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{{#Wiki_filter:i QF-1071-0*1 'JV. 2 (FP-T-SAT-7 1) j fl Xcel Energ y-\ MASTER SECURITY AGREEMENT l:'P f 2 ---= T he M as t e r Security Agr ee m ent i s used for t hose personnel having both knowledge of Exam Sens itiv e Mate ri al and unr estric t e d access to Pr imary and Secon da ry Containment.
{{#Wiki_filter:i QF-1071 -0*1   'JV. 2 (FP-T-SAT-7 1)                                                                                                       Pa~t. l:'Pf 2
: 1. Pr e-Examination (Review FP-T-SAT-71 , Attach ment 1 for pre-job briefi n g re qu i remen t s) ! ackno w ledge t ha t I h a ve acq uire d specia li zed knowledge about the 2015 MNGP I LT NRC exam i nation scheduled for t he date of 06-01-15. As of the da te of my signature, I agree that I will not knowingly divulge any information about these examinat i ons to any persons who have not bee n authoriz ed by an Operat ions Train i ng Supervisor. I understand that I am not to instruct or provide performance feedback to t hose i ndividuals scheduled to be administere d these examinations from this date until completion of examination administrat i on. I also understand t ha t I a m not to evaluate indiv i du als schedu led to be adm i nistered these examinations from this date until the date of adm i nist r ation. Act i ng as a simulato r bo ot h operator or commu nica tor is acceptable i f I do not select the training con t ent or provide d ir ect or i ndirect feedback to an exa mi nee. Furthermore , l am awa re of t he physica l security measures and requirements (as documented in NSPM procedures) and u n d ers tan d that vio ia t ion of th e conditions o f th is ag r eemen t may result in cancellation of the examinations and/or an enforcement action aga i nst m y facility o r me. ! w ill immedia tel y report to the E xa m Pro ject Manager any i ndications or suggestions that examinat i on sec u r ity may h a ve bee n compromised.
                                                                                                                                        ---=              ~--i j fl Xcel Energy- \                                                    MASTER SECURITY AGREEMENT
: 2. Post-Exami nati on To the best o f my knowled ge , I did n ot divu lg e to any unauthorized persons any information concerning the exam in ations ad min i s ter ed dur in g the dat e(s) of . From th e date that I entered into th i s security agreement until the comp l et i on of exam i nat i on ad m ini stration , i did not instruct, ev a luate , or provide performance feedback to those individua l s who were administered these exa m inatio ns. Retention:
                                                                                                                      *-*----*--------~J T he Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment.
Li fe of Plant Re tai n in: Exam Fi le SIGNATURE (!) DATE NOTE (,-15-!5 --
: 1. Pre-Examination (Review FP-T-SAT-71 , Attachment 1 for pre-job briefi ng requirements)
7 ft ? hr NU 'l -->.1 ;...::>
      ! acknow ledge that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. As of the date of my signature, I agree that I will not knowingly divulge 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.
6/15/15 tdt'S"h5'-I ,. 'I ---
Furthermore , l am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that vioiation of the conditions of this ag reement may result in cancellation of the examinations and/or an enforcement action against my facility or me. ! will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
QF-1071-0. 2v. 2 fF P-T-SAT-71\
: 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                           . From the date that I entered into this security agreement until the completion of examination administration , i did not instruct, evaluate, or provide performance feedback to those individuals who were administered these examinations.
________ . I '(! Xcel Energ y-/ I ' MASTER SECURITY AGREEMENT T he Master Secur i ty Agre e me nt i s use d for those personne l having both know l edge of Exam Sens i t i ve Material and u nrestricted access to P ri ma ry and Seco nd a r y C o ntainment.
SIGNATURE (! )                                                DATE          NOTE
: 8. 9. 10. i 1. 12. 1 3. 14. 15. NOTES: PRINTE D NAME \ t .)Lf'C 7 .k Ls OA Re t ention: Li fe of Pl ant Re t a i n in: Exam File JOB T I T LE I RE S PO NSIB I LIT Y S I GNATURE (1) 9¥74 S I GNA T URE (2) D AT E N O TE t/l s/15 QF-1071 '2 v. 2 (F P-T-S J\T-71) f2 i '(l Xcel Energy-LIMITED SECURITY AGREE MENT \ ---**-------*--------*----------' The Li m i ted Secur it y Agre e ment i s used for t hose personnel having limited k nowledge of Exam Sens i tiv e Material but do not have unre s t ricte d access t o Primary an d Seconda r y Containment.
(,-15-!5
: 1. Pre-E xamination (Review FP-T-S A T-7 1, Attachment 1 for pre-job briefing requirements)
                                                                                                                                                            - -
I ackn o w le d ge that I have a cquired specialized k nowledge about the 2015 MNGP IL T NRC examination scheduled f o r the date o f 06-01-15. A s of th e d at e o f m y signa tu r e , I agree that I will not know ingly divulge any i nformation a bou t this examination t o any per sons who h a ve not been auth oriz ed by an Operat i ons T r aining Superv i sor .. I und e rst and that I am not to i ns tr uct o r prov ide p erf ormance f eedbac k to those i nd i viduals s che du le d to be administered these exami nat ions fro m this date until completion of examination adm i nist ra tion. l also understan d tha t I am not to ev a l uate i nd i viduals scheduled to be administered these examinations from this date until the date o f adm inis t rat ion. Acting as a simulato r bo o t h operato r o r communicator is acceptable if I do not select the training con t ent or provide di r ect or indirect feedback to an exam i nee. Furth e r more , I am aware of t he phys ica l security measures and requirements (a s documented i n NSPM procedures) and under s tand that v iolat ion of t he c o nditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me. I w i ll im me d iately report to the Exam Project Manager any indications or suggestions that examination security may ha ve be en compromised. 2. Po s t-E xam i na ti on 1. ,., L. 3. 4. 5. To the b e st of m y know l edge , I did not divulge to any unauthorized persons any information concerning the exa m i nation adm i ni s t ered dur i ng the d a t e(s) o f . From the date that I entered into this security agreement until the completio n of this exam inat i on adminis trat i o n, i did not instruct, evaluate , or provide performance feedback to those individuals who were adm i nistered t h is exam i nation. F u rt h e r mo r e , I agree t o NOT discuss any aspects associated with the contents of this examinat i on with ANY examinee until the completion o f t he ir ex aminatio n admin i stration.
0~r
I further understand that violation of the conditions of this ag r eement may result in cancellation of the exam i n ati on a n d/or enforcemen t action again st t he facility l i censee o r me. Ret e nti o n: Life o f p la n t Retain in: Exam file Form reta ined in a c cordance with record reten tion schedule identified i n FP-G-RM-01.
                                                                                                                                          ~>f>
QF-1Q7*i-Oi , (FP-T-SAT-71) I fl Xcel Energy-I LIMITED sEcuR1TY AGREEMENT  
7  ft ? hr NU 6~~"4
*-*----1 The Limit ed Sec ur ity Agreement is used for those personnel having lim i ted knowledge of Exam Sensit i ve Ma terial but do not have unre str i cted acce s s to Primary and Secondary Cont ainmen t. 6. 8. S. j\ PRINTAD N,AME 1 t_ t, v e ,-;I I Sc:-crn-Do \/vQ 10.
                                                                                                                                          ' l -->.1 ;...::> (.~v~ K4..b 6/15/15 tdt'S"h5' I ,. 'I ---
: 11. (M-et* --,....-,---
                                                                                                                                                          -~~
: 12. Jet:>f
h{ tl:S( ~
: 13. J, e:f t r:)IS c.¥\ 14. Bo B ">Tf(.A-i3lt?t
Retention: Life of Plant Retain in: Exam File
: 15. _ _/{ 6fll _ _/lf-Low NOTES: Ret e n tio n: Life of pia nt Re t ain i n: Exam file JOB TITLE S& O /JOJ' Form r etained in accordance with record retent i o n schedule ide n tified in FP-G-RM-01. DATE ll/;o/, 1 f D ATE NOTE tRlut/t{'
---r r1 /f 5. <Pl1c,}1 r---(,,*tJ.*IS' ?/(f!1r-__ 
;;v. 2 (FP-T-SA T-71) Paf, .:>f 2 LIMITED SECURITY AGREEMENT The limited Security Agreement is used for those personne l having limited knowledge of Exam Sensitive Material but do not have unrest rict ed ac cess to Primary and Secondary Containment.
: 1. Pr e-Examination
{Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)
I acknowledge that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15.
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 n o t been authorized by an Operations Training Supervisor  
.. I unde r stand that I am not to instruct or provide performance feedback to those indiv i duals sch eduled to be administered these examinations from this date until complet io n of examinat i on administrat i on. I also understand that I am not t o evaluate individuals scheduled to be administered these examinations from this date until the date of administration.
Acting as a simulator boo th operator or communicator is acceptable if I do not select the training content or provide direct or i ndirect feedbac k to an examinee. Furth ermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) a n d understand that violati on of th e conditions of this agreement may result in cancellation of the examination and/or an enforcement act i on against my faci l ity or me. I will imm ediately report to the Exam Project Manager any indications or suggestions that exam i nat i on security may h a v e been compromised. 2. Post-E xamination To the best of my knowledge, I did* not divulge to any unauthorized persons any info rmation concern i ng the exam i nat ion administered du ri ng the date(s) of_ . From the date that I entered into this security agreement unt il the completion of this examinat i on a dministration, f did not instruc t. evaluate, or provide performance feedback to those individuals who were administered this exam inatio n. Furthermore, I agree to NOT discuss any aspects associated with the contents of this examina ti on with ANY examinee until the comp l e ti on of t heir examination administration. J further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement a0ion against the facility licensee or me. R etention:
Life of plant R etain in: Exam file F orm retained in accordance with record retention schedule identified in FP-G-RM-01. i I I I I I I I I I I I I I I I I I I I QF-1071-C
.;v. 2 (F P-T-SAT-7 1) I fl Xcel Energy I LIMITED SECURITY AGREEMENT T he Li mi t ed Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted a cce s s to Primary and Secondary Containment.
: 1. Pr e-E xamination (Rev i ew FP-T-S AT-71 , Attachment 1 for pre-job briefing requirements)
I ackn owledge t h at I have acquired speci alized knowledge about the 2015 MNGP IL T NRC examination scheduled for the date of 06-01-15. As of t h e date of my signature, I agree t hat I will not knowingly divulge any information about this examination to any persons who have not been au th o r i zed by an Op e rat ions Training Supervisor
.. I understand that I am not to instruct or provide performance feedback to those individuals sch e d uled to be adm i nistered these examinations from this date until completion of examination administration.
I also understand that I am no t to e va l uate i ndividuals scheduled to be admin i stered these examinations from this date until the date of admin i stration. Acting as a simulator bo oth o perator or communic a tor is a cceptable if I do not select the training content or prov i de direct or indirect feedback to an examinee.
Fu rthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that viol a t ion o f the conditions of thi s ag r eement may result in cancellation of the examination and/or an enforcement action against my facility or me. I will i m med i ate l y report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Po st-Exam i nation 1. 2. To the best of my k n owledge, I did n ot divulge to any unauthorized persons any information concerning the examination administered during the da te (s) of . From the date that I entered into this security agreement until the completion of this exam i nation ad m i n i stration , I d i d not i nstruct , ev a luate , or provide performance feedback to those individuals who were administered this examination. Furth ermore , I agree to NOT discuss any aspects associated with the contents of th i s examination with ANY examinee until the completion of the ir examination administration.
I further understand that violation of the conditions of this agreement may result in cancellation of the ex amination and/or enforce men t ac t ion aga i ns t the facility licensee or me. P RINTED NAME JOB TITLE I RESPONSIBILITY
:JC PG V\ Ks <Ro je s Sr \n
________
3_ _____ .........
: 4. /YZ H /:?lu+.,_
______
: 5. JOA"  
<1 Ao ------------Retenti on: Li fe of plant R et a in in: Exam file Fo rm retai ned in acco r dance with record retention schedule identified in FP-G-RM-01.
Q F-1 071-02, .. c v. 2 (F P-T-SAT-7 1) Pag f2 LIMITED SECURITY AGREEMENT The li m it ed Security Agreement i s use d for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted a c cess to Primary and Secondary Containment.
: 6. 7. 8. 9. P RINTED NAME f)ofliv...
6 A1 lf Ic;J uxPr J crz JS l) NE I ,_l 0 12. ,/r/ ,./!vb I tv" c1 13. Bllt.MV W.aeNttr ;:
NOTES: R e tention: Life of plant R e tai n in: Exam file JOB TI TLE I RESPONSIBILITY S v(o .SRO NlJ clew Btirli (Jr trrlt:VYL DPS IMS:n i u.(:fr:,:.,;L F o r m r eta i ne d in accordance with record retention schedule i dentified in FP-G-RM-01. 


'--------.,..--*-----*---
QF-1071-0 .      2v. 2 fFP-T-SAT-71\ ___ _ _ _ _ _.
r-~ ** ------ - - ----~------..:J_
I '(!  Xcel Energy- /                                            MASTER SECURITY AGREEMENT I                          '
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)                      SIGNAT URE (2)          DATE    NOTE 8.
            \
            .)Lf'C t
7 .k Ls    OA                                        9&#xa5;74                                                    t/ls/15 9.
10.
i 1.
12.
13 .
14.
15.
NOTES:
Retention: Life of Plant Retain in: Exam File
 
QF-1071          '2v. 2 (FP-T-SJ\T-71 )                                                                                                              f2
,-,,~------.------------------------------------------------~
i '(l Xcel Energy-
~-------~----------------*------------
LIMITED SECURITY AGREEMENT
                                                                                                                  - - -**- -- -- -- *- ---    --
                                                                                                                                                                \
                                                                                                                                                - -*- - --------'
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 that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. 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 . l 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 my knowledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of                          . From the date that I entered into this security agreement until the completion of this exam ination 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.
1.
  ,.,L .
3.
4.
5.
Retention: Life of plant Retain in: Exam file Form reta ined in accordance with record retention schedule identified in FP-G-RM-01 .
 
QF-1Q7*i-Oi, .av.~ (FP-T-SAT-71)
I fl Xcel Energy-              I
~-----~-~-------------------------------------~---__J LIMITED sEcuR1TY AGREEMENT                                  *- *----1 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.
j\ PRINTAD N,AME          JOB TITLE /(<E~ONSI BILITY                                DATE                                  DATE      NOTE 6.
1t_ t,ve ~s ,-;IIc~                                                                  ll/;o/,1f -=;:,.---:;__~=--:;__-
                                            ~o
: 8.  ~
S.        Sc:-crn-      Do \/vQ                                                                                                  tRlut/t{'- -
: 10.  -~*Ant<;;                                                                                                                  6~-
: 11.      {~ (M-et*                                                                                                              -rr1 /f 5.
12.
              --
Jet:>f
                    ,....-,---
                        /&#xa3;1~?....                                                                                                  <Pl1c,}1r- - -
                                                                                                                                    ~
: 13.      J,e:ft  r:)ISc.&#xa5;\                                                                                                  (,,*tJ.
* IS'
: 14.        Bo B  ">Tf(.A-i3lt?t              S& O                                                                                ~
: 15. __/{ 6fll __/lf-Low                    /JOJ'                                                                              ?/(f!1r-__
NOTES:
Retention: Life of piant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .
 
                                                                                                                                                      ~~
i QF-1 071-0~    ;;v. 2 (FP-T-SAT-71)                                                                                                      Paf, .:>f 2  I LIMITED SECURITY AGREEMENT 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.                                                                                                          I
: 1. Pre-Examination {Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements)                                                                I I acknowledge that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. As            I 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      I 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      II to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator I
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 I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
: 2. Post-Examination                                                                                                                                    I To the best of my knowledge, I did* not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of_                          . From the date that I entered into this security agreement until the completion of this examination administration, f did not instruct. evaluate, or provide performance feedback to those individuals who were administered this examination.          I I
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. J further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement a0ion against the facility licensee or me.
I I
I I
I Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .
I
 
              ~
QF-1071-C      .;v. 2 (FP-T-SAT-71)
I fl Xcel Energy I                                                      LIMITED SECURITY AGREEMENT 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 that I have acquired specialized knowledge about the 2015 MNGP IL T NRC examination scheduled for the date of 06-01-15 . 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 adm inistered 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 ag reement may result in cancellation of the examination and/or an enforcement action against my facility or me.
I will immed iately 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 examination administered during the date(s) of                            . From the date that I entered into this security agreement until the completion of this exam ination 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 I RESPONSIBILITY
: 1.    :JC PG tie~ V\ Ks              <Ro
: 2. je sSr    \n v~              _S_~_CJ
                                            ...;:_________ ,,1-~'--'-~~""""':;..+-11---
3_ tf'frtG Q;flii!>'lfz:Kofr_          ~~D_ _ _ _ _. . . . . "'1:!~~~~~
: 4.    /YZ    H /:?lu+.,_            -~S._      !C..a
______ --d.-..--::~
: 5.      JOA" ~"'.s <1                    Ao
                                      - - -- - - ------
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01.
 
QF-1 071-02, .. c v. 2 (FP-T-SAT-71)                                                                                            Pag      f2 LIMITED SECURITY AGREEMENT 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
: 6. DG~E.\<. &<Ros~lt1'tM            S v(o
: 7. f)ofliv... 6 A1lf Ic;JuxPr 8.
9.
JJScrz    l) s, ~.sp,v NE I ,_l 0
: 12.    /~ ,/r/      ,./!vb Itv" c1
: 13. Bllt.MV W.aeNttr                  .SRO Btirli(Jr trrlt:VYL
;:    j~~!tCO                        NlJ clew DPS  IMS:ni u.(:fr:,:.,;L NOTES:
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .
 
-~-.....  '--------.,..--*-----*---
;
;
* Xcel.Enerav-i  
* Xcel.Enerav- i                                                           LIMITED SECURITY AGREEMENT
,,P.J I LIMITED SECURITY AGREEMENT The Limited Secu1ity Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but .. do not have access to Primary and . . . 1. Pre-Examination
~--*--~--                  ,,P.J I The Limited Secu1ity Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but..do not have unr&~cte?
{Review FP-T .SAT-71, Attachment 1 for r:ire-job briefing requirements)
access to Primary and Se~ndary Containm~ri~ .                                               ..
I acl<novvledge that i have acquired specialized knowledge about the 2015 MNGP !LT NRC examination scheduled for the date of 06-01-15.
: 1. Pre-Examination {Review FP-T.SAT-71, Attachment 1 for r:ire-job briefing requirements)
As of the date of my signature, l agree that I v1m no!"khowingiy"divufge any&deg; information about this examination to any persons who have not been authorized by an Operations Training Supervisor  
I acl<novvledge that i have acquired specialized knowledge about the 2015 MNGP !LT NRC examination scheduled for the date of 06-01-15. As of the date of my signature, l agree that I v1m no!"khowingiy"divufge any&deg; information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. l understand that I am not to instruct or'provide performan~ff*ltjpack to those individuals scheduled to be administered these examinations from this date until completion of examination administration. r also uffderstand that 1 am, !!Pt 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.
.. l understand that I am not to instruct or'provide to those individuals scheduled to be administered these examinations from this date until completion of examination administration.
Furthermore, l am aware of the physical security measures and req.uirements (as documented in NSPM procedures) and understand that violation of the conditions of this agre-ement may result in cancellation of the examination and/or an enforcem~nt action against myfac!lity or me.
r also uffderstand that 1 am, !!Pt to evaluate individuals scheduled to be administered these examinations from this date until the date of administration.
            ! 'NiH lmmedlately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
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.
: 2. P,:ist-Examination To the b~i of my knowledge, l did not divulge to     any unauthorized persons any information concerning the examination administered during the date(s) of**                         . From the date that I, entered into this security agreement until the completion qf this examination administration, ! did not instruct, evaluate, or provide performance feedback to those individuals who were admii:iistered this examination.
Furthermore, l am aware of the physical security measures and req.uirements (as documented in NSPM procedures) and understand that violation of the conditions of this agre-ement may result in cancellation of the examination and/or an action against myfac!lity or me. ! 'NiH lmmedlately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
Furtherrr:ore, l agree to NOT d!scuss any aspects associated wtth the contents of this examination vvith ANY examlnee until~the completion of their examlnation administration. l further understand that violation of the et,)nditions of this agreement may result in cancellation of the examlnation and/or enforcement action against the facility licensee or me.
: 2. P,:ist-Examination
PRINTED N/;,,ME         ,JOB TITL.E I RESPONS!BIUTY                                                                             DATE               NOTE
: 4. To the of my knowledge, l did not divulge to any unauthorized persons any information concerning the examination administered during the date( s) of** . From the date that I, entered into this security agreement until the completion qf this examination administration, ! did not instruct, evaluate, or provide performance feedback to those individuals who were admii:iistered this examination.
                                                                                                                                                  *~*      1
Furtherrr:ore, l agree to NOT d!scuss any aspects associated wtth the contents of this examination vvith ANY examlnee completion of their examlnation administration.
                                            ~f\~ s~ t>Atc
l further understand that violation of the et,)nditions of this agreement may result in cancellation of the examlnation and/or enforcement action against the facility licensee or me. PRINTED N/;,,ME ,JOB TITL.E I RESPONS!BIUTY DATE NOTE t>Atc 1 _.,iv) ..-\<--. .,.,, , 1 It,,,,.'\[_;.,
_.,iv)           ..-
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.. R.r;tentlon:
* VlrJ         O\')~..,,
Life of ulant Retaln ir;: Exam \*ne Fom1 retain$d in accordance v.tith record retention schedule identified in F?-G-Rl\li-01.
4.
QF-'i0/1-02, .. ..;v. 2 (F P-T-SAT-71) Pa g'' f 2 LIMITED SECURITY AGREEMENT The Limi t e d Se cu rity Agreeme n t i s u sed for those personnel having limited knowledge of Exam Sensitive Material but do not have u nres t ricted access t o Pr i m a ry a n d Se c ondary Conta i nment. PR I NT E D NA M E 6. \)S.,O._E,\(
                                                                                                                                        ..
: 7. r)_o(lrr-..
R.r;tentlon: Life of ulant Retaln ir;: Exam \*ne Fom1 retain$d in accordance v.tith record retention schedule identified in F?-G-Rl\li-01.
6Allf ie;JElA+-l NOTES: Rete nt i on: Life of p l a n t R e ta in in: E x a m fi l e J OB TI TL E I RESPONSIBILITY 12.o Sr<.o Form ret a ined in a cc ord a n ce w i th r ecord reten ti o n schedule identified in FP-G-RM-01. SIGNATURE (2) DATE NOTE}}
 
QF-'i0/1-02, ....;v. 2 (FP-T-SAT-71)                                                                                             Pag''   f2 LIMITED SECURITY AGREEMENT 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 (2)          DATE    NOTE
: 6.   \)S.,O._E,\( 6f!'<pS~\lt1Atj    S'~o
: 7. r)_o(lrr-.. 6Allf ie;JElA+-l 12.o Sr<.o NOTES:
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .}}

Revision as of 08:30, 31 October 2019

2015 Monticello Nuclear Generating Plant Initial License Examination Form ES-201-3
ML15216A116
Person / Time
Site: Monticello Xcel Energy icon.png
Issue date: 06/05/2015
From: Mcneil D
NRC/RGN-III/DRS/OLB
To:
Northern States Power Co
References
Download: ML15216A116 (9)


Text

i QF-1071 -0*1 'JV. 2 (FP-T-SAT-7 1) Pa~t. l:'Pf 2

---= ~--i j fl Xcel Energy- \ MASTER SECURITY AGREEMENT

  • -*----*--------~J T he 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 briefi ng requirements)

! acknow ledge that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. As of the date of my signature, I agree that I will not knowingly divulge 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 , l am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that vioiation of the conditions of this ag reement may result in cancellation of the examinations and/or an enforcement action against my facility or me. ! 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 . From the date that I entered into this security agreement until the completion of examination administration , i did not instruct, evaluate, or provide performance feedback to those individuals who were administered these examinations.

SIGNATURE (! ) DATE NOTE

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Retention: Life of Plant Retain in: Exam File

QF-1071-0 . 2v. 2 fFP-T-SAT-71\ ___ _ _ _ _ _.

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I '(! Xcel Energy- / MASTER SECURITY AGREEMENT I '

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) SIGNAT URE (2) DATE NOTE 8.

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10.

i 1.

12.

13 .

14.

15.

NOTES:

Retention: Life of Plant Retain in: Exam File

QF-1071 '2v. 2 (FP-T-SJ\T-71 ) f2

,-,,~------.------------------------------------------------~

i '(l Xcel Energy-

~-------~----------------*------------

LIMITED SECURITY AGREEMENT

- - -**- -- -- -- *- --- --

\

- -*- - --------'

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 that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. 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 . l 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 my knowledge, I did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of . From the date that I entered into this security agreement until the completion of this exam ination 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.

1.

,.,L .

3.

4.

5.

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

QF-1Q7*i-Oi, .av.~ (FP-T-SAT-71)

I fl Xcel Energy- I

~-----~-~-------------------------------------~---__J LIMITED sEcuR1TY AGREEMENT *- *----1 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.

j\ PRINTAD N,AME JOB TITLE /(<E~ONSI BILITY DATE DATE NOTE 6.

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NOTES:

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

~~

i QF-1 071-0~  ;;v. 2 (FP-T-SAT-71) Paf, .:>f 2 I LIMITED SECURITY AGREEMENT 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. I

1. Pre-Examination {Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) I I acknowledge that I have acquired specialized knowledge about the 2015 MNGP ILT NRC examination scheduled for the date of 06-01-15. As I 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 I 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 II to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator I

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 I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. Post-Examination I To the best of my knowledge, I did* not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of_ . From the date that I entered into this security agreement until the completion of this examination administration, f did not instruct. evaluate, or provide performance feedback to those individuals who were administered this examination. I I

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. J further understand that violation of the conditions of this agreement may result in cancellation of the examination and/or enforcement a0ion against the facility licensee or me.

I I

I I

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

I

~

QF-1071-C .;v. 2 (FP-T-SAT-71)

I fl Xcel Energy I LIMITED SECURITY AGREEMENT 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 that I have acquired specialized knowledge about the 2015 MNGP IL T NRC examination scheduled for the date of 06-01-15 . 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 adm inistered 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 ag reement may result in cancellation of the examination and/or an enforcement action against my facility or me.

I will immed iately 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 examination administered during the date(s) of . From the date that I entered into this security agreement until the completion of this exam ination 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 I RESPONSIBILITY

1. :JC PG tie~ V\ Ks <Ro
2. je sSr \n v~ _S_~_CJ

...;:_________ ,,1-~'--'-~~""""':;..+-11---

3_ tf'frtG Q;flii!>'lfz:Kofr_ ~~D_ _ _ _ _. . . . . "'1:!~~~~~

4. /YZ H /:?lu+.,_ -~S._ !C..a

______ --d.-..--::~

5. JOA" ~"'.s <1 Ao

- - -- - - ------

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

QF-1 071-02, .. c v. 2 (FP-T-SAT-71) Pag f2 LIMITED SECURITY AGREEMENT 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

6. DG~E.\<. &<Ros~lt1'tM S v(o
7. f)ofliv... 6 A1lf Ic;JuxPr 8.

9.

JJScrz l) s, ~.sp,v NE I ,_l 0

12. /~ ,/r/ ,./!vb Itv" c1
13. Bllt.MV W.aeNttr .SRO Btirli(Jr trrlt:VYL
j~~!tCO NlJ clew DPS IMS
ni u.(:fr:,:.,;L NOTES:

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

-~-..... '--------.,..--*-----*---

  • Xcel.Enerav- i LIMITED SECURITY AGREEMENT

~--*--~-- ,,P.J I The Limited Secu1ity Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but..do not have unr&~cte?

access to Primary and Se~ndary Containm~ri~ . ..

1. Pre-Examination {Review FP-T.SAT-71, Attachment 1 for r:ire-job briefing requirements)

I acl<novvledge that i have acquired specialized knowledge about the 2015 MNGP !LT NRC examination scheduled for the date of 06-01-15. As of the date of my signature, l agree that I v1m no!"khowingiy"divufge any° information about this examination to any persons who have not been authorized by an Operations Training Supervisor.. l understand that I am not to instruct or'provide performan~ff*ltjpack to those individuals scheduled to be administered these examinations from this date until completion of examination administration. r also uffderstand that 1 am, !!Pt 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, l am aware of the physical security measures and req.uirements (as documented in NSPM procedures) and understand that violation of the conditions of this agre-ement may result in cancellation of the examination and/or an enforcem~nt action against myfac!lity or me.

! 'NiH lmmedlately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.

2. P,:ist-Examination To the b~i of my knowledge, l did not divulge to any unauthorized persons any information concerning the examination administered during the date(s) of** . From the date that I, entered into this security agreement until the completion qf this examination administration, ! did not instruct, evaluate, or provide performance feedback to those individuals who were admii:iistered this examination.

Furtherrr:ore, l agree to NOT d!scuss any aspects associated wtth the contents of this examination vvith ANY examlnee until~the completion of their examlnation administration. l further understand that violation of the et,)nditions of this agreement may result in cancellation of the examlnation and/or enforcement action against the facility licensee or me.

PRINTED N/;,,ME ,JOB TITL.E I RESPONS!BIUTY DATE NOTE

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R.r;tentlon: Life of ulant Retaln ir;: Exam \*ne Fom1 retain$d in accordance v.tith record retention schedule identified in F?-G-Rl\li-01.

QF-'i0/1-02, ....;v. 2 (FP-T-SAT-71) Pag f2 LIMITED SECURITY AGREEMENT 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 (2) DATE NOTE

6. \)S.,O._E,\( 6f!'<pS~\lt1Atj S'~o
7. r)_o(lrr-.. 6Allf ie;JElA+-l 12.o Sr<.o NOTES:

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