ML18060A246

Indian Point, Single Positive Test Form, Random, Collected on 10/16/17

ML18060A246
Person / Time
Site:	Indian Point
Issue date:	02/15/2018
From:	Griffin W, Pettus K Entergy Nuclear Northeast
To:	Office of Nuclear Security and Incident Response
References
IPEC 2017-009, NL-18-011
Download: ML18060A246 (1)

Text

-*-* ---------------------------------------------------------------------, .1 U.S.NRC ' FFD Program Performance Data Reporting System I'-' NRC Form 890 Single Pos1t1ve Test Form I, ,, ,, '\.u I k, " -1EIE General Submission Portal1 l'r11t1*, t111g l'1*oph' mul the I m ,r111u1t1 ,,, 1) All fields required except those marked 'opUonal' APPROVED BY 0MB: CLEARANCE NO. 3150-0146 EXPIRES: 11130/2017 2) Entries in some fields auto--populate informaUon in other fields Estimated burden per response to comply with this collection request is 30 minutes. This 3) Mouse over form fields to view additional Information form is a voluntary means of reporting the information required under 10 CFR 26.717. The 4) Use of Adobe Reader 8 or later Is required information is required by NRC to obtain on an annual basis site specific fitness-for-duty (FFO) program performance data on drug and alcohol programs from licensees and other D Submission D ~~~e~~ssion entities. Send comments regarding burden estimate to the FOIA, Privacy and Information Update Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission, Washington DC 20555-0001, or by e-mail to lnfocoUects Resource@NRC gov. and to the Desk Officer, Unlaue Reference ID /License Suoolied\ Office of Information and Regulatory Affairs, NEDB-1020. (3150-0146), Office of IIPEC 2017-009 I Management and Budget, Washington DC 20503. If a means used to impose information collection does not display a currently valid 0MB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection. Select Fac/1/ty I Indian Point [50-247; 50-286) I Date of Collection I (mm/dd/yyyy) 10/16/2017 I Reason for Testing-26.717(bl(5) Please elaborate (optional) I Random I I I Employment Type -26. 717(b)(3) Outage Worker (optional)? I Licensee Employee I INo I Labor Category-26.717(bl(3) I Maintenance (general facility) I Is this a 24-hour reporting event? -26. 719(b) Was this collection refused? -26.717(bl(7) & 26.75 Test Results-26.717(b)(4) Test Type(s) for Result(s) Reported* 26.717(bl(2) Drug Specimen Tested lonug Only I junne I Test Validity lvalid I Was this collection observed?-26.717(b)(7) & 26.75 How many substances were confirmed positive for this individual? I 1 I Substance-26.717(b)(2) & (b)(6) UseNRC Initial Confirmatory Umitof Cutoffs? Cutoff Cutoff Detection jcocaine I lc;J Subversion Attempt* Did this collection involve a subversion attempt?-26.717(b)(7) and 26.75(b) I No I Management Actions -26. 717(b)(8) & 26. 75 Reason for the Action I First drug or alcohol positive I Sanction Applied (NRC Minimum or Licensee Administrated) INRC Minimum I Specific Sanction Applied 114-Day Denial I Person(s) Responsible for Information Provided Person 1 (required): I Kelly I I Pettus I lsr. Secun1y Coordinator, Access/FFD I kpettus@entergy.com First Name Last Name Position Title Company Email Address Person 2 (optional): lwayne IIGriffin I I supervisor. AccesslFFD I wgriff1@entergy.com 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 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. -Form Locked On:!Feb 15, 2018 at 10:35:12 AM [ I Save to Local PC 11 Print this Report I Single Positive Test Form (version 1.7.0 December 2016) NRC Form 890 (12/2014)