ML13086A324

2013 Monticello Nuclear Generating Plant Initial License Examination: Examination Security Agreement (Form ES-201-3)

ML13086A324
Person / Time
Site:	Monticello
Issue date:	01/28/2013
From:	Mcneil D NRC/RGN-III/DRS/OLB
To:
Shared Package
ML11354A221	List: ML13086A302 ML13086A324 ML13086A337
References
Download: ML13086A324 (9)

Text

~F-1071-ot.V.

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• MASTER SECURITY AGREEMENT The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

.;)~/3 I acknowledge that I have acquired specialized knowledge about the QJtI GP ;~~J2rexamination(s) scheduled for the date(s) of

/-Q?8-13h =ii/IS as of the date of my signature. I agree that I will not knowing y ~vulge any information about these examinations to any persons who haVe not been authorized by an Operations Training Supervisor. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager 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 examinations administered during the date(s) of IIz'1h! - ;;(./13 . From the date that I entered into this security agreement until the completion of examination administration,/1 did not i'nstruct, evaluate, or provide performance feedback to those individuals who were administered these examinations.

PRINTED NAME JOB TITLE / RESPONSIBILITY TNOTE

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Retention: Life of Plant Retain in: Exam File

• MASTER SECURITY AGREEMENT P,ttOf2 The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.

PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE 8.

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Retention: Life of Plant Retain in: Exam File

QF-1071-A,V. 2 (FP-T-SAT-71) l~iC8I~1

• LIMITED SECURITY AGREEMENT P.Of2 The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge hat I have acquired specialized knowledge about the J1'IN("l ZCH,3 \\,T examination scheduled for the date(s) of

~-I" to 2. 'I (:s as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.

Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best 9f I1lY knowle ge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of 'll1( 13 - .;) ~ 13 . From the date that I entered into this security agreement until the completion of this examination .

administration, I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me.

PRINTED NAME JOB TITLE / RESPONSIBILITY DATE ~lpNATURE (2) DATE NOTE 1.

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Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071-A,Vo 2 (FP-T-SAT-71) III XcelEnergrJ

• LIMITED SECURITY AGREEMENT plof2 J

The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. PRINTED NAME DATE NOTE -)

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Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

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• QF-1071-02. Rev. 2 (FP-T-SAT-71)

XcelEnefgyT ._. ~ITED

• SECURITY AGREEMENT
• Page 2 of2 I

The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. PRINTED NAME JOB TITLE I RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2) DATE NOTE - ) 5. ~e Z'b.wQ'cnc/ ~;r:?~ h~.a:.......--~ "<~£~--~3_

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NOTES: Retention: Life of plant Retain in: Exam tile. Fonn retained in accordance with record retention schedule identified in FP-G-RM-01.

I OF-1071Rev. 2 (FP-T-SAT-71) fl xCiI Energr I

• LIMITED SECURITY AGREEMENT 1.1012 The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT -71, Attachment 1 for pre-job briefing requirements)

I acknowledge tbat I have acquired specialized knowledge about the Millie 21)/3 J2r examination scheduled for the date(s) of

       -"t - 1hz ~         as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not een authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.

Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best f y knowle ge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of I l ' I'J - z 13 . From the date that I entered into this security agreement until the completion of this examination administration, I did not Instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me. PRINTED NAME JOB TITLE / RESPONSIBILITY DATE SIGNATURE...L2) DATE NOTE

1. /i'lcM/2i) ~Ct5e'-'1 SIZO I/l1;/z.

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4. <~rA~oi4 Zo ~-'11- t;;~tz ~L A-.ri '*11013 Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071Rev. 2 (FP-T-SAT-71) 11l~EnerWl

• LIMITED SECURITY AGREEMENT tl2of2 J

The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. JOB TITLE I RESPONSIBILITY DATE NOTE f'D ;2.-7-/3

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15. "H'/l.l~ l~rn t.@c,( tN.!.,I\.1oI(;10'l. ~ 1l/2.'1Jlt zla6s NOTES:

Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071-lev. 2 (FP-T-SAT-71) III Xcel Energy I

• LIMITED SECURITY AGREEMENT P.Of2 The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.

1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)

I acknowledge hat I have acquired specialized knowledge about the 2"/3111#1,1' ILl examination scheduled for the date(s) of

   /- Z - /      l) 2. I) as of the date of my signature. I agree that I will not knowingly divulge any information about this examination to any persons who have not een authorized by an Operations Training Supervisor.. I understand that I am not to instruct or provide performance feedback to those individuals scheduled to be administered these examinations from this date until completion of examination administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.

Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of [y knO~I,dge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of 1/2'1 /3 - cJ, 13. . From the date that I entered into this security agreement until the completion of this examination administration: I did not instruct, evaluate, or provide performance feedback to those individuals who were administered this examination.

Furthermore, I agree to NOT discuss any aspects associated with the contents of this examination with ANY examinee until the completion of their examination administration. I further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement action against the facility licensee or me. PRINTED NAME JOB TITLE / RESPONSIBILITY DATE DATE NOTE

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4. I t/3/WA 6V1JO~ ~ M zkk Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.

QF-1071.1ev. 2 (FP-T-SAT-71) Ifl Xcf!IEOOrg, I

                                                               ---          ---

• LIMITED SECURITY AGREEMENT

_012 The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. PRINTED1AM'7 JOB TITLE I RESPONSIBILITY NOTE

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