ML22055A728
| ML22055A728 | |
| Person / Time | |
|---|---|
| Site: | Oyster Creek |
| Issue date: | 02/24/2022 |
| From: | Schratz L AmerGen Energy Co |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation, Office of Nuclear Security and Incident Response |
| References | |
| OYC-2021-01, OYC-2021-02, OYC-2021-03, OYC-2021-04, OYC-2021-05, OYC-2021-06, OYC-2021-07, OYC-2021-08 | |
| Download: ML22055A728 (10) | |
Text
<1Jj US NR C \\
FFD Program Performance Data Reporting System
'x.J NRC Form 891, Annual Reporting Form for Drug and Alcohol Tests llnued S1.u e~ Nude-ar Regul.1to')' Commm,1on l'rott!Clillf! l't!O/lle mu/ the £tll'ITOJllltl!III (EIE General Subm1ss1on Portal)
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply with this collection request is 106 hours0.00123 days <br />0.0294 hours <br />1.752645e-4 weeks <br />4.0333e-5 months <br />. This form is a voluntary means of reporting the information required under 10 CFR 26.417(b)(2) and 26.717. The Information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FFO) program performance data on drug and alcohol progr~s from licensees and other entities. Send comments regarding burden estimate lo the FOIA, Libre¥)',
and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e_mail to lofocollects Rosoorce@NRC g~ and the OMBreviewer at: 0MB Office of Information and Regulato,y Affair~ (3150-0146), Attn: Desk Off<er fo, lhe Nucfear Regulalory Commission, 725 17lh Street NW, Washinglon, DC 20503; e-mail: O-_!i_.!;!Jbmssioo@omb oop ooy. The NRC may not conduct or sponsor, and a person is not requirod to respond to, a collection of information unless the documoot requesting or requiring the oollectioo displays a currently valid 0MB control number.
- 1) All llclds required unloss marked 'optional'
- 2) Use of Adobe Reader 8 or later Is required
- 3) Mouse over flalds for additional information D Submission Update Facility Period of Report
!oyster Creek [50-2191 I I 2021 I
Tests Conducted in the Calendar Year Total Number of Tests Conducted Total Number of Positive, Adulterated, Substituted, and Refusal to Test Results Reason For Testing Licensee Employees Pre-Access I
183 Random I
149 For Cause I
0 Post-Event I
1 Followup I
51 Total (Calculated)
I 384 FFD Program Random Testing Population and Rate Average number of licensee employees 1
209 1 Laboratory Testing Average number of contractors/vendors Does your program use a I I
Licensee Testing Facility?
No (Yes I No)
Contractors/Vendors 102 \\
0 11 169 Total size of the random testing pool throughout the period (Calculated) 1 2831 I
6 I
2 I
D I
0 I
0 I
8 Annual random testing percentage achieved for the testing pool I
72.1 I HHS-Certified Laboratory (Primary)
IMedTox I HHS-Certified Laboratory (Backup)
IEtsohly Labs I
Identify your Blind Performance Test Sample supplier(s)I ~E_1_so_h_1_y_L_a_b_s ____ _________________________ _,I Substances Tested Did your program only test for NRC-required substances Iv I
8.1:ill at the NRG-specified minimum cutoff levels? (Yes / No) ~-_e_s _ _____ _
Does your program conduct LOO testing I I
permitted in 26.163(a)(2)? (Yes / No)
Yes Special Analyses Testing Results Substance Use NRC Cutoffs?
Alcohol IYes Cocaine Ives Marijuana I Yes Amphetamines Ives Opiates Ives PCP Ives Specimen Test Results Total Number of "Dilute" Specimens Total Number of "Dilute" 1
1 1
(Optional)
(Special Analyses Testing Conducted)
Initial Cutoff Confirmatory Cutoff Lim it of Detection (LOO) Testing?
I Not Applicable Ives Ives Ives Ives Ives Comment (Optional)
Annual Report Form (version 1.10.0-0ctober 2021)
- Page 1 of 2 -
Substances Tested - continued Summary of Management Actions - 26.717(b)(8)
Summarize actions implemented to improve FFD program performance. As applicable, reference in the topic description audit reports, 30-day reports, and/or corrective action reports. If reporting information on more than three topics, select "Others" for Topic 3 to report any additional topics.
Topic 1 jPlease Select Person(s) Responsible for Information Provided Person 1 (required):
~IL_in_d_a __ ~~-------~I lschratz I
IANFFD Supervisor First Name
~-----,L-a-s.,-t.,.N,..a_m_e _ _ __ ~
Position Title Person 2 (optional):
First Name Last Name Position Title l.schratz@holtec.com Company Email Address Company Email Address Final Step (Required) - NRC will consider this form authentic in accordance with 10 CFR 26.11 only when the "Validate & Lock" button has been selected and all errors (i.e., those highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successfully completed and the form is ready for submission.
Form Locked On: I Feb 24, 2022 at 12:15:43 PM I I Save to Local PC 11 Print this Report Annual Report Form (version 1.10.0 - October 2021)
- Page 2 of 2 -
<ii* US NR C FFD Program Performance Data Reporting System
--l Vn,<<Js, *.,,N:dwn".i.~i..w-,*Con,nu"""
NRC Form 890, Single Pos1t1ve Test Form Prot~ct/111-: Piaplenml the £ m*iranmelll (EIE General Submission Portal)
- 1) All fields required cxc*pt those rmrked 'optional' 2J Entries in some fields auio-populate Information in other fields
- 3) Mouse over form fialds to view additional lnlorm.Jtion
- 4) Use at Adobe Reader I or later is required Submission Update Uni uo Reference ID Licensee Su lied OYC-2021-01 Facility I
Oyster Creek [50-219)
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply with tin collection request Is 30 minutes Thts form Is a voluntary means of reporting the inform.ition required under 10 CFR 26 4H(b)(2) and 26 717 The information 1s required by NRC to obtain on an annual basis stte specific mness.
for-duty (FFD) program perf01mance data on drug and alcohol programs from hcensees and ofher enlihes Send comments regarding burden estimate to the FOIA. Library, and Information Collections Branch (T-6 A10M), US Nuclear Regulatory Commission, Washmgton. DC 20555-0001, or by e_maII to l~IS~
. and the 0MB reviewer at: 0MB Offk:e of Information and Regulatory Affairs, {3150-0146), Attn Desk Officer for the Nuclear Regulatory Comm1sslon, 725 17th Street NW, Washington.
OC
- 20503, e.ma11.
ova subm,ss1on@ocnb_tO~QV The NRC may nOI conduct or sponsor, and a person is nOI required to respond lo, a collection of inf01mat10n unless lhe document requesting or requmng the collection displays a currently valid 0MB control number Date of Co/Joction I 0112012021 I (mm/dd/yyyy)
Reason for Testing - 26, 717(b)(5)
I Pre-Access Pre-Access Testing Reason (optional)
Employment Type - 26.717(b)(3)
)conlractorNendor Labor Category - 26. 717(b)(3)
I Maintenance (general facility)
!Please Select Outage Worker (optional)?
I No Is this a 24-hour reportable event under 26. 719(b)7 ~
Was this collection refused?
- 26. 717(b)(7) & 26. 75 ~
Test Resu/ts - 26.717(b)(4)
Test Type(s) for Result(s) Reported - 26.717(b)(2)
Drug Specimen Tested IDrug Only lu_n_*n_e _____ _,
Tesl Validity lvalid Was this collection observed? - 26.717(b)(7) & 26.75 ~
How many substances were confirmed positive for this individual? ~I -----~
Substanco - 26.717(b)(2) & (b)(6)
!Marijuana UseNRC Cutoffs?
Initial Confirmatory Limit or Cutoff Cutoff Detection Subversion Attompt -
Did this collection involve a subversion attempt? - 26.717(b)(7) and 26.75(b)._I _ _ _
N_o __
Management Actions - 26.717(b)(8) & 26.75 Reason for the Action I
First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated Licensee Administrated Specific Sanction Applied Porson(s) Responsible for Information Provided Person 1 (requifed):
I..._L_in_d*--~~~------'11 Schratz I
IAA/FFD Supervisor First Name
~---,L~as~t~N~a~m~e ___ __, ~--~P~o-s=iti-on~T=itl_e ___
~
Person 2 (optional):
First Name Last Name Position Title l.schratz@hollec.com Company Email Address Company Email Address Final Step (Rr:quired)
- NRC will consider this form authenlic in accordance with 1 O CFR 26.11 only when the "Validate & Lock* button is clicked and all errors (highlighled in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successrully completed indicating the form is ready for submission.
Form Locked On: !Feb 3, 2022 at 12:42:25 PM Single Positive Test Form {version 1.10.0 -October 2021)
I Save to Local PC 11 Print this Report I NRC Form 890
<i:t' US NR C FFD Program Performance Data Reporting System L'm1cd Soa<<, N: cl,,,R~ uL<<oryCun,nu,,,,,,
NRC Form 890, Single Pos1t1ve Test Form Ptllla tin,: Peoplt wul the Em*1rom11m1 (EIE General Submission Portal)
- 1) All fi~lds required except those m:,rked 'optional'
- 2) EntrlH In some fields ;>ulo--popul11te information In other (fold*
- 3) Mouse over form fields to view additional Information
- 4) Uu of Adobe RHdcr a or /;1ter i* n1qulred Submission Update Uni uc Rofarenco ID Licensee Su lied OYC-2021-02 Facility
!Oyster Creek [50-219)
APPROVED BY 0MB: CLEARANCE NO. 31 50.01 46 EXPIRES: 09/30/2024 Estimated burden per response to comply with this collection request is 30 mmutes This fOJm 1s a voluntary means of,eport/ng the mformation required under 10 CFR 26 417(bH2) and 26 717 The 1nf0fmation Is requited by NRC to o~a1n on an annual basis site specific frtness-for-duty (FFD) program performance d3ta on drug and aloohol programs from licensees and other entities Send comments regarding burden estimate to !he FOIA Library. and Information Collecttons Branch (T-6 A10M). US. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e_ma1I to lnfQ@!.l~:l}JiH2Y!C~. and the 0MB reviewer at. 0MB Office of Information and Regulatory Affairs, (3150-0146), Attn Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC
- 20503, e-mail.
Oll'il submlSSJOQ@gJJ)b (QR.g_OY The NRC may not conduct or sponsor, and a person Is not required to respond to. a collection of mformatlon unless the document requesting or requiring the collection displays a currently valid 0MB control number Doto of Collection I 0210412021 (mmlddlyyyy)
Roason for Testing
- 26.71 7(b)(5)
I Pre-Access Pre-Access Testing Reason (optional)
Employment Type
- 26.71 7(b)(3)
IContractorNendor Labor Category - 26. 717(b)(3) j Maintenance (general facility)
I Please Select Outage Worker (optional)?
!No Is this a 24-hour reponablo ovent under 26.719(b)? ~
Was this collection rofused?
- 26.717(b)(7) & 26.75 ~
Test Rosu/ts. 26.717(b)(4)
Test Type(s) for Result(s) Reported
- 26,71 7(b)(2)
Drug Specimen Tested I
Drug Only
~lu_n_*n_e _____ ~
Test Validity Was this collection observed? - 26.717(b)(7) & 26.75 ~
How many substances were confirmed positive for this individual? I~---- -~
Substance - 26.717(b)(2) & (b)(6)
I Methamphetamine Use NRC Cutolfs?
Initial Confirmatory Limit of Cutoff Cutoff Detection Subversion Attempt
- Did this collection involve a subversion attempt?* 26.71 7(b)(7) and 26.75(b) '~
- N_o __
~
Management Actions
- 26. 717(b)(8) & 26.75 Reason for the Action I
First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated Licensee Administrated Specific Sanction Applied 13-Year Denial Porson(s) Ro$ponsiblo for Information Provided Person 1 (required):
l~L-ln_d*- -~-
~ ----~11 s, h,atz I IANFFD
- SupeNlso, First Name
~ ---~L-a~st~N~a_m_e-
- -~ ~
- -~P~o-s~iti~on~ T~itl_e ___ _,
Person 2 (oplion.l l):
First Name Last Name Pos11ton Title l.schratz@holtec.com Company Email Address Company Email Address Fin.I/ Step (Required)
- NRC will consider !hi$ form authentic in accord3nce with 10 CFR 26.11 only when the 'Validate & Lock" button is clicked and all errors (highlighted in red) have been corrected. The *validate & Lock~ button will change to "Locked~ after th e data validation process has been success fully completed indicating the form is ready for submission.
I Form Locked On:IFeb 3, 2022 at 12:50:28 PM Single Positive Test Form (version 1.10.0 - October 2021)
I Save to Local PC 1 1 Print this Report I NRC Form 890
<7iL US NR C t FFD Program Performance Data Reporting System un.. ed Su1<, N: d.,,R.q;ul.1o'}'Con,nu,,ocu NRC Form 890, Single Pos1t1ve Test Form Prat,*ct/111: People and tht r:m*1t,1111nent (EIE General Subm1ss1on Portal)
- 1) All fields required except lhosa m:,rlred 'option:,/'
- 2) Entries In.some fields auto-populate lnformo lion In other fields
- 3) Mouse over form fleld$ to vlow.rddltion:il Jnform.Jtlon
- 4) Use of Adobe Reader B or J:,tar Is required Submission Update Uni ue Roferencc ID Licensee Su lied OYC-2021-03 Facility I
Oyster Creek (50-219)
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/3012024 Eslimated burden per response to comply with this coffect10n request is 30 minutes This form is a voluntary means of reporting the mlormahon required under 10 CFR 26 417(b)(2) and 26 717 The anformat1on Is required by NRC 10 obl:a1n on an annu.al basis site specific frtness-for-duty (FFD) program performance data on drug and alcohol programs from hcem*ees and other entitles Send comments regarding burden estimate to the FOtA, Library. and Information Collections Branch (T-6 A10M). US Nuclear Regulatory Comm1ss1on, Washington, DC 20555.0001, or by e_ma~ to lnfocotlecls 8r:10urcc~. and the 0MB reviewer at 0MB Office of Information and Regulatory Affairs, (3150-0146). Alln Desk omcer for the Nuclear Regulatory Comm1ss1on, 725 17th Street MN.
- 20503, e*ma1I*
01[3 subm1S11on@omb e:oc goy The NRC may not conduct or sponsor. and a person Is not required to respond to. a cotlectton of information unless the document requesting or requmng the collection displays a currently valid 0MB control number Date of Collection I 0311612021 (mm/dd/yyyy)
Reason for Testing - 26. 717(b)(5)
I Pre-Access Pre-Access Testing Reason (optional)
Employment Typo - 26. 717(b)(3)
IContractorN endor Labor Catogory - 26.717(b)(3)
I Maintenance (general facility)
I Please Select Outage Worker (optional)?
INo Is this a 24-hour reportable event under 26.719/b)? ~
Was this col/oction refused? - 26.717(b)(7) & 26.75 ~
Test Rosu/ts - 26.717(b)(4)
Test Type(s) for Result(s) Reported-26.717(b)(2)
Drug Specimen Tested I
Drug Only I
Urine I
Was this collection observed7 -26.717(b)(7) & 26.75 ~
How many substances were confirmed positive for this individual? LI _
____ ~
Substance - 26. 717(b)(2) & (b)(6)
/Marijuana Use NRC Cutoffs?
~
Initial Confirmatory Limit of Cutoff Cutoff Detection Subversion Attempt - Did this collection involve a subversion attempt?* 26. 717(b)(7) and 26. 75(b) LI ___
N_o __
J Managomont Actions - 26.717(b)(8) & 26.75 Reason for the Action I
First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated Licensee Administrated Specific Sanction Applied 13-Year Denial Porson(s) Responsib/o for Information Provided Person 1 (required):
LIL_;n_d*--~------~
I Jschratz I IAA/FFD Superv;sor First Name
~ ---
-L-as-t~N-a_m_e ___ ~
'---~P~o-s-iti~o-n~T~itl~e---_,
Person 2 (optional):
J.schratz@hollec.com Company Email Address
~--=-ll~
---==-11.___~-~~~~
First Name Last Name Position Title Company Email Address Final Stop (Requlrod)
- NRC will consider this fo,m authentic in accordance with 10 CFR 26.11 only when th e "Validate & Lock" button is clicked and all errors {highlighted in red) have been corrected. The.. Validate & Lock~ button will change to
- Locked" ofter the data validation process has been successfully completed indicating fh e form is ready for submission.
I Form Locked On:IFeb 3, 2022 at 1:08:32 PM Single Positive Test Form (version 1.10.0 - October 2021)
I Save to Local PC 11 Print this Report I NRG Form 890
~ *us NR c--l
FFD Program Performance Data Reporting System L'n,1cJs,.... N:dw;q;uu<oryCon,n1>1uon NRC Form 890, Single Positive Test Form Prnt1;crilt1: P1;nple amt 1h~ £t1dmm11,*n1 (EIE General Subm1ss1on Portal)
- 1) All fields requ;red excttpl those m;Jrl(ed 'optloniJ/'
- 2) Entries In some fields auto-populate Information In other fields
- 3) Moun over form fields to vltJw additional inform;Jtlon
- 4) Use of Adobft Reader a or later Is roqulred Submission Update Uni uo Roforonce ID Licensee Su lied OYC-2021-04 Fac/llty
!Oyster Creek [50-219]
APPROVED BY 0MB: CLEARANCE NO, 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply with this coffect10n request is 30 minutes This form is a voluntary means ol reporting the information required under 10 CFR 26 417(b)(2) and 26 717 The inf0Imat10n 1s required by NRC to obtain on an annual basis site specific frtness-for-duty {FFD) program perfOfmance data on drug and alcohol programs from licensees and other entities Send comments regarding burden estimate to the FOIA library, and Information Collections Branch {T--6 A10M ), U S Nuclear Regulatory Commission, Washington, DC 20555-0001, or bye_ma~ to lnfoeoll<:cts BesourceCNRC gov, and the 0MB reviewer at 0MB Office of Information and Regulatory Affarrs, (3150-0146). Attn. Desk Orticer for the Nuclear Regulatory Commission. 725 17th Street NW. Washington, DC 20503, e-ma1!
01rn submlSSl00@omtJ <:00.QQ.V The NRC may not conduct or sponsor, and a person Is not required to respond to, a conec110n or information unless the document requestmg or requiring the colle<:llon displays a currently vahd 0MB control number Dato of Col/action I 0912812021 (mm/dd/yyyy)
Reason for Tasting - 26. 717(b)(5)
I Pre-Access Pre-Access Testing Reason (optional)
Employment Type - 26.717(b)(3)
IContractorNendor Labor Catogory - 26.717(b)(3)
!Maintenance (general facility)
I Please Select Outage Worker (optional) ?
!No Is this a 24-hour roportab/o event under 26.719/b)7 ~
Was this collection refused? - 26. 717(b)(7) & 26.75 ~
Test Results - 26.717(b)(4)
Test Type(s) for Result(s) Reported
- 26.717(b)(2)
Drug Specimen Tested
\\orug Only
~lu_ri_n_e _____ ~
Test Validity lvalid Was this collection observed? - 26. 717(b)(7) & 26. 75 ~
How many substances were confirmed positive for this individual? ~' -----~
Substanco - 26. 717(b)(2) & (b)(6)
!cocaine Use NRC Culotfs?
Initial Confirmatory Limit or Cutoff Cutoff Detection Subvorsion Attempt -
Did this collection involve a subversion attempt? - 26.717(b)(7) and 26.75(b) l~ __ N_o __ ~
Management Actions - 26. 717(b)(8) & 26. 75 Reason for the Action I
First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated)
Licensee Administrated Specific Sanction Applied 13-Year Denial Pcrson(s) Responsible for Information Provided Person 1 (required):
l~L-in_**----.c-.--=--,-,--,---~I Lls_
,h_,_""--~~~----~I IAAIFFD Supen,iso, First Name Last Name
'---~P~o-s~iti~on~T~itl_e ___ _,
Person 2 (optional):
First Name Last Name Position Title l.schratz@holtcc.com Company Email Address Company Email Address Final Step (Required) - NRC will consider this form authentic in accordance with 10 CFR 26.1 1 only wtlen the 'Validate & Lock" button is clicked and all errors (highlighted in red) have been corrected, The "Validate & Lock~ button wilt change to ~Locked" after the data validation process has been success fully completed indicating the form is ready for submission.
Form Locked On:IFeb 3, 2022 at 1:17:32 PM Single Positive Test Form (version 1.10.0- October 2021)
I Save to Local PC 11 Print this Report I NRC Form 890
<i!_;, us NR C \\
FFD Program Performance Data Reporting System l'nH<<IS1a1<,N:dw R:,.uJ.,u,y Co,,,nn,,,.,.
NRC Form 890, Single Pos1t1ve Test Form fro1ectl11,: People am/ the Em *u,wmcnt (EIE General Subm1ss1on Portal)
- 1) Alf fields required OKcept those mari(ed 'optional'
- 2) Entries in somo fields auto*popUI.Jte Information in other fields
- 3) Mouse over form fi11lds to view additional Information
- 4) Use of Adobe Reader 8 or later Is required Submission Update un; ue Reference JD Licensee Su lied OYC-2021-05 Facility
!Oyster Creek (50-219]
Reason for Testing
- 26. 717(b)(5)
I Random Employment Typo - 26. 717(b)(3)
IContractorNendor Labor Category - 26. 717(b)(3)
)Maintenance (general facility)
Please elaborate (optional)
Outage Worker (optionalj 7 INo Is this a 24-hour reportable event under 26.119(b)7 ~
Was this collection refused? - 26.717(b)(7) & 26.75 ~
Test Results - 26.717(b)(4)
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply v.-,th this collectlon request Is 30 minutes This form is a voluntary means of reporting the information required under 10 CFR 26 417(b)(2) and 26.717 The inlormat10n is required by NRC to attain on an annual basis site specific fitness-for-.duty (FFD) program performance data on drug and alcohol programs lrom licensees and other ent~les Send comments regarding burden estimate to the FOIA. Library, and Information Collections Branch (T--6 A10M), US Nuclear Regulatory Commlss!oo. Washington, DC 20555-0001, or by e_mail to ~
r~ov. and the 0MB reviewer at 0MB Off1c:e of lnformahon and Regulatory Affairs. (3150..0146), Attn Desk Officer fOf the Nuclear Regu!;:atory Commission, 725 17th Street NW. Washington, DC
- 20503, e-ma1I*
2!li! subm11s1on@omb eoo gQY The NRC may not conduct or sponsor, and a person,s not reqwred to respond to, a collection of mf0Jma11on unless the document requesting or requiring the collection displays a currently v.altd 0MB control number.
Date of Collection I 0110812021 I (mm/dd/yyyy)
Test Type(s) for Result(s) Reported* 26.717(b)(2)
Drug Specimen Tested I
Drug Only
~lu_n_*n_e _____ ~
Test Validity lvalid Was this collect/on observed?
- 26. 717(b)(7) & 26. 75 ~
How many substances were confirmed positive for this individual? I~-----~
Substance - 26. 717(b)(2) & (b)(6) jcocalne Use NRC Cutoffs?
Initial Confirmatory Limit of Cutoff Cutoff Detection Subversion Attempt
- Did this collection involve a subversion attempt?* 26.717(b)(7) and 26.75(b) LI _
_ N_o __ ~
Management Actions - 26.717(b)(8) & 26.75 Reason for the Action I
First drug or alcohol positive Sanction Applied NRC Minimum or Licensee Administrated Licensee Administrated Specific Sanction Applied 13*Year Denial Pcrson(s) Rosponslblo for Information Provided Person 1 (required):
~lu
_*n_
d*--~~~----~l lschrntz I IANFFD Supervisor First Name
~ -
- -~L-a~st~N~a_m_e---~
~--~P~o-s~iti-on~T,~11-e ___ _,
Person 2 (optional):
First Name Last Name Position Title l.schratz@holtec.com Company Email Address Company Email Address Fina/ Stop (Requfr~d)
- NRC will consider this form authentic in accordance with 10 CFR 26.11 only when the "Validate & Lock" button is clicked and all errors (highlighted in red) have been corrected. The "Valfdate & Lock~ button will change to "Locked" after th e data validation process has been successfully completed indicating the form is ready for submission.
I Form Locked On:JFeb 3, 2022 at 1:24:32 PM Single Positive Test Form (version 1.10.0- October 2021) j Save to Local PC 11 Print this Report I NRC Form 890
<it; US NR C l""
FFD Program Performance Data Reporting System llo"<<ISme,N:d.,., ;... 1.-0,yCon,m""' "
NRC Form 890, Single Pos1t1ve Test Form Pror,*ctln,: Ptople a,,d the £ 1wirmm,,.,r1 (EIE General Subm1ss1on Portal)
- 1) All fields required r:xcopt those tm1rh'd 'optlom,I'
- 2) Entries in some fields 1111l0-poputate Information fn othor fields
- 3) Mouse ov~r form fields to view additional inform:.tion
- 4) UH of Adobi: Roadcr a or later is required Submission Upda!e Uni uc Reference ID Licensee Su lied OYC-2021-06 Facil/ty IOysterCreek (50-21 9)
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply *with this coMection request 1s 30 minutes This fOl'm 1s a voluntary means of reporting the information required under 10 CFR 26 417(bX2) and 26 717 The 1nf0fmat10n is required by NRC to obtarn on an annual basts srte specific rrtness-fOJ-.duty jFFD) program pertormarlCe data on drug and alcohol programs from licensees and other ent~1es Send comments regarding burden estimate to the FOIA. Ubfary. and Information Collections Branch (T-6 A10M). US Nuclear Regulatory Commlssfon. Washington, DC 20555-CX>01, or by e_ma~ to ~BtisW(Cl!_~. and the OMS reviewer al OMS Office of lntormatton and Regulatory Affairs, (3150-0146). Attn Desk Officer for lhe Nuelear Regulatory Comm1ss1on.
725 17th Street NW.
- 20503, e-ma11*
olra submtSS'oO~O\\l The NRG may not conduct or sponsor, and a person,snot reqwed to respond to, a coltectk>n of 1nf0Jmat10n unless the document requesting or requiring the collection displays a currently valid 0MB control number Dato of Col/octlon I 0112012021 (mmlddlyyyy)
Rosson for Tasting
- 26. 717(b)(5)
I Pre-Access Pre-Access Testing Reason (optional)
Employment Type - 26.717(b)(3)
IContractorNendor Labor Catogory
- 26. 717(b)(3)
I Maintenance (general facility) j Please Select Outage Workor (optional) ?
!No Is th;s a 24-hour roportablo event under 26.719(b)? ~
Was this colloctlon rofusod?
- 26. 717(b)(7) & 26. 75 ~
Subversion Attempt
- Did !his collection involve a subversion attempt? - 26.717(b){7) and 26.75(b) ~[ __
v_e_s _~
0 Did not appear for testing O Shy-bladder (no medical condition)
D Refused to provide initial specimen 181 Refused to provide second specimen 181 Specimen temperature (out of range)
D Specimen paraphernalia identified D Specimen characteristics (e.g., color, odor, precipitant) 0 Invalid test result {initial specimen collected) - 26.185(0 D Refused to follow directions D Donor admitted to subversion attempt OO!her Mansgoment Actions - 26. 717(b)(8) & 26. 75 Reason for the Action jsubversion attempt Sanction Applied NRC Minimum or Licensee Administrated)
NRC Minimum Specific Sanction Applied I
Permanent Denial Person(s) Responsible for Information Provided Person 1 (required):
Please elaborate on the choice(s) selected:
The Initial test temperature was out of range. The donor volunteered to a 2nd observed test per approval by the MRO. Donor changed their mind on the obseNed test and refused to provide second specimen.
l.schratz@holtec.com l~L-in_d*- -~~~----~l lschratz I IANFFD Supe,visor First Name
~ ---~L-as~t~N~a_m_e ___ ~
'------,P~o-s7.it~,o-n~T~itl~e---~
Company Email Address Person 2 (optional):
First Name Last Name Position Title Company Email Address Final Step (Required)
- NRC will consider this form authentic in accordan ce with 10 CFR 26.11 only when the 'Validate & Lock~ button is clicked and all errors (highlighted in red) have been corrected. The "Validate & Lock~ button will change to "Locked" after the data validalion process has been successfully completed indicating the form is ready for submission.
Form Locked On:IFeb 3, 2022 at 1:36:04 PM Single Positive Test Form {version 1.10.0 - October 2021)
I Save to Local PC 11 Print this Report I NRC Form 890
<ii US NR C FFD Program Performance Data Reporting System
- t lJn<<.JSu1e, N:dw : q;uln0,y Con,nu>>0UU NRC Form 890, Single Pos1t1ve Test Form Pr<Jt,*c1Jn,: People amt tht! £1wiro11111m r (EIE General Subm1ss1on Portal)
- 1) All fields requ;red except those m;,rl<ad 'optional'
- 2) Entries In some fields auto-popuftde Information in other nclds
- 3) Mouse over form field* to view additional Information
- 4) Use of Adobe Reader 8 or t11ter Is required Submission Update Uni ue Reforenco ID Licensee Su lied OYC-2021-07 Fsc/lity I
Oyster Creek (50-219]
APPROVED BY 0MB: CLEARANCE NO. 3150.0146 EXPIRES: 09/30/2024 Estimated burden per response to comply with this coMect10n request 1s 30 minutes This form Is a voluntary means of reporting the informalion required under 10 CFR 26 417(bX2) and 26.717 The information ls required by NRC to obtain on an annual basis site specific frtness-for-duty (FFD) program performance data on drug and a\\cohOI programs from IK:ensees and other entities Send commenls regarding burden estimate to the FOIA. Library, and Information Collections Branch (T -6 A10M). U.S Nuclear Regulatory Commssioo, Washington. DC 20555-0001, or by e_maR to lnf~Resource:C NRC 90'- and the OMS reviewer at 0MB Office ol lnformat1on ;;ind Regulatory Affairs. (3150-0146), Attn Desk Officer f0< the Nuclear Regulatory Comm1ss1on. 725 17th Street t,N,/,
Washmgton.
DC 20503, e-mail*
QJ(L$.J.llll'1~on@omb eoo gov The NRC may not conduct or sponsor, and a per.K>n is noc required 10 respond to, a coUect10n of informatkin unless the document requesting or requmng the collection displays a currently valid 0MB control number Date of Collection I 0210412021 I (mm/dd/yyyy)
Roa son for Tasting
- 26. 71 ?(b)(S) j Pre*Access Pre.Access Testing Reason (optional)
Employmont Typo
- 26.717(b)(3)
IContractorNendor Labor Category
- 26.717(b)(3)
I Maintenance (general facility)
I Please Select Dutago Worker (optional)?
iNo Is this a 24-hour reportable evont under 26.719(b)? ~
Was this collection refused?
- 26.717(b)(7) & 26.75 ~
Subversion Attempt-Did this collection involve a subversion attempt? - 26.717(b){7) and 26.75(b) ~I __
Y_e_s __ ~
D Did not appear for testing D Shy-bladder (no medical condition)
D Refused to provide initial specimen D Specimen characteristics (e.g., color, odor, precipitant)
D Invalid test result (initial specimen collected). 26.1asm D Refused to follow directions 181 Refused to provide second specimen D Donor admitted to subversion attempt 181 Specimen temperature (out of range)
D Other D Specimen paraphernalia identified Management Actions
- 26.717(b)(B) & 26.75 Reason for the Action I
Subversion attempt Sanction Applied NRC Minimum or Licensee Administrated NRC Minimum Specific Sanctfon Applied jPermanent Denial Pcrson(s) Rosponsib/c for Information Provided Person 1 (required):
Please elaborate on the choice(s) selected:
The Initial specimen provided by the donor was out of the acceptable temperature range. The donor refused lo provide a second specimen under direct obseNalion.
l.schratz@hollec.com
~IL_in_d*- -~------~I ~'S-ch_,_*tz--~~~----~' IANFFD Supervisor First Name Last Name
~--~P~o-s~iti-on~Ti~tle ___ __,
Company Email Address Person 2 (optional):
First Name Last Name Position Title Company Email Address Final Step (Required) - NRC will consider this form authentic in accordance with 10 CFR 26.11 only wtien the "Validate & Lock~ button is clicked and all errors (highlighted in red) have been corrected. The "Validate & Lock~ button will change to *Locked~ after the data validation process has been successfully completed indicating the form is ready for submission.
Fonn Locked On:IFeb 3, 2022 at 1:46:07 PM Single Positive Test Form (version 1.10.0-October 2021)
I Save to Local PC 1 1 Print this Report I NRC Form 890
~ -us NR C \\***
FFD Program Performance Data Reporting System Un,1eJS1a1e, N:dwR~ ol>tary Can1m""'"
NRC Form 890, Single Pos1t1ve Test Form Prot,*c11t11: Peopleamltfle £Jn-i1111,m,*t1t (EIE General Submission Portal)
- 1) All fields required except those marhd 'optional'
- 2) Entrie* in some fields auto-populate Jnfom,ation in other fields
- 3) Moun ov.ir form fields lo view additional lnformaUon 4} Use of Adobe Reader I or Jatar is required Submission Updale Uni uc Reference ID Licensee Su lied OYC-2021-08 Facility I
Oyster Creek [50-219)
Reason for Testing
- 26.717(b)(S)
!Random Employment Type
- 26. 717(b)(3) lcontractorNendor Labor Category
- 26. 717(b)(3)
I Maintenance (general facility)
Please elaborate (optional)
Outage Worker (optionaQ 7 INo Is this a 24-hour reportable event under 26.719(b)? ~
Was this collection refused?
- 26.717(b)(7) & 26.75 ~
APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 09/30/2024 Estimated burden per response to comply with this collection request is 30 minutes This form is a voluntary means of reporting the information required under 10 CFR 26 41 7(b)(2) and 26 717 The mformahon Is requcred by NRC to obtain on an annual basis sfle specific filness-for-Outy (FFD) program performance data on drug and alcohol programs from licensees and other entttles Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T -6 A10M), US Nucle.ir Regulatory Commission, Washington, DC 20555-0001, or by e_mail to lnfocollects ResourcfCNBC gpy. and the 0MB reviewer at 0MB Office of lnformaI100 and Regulatory Affairs, (3150-0146), Alln Desk Officer for the Nuclear Regulatory Comm1ssfon.
725 17th Street NW, Washington, DC
- 20503, e-m3tl o,ca submtss100Q omb cop goy The NRC may not conduct or sponsor. and a person is not required to respond to, a coUection of 1nformat10n unless the document requesting or requiring the coUecllon displays.i currently valid OMS control number Date of Collection I I
(mmtdd/yyyy) 03/19/2021 Subversion Attempt
- Did this collection involve a subversion attempl?
- 26.717(b)(7) and 26.75(b) LI ___ Ye_s __
D Did not appear for testing D Shy-bladder (no medical condition) 0 Refused to provide initial specimen D Specimen characteristics (e.g., color, odor, precipitant)
D Invalid test result (initial specimen collected)* 26.185(0 D Refused to follow directions 181 Refused to provide second specimen D Donor admitted to subversion attempt 181 Specimen temperature (out of range)
D Other D Specimen paraphernalia identified Management Actions - 26.717(b)(8) & 26.75 Reason for the Action I
Subversion attempt Sanction Applied NRC Minimum or Licensee Administrated NRC Minimum Specific Sanction Applied j Permanent Denial Person(s) Responsible for Information Provided Person 1 (requited):
Please elaborate on the choice(sl selected:
The initial specimen provided by the donor was out of acceptable temperature range. The donor refused to provide a second specimen under direct observation.
LIL_in_d_*--=~~-- --_,J' Lls_c_h,_*tz--~~~----_,I Ll~_F_F_o_s_"_P*_rv_i,_o_r _____ _,J _,.._,_"'_"_*@_ho~lt-*c_.,_o_m~~~~-----
First Name Last Name Position Title Company Email Address Person 2 (optional):
First Name Last Name Position Title Company Email Address Final Step (R~quired) - NRC will consider this form authentic in accordance with 1 O CFR 26.11 only when the "Validate & Lock" button is clicked and all errors (highlighted in red) have been corrected. The "Validate & Lock" button will change to "Locked" after the data validation process has been successfully completed Indicating the form is ready for submission.
I Form Locked On: I Feb 3, 2022 at 1 :55:02 PM Single Positive Test Form (version 1.10.0 -October 2021)
I Save to Local PC 11 Print this Report I NRG Form 890