ML15216A116

2015 Monticello Nuclear Generating Plant Initial License Examination Form ES-201-3

ML15216A116
Person / Time
Site:	Monticello
Issue date:	06/05/2015
From:	McNeil D R 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-71) j fl Xcel Energy-\ MASTER SECURITY AGREEMENT l:'Pf 2 ---= 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) ! 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 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 administere d these examinations from this date until completion of examination administrat ion. 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 agreement 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-Exami nation 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 individua ls who were administered these examinations. Retention:

Life of Plant Retain in: Exam File SIGNATURE

(!) DATE NOTE (,-15-!5 --

7 ft ? hr NU 'l -->.1 ;...::>

6/15/15 tdt'S"h5'-I ,. 'I ---

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

________ . I '(! Xcel Energy-/ I ' 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.

8. 9. 10. i 1. 12. 13. 14. 15. NOTES: PRINTED NAME \ t .)Lf'C 7 .k Ls OA Retention: Life of Plant Retain in: Exam File JOB TITLE I RESPONSIBILITY SIGNATURE (1) 9¥74 SIGNATURE (2) DATE NOTE t/ls/15 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 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 administered these examinations from this date until completion of examination administration. l also understan d 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 1. ,., L. 3. 4. 5. 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 completio n 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 enforcemen t action against the facility licensee or me. Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01

.

QF-1Q7*i-Oi

,

(FP-T-SAT-71)

I fl Xcel Energy-I 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. 6. 8. S. j\ PRINTAD N,AME 1t_ t,ve ,-;I I Sc:-crn-Do \/vQ 10.

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15. _ _/{ 6fll _ _/lf-Low NOTES: Retention: Life of piant Retain in: Exam file JOB TITLE S& O /JOJ' Form retained in accordance with record retention schedule identified in FP-G-RM-01

. DATE ll/;o/,1f DATE NOTE tRlut/t{'

---r r1 /f 5. <Pl1c,}1r---(,,*tJ.*IS' ?/(f!1r-__

v. 2 (FP-T-SAT-71) Paf, .

>f 2 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 administrat ion. 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 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. 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. Retention:

Life of plant Retain in: Exam file Form 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 (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 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 1. 2. 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, 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

JC PG V\ Ks <Ro je s Sr \n

________

3_ _____ .........

4. /YZ H /:?lu+.,_

______

5. JOA"

<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-1071-02, .. cv. 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.

6. 7. 8. 9. PRINTED NAME f)ofliv...

6A1lf Ic;JuxPr Jcrz JS l) NE I ,_l 0 12. ,/r/ ,./!vb I tv" c1 13. Bllt.MV W.aeNttr

NOTES: Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY Sv(o .SRO NlJ clew Btirli (Jr trrlt:VYL DPS IMS:niu.(:fr:,:.,;L Form retained in accordance with record retention schedule identified in FP-G-RM-01

.

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

• Xcel.Enerav-i

,,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

{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 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 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

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.

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.

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,,,,.'\[_;.,

• VlrJ

.. 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 f 2 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 6. \)S.,O._E,\(

7. r)_o(lrr-..

6Allf ie;JElA+-l NOTES: Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY 12.o Sr<.o Form retained in accordance with record retention schedule identified in FP-G-RM-01. SIGNATURE (2) DATE NOTE