ML20138N724

Applicant Exhibit A-41,consisting of 850219 Employee Exit Questionnaire for Ps Miriello

ML20138N724
Person / Time
Site:	Harris
Issue date:	10/03/1985
From:	Lowry B AFFILIATION NOT ASSIGNED
To:
References
OL-A-041, OL-A-41, NUDOCS 8511060001
Download: ML20138N724 (2)

Text

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e s S0 '/00 */ 4/fl En # 4I 6 < R- 4/ z Form 802 V ATTACIC4ENT 3 5/84 g .n9

[ h'I /d hgN j$ #y'Q QCP Case Number (Assigned by QCP Coordinator)

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/;. 6, c->- YEE EXIT QUESTIONNAIRE '

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1. Were you prov ed o entation on the Harris Nuclear Project Quality Check program? Yes No

2. Have you reported any concerns or allegations in regard to the design, fabrication, construction, test, start- or inspection of the Harris

, Nuclear Project? Yes] No

3. If you reported concerns or allegations, were the results satisfactory?

Yes No Not applicable

4. Do you have any remaining concerns or allegations which you have not reported?

Yes No If answer is YES, complete,QCR form.

5. What is yourreason / -

G for leaving the Harris Nuclear'Prdjget?

\

/.2C.<.W t 4 Ad C4 b, The attached Q icy Check Report form may be used at somo latar cima for reporting concerns results or or allegations which you'may have reported previously without satisfactory ich you have not r port -

0 0 5Y I Date k~l Y ~

Signature d v [ .M[ ,

N lea P j O[7 I ((b Date Commenced Work Name ATM' M /'J7 / A /E / /-C) (Print) at Harris Project #

N Address 80, Od E!@O 7/ _ Telephone No. [ f

• l-//o f ifdL E / GM, A/ d. 2 76 // .

The QCP Coordinator or one of his representatives will assist if needed in filling out this form or the attachment.

Date k-'/ h '

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Notes:

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.g V, - } Q h(f k .

l 1 .A%

f[CY Coordinator od/Represertes ive

Attachment:

Quality. Check Report form ^

(To be provided to employee) l 1

8511060001 851003 l PDR ADOCK 05000400 i

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