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=Text=
=Text=
{{#Wiki_filter:APA-ZZ-OO1Ol 7.0 (Dept. Vahdation AddI AddlReview TechnicaiReview Technical 6M 5.0 4.0 3M. Personnel CR 2.0 Level
{{#Wiki_filter:PROCEDURE REVIEW FORM (PRF) 1.0 Initiation Initiator: David Traub PIN 85245 Date: 7/25/2023 Procedure Dept EP Document #: EtP-ZZ-COO1 0 ADD D New Rev. #
022 (3 digits required)


==Title:==
==Title:==
Document Initiator: 1.0 D Senior Approval Preparer Reviews Comments: Interim flAdministrative üTemp Document 2023031 Reason of Initiation head Review Review Dpt. Use:
Dose Assessment_Coordinator (DAC) Checklist Level of Use:
2,5,35 tmcnt Director Review reporting #:
Continuous Refcrence Information Mu1tip1e EN/A 2.0 Reason for Change/Description of Change (List commitments, CRs, eB Change Reqttesis, OERs, Plant Mods etc. and record numbers here.)
: or CognizantSupervisor Approval Head Change 14-002 for Assessment_Coordinator EtP-ZZ-COO1 Dept. lleaj1 Designated CA25 ; and or Disposition Change/Description Continuous Traub
CR 2023031 14-002
- Adding guidance for obtaining Recovery Manager concurrence prior to issuing KI to ERO Personnel reporting to the EOF.
Continued: fl 3M.
Document Disposition
üTemp Change 1New Document ElMajor Revision Minor Revision LjCancellation flAdministrative Correction Dpt. Head or Designated Approver required for Administrative Corrections (S4PJNtDatc) no other signatures 4.0 Interim Approval (Temp. Change Only)
Temp. Change #:
Expiration Date:
CognizantSupervisor (Signature/PIN/Date)
SRO (Signaflire/PIN/Date)


I Signatures Designated A210.0062,65, 1-lead Nuclear ic tothe Adding Final 10 EP Correction or Approver) EOF. PIN Designated Review Operations 11CA25 Approver 1New
==5.0 Comments==
Continued: i:
6M Reviews and Signatures (NOT requiredfbr Administrative Corrections)
Reviews Required I
Dept I
PIN Sigitti re Date (40139 Attached Preparer EP
, 85245 7t2512023%
N/A Technical Review E Yes kJ No TechnicaiReview ic
/L-
. oZol flYes No AddlReview
. ElYes DNo AddI Review LI Yes No EjAdditional Reviews (See Attached CAOl39Jbrrns).
Number of additional CAO139s:
Type Coordinator - PIN Signature j
Date CA0139 Attached Vahdation I


I guidance 85245 (NOT 0ADD 85245
. L: Yes E No 50.59 Review CA25 10 11CA25 1 1 L1CA2512 I N!A (perAPA-ZZ-OO1%3)
Screener InitiaI/ PIN Reviewer Iitiat/PIN (Dept. head or Designated Approver) Is a Change Management Plan required?
LlYes No (IF YES, attach CA2773 or CA2774)
Is a Cross-Disciplinary review required?
ElYes No 7.0 Approval (Either approval mttst be qitaIed as PA T/APVR or PAT/GAPR in Qitatliastet)
Senior Director Nuclear Operations Approval (per APA-ZZ-OO1O1)
ORC is required in accordance with APA-ZZ-00091 D
tmcnt lleaj1 Final Review and Approval ORC Meeting:
7fo/3 63%6 Dept. 1-lead or Designated Approver Senior Director Nuctear Operations (Signature/PIN/Date)
(Signature/PEN/Date) iVote: Page 2 provides instrtictions to complete thisJbrm and may be discarded
;:ioooi, 2, 5,35
- A210.0062,65, 69; M190.0001 Page lof2 CA0033 APA-ZZ-OO1Ol Rev. 002


69; and Is Document M190.0001 Approver Is 1 requiredfbr required Refcrence 7fo/3 Approval Approval aCross-Disciplinary aChange 1 % for of D L1CA2512 obtaining Change for (DAC) ________________
APPLICABILITY DETERMINATION Address the questions below for all aspects of the activity If the answer is YES for any portion of the activity, apply the identified procedures to that portion of the activity. Note that it is not unusual to have more than one process apply to a given activity. Refer to Section 4 of the 10 CFR 50.59 Resource Manual (RM) and the iiistructions on pages 5-6 for additional guidance.
Management - Administrative Page Administrative Temp. ElMajor Recovery I N!A Number Information Checklist New Date:
ActivitylDocument Number: EIP-ZZ-COOlO ADDD III.
lof2 Change review Plan Corrections Revision Rev. 7/25/2023 of Manager ORC required? required? additional Corrections) #: #
Does the proposed atlivity involve a change to the:
1.
Technical Specifications or the Renewed Operating License?
(Sec 10 CFR 5090.)
2.
Quality Assurance Plan? (See 10 CFR 50.54(a).)
3.
Security Plan which also includes the Cyber Security Plan?
NO (See 10 CFR 50.54(j).)
4.
RadiologicalEmergencyResponse Plan (RERP) or Emergency Action Levels (EALS)? (See 10 CFR 50.54(q).)
Note: If your proposed change alters a RERP implementing procedure [any EIP-ZZ-XXXX], equipment identified as important to emergency response [refer to KDP-ZZ-00013], or could alter response time, staffing, or other items covered in the 1 6 Planning Standards or in Appendix E to Part 50.47(b) [refer to KDP-ZZ-00400],
answer this question YES.
Revision Number: 022 APA-ZZ-OO 143 A170.OO1O Page 1 II.


ORC concurrence 022 Meeting: Minor Mu1tip1e isrequired CAO139s: SRO Senior ElYes LlYes (Signaflire/PIN/Date)
==Title:==
I Expiration Revision Procedure Director in No No 7t2512023% prior accordance oZol to
Dose Assessment Coordinator (DAC) Checklist Brief Description of activity (what is being changed and why):
forDACtogetRecoveryManagerconcurrenceportosuing KHOEROPerSOnne eporting to the EOF. CR 202303114
.1.
IfYES, no further 50.59 (or 72.48) review beyond this Applicability Determination (AD) is required, but Does the proposed activity fall within the scope of an activity
 
===Response===
complete the remainder of this form.
that has been previously approved by the NRC or for which a
(
Identify the applicable 50.59/72.48 50.59/72.48 Screen or evaluation has already been performed?
(See Section 4.2 of the RM.)
NO YES Evaluation Log No., License Amendment No., or applicable document number.
Document #
 
===Response===
See Section 4.2.1 of the RM.
NO El YES IfYES, process per APA-ZZ-00 108 and FDP-ZZ-00 103.
If YES, process per APA-ZZ-00 108 NO El YES and GDP-ZZ-00600 and related facility or procedure change programs.
If YES, process per APA-ZZ-0O 108 LI YES ai SDP-ZZ-00030 for Security Plan and related facility or I
procedure change programs.
If YES, process per APA-ZZ-00 108 NO YES
* and KDP-ZZ-00400 for RERP and
-J related facility or procedure change programs.
CA25 10 Rev. 005
 
APPLICABILITY DETERMINATION (Continued)
IIfYBS, process APA-ZZ-00356 for ASME code compliance and related facility or procedure change programs.
5.
1ST Program Plan? (See 10 CFR 50.55a(f).)
NO U YES IfYES, process per EDP-ZZ-O 1003 for ASME code compliance and related facility or procedure change programs.
6.
151 Program Plan? (See 10 CFR 50.55a(g).)
NO EJ YES See FP Screening questions in EDP C
ZZ-04044. If any ofthc screening 7.
Fire Protection Program ? (See Operating License Condition 2.C(5).)
NO YES questions are answered YES, a Fire Protection review is needed in accordance with EDP-ZZ-04044.
i.
Storage Cask Certificate of Comphance(CoC), including If YES, then contact Regulatory appendices?
(See 10 CFR 72.244.)
NO fl YES Affairs/Licensing to determine next 1steps.
9.
Does the proposed activity impact other programs (e.g.,
the ODCM) that are controlled by regulations, the Operating License (including Orders and License If YES, indicate the applicable Conditions) or the Technical Specifications? (See Section NO LI YES program in Brief Description 4.2.1 ofthe RM.)
Section.
Iv.
Does the proposed activity involve:
 
===Response===
Sec Section 4.2.2 oftheRM
: 1. Maintenance which restores SSCs to their original (as designed) condition?
(See 10 CFR 50.65(a)(4).)
IfYES, process change per rci NO YES 1APA-ZZ-0010l for procedure Note: If the maintenance is on ISFSI or cask-related items, changes or APA-ZZ-00320/330/340 the Maintenance Rule does NOT apply, and the activity is for Maintenance activities.
 
subject toalO CFR 72.48 Screen onaCA3l45.
IfYES, process per APA-ZZ-0010l for procedure changes or APA-ZZ-00605 for facility changes 2.
A temporary alteration (to procedures or the facility)
R7 or Procedurally Controlled supporting maintenance (TASM) that will be in effect j NO YES C
Temporary Modifications or during at-power operations for 90 days or less?
MDPZZ-FSOO1 for Freeze Seals.
Evaluate risk using APA-ZZ-003l5, Appendix A.
APA-ZZ-00143 Page2 CA2510 A170.OO1O Rev. 005
 
If the above response is YES, does the proposed activity involve an fSAR change that may be excluded from the requirement to perform a 50.59 ScreenlEvaluation by NEI 9607 or NEI 9803? (Provide a YES or NO response to this question in the Response column at right.)
Note: In lieu ofthe exclusion criteria ofRM Section 42.3, a YES response may also be provided if the FSAR change requires no further 50.59 review based on a YES response to the question in Section 11 of this Applicability Determination form.)
2.
Technical Specification Bases?
NO YES If the above response is NO, check N/A in the Response column at right.
Ifthe above response is YES, does the proposed activity involve a TS Bases change comparable to that which may be excluded from the requirement to perform a 50.59 Screen/Evaluation by NET 9607 or NET 9803 (as described for an f$AR change)? (Provide a YES or NO response to this question in the Response column at right.)
Note: In lieu ofthe exclusion criteria ofRM Section 4.2.3, a YES response may also be provided if the TS Bases change requires no further 50.59 review based on a YES response to the question in Section II of this Applicability Determination form.)
yI.
Does the pTOpOsCd activity involve a change to; I.
Managerial or administrative procedures, controls, or activities (including software used only for the implementation of administrative procedures, controls, or activities) governing the conduct of facility operations (subject to the controlof 10CFR5O. Appendix B)?
2.
Regulatory commitment not covered by another regulation based change proccsW? (See NE199-04.)
A NO response in the Response U NO YES column at left means that the FSAR/TS Bases change is one that N/A requires further 50.59 review (i.e., is not excludable from further review).
A YES response means that the FSAR does NOT require further 50.59 review.


Nuctear issuing EN/A Dept Date: LjCancellation
Process the TS Bases change per APA-ZZ-OO 108 and fDP-ZZ-OO I 03 for revising License Documents.
Note:
A NO response in the Response colunrn at left means that the IS LI NO YES Bases change is one that requires further 50.59 review (i.e., is not N/A excludable from further review).
A YES response means that the TS Bases Change does NOT require further 50.59 review.
See Section4.2.4/4.2.6 of the RM.
LI YES YES, process per APA-ZZ-00 101 or APA-ZZ-00 109.
El YES If YES, process per
*.APA-ZZ-00540.
If YES, perform a 72.48 Screen per APA-ZZ-00143 unless the change is completely covered by the response to Section II.
V.
APPLICABILITY DETERMINATION (Continued)
Does the pi opoed cdr it> involve a h ui. to the J


Operations with KI 63%6. L: to APA-ZZ-00091 LI ElYes flYes E ERO EP Rev. CA0033 Yes Yes Yes N/A Continued:
===Response===
See Section 4 2 3 of the RM 1
FSAR rci NO LI YES Process the FSAR change per v.,I APA-ZZ-00 108 and fDP-ZZ-00 103 Ifthe above response is NO, check N/A in the Response 1for revising License Documents.
column at right.
Note:
esponse NO NO VII Does the proposed activity potentially affect the design,
. operation, or maintenance of the ISFSI facility as described in NO YES the dry cask storage FSAR or the 72.212 Report? (See FDP zz-00105 and Attachment 1 ofAPA-ZZ-00143.)
Note Editorial or administrative changes are excluded from the requirement
-- to perform a 72.48 Review.
APA-ZZ-OO1 43 Al 70.00 10 CA2510 Page 3 Rev. 005


002 E DNo No kJ No No No i:
APPLICABILITY DETERMINATION (Continued) viii. Justification/explanation for Response(s) (as needed):
additional given identified Address III. II.
The revision to EIP-ZZ-COO1O Add D adds clarification on Emergency Response roles and responsibilities related to authorization of issuance of Potassium Iodide (KI). This change ensures the DAC informs and receives concurrence from the Recovery Manager on issuance ofKI as the RM is responsible for offsite emergency response activities including protection of the health and safety of personnel.
activity.
EIP-ZZ-COOlO Add D is an RERP implementing procedure and this change is controlled by solely by 10CFR5O.54(q) and KDP-ZZ-00400, RERP Impact Evaluations and Change, for evaluation if the NRC requires notification approval for this change. 10CFR 50.59 process is not required.
: 4. 3. 2. 1 Does (See 50.59/72.48 that Does eporting Brief
Ix.
 
== Conclusion:==
Alt aspççts of the activity are controlled by one or more of the procedures above, therefore a 50.59 Screen isnot required.
LI A portion of the activity isnot controlled by one or more of the procedures above, therefore a 50.59 Screen is required.
x.:::: Preparer:
Date: çJ 1Z3 Qualified Reviewer:
Date:
lie I rj (Print name)
(Sig&PIN)
Ensure that once signed, this record is loaded into EB with the Activity/Document Number listed above or submit this form to either the Regulatory Affairs clerk or another member of Administration in accordance with APA-ZZ-00220.
APA-ZZ-00143 Page 4 CA2510 A170.OO1()
Rev. 005
 
50.54(q) Screening Form Document #, Rev #, &


==Title:==
==Title:==
ActivitylDocument procedures the answer Appendix other KDP-ZZ-00013], identified implementing Note: 50.54(q).) Emergency RadiologicalEmergencyResponse (See Security Quality License? Technical has guidance. questions the Section the Description Dose Refer items Ifyour 10 proposed been proposed to this CFR Plan Assurance 4.2 Screen previously the Assessment to question Eto covered as Action (Sec Specifications EOF. Section tothat below Part important procedure proposed 50.54(j).) which atlivity of activity of 10 the or Number:
EIP-ZZ-COOJ 0, Addendum D, Rev. 022,_DoseAssessment Coordinator_(DAC) Checklist EP Tracking #:
50.47(b) or Levels Plan? CFR RM.) evaluation CR activity portion YES. in could also approved 202303114 Coordinator 4of all the to change 5090.) involve fall the aspects APPLICABILITY emergency [any includes (See or. forDACtogetRecoveryManagerconcurrenceportosuing (what of 16Planning alter (EALS)? the within EIP-ZZ-COOlO
Activity Description and  
[refer EIP-ZZ-XXXX], has by 10 the response alters 10 Renewed achange already isbeing (DAC) CFR activity. of to Plan the CFR the the the KDP-ZZ-00400], Standards response aRERP (See Cyber NRC scope 50.59 time, (RERP) 50.54(a).) Operating to been changed Checklist activity 10 the: or ADDD Resource Note ___________
CFR Security for of staffing, [refer equipment or performed? an that Ifthe or which activity and DETERMINATION in to Plan? Manual itisnot or a why): answer


I NO NO NO NO NO Response (RM) unusual isYES
==References:==
Page 3 Step 4: Added steps for DAC to get Recovery Manager concurrence prior to issuing Ki to ERO Personnel Reporting to the EOF. CR 202303114 Activity Scope:
YES NO Does this activity revise the Radiological Emergency Response Plan (RERP) or Implementing Procedures?
.... LXI ChangeType:
YES NO Is this activity editorial or typographica1?....
El Previously Approved Change:
YES NO Is this activity being processed to conform to a previously approved activity7
.. U IfYES, what is the previously approved activity?
Planning Standard Determination:
Does this activity impact any of the 50.47(b) Planning Standards or Part 50 Appendix E:
YES NO 50.47(b)(1) - Assignment ofResponsibihty (Organization Control)?.....
., U f
50.47(b)(2) - Onsite Emergency Organization7 0
50.47(b)(3) - Emergency Response Support and Resources 0
50.47(b)(4)
- Emergency Classification Syste&......
LI 50.47(b)(5) - Notification Methods and Procedures7
. 0 50.47(b)(6) - Emergency Communications?
. 11 I
50.47(b)(7)
- Public Education and Information?
.. U 50.47(b)(8)
- Emergency facility and Equipment7
.. El 50.47(b)(9) - Accident Assessment?
,.. C 50.47(b)(1O)
- Protective Response?
. Li 50.47(b)(1 1)
- Radiological Exposure Control9 50.47(b)(12)
- Medical and Public health Support7 E1 50.47(b)(13)
- Recovery Planning and Post Accident Operations?
50.47(b)(14)
- Drills and Exercises El 50.47(b)(l 5)
- Emergency Responder Training7
. Li 50.47(b)(16)
- Emergency Plan Maintenance9 1
1 Part 5OAppendix E?
Commitment Impact Determination:
YES NO Does this activity impact a Site Specific EP Commitment not associated with a Planning Standard or Element?
If Yes, record the Commitment number:
Explanation of Determination: (Enter an explanation to each determination-answer that needs clarification.)
This change is associated with Planning Standard 50.47(b)(2) Onsite Emergency Organization, 50.47(b)(9) Accident Assessment, 50.47(b)(1O) Protective Response, and 50.47(b)(11) Radiological Exposure Control. This change ensures the Dose Assessment Coordinator gets concurrence from the Recovery Manger to issue KI to ERO Personnel Reporting to the EOF. This does not change the responsibility of issuance, or how to issue. This is to ensure the DAC has communicated the need for KI to the RM, and the RM provides a peer check to ensure KI is warranted. Therefore, there is no impact to the Planning Standards.
File#A210.0038 Pagelof2 CA1523 KDP-ZZ-00400 Rev. 002


===Response===
50.54(q) Screening Form Screening Evaluation Results:
LI El El and to for YES YES YES YES YES the have iiistructions any programs. related and IfYES, procedure Plan IfYES, programs. facility and IfYES, and IfYES, See Document document Amendment Evaluation Identify complete Determination review IfYES, more portion KDP-ZZ-00400 and SDP-ZZ-00030 GDP-ZZ-00600 FDP-ZZ-00 Section Revision than facility process related process or process process the beyond no KHOEROPerSOnne of change procedure # number. Log the further one 4.2.1 No., applicable remainder Number: on the or per facility per per 103. per No., (AD) this pages process activity, procedure APA-ZZ-00 programs. APA-ZZ-0O APA-ZZ-00 APA-ZZ-00 of or Applicability 50.59 for for change and the applicable License isrequired, 5-6 RERP or Security related RM. 50.59/72.48 of (or 022 apply apply Rev. CA25 change this 72.48) for 005 and 108 108 108 108 form. but to the 10 a
Based on the results of the information above, can the activity be implemented without performing a YES NO ftill 50.54(qJ Effectiveness Evaluation9 ReviewfApproval:
Preparer (SIgnIPJN) jqq Date:______
f I flhttYt be q i.Iifltd nwrgi expwa Coordinator Reviewer (Sign)
L Reviewer tint.
c tw1U in rg 1?CV Response Coordinator.
Emergency Preparedness Manager (SigWPIN):


APPLICABILITY DETERMINATION (Continued) viii.Justification/explanation forResponse(s) (asneeded):
I3 Date:
Therevision toEIP-ZZ-COO1O AddDaddsclarification onEmergency Response rolesandresponsibilities relatedto authorization ofissuanceofPotassium Iodide(KI).ThischangeensurestheDACinformsandreceivesconcurrence from theRecovery Manager onissuanceofKIastheRMisresponsible foroffsiteemergency response activities including protection ofthehealthandsafetyofpersonnel.
File#A210.0038 Page2of2 CA1523 KDP-ZZ-00400 Rev. 002}}
EIP-ZZ-COOlO AddDisanRERPimplementing procedure andthischangeiscontrolled bysolelyby1OCFR5O.54(q) and KDP-ZZ-00400, RERPImpactEvaluations andChange,forevaluation iftheNRCrequiresnotification approval forthis change. 10CFR50.59processisnotrequired.
Ix.Conclusion:
Altaspççtsoftheactivityarecontrolled byoneormoreoftheprocedures above,therefore a50.59Screenisnotrequired.
LIAportionoftheactivityisnotcontrolled byoneormoreoftheprocedures above,therefore a50.59Screenisrequired.
x.:::: Preparer: Date:çJ1Z3 Qualified Reviewer: Date:lieIrj (Printname) (Sig&PIN)
Ensurethatoncesigned,thisrecordisloadedintoEBwiththeActivity/Document Numberlistedaboveorsubmitthis formtoeithertheRegulatory AffairsclerkoranothermemberofAdministration inaccordance withAPA-ZZ-00220.
APA-ZZ-00143 Page4 CA2510 A170.OO1() Rev.005}}

Latest revision as of 07:15, 25 November 2024

EtP-ZZ-COO10 Add D, Rev 22, Dose Assessment Coordinator (DAC) Checklist
ML24002A819
Person / Time
Site: Callaway Ameren icon.png
Issue date: 07/25/2023
From: Traub D
- No Known Affiliation
To:
Office of Nuclear Reactor Regulation, Document Control Desk
References
EtP-ZZ-COO1 0 ADD D, Rev 22
Download: ML24002A819 (1)


Text

PROCEDURE REVIEW FORM (PRF) 1.0 Initiation Initiator: David Traub PIN 85245 Date: 7/25/2023 Procedure Dept EP Document #: EtP-ZZ-COO1 0 ADD D New Rev. #

022 (3 digits required)

Title:

Dose Assessment_Coordinator (DAC) Checklist Level of Use:

Continuous Refcrence Information Mu1tip1e EN/A 2.0 Reason for Change/Description of Change (List commitments, CRs, eB Change Reqttesis, OERs, Plant Mods etc. and record numbers here.)

CR 2023031 14-002

- Adding guidance for obtaining Recovery Manager concurrence prior to issuing KI to ERO Personnel reporting to the EOF.

Continued: fl 3M.

Document Disposition

üTemp Change 1New Document ElMajor Revision Minor Revision LjCancellation flAdministrative Correction Dpt. Head or Designated Approver required for Administrative Corrections (S4PJNtDatc) no other signatures 4.0 Interim Approval (Temp. Change Only)

Temp. Change #:

Expiration Date:

CognizantSupervisor (Signature/PIN/Date)

SRO (Signaflire/PIN/Date)

5.0 Comments

Continued: i:

6M Reviews and Signatures (NOT requiredfbr Administrative Corrections)

Reviews Required I

Dept I

PIN Sigitti re Date (40139 Attached Preparer EP

, 85245 7t2512023%

N/A Technical Review E Yes kJ No TechnicaiReview ic

/L-

. oZol flYes No AddlReview

. ElYes DNo AddI Review LI Yes No EjAdditional Reviews (See Attached CAOl39Jbrrns).

Number of additional CAO139s:

Type Coordinator - PIN Signature j

Date CA0139 Attached Vahdation I

. L: Yes E No 50.59 Review CA25 10 11CA25 1 1 L1CA2512 I N!A (perAPA-ZZ-OO1%3)

Screener InitiaI/ PIN Reviewer Iitiat/PIN (Dept. head or Designated Approver) Is a Change Management Plan required?

LlYes No (IF YES, attach CA2773 or CA2774)

Is a Cross-Disciplinary review required?

ElYes No 7.0 Approval (Either approval mttst be qitaIed as PA T/APVR or PAT/GAPR in Qitatliastet)

Senior Director Nuclear Operations Approval (per APA-ZZ-OO1O1)

ORC is required in accordance with APA-ZZ-00091 D

tmcnt lleaj1 Final Review and Approval ORC Meeting:

7fo/3 63%6 Dept. 1-lead or Designated Approver Senior Director Nuctear Operations (Signature/PIN/Date)

(Signature/PEN/Date) iVote: Page 2 provides instrtictions to complete thisJbrm and may be discarded

ioooi, 2, 5,35

- A210.0062,65, 69; M190.0001 Page lof2 CA0033 APA-ZZ-OO1Ol Rev. 002

APPLICABILITY DETERMINATION Address the questions below for all aspects of the activity If the answer is YES for any portion of the activity, apply the identified procedures to that portion of the activity. Note that it is not unusual to have more than one process apply to a given activity. Refer to Section 4 of the 10 CFR 50.59 Resource Manual (RM) and the iiistructions on pages 5-6 for additional guidance.

ActivitylDocument Number: EIP-ZZ-COOlO ADDD III.

Does the proposed atlivity involve a change to the:

1.

Technical Specifications or the Renewed Operating License?

(Sec 10 CFR 5090.)

2.

Quality Assurance Plan? (See 10 CFR 50.54(a).)

3.

Security Plan which also includes the Cyber Security Plan?

NO (See 10 CFR 50.54(j).)

4.

RadiologicalEmergencyResponse Plan (RERP) or Emergency Action Levels (EALS)? (See 10 CFR 50.54(q).)

Note: If your proposed change alters a RERP implementing procedure [any EIP-ZZ-XXXX], equipment identified as important to emergency response [refer to KDP-ZZ-00013], or could alter response time, staffing, or other items covered in the 1 6 Planning Standards or in Appendix E to Part 50.47(b) [refer to KDP-ZZ-00400],

answer this question YES.

Revision Number: 022 APA-ZZ-OO 143 A170.OO1O Page 1 II.

Title:

Dose Assessment Coordinator (DAC) Checklist Brief Description of activity (what is being changed and why):

forDACtogetRecoveryManagerconcurrenceportosuing KHOEROPerSOnne eporting to the EOF. CR 202303114

.1.

IfYES, no further 50.59 (or 72.48) review beyond this Applicability Determination (AD) is required, but Does the proposed activity fall within the scope of an activity

Response

complete the remainder of this form.

that has been previously approved by the NRC or for which a

(

Identify the applicable 50.59/72.48 50.59/72.48 Screen or evaluation has already been performed?

(See Section 4.2 of the RM.)

NO YES Evaluation Log No., License Amendment No., or applicable document number.

Document #

Response

See Section 4.2.1 of the RM.

NO El YES IfYES, process per APA-ZZ-00 108 and FDP-ZZ-00 103.

If YES, process per APA-ZZ-00 108 NO El YES and GDP-ZZ-00600 and related facility or procedure change programs.

If YES, process per APA-ZZ-0O 108 LI YES ai SDP-ZZ-00030 for Security Plan and related facility or I

procedure change programs.

If YES, process per APA-ZZ-00 108 NO YES

  • and KDP-ZZ-00400 for RERP and

-J related facility or procedure change programs.

CA25 10 Rev. 005

APPLICABILITY DETERMINATION (Continued)

IIfYBS, process APA-ZZ-00356 for ASME code compliance and related facility or procedure change programs.

5.

1ST Program Plan? (See 10 CFR 50.55a(f).)

NO U YES IfYES, process per EDP-ZZ-O 1003 for ASME code compliance and related facility or procedure change programs.

6.

151 Program Plan? (See 10 CFR 50.55a(g).)

NO EJ YES See FP Screening questions in EDP C

ZZ-04044. If any ofthc screening 7.

Fire Protection Program ? (See Operating License Condition 2.C(5).)

NO YES questions are answered YES, a Fire Protection review is needed in accordance with EDP-ZZ-04044.

i.

Storage Cask Certificate of Comphance(CoC), including If YES, then contact Regulatory appendices?

(See 10 CFR 72.244.)

NO fl YES Affairs/Licensing to determine next 1steps.

9.

Does the proposed activity impact other programs (e.g.,

the ODCM) that are controlled by regulations, the Operating License (including Orders and License If YES, indicate the applicable Conditions) or the Technical Specifications? (See Section NO LI YES program in Brief Description 4.2.1 ofthe RM.)

Section.

Iv.

Does the proposed activity involve:

Response

Sec Section 4.2.2 oftheRM

1. Maintenance which restores SSCs to their original (as designed) condition?

(See 10 CFR 50.65(a)(4).)

IfYES, process change per rci NO YES 1APA-ZZ-0010l for procedure Note: If the maintenance is on ISFSI or cask-related items, changes or APA-ZZ-00320/330/340 the Maintenance Rule does NOT apply, and the activity is for Maintenance activities.

subject toalO CFR 72.48 Screen onaCA3l45.

IfYES, process per APA-ZZ-0010l for procedure changes or APA-ZZ-00605 for facility changes 2.

A temporary alteration (to procedures or the facility)

R7 or Procedurally Controlled supporting maintenance (TASM) that will be in effect j NO YES C

Temporary Modifications or during at-power operations for 90 days or less?

MDPZZ-FSOO1 for Freeze Seals.

Evaluate risk using APA-ZZ-003l5, Appendix A.

APA-ZZ-00143 Page2 CA2510 A170.OO1O Rev. 005

If the above response is YES, does the proposed activity involve an fSAR change that may be excluded from the requirement to perform a 50.59 ScreenlEvaluation by NEI 9607 or NEI 9803? (Provide a YES or NO response to this question in the Response column at right.)

Note: In lieu ofthe exclusion criteria ofRM Section 42.3, a YES response may also be provided if the FSAR change requires no further 50.59 review based on a YES response to the question in Section 11 of this Applicability Determination form.)

2.

Technical Specification Bases?

NO YES If the above response is NO, check N/A in the Response column at right.

Ifthe above response is YES, does the proposed activity involve a TS Bases change comparable to that which may be excluded from the requirement to perform a 50.59 Screen/Evaluation by NET 9607 or NET 9803 (as described for an f$AR change)? (Provide a YES or NO response to this question in the Response column at right.)

Note: In lieu ofthe exclusion criteria ofRM Section 4.2.3, a YES response may also be provided if the TS Bases change requires no further 50.59 review based on a YES response to the question in Section II of this Applicability Determination form.)

yI.

Does the pTOpOsCd activity involve a change to; I.

Managerial or administrative procedures, controls, or activities (including software used only for the implementation of administrative procedures, controls, or activities) governing the conduct of facility operations (subject to the controlof 10CFR5O. Appendix B)?

2.

Regulatory commitment not covered by another regulation based change proccsW? (See NE199-04.)

A NO response in the Response U NO YES column at left means that the FSAR/TS Bases change is one that N/A requires further 50.59 review (i.e., is not excludable from further review).

A YES response means that the FSAR does NOT require further 50.59 review.

Process the TS Bases change per APA-ZZ-OO 108 and fDP-ZZ-OO I 03 for revising License Documents.

Note:

A NO response in the Response colunrn at left means that the IS LI NO YES Bases change is one that requires further 50.59 review (i.e., is not N/A excludable from further review).

A YES response means that the TS Bases Change does NOT require further 50.59 review.

See Section4.2.4/4.2.6 of the RM.

LI YES YES, process per APA-ZZ-00 101 or APA-ZZ-00 109.

El YES If YES, process per

  • .APA-ZZ-00540.

If YES, perform a 72.48 Screen per APA-ZZ-00143 unless the change is completely covered by the response to Section II.

V.

APPLICABILITY DETERMINATION (Continued)

Does the pi opoed cdr it> involve a h ui. to the J

Response

See Section 4 2 3 of the RM 1

FSAR rci NO LI YES Process the FSAR change per v.,I APA-ZZ-00 108 and fDP-ZZ-00 103 Ifthe above response is NO, check N/A in the Response 1for revising License Documents.

column at right.

Note:

esponse NO NO VII Does the proposed activity potentially affect the design,

. operation, or maintenance of the ISFSI facility as described in NO YES the dry cask storage FSAR or the 72.212 Report? (See FDP zz-00105 and Attachment 1 ofAPA-ZZ-00143.)

Note Editorial or administrative changes are excluded from the requirement

-- to perform a 72.48 Review.

APA-ZZ-OO1 43 Al 70.00 10 CA2510 Page 3 Rev. 005

APPLICABILITY DETERMINATION (Continued) viii. Justification/explanation for Response(s) (as needed):

The revision to EIP-ZZ-COO1O Add D adds clarification on Emergency Response roles and responsibilities related to authorization of issuance of Potassium Iodide (KI). This change ensures the DAC informs and receives concurrence from the Recovery Manager on issuance ofKI as the RM is responsible for offsite emergency response activities including protection of the health and safety of personnel.

EIP-ZZ-COOlO Add D is an RERP implementing procedure and this change is controlled by solely by 10CFR5O.54(q) and KDP-ZZ-00400, RERP Impact Evaluations and Change, for evaluation if the NRC requires notification approval for this change. 10CFR 50.59 process is not required.

Ix.

Conclusion:

Alt aspççts of the activity are controlled by one or more of the procedures above, therefore a 50.59 Screen isnot required.

LI A portion of the activity isnot controlled by one or more of the procedures above, therefore a 50.59 Screen is required.

x.:::: Preparer:

Date: çJ 1Z3 Qualified Reviewer:

Date:

lie I rj (Print name)

(Sig&PIN)

Ensure that once signed, this record is loaded into EB with the Activity/Document Number listed above or submit this form to either the Regulatory Affairs clerk or another member of Administration in accordance with APA-ZZ-00220.

APA-ZZ-00143 Page 4 CA2510 A170.OO1()

Rev. 005

50.54(q) Screening Form Document #, Rev #, &

Title:

EIP-ZZ-COOJ 0, Addendum D, Rev. 022,_DoseAssessment Coordinator_(DAC) Checklist EP Tracking #:

Activity Description and

References:

Page 3 Step 4: Added steps for DAC to get Recovery Manager concurrence prior to issuing Ki to ERO Personnel Reporting to the EOF. CR 202303114 Activity Scope:

YES NO Does this activity revise the Radiological Emergency Response Plan (RERP) or Implementing Procedures?

.... LXI ChangeType:

YES NO Is this activity editorial or typographica1?....

El Previously Approved Change:

YES NO Is this activity being processed to conform to a previously approved activity7

.. U IfYES, what is the previously approved activity?

Planning Standard Determination:

Does this activity impact any of the 50.47(b) Planning Standards or Part 50 Appendix E:

YES NO 50.47(b)(1) - Assignment ofResponsibihty (Organization Control)?.....

., U f

50.47(b)(2) - Onsite Emergency Organization7 0

50.47(b)(3) - Emergency Response Support and Resources 0

50.47(b)(4)

- Emergency Classification Syste&......

LI 50.47(b)(5) - Notification Methods and Procedures7

. 0 50.47(b)(6) - Emergency Communications?

. 11 I

50.47(b)(7)

- Public Education and Information?

.. U 50.47(b)(8)

- Emergency facility and Equipment7

.. El 50.47(b)(9) - Accident Assessment?

,.. C 50.47(b)(1O)

- Protective Response?

. Li 50.47(b)(1 1)

- Radiological Exposure Control9 50.47(b)(12)

- Medical and Public health Support7 E1 50.47(b)(13)

- Recovery Planning and Post Accident Operations?

50.47(b)(14)

- Drills and Exercises El 50.47(b)(l 5)

- Emergency Responder Training7

. Li 50.47(b)(16)

- Emergency Plan Maintenance9 1

1 Part 5OAppendix E?

Commitment Impact Determination:

YES NO Does this activity impact a Site Specific EP Commitment not associated with a Planning Standard or Element?

If Yes, record the Commitment number:

Explanation of Determination: (Enter an explanation to each determination-answer that needs clarification.)

This change is associated with Planning Standard 50.47(b)(2) Onsite Emergency Organization, 50.47(b)(9) Accident Assessment, 50.47(b)(1O) Protective Response, and 50.47(b)(11) Radiological Exposure Control. This change ensures the Dose Assessment Coordinator gets concurrence from the Recovery Manger to issue KI to ERO Personnel Reporting to the EOF. This does not change the responsibility of issuance, or how to issue. This is to ensure the DAC has communicated the need for KI to the RM, and the RM provides a peer check to ensure KI is warranted. Therefore, there is no impact to the Planning Standards.

File#A210.0038 Pagelof2 CA1523 KDP-ZZ-00400 Rev. 002

50.54(q) Screening Form Screening Evaluation Results:

Based on the results of the information above, can the activity be implemented without performing a YES NO ftill 50.54(qJ Effectiveness Evaluation9 ReviewfApproval:

Preparer (SIgnIPJN) jqq Date:______

f I flhttYt be q i.Iifltd nwrgi expwa Coordinator Reviewer (Sign)

L Reviewer tint.

c tw1U in rg 1?CV Response Coordinator.

Emergency Preparedness Manager (SigWPIN):

I3 Date:

File#A210.0038 Page2of2 CA1523 KDP-ZZ-00400 Rev. 002