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{{#Wiki_filter:i QF-1071 -0*1 | {{#Wiki_filter:i QF-1071 -0*1 | ||
'JV. 2 (FP-T-SAT-71) j fl Xcel Energy- \\ | |||
MASTER SECURITY AGREEMENT Pa~t. l:'Pf 2 | |||
: 1. Pre-Examination (Review FP-T-SAT-71 , Attachment 1 for pre-job | ---= ~--i | ||
*-*---- *--------~J The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment. | |||
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 | : 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) | ||
: 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 | ! 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 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. | ||
SIGNATURE (! ) | 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. | ||
(,-15-!5 0~r | : 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. | |||
7 | Retention: Life of Plant Retain in: Exam File SIGNATURE (! ) | ||
DATE NOTE | |||
(,-15-!5 - | |||
h{ tl:S( ~ | 0~r | ||
~>f> | |||
7 ft ? hr NU 6~~"4 | |||
' l -->.1 ;...::> | |||
(.~v~ K4..b 6/15/15 tdt'S"h5'- | |||
I,. 'I --- ~~ | |||
h{ tl:S( ~ | |||
QF-1071-0 . | QF-1071-0. | ||
r-~ ** ------ - - ----~------..:J_ | 2v. 2 fFP-T-SAT-71\\ | ||
I '(! | r-~ ** ------ - | ||
The Master Security Agreement is used for those personnel having both knowledge of Exam Sensitive Material and unrestricted access to Primary and Secondary Containment. | -----~------..:J_ ________ | ||
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. | : 10. | ||
i 1. | i 1. | ||
12. | : 12. | ||
13 . | : 13. | ||
14. | : 14. | ||
15. | : 15. | ||
NOTES: | NOTES: | ||
Retention: Life of Plant Retain in: Exam File | 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 | QF-1071 | ||
'2v. 2 (FP-T-SJ\\T-71 ) | |||
f2 | |||
,-,,~------.------------------------------------------------~ | ,-,,~------.------------------------------------------------~ | ||
i '(l Xcel Energy- | 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. | 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) | : 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 | 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 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. | 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 . | 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 | : 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 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. | 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. | ||
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01. | |||
Retention: Life of plant Retain in: Exam file Form | |||
QF-1Q7*i-Oi, .av.~ (FP-T-SAT-71) | QF-1Q7*i-Oi, | ||
I fl Xcel Energy- | .av.~ (FP-T-SAT-71) | ||
I fl Xcel Energy-I LIMITED sEcuR1TY AGREEMENT | |||
j\ PRINTAD N,AME | *-*----1 | ||
1t_ t,ve ~s ,-; | ~-----~-~-------------------------------------~---__J The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment. | ||
: 6. | |||
: 8. | |||
S. | |||
: 10. | j\\ PRINTAD N,AME 1t_ t,ve ~s,-;I I c~ | ||
: 11. | ~ | ||
12. | Sc:-crn-Do \\/vQ | ||
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: 11. | |||
: 13. | {~ (M-et* | ||
: 12. | |||
: 14. | Jet:>f | ||
: 15. | /£1~?.... | ||
NOTES: | : 13. J,e:ft r:)ISc.¥\\ | ||
Retention: Life of piant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 . | : 14. | ||
Bo B ">Tf(.A-i3lt?t | |||
: 15. _ _/{ 6fll _ _/lf-Low NOTES: | |||
Retention: Life of piant Retain in: Exam file JOB TITLE /(<E~ONSI BILITY | |||
~o 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{' -- | |||
6~- | |||
-r r1 /f 5. | |||
<Pl1c,}1r- | |||
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(,,*tJ. *IS' | |||
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QF-1 071-0~ | |||
;;v. 2 (FP-T-SAT-71) | |||
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. | : Paf, | ||
: 1. Pre-Examination {Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) | .:>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. | ||
booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee. | : 1. Pre-Examination {Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) | ||
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 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. 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. | ||
: 2. Post-Examination | 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. | 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 | ||
I | I I | ||
I I | |||
I | |||
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QF-1071-C | QF-1071-C | ||
I fl Xcel Energy I | .;v. 2 (FP-T-SAT-71) | ||
: 1. Pre-Examination (Review FP-T-SAT-71 , Attachment 1 for pre-job briefing requirements) | 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. | ||
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 | : 1. Pre-Examination (Review FP-T-SAT-71, Attachment 1 for pre-job briefing requirements) | ||
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 | 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. | ||
I will | 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. | ||
: 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 | 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. | 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 | PRINTED NAME JOB TITLE I RESPONSIBILITY | ||
:JC PG tie~ V\\ Ks | |||
<Ro je s Sr \\n v~ | |||
_S_~_CJ | |||
3_ tf'frtG Q;flii!>'lfz:Kofr_ | ...;:_ ________,,1-~'--'-~~""""':;..+-11--- | ||
: 4. | 3_ tf'frtG Q;flii!>'lfz:Kofr_~~D _____ | ||
......... "'1:!~~~~~ | |||
: 4. /YZ H /:?lu+.,_ | |||
-~S._ | |||
!C..a | |||
______ --d.-..--::~ | ______ --d.-..--::~ | ||
: 5. | : 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, .. | QF-1 071-02,.. 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. | |||
: 12. | PRINTED NAME DG~E.\\<. | ||
: 13. Bllt.MV W.aeNttr | &<Ros~lt1'tM f)ofliv... 6 A1lf Ic;JuxPr Jcrz s, ~.sp,v JS l) NE I,_l 0 | ||
;: | : 12. | ||
/~,/r/,./!vb I tv" c1 | |||
: 13. Bllt.MV W.aeNttr | |||
;: j~~!tCO NOTES: | |||
Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY S v(o | |||
.SRO NlJ clew Btirli (Jr trrlt:VYL DPS IMS:ni u.(:fr:,:.,;L Form retained in accordance with record retention schedule identified in FP-G-RM-01. | |||
-~-..... | -~-..... '--------.,..--*-----*--- | ||
; | ; | ||
* Xcel.Enerav- i | * Xcel.Enerav-i | ||
~--*--~-- | ~--*--~-- | ||
access to Primary and Se~ndary Containm~ri~ | ,,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 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) | : 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. | 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. | 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 | : 2. P,:ist-Examination | ||
: 4. | |||
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. | 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 | PRINTED N/;,,ME | ||
,JOB TITL.E I RESPONS!BIUTY DATE NOTE | |||
~f\\~ s~ t>Atc | |||
_.,iv) | *~* | ||
1~1 \<--. | 1 | ||
* VlrJ | _.,iv) 1~1 \\<--..,.,,, 1 It,,,,.'\\[_;., | ||
* VlrJ O\\')~..,, | |||
R.r;tentlon: Life of ulant Retaln ir;: Exam \*ne Fom1 retain$d in accordance v.tith record retention schedule identified in F?-G-Rl\li-01. | R.r;tentlon: Life of ulant Retaln ir;: Exam \\*ne Fom1 retain$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) | QF-'i0/1-02,....;v. 2 (FP-T-SAT-71) | ||
PRINTED NAME | Pag'' | ||
: 6. | 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. | ||
: 7. r)_o(lrr-.. 6Allf ie;JElA+-l | PRINTED NAME | ||
Retention: Life of plant Retain in: Exam file Form retained in accordance with record retention schedule identified in FP-G-RM-01 .}} | : 6. | ||
\\)S.,O._E,\\( | |||
6f!'<pS~\\lt1Atj | |||
: 7. | |||
r)_o(lrr-.. 6Allf ie;JElA+-l NOTES: | |||
Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY S'~o 12.o Sr<.o Form retained in accordance with record retention schedule identified in FP-G-RM-01. | |||
SIGNATURE (2) | |||
DATE NOTE}} | |||
Latest revision as of 10:07, 10 January 2025
| ML15216A116 | |
| Person / Time | |
|---|---|
| Site: | Monticello |
| 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-71) j fl Xcel Energy- \\
MASTER SECURITY AGREEMENT Pa~t. l:'Pf 2
---= ~--i
- -*---- *--------~J 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 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 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-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.
Retention: Life of Plant Retain in: Exam File SIGNATURE (! )
DATE NOTE
(,-15-!5 -
0~r
~>f>
7 ft ? hr NU 6~~"4
' l -->.1 ;...::>
(.~v~ K4..b 6/15/15 tdt'S"h5'-
I,. 'I --- ~~
h{ tl:S( ~
QF-1071-0.
2v. 2 fFP-T-SAT-71\\
r-~ ** ------ -
~------..:J_ ________
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 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.
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 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.
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,
.av.~ (FP-T-SAT-71)
I fl Xcel Energy-I LIMITED sEcuR1TY AGREEMENT
- -*----1
~-----~-~-------------------------------------~---__J The Limited Security Agreement is used for those personnel having limited knowledge of Exam Sensitive Material but do not have unrestricted access to Primary and Secondary Containment.
- 6.
- 8.
S.
j\\ PRINTAD N,AME 1t_ t,ve ~s,-;I I c~
~
Sc:-crn-Do \\/vQ
- 10.
-~*Ant<;;
- 11.
{~ (M-et*
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Retention: Life of piant Retain in: Exam file JOB TITLE /(<E~ONSI BILITY
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.:>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 administration. I also understand that I am not to evaluate individuals scheduled to be administered these examinations from this date until the date of administration. Acting as a simulator booth operator or communicator is acceptable if I do not select the training content or provide direct or indirect feedback to an examinee.
Furthermore, I am aware of the physical security measures and requirements (as documented in NSPM procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examination and/or an enforcement action against my facility or me.
I will immediately report to the Exam Project Manager any indications or suggestions that examination security may have been compromised.
- 2. Post-Examination To the best of 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.
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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
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QF-1 071-02,.. 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 DG~E.\\<.
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Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY S v(o
.SRO NlJ clew Btirli (Jr trrlt:VYL DPS IMS:ni u.(:fr:,:.,;L Form retained in accordance with record retention schedule identified in FP-G-RM-01.
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- Xcel.Enerav-i
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LIMITED SECURITY AGREEMENT 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
- 4.
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
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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
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.
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- 7.
r)_o(lrr-.. 6Allf ie;JElA+-l NOTES:
Retention: Life of plant Retain in: Exam file JOB TITLE I RESPONSIBILITY S'~o 12.o Sr<.o Form retained in accordance with record retention schedule identified in FP-G-RM-01.
SIGNATURE (2)
DATE NOTE