ML18060A244

Single Positive Test Form, for Pre-Access, Collected on 10/11/17

ML18060A244
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 2017-007, NL-18-011
Download: ML18060A244 (1)

Text

.1 U.S.NRC \ FFD Program Performance Data Reporting System I '-., NRC F o rm 89 0. Single P o s1t1v e Te s t Form 1, I'-,,,\.ul,"k' 11, l'r111t*1flllf;f l'c oph.: mullltt* fmrr, , mu ,, u (EIE General Subn11ss 1 on Portal) 1) Al l llelds required except those marlced 'optional' APPRO V ED B Y 0M B: C LEARAN CE NO. 3 1 50-0 146 EX P IRE S: 11/3 0/2 01 7 2) Entries In some fields auto*,popu l ate Information In other fields E sti mat ed burden per response to co mply with this collection reque st is 30 minutes. This 3) Mouse over form fields to view additional Information form is a voluntary means of reporting the information required und er 10 CFR 26.717. T he 4) Use of Adobe Reader 8 or later is required information is required by NRC to obtain on an annual basis site speci fi c fitness-for-du ty (F F D) program performance da t a on drug and alcohol programs from licensees and othe r 0 Submission D ~~~e!~ssion entities. Send co mments regarding burden estimate to the FOIA , Privacy and Information Collection Branch (T5-F53), U.S. Nuclear Regulatory Commission , Washington DC Update 20555-0001 , or by e-mail to l ofoco ll ects Resou r ce@NR C g ov , and to th e Desk Officer , Unique Reference ID (License Supplied)

Office of Information and Regulatory Affairs , NEOB-1020 , (315 0-0 146), Office of I I PEC 20 1 7-007 I Management and Budget. Washington DC 20503. If a means used to impose information collection does not di s play a cu rrently valid 0MB contro l number. the NRC may not con d uct or sponsor , and a person is not required to respond to , the information collectio n. Select Facllity !India n Point [50-247; 50-286) I Date of Collection I (m m lddlyyyy) 10 1 11 1 2017 I Reason for Testing. 26.7 1 7(b)(5) Pre-Access Testing Reason (o ptional) P l ease elaborate (optional)

!P r e-Access I I Initial Au th or i zation I I I Employment Type -26. 717(b)(3)

Outage Worker (optional)?

IContractorNendor I !No I Labor Category-26. 717(b)(3)

!Facility Support I Is this a 24-hour reporting event?-26.719(b) Was this collect i on refused? -26.717(b)(7) & 26.75 Test Results-26.7 17(b)(4) T est Type(s) for Result(s)

Reported*

26.717(b)(2)

D r ug Specimen Tested lorug O n ly I Junne I Test Validity jvalid I Was this collect i on observed?. 26.717(b)(7)

& 26.75 How many substances were confirmed positive for t h is individual?

I 1 I Substance

-26. 717(b)(2)

& (b)(6) UseNRC Initial Confirmatory Limit of Cutoffs? Cutoff Cutoff Detect i o n I Marijuana I I~ Subversion Attempt* Did this collection involve a subversion attempt? -26.717(b)(7) and 26.75(b) [ No I Management Actions -26.717(b)(8)

& 26.75 Reaso n for the Action I Firs t drug or alcohol posi t ive I Sanctio n Applied (NRC Minimum or Licensee Administrated) lucensee Administrated I S p ecific Sanction Appl i ed 13-Year Denial I Person(s)

Responsible for Inform a tion Pro~lded Person 1 (required)

I Kelly I I Pettus I i s'-Security Coordinato, , Access/FFD I kpettus@en t ergy.com First Name Las t Name Pos ition Title Compa n y Email Address Person 2 (o ptional): lwayne I IGdffin I l supe,viso, , Access/FFD I wg,iff1@ente,gy.com First Name Last Name Position Ti t le Company Email Add r ess Final Step (Required)

-NRC will consider this form authentic in accordance with 10 CFR 26.11 only when the "Valida te & Lo c k* button is clicked and all errors (high lighted in red) ha ve been corrected. The " Validate & L ock~ button will change to " Locked* aft er the data validation process has been successfully com plet ed indicating the form is r eady for submission. -Form Locked On:jFeb 15 , 2018 at 10:34:05 AM I I Sa v e t o L o ca l P C 1 1 Print thi s R e p o rt I Single Positive Test Form (versio n 1.7.0 -December 20 1 6) NRG Form 890 (12/2 0 1 4)