ML103080887

Final Qa/Related Forms (Folder 1)

ML103080887
Person / Time
Site:	Limerick
Issue date:	10/20/2010
From:	Caruso J Operations Branch I
To:	Goff C Exelon Nuclear
Hansell S
Shared Package
ML100560247	List: IR 05000352/2010302 ML101650598 ML102720677 ML102870021 ML102920654 ML102920658 ML102920661 ML102920664 ML102920667 ML102920669 ML102920673 ML102920676 ML103080887
References
TAC U01767
Download: ML103080887 (18)

Text

ES-201 Examination Preparation Checklist Form ES-201-1

• Facility: Lt A1<C.Kt c K rJtVlts I~ 2- Date of Examination: DtPT'f-f;).d()

Developed by: Written - Facility ~ NRC 0 /I Operating - Facility ~ NRC all t 10'<

Target Chief Date* Task Description (Reference) Examiner's Initials

-180 1. Examination administration date confirmed (C.1.a; C.2.a and b)

"'il

-120 2. NRC examiners and facility contact assigned (C.1.d; C.2.e) '1,

-120 3. Facility contact briefed on security and other requirements (C.2.c) ~\

-120 4. Corporate notification letter sent (C.2.d) ~J\

[-90] [5. Reference material due (C.1.e; C.3.c; Attachment 3)] ~A v

{-75} 6. Integrated examination outline(s) due, inclu Forms ES-201-2, ES-201-3, ES-301-1. ES-301-2, ES-301-5, ES-D-1's, E 401-1/2, ES-401-3, and ES-401-4, as applicable (C.1.e and f; C.3.d) 1<J.v .~

{-70} {7. Examination outline(s) reviewed by NRC and feedback provided to facility licensee (C.2.h; C.3.e)}

~

V

{-45} 8. Proposed examinations (including wril1en. walk-through JPMs, and scenarios, as applicable). supporting documentation (including Forms ES-301-3, ES-301-4, ES-301-5, ES-301-6, and ES-401-6, and any Form ES-201-3 updates), and reference materials due (C.1.e, f, 9 and h; C.3.d)

Xl

-30

-14

9. Preliminary license applications (NRC Form 398's) due (C.1.1; C.2.g; ES-202)

10. Final license applications due and Form ES-201-4 prepared (C.1.1: C.2.1; 7\

.v ES-202) C&.~

V

-14 11. Examination approved by NRC supervisor for facility licensee review (C.2.h; C.3.f) ~

-14 12. Examinations reviewed with facility licensee (C.1.j; C.2.f and h; C.3.g) I~

U

-7 13. Written examinations and operating tests approved by NRC supervisor (C.2.i; C.3.h)

~",/

-7 14. Final applications reviewed; 1 or 2 (if ;:.10) applications audited to confirm qualifications I eligibility; and examination approval and waiver letters sent (C.2.i; Attachment 5; ES-202, C.2.e; ES-204)

W

~7 15. Proctoring/written exam administration guidelines reviewed Ul with facility licensee (C.3.k)

~ I},\

-7 16. Approved scenarios, job performance measures, and questions distributed to NRC examiners (C.3.i)

~, v

" T dates are generally based on facility-prepared examinations and are keyed to the examination date ide d in the corporate notification letter. They are for planning purposes and may be adjusted on a case-by case basis in coordination with the facility licensee.

[Applies only] {Does not apply} to examinations prepared by the NRC.

ES-201, Page 25 of 28

ES-201 Examination Outline Quality Checklist Form ES-201-2 Facility: Date of Examination:

Initials Item Task Description a

1.

W

a. Verify that the outline(s) fit(s} the appropriate moclel, in accordance with ES-401.

Ivf\/'.

R b. Assess whether the outline was systematically and randomly prepared in accordance with T

I Section 0.1 of ES-401 and whether all KiA categories are appropriately sampled. IDrA T c. Assess whether the outline over-emphasizes any systems, evolutions, or generic topics. tJrA f\-1 E

N I d. Assess whether the justifications for deselected or rejected KiA statements are appropriate. rvfV'\ f\- !/9-.

J

2. a. Using Form ES-301-5, verify that the proposed scenario sets cover the required number vrJI. I'--

S I

b.

of normal evolutions, instrument and component failures, technical specifications, and major transients.

Assess whether there are enough scenario sets (and spares) to test the projected number Iv M

U and mix of applicants in accordance with the expected crew composition and rotation schedule L

A T

without compromising exam integrity, and ensure that each applicant can be tested using at least one new or significantly modified scenario, that no scenarios are duplicated from the applicants' audit test(s), and that scenanos will not be repeated on subsequent days.

TJrJ.

It- (r 0

R

c. To the extent possible, assess whether the outline(s) conform(s) with the qualitative and quantitative criteria specified on Form ES-301-4 and described in Appendix D. -prJ. t-r1v V

3. a. Verify that the systems walk-through outline meets the criteria specified on Form ES-301-2:

(1 ) the outline(s) contain(s) the required number of control room and in-plant tasks W distributed among the safety functions as specified on the form I (2) task repetition from the last two NRC examinations is within the limits specified on the form T (3) no tasks are duplicated from the applicants' audit test(s)

(4) the number of new or modified tasks meets or E!XCeeds the minimums specified on the form (5) the number of alternate path, low-power, emergency, and RCA tasks meet the criteria

!PM It on the form.

b. Verify that the administrative outline meets the criteria specified on Form ES-301-1:

(1 ) the tasks are distributed among the topics as specified on the form (2) at least one task is new or significantly modified IV"'" jL f (3) no more than one task is repeated from the last two NRC licensing examinations I f\

c. Determine if there are enough different outlines to test the projected number and mix D /'11 ,\.

of applicants and ensure that no items are duplicated on subsequent days. l- ~

4. a. Assess whether plant-specific priorities (including PRA and IPE insights) are covered h

'O,M in the appropriate exam sections. ~ ~

G E b. Assess whether the 10 CFR 55.41/43 and 55.45 sampling is appropriate. 1)tJI /'--'

N E

c. Ensure that KiA importance ratings (except for plant-specific priorities) are at least 2.5. ~M ~

R d. Check for duplication and overlap among exam sl3ctions. DM /A.. VI ~ ...,

A L e. Check the entire exam for balance of coverage. tJM. 'jl: \ "

f. Assess whether the exam fits the appropriate job level (RO or SRO). DM /- r-,

a. Author J>A'VI D M MloN AI-! Prin~XA/S~.2 to fJ "

zate

/_lifl/(/

Lt* SHVl-T'L ~ 'j'-

b. Facility Reviewer (*)

c. NRC Chief Examiner (#)

d. NRC Supervisor

&(ZI)..NOCN a;, fl.,J .C- (.I~4~,£' I~ ~R'A.

-<C. /..Jatl\S-e II ~rl)

/~-

JI> ~  ::;;> >J

-WJh

") ~'i/ID Note:

.

1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

Not applicable for NRC-prepared examination outlines

/-;fVlf:j1_LLi( £XfWL1 ES-201 Examination Security Agreement Form ES-~01-3

1. Pre-Examination 0 I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of I.%' /~ ~o 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 b e authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner 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 NRC licensing examinations administered during the week(s) of Iv!" -'iit'! 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 applicants who were administered these licensing examinations. except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE I RESPONSIBILITY DATE DATE NOTE Ofs: SJt>av\sdL 10 lit/Iv II(]

<fq,v ~ V .. (~ "!t~J,,~

.* ~ I I" 1.z..,'I(oI.

~....

-- ~~ -- --, "'"

.-. ..... ~, ~

41"11t. ..... -- .,. -

..... - /' ~" " '''." "\

' u_ ....~"'I/'

I_I 7' r1W' to'~ I~

~

iff-

. r¥ :I~" <IV A

'.n r7 I0 __

I

,Co <-."..'.., /I-S>/!)

ES-201, Page 27 of 28

ES-201 Examination Security Agreement Form ES-~U1*3

1. Pre-Examination 101"1//1>

I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of /0/11// 0 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 b~en' authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.

2. Post-Examination To the best of my knowledge. I id not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of /(). 4 I 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 applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME 1>A\I~ i) MoNA~A rJ J 0 H" H.I j'.I I<oe-t'-~

'5,'11 fA!At/l.()

D4hl() Mcy9\

~l)9N y;;. 5"~v~ FACtUT~ ~~~ve ~ ~

ic~ H,~ -Sir=wi

SQ 3?3j)(PciJa ?~_

~ ~~~

r

.JIPJI!!  ;;

\( 1'2. -i \h K", r vh .

S i,/VI"j" I... .r:: I OnC/fi4/

rvl i (\

GJl4/'1. (lu*A:J

(/.b 'lilttbllraL IK~ vJ.:(4\-t, t' 1\.0 rn c:)

"\ec"',... liCJlt.. ~"I-c'...,J ES-201, Page 27 of 28

ES*201 Examination Security Agreement Form ES*201*3

1. Pre-Examination

,. ~o I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of It 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 een authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations andlor an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner 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 NRC licensing examinations administered during the week(s) of/{)Iit-~/441P 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 applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

JOB TITLE I RESPONSIBILITY SILo

.~ <..\.n JC rv--~

~ :;P;C;*Cfi I""

+M ~ r~f fe.",..

CiJ()r;..rLtJofdtt

~~~

S(L.::J

---

---

---

ES-201, Page 27 of 28

ES-301 Operating Test Quality Checklist Form ES-301-3

.. S I {. 'fi;J 9-/

J /. Date of Examination: }o/ If/IO OperatinQ Test Number:

Initials

1. General Criteria a b* c#

a. The operating test conforms with the previously approved outline; changes are consistent with sampling requirements (e.g., 10 CFR 55.45, operational importance, safety function distribution).

17rA t- 1A1

b. There is no day*to-day repetition between this and other operating tests to be administered

- ~

c.

durinQ this examination.

The operating test shall not duplicate items from the allplicants' audit testis). (see Section D.1.a.)

'pr" 0"'" j'- ~

V

d. Overlap with the written examination and between different parts of the operating test is within acceptable limits. f)rI' / ~

'/

e. It appears that the operating test will differentiate between competent and less-than-competent applicants at the designated license level.

pr!' ~ \\

2. Walk-Through Criteria -- -- -

a. Each JPM includes the following, as applicable:

• • initial conditions initiating cues

• • references and tools, including associated procedures.

reasonable and validated time limits (average time allowed for completion) and specific designation if deemed to be time-critical by the facility licensee

• operationally important specific performance criteria that include:

- detailed expected actions with exact criteria and nomenclature

\){I'; ~

-

-

-

system response and other examiner cues statements describing important observations to be made by the applicant criteria for successful completion of the task

f!I

- identification of critical steps and their associated performance standards

- restrictions on the sequence of steps, if applicable

b. Ensure that any changes from the previously approved systems and administrative walk-through

/'-

~

outlines (Forms ES-301-1 and 2) have not caused the test to deviate from any of the acceptance criteria (e.g., item distribution, bank use, repetition from the last 2 NRC examinations) specified on those forms and Form ES-201-2.

OrA

3. Simulator Criteria -- -- -

The associated simulator operating tests (scenario sets) have been Form ES-301-4 and a copy is attached.

n~viewed in accordance with 'f)rf\ /'- 11'

.

Printed Name I Si9natur~ Date

a. Author 1)fl~1 M Mo NBj.\AtJ/~)M i) gL'3l{ 0

b. Facility Reviewer(*) "M..A..I "",J ~ - St,WCi'~/~..~ 8{','/'O

c. NRC Chief Examiner (#)

-:fol{v ~d//Jail ,,/L cr jro

~~ .&.~.fJIV 'Sr 7) /::)O!J Q(Z9/1(}

d. NRC Supervisor

(

- I NOTE:

• The facility signature is not applicable for NRC-developed tests.

1. Independent NRC reviewer initial items in Column "c"; chief examiner concurrence required.

ES-301, Page 24 of 27

ES-301 Simulator Scenario Quality Checklist Form ES-301-4

~'-&-S /":ItYt; /.;-

Date of Exam: Scenario Numbers:~ 1'1,-;; /3 Op

.,

h::f" QUALITATIVE ATTRIEl~UTES b* c#

-oM /'- ~~

1. The initial conditions are realistic, in that some equipment and/or instrumentation may be out of service, but it does not cue the operators into expected events.

D,I\II '/,- ~~

2.

3.

The scenarios consist mostly of related events.

Each event description consists of

,

• the point in the scenario when it is to be initiated

• the malfunction(s) that are entered to initiate the event

• the symptoms/cues that will be visible to the crew -PM

• the expected operator actions (by shift position)

• the event termination point (if applicable)  ; ~

4. No more than one non*mechanistic failure (e.g., pipe break) is incorporated into the scenario

~

without a credible preceding incident such as a seismiG event.

5. The events are valid with regard to physics and thermodynamics.

6. Sequencing and timing of events is reasonable, and allows the examination team to obtain complete evaluation results commensurate with the scenario objectives.

7. If time compression techniques are used, the scenario summary cfearly so indiGates. 1('

8.

Operators have sufficient time to carry out expected activities without undue time constraints.

Cues are given.

The simulator modeling is not altered.

10M.

bM.

r- ~lA 1

A....-

9. The scenarios have been validated. Pursuant to 10 CFR 55.46(d), any open simulator / "

performance deficiencies or deviations from the referenced plant have been evaluated -OM to ensure that functional fidelity is maintained while running the planned scenarios. /'- ~

10. Every operator will be evaluated using at least one new or signifiGantly modified scenario. V All other scenarios have been altered in accordance with Section 0.5 of ES*301. 1:>/IA /'-~

l'

11. All individual operator competencies can be evaluated, as verified using Form ES*301*6 (submit the form along with the simulator scenarios). DM I'--~ "

12. Each applicant will be significantly involved in the minimum number of transients and events specified on Form ES-301-5 (submit the form with the Simulator scenarios). 1.:>tIA /' ~

13. The level of difficulty is appropriate to support licensin~1 decisions for each crew position. ~ i~

Target Quantitative Attributes (Per Scenario; See Section D.5.d) Actual Attribut~~ .IL -- - -

S#2/S#4/S#5l?~~ ;l-I~

1. Total malfunctions (5-8) 6 17 / 8 I 7 DM PM !A

-

2. Malfunctions after EOP entry (1-2) 2 / 3  ! 3 / 2 DM r

3. Abnormal events (2-4) 2 I 4 I 4 , 5 1:>1\'\ /'

4. Major transients (1-2) 1 / 1 / 2 / 1 DM .!\....-(

5. EOPs entered/requiring substantive actions (1-2) 2 / 2 / 3 / 2 \)tv\ I'-

6. EOP contingencies requiring substantive actions (0-2) 1 / 1 / 1 I 2 PM /\

7. Critical tasks (2-3) 2 I 2 I 2 I 3 Vtvl .A-J v

ES-301 Transient and Event Checklist Form ES-301-5 Facility: Limerick Date of Exam: 08/23/2010 Operating Test No.: ILT09-1 CERT A E Scenarios ()rl~

P V 1(S#2) 2(S#4) 3(S#5) 4(S#3)<;' T M P E 0 I L N CREW CREW CREW CREW T N I T POSITION POSITION I POSITION POSITION A I

M C S A B S A B S A B S A B L U A T R T 0 R T 0 R T 0 R T 0 M(*)

N Y 0 C P 0 C P 0 C P 0 C P R I U T P E

ROD. RX 2 3 2 1 1 0 Willingha m NOR I/C MAJ 1

458 6

378 6

I 59 67

, 4 1

4 2

1 4

2 1

2 1

rrs- 0 2 2 RX NOR 2

1 1

1 1

1

!1to 1 1 RO Williams on I/C 3578 2589 8 4 4 211 MAJ 6 67 3 2 2 1 I

TS 1 0 12 2

RO RX 3 1 1 1 0 Warner NOR I 1 1 1 I/C 458 5 4 4 MAJ 6 67 3 2 2 1 2 2 RO RX 2 1 1 1 0 Corey NOR 1 1 2 1 1 11

~

458 378 2589 10 4 4 12 6 6 67 4 2 2 1 0 2 2 Instructions:

1, Check the applicant level and enter the operating test number and Form ES-D-1 event numbers for each event type; TS are not applicable for RO applicants, ROs must serve in both the "at-the-controls (ATC)" and "balance-ol-plant (BOP)" positions; Instant SROs must serve in both the SRO and the ATC positions, including at least two instrument or component (IIC) malfunctions and one major transient, in the ATC position, If an Instant SRO additionally serves in the BOP position, one lie malfunction can be credited toward the two lie malfunctions required for the ATC position,

2. Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D,S.d) but must be significant per Section C,2,a of Appendix D, (0) Reactivity and normal evolutions may be replaced with additional instrument or component malfunctions on a 1-for-1 basis, 3, Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirements specified for the applicant'S license level in the righI-hand columns.

ES-301 Transient and Event Checklist Form ES-301-5 lity: Limerick Date of Exam: 08/23/2010 Operating Test No.: ILT09-1 CERT A E Scenarios P V 1 (S#2) 2(S#4) 3(S#5) 4(S#3) M P E I L N CREW CREW CREW CREW N T

I T POSITION POSITION POSITION POSITION A I

M C S A B S S A B S A B L U A T R T 0 R R T 0 R T 0 M(*)

0 C P 0 C P 0 C P 0 C p N Y R U T P E

SRO-I RX 2 X Seth NOR 12 X Mitten IIC 3578 3459 X MAJ 6 6 X 35 X X 2 1 0 NOR X 1 1 SRO-I Jason I/C X 378 2345 8 4 Prechtl 9 MAJ X 6 67 3 2 TS X 245 3 0 SRO-I RX Bill NOR 1 1 Martin I/C 9 4 4 2 MAJ 3 2 2 1 TS X 245 3 0 2 2 SRO-I RX X 3 1 1 Scott Auve NOR 2 X I/C 3458 59 6 4 4 2 MAJ 6 67 3 2 2 1 TS X 2 0 2 2 SRO-I RX 2 X 1 0 Barczyk NOR X 1 1 1 I/G 3578 X 2345 9 4 4 2 9

MAJ 6 TS

ES-301 Transient and Event Checklist Form ES-301-5 Date of Exam: 08/23/2010 Operating Test No.: ILT09-1 CERT A E Scenarios P V 1(S#2) 2(S#4) 3(S#5) 4(S#3) M P E I L N CREW CREW CREW CREW T N I T POSITION POSITION POSITION POSITION A I

M C S A B S A B S A B S A B L U A T R T 0 R T 0 R T 0 R T 0 M(*)

N Y 0 C P 0 C P 0 C P 0 G P T P E

SRO-U RX Gramer NOR 2 I/C 3458 MAJ 6 TS 34 RX SRO-U NOR 12 Kirse IIG 3459 MAJ 2 2 1 TS 2 0 2 2 SRO-U RX 0 Weaver NOR 2 1 1 I/C 3458 4 MAJ 6 TS 34 2 RX 1 SRO-U NOR 2 1 1 Sokso IIG 3458 4 4 4 2 MAJ 6 2 2 1 TS 34 2 0 2 2 SRO-U RX 1 0 Strauser NOR 12 2 1 1 IIG 3459 4 4 4 2 MAJ 6 2 2 1 TS 35 0 2 2

ES-301 Competencies Checklist Form ES-301-6 Facility: LGS Date of Examination: 10104/10 Operating Test No.: ILT09-1 APPLICANTS Williamson Warner

• Willingham Corey RO-1 SRO-I SRO-U D

D RO-2 SRO-I SRO-U

• D D

RO-3 SRO-I SRO-U

• D D

RO-4 SRO-I SRO-U

• D D

Competencies SCENARIO SCENARIO SCENARIO SCENARIO 2 4 5 3 2 4 5 3 2 4 5 ~ 2 5 3 InterpreVDiagnose 345 367 456 3678 123 345 45 34 367 123 Events and Conditions 68 8 7 567 68 67 56 8 567 89 8 89 Comply With and 123 123 345 1236 123 123 34 ]2 123 123 Use Procedures (1) 456 678 67 456 456 56 34 678 456 789 7 56 789 Operate Control 134 123 345 2567 124 134 34 13 123 124 Boards (2) 568 678 67 567 568 56 45 678 567 89 7 68 89 Communicate 123 123 123 1234 123 123 12 123 123 and Interact 456 456 456 5678 456 456 34 456 456 8 78 789 789 8 56 78 789 78 9

Demonstrate Supervisory Ability (3)

Comply With and Use Tech. Specs. (3)

Notes:

(1 ) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-301 Competencies Checklist Form ES-301-6 Facility: LGS Date of Examination: 10104/10 Operating Test No.: ILT09-1 APPLICANTS Mitten Prechtl Martin Auve 0 0

• RO RO

• RO RO SRO-I-1 SRO-I-2 SRO-I-3

• SRO-I SRO-U 0 SRO-U 0 SRO-U 0 SRO-U 0 Competencies SCENARIO SCENARIO SCENARIO SCENARIO 2 4 5 3 2 4 5 3 2 4 5 3 2 4 5 3 II InterpreVDiagnose 3678 367 X X 367 456 367 X 35 X 45 Events and Conditions 8 7 8 68 67 Comply With and 1236 1234 X X 123 345 123 X 34 34 X 34 Use Procedures (1) 5679 678 678 6 56 68 56 9 78 7 9

Operate Control 2567 x X 123 256 X X 34 Boards (2) 678 7 56 7

Communicate 1234 1234 X X 123 123 123 X 12 23 X 12 and Interact 5678 5678 456 456 456 34 45 34 9 78 789 78 56 68 56 78 78 9 9 Demonstrate 1234 x X 123 X 12 12 X Supervisory Ability (3) 5678 456 34 34 9 789 56 56 78 8 Comply With and Use Tech. Specs. (3) 3567 x X 24 xElliIx Notes:

(1 ) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-301 Competencies Checklist Form ES-301-6 Facility: LGS Date of Examination: 10/04/10 Operating Test No.: ILT09-1 APPLICANTS Barczyk RO D RO RO D RO SRO+5. SRO+6 D SRO-I D SRO-I SRO-U D SRO-U D SRO-U D SRO-U Competencies SCENARIO SCENARIO SCENARIO SCENARIO 2 4 5 3 1 2 3 4 3 4 1 2 Interpret/Diagnose 367 X 456 Events and Conditions 8 7 Comply With and 1 X 345 Use Procedures (1) 678 9

Operate Control 256 X Boards (2) 7 Communicate 11123 1 X 1123 and Interact 456 456 78 789 Demonstrate X 123 Supervisory Ability (3) 456 789 Comply With and Use Tech. Specs. (3)

Notes:

(1 ) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-301 Competencies Checklist Form ES-301-6 Facility: LGS Date of Examination: 10/04/10 Operating Test No.: ILT09-1 APPLICANTS Cramer Kirse Weaver Sokso D D D D

-

RO RO RO RO SRO-I D SRO-I D SRO-I D SRO-I D SRO-U-1 SRO-U-2 SRO-U-3 SRO-U-4 Competencies SCENARIO SCENARIO SCENARIO SCENARIO 2 4 5 3 2 4 5 3 2 4 15 3 2 4 5 3 Interpret/Diagnose 356 367 35 35 Events and Conditions 8 68 68 Comply With and 346 123 34 34 Use Procedures (1) 8 456 68 68 79 Operate Control Boards (2)

Communicate 234 123 23 and Interact 568 456 45 45 789 68 68 Demonstrate 123 123 12 12 Supervisory Ability (3) 456 456 34 34 8 789 56 56 8 8 Comply With and 346 356 34 34 Use Tech. Specs. (3) 7 6 6 Notes:

(1 ) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-301 Competencies Checklist Form ES-301-6 Facility: LGS Date of Examination: 10/04/10 Operating Test No.: ILT09-1 APPLICANTS Strauser RO D RO D RO D RO D D D D D

• SRO-I SRO-I SRO-I SRO-I SRO-U SRO-U D SRO-U 0 SRO-U 0 Competencies SCENARIO SCENARIO SCENARIO SCENARIO 2 4 5 3 1 2 3 4 1 2 3 4 1 2 3 4 InterpretlDiagnose 367 Events and Conditions Comply With and 123 Use Procedures (1) 456 79 Operate Control Boards (2)

Communicate 123 and Interact 456 789 Demonstrate 123 Supervisory Ability (3) 456 789 Comply With and 356 Use Tech. Specs. (3) 7 Notes:

(1 ) Includes Technical Specification complianee for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Check the applicants' license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant.

ES-401 Written Examination Quality Checklist Form ES-401*6 Date of Exam: 10/15/2010 Exam Level:

Item Descri lion Questions and answers are technicall accurate and a ,licable to the facili

2. a. NRC KJAs are referenced for all questions.

b. Facili leamin ob'ectives are referenced as available.

3. SRO

4. The sampling process was random and systematic (If more than 4 RO or 2 SRO questions were re eated from the last 2 NRC licensin exams, consult the NRR OL ro ram office.

5. Question duplication from the license screening/audit exam was controlled as indicated below (check the item that applies) and appl;lars appropriate:

_ the audit exam was systematically and randomly developed; or

-tthe audit exam was completed before the license exam was started; or

.Jt.. the examinations were developed independently; or the licensee certifies that there is no duplication; or other (explain)

6. Bank use meets limits (no more than 75 percent Bank Modified New from the bank, at least 10 percent new, and the rest new or modified); enter the actual RO / SRO-only 25/75 9/75 41/75 uestion distribution s at ri ht.

7. Between 50 and 60 percent of the questions on the RO Memory CIA exam are written at the comprehension/ analysis level; the SRO exam may exceed 60 percent if the randomly 35/75 40/75 selected KJAs support the higher cognitive levels; enter the actual RO I SRO uestion distribution s at ri ht.

8. References/handouts provided do not give away answers or aid in the elimination of distractors.

9. Question content conforms with specific KJA statements in the previously approved examination outline and is appropriate for the tier to which they are assigned; deviations are *ustified.

10.

11. The exam contains the required number of one-point, multiple choice items; the total is correct and a rees with the value on the cover sheet.

Date

a. Author I~' II j)

b. Facility Reviewer (*) 10 10

c. NRC Chief Examiner (#) a '/1 1'0

d. NRC Regional Supervisor .

/6'/11*//4 Note:

• The facility reviewer's initials/signature are not applicable for NRC-developed examinations.

1. Inde endent NRC reviewer initial items in Column "c"; chief examiner concurre

ES*401 Written Examination Quality Checklist Form ES-401*6 Facility: Date of Exam: Exam Level:

Ro~1 Initial Item Description a b* c#

1. QUestions and answers are technically accurate and applicable to the facility. -at!' f- ."V:J..

I

2. a. NRC KlAs are referenced for all questions.

b. Facility learninQ objectives are referenced as available. tJr*f\

3. SRO questions are appropriate in accordance with Section D.2.d of ES-401 t;f\/\

II i\

4. The sampling process was random and systematic (If more than 4 RO or 2 SRO questions were repeated from the last 2 NRC licensing exams, consult the NRR OL proQram office).

V

5. Question duplication from the license screening/audit exam was controlled as indicated below (check the item that applies) and appears appropriate:

_ the audit exam was systematically and randomly developed; or 1)tA

~~

-Ithe audit exam was completed before the license exam was started; or

_ the examinations were developed independently; or the licensee certifies that there is no duplication; or other (explain)

6. Bank use meets limits (no more than 75 percent from the bank, at least 10 percent new, and the rest new or modified); enter the actual RO / SRO-only Question distribution(s) at right.

Bank 8/25 Modified 2/25 New 15/25 i)rJ\ AC~

7. Between 50 and 60 percent of the questions on the RO Memory CIA DM /-

exam are written at the comprehension/ analysis level;

~

the SRO exam may exceed 60 percent if the randomly 7/25 18/25 selected K/As support the higher cognitive levels; enter the actual RO I SRO Question distribution(s) at riQht.

S. References/handouts provided do not give away answers or aid in the elimination of distractors.

1>t.A ~ ~

9. Question content conforms with specific KIA statements in the previously approved examination outline and is appropriate for the tier to which they are assigned; deviations are justified.

l)M /\- I\~

10. Question psychometric Quality and format meet the Quidelines in ES Appendix B. T)M /l- I\~

/"- ~

11. The exam contains the required number of one-point, multiple choice items; 1)tJ\.

the total is correct and aQrees with the value on the cover sheet.

Printed Name / Signature L{~ Date D fA t~,ONAtiAtJ~

~

a. Author 12~1 "

~~~

b. Facility Reviewer (*) ,,;)

/QI!J~

c, NRC Chief Examiner (#)

d. NRC Regional Supervisor 0

Note:

• The facility reviewer's initials/signature are not applicable for NRC-developed examinations.

1. Independent NRC reviewer initial items in Column *c"; chief examiner concurrence required,

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Date of Exam: /0 I /0 Exam Level: RO Initials Item Descri tion a 1.

2. Answer key changes and question deletions justified and documented

3. Applicants' scores checked for addition errors reviewers s ot check> 25% of examinations pM

4. Grading for all borderline cases (80 +/-2% overall and 70 or 80, as a licable, +/-4% on the SRO-onl reviewed in detail

5. All other failing examinations checked to ensure that grades are 'ustified

6. Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of uestions missed b half or more of the a licants

a. Grader l¥lVID lojtq/(O

b. Facility Reviewer("') fO/ZO/tO

c. NRC Chief Examiner ("')

--

J~ 19kb O

d. NRC Supervisor ("') /o/20/n'J

("') The facility reviewer's signature is not applicable for examinations graded by the NRC; two inde endent NRC reviews are re Uifi9d.