ML030360062

Init Exam - 10/2002- Public Forms

ML030360062
Person / Time
Site:	Columbia
Issue date:	04/11/2002
From:	Gody A NRC Region 4
To:	Parrish J Energy Northwest
References
50-397/02-301
Download: ML030360062 (41)

Text

Operations Branch Assignment Check Sheet:

(Includes ES-201-1 & ES-501-1 Rev. 8, Supplement 1 information)

Chief: T. Stetka Facility/Task: CG IN EX Task Start Date: 10/07/2002 as of: 10/15/2001 ITEM DESCRIPTION DUE DATE A INIT DATE 0

Exam/Inspection Schedule Agreement (C.l.a;C.2.a&b)

Apr 10, 2002 ATG 10/15/2001 1

NRC Staff & Fac. Contact Assigned (C.l.c;C.2.e)

Apr 10, 2002 /kTG 10/15/2001 2

Facility contact briefed on security & other issues (C.2.c)

Apr 10, 2002 3

Corp. Notification Letter Sent (C.2.d) (Exams only)

Apr 10, 2002

[

3a Inspection Announcement Letter Sent (PIR & LORT if req'd)

Aug 23, 2002 4

Task Expectations, Issues, & Standards Discussed w/ BC Jul 9, 2002 5'

[Reference Material Due (C.l.d;C.3.c)]

Jun 9, 2002

,/4 6# Integrated Exam Outlines Due (C.l.d&e;C.3.d)

Jun 9, 2002 C/ez.

7# Outlines reviewed by NRC & Feedback Sent (c.2.h;C.3.e)

Jun 23, 2002 8'

Preliminary Applications Due (C.I.j;C.2.g;ES202)

Sep 7, 2002

/

9# Draft Exams w/ Doc./Ref. Due (C.1.d/e/f;C.3.d)

Aug 8, 2002 8113 z 104 Peer Reviewer Initials As Reviewed All Parts*

Aug 18, 2002 11' NRC Supervisor. Initials Approving for Fac. Rev. (C.2.h;C.3.f)*

Aug 18, 2002 99 a 12" Exams Reviewed w/ Fac. (C.l.h;C.2.f&h;C.3.g)

Aug 18, 2002

'"//oz 13' Final Appl. Due & Assign. Sheet Prepared (C.I.j;C.2.h;ES202)

Sep 23, 2002 q/zs/oz 14# NRC Supervisor Approved Final Exams (C.2.i;C.3.h)*

Sep 30, 2002I/

/

15' Final Appl. Rec'd & Waivers Sent (C.2.g)

Sep 30, 2002 16# Proctor Rules Reviewed w/ Fac. & Written Authorized (C.3.k)

Sep 30, 2002 17 Exam/Insp Material to Team (C.3.i)

Sep 30, 2002 VIE 18# Fac. graded exam & Comments Rec'd Oct 19, 2002 V'

19# NRC Written Grading Completed.

Oct 22, 2002 20' Examiners Finished Grading Op. Tests Oct 22, 2002 P

i,/5"R.

21# NRC Ch. Ex. Review Completed Nov 1, 2002 v-,

22 NRC BC Review Completed*

Nov 2, 2002

)1r 23# RPS/IP # Examinees Updated Before Report Issued Nov 7, 2002 it ii/fjoz.

24 License/Denials Signed & Report Issued Nov 7, 2002 25 Package Closed Out Nov 28, 2002 Final Inspection Report Issued, Exam Package to OLA, Facility. Contact Notified of Results

1. Not required for inspections, except as noted.

• Note Supervisor/Peer initials required.

[]Required NRC-auth. exams only.

When complete, for exams, add to pkg & fwd copy to BC, for insp, fwd orig'l to BC.

Last revised 10/15/01 S:\\DRS\\OB\\EXAMS\\WNP2\\October 2002 Exam\\exam assignment sheet.wpd

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

Date of Examination:

Initials Item Task Description a

b*

c#

1.

a. Verify that the outline(s) fit(s) the appropriate model per ES-401.

(244 W

R

b. Assess whether the outline was systematically and randomly prepared in accordance with 1

Section D.1 of ES-401 and whether all K/A categories are appropriately sampled.9 T

T

c. Assess whether the outline over-emphasizes any systems, evolutions, or generic topics.

_ __ýs 9&

E N

d. Assess whether the justifications for deselected or reected K/A statements are appropriate.

( f

2.

a. Using Form ES-301 -5, verify that the proposed scenario sets cover the required number of QZ normal evolutions, instrument and component failures, and major transients.

9L4 S

I

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

mix of applicants in accordance with the expected crew composition and rotation schedule without compromising exam integrity;, ensure 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)9, and scenarios will not be repeated over successive days.

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.

3.

a. Verify that:

(1) the outline(s) contain(s) the required number of control room and in-plant tasks, W

(2) no more than 30% of the test material is repeated from the last NRC examination,

/

(3)° no tasks are duplicated from the applicants' audit test(s), and T

(4) no more than 80% of any operating test is taken directly from the licensee's exam banks.

b. Verify that:

(1) the tasks are distributed among the safety function groupings as specified in ES-301, (2) one task is conducted in a low-power or shutdown condition, Qs (3) 40%/. of the tasks require the applicant to implement an alternate path procedure,.

(4) one in-plant task tests the applicant's response to an emergency or abnormal condition, and (5) the in-plant walk-through requires the applicant to enter the RCA.

c. Verify that the required administrative topics are covered, with emphasis on performance based activities.

d. Determine if there are enough different outlines to test the projected number and mix of applicants and ensure that no items are duplicated on successive days.

4.

a. Assess whether plant-specific priorities (including PRA and IPE insights) are covered in the apprprate exam section.

E

b. Assess whether the 10 CFR 55.41/43 and 55.45 sampling is appropriate.

N E

c. Ensure that K/A importance ratings (except for plant-specific priorities) are at least 2.5.

14 Ivy R

A

d. Check for duplication and overlap among exam sections.

L

e. Check the entire exam for balance of coverage.

f. Assess whether the exam fits the appropriate job level (RO or SR).

Author*.*

__*ed Naneý.49nture, a

a. Author iee u

ir

b. Facility Reviewer (*)

R.t

c. NRC Chief Examiner(#)

"-.-int.*

=-s

£gka/

I.

d. NRC Supervisor

,/AMOA/V I-,

,,2b, Note:

• Not applicable for NRC-developed examinations.

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

23 of 24 NUREG-1021, Revision 8, Supplement 1

ES-401 Written Examination Form ES-401-7 Quality Checklist Facility: 831.,

m,,all*

Date of Exam: 0A.

-1A Exam Level: R O*

Initial Item Description a

b" ct

1.

Questions and'answers technically accurate and applicable to facility

2.

a. NRC K/As referenced for all questions

b. Facility learning objectives referenced as available

3.

RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate

(

(

per Section D.2.d of ES-401

4.

Question selection and duplication from the last two NRC licensing exams r4 '(

appears consistent with a systematic sampling process

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 the audit exam was completed before the license exam was started; or the examinations were developed independently; or n

(

the licensee certifies that there is no duplication; or other (explain)

6.

Bank use meets limits (no more than 75 Bank Modified New percent from the bank at least 10 percent new, and the rest modified); enter the actual question 3/,

Sq

-/2A distribution at right

7.

Between 50 and 60 percent of the questions on Memory C/A the exam (including 10 new questions) are written at the comprehension/analysis level; q*/-6 enter the actual question distribution at right 41 1

8.

References/handouts provided do not give away answers S

1 (4

9.

Question content conforms with specific K/A statements in the previously approved examination outline and is appropriate for the "1ier to which they are

{

('*

assigned; deviations are iustified

10.

Question psychometric quality and format meet ES, Appendix B, guidelines

11.

The exam contains 100, one-point, multiple choice items; the total is correct and Q,*

agrees with value on cover sheet Printed Name /

nature Date

a. Author

b. Facility Reviewer (2)

c. NRC Chief Examiner (#)

.(0?imr Lgisy7"

//lTw, K,*,0,-

"14*

d. NRC Regional Supervisor j-n-A0o,*

1 -4

• Z 214-

&2...,

Note:

The facility reviewers initials/signature are not applicable for NRC-developed examinations.

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

NUREG-1021, Revision 8, Supplement 1 42 of 46

ES-401 Written Examination Form ES-401-7 Quality Checklist Facility: (2,.

R-.. SI -t..Date of Exam: C)(

i

• . Exam Level:(*SRO I Initial Item Description a

b*

c'

1.

Questions and'answers technically accurate and applicable to facility

2.

a. NRC K/As referenced for all questions

b. Facility learning objectives referenced as available

(

3.

RO/SRO overlap is no more than 75 percent, and SRO questions are appropriate per Section D.2.d of ES-401

4.

Question selection and duplication from the last two NRC licensing exams appears consistent with a systematic sampling process

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

_ the audit exam was completed before the license exam was started; or

.L 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 Bank Modified New percent from the bank at least 10 percent new, (j4 and the rest modified); enter the actual question 5 L

\\

distribution at right

7.

Between 50 and 60 percent of the questions on Memory C/A the exam (including 10 new questions) are 9.iO written at the comprehension/analysis level; L53 8

enter the actual question distribution at right I

8.

References/handouts provided do not give away answers

9.

Question content conforms with specific K/A statements in the previously approved examination outline and is appropriate for the Tier to which they are

" 6 assigned; deviations are justified

10.

Question psychometric quality and format meet ES, Appendix B, guidelines

(

11.

The exam contains 100, one-point, multiple choice items; the total is correct and O*

agrees with value on cover sheet Printed Name/ Si Date

a. Author i

b. Facility Reviewer (*)

c. NRC Chief Examiner (#)

54W Wý H.,

T

d. NRC Regional Supervisor A-ncok QM

-L 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.

NUREG-1021, Revision 8, Supplement 1 42 of 46 If FL

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

Date of Examination:

Operating Test Number.

Initias

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).

b.

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

9_4

c.

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

K

d.

Overlap with the written examination and between operating test categories is within acceptable limits.

ý4.A

e.

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

2. WALK-THROUGH (CATEGORY A & B) 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 specific performance criteria that include:

- detailed expected actions with exact criteria and nomenclature

- system response and other examiner cues

- statements describing important observations to be made by the applicant

- criteria for successful completion of the task

- identification of critical steps and their associated performance standards

- restrictions on the sequence of steps, if applicable

b.

The prescripted questions in Category A are predominantly open reference and meet the criteria in Attachment I of ES-301.

c.

Repetition from operating tests used during the previous licensing examination is within acceptable limits (30% for the walk-through) and do not compromise test integrity.

d.

At least 20 percent of the JPMs on each test are new or significantly modified.

3. SIMULATOR (CATEGORY C) CRITERIA

a.

The associated simulator operating tests (scenario sets) have been reviewed in accordance with 2g4 Form ES-301-4 and a copy is attached.

,Printed Name,/ Signature Date

a. Author C IL.

b. Facility Reviewer(*)

c

/ '

,Q,

c. NRC Chief Examiner(#

C et

(

'#f8f3j

d. NRC Supervisor VTX' N t

(-"Ob NOTE:

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

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

-U o

,,W 23 of 26 NUREG-1021, Revision 8, Supplement 1

STATEMENT CONCERNING ADMIN (SEC. A) QUESTIONS The RO Admin Exam contains prescripted questions for sections three and four.

These questions are all closed reference, as approved on the original outline submitted.

ES-301 Simulator Scenario Quality Checklist Form ES-301-4 Facility: C&_LMBiA Date of Exam:IdI7/0.2-Scenario Numbers: i /

7J i Operating Test No.: I QUAUTATIVE ATTRIBUTES Initals a

b" c#

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.

2.

The scenarios consist mostly of related events.

3.

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 the expected operator actions (by shift position) the event termination point (if applicable)

M

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 seismic 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 OE4,,t 4 complete evaluation results commensurate with the scenario objectives.

7.

If time compression techniques are used, the scenario summary clearly so indicates. Operators have sufficient time to carry out expected activities without undue time constraints. Cues are given.

8.

The simulator modeling is not altered.

9.

The scenarios have been validated. Any open simulator performance deficiencies have been evaluated to ensure that functional fidelity is maintained while running the planned scenarios.

10.

Every operator will be evaluated using at least one new or significantly modified scenario. All other scenarios have been altered in accordance with Section D.4 of ES-301.

11.

All individual operator competencies can be evaluated, as verified using Form ES-301-6 (submit the form along with the simulator scenarios).

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).

13.

The level of difficulty is appropriate to support licensing decisions for each crposition.

TARGET QUANTITATIVE ATTRIBUTES (PER SCENARIO; SEE SECTION D.4.D)

Actual Attributes

1.

Total malfunctions (5-8)

_/7/________

2.

Malfunctions after EOP entry (1-2)

/.),/

).

3.

Abnormal events (2-4)

J (ai5'

4.

Major transients (1-2)

der,

5.

EOPs entered/requiring substantive actions (1-2) 411

6.

EOP contingencies requiring substantive actions (0-2)

L7.

Criti~cal tasks (2-3) 1 1

ka~j rwf* -ý co'. SCAA-^4

.r,

0 LC 0114

.i-t

'(-.~o NUREG-1021, Revision 8, Supplement 1 24 of 26

.4 I

?,C-Ž SfaWjp$

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

COL4'UM 6 (A

Date of Exam:'.

,10 Scenario Numbers: ti l rating Test No..

QUALITATIVE ATTRIBUTES Initials a

b*

c#

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.

2.

The scenarios consist mostly of related events.

3.

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 Al 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 seismic 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.70

7.

If time compression techniques are used, the scenario summary dearly so indicates. Operators 4

have sufficient time to carry out expected activities without undue time constraints. Cues are-9 yiven.

8.

The sim ulator m odeling is not altered.

been

9.

The scenarios have been validated. Any open simulator performance deficiencies have evaluated to ensure that functional fidelity is maintained while running the planned sceais

10.

Every operator will be evaluated using at least one new or significantly modified scenario. ANl other scenarios have been altered in accordance with Section DA4 of ES-301.

11.

Ali individual operator competencies can be evaluated, as verified using Form ES-301-6 (submit A9 the form along with the simulator scenarios).

4V4 A

12.

Each applicant will be significantly involved in the minimum number of Ininsients and events 4j r, i IA specified on Form ES-301-5 (submit the form with the simulator scenarios).

13.

The level of diffi*cu*t isaMpriate to support licensinjgdecisions for each crewo n

0 14 TARGET QUANTITATIVE ATTRIBUTES (PER SCENARIO; SEE SECTION D.n.D)

Actual Attributes

1.

Total malfunctions (5-8) 7_

/

/_____

2.

Malfunctions after SOP entry (1-2) 1.31_______

3.

Abnormal events (2-4)

/

/

_____/_

4.

Major transients (1-2) 14

5.

EOPs entered/requiring substantive actions (1-2) 2 4

/

-44

6.

EOP contingencies requiring substantive actions (0-2)

7.

Critical tasks (2-3)

NUREG-1021, Revision 8, Supplement 1 24 of 26 I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evolution lFlnirum Scenario Number I ype I ype Num er 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

Normal 0

As RO Instrument /

2 Component Major SRO-I S

Reactivity 0

Normal 1

As SRO Instrument!

2 Component Major Reactivity 0

Normal 1

SRO-U Instrument 2

s,4 soe q

Major 1

I a V

Instructions:

Author:

NRC Review/

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the aplicant'- prppetence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement 1 I

I f

I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evolution Minimum Scenario Number I ype I ype Number 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

Normal 0

As RO Instrument,/

2 Component

/

Major 1

SRO-l Reactivity 0

Normal 1

As SRO Instrument!

2 Component Major 1__

Reactivity 0

Normal 1

z

\\/

4 SRO-U Instrument 2

Component 1_____\\_____\\_

Major t

1_

ns:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the alplicantpompetence count toward the minimum requirement.

Author:

NRC Reviewer 25 of 26 NUREG-1021, Revision 8, Supplement 1 Instructio I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Insrue t3 Instructio Applicant Ev..lution Minirmum Scenario Number I ype I ype Number 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

Normal 0

As RO Instrument,/

2 Component

/

Major 1___

SRO-l Reactivity 0

Normal 1

As SRO Instrument /

2 Component Major 1

Reactivity 0

Normal 1

V 1

V SRO-U Instrument /

_2 Component A

I" A

Major 1

8 1 a ns:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant',sprcppetence count toward the minimum requirement.

Author:

NRC Reviewer:,._

1-i" 25 of 26 NUREG-1021, Revision 8, Supplement 1 I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev.olution Minimum Scenario Number lype I ype Number 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

Normal 0

As RO Instrument /

2 Component

___/

Major 1

SRO-I Reactivity 0

N Normal 1

L4 As SRO Instrument 2

Component Major 1

\\

Reactivity 0

Normal 1

SRO-U Instrument /

2 Component Major 1

j

Instructions:

Author:

NRC Reviewer (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the ap icants,,

etence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement 1 TcAA-4 0

• I I

I r:

I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evolution ni umer Scenario Number I ype I ype

`4umoe 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

1 Normal 0

-44 As RO Instrument /

2 Component Major SRO-I 14

" SR_-l Reactivity 0

Normal 1(

As SRO Instrument /

2 A

/

Component Major 1I_

Reactivity 0

Normal 1

SRO-U Instrument /

2 Component Major 1

Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the ap icant's petence count toward the minimum requirement.

Author:

NRC Reviewe.r A-25 of 26 NUREG-1021, Revision 8, Supplement 1 I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the a icant's 7s, etence count toward the minimum requirement.

Author:

NRC Reviewe.ýc'l 25 of 26 NUREG-1021, Revision 8, Supplement 1 I "

W",

ý ý *3

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev...olution nirScenario Number lype Iype Number 1

2 3

4 Reactivity 1

Normal 1

RO Instrument /

4 Component Major 1

Reactivity 1

3 Normal 0

As RO Instrument!

2 Component Major 1"/

SRO-l Reactivity 0

Normal 1

L4 As SRO Instrument /

2 3, S, Component Major 1

S Reactivity 0

Normal 1

SRO-U Instrument 2

Component Major 1r I__

ns:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant,*m**petence count toward the minimum requirement.

Author:

NRC Reviewer:4 25 of 26 NUREG-1021, Revision 8, Supplement 1 Instructio I

zol m

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev..oution Minimum Scenario Number I ype I ype Number 1

2 3

4 Reactivity 1

Normal 1

0, RO Instrument /

4 Component Major 1

Reactivity 1

/

Normal 0

As RO Instrument!

2 Component A__,,__,_

Major 1

_\\

SRO-I Reactivity 0

Normal 1

(I/

As SRO Instrument!

2 ComponentAA I

Major 1

__/___

Reactivity 0

Normal 1

SRO-U Instrument/

2 Uomponent Major 1

Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the appl ant's c-etence count toward the minimum requirement.

Author:

NRC Reviewer:

L 25 of 26 NUREG-1021, Revision 8, Supplement 1 T

'Ilý

• 1 I

I

=

I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Instructio Author:

NRC Re%

Applicant EvlOution iniimUm Scenario Number IType T ype Number 1

2 3

4 Reactivity 1

Normal 1

RO 4astrument 4

Uomponent Major 1

Reactivity 1

Normal 0

t AsRO Irstrument/

2 2,1l t..317 ComponentA Major 1 i SRO-I

! I-o Reactivity 0

Normal 1

2 As SRO Irastrument!

2 Component Major 1

Reactivity 0

Normal 1

SRO-U Instrument /

2 Component Major 1

/

ns:

iew (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's*pYetence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement 1 I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev..lution Minimur Scenario Number I ype l ype Number 0

-DO-p 1

2 3

4 Reactivity 1

1 Normal 1

RO Instrument/

4 Z,.,7 Component

/

Major 1

Reactivity 1

Normal 0

As RO Irjstrument /2 Component ASRO Major 1 1 Reactivity 0

Normal 1

As SRO Instrument 2

Component 2

Major 1Ivio Reactivity 0

Normal 1

SRO-U Instrument /

2 Component Major 1

Instructions:

Author:

NRC Reviewe (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the appicnt's tence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement 1 I

I r:

I

FROM OPS TRAINING 509 377 8662 ES-301 Transient and Event Checklist Form ES-301 -5 OPERATING TEST NO.:

As RO SRO-0 As SRO Reactivity I

1 S -

p -

/

Normal 0

Istrument/

2

,,Component Major I

......, \\

0 Normal I

I*ument 2

/

omonent/

Major 1

Normal 1

SRO-U I trument/

2 Maompnernt Majo 1

I (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C*..a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to

.,aim';

opetence count toward the minimum requirement.

Instructions Author:

NRC Reviewe 25 of 26 NUREG-1021, Revision 8, Supplement I r.

I

. 9-03-2002 12:34PM P. I I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evplution Minimum Scenario Number I ype I ype Number 6p go 1

2 3

4 Reactivity 1

Normal 1

RO Instrument/

4 1

/

Component Major1 Reactivity 1

Normal 0

As RO Instrument 2

Component Major 1_/

SRO-I

/_

Reactivity 0

Normal 1

As SRO Instrument 2

Component Major 1

Reactivity 0

Normal 1

SRO-U InstrumentI 2

Component Major 1

J Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant' e ence count toward the minimum requirement.

Author:

NRC Reviewer:

25 of 26 NUREG-1021, Revision 8, Supplement 1 at, I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Evolution lnimum Scenario Number I ype I ype

`4u moner zpar Io3 Reactivty 1

Normal 1

V RO Instrument/

4 Component AA Major 1

Reactivity 1

/

Normal 0

As RO Instrument /

2 Component Major 1

SRO-l

/_

Reactivity 0

Normal 1

As SRO Instrument /2 Component Major 1

Reactivity 0

Normal 1

SRO-U Instrument/

2 Component Major 1

Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the appli nt's c e nce count toward the minimum requirement.

Author:

count t tme NRC Review* "*,

25 of 26 NUREG-1021, Revision 8, Supplement 1 J?6 *3 I

I I

FROM OPS TRAINING 509 377 8662 ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Normal 1

SRO-U Istrument./

2

( o m p o n e n t Wor 1

Instructions:

Author.

NRC Reviewer.

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or contin/ed abnormal conditions (refer to Section D.4.d) but must be significant per Section C2.a of Appendix D.

(3)

Whenever practical, both knstrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's competence count toward the minimum requirement SV

,)

I 25 of 26 NUREG-1 021, Revision 8, Supplement I I

• I 9-e3-2002 12:35PM P. 2 I

VO -Aq awý,.,AA-00

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev..lution rinirum Scenario Number Reactivity 1

Normal 1

4 V

RO Instrument/

4 Component A

4 Major 1

Reactivity 1

Normal 0

RInstrument /

2 Component Y

Major SRO-I Reactivity 0

Normal 1

As SRO Instrument/

2 Component Major 1

Reactivity 0

Normal 1

SRO-U Instrument/

2 Component Major 1

ns:

Mew (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's ey~ptence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement 1 Instructio Author:

NRC Rev I

I I

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev_91ution

_ni Scenario Number I ype I ype

`4u mluer 0

so' 1

2 3

4 Reactivity 1

Normal 1

RO Instrument/

4 Component Major 1

N Reactivity 1

Normal 0

I As RO Irsumn/2 ent

/2 Major 1

SRO-I

/_

Reactivity 0

Normal 1

As SRO Isrmn LcomponentI Major 1

Reactivity 0

Normal 1

SRO-U Instrument!

2 Component I

Maior L

I Instructions:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the app nat'semn tence count toward the minimum requirement.

Author:

NRC Review"-

25 of 26 NUREG-1021, Revision 8, Supplement 1

ýD.05-I I

I

FROM OPS TRAINING 509 377 8662 ES-301 Transient and Event Checklist Form ES-301 -5 OPERATING TEST NO.:

C6~e4 e 3 Apphcant EVplution I

un Scenario Number

-F r

Normal 1

\\

Ro tuen

' 4 v 5, As RO Iastrument /

2 Component A_?_40___

Major 1

SRO-I NoRONormal 1

As SO l,asgrImentI 2

Component

-Major 1

Normal 1

SRO-U Igstrument I 2

.poent Major 1

Instructions:

Author.

NRC Reviewei (1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included-only those that require verifiable actions that provide insight to lcancompetence count toward the minimum requirement.

25 of 26 NUREG-1021, Revision 8, Supplement I I

I I

I

• I I

-" 9-03-2002 12:36PM P. 3 r:

ES-301 Transient and Event Checklist Form ES-301-5 OPERATING TEST NO.:

Applicant Ev.01ution

%iJnimum Scenario Number l ype I ype rTme r eaF*

1 2

-S4 Reactivity 1

V,

/

I

\\

Normal 1

V" RO Instrument/

4

,7 S" Component A____A_

Major 1

Reactivity 1

Normal 0

As RO Instrument /

2 Component N_

Major 1

F__

SRO-l Reactivity 0

/

Normal 1

As SRO Instrument /

2 Component Major 1

VI Reactivity 0

Normal 1

SRO-U Instrument/

2 Component Major 1

1_

ns:

(1)

Enter the operating test number and Form ES-D-1 event numbers for each evolution type.

(2)

Reactivity manipulations may be conducted under normal or controlled abnormal conditions (refer to Section D.4.d) but must be significant per Section C.2.a of Appendix D.

(3)

Whenever practical, both instrument and component malfunctions should be included; only those that require verifiable actions that provide insight to the applicant's copetence count toward the minimum requirement.

7 74.x zN NRC Reviewe r*

V-*

25 of 26 NUREG-1021, Revision 8, Supplement 1 Instructio Author:

]ý(_

4824 I

I I

ES-301 Competencies Checklist Form ES-301-6 As 1 t #1 Apjint #2 Apliant #3 R2(

SRO-U ROR-SRO-U RO6RO-SRO-U Competencies SCENARIO SCENARIO SCENARIO 1_2 3_

11 2

3 1

2 3

Understand and Interpret

4. 7,2 4

A A 1,

- 4 Annunciators and Alarms 7 -,

Diagnose Events 3

1#,.,f7#+

1 V,(10 114 2,G z,$

and Conditions Understand Plant A

+. 4 and System Response 7

L,7 7

Comply With and At's 3,*.

1#4 A)

I, Use Procedures (1) 7 j6 Operate Control

-I Boards (2) 4 13, Communicate and 21'.,4 4

l' Interact With the Crew S0 317 Demonstrate Supervisory Ability (3)

Comply With and Z 1 4L, 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:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every applicabl o petency for every applicant.

Author:

NRC Revie NUREG-1021, Revision 8, Supplement 1 26 of 26 I

ES-301 Competencies Checklist Form ES-301-6 Ap lIpant #Yi4 Ap licnt #2"5" Appfij*pt #2((*

RO104-R-0ý-SRO-U ROZOIMISRO-U RO2SO-JSRO-U Competencies SCENARIO SCENARIO SCENARIO 1

2 3

1 2

3 1

2 3

4 1A

'4 ja 154f 13,4 r 1#

Understand and Interpret Annunciators and Alarms Diagnose Events 4P and Conditions 7_

Understand Plant 5,

14."

and System Response Comply With and 4% 3ý

&J.-

114 Ag.

t,-,

Use Procedures (1)

Operate Control 23 Boards (2) 3 Communicate and

-3 Interact With the Crew If t

3 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:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every applicable competency for every applicant Author:.>

NRC Reviewer:

NUREG-1021, Revision 8, Supplement 1 26 of 26 I

ES-301 Competencies Checklist Form ES-301-6 Applicant #1 Applicant #2 Applicant #3 R

RO-l/SR 0- RO-I/SRO-U (RORO-I/SRO-U Competencies SCENARIO SCENARIO SCENARIO 1

2 3

4 1

2 3

4 Understand and Interpret Annunciators and Alarms Diagnose Events 1

and Conditions Understand Plant 444 3,

1,4 4, V and System Response Comply With and 14, I,-

Ali 4,4 4#:r Use Procedures (1) 4 1

0 Operate Control 11 q 1

11 3 11 4

Boards (2)

If 1 (eI Communicate and 144 t4

-'+"

Interact With the Crew Demonstrate Supervisory Ability (3)

Comply With and Use Tech. Specs. (3)

I I

I Notes:

(1) Includes Technical Specification compliance for an RO.

(2) Optional for an SRO-U.

(3) Only applicable to SROs.

Instructions:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every applicable e ncy for every applicant.

Author:

NRC Revie4 NUREG-1021, Revision 8, Supplement 1 26 of 26 I

l,

9-04-2002 1:01PM FROM OPS TRAINING 509 377 8662 P. 1 c~wtCA (eo ES-,301 Com" etencies.Checkl'st orm ES301 Applicant #*"t Apcant #2'%

Applicant #$ (

RO(RO O-U 'RSRO-ISRO-U (*SRO-I/SRO4J Competencies SCENARIO

__SCENARIO SCENARIO 13

..j X

3 3 4

Understand and Interpret ZJ.413 7,

(0 21,V Annunciators and Alarms Diagnose Events

-,,5 and Conditions Understand Plant and System Response...

1,7'$

Comply With and 2

It

-1 2-t,.

Use Procedures (1) 3 Operate Control 2*3...

.I"ll-4

• -i,

I Boards (2)

.'7!

Communicate and a.-

/"

• ,P i,

1?.iZ Interact With the Crew Demonstrate Supervisory Abiliy (3)....

Comply With and Use Tech. Sp-c. l(3)

Notes:

(1) Includes Technical Specifcation compliance for an RO.

(2) Optional for an SRO-U.

(3) Only gpicate to

-ROs.

Instructions:

Curcls the applicant's license Wye and enter one or more ewent numbers that Will allow the S..-.-.-.-...-.-....-.

Complyer Wth ealutnd vryapiat Auseteho.

S es.

(3 NRC Revaie c..e t

Instmfion/

NUREG-1 021, Revision 8, Supplement 1 26 of 26 I

ES-301 Competencies Checklist Form ES-301-6 Applicant #1"t Applicant #/%

Applicant #$ (p (RQ)RO-I/SRO-U,FO*iZRO-I/SRO-U SRO-I/SR Competencies SCENARIO SCENARIO SCEN 1O 1

X

,3 33 Understand and Interpret 2.1¶ 7

Annunciators and Alarms Diagnose Events and Conditions

/

Understand Plant 21~3 I9.S 1,2..

and System Response 3

Comply With and 1 %2.

Use Procedures (1)

Operate Control 2,3 11510 Boards (2)

Communicate and 14 Interact With the Crew 41 Demonstrate Supervisory Ability (3)

Comply With and Use Tech. Specs. (3)

Notes:

(1) Includes Technical S cification compliance for an RO.

(2) Optional for an SRV 6s.

(3) Only applicable to/ROs.

Instructions:

Circle the applicants license type and enter one or more event numbers that will allow the examiners to evaluate every apprcablep0yetency for every applicant.

Author:

NRC Reviewer7 NUREG-1021, Revision 8, Supplement 1 26 of 26 I

ES-301 Competencies Checklist Form ES-301-6 Applicant Applicant #.

Applicant #3 RO/SRROO-.j RO/SRO-l RO-RO/SRO-IlRO-U Competencies SCENARIO SCENARIO SCENARIO IX 3

2 3

Understand and Interpret 1 to, V, Annunciators and Alarms Diagnose Events

,14 and Conditions Understand Plant A4,.

and System Response Comply With and Use Procedures (1)

Operate Control Boards (2)

Communicate and Interact With the Crew Demonstrate Supervisory AL,&

A 1

• v*

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:

Circle the applicant's license type and enter one or more event numbers that will allow the examiners to evaluate every appiable c tency for every applicant.

Author:

A NRC Reviewer:.-

NUREG-1021, Revision 8, Supplement 1 26 of 26 I

I m

ES-403 Written Examination Grading Form ES-403-1 Quality Checklist Facility:

Date of Exam:

Nokto, Exam Level: RO/SRO Initials Item Description a

b c

1.

Clean answer sheets copied before grading 9t4 VO

2.

Answer key changes and question deletions justified and documented

3.

Applicants' scores checked for addition errors (reviewers spot check > 25% of examinations)

'?"

4.

Grading for all borderline cases (80% +/- 2%) reviewed in 1J...

4 detail

5.

All other failing examinations checked to ensure that grades f

-J are justified

ý- -

tr

6.

Performance on missed questions checked for training deficiencies and wording problems; evaluate validity of 4

questions missed by half or more of the applicants Printed Name / Signature Date

a. Grader

/v tvt,"

k

!ýVA

b. Facility Reviewer(*)

COUtfA-Zc&

c. NRC Chief Examiner (*) -F".,w F.

1. -,t* t*

/i

/oz

d. NRC Supervisor (*)WVW

-F z 007>XS

(*)

The facility reviewer's signature is not applicable for examinations graded by the NRC; two independent NRC reviews are required.

5 of 5 NUREG-1021, Revision 8, Supplement I I

Operator Licensing Exam Schedule From 10/01/2002 To 10/31/2002 Page 1 of 4 01/31/2003 Report 21 Region: 4 Exam Week Site/Docket No/Insp Rpt #

10/07/2002 Columbia Generating Station / 05000397 / 2002301 RO -6 TAC #: X02226 SROU - 3 Candidates T

e Exam Author Chief Examiner SROI - 6 Admin STETKA, THOMAS F.

II Examiners Assigned BUNDY, HOWARD F.

LANTZ, RYAN E.

MCKERNON, THOMAS 0.

STETKA, THOMAS F.

Sites: WNP Orgs: 4620 Exam Author: ALL Phase Code: 6 Operational 16:04:04

[.I h

==I o

Operator Licensing Exam Schedule From 10/01/2002 To 10/31/2002 Page 2 6f 4 01/31/2003 IKeport 21 Region: 4 Summary By Date 10/2002 WNP - Columbia Generating Station RO - 6 SROI - 6 SROU - 3 LSRO - 0 Total for Columbia Generating Station: 15 Sites: WNP Orgs: 4620 Exam Author: ALL Phase Code: 5 Operational 16:04:04

Operator Licensing Exam Schedule From 10/01/2002 To 10/31/2002 Page 3 6f 4 0113112003 Report 21 Region: 4 summary By Site I

WNP - Columbia Generating Station RO-6 SROI - 6 SROU - 3 LSRO - 0 Total for Columbia Generating Station: 15 Sites: WNP Orgs: 4620 Exam Author: ALL Phase Code: 5 Operational 16:04:04

Operator Licensing Exam Schedule From 10101/2002 To 10/31/2002 Page 4 6f 4 01131/2003 Report 21 Region: 4 Summag By Region SROI - 6 SROU - 3 LSRO - 0 Total for Region 4:15 Sites: WNP Orgs: 4620 Exam Author: ALL Phase Code: 6 Operational 16:04:04 Region 4 RO -6

ES-201 Examination Security Agreement Form ES-201 -3

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 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 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.lRCYfithe..rq*, 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 _.

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 NOTES:

NUREG-1021, Revision 8, Supplement 1 24 of 24 H-

ES-201 Examination Security Agreement Form ES-201 -3

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of 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 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 lRC.,Jrthe.,-ocre. 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 conceming the NRC licensing examinations administered during the week(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 applicants who were administered these licensing examinations, except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1)

DATE SIGNATURE (2) DATENOTE

2.

-2&

g.

7.

9..

9.0..

11.12

13.

14.

15.

NOTES:

NUREG-1021, Revision 8, Supplement 1 24 of 24

ES-201 Examination Security Agreement Form ES-201 -3 I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of as of the date of my signature. I agree that I wil not krowingly divulge any information about these examinations to any persons who have not been 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 KIRC.Airte.nwo, 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-Examina an To the best of my knowledge, I tid not divulge to any unauthorized persons any information concerning the NRC ricensing examinations administered during the week(s) of _

4 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 specificlly noted below and authorized by the NRC.

PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1)

DATE SIGNI R.IE (2) DATENOTE 4,

9.

t0.,

12.

13.

S~15.

NOTES, NNUREG-1021, Revision 8, Supplement 1 24 of 24 I.

ES-201 Examination Security Agreement Form ES-201 -3

1.

Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) 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 been 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 KIR.,irtheT.-cre, 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

. 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 / RESPONSIBILITY SIGNA URE (1)

DATE SIGN RE (2)DATENOTE 2.-2

7. C* L

10.

0 1 1.. mI.V A L O 7 _

-7 " )_

H /

12. V'.'AAM T

P 0

14.

NOTES:

NUREG-1021, Revision 8, Supplement 1 24 of 24 F-