Revision 8, Supplement 1 2/ 24

-FP're a ES-Z01 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 C/11o03 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC.Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of i From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide erformance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATENOTE 1$4l4%a K. C uaL.

trW A46,sst TWA.oi3 t-e-o3 _W_

2.a> NA 0- or Opea~kt.AS f B I L K asksg t-01436h;iX -- Z 3 . L - *7fB.a As .5.,.,S . . t7/ 9 1.423 .-

amp-..-19 5.

6. .ides - - c.C4 lo k w 'Guse J awX----

2 ^

9 3.u Lr fora.~&' iM4WuG.I0 _____________________xh

10. _____-___

11. ,))dv, -

12.

13..

14.

15.

NOTES:

NUFk *1021, Revision 8, Supplement 1 2,' ' 24 g',"- "177 ? ? 47:' _1_6,9., -M_!