[Form ES-201-1](#BM_1_) Examination Preparation Checklist

[Form ES-201-2](#BM_2_) Examination Outline Quality Checklist

[Form ES-201-3](#BM_3_) Examination Security Agreement

[Form ES-201-4](#BM_4_) List of Applicants

[Form ES-301-1](#BM_5_) Administrative Topics Outline

[Form ES-301-2](#BM_6_) Control Room/In-Plant systems Outline

[Form ES-301-3](#BM_7_) Operating Test Quality Checklist

[Form ES-301-4](#BM_8_) Simulator Scenario Quality Checklist

[Form ES-301-5](#BM_9_) Transient and Event Checklist

[Form ES-301-6](#BM_10_) Competencies Checklist

[Form ES-303-1](#BM_11_) Individual Examination Report

[Form ES-303-2](#BM_12_) Operating Test Comments

[Form ES-303-3](#BM_13_) RO Competency Grading Worksheet for the
Simulator Operating Test

[Form ES-303-4](#BM_14_) SRO Competency Grading Worksheet for the
Simulator Operating Test

[Form ES-401-1](#BM_15_) BWR Examination Outline

[Form ES-401-2](#BM_16_) PWR Examination Outline

[Form ES-401-3](#BM_17_) Generic Knowledge and Abilities Outline (Tier
3)

[Form ES-401-4](#BM_18_) Record of Rejected K/As

[Form ES-401-5](#BM_19_) Sample Written Examination Question Worksheet

[Form ES-401-6](#BM_20_) Written Examination Quality Checklist

[Form ES-401-7](#BM_21_) Site-Specific RO Written Examination Cover
Sheet

[Form ES-401-8](#BM_22_) Site-Specific SRO Written Examination Cover
Sheet

[Form ES-401-9](#BM_23_) Written Examination Review Worksheet

[Form ES-403-1](#BM_24_) Written Examination Grading Quality Checklist

[Form ES-501-1](#BM_25_) Post-Examination Check Sheet

[Form ES-501-2](#BM_26_) Power Plant Examination Results Summary

[Form ES-601-1](#BM_27_) Examination Security Agreement

[Form ES-601-2](#BM_28_) Evaluation Checklist for Facility Reference
Material

[Form ES-601-3](#BM_29_) Power Plant Requalification Results Summary
Sheet

[Form ES-601-4](#BM_30_) Power Plant Requalification Results
Continuation Sheet

[Form ES-601-5](#BM_31_) Individual Requalification Examination Report

[Form ES-602-1](#BM_32_) NRC Checklist for Open-Reference Test Items

[Form ES-602-2](#BM_33_) Written Requalification Examination Cover Sheet

[Form ES-603-1](#BM_34_) JPM Summary Matrix

[Form ES-604-1](#BM_35_) Simulator Scenario Review Checklist

[Form ES-604-2](#BM_36_) Simulator Crew Evaluation Form

[Form ES-701-1](#BM_37_) LSRO BWR Written Examination Outline

[Form ES-701-2](#BM_38_) LSRO PWR Written Examination Outline

[Form ES-701-3](#BM_39_) LSRO Generic Knowledge and Abilities Outline

[Form ES-701-4](#BM_40_) LSRO Operating Test Outline

[Form ES-701-5](#BM_41_) LSRO Examination Outline Quality Checklist

[Form ES-701-6](#BM_42_) LSRO Written Examination Quality Checklist

[Form ES-701-7](#BM_43_) LSRO Operating Test Quality Checklist

[Form ES-701-8](#BM_44_) LSRO Written Examination Cover Sheet

[Form ES-702-1](#BM_45_) Individual LSRO Requalification Examination
Report

[Form ES-702-2](#BM_46_) Power Plant LSRO Requalification Results
Summary

[Form ES-702-3](#BM_47_) LSRO Written Requalification Examination Cover
Sheet

[Form ES-C-1](#BM_48_) Appendix C - Job Performance Measure Worksheet

[Form ES-C-2](#BM_49_) Appendix C -- Job Performance Measure Quality
Checklist

[Form ES-D-1](#BM_50_) Appendix D -- Scenario Outline

[Form ES-D-2](#BM_51_) Appendix D -- Required Operator Actions

[sr1020r9-sup1-final-forms-ms.doc](../sr1020r9-sup1-final-forms-ms.doc)

[]{#BM_1_ .anchor}**ES-201 Examination Preparation Checklist [Form
ES-201-1](../sr1020r9-sup1-final-forms-ms.doc#ES-201-1)**

+--------+--------------------------------------------------+----------+
| Fac    |                                                  |          |
| ility: |                                                  |          |
| Date   |                                                  |          |
| of     |                                                  |          |
| Examin |                                                  |          |
| ation: |                                                  |          |
| \_     |                                                  |          |
| \_\_\_ |                                                  |          |
| \_\_\_ |                                                  |          |
| \_\_\_ |                                                  |          |
|        |                                                  |          |
| Dev    |                                                  |          |
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| tten - |                                                  |          |
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| ![]    |                                                  |          |
| (media |                                                  |          |
| /image |                                                  |          |
| 1.wmf) |                                                  |          |
| {width |                                                  |          |
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| h      |                                                  |          |
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| 12in"} |                                                  |          |
| NRC    |                                                  |          |
| ![]    |                                                  |          |
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| //     |                                                  |          |
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| 1.wmf) |                                                  |          |
| {width |                                                  |          |
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| h      |                                                  |          |
| eight= |                                                  |          |
| "0.165 |                                                  |          |
| 277777 |                                                  |          |
| 777777 |                                                  |          |
| 77in"} |                                                  |          |
| NRC    |                                                  |          |
| ![]    |                                                  |          |
| (media |                                                  |          |
| /image |                                                  |          |
| 1.wmf) |                                                  |          |
| {width |                                                  |          |
| ="0.16 |                                                  |          |
| 527777 |                                                  |          |
| 777777 |                                                  |          |
| 777in" |                                                  |          |
| h      |                                                  |          |
| eight= |                                                  |          |
| "0.165 |                                                  |          |
| 277777 |                                                  |          |
| 777777 |                                                  |          |
| 77in"} |                                                  |          |
+--------+--------------------------------------------------+----------+
| Target | Task Description (Reference)                     | Chief    |
| Date\* |                                                  | Ex       |
|        |                                                  | aminer's |
|        |                                                  |          |
|        |                                                  | Initials |
+--------+--------------------------------------------------+----------+
| -180   | 1\. Examination administration date confirmed    |          |
|        | (C.1.a; C.2.a and b)                             |          |
+--------+--------------------------------------------------+----------+
| -120   | 2\. NRC examiners and facility contact assigned  |          |
|        | (C.1.d; C.2.e)                                   |          |
+--------+--------------------------------------------------+----------+
| -120   | 3\. Facility contact briefed on security and     |          |
|        | other requirements (C.2.c)                       |          |
+--------+--------------------------------------------------+----------+
| -120   | 4\. Corporate notification letter sent (C.2.d)   |          |
+--------+--------------------------------------------------+----------+
| \      | \[5. Reference material due (C.1.e; C.3.c;       |          |
| [-90\] | Attachment 3)\]                                  |          |
+--------+--------------------------------------------------+----------+
| {-75}  | 6\. Integrated examination outline(s) due,       |          |
|        | including Forms ES-201-2, ES-201-3, ES-301-1,    |          |
|        | ES-301-2, ES-301-5, ES-D-1\'s, ES-401-1/2,       |          |
|        | ES-401-3, and ES-401-4, as applicable (C.1.e and |          |
|        | f; C.3.d)                                        |          |
+--------+--------------------------------------------------+----------+
| {-70}  | {7. Examination outline(s) reviewed by NRC and   |          |
|        | feedback provided to facility licensee (C.2.h;   |          |
|        | C.3.e)}                                          |          |
+--------+--------------------------------------------------+----------+
| {-45}  | 8\. Proposed examinations (including written,    |          |
|        | walk-through JPMs, and scenarios, as             |          |
|        | applicable), supporting documentation (including |          |
|        | Forms ES-301-3, ES-301-4, ES-301-5, ES-301-6,    |          |
|        | and ES-401-6, and any Form ES-201-3 updates),    |          |
|        | and reference materials due (C.1.e, f, g and h;  |          |
|        | C.3.d)                                           |          |
+--------+--------------------------------------------------+----------+
| -30    | 9\. Preliminary license applications (NRC Form   |          |
|        | 398\'s) due (C.1.l; C.2.g; ES-202)               |          |
+--------+--------------------------------------------------+----------+
| -14    | 10\. Final license applications due and Form     |          |
|        | ES-201-4 prepared (C.1.l; C.2.i; ES-202)         |          |
+--------+--------------------------------------------------+----------+
| -14    | 11\. Examination approved by NRC supervisor for  |          |
|        | facility licensee review (C.2.h; C.3.f)          |          |
+--------+--------------------------------------------------+----------+
| -14    | 12\. Examinations reviewed with facility         |          |
|        | licensee (C.1.j; C.2.f and h; C.3.g)             |          |
+--------+--------------------------------------------------+----------+
| -7     | 13\. Written examinations and operating tests    |          |
|        | approved by NRC supervisor (C.2.i; C.3.h)        |          |
+--------+--------------------------------------------------+----------+
| -7     | 14\. Final applications reviewed; 1 or 2 (if     |          |
|        | \>10) applications audited to confirm            |          |
|        | qualifications / eligibility; and examination    |          |
|        | approval and waiver letters sent (C.2.i;         |          |
|        | Attachment 5; ES-202, C.2.e; ES-204)             |          |
+--------+--------------------------------------------------+----------+
| -7     | 15\. Proctoring/written exam administration      |          |
|        | guidelines reviewed with facility licensee       |          |
|        | (C.3.k)                                          |          |
+--------+--------------------------------------------------+----------+
| -7     | 16\. Approved scenarios, job performance         |          |
|        | measures, and questions distributed to NRC       |          |
|        | examiners (C.3.i)                                |          |
+--------+--------------------------------------------------+----------+
| \*     |                                                  |          |
| Target |                                                  |          |
| dates  |                                                  |          |
| are    |                                                  |          |
| gen    |                                                  |          |
| erally |                                                  |          |
| based  |                                                  |          |
| on     |                                                  |          |
| facil  |                                                  |          |
| ity-pr |                                                  |          |
| epared |                                                  |          |
| examin |                                                  |          |
| ations |                                                  |          |
| and    |                                                  |          |
| are    |                                                  |          |
| keyed  |                                                  |          |
| to the |                                                  |          |
| exami  |                                                  |          |
| nation |                                                  |          |
| date   |                                                  |          |
| iden   |                                                  |          |
| tified |                                                  |          |
| in the |                                                  |          |
| cor    |                                                  |          |
| porate |                                                  |          |
| notifi |                                                  |          |
| cation |                                                  |          |
| l      |                                                  |          |
| etter. |                                                  |          |
| The    |                                                  |          |
| y are  |                                                  |          |
| for pl |                                                  |          |
| anning |                                                  |          |
| pu     |                                                  |          |
| rposes |                                                  |          |
| and    |                                                  |          |
| may be |                                                  |          |
| ad     |                                                  |          |
| justed |                                                  |          |
| on a   |                                                  |          |
| case-b |                                                  |          |
| y-case |                                                  |          |
| basis  |                                                  |          |
| in     |                                                  |          |
| coordi |                                                  |          |
| nation |                                                  |          |
| with   |                                                  |          |
| the fa |                                                  |          |
| cility |                                                  |          |
| lic    |                                                  |          |
| ensee. |                                                  |          |
|        |                                                  |          |
| \[A    |                                                  |          |
| pplies |                                                  |          |
| only\] |                                                  |          |
| {Does  |                                                  |          |
| not    |                                                  |          |
| apply} |                                                  |          |
| to     |                                                  |          |
| examin |                                                  |          |
| ations |                                                  |          |
| pr     |                                                  |          |
| epared |                                                  |          |
| by the |                                                  |          |
| NRC.   |                                                  |          |
+--------+--------------------------------------------------+----------+

[]{#BM_2_ .anchor}**ES-201 Examination Outline Quality Checklist [Form
ES-201-2](../sr1020r9-sup1-final-forms-ms.doc#ES-201-2)**

+----+------------------------------------------------------+---+---+---+
| F  |                                                      |   |   |   |
| ac |                                                      |   |   |   |
| il |                                                      |   |   |   |
| it |                                                      |   |   |   |
| y: |                                                      |   |   |   |
| Da |                                                      |   |   |   |
| te |                                                      |   |   |   |
| of |                                                      |   |   |   |
| Ex |                                                      |   |   |   |
| am |                                                      |   |   |   |
| in |                                                      |   |   |   |
| at |                                                      |   |   |   |
| io |                                                      |   |   |   |
| n: |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
| It | Task Description                                     | I |   |   |
| em |                                                      | n |   |   |
|    |                                                      | i |   |   |
|    |                                                      | t |   |   |
|    |                                                      | i |   |   |
|    |                                                      | a |   |   |
|    |                                                      | l |   |   |
|    |                                                      | s |   |   |
+----+------------------------------------------------------+---+---+---+
|    |                                                      | a | b | c |
|    |                                                      |   | \ | # |
|    |                                                      |   | * |   |
+----+------------------------------------------------------+---+---+---+
| 1  | a\. Verify that the outline(s) fit(s) the            |   |   |   |
| \. | appropriate model, in accordance with ES-401.        |   |   |   |
|    |                                                      |   |   |   |
| W  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| I  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| N  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Assess whether the outline was systematically    |   |   |   |
|    | and randomly prepared in accordance with Section D.1 |   |   |   |
|    | of ES-401 and whether all K/A categories are         |   |   |   |
|    | appropriately sampled.                               |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Assess whether the outline over-emphasizes any   |   |   |   |
|    | systems, evolutions, or generic topics.              |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | d\. Assess whether the justifications for deselected |   |   |   |
|    | or rejected K/A statements are appropriate.          |   |   |   |
+----+------------------------------------------------------+---+---+---+
| 2  | a\. Using Form ES-301-5, verify that the proposed    |   |   |   |
| \. | scenario sets cover the required number of normal    |   |   |   |
|    | evolutions, instrument and component failures,       |   |   |   |
| S  | technical specifications, and major transients.      |   |   |   |
|    |                                                      |   |   |   |
| I  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| M  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| U  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| L  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| A  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| O  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Assess whether there are enough scenario sets    |   |   |   |
|    | (and spares) to test the projected number and mix of |   |   |   |
|    | applicants in accordance with the expected crew      |   |   |   |
|    | composition and rotation schedule without            |   |   |   |
|    | compromising exam integrity, and ensure that each    |   |   |   |
|    | applicant can be tested using at least one new or    |   |   |   |
|    | significantly modified scenario, that no scenarios   |   |   |   |
|    | are duplicated from the applicants' audit test(s),   |   |   |   |
|    | and that scenarios will not be repeated on           |   |   |   |
|    | subsequent 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 the systems walk-through outline     |   |   |   |
| \. | meets the criteria specified on Form ES-301-2:       |   |   |   |
|    |                                                      |   |   |   |
| W  | > \(1\) the outline(s) contain(s) the required       |   |   |   |
|    | > number of control room and in-plant tasks          |   |   |   |
| /  | > distributed among the safety functions as          |   |   |   |
|    | > specified on the form                              |   |   |   |
| T  | >                                                    |   |   |   |
|    | > \(2\) task repetition from the last two NRC        |   |   |   |
|    | > examinations is within the limits specified on the |   |   |   |
|    | > form                                               |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(3\) no tasks are duplicated from the applicants' |   |   |   |
|    | > audit test(s)                                      |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(4\) the number of new or modified tasks meets or |   |   |   |
|    | > exceeds the minimums specified on the form         |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(5\) the number of alternate path, low-power,     |   |   |   |
|    | > emergency, and RCA tasks meet the criteria on the  |   |   |   |
|    | > form.                                              |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Verify that the administrative outline meets the |   |   |   |
|    | criteria specified on Form ES-301-1:                 |   |   |   |
|    |                                                      |   |   |   |
|    | > \(1\) the tasks are distributed among the topics   |   |   |   |
|    | > as specified on the form                           |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(2\) at least one task is new or significantly    |   |   |   |
|    | > modified                                           |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(3\) no more than one task is repeated from the   |   |   |   |
|    | > last two NRC licensing examinations                |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Determine if there are enough different outlines |   |   |   |
|    | to test the projected number and mix of applicants   |   |   |   |
|    | and ensure that no items are duplicated on           |   |   |   |
|    | subsequent days.                                     |   |   |   |
+----+------------------------------------------------------+---+---+---+
| 4  | a\. Assess whether plant-specific priorities         |   |   |   |
| \. | (including PRA and IPE insights) are covered         |   |   |   |
|    | in the appropriate exam sections.                    |   |   |   |
| G  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| N  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| A  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| L  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Assess whether the 10 CFR 55.41/43 and 55.45     |   |   |   |
|    | sampling is appropriate.                             |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Ensure that K/A importance ratings (except for   |   |   |   |
|    | plant-specific priorities) are at least 2.5.         |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | d\. Check for duplication and overlap among exam     |   |   |   |
|    | sections.                                            |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | e\. Check the entire exam for balance of coverage.   |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | f\. Assess whether the exam fits the appropriate job |   |   |   |
|    | level (RO or SRO).                                   |   |   |   |
+----+------------------------------------------------------+---+---+---+
| >  |                                                      |   |   |   |
|  P |                                                      |   |   |   |
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| na |                                                      |   |   |   |
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| \. |                                                      |   |   |   |
| Au |                                                      |   |   |   |
| th |                                                      |   |   |   |
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| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
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| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
|    |                                                      |   |   |   |
| b  |                                                      |   |   |   |
| \. |                                                      |   |   |   |
| Fa |                                                      |   |   |   |
| ci |                                                      |   |   |   |
| li |                                                      |   |   |   |
| ty |                                                      |   |   |   |
| Re |                                                      |   |   |   |
| vi |                                                      |   |   |   |
| ew |                                                      |   |   |   |
| er |                                                      |   |   |   |
| (\ |                                                      |   |   |   |
| *) |                                                      |   |   |   |
| [\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _] |                                                      |   |   |   |
| {. |                                                      |   |   |   |
| un |                                                      |   |   |   |
| de |                                                      |   |   |   |
| rl |                                                      |   |   |   |
| in |                                                      |   |   |   |
| e} |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
|    |                                                      |   |   |   |
| c  |                                                      |   |   |   |
| \. |                                                      |   |   |   |
| N  |                                                      |   |   |   |
| RC |                                                      |   |   |   |
| C  |                                                      |   |   |   |
| hi |                                                      |   |   |   |
| ef |                                                      |   |   |   |
| Ex |                                                      |   |   |   |
| am |                                                      |   |   |   |
| in |                                                      |   |   |   |
| er |                                                      |   |   |   |
| (  |                                                      |   |   |   |
| #) |                                                      |   |   |   |
| [\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _] |                                                      |   |   |   |
| {. |                                                      |   |   |   |
| un |                                                      |   |   |   |
| de |                                                      |   |   |   |
| rl |                                                      |   |   |   |
| in |                                                      |   |   |   |
| e} |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
|    |                                                      |   |   |   |
| d  |                                                      |   |   |   |
| \. |                                                      |   |   |   |
| N  |                                                      |   |   |   |
| RC |                                                      |   |   |   |
| Su |                                                      |   |   |   |
| pe |                                                      |   |   |   |
| rv |                                                      |   |   |   |
| is |                                                      |   |   |   |
| or |                                                      |   |   |   |
| [\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _\ |                                                      |   |   |   |
| _] |                                                      |   |   |   |
| {. |                                                      |   |   |   |
| un |                                                      |   |   |   |
| de |                                                      |   |   |   |
| rl |                                                      |   |   |   |
| in |                                                      |   |   |   |
| e} |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
| N  |                                                      |   |   |   |
| ot |                                                      |   |   |   |
| e: |                                                      |   |   |   |
| \# |                                                      |   |   |   |
| I  |                                                      |   |   |   |
| nd |                                                      |   |   |   |
| ep |                                                      |   |   |   |
| en |                                                      |   |   |   |
| de |                                                      |   |   |   |
| nt |                                                      |   |   |   |
| N  |                                                      |   |   |   |
| RC |                                                      |   |   |   |
| re |                                                      |   |   |   |
| vi |                                                      |   |   |   |
| ew |                                                      |   |   |   |
| er |                                                      |   |   |   |
| i  |                                                      |   |   |   |
| ni |                                                      |   |   |   |
| ti |                                                      |   |   |   |
| al |                                                      |   |   |   |
| i  |                                                      |   |   |   |
| te |                                                      |   |   |   |
| ms |                                                      |   |   |   |
| in |                                                      |   |   |   |
| Co |                                                      |   |   |   |
| lu |                                                      |   |   |   |
| mn |                                                      |   |   |   |
| "c |                                                      |   |   |   |
| "; |                                                      |   |   |   |
| c  |                                                      |   |   |   |
| hi |                                                      |   |   |   |
| ef |                                                      |   |   |   |
| ex |                                                      |   |   |   |
| am |                                                      |   |   |   |
| in |                                                      |   |   |   |
| er |                                                      |   |   |   |
| c  |                                                      |   |   |   |
| on |                                                      |   |   |   |
| cu |                                                      |   |   |   |
| rr |                                                      |   |   |   |
| en |                                                      |   |   |   |
| ce |                                                      |   |   |   |
| r  |                                                      |   |   |   |
| eq |                                                      |   |   |   |
| ui |                                                      |   |   |   |
| re |                                                      |   |   |   |
| d. |                                                      |   |   |   |
|    |                                                      |   |   |   |
| >  |                                                      |   |   |   |
| \* |                                                      |   |   |   |
| >  |                                                      |   |   |   |
|  N |                                                      |   |   |   |
| ot |                                                      |   |   |   |
| >  |                                                      |   |   |   |
| ap |                                                      |   |   |   |
| pl |                                                      |   |   |   |
| ic |                                                      |   |   |   |
| ab |                                                      |   |   |   |
| le |                                                      |   |   |   |
| >  |                                                      |   |   |   |
|  f |                                                      |   |   |   |
| or |                                                      |   |   |   |
| >  |                                                      |   |   |   |
| NR |                                                      |   |   |   |
| C- |                                                      |   |   |   |
| pr |                                                      |   |   |   |
| ep |                                                      |   |   |   |
| ar |                                                      |   |   |   |
| ed |                                                      |   |   |   |
| >  |                                                      |   |   |   |
|  e |                                                      |   |   |   |
| xa |                                                      |   |   |   |
| mi |                                                      |   |   |   |
| na |                                                      |   |   |   |
| ti |                                                      |   |   |   |
| on |                                                      |   |   |   |
| >  |                                                      |   |   |   |
| ou |                                                      |   |   |   |
| tl |                                                      |   |   |   |
| in |                                                      |   |   |   |
| es |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+

[]{#BM_3_ .anchor}**ES-201 Examination Security Agreement [Form
ES-201-3](../sr1020r9-sup1-final-forms-ms.doc#ES-201-3)**

**1. [Pre-Examination]{.underline}**

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 NRC (e.g., acting as a simulator booth
operator or communicator is acceptable if the individual does not select
the training content or provide direct or indirect feedback).
Furthermore, I am aware of the physical security measures and
requirements (as documented in the facility licensee's procedures) and
understand that violation of the conditions of this agreement may result
in cancellation of the examinations and/or an enforcement action against
me or the facility licensee. I will immediately report to facility
management or the NRC chief examiner any indications or suggestions that
examination security may have been compromised.

**2. [Post-Examination]{.underline}**

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 SIGNATURE (1) DATE SIGNATURE
> (2) DATE NOTE

1\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

2\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

3\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

4\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

5\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

6\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

7\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

8\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

9\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

10.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

11.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

12.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

13.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

14.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

15.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

NOTES:

[]{#BM_4_ .anchor}**ES-201 List of Applicants [Form
ES-201-4](../sr1020r9-sup1-final-forms-ms.doc#ES-201-4)**

*PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY*

+----------------------------+------+-------+---+----+----+----+----+
| Facility:                  | Wri  |       |   |    |    |    |    |
|                            | tten |       |   |    |    |    |    |
|                            | Exa  |       |   |    |    |    |    |
|                            | mina |       |   |    |    |    |    |
|                            | tion |       |   |    |    |    |    |
|                            | D    |       |   |    |    |    |    |
|                            | ate: |       |   |    |    |    |    |
|                            |      |       |   |    |    |    |    |
|                            | O    |       |   |    |    |    |    |
|                            | pera |       |   |    |    |    |    |
|                            | ting |       |   |    |    |    |    |
|                            | Test |       |   |    |    |    |    |
|                            | Da   |       |   |    |    |    |    |
|                            | tes: |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
| Applicant Name             | Do   | Exam  | W |    | O  |    |    |
|                            | cket | Level | r |    | pe |    |    |
|                            | No.  |       | i |    | ra |    |    |
|                            |      |       | t |    | ti |    |    |
|                            |      |       | t |    | ng |    |    |
|                            |      |       | e |    | Te |    |    |
|                            |      |       | n |    | st |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       | R | S  | Ad | Sy | Si |
|                            |      |       | O | RO | m. | s. | m. |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
|                            |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+
| Instructions: For each     |      |       |   |    |    |    |    |
| approved applicant, enter  |      |       |   |    |    |    |    |
| the exam level (RO, SRO-I, |      |       |   |    |    |    |    |
| or SRO-U) and an "X" or    |      |       |   |    |    |    |    |
| "W" to indicate whether    |      |       |   |    |    |    |    |
| each portion of the        |      |       |   |    |    |    |    |
| examination is to be       |      |       |   |    |    |    |    |
| administered or waived.    |      |       |   |    |    |    |    |
+----------------------------+------+-------+---+----+----+----+----+

*PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY*

[]{#BM_5_ .anchor}**ES-301 Administrative Topics Outline
[Form ES-301-1](../sr1020r9-sup1-final-forms-ms.doc#ES-301-1)**

+---------------------+--------+---------------------------------------+
| Facility:           |        |                                       |
| \_\_\               |        |                                       |
| _\_\_\_\_\_\_\_\_\_ |        |                                       |
| \_\_\_\_\_\_\_\_\_\ |        |                                       |
| _\_\_\_\_\_\_\_\_\_ |        |                                       |
| Date                |        |                                       |
| of Examination:     |        |                                       |
| \_\_\_\             |        |                                       |
| _\_\_\_\_\_\_\_\_\_ |        |                                       |
|                     |        |                                       |
| Examination Level:  |        |                                       |
| RO                  |        |                                       |
| ![](media/ima       |        |                                       |
| ge3.wmf){width="0.1 |        |                                       |
| 7777777777777778in" |        |                                       |
| height="0.17        |        |                                       |
| 777777777777778in"} |        |                                       |
| SRO                 |        |                                       |
| ![](media/ima       |        |                                       |
| ge3.wmf){width="0.1 |        |                                       |
| 7777777777777778in" |        |                                       |
| height="0.17        |        |                                       |
| 777777777777778in"} |        |                                       |
| Operating Test      |        |                                       |
| Number:             |        |                                       |
| \                   |        |                                       |
| _\_\_\_\_\_\_\_\_\_ |        |                                       |
+---------------------+--------+---------------------------------------+
| Administrative      | Type   | Describe activity to be performed     |
| Topic (see Note)    | Code\* |                                       |
+---------------------+--------+---------------------------------------+
| Conduct             |        |                                       |
| of Operations       |        |                                       |
+---------------------+--------+---------------------------------------+
| Conduct             |        |                                       |
| of Operations       |        |                                       |
+---------------------+--------+---------------------------------------+
| Equipment Control   |        |                                       |
+---------------------+--------+---------------------------------------+
| Radiation Control   |        |                                       |
+---------------------+--------+---------------------------------------+
| Emergency           |        |                                       |
| Procedures/Plan     |        |                                       |
+---------------------+--------+---------------------------------------+
| NOTE: All items (5  |        |                                       |
| total) are required |        |                                       |
| for SROs. RO        |        |                                       |
| applicants require  |        |                                       |
| only 4 items unless |        |                                       |
| they are retaking   |        |                                       |
| only                |        |                                       |
| the administrative  |        |                                       |
| topics, when all 5  |        |                                       |
| are required.       |        |                                       |
+---------------------+--------+---------------------------------------+
| \* Type Codes &     |        |                                       |
| Criteria: (C)ontrol |        |                                       |
| room, (S)imulator,  |        |                                       |
| or Class(R)oom      |        |                                       |
|                     |        |                                       |
| > (D)irect          |        |                                       |
| > from bank (≤ 3    |        |                                       |
| > for ROs; ≤ 4 for  |        |                                       |
| > SROs & RO         |        |                                       |
| > retakes)          |        |                                       |
| >                   |        |                                       |
| > (N)ew or          |        |                                       |
| > (M)odified        |        |                                       |
| > from bank (≥ 1)   |        |                                       |
| >                   |        |                                       |
| > (P)revious 2      |        |                                       |
| > exams (≤ 1;       |        |                                       |
| > randomly          |        |                                       |
| > selected)         |        |                                       |
+---------------------+--------+---------------------------------------+

[]{#BM_6_ .anchor}**ES-301 Control Room/In-Plant Systems Outline
[Form ES-301-2](../sr1020r9-sup1-final-forms-ms.doc#ES-301-2)**

+----------------------------------+------------+----------+-----------+
| Facility:                        |            |          |           |
| \_\_\_\_\_\_\_\_\_\_\_\_\_       |            |          |           |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |            |          |           |
| Date of Examination:             |            |          |           |
| \_\_\_\_\_\_\_\_\_\_\_\_\_       |            |          |           |
|                                  |            |          |           |
| Exam Level: RO                   |            |          |           |
| ![](media/image3.wm              |            |          |           |
| f){width="0.17777777777777778in" |            |          |           |
| height="0.17777777777777778in"}  |            |          |           |
| SRO-I                            |            |          |           |
| ![](media/image3.wm              |            |          |           |
| f){width="0.17777777777777778in" |            |          |           |
| height="0.17777777777777778in"}  |            |          |           |
| SRO-U                            |            |          |           |
| ![](media/image3.wm              |            |          |           |
| f){width="0.17777777777777778in" |            |          |           |
| height="0.17777777777777778in"}  |            |          |           |
| Operating Test No.:              |            |          |           |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_     |            |          |           |
+----------------------------------+------------+----------+-----------+
| Control Room Systems^@^ (8 for   |            |          |           |
| RO); (7 for SRO-I); (2 or 3 for  |            |          |           |
| SRO-U, including 1 ESF)          |            |          |           |
+----------------------------------+------------+----------+-----------+
| System / JPM Title               |            | Type     | Safety    |
|                                  |            | Code\*   |           |
|                                  |            |          | Function  |
+----------------------------------+------------+----------+-----------+
| a\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| b\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| c\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| d\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| e\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| f\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| g\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| h\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| In-Plant Systems^@^ (3 for RO);  |            |          |           |
| (3 for SRO-I); (3 or 2 for       |            |          |           |
| SRO-U)                           |            |          |           |
+----------------------------------+------------+----------+-----------+
| i\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| j\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| k\.                              |            |          |           |
+----------------------------------+------------+----------+-----------+
| @ All RO and SRO-I control room  |            |          |           |
| (and in-plant) systems must be   |            |          |           |
| different and serve different    |            |          |           |
| safety functions; all 5 SRO-U    |            |          |           |
| systems must serve different     |            |          |           |
| safety functions;                |            |          |           |
| in-plant systems and functions   |            |          |           |
| may overlap those tested         |            |          |           |
| in the control room.             |            |          |           |
+----------------------------------+------------+----------+-----------+
| \* Type Codes                    | > Cr       |          |           |
|                                  | iteria for |          |           |
|                                  | > RO /     |          |           |
|                                  | > SRO-I /  |          |           |
|                                  | > SRO-U    |          |           |
+----------------------------------+------------+----------+-----------+
| (A)lternate path                 | > 4-6 /    |          |           |
|                                  | > 4-6 /    |          |           |
| (C)ontrol room                   | > 2-3      |          |           |
|                                  | >          |          |           |
| (D)irect from bank               | > ≤ 9 / ≤  |          |           |
|                                  | > 8 / ≤ 4  |          |           |
| (E)mergency or abnormal in-plant | >          |          |           |
|                                  | > ≥ 1 / ≥  |          |           |
| (EN)gineered safety feature      | > 1 / ≥ 1  |          |           |
|                                  | >          |          |           |
| (L)ow-Power / Shutdown           | > \- / - / |          |           |
|                                  | > ≥1       |          |           |
| (N)ew or (M)odified from bank    | > (control |          |           |
| including 1(A)                   | > room     |          |           |
|                                  | > system)  |          |           |
| (P)revious 2 exams               | >          |          |           |
|                                  | > ≥ 1 / ≥  |          |           |
| (R)CA                            | > 1 / ≥ 1  |          |           |
|                                  | >          |          |           |
| (S)imulator                      | > ≥ 2 / ≥  |          |           |
|                                  | > 2 / ≥ 1  |          |           |
|                                  | >          |          |           |
|                                  | > ≤ 3 / ≤  |          |           |
|                                  | > 3 / ≤ 2  |          |           |
|                                  | >          |          |           |
|                                  |  (randomly |          |           |
|                                  | >          |          |           |
|                                  |  selected) |          |           |
|                                  | >          |          |           |
|                                  | > ≥ 1 / ≥  |          |           |
|                                  | > 1 / ≥ 1  |          |           |
+----------------------------------+------------+----------+-----------+

[]{#BM_7_ .anchor}**ES-301 Operating Test Quality Checklist
[Form ES-301-3](../sr1020r9-sup1-final-forms-ms.doc#ES-301-3)**

  ----------------------------------------------------------- ---------- ----- -----
  Facility: Date of Examination: Operating Test Number:                        

  **1. General Criteria**                                     Initials         

                                                              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.                                                                 

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

  d\. Overlap with the written examination and between                         
  different parts of the operating test is within acceptable                   
  limits.                                                                      

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

  **2. Walk-Through Criteria**                                \--        \--   \--
  ----------------------------------------------------------- ---------- ----- -----

+-----------------------------------------------------------+---+---+---+
| a\. Each JPM includes the following, as applicable:       |   |   |   |
|                                                           |   |   |   |
| -   initial conditions                                    |   |   |   |
|                                                           |   |   |   |
| -   initiating cues                                       |   |   |   |
|                                                           |   |   |   |
| -   references and tools, including associated procedures |   |   |   |
|                                                           |   |   |   |
| -   reasonable and validated time limits (average time    |   |   |   |
|     allowed for completion) and specific designation if   |   |   |   |
|     deemed to be time-critical by the facility licensee   |   |   |   |
|                                                           |   |   |   |
| -   operationally important specific performance          |   |   |   |
|     criteria that include:                                |   |   |   |
|                                                           |   |   |   |
| ```{=html}                                                |   |   |   |
| <!-- -->                                                  |   |   |   |
| ```                                                       |   |   |   |
| -   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\. Ensure that any changes from the previously approved  |   |   |   |
| systems and administrative walk-through outlines          |   |   |   |
| (Forms ES-301-1 and 2) have not caused the test to        |   |   |   |
| deviate from any of  the acceptance criteria (e.g., item  |   |   |   |
| distribution, bank use, repetition from the last 2 NRC    |   |   |   |
| examinations) specified on those forms and Form ES-201-2. |   |   |   |
+-----------------------------------------------------------+---+---+---+
| **3. Simulator Criteria**                                 | \ | \ | \ |
|                                                           | - | - | - |
|                                                           | - | - | - |
+-----------------------------------------------------------+---+---+---+
| The associated simulator operating tests (scenario sets)  |   |   |   |
| have been reviewed in accordance with Form ES-301-4       |   |   |   |
| and a copy is attached.                                   |   |   |   |
+-----------------------------------------------------------+---+---+---+
| Printed Name / Signature Date                             |   |   |   |
|                                                           |   |   |   |
| a\. Author                                                |   |   |   |
| [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\                      |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_ \_]{.underline} \_\_\_\_\_\_\_\_\_\_\_\_\_\_         |   |   |   |
|                                                           |   |   |   |
| b\. Facility Reviewer(\*)                                 |   |   |   |
| [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\                      |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_ \_]{.underline} \_\_\_\_\_\_\_\_\_\_\_\_\_\_         |   |   |   |
|                                                           |   |   |   |
| c\. NRC Chief Examiner (#)                                |   |   |   |
| [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\                      |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_ \_]{.underline} \_\_\_\_\_\_\_\_\_\_\_\_\_\_         |   |   |   |
|                                                           |   |   |   |
| d\. NRC Supervisor                                        |   |   |   |
| [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\                      |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_ \_]{.underline} \_\_\_\_\_\_\_\_\_\_\_\_\_\_         |   |   |   |
+-----------------------------------------------------------+---+---+---+
| NOTE: \* The facility signature is not applicable for     |   |   |   |
| NRC-developed tests.                                      |   |   |   |
|                                                           |   |   |   |
| \# Independent NRC reviewer initial items in Column "c";  |   |   |   |
| chief examiner concurrence required.                      |   |   |   |
+-----------------------------------------------------------+---+---+---+

[]{#BM_8_ .anchor}**ES-301 Simulator Scenario Quality Checklist
[Form ES-301-4](../sr1020r9-sup1-final-forms-ms.doc#ES-301-4)**

+---------------------------------------------+------------+---+---+---+
| Facilty: Date of Exam: Scenario Numbers: /  |            |   |   |   |
| / Operating Test No.:                       |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| **QUALITATIVE ATTRIBUTES**                  |            | I |   |   |
|                                             |            | n |   |   |
|                                             |            | i |   |   |
|                                             |            | t |   |   |
|                                             |            | i |   |   |
|                                             |            | a |   |   |
|                                             |            | l |   |   |
|                                             |            | s |   |   |
+---------------------------------------------+------------+---+---+---+
|                                             |            | 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)                             |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 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.               |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 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.      |            |   |   |   |
| Pursuant to 10 CFR 55.46(d), any open       |            |   |   |   |
| simulator                                   |            |   |   |   |
|                                             |            |   |   |   |
| performance deficiencies or deviations      |            |   |   |   |
| from the referenced plant 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.5      |            |   |   |   |
| 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     |            |   |   |   |
| crew position.                              |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| **Target Quantitative Attributes (Per       | Actual     | \ | \ | \ |
| Scenario; See Section D.5.d)**              | Attributes | - | - | - |
|                                             |            | - | - | - |
+---------------------------------------------+------------+---+---+---+
| 1\. Total malfunctions (5--8)               | / /        |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 2\. Malfunctions after EOP entry (1--2)     | / /        |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 3\. Abnormal events (2--4)                  | / /        |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 4\. Major transients (1--2)                 | / /        |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 5\. EOPs entered/requiring substantive      | / /        |   |   |   |
| actions (1--2)                              |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 6\. EOP contingencies requiring substantive | / /        |   |   |   |
| actions (0--2)                              |            |   |   |   |
+---------------------------------------------+------------+---+---+---+
| 7\. Critical tasks (2--3)                   | / /        |   |   |   |
+---------------------------------------------+------------+---+---+---+

[]{#BM_9_ .anchor}**ES-301 Transient and Event Checklist
[Form ES-301-5](../sr1020r9-sup1-final-forms-ms.doc#ES-301-5)**

<table>
<colgroup>
<col style="width: 9%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="18">Facility: Date of Exam: Operating Test No.:</td>
</tr>
<tr class="even">
<td rowspan="5"><p>A</p>
<p>P</p>
<p>P</p>
<p>L</p>
<p>I</p>
<p>C</p>
<p>A</p>
<p>N</p>
<p>T</p></td>
<td rowspan="5"><p>E</p>
<p>V</p>
<p>E</p>
<p>N</p>
<p>T</p>
<p>T</p>
<p>Y</p>
<p>P</p>
<p>E</p></td>
<td colspan="16">Scenarios</td>
</tr>
<tr class="odd">
<td colspan="3">1</td>
<td colspan="3">2</td>
<td colspan="3">3</td>
<td colspan="3">4</td>
<td rowspan="4"><p>T</p>
<p>O</p>
<p>T</p>
<p>A</p>
<p>L</p></td>
<td colspan="3" rowspan="3"><p>M</p>
<p>I</p>
<p>N</p>
<p>I</p>
<p>M</p>
<p>U</p>
<p>M(*)</p></td>
</tr>
<tr class="even">
<td colspan="3">CREW POSITION</td>
<td colspan="3">CREW POSITION</td>
<td colspan="3">CREW POSITION</td>
<td colspan="3">CREW POSITION</td>
</tr>
<tr class="odd">
<td rowspan="2"><p>S</p>
<p>R</p>
<p>O</p></td>
<td rowspan="2"><p>A</p>
<p>T</p>
<p>C</p></td>
<td rowspan="2"><p>B</p>
<p>O</p>
<p>P</p></td>
<td rowspan="2"><p>S</p>
<p>R</p>
<p>O</p></td>
<td rowspan="2"><p>A</p>
<p>T</p>
<p>C</p></td>
<td rowspan="2"><p>B</p>
<p>O</p>
<p>P</p></td>
<td rowspan="2"><p>S</p>
<p>R</p>
<p>O</p></td>
<td rowspan="2"><p>A</p>
<p>T</p>
<p>C</p></td>
<td rowspan="2"><p>B</p>
<p>O</p>
<p>P</p></td>
<td rowspan="2"><p>S</p>
<p>R</p>
<p>O</p></td>
<td rowspan="2"><p>A</p>
<p>T</p>
<p>C</p></td>
<td rowspan="2"><p>B</p>
<p>O</p>
<p>P</p></td>
</tr>
<tr class="even">
<td>R</td>
<td>I</td>
<td>U</td>
</tr>
<tr class="odd">
<td rowspan="5"><p>RO</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-I</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-U</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p></td>
<td>RX</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>0</td>
</tr>
<tr class="even">
<td>NOR</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr class="odd">
<td>I/C</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>4</td>
<td>4</td>
<td>2</td>
</tr>
<tr class="even">
<td>MAJ</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
<tr class="odd">
<td>TS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>0</td>
<td>2</td>
<td>2</td>
</tr>
<tr class="even">
<td rowspan="5"><p>RO</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-I</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-U</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p></td>
<td>RX</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>0</td>
</tr>
<tr class="odd">
<td>NOR</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr class="even">
<td>I/C</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>4</td>
<td>4</td>
<td>2</td>
</tr>
<tr class="odd">
<td>MAJ</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
<tr class="even">
<td>TS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>0</td>
<td>2</td>
<td>2</td>
</tr>
<tr class="odd">
<td rowspan="5"><p>RO</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-I</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-U</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p></td>
<td>RX</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>0</td>
</tr>
<tr class="even">
<td>NOR</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr class="odd">
<td>I/C</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>4</td>
<td>4</td>
<td>2</td>
</tr>
<tr class="even">
<td>MAJ</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
<tr class="odd">
<td>TS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>0</td>
<td>2</td>
<td>2</td>
</tr>
<tr class="even">
<td rowspan="5"><p>RO</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-I</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p>
<p>SRO-U</p>
<p><img src="media/image4.wmf"
style="width:0.16667in;height:0.16597in" /></p></td>
<td>RX</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>0</td>
</tr>
<tr class="odd">
<td>NOR</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>1</td>
<td>1</td>
<td>1</td>
</tr>
<tr class="even">
<td>I/C</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>4</td>
<td>4</td>
<td>2</td>
</tr>
<tr class="odd">
<td>MAJ</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>2</td>
<td>2</td>
<td>1</td>
</tr>
<tr class="even">
<td>TS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>0</td>
<td>2</td>
<td>2</td>
</tr>
<tr class="odd">
<td colspan="18"><p>Instructions:</p>
<ol type="1">
<li><p>Check the applicant level and enter the operating test number
and Form ES-D-1 event numbers for each event type; TS are not applicable
for RO applicants. ROs must serve in both the “at-the-controls (ATC)”
and “balance-of-plant (BOP)” positions; Instant SROs must serve in both
the SRO and the ATC positions, including at least two instrument or
component (I/C) malfunctions and one major transient, in the ATC
position. If an Instant SRO <em>additionally</em> serves in the BOP
position, one I/C malfunction can be credited toward the two I/C
malfunctions required for the ATC position.</p></li>
<li><p>Reactivity manipulations may be conducted under normal or
<em>controlled</em> abnormal conditions (refer to Section D.5.d)
but must be significant per Section C.2.a of Appendix D. (*) Reactivity
and normal evolutions may be replaced with additional instrument or
component malfunctions on a 1-for-1 basis.</p></li>
</ol>
<p>3. Whenever practical, both instrument and component malfunctions
should be included; only those that require verifiable actions
that provide insight to the applicant’s competence count toward
the minimum requirements specified for the applicant’s license level in
the right-hand columns.</p></td>
</tr>
</tbody>
</table>

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

[]{#BM_10_ .anchor}**ES-301 Competencies Checklist
[Form ES-301-6](../sr1020r9-sup1-final-forms-ms.doc#ES-301-6)**

<table>
<colgroup>
<col style="width: 28%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="17">Facility: Date of Examination: Operating Test No.:</td>
</tr>
<tr class="even">
<td rowspan="4">Competencies</td>
<td colspan="16">APPLICANTS</td>
</tr>
<tr class="odd">
<td colspan="4"><p>RO <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-I <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-U <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p></td>
<td colspan="4"><p>RO <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-I <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-U <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p></td>
<td colspan="4"><p>RO <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-I <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-U <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p></td>
<td colspan="4"><p>RO <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-I <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p>
<p>SRO-U <img src="media/image5.wmf"
style="width:0.17153in;height:0.14861in" /></p></td>
</tr>
<tr class="even">
<td colspan="4">SCENARIO</td>
<td colspan="4">SCENARIO</td>
<td colspan="4">SCENARIO</td>
<td colspan="4">SCENARIO</td>
</tr>
<tr class="odd">
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
</tr>
<tr class="even">
<td>Interpret/Diagnose Events and Conditions</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p>Comply With and</p>
<p>Use Procedures (1)</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>Operate Control</p>
<p>Boards (2)</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p>Communicate</p>
<p>and Interact</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>Demonstrate Supervisory Ability (3)</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p>Comply With and</p>
<p>Use Tech. Specs. (3)</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="17"><p>Notes:</p>
<p>(1) Includes Technical Specification compliance for an RO.</p>
<p>(2) Optional for an SRO-U.</p>
<p>(3) Only applicable to SROs.</p></td>
</tr>
</tbody>
</table>

*Instructions:*

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

[]{#BM_11_ .anchor}**ES-303 Individual Examination Report [Form
ES-303-1](../sr1020r9-sup1-final-forms-ms.doc#ES-303-1)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+---+---+--------------------------------+-----------------+---+-------+
| * |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
| U |   |                                |                 |   |       |
| . |   |                                |                 |   |       |
| S |   |                                |                 |   |       |
| . |   |                                |                 |   |       |
| N |   |                                |                 |   |       |
| u |   |                                |                 |   |       |
| c |   |                                |                 |   |       |
| l |   |                                |                 |   |       |
| e |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| r |   |                                |                 |   |       |
| R |   |                                |                 |   |       |
| e |   |                                |                 |   |       |
| g |   |                                |                 |   |       |
| u |   |                                |                 |   |       |
| l |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| t |   |                                |                 |   |       |
| o |   |                                |                 |   |       |
| r |   |                                |                 |   |       |
| y |   |                                |                 |   |       |
| C |   |                                |                 |   |       |
| o |   |                                |                 |   |       |
| m |   |                                |                 |   |       |
| m |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| s |   |                                |                 |   |       |
| s |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| o |   |                                |                 |   |       |
| n |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
|   |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
| I |   |                                |                 |   |       |
| n |   |                                |                 |   |       |
| d |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| v |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| d |   |                                |                 |   |       |
| u |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| l |   |                                |                 |   |       |
| E |   |                                |                 |   |       |
| x |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| m |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| n |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| t |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| o |   |                                |                 |   |       |
| n |   |                                |                 |   |       |
| R |   |                                |                 |   |       |
| e |   |                                |                 |   |       |
| p |   |                                |                 |   |       |
| o |   |                                |                 |   |       |
| r |   |                                |                 |   |       |
| t |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
| * |   |                                |                 |   |       |
+---+---+--------------------------------+-----------------+---+-------+
| A |   |                                | Docket Number   |   |       |
| p |   |                                | 55-             |   |       |
| p |   |                                |                 |   |       |
| l |   |                                |                 |   |       |
| i |   |                                |                 |   |       |
| c |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| n |   |                                |                 |   |       |
| t |   |                                |                 |   |       |
| ' |   |                                |                 |   |       |
| s |   |                                |                 |   |       |
| N |   |                                |                 |   |       |
| a |   |                                |                 |   |       |
| m |   |                                |                 |   |       |
| e |   |                                |                 |   |       |
+---+---+--------------------------------+-----------------+---+-------+
| I | R | Examination Type (Initial or   | Facility Name   |   |       |
|   |   | Retake)                        |                 |   |       |
+---+---+--------------------------------+-----------------+---+-------+
|   |   | Reactor Operator               | Facility        |   | Hot   |
|   |   |                                |                 |   |       |
|   |   |                                | Description     |   |       |
+---+---+--------------------------------+-----------------+---+-------+
|   |   | Senior Reactor Operator (SRO)  |                 |   | Cold  |
|   |   | Instant                        |                 |   |       |
+---+---+--------------------------------+-----------------+---+-------+
|   |   | SRO Upgrade                    |                 |   | BWR   |
+---+---+--------------------------------+-----------------+---+-------+
|   |   | SRO Limited to Fuel Handling   |                 |   | PWR   |
+---+---+--------------------------------+-----------------+---+-------+

  ------------------- -------------- ------ -------------- -------------- ------- --------------------- ------
  **Written                                                                                             
  Examination                                                                                           
  Summary**                                                                                             

  NRC Author/Reviewer                                      RO/SRO/Total                                 
                                                           Exam Points                                  
                                                           \_\_\_ /                                     
                                                           \_\_\_ /                                     
                                                           \_\_\_ \_\_\_                                
                                                           /\_\_\_                                      
                                                           /\_\_\_                                      

  NRC Grader/Reviewer                                      Applicant                                    
                                                           Points \_\_\_                                
                                                           / \_\_\_ /                                   
                                                           \_\_\_ \_\_\_                                
                                                           /\_\_\_                                      
                                                           /\_\_\_                                      

  Date Administered                                        Applicant                                    
                                                           Grade (%)                                    
                                                           \_\_\_ /                                     
                                                           \_\_\_ /                                     
                                                           \_\_\_ \_\_\_                                
                                                           /\_\_\_                                      
                                                           /\_\_\_                                      

  **Operating Test                                                                                      
  Summary**                                                                                             

  Administered by                                          Date                                         
                                                           Administered                                 

  Walk-Through                                                                                          
  (Overall)                                                                                             

  Administrative                                                                                        
  Topics                                                                                                

  Simulator Operating                                                                                   
  Test                                                                                                  

  **Examiner                                                                                            
  Recommendations**                                                                                     

  Check Blocks                       Pass   Fail                          Waive   Signature             Date

  Written Examination                                                                                   

  Operating Test                                                                                        

  Final                                                                                                 
  Recommendation                                                                                        

  **License                                                                                             
  Recommendation**                                                                                      

                      Issue License         Supervisor's                                                Date
                                            Signature                                                   

                      Deny License                                                                      
  ------------------- -------------- ------ -------------- -------------- ------- --------------------- ------

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

**ES-303 2 [Form
ES-303-1](../sr1020r9-sup1-final-forms-ms.doc#ES-303-1)**

\_\_

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+---------------------------------------------+---------+--------------+
| Applicant Docket Number: 55- Page of        |         |              |
+---------------------------------------------+---------+--------------+
| **Walk-Through Grading Details**            | **Evalu | **Comment    |
|                                             | ation** | Page**       |
|                                             |         |              |
|                                             | **(S or | **Number**   |
|                                             | U)**    |              |
+---------------------------------------------+---------+--------------+
| **Administrative Topics**                   |         |              |
+---------------------------------------------+---------+--------------+
| a\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| b\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| c\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| d\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| e\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| **Systems --- Control Room**                |         |              |
+---------------------------------------------+---------+--------------+
| a\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| b\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| c\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| d\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| e\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| f\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| g\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| h\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| **Systems --- In-Plant**                    |         |              |
+---------------------------------------------+---------+--------------+
| i\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| j\.                                         |         |              |
+---------------------------------------------+---------+--------------+
| k\.                                         |         |              |
+---------------------------------------------+---------+--------------+

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

**ES-303 3.a [Form
ES-303-1](../sr1020r9-sup1-final-forms-ms.doc#ES-303-1)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+--------------------------+-------+--------+-------+------+---------+
| Applicant Docket Number: |       |        |       |      |         |
| 55- Page of              |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| **Reactor Operator       |       |        |       |      |         |
| Simulator Operating Test |       |        |       |      |         |
| Grading Details**        |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| Competencies/            | RF    | RF     | RF    | C    | Comment |
|                          |       |        |       | omp. | Page    |
| Rating Factors (RFs)     | We    | Scores | G     |      | No.     |
|                          | ights |        | rades | Gr   |         |
|                          |       |        |       | ades |         |
+--------------------------+-------+--------+-------+------+---------+
| 1\.                      | \_\_\ | \_\_   | \_\_\ | \_   | \_\     |
| Interpretation/Diagnosis | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       | \_\_ |         |
| > a\. Recognize & Verify | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > Status                 | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > b\. Interpret &        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > Diagnose Conditions    | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > c\. Prioritize         |       |        |       |      |         |
| > Response               |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| 2\. Procedures/Tech      | \_\_\ | \_\_   | \_\_\ | \_   | \_\     |
| Specs                    | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       | \_\_ |         |
| > a\. Reference          | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > b\. Procedure          |       |        |       |      |         |
| > Compliance             | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > c\. Tech Spec Entry    |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| 3\. Control Board        | \_\_\ | \_\_   | \_\_\ | \_   | \_\     |
| Operations               | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       | \_\_ |         |
| > a\. Locate &           | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > Manipulate             | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > b\. Understanding      | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > c\. Manual Control     |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| 4\. Communications       | \_\_\ | \_\_   | \_\_\ | \_   | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
| > a\. Provide            |       |        |       | \_\_ |         |
| > Information            | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > b\. Receive            |       |        |       |      |         |
| > Information            | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > c\. Carry Out          |       |        |       |      |         |
| > Instructions           |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+

\[Note: Enter RF Weights (nominal, adjusted, or "0" if not observed
(N/O)), RF Scores (1, 2, 3, or N/O), and RF Grades from Form ES-303-3
and sum to obtain Competency Grades.\]

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

**ES-303 3.b [Form
ES-303-1](../sr1020r9-sup1-final-forms-ms.doc#ES-303-1)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+--------------------------+-------+--------+-------+------+---------+
| Applicant Docket Number: |       |        |       |      |         |
| 55- Page of              |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| **Senior Reactor         |       |        |       |      |         |
| Operator Simulator       |       |        |       |      |         |
| Operating Test Grading   |       |        |       |      |         |
| Details**                |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+
| Competencies/            | RF    | RF     | RF    | C    | Comment |
|                          |       |        |       | omp. |         |
| Rating Factors (RFs)     | We    | Scores | G     |      | Page    |
|                          | ights |        | rades | Gr   | No.     |
|                          |       |        |       | ades |         |
+--------------------------+-------+--------+-------+------+---------+
| 1\.                      | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
| Interpretation/Diagnosis | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       |      |         |
| > a\. Recognize & Attend | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > b\. Ensure Accuracy    |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > c\. Understanding      | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > d\. Diagnose           | \_\_\ | \_\_   | \_\_\ |      | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
+--------------------------+-------+--------+-------+------+---------+
| 2\. Procedures           | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
| > a\. Reference          |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > b\. EOP Entry          | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > c\. Correct Use        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
+--------------------------+-------+--------+-------+------+---------+
| 3\. Control Board        | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
| Operations               | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       |      |         |
| > a\. Locate &           | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > Manipulate             | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > b\. Understanding      | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > c\. Manual Control     |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+

+--------------------------+-------+--------+-------+------+---------+
| 4\. Communications       | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
| > a\. Clarity            |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > b\. Crew & Others      | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > Informed               |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > c\. Receive            | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > Information            |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+

+--------------------------+-------+--------+-------+------+---------+
| 5\. Directing Operations | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
|                          | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
| > a\. Timely & Decisive  |       |        |       |      |         |
| > Action                 | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| >                        | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > b\. Oversight          |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > c\. Solicit Crew       | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > Feedback               |       |        |       |      |         |
| >                        | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > d\. Monitor Crew       | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| > Activities             |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+

+--------------------------+-------+--------+-------+------+---------+
| 6\. Technical            | \_\_\ | \_\_   | \_\_\ | \_\_ | \_\     |
| Specifications           | _\_\_ | \_\_\_ | _\_\_ | \_\_ | _\_\_\_ |
|                          |       |        |       |      |         |
| > a\. Recognize and      | \_\_\ | \_\_   | \_\_\ |      | \_\     |
| > Locate                 | _\_\_ | \_\_\_ | _\_\_ |      | _\_\_\_ |
| >                        |       |        |       |      |         |
| > b\. Compliance         |       |        |       |      |         |
+--------------------------+-------+--------+-------+------+---------+

\[Note: Enter RF Weights (nominal, adjusted, or "0" if not observed
(N/O)), RF Scores (1, 2, 3, or N/O), and RF Grades from Form ES-303-4
and sum to obtain Competency Grades.\]

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

[]{#BM_12_ .anchor}**ES-303 Operating Test Comments [Form
ES-303-2](../sr1020r9-sup1-final-forms-ms.doc#ES-303-2)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+------------------+---------------------------------------------------+
| Applicant Docket |                                                   |
| Number: 55- Page |                                                   |
| of               |                                                   |
+------------------+---------------------------------------------------+
| Form ES-303-1    | Comments                                          |
|                  |                                                   |
| Cross-Reference  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+
|                  |                                                   |
+------------------+---------------------------------------------------+

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

[]{#BM_13_ .anchor}**ES-303 RO Competency Grading Worksheet [Form
ES-303-3](../sr1020r9-sup1-final-forms-ms.doc#ES-303-3)**

**for the Simulator Operating Test**

+----------------------------+----------------+--------+------+------+
| **1. Interpret/Diagnose    |                |        |      |      |
| Events and Conditions      |                |        |      |      |
| Based on Alarms, Signals,  |                |        |      |      |
| and Readings**             |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | **   |
| RECOGNIZE and VERIFY       |                |        |      | \_\_ |
| off-normal trends and      |                |        |      | \_\_ |
| status?                    |                |        |      | \_\_ |
|                            |                |        |      | \_** |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.40**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) or (c)   | 1      |      |      |
|                            | N/O = 0.57     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant    | N/O = 0        | 3      |      |      |
| correctly                  |                |        |      |      |
| INTERPRET/DIAGNOSE         |                |        |      |      |
| plant conditions based on  |                |        |      |      |
| control room indications?  |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(c\) Did the applicant    | N/O = 0        | 3      |      |      |
| ATTEND TO annunciators,    |                |        |      |      |
| alarm signals, and         |                |        |      |      |
| instrument readings in     |                |        |      |      |
| order of importance and    |                |        |      |      |
| severity?                  |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+

+----------------------------+----------------+--------+------+------+
| **2. Comply with and Use   |                |        |      |      |
| Procedures, References,    |                |        |      |      |
| and Technical              |                |        |      |      |
| Specifications**           |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | [\_\ |
| REFER TO the appropriate   |                |        |      | _\_\ |
| procedure or reference     |                |        |      | _\_\ |
| in a timely manner?        |                |        |      | _\_] |
|                            |                |        |      | {.un |
|                            |                |        |      | derl |
|                            |                |        |      | ine} |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant    | N/O = 0        | 3      |      |      |
| COMPLY WITH procedures     |                |        |      |      |
| (including precautions     |                |        |      |      |
| and limitations) and       |                |        |      |      |
| references in an accurate  |                |        |      |      |
| and timely manner?         |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.40**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) or (c)   | 1      |      |      |
|                            | N/O = 0.57     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(c\) Did the applicant    | N/O = 0        | 3      |      |      |
| RECOGNIZE plant conditions |                |        |      |      |
| that are addressed         |                |        |      |      |
| in technical               |                |        |      |      |
| specifications?            |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+

**ES-303 2 [Form
ES-303-3](../sr1020r9-sup1-final-forms-ms.doc#ES-303-3)**

+----------------------------+----------------+--------+------+------+
| **3. Operate the Control   |                |        |      |      |
| Boards**                   |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | \_   |
| LOCATE AND MANIPULATE      |                |        |      | \_\_ |
| controls in an accurate    |                |        |      | \_\_ |
| and timely manner?         |                |        |      | \_\_ |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.40**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) or (c)   | 1      |      |      |
|                            | N/O = 0.57     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant's  | N/O = 0        | 3      |      |      |
| actions demonstrate        |                |        |      |      |
| UNDERSTANDING OF SYSTEM    |                |        |      |      |
| OPERATION, including set   |                |        |      |      |
| points, interlocks, and    |                |        |      |      |
| automatic actions?         |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(c\) Did the applicant    | N/O = 0        | 3      |      |      |
| demonstrate the ability to |                |        |      |      |
| take MANUAL CONTROL        |                |        |      |      |
| of automatic functions?    |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    | 1      |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    |        |      |      |
|                            | 0.50           |        |      |      |
+----------------------------+----------------+--------+------+------+
| **4. Communicate and       |                |        |      |      |
| Interact with Other Crew   |                |        |      |      |
| Members**                  |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | \_   |
| PROVIDE clear and accurate |                |        |      | \_\_ |
| INFORMATION on system      |                |        |      | \_\_ |
| status to others for the   |                |        |      | \_\_ |
| performance of their jobs? |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.34**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) or (c)   | 1      |      |      |
|                            | N/O = 0.50     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant    | N/O = 0        | 3      |      |      |
| effectively RECEIVE        |                |        |      |      |
| INFORMATION from others    |                |        |      |      |
| (including requesting,     |                |        |      |      |
| acknowledging, and         |                |        |      |      |
| attending to information)? |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.33**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) or (c)   | 1      |      |      |
|                            | N/O = 0.50     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(c\) Did the applicant    | N/O = 0        | 3      |      |      |
| successfully CARRY OUT THE |                |        |      |      |
| INSTRUCTIONS of the        |                |        |      |      |
| supervisor?                |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.33**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) or (b)   | 1      |      |      |
|                            | N/O = 0.50     |        |      |      |
+----------------------------+----------------+--------+------+------+

[]{#BM_14_ .anchor}**ES-303 SRO Competency Grading Worksheets [Form
ES-303-4](../sr1020r9-sup1-final-forms-ms.doc#ES-303-4)**

**For the Simulator Operating Test**

+----------------------------+----------------+-------+------+-------+
| **1. Interpret/Diagnose    |                |       |      |       |
| Events and Conditions      |                |       |      |       |
| Based on Alarms, Signals,  |                |       |      |       |
| and Readings**             |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
| Rating Factors             | Weighting      | RF    | RF   | Comp. |
|                            | Factors        | S     | Gr   |       |
|                            |                | cores | ades | Grade |
+----------------------------+----------------+-------+------+-------+
| \(a\) Did the applicant    | N/O = 0        | 3     |      | **\   |
| RECOGNIZE AND ATTEND TO    |                |       |      | _\_\_ |
| off-normal trends and      |                |       |      | \_\_\ |
| status in order of their   |                |       |      | _\_** |
| importance and severity?   |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.20**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(b\) N/O =    | 1     |      |       |
|                            | 0.25           |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(c\) or (d)   |       |      |       |
|                            | N/O = 0.29     |       |      |       |
+----------------------------+----------------+-------+------+-------+
| \(b\) Did the applicant    | N/O = 0        | 3     |      |       |
| ensure the collection of   |                |       |      |       |
| CORRECT, ACCURATE, and     |                |       |      |       |
| COMPLETE information and   |                |       |      |       |
| reference material on      |                |       |      |       |
| which to base diagnoses?   |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.20**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(a\) N/O =    | 1     |      |       |
|                            | 0.25           |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(c\) or (d)   |       |      |       |
|                            | N/O = 0.28     |       |      |       |
+----------------------------+----------------+-------+------+-------+
| \(c\) Did the applicant's  | N/O = 0        | 3     |      |       |
| directives and actions     |                |       |      |       |
| demonstrate an             |                |       |      |       |
| UNDERSTANDING of how the   |                |       |      |       |
| PLANT, SYSTEMS, and        |                |       |      |       |
| COMPONENTS OPERATE AND     |                |       |      |       |
| INTERACT (including set    |                |       |      |       |
| points, interlocks, and    |                |       |      |       |
| automatic actions)?        |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.30**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(a\) or (b)   | 1     |      |       |
|                            | N/O = 0.38     |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(d\) N/O =    |       |      |       |
|                            | 0.43           |       |      |       |
+----------------------------+----------------+-------+------+-------+
| \(d\) Did the applicant    | N/O = 0        | 3     |      |       |
| correctly                  |                |       |      |       |
| INTERPRET/DIAGNOSE plant   |                |       |      |       |
| conditions based on        |                |       |      |       |
| control room indications?  |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.30**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(a\) or (b)   | 1     |      |       |
|                            | N/O = 0.37     |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(c\) N/O =    |       |      |       |
|                            | 0.43           |       |      |       |
+----------------------------+----------------+-------+------+-------+
| **2. Comply with and Use   |                |       |      |       |
| Procedures and             |                |       |      |       |
| References**               |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
| Rating Factors             | Weighting      | RF    | RF   | Comp. |
|                            | Factors        | S     | Gr   |       |
|                            |                | cores | ades | Grade |
+----------------------------+----------------+-------+------+-------+
| \(a\) Did the applicant    | N/O = 0        | 3     |      | **    |
| REFER to correct           |                |       |      | [\_\_ |
| procedures, procedural     |                |       |      | \_\_\ |
| steps, and references when |                |       |      | _\_\_ |
| appropriate?               |                |       |      | ]{.un |
|                            |                |       |      | derli |
|                            |                |       |      | ne}** |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.30**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(b\) N/O =    | 1     |      |       |
|                            | 0.43           |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(c\) N/O =    |       |      |       |
|                            | 0.50           |       |      |       |
+----------------------------+----------------+-------+------+-------+
| \(b\) Did the applicant    | N/O = 0        | 3     |      |       |
| RECOGNIZE EOP ENTRY        |                |       |      |       |
| CONDITIONS?                |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.30**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(a\) N/O =    | 1     |      |       |
|                            | 0.43           |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(c\) N/O =    |       |      |       |
|                            | 0.50           |       |      |       |
+----------------------------+----------------+-------+------+-------+
| \(c\) Did the applicant    | N/O = 0        | 3     |      |       |
| USE PROCEDURES CORRECTLY,  |                |       |      |       |
| including following        |                |       |      |       |
| procedural steps in        |                |       |      |       |
| correct sequence, abiding  |                |       |      |       |
| by procedural cautions and |                |       |      |       |
| limitations, selecting     |                |       |      |       |
| correct paths on decisions |                |       |      |       |
| blocks, and correctly      |                |       |      |       |
| transitioning between      |                |       |      |       |
| procedures?                |                |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | **Nominal =    | 2     |      |       |
|                            | 0.40**         |       |      |       |
+----------------------------+----------------+-------+------+-------+
|                            | \(a\) or (b)   | 1     |      |       |
|                            | N/O = 0.57     |       |      |       |
+----------------------------+----------------+-------+------+-------+

**ES-303 2 [Form
ES-303-4](../sr1020r9-sup1-final-forms-ms.doc#ES-303-4)**

+----------------------------+----------------+--------+-------+-----+
| **3. Operate the Control   |                |        |       |     |
| Boards**                   |                |        |       |     |
|                            |                |        |       |     |
| > *\[NOTE: This competency |                |        |       |     |
| > is optional for          |                |        |       |     |
| > SRO-upgrade applicants;  |                |        |       |     |
| > refer to Section         |                |        |       |     |
| > D.2.b.\]*                |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| Rating Factors             | Weighting      | RF     | RF    | Co  |
|                            | Factors        | Scores | G     | mp. |
|                            |                |        | rades |     |
|                            |                |        |       | Gr  |
|                            |                |        |       | ade |
+----------------------------+----------------+--------+-------+-----+
| \(a\) Did the applicant    | N/O = 0        | 3      |       | [\  |
| LOCATE AND MANIPULATE      |                |        |       | _\_ |
| CONTROLS in an accurate    |                |        |       | \_\ |
| and timely manner?         |                |        |       | _\_ |
|                            |                |        |       | \_] |
|                            |                |        |       | {.u |
|                            |                |        |       | nde |
|                            |                |        |       | rli |
|                            |                |        |       | ne} |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.34**         |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(b\) or (c)   | 1      |       |     |
|                            | N/O = 0.5      |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| \(b\) Did the applicant's  | N/O = 0        | 3      |       |     |
| control manipulations      |                |        |       |     |
| demonstrate an             |                |        |       |     |
| UNDERSTANDING OF SYSTEM    |                |        |       |     |
| OPERATION, including set   |                |        |       |     |
| points, interlocks, and    |                |        |       |     |
| automatic actions?         |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.33**         |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(a\) or (c)   | 1      |       |     |
|                            | N/O = 0.5      |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| \(c\) Did the applicant    | N/O = 0        | 3      |       |     |
| demonstrate the ability    |                |        |       |     |
| to take MANUAL CONTROL of  |                |        |       |     |
| automatic functions?       |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.33**         |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(a\) or (b)   | 1      |       |     |
|                            | N/O = 0.5      |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| **4. Communicate and       |                |        |       |     |
| Interact with the Crew and |                |        |       |     |
| Other Personnel**          |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| Rating Factors             | Weighting      | RF     | RF    | Co  |
|                            | Factors        | Scores | G     | mp. |
|                            |                |        | rades |     |
|                            |                |        |       | Gr  |
|                            |                |        |       | ade |
+----------------------------+----------------+--------+-------+-----+
| \(a\) Did the applicant    | N/O = 0        | 3      |       | [   |
| communicate in a clear,    |                |        |       | \_\ |
| easily understood manner?  |                |        |       | _\_ |
|                            |                |        |       | \_\ |
|                            |                |        |       | _\_ |
|                            |                |        |       | \_] |
|                            |                |        |       | {.u |
|                            |                |        |       | nde |
|                            |                |        |       | rli |
|                            |                |        |       | ne} |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.4**          |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(c\) N/O =    | 1      |       |     |
|                            | 0.5            |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(b\) N/O =    |        |       |     |
|                            | 0.67           |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| \(b\) Did the applicant    | N/O = 0        | 3      |       |     |
| keep crew members          |                |        |       |     |
| and those outside the      |                |        |       |     |
| control room informed of   |                |        |       |     |
| plant status?              |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.4**          |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(c\) N/O =    | 1      |       |     |
|                            | 0.5            |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(a\) N/O =    |        |       |     |
|                            | 0.67           |        |       |     |
+----------------------------+----------------+--------+-------+-----+
| \(c\) Did the applicant    | N/O = 0        | 3      |       |     |
| ENSURE RECEIPT of clear,   |                |        |       |     |
| easily-understood          |                |        |       |     |
| communications from crew   |                |        |       |     |
| and others?                |                |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | **Nominal =    | 2      |       |     |
|                            | 0.2**          |        |       |     |
+----------------------------+----------------+--------+-------+-----+
|                            | \(a\) or (b)   | 1      |       |     |
|                            | N/O = 0.33     |        |       |     |
+----------------------------+----------------+--------+-------+-----+

**ES-303 3 [Form
ES-303-4](../sr1020r9-sup1-final-forms-ms.doc#ES-303-4)**

+----------------------------+----------------+--------+------+------+
| **5. Direct Shift          |                |        |      |      |
| Operations**               |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | \_   |
| take TIMELY AND DECISIVE   |                |        |      | \_\_ |
| ACTION that demonstrated   |                |        |      | \_\_ |
| appropriate CONCERN for    |                |        |      | \_\_ |
| the SAFETY of the plant,   |                |        |      |      |
| staff, and public?         |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) or (d)   | 1      |      |      |
|                            | N/O = 0.38     |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    |        |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant    | N/O = 0        | 3      |      |      |
| remain ATTENTIVE           |                |        |      |      |
| to control room            |                |        |      |      |
| indications, stay in a     |                |        |      |      |
| position of OVERSIGHT, and |                |        |      |      |
| provide an APPROPRIATE     |                |        |      |      |
| AMOUNT of DIRECTION and    |                |        |      |      |
| GUIDANCE that facilitated  |                |        |      |      |
| CREW PERFORMANCE?          |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.30**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) or (d)   | 1      |      |      |
|                            | N/O = 0.37     |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    |        |      |      |
|                            | 0.43           |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(c\) Did the applicant    | N/O = 0        | 3      |      |      |
| SOLICIT and INCORPORATE    |                |        |      |      |
| FEEDBACK from the crew to  |                |        |      |      |
| foster an effective,       |                |        |      |      |
| team-oriented approach     |                |        |      |      |
| to problem solving and     |                |        |      |      |
| decision making?           |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.20**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(d\) N/O =    | 1      |      |      |
|                            | 0.25           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) or (b)   |        |      |      |
|                            | N/O = 0.29     |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(d\) Did the applicant    | N/O = 0        | 3      |      |      |
| ensure that CORRECT AND    |                |        |      |      |
| TIMELY ACTIVITIES          |                |        |      |      |
| (including diagnosis,      |                |        |      |      |
| procedural implementation, |                |        |      |      |
| and control board          |                |        |      |      |
| operations) were carried   |                |        |      |      |
| out BY THE CREW?           |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.20**         |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(c\) N/O =    | 1      |      |      |
|                            | 0.25           |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) or (b)   |        |      |      |
|                            | N/O = 0.28     |        |      |      |
+----------------------------+----------------+--------+------+------+
| **6. Comply with and Use   |                |        |      |      |
| Technical Specifications   |                |        |      |      |
| (TS)**                     |                |        |      |      |
+----------------------------+----------------+--------+------+------+
| Rating Factors             | Weighting      | RF     | RF   | C    |
|                            | Factors        | Scores | Gr   | omp. |
|                            |                |        | ades |      |
|                            |                |        |      | G    |
|                            |                |        |      | rade |
+----------------------------+----------------+--------+------+------+
| \(a\) Did the applicant    | N/O = 0        | 3      |      | \_   |
| RECOGNIZE when conditions  |                |        |      | \_\_ |
| were covered by the TS     |                |        |      | \_\_ |
| and LOCATE the appropriate |                |        |      | \_\_ |
| TS?                        |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.4**          |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(b\) N/O =    | 1      |      |      |
|                            | 1.0            |        |      |      |
+----------------------------+----------------+--------+------+------+
| \(b\) Did the applicant    | N/O = 0        | 3      |      |      |
| ensure correct COMPLIANCE  |                |        |      |      |
| with TS and LCO            |                |        |      |      |
| action statements?         |                |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | **Nominal =    | 2      |      |      |
|                            | 0.6**          |        |      |      |
+----------------------------+----------------+--------+------+------+
|                            | \(a\) N/O =    | 1      |      |      |
|                            | 1.0            |        |      |      |
+----------------------------+----------------+--------+------+------+

[]{#BM_15_ .anchor}**ES-401 BWR Examination Outline
[Form ES-401-1](../sr1020r9-sup1-final-forms-ms.doc#ES-401-1)**

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 12%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 7%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 9%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="19">Facility: Date of Exam:</td>
</tr>
<tr class="even">
<td rowspan="2">Tier</td>
<td rowspan="2">Group</td>
<td colspan="12">RO K/A Category Points</td>
<td colspan="5">SRO-Only Points</td>
</tr>
<tr class="odd">
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td><p>G</p>
<p>*</p></td>
<td>Total</td>
<td colspan="2">A2</td>
<td colspan="2">G*</td>
<td>Total</td>
</tr>
<tr class="even">
<td rowspan="3"><p>1.</p>
<p>Emergency &amp; Abnormal Plant Evolutions</p></td>
<td>1</td>
<td></td>
<td></td>
<td></td>
<td colspan="3" rowspan="3">N/A</td>
<td></td>
<td></td>
<td colspan="2" rowspan="3">N/A</td>
<td></td>
<td>20</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>7</td>
</tr>
<tr class="odd">
<td>2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>7</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>3</td>
</tr>
<tr class="even">
<td>Tier Totals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>27</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>10</td>
</tr>
<tr class="odd">
<td rowspan="3"><p>2.</p>
<p>Plant</p>
<p>Systems</p></td>
<td>1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>26</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>5</td>
</tr>
<tr class="even">
<td>2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>12</td>
<td></td>
<td></td>
<td colspan="2"></td>
<td>3</td>
</tr>
<tr class="odd">
<td>Tier Totals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>38</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>8</td>
</tr>
<tr class="even">
<td colspan="5" rowspan="2">3. Generic Knowledge and Abilities
Categories</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">3</td>
<td colspan="2">4</td>
<td rowspan="2">10</td>
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
<td rowspan="2">7</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="19"><p>Note: 1. Ensure that at least two topics from every
applicable K/A category are sampled within each tier of the RO
and SRO-only outlines (i.e., except for one category in Tier 3
of the SRO-only outline, the “Tier Totals” in each K/A category shall
not be less than two).</p>
<blockquote>
<p>2. The point total for each group and tier in the proposed outline
must match that specified in the table. The final point total for each
group and tier may deviate by ±1 from that specified in the table based
on NRC revisions. The final RO exam must total 75 points
and the SRO-only exam must total 25 points.</p>
<p>3. Systems/evolutions within each group are identified
on the associated outline; systems or evolutions that do not apply
at the facility should be deleted and justified; operationally
important, site-specific systems/evolutions that are not included
on the outline should be added. Refer to Section D.1.b of ES-401
for guidance regarding the elimination of inappropriate K/A
statements.</p>
<p>4. Select topics from as many systems and evolutions as possible;
sample every system or evolution in the group before selecting a second
topic for any system or evolution.</p>
</blockquote>
<p>5. Absent a plant-specific priority, only those K/As having
an importance rating (IR) of 2.5 or higher shall be selected. Use the RO
and SRO ratings for the RO and SRO-only portions, respectively.</p>
<p>6. Select SRO topics for Tiers 1 and 2 from the shaded systems
and K/A categories.</p>
<p>7.* The generic (G) K/As in Tiers 1 and 2 shall be selected
from Section 2 of the K/A Catalog, but the topics must be relevant
to the applicable evolution or system. Refer to Section D.1.b of ES-401
for the applicable K/As.</p>
<p>8. On the following pages, enter the K/A numbers, a brief description
of each topic, the topics’ importance ratings (IRs) for the applicable
license level, and the point totals (#) for each system and category.
Enter the group and tier totals for each category in the table above; if
fuel handling equipment is sampled in other than Category A2 or G* on
the SRO-only exam, enter it on the left side of Column A2 for Tier 2,
Group 2 (Note #1 does not apply). Use duplicate pages for RO
and SRO-only exams.</p>
<blockquote>
<p>9. For Tier 3, select topics from Section 2 of the K/A catalog,
and enter the K/A numbers, descriptions, IRs, and point totals (#)
on Form ES-401-3. Limit SRO selections to K/As that are linked
to 10 CFR 55.43.</p>
</blockquote></td>
</tr>
</tbody>
</table>

**ES-401 2
[Form ES-401-1](../sr1020r9-sup1-final-forms-ms.doc#ES-401-1)**

<table>
<colgroup>
<col style="width: 33%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 39%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p>ES-401 BWR Examination Outline Form ES-401-1</p>
<p>Emergency and Abnormal Plant Evolutions - Tier 1/Group 1 (RO /
SRO)</p></td>
</tr>
<tr class="even">
<td>E/APE # / Name / Safety Function</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>295001 Partial or Complete Loss of Forced Core Flow Circulation / 1
&amp; 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295003 Partial or Complete Loss of AC / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295004 Partial or Total Loss of DC Pwr / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295005 Main Turbine Generator Trip / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295006 SCRAM / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295016 Control Room Abandonment / 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295018 Partial or Total Loss of CCW / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295019 Partial or Total Loss of Inst. Air / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295021 Loss of Shutdown Cooling / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295023 Refueling Acc / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295024 High Drywell Pressure / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295025 High Reactor Pressure / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295026 Suppression Pool High Water Temp. / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295027 High Containment Temperature / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295028 High Drywell Temperature / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295030 Low Suppression Pool Wtr Lvl / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295031 Reactor Low Water Level / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295037 SCRAM Condition Present and Reactor Power Above APRM
Downscale or Unknown / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295038 High Off-site Release Rate / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>600000 Plant Fire On Site / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>700000 Generator Voltage and Electric Grid Disturbances / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>20/7</td>
</tr>
</tbody>
</table>

**ES-401 3
[Form ES-401-1](../sr1020r9-sup1-final-forms-ms.doc#ES-401-1)**

<table>
<colgroup>
<col style="width: 33%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 41%" />
<col style="width: 4%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p>ES-401 BWR Examination Outline Form ES-401-1</p>
<p>Emergency and Abnormal Plant Evolutions - Tier 1/Group 2 (RO /
SRO)</p></td>
</tr>
<tr class="even">
<td>E/APE # / Name / Safety Function</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>295002 Loss of Main Condenser Vac / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295007 High Reactor Pressure / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295008 High Reactor Water Level / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295009 Low Reactor Water Level / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295010 High Drywell Pressure / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295011 High Containment Temp / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295012 High Drywell Temperature / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295013 High Suppression Pool Temp. / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295014 Inadvertent Reactivity Addition / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295015 Incomplete SCRAM / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295017 High Off-site Release Rate / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295020 Inadvertent Cont. Isolation / 5 &amp; 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295022 Loss of CRD Pumps / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295029 High Suppression Pool Wtr Lvl / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295032 High Secondary Containment Area Temperature / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295033 High Secondary Containment Area Radiation Levels / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295034 Secondary Containment Ventilation High Radiation / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295035 Secondary Containment High Differential Pressure / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295036 Secondary Containment High Sump/Area Water Level / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>500000 High CTMT Hydrogen Conc. / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>7/3</td>
</tr>
</tbody>
</table>

**ES-401 4
[Form ES-401-1](../sr1020r9-sup1-final-forms-ms.doc#ES-401-1)**

<table>
<colgroup>
<col style="width: 25%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 34%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p>ES-401 BWR Examination Outline Form ES-401-1</p>
<p>Plant Systems - Tier 2/Group 1 (RO / SRO)</p></td>
</tr>
<tr class="even">
<td>System # / Name</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>203000 RHR/LPCI: Injection Mode</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>205000 Shutdown Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>206000 HPCI</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>207000 Isolation (Emergency) Condenser</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>209001 LPCS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>209002 HPCS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>211000 SLC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>212000 RPS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>215003 IRM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>215004 Source Range Monitor</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>215005 APRM / LPRM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>217000 RCIC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>218000 ADS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>223002 PCIS/Nuclear Steam Supply Shutoff</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>239002 SRVs</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>259002 Reactor Water Level Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>261000 SGTS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>262001 AC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>262002 UPS (AC/DC)</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>263000 DC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>264000 EDGs</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>300000 Instrument Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>400000 Component Cooling Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>26/5</td>
</tr>
</tbody>
</table>

**ES-401 5
[Form ES-401-1](../sr1020r9-sup1-final-forms-ms.doc#ES-401-1)**

<table>
<colgroup>
<col style="width: 27%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 31%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p>ES-401 BWR Examination Outline Form ES-401-1</p>
<p>Plant Systems - Tier 2/Group 2 (RO / SRO)</p></td>
</tr>
<tr class="even">
<td>System # / Name</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>201001 CRD Hydraulic</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>201002 RMCS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>201003 Control Rod and Drive Mechanism</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>201004 RSCS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>201005 RCIS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>201006 RWM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>202001 Recirculation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>202002 Recirculation Flow Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>204000 RWCU</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>214000 RPIS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>215001 Traversing In-core Probe</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>215002 RBM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>216000 Nuclear Boiler Inst.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>219000 RHR/LPCI: Torus/Pool Cooling Mode</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>223001 Primary CTMT and Aux.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>226001 RHR/LPCI: CTMT Spray Mode</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>230000 RHR/LPCI: Torus/Pool Spray Mode</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>233000 Fuel Pool Cooling/Cleanup</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>234000 Fuel Handling Equipment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>239001 Main and Reheat Steam</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>239003 MSIV Leakage Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>241000 Reactor/Turbine Pressure Regulator</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>245000 Main Turbine Gen. / Aux.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>256000 Reactor Condensate</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>259001 Reactor Feedwater</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>268000 Radwaste</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>271000 Offgas</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>272000 Radiation Monitoring</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>286000 Fire Protection</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>288000 Plant Ventilation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>290001 Secondary CTMT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>290003 Control Room HVAC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>290002 Reactor Vessel Internals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>12/3</td>
</tr>
</tbody>
</table>

[]{#BM_16_ .anchor}**ES-401 PWR Examination Outline
[Form ES-401-2](../sr1020r9-sup1-final-forms-ms.doc#ES-401-2)**

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 11%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 7%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 8%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="19">Facility: Date of Exam:</td>
</tr>
<tr class="even">
<td rowspan="2">Tier</td>
<td rowspan="2">Group</td>
<td colspan="12">RO K/A Category Points</td>
<td colspan="5">SRO-Only Points</td>
</tr>
<tr class="odd">
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td><p>G</p>
<p>*</p></td>
<td>Total</td>
<td colspan="2">A2</td>
<td colspan="2">G*</td>
<td>Total</td>
</tr>
<tr class="even">
<td rowspan="3"><p>1.</p>
<p>Emergency &amp; Abnormal Plant Evolutions</p></td>
<td>1</td>
<td></td>
<td></td>
<td></td>
<td colspan="3" rowspan="3">N/A</td>
<td></td>
<td></td>
<td colspan="2" rowspan="3">N/A</td>
<td></td>
<td>18</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>6</td>
</tr>
<tr class="odd">
<td>2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>9</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>4</td>
</tr>
<tr class="even">
<td>Tier Totals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>27</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>10</td>
</tr>
<tr class="odd">
<td rowspan="3"><p>2.</p>
<p>Plant</p>
<p>Systems</p></td>
<td>1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>28</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>5</td>
</tr>
<tr class="even">
<td>2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>10</td>
<td></td>
<td></td>
<td colspan="2"></td>
<td>3</td>
</tr>
<tr class="odd">
<td>Tier Totals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>38</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>8</td>
</tr>
<tr class="even">
<td colspan="5" rowspan="2">3. Generic Knowledge and Abilities
Categories</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">3</td>
<td colspan="2">4</td>
<td rowspan="2">10</td>
<td>1</td>
<td>2</td>
<td>3</td>
<td>4</td>
<td rowspan="2">7</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="19"><p>Note: 1. Ensure that at least two topics from every
applicable K/A category are sampled within each tier of the RO
and SRO-only outlines (i.e., except for one category in Tier 3
of the SRO-only outline, the “Tier Totals” in each K/A category shall
not be less than two).</p>
<blockquote>
<p>2. The point total for each group and tier in the proposed outline
must match that specified in the table. The final point total for each
group and tier may deviate by ±1 from that specified in the table
based on NRC revisions. The final RO exam must total 75 points
and the SRO-only exam must total 25 points.</p>
<p>3. Systems/evolutions within each group are identified
on the associated outline; systems or evolutions that do not apply
at the facility should be deleted and justified; operationally
important, site-specific systems/evolutions that are not included
on the outline should be added. Refer to Section D.1.b of ES-401
for guidance regarding the elimination of inappropriate K/A
statements.</p>
<p>4. Select topics from as many systems and evolutions as possible;
sample every system or evolution in the group before selecting a second
topic for any system or evolution.</p>
<p>5. Absent a plant-specific priority, only those K/As having
an importance rating (IR) of 2.5 or higher shall be selected. Use the RO
and SRO ratings for the RO and SRO-only portions, respectively.</p>
<p>6. Select SRO topics for Tiers 1 and 2 from the shaded systems
and K/A categories.</p>
<p>7.* The generic (G) K/As in Tiers 1 and 2 shall be selected
from Section 2 of the K/A Catalog, but the topics must be relevant
to the applicable evolution or system. Refer to Section D.1.b of ES-401
for the applicable K/As.</p>
<p>8. On the following pages, enter the K/A numbers, a brief description
of each topic, the topics’ importance ratings (IRs) for the applicable
license level, and the point totals (#) for each system and category.
Enter the group and tier totals for each category in the table above; if
fuel handling equipment is sampled in other than Category A2 or G* on
the SRO-only exam, enter it on the left side of Column A2 for Tier 2,
Group 2 (Note #1 does not apply). Use duplicate pages for RO
and SRO-only exams.</p>
<p>9. For Tier 3, select topics from Section 2 of the K/A catalog,
and enter the K/A numbers, descriptions, IRs, and point totals (#)
on Form ES-401-3. Limit SRO selections to K/As that are linked
to 10 CFR 55.43.</p>
</blockquote></td>
</tr>
</tbody>
</table>

**ES-401 2
[Form ES-401-2](../sr1020r9-sup1-final-forms-ms.doc#ES-401-2)**

<table>
<colgroup>
<col style="width: 32%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 39%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p>ES-401 PWR Examination Outline Form ES-401-2</p>
<p>Emergency and Abnormal Plant Evolutions - Tier 1/Group 1 (RO /
SRO)</p></td>
</tr>
<tr class="even">
<td>E/APE # / Name / Safety Function</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>000007 (BW/E02&amp;E10; CE/E02) Reactor Trip - Stabilization -
Recovery / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000008 Pressurizer Vapor Space Accident / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000009 Small Break LOCA / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000011 Large Break LOCA / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000015/17 RCP Malfunctions / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000022 Loss of Rx Coolant Makeup / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000025 Loss of RHR System / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000026 Loss of Component Cooling Water / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000027 Pressurizer Pressure Control System Malfunction / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000029 ATWS / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000038 Steam Gen. Tube Rupture / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000040 (BW/E05; CE/E05; W/E12) Steam Line Rupture - Excessive Heat
Transfer / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000054 (CE/E06) Loss of Main Feedwater / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000055 Station Blackout / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000056 Loss of Off-site Power / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000057 Loss of Vital AC Inst. Bus / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000058 Loss of DC Power / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000062 Loss of Nuclear Svc Water / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000065 Loss of Instrument Air / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>W/E04 LOCA Outside Containment / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>W/E11 Loss of Emergency Coolant Recirc. / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>BW/E04; W/E05 Inadequate Heat Transfer - Loss of Secondary Heat Sink
/ 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000077 Generator Voltage and Electric Grid Disturbances / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>18/6</td>
</tr>
</tbody>
</table>

**ES-401 3
[Form ES-401-2](../sr1020r9-sup1-final-forms-ms.doc#ES-401-2)**

<table>
<colgroup>
<col style="width: 39%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 33%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p>ES-401 PWR Examination Outline Form ES-401-2</p>
<p>Emergency and Abnormal Plant Evolutions - Tier 1/Group 2 (RO /
SRO)</p></td>
</tr>
<tr class="even">
<td>E/APE # / Name / Safety Function</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>000001 Continuous Rod Withdrawal / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000003 Dropped Control Rod / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000005 Inoperable/Stuck Control Rod / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000024 Emergency Boration / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000028 Pressurizer Level Malfunction / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000032 Loss of Source Range NI / 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000033 Loss of Intermediate Range NI / 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000036 (BW/A08) Fuel Handling Accident / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000037 Steam Generator Tube Leak / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000051 Loss of Condenser Vacuum / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000059 Accidental Liquid RadWaste Rel. / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000060 Accidental Gaseous Radwaste Rel. / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000061 ARM System Alarms / 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000067 Plant Fire On-site / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000068 (BW/A06) Control Room Evac. / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000069 (W/E14) Loss of CTMT Integrity / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000074 (W/E06&amp;E07) Inad. Core Cooling / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000076 High Reactor Coolant Activity / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>W/EO1 &amp; E02 Rediagnosis &amp; SI Termination / 3</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>W/E13 Steam Generator Over-pressure / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>W/E15 Containment Flooding / 5</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>W/E16 High Containment Radiation / 9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>BW/A01 Plant Runback / 1</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>BW/A02&amp;A03 Loss of NNI-X/Y / 7</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>BW/A04 Turbine Trip / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>BW/A05 Emergency Diesel Actuation / 6</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>BW/A07 Flooding / 8</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>BW/E03 Inadequate Subcooling Margin / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>BW/E08; W/E03 LOCA Cooldown - Depress. / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>BW/E09; CE/A13; W/E09&amp;E10 Natural Circ. / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>BW/E13&amp;E14 EOP Rules and Enclosures</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>CE/A11; W/E08 RCS Overcooling - PTS / 4</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>CE/A16 Excess RCS Leakage / 2</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>CE/E09 Functional Recovery</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>9/4</td>
</tr>
</tbody>
</table>

**ES-401 4
[Form ES-401-2](../sr1020r9-sup1-final-forms-ms.doc#ES-401-2)**

<table>
<colgroup>
<col style="width: 26%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 31%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p>ES-401 PWR Examination Outline Form ES-401-2</p>
<p>Plant Systems - Tier 2/Group 1 (RO / SRO)</p></td>
</tr>
<tr class="even">
<td>System # / Name</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>003 Reactor Coolant Pump</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>004 Chemical and Volume Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>005 Residual Heat Removal</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>006 Emergency Core Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>007 Pressurizer Relief/Quench Tank</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>008 Component Cooling Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>010 Pressurizer Pressure Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>012 Reactor Protection</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>013 Engineered Safety Features Actuation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>022 Containment Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>025 Ice Condenser</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>026 Containment Spray</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>039 Main and Reheat Steam</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>059 Main Feedwater</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>061 Auxiliary/Emergency Feedwater</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>062 AC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>063 DC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>064 Emergency Diesel Generator</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>073 Process Radiation Monitoring</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>076 Service Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>078 Instrument Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>103 Containment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>28/5</td>
</tr>
</tbody>
</table>

**ES-401 5
[Form ES-401-2](../sr1020r9-sup1-final-forms-ms.doc#ES-401-2)**

<table>
<colgroup>
<col style="width: 26%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 33%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p>ES-401 PWR Examination Outline Form ES-401-2</p>
<p>Plant Systems - Tier 2/Group 2 (RO / SRO)</p></td>
</tr>
<tr class="even">
<td>System # / Name</td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>001 Control Rod Drive</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>002 Reactor Coolant</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>011 Pressurizer Level Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>014 Rod Position Indication</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>015 Nuclear Instrumentation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>016 Non-nuclear Instrumentation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>017 In-core Temperature Monitor</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>027 Containment Iodine Removal</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>028 Hydrogen Recombiner and Purge Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>029 Containment Purge</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>033 Spent Fuel Pool Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>034 Fuel Handling Equipment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>035 Steam Generator</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>041 Steam Dump/Turbine Bypass Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>045 Main Turbine Generator</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>055 Condenser Air Removal</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>056 Condensate</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>068 Liquid Radwaste</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>071 Waste Gas Disposal</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>072 Area Radiation Monitoring</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>075 Circulating Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>079 Station Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>086 Fire Protection</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Point Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Group Point Total:</td>
<td>10/3</td>
</tr>
</tbody>
</table>

**ES-401** **Generic Knowledge and Abilities Outline (Tier 3)
[Form ES-401-3](../sr1020r9-sup1-final-forms-ms.doc#ES-401-3)**

[]{#BM_17_ .anchor}

+---------+----+---------------------------------+----+----+----+----+
| Fa      |    |                                 |    |    |    |    |
| cility: |    |                                 |    |    |    |    |
| Date    |    |                                 |    |    |    |    |
| o       |    |                                 |    |    |    |    |
| f Exam: |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
| C       | K  | Topic                           | RO |    | SR |    |
| ategory | /A |                                 |    |    | O- |    |
|         | \# |                                 |    |    | On |    |
|         |    |                                 |    |    | ly |    |
+---------+----+---------------------------------+----+----+----+----+
|         |    |                                 | IR | \# | IR | \# |
+---------+----+---------------------------------+----+----+----+----+
| 1\.     | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
| Conduct |    |                                 |    |    |    |    |
| of Ope  |    |                                 |    |    |    |    |
| rations |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 1. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | Su |                                 |    |    |    |    |
|         | bt |                                 |    |    |    |    |
|         | ot |                                 |    |    |    |    |
|         | al |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
| 2\.     | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
| Eq      |    |                                 |    |    |    |    |
| uipment |    |                                 |    |    |    |    |
| Control |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 2. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | Su |                                 |    |    |    |    |
|         | bt |                                 |    |    |    |    |
|         | ot |                                 |    |    |    |    |
|         | al |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
| 3\.     | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
| Ra      |    |                                 |    |    |    |    |
| diation |    |                                 |    |    |    |    |
| Control |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 3. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | Su |                                 |    |    |    |    |
|         | bt |                                 |    |    |    |    |
|         | ot |                                 |    |    |    |    |
|         | al |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
| 4\.     | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
| Em      |    |                                 |    |    |    |    |
| ergency |    |                                 |    |    |    |    |
| Pro     |    |                                 |    |    |    |    |
| cedures |    |                                 |    |    |    |    |
| / Plan  |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | 2. |                                 |    |    |    |    |
|         | 4. |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
|         | Su |                                 |    |    |    |    |
|         | bt |                                 |    |    |    |    |
|         | ot |                                 |    |    |    |    |
|         | al |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+
| Tier 3  |    |                                 |    | 10 |    | 7  |
| Point   |    |                                 |    |    |    |    |
| Total   |    |                                 |    |    |    |    |
+---------+----+---------------------------------+----+----+----+----+

[]{#BM_18_ .anchor}**ES-401 Record of Rejected K/As
[Form ES-401-4](../sr1020r9-sup1-final-forms-ms.doc#ES-401-4)**

  -------- --------------- -----------------------------------------------
  Tier /   Randomly        Reason for Rejection
  Group    Selected K/A    

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           

                           
  -------- --------------- -----------------------------------------------

[]{#BM_19_ .anchor}**ES-401 Sample Written Examination
[Form ES-401-5](../sr1020r9-sup1-final-forms-ms.doc#ES-401-5)**

**Question Worksheet**

Examination Outline Cross-Reference: Level RO SRO

> Tier # \_\_\_\_\_ \_\_\_\_\_
>
> Group \# \_\_\_\_\_ \_\_\_\_\_
>
> K/A \# \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Importance Rating \_\_\_\_\_ \_\_\_\_\_

Proposed Question:

Proposed Answer: \_\_\_\_\_\_

Explanation (Optional):

Technical Reference(s):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Attach if not previously provided)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(including version/revision number)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Proposed references to be provided to applicants during examination:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Learning Objective: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(As available)

Question Source: Bank \# \_\_\_\_\_\_\_

> Modified Bank \# \_\_\_\_\_\_\_ (Note changes or attach parent)
>
> New \_\_\_\_\_\_\_

Question History: Last NRC Exam \_\_\_\_\_\_\_\_\_\_\_\_

*(Optional: Questions validated at the facility since 10/95 will
generally undergo less rigorous review by the NRC; failure to provide
the information will necessitate a detailed review of every question.)*

Question Cognitive Level: Memory or Fundamental Knowledge \_\_\_\_\_

> Comprehension or Analysis \_\_\_\_\_

10 CFR Part 55 Content: 55.41 \_\_\_\_\_

> 55.43 \_\_\_\_\_

Comments:

[]{#BM_20_ .anchor}**ES-401 Written Examination Quality Checklist
[Form ES-401-6](../sr1020r9-sup1-final-forms-ms.doc#ES-401-6)**

+----------------------------------------------------------+---+---+---+
| Facility: Date of Exam: Exam Level: RO                   |   |   |   |
| ![](media/image6.wmf){width="0.16666666666666666in"      |   |   |   |
| height="0.15833333333333333in"} SRO                      |   |   |   |
| ![](media/image7.wmf){width="0.16666666666666666in"      |   |   |   |
| height="0.15833333333333333in"}                          |   |   |   |
+----------------------------------------------------------+---+---+---+
| Item Description                                         | I |   |   |
|                                                          | n |   |   |
|                                                          | i |   |   |
|                                                          | t |   |   |
|                                                          | i |   |   |
|                                                          | a |   |   |
|                                                          | l |   |   |
+----------------------------------------------------------+---+---+---+
|                                                          | a | b | c |
|                                                          |   | \ | ^ |
|                                                          |   | * | \ |
|                                                          |   |   | # |
|                                                          |   |   | ^ |
+----------------------------------------------------------+---+---+---+
| 1\. Questions and answers are technically accurate       |   |   |   |
| and applicable to the facility.                          |   |   |   |
+----------------------------------------------------------+---+---+---+
| 2\. a. NRC K/As are referenced for all questions.        |   |   |   |
|                                                          |   |   |   |
| > b\. Facility learning objectives are referenced        |   |   |   |
| > as available.                                          |   |   |   |
+----------------------------------------------------------+---+---+---+
| 3\. SRO questions are appropriate in accordance with     |   |   |   |
| Section D.2.d of ES-401                                  |   |   |   |
+----------------------------------------------------------+---+---+---+

+-------------------------------------+------+---+---+-----+---+---+---+
| 4\. The sampling process was random |      |   |   |     |   |   |   |
| and systematic (If more than 4 RO   |      |   |   |     |   |   |   |
| or 2 SRO questions were repeated    |      |   |   |     |   |   |   |
| from the last 2 NRC licensing       |      |   |   |     |   |   |   |
| exams, consult the NRR OL program   |      |   |   |     |   |   |   |
| office).                            |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 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         |      |   |   |     |   |   |   |
|                                     |      |   |   |     |   |   |   |
| \_\_ the licensee certifies         |      |   |   |     |   |   |   |
| that there is no duplication; or    |      |   |   |     |   |   |   |
|                                     |      |   |   |     |   |   |   |
| \_\_ other (explain)                |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 6\. Bank use meets limits (no more  | Bank | M |   | New |   |   |   |
| than 75 percent from the bank,      |      | o |   |     |   |   |   |
| at least 10 percent new,            |      | d |   |     |   |   |   |
| and the rest new or modified);      |      | i |   |     |   |   |   |
| enter the actual RO / SRO-only      |      | f |   |     |   |   |   |
| question distribution(s) at right.  |      | i |   |     |   |   |   |
|                                     |      | e |   |     |   |   |   |
|                                     |      | d |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
|                                     | /    | / |   | /   |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 7\. Between 50 and 60 percent       | Me   |   | C |     |   |   |   |
| of the questions on the RO exam are | mory |   | / |     |   |   |   |
| written at the comprehension/       |      |   | A |     |   |   |   |
| analysis level; the SRO exam may    |      |   |   |     |   |   |   |
| exceed 60 percent if the randomly   |      |   |   |     |   |   |   |
| selected K/As support the higher    |      |   |   |     |   |   |   |
| cognitive levels; enter the actual  |      |   |   |     |   |   |   |
| RO / SRO question distribution(s)   |      |   |   |     |   |   |   |
| at right.                           |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
|                                     | /    |   | / |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 8\. References/handouts provided do |      |   |   |     |   |   |   |
| not give away answers               |      |   |   |     |   |   |   |
| or aid                              |      |   |   |     |   |   |   |
|  in the elimination of distractors. |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 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 assigned;                  |      |   |   |     |   |   |   |
| deviations are justified.           |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 10\. Question psychometric quality  |      |   |   |     |   |   |   |
| and format meet the guidelines in   |      |   |   |     |   |   |   |
| ES Appendix B.                      |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| 11\. The exam contains the required |      |   |   |     |   |   |   |
| number of one-point, multiple       |      |   |   |     |   |   |   |
| choice items; the total is correct  |      |   |   |     |   |   |   |
| and agrees with the value on the    |      |   |   |     |   |   |   |
| cover sheet.                        |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| Printed Name / Signature            |      |   |   |     |   | D |   |
|                                     |      |   |   |     |   | a |   |
|                                     |      |   |   |     |   | t |   |
|                                     |      |   |   |     |   | e |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| a\. Author                          |      |   |   |     |   | \ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  |      |   |   |     |   | _ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |      |   |   |     |   | \ |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
| b\. Facility Reviewer (\*)          |      |   |   |     |   | _ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  |      |   |   |     |   | \ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |      |   |   |     |   | _ |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
| c\. NRC Chief Examiner (#)          |      |   |   |     |   | \ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  |      |   |   |     |   | _ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |      |   |   |     |   | \ |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   |   |   |
| d\. NRC Regional Supervisor         |      |   |   |     |   | \ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  |      |   |   |     |   | _ |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |      |   |   |     |   | \ |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   |   |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   |   |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
|                                     |      |   |   |     |   | \ |   |
|                                     |      |   |   |     |   | _ |   |
+-------------------------------------+------+---+---+-----+---+---+---+
| Note: \* The facility reviewer's    |      |   |   |     |   |   |   |
| initials/signature are not          |      |   |   |     |   |   |   |
| applicable for NRC-developed        |      |   |   |     |   |   |   |
| examinations.                       |      |   |   |     |   |   |   |
|                                     |      |   |   |     |   |   |   |
| \# Independent NRC reviewer initial |      |   |   |     |   |   |   |
| items in Column "c"; chief examiner |      |   |   |     |   |   |   |
| concurrence required.               |      |   |   |     |   |   |   |
+-------------------------------------+------+---+---+-----+---+---+---+

[]{#BM_21_ .anchor}**ES-401 Site-Specific RO Written Examination
[Form ES-401-7](../sr1020r9-sup1-final-forms-ms.doc#ES-401-7)**

**Cover Sheet**

+-----------------------------------+-----------------------------------+
| **U.S. Nuclear Regulatory         |                                   |
| Commission**                      |                                   |
|                                   |                                   |
| **Site-Specific RO Written        |                                   |
| Examination**                     |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Information**         |                                   |
+-----------------------------------+-----------------------------------+
| Name:                             |                                   |
+-----------------------------------+-----------------------------------+
| Date:                             | Facility/Unit:                    |
+-----------------------------------+-----------------------------------+
| Region: I                         | Reactor Type: W                   |
| ![](m                             | ![](media/image9.w                |
| edia/image8.wmf){width="0.1875in" | mf){width="0.20555555555555555in" |
| height="0.1875in"} II             | height="0.19652777777777777in"}   |
| ![](m                             | CE                                |
| edia/image8.wmf){width="0.1875in" | ![](media/image9.w                |
| height="0.1875in"} III            | mf){width="0.20555555555555555in" |
| ![](m                             | height="0.19652777777777777in"}   |
| edia/image8.wmf){width="0.1875in" | BW                                |
| height="0.1875in"} IV             | ![](media/image9.w                |
| ![](m                             | mf){width="0.20555555555555555in" |
| edia/image8.wmf){width="0.1875in" | height="0.19652777777777777in"}   |
| height="0.1875in"}                | GE                                |
|                                   | ![](media/image9.w                |
|                                   | mf){width="0.20555555555555555in" |
|                                   | height="0.19652777777777777in"}   |
+-----------------------------------+-----------------------------------+
| Start Time:                       | Finish Time:                      |
+-----------------------------------+-----------------------------------+
| **Instructions**                  |                                   |
|                                   |                                   |
| Use the answer sheets provided    |                                   |
| to document your answers. Staple  |                                   |
| this cover sheet                  |                                   |
| on top of the answer sheets. To   |                                   |
| pass the examination, you must    |                                   |
| achieve a final grade of at least |                                   |
| 80.00 percent. Examination papers |                                   |
| will be collected 6 hours after   |                                   |
| the examination begins.           |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Certification**       |                                   |
|                                   |                                   |
| All work done on this examination |                                   |
| is my own. I have neither given   |                                   |
| nor received aid.                 |                                   |
|                                   |                                   |
| \_\_\_\_\_                        |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| > Applicant's Signature           |                                   |
+-----------------------------------+-----------------------------------+
| **Results**                       |                                   |
+-----------------------------------+-----------------------------------+
| Examination Value                 |                                   |
| \_\_\_\_\_\_\_\_\_\_ Points       |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Score                 |                                   |
| \_\_\_\_\_\_\_\_\_\_ Points       |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Grade                 |                                   |
| \_\_\_\_\_\_\_\_\_\_ Percent      |                                   |
+-----------------------------------+-----------------------------------+

[]{#BM_22_ .anchor}**ES-401 Site-Specific SRO Written Examination
[Form ES-401-8](../sr1020r9-sup1-final-forms-ms.doc#ES-401-8)**

**Cover Sheet**

+-----------------------------------+-----------------------------------+
| **U.S. Nuclear Regulatory         |                                   |
| Commission**                      |                                   |
|                                   |                                   |
| **Site-Specific SRO Written       |                                   |
| Examination**                     |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Information**         |                                   |
+-----------------------------------+-----------------------------------+
| Name:                             |                                   |
+-----------------------------------+-----------------------------------+
| Date:                             | Facility/Unit:                    |
+-----------------------------------+-----------------------------------+
| Region: I                         | Reactor Type: W                   |
| ![](m                             | ![](media/image9.w                |
| edia/image8.wmf){width="0.1875in" | mf){width="0.20555555555555555in" |
| height="0.1875in"} II             | height="0.19652777777777777in"}   |
| ![](m                             | CE                                |
| edia/image8.wmf){width="0.1875in" | ![](media/image9.w                |
| height="0.1875in"} III            | mf){width="0.20555555555555555in" |
| ![](m                             | height="0.19652777777777777in"}   |
| edia/image8.wmf){width="0.1875in" | BW                                |
| height="0.1875in"} IV             | ![](media/image9.w                |
| ![](m                             | mf){width="0.20555555555555555in" |
| edia/image8.wmf){width="0.1875in" | height="0.19652777777777777in"}   |
| height="0.1875in"}                | GE                                |
|                                   | ![](media/image9.w                |
|                                   | mf){width="0.20555555555555555in" |
|                                   | height="0.19652777777777777in"}   |
+-----------------------------------+-----------------------------------+
| Start Time:                       | Finish Time:                      |
+-----------------------------------+-----------------------------------+
| **Instructions**                  |                                   |
|                                   |                                   |
| Use the answer sheets provided    |                                   |
| to document your answers. Staple  |                                   |
| this cover sheet                  |                                   |
| on top of the answer sheets. To   |                                   |
| pass the examination you must     |                                   |
| achieve a final grade of at least |                                   |
| 80.00 percent overall,            |                                   |
| with 70.00 percent or better      |                                   |
| on the SRO-only items             |                                   |
| if given in conjunction           |                                   |
| with the RO exam; SRO-only exams  |                                   |
| given alone require a final grade |                                   |
| of 80.00 percent to pass. You     |                                   |
| have 8 hours to complete          |                                   |
| the combined examination,         |                                   |
| and 3 hours if you are only       |                                   |
| taking the SRO portion.           |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Certification**       |                                   |
|                                   |                                   |
| All work done on this examination |                                   |
| is my own. I have neither given   |                                   |
| nor received aid.                 |                                   |
|                                   |                                   |
| \_\_\_\_\_                        |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| > Applicant's Signature           |                                   |
+-----------------------------------+-----------------------------------+
| **Results**                       |                                   |
+-----------------------------------+-----------------------------------+
| RO/SRO-Only/Total Examination     |                                   |
| Values / / Points                 |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Scores / / Points     |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Grade / / Percent     |                                   |
+-----------------------------------+-----------------------------------+

[]{#BM_23_ .anchor}**ES-401 Written Examination** **Review Worksheet
[Form ES-401-9](../sr1020r9-sup1-final-forms-ms.doc#ES-401-9)**

<table style="width:100%;">
<colgroup>
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 37%" />
</colgroup>
<thead>
<tr class="header">
<th rowspan="2">Q#</th>
<th rowspan="2"><p>1.</p>
<p>LOK</p>
<p>(F/H)</p></th>
<th rowspan="2"><p>2.</p>
<p>LOD</p>
<p>(1-5)</p></th>
<th colspan="5">3. Psychometric Flaws</th>
<th colspan="4">4. Job Content Flaws</th>
<th colspan="2">5. Other</th>
<th rowspan="2"><p>6.</p>
<p>B/M/N</p></th>
<th rowspan="2"><p>7.</p>
<p>U/E/S</p></th>
<th rowspan="2"><p>8.</p>
<p>Explanation</p></th>
</tr>
<tr class="odd">
<th><p>Stem</p>
<p>Focus</p></th>
<th>Cues</th>
<th>T/F</th>
<th><p>Cred.</p>
<p>Dist.</p></th>
<th>Partial</th>
<th>Job-Link</th>
<th>Minutia</th>
<th><p>#/</p>
<p>units</p></th>
<th>Back-ward</th>
<th><p>Q=</p>
<p>K/A</p></th>
<th><p>SRO</p>
<p>Only</p></th>
</tr>
</thead>
<tbody>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| Instructions                                                          |
|                                                                       |
| \[Refer to Section D of ES-401 and Appendix B for additional          |
| information regarding each of the following concepts.\]               |
|                                                                       |
| 1.  Enter the level of knowledge (LOK) of each question as either     |
|     (F)undamental or (H)igher cognitive level.                        |
|                                                                       |
| 2.  Enter the level of difficulty (LOD) of each question using a 1 -- |
|     5 (easy -- difficult) rating scale (questions in the 2 -- 4 range |
|     are acceptable).                                                  |
|                                                                       |
| 3.  Check the appropriate box if a psychometric flaw is identified:   |
|                                                                       |
| -   The stem lacks sufficient focus to elicit the correct answer      |
|     (e.g., unclear intent, more information is needed, or too much    |
|     needless information).                                            |
|                                                                       |
| -   The stem or distractors contain cues (i.e., clues, specific       |
|     determiners, phrasing, length, etc).                              |
|                                                                       |
| -   The answer choices are a collection of unrelated true/false       |
|     statements.                                                       |
|                                                                       |
| -   The distractors are not credible; single implausible distractors  |
|     should be repaired, more than one is unacceptable.                |
|                                                                       |
| -   One or more distractors is (are) partially correct (e.g., if      |
|     the applicant can make unstated assumptions that are not          |
|     contradicted by stem).                                            |
|                                                                       |
|     4\. Check the appropriate box if a job content error is           |
|     identified:                                                       |
|                                                                       |
| -   The question is not linked to the job requirements                |
|     (i.e., the question has a valid K/A but, as written, is not       |
|     operational in content).                                          |
|                                                                       |
| -   The question requires the recall of knowledge that is too         |
|     specific for the closed reference test mode (i.e., it is not      |
|     required to be known from memory).                                |
|                                                                       |
| -   The question contains data with an unrealistic level of accuracy  |
|     or inconsistent units (e.g., panel meter in percent with question |
|     in gallons).                                                      |
|                                                                       |
| -   The question requires reverse logic or application compared       |
|     to the job requirements.                                          |
|                                                                       |
|     5\. [Check questions that are sampled]{.underline}                |
|     for conformance with the approved K/A and those that are          |
|     *designated SRO-only* (K/A and license level mismatches are       |
|     unacceptable).                                                    |
|                                                                       |
|     6\. Enter question source: (B)ank, (M)odified, or (N)ew. Check    |
|     that (M)odified questions meet criteria of ES-401 Section D.2.f.  |
|                                                                       |
|     7\. Based on the reviewer's judgment, is the question as written  |
|     (U)nsatisfactory (requiring repair or replacement), in need       |
|     of (E)ditorial enhancement, or (S)atisfactory?                    |
|                                                                       |
|     8\. At a minimum, explain any "U" ratings (e.g., how              |
|     the Appendix B psychometric attributes are not being met).        |
+-----------------------------------------------------------------------+

**ES-401 2
[Form ES-401-9](../sr1020r9-sup1-final-forms-ms.doc#ES-401-9)**

<table style="width:100%;">
<colgroup>
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 38%" />
</colgroup>
<thead>
<tr class="header">
<th rowspan="2">Q#</th>
<th rowspan="2"><p>1.</p>
<p>LOK</p>
<p>(F/H)</p></th>
<th rowspan="2"><p>2.</p>
<p>LOD</p>
<p>(1-5)</p></th>
<th colspan="5">3. Psychometric Flaws</th>
<th colspan="4">4. Job Content Flaws</th>
<th colspan="2">5. Other</th>
<th rowspan="2"><p>6.</p>
<p>B/M/N</p></th>
<th rowspan="2"><p>7.</p>
<p>U/E/S</p></th>
<th rowspan="2"><p>8.</p>
<p>Explanation</p></th>
</tr>
<tr class="odd">
<th><p>Stem</p>
<p>Focus</p></th>
<th>Cues</th>
<th>T/F</th>
<th><p>Cred.</p>
<p>Dist.</p></th>
<th>Partial</th>
<th>Job-Link</th>
<th>Minutia</th>
<th><p>#/</p>
<p>units</p></th>
<th>Back-ward</th>
<th><p>Q=</p>
<p>K/A</p></th>
<th><p>SRO</p>
<p>Only</p></th>
</tr>
</thead>
<tbody>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
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<td></td>
<td></td>
<td></td>
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<td></td>
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<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
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</tr>
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</tr>
<tr class="odd">
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</tr>
<tr class="even">
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<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
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</tr>
<tr class="even">
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</tr>
<tr class="odd">
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<td></td>
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</tr>
<tr class="even">
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<td></td>
<td></td>
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<td></td>
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</tr>
<tr class="odd">
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<tr class="even">
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</tr>
<tr class="even">
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</tr>
<tr class="odd">
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</tr>
<tr class="odd">
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<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

[]{#BM_24_ .anchor}**ES-403 Written Examination Grading [Form
ES-403-1](../sr1020r9-sup1-final-forms-ms.doc#ES-403-1)**

**Quality Checklist**

+-----------------------------------------------------+-----+----+-----+
| Facility: Date of Exam: Exam Level: RO              |     |    |     |
| !                                                   |     |    |     |
| [](media/image10.wmf){width="0.21458333333333332in" |     |    |     |
| height="0.1875in"} SRO                              |     |    |     |
| !                                                   |     |    |     |
| [](media/image10.wmf){width="0.21458333333333332in" |     |    |     |
| height="0.1875in"}                                  |     |    |     |
+-----------------------------------------------------+-----+----+-----+
| Item Description                                    | In  |    |     |
|                                                     | iti |    |     |
|                                                     | als |    |     |
+-----------------------------------------------------+-----+----+-----+
|                                                     | a   | b  | c   |
+-----------------------------------------------------+-----+----+-----+
| 1.  Clean answer sheets copied before grading       |     |    |     |
+-----------------------------------------------------+-----+----+-----+
| 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%        |     |    |     |
| overall and 70 or 80, as applicable, ±4% on the     |     |    |     |
| SRO-only) reviewed in detail                        |     |    |     |
+-----------------------------------------------------+-----+----+-----+
| 5\. All other failing examinations checked to       |     |    |     |
| ensure that grades are justified                    |     |    |     |
+-----------------------------------------------------+-----+----+-----+
| 6\. Performance on missed questions checked for     |     |    |     |
| training deficiencies and wording problems;         |     |    |     |
| evaluate validity of questions missed by half or    |     |    |     |
| more of the applicants                              |     |    |     |
+-----------------------------------------------------+-----+----+-----+
| Printed Name/Signature                              |     | Da |     |
|                                                     |     | te |     |
+-----------------------------------------------------+-----+----+-----+
| a\. Grader                                          |     | \_ |     |
| \_\_\_\_\_\_\_\                                     |     | \_ |     |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     | \_ |     |
|                                                     |     | \_ |     |
| b\. Facility Reviewer(\*)                           |     | \_ |     |
| \_\_\_\_\_\_\_\                                     |     | \_ |     |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     | \_ |     |
|                                                     |     | \_ |     |
| c\. NRC Chief Examiner (\*)                         |     | \_ |     |
| \_\_\_\_\_\_\_\                                     |     |    |     |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     | \_ |     |
|                                                     |     | \_ |     |
| d\. NRC Supervisor (\*)                             |     | \_ |     |
| \_\_\_\_\_\_\_\                                     |     | \_ |     |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     |    |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     |    |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
|                                                     |     | \_ |     |
+-----------------------------------------------------+-----+----+-----+
| (\*) The facility reviewer's signature is not       |     |    |     |
| applicable for examinations graded by the NRC; two  |     |    |     |
| independent NRC reviews are required.               |     |    |     |
+-----------------------------------------------------+-----+----+-----+

[]{#BM_25_ .anchor}**ES-501 Post-Examination Check Sheet [Form
ES-501-1](../sr1020r9-sup1-final-forms-ms.doc#ES-501-1)**

  ------------------------------------------------------ ----------------
  **Post-Examination Check Sheet**                       

  **Facility: Date of Examination:**                     

  **Task Description**                                   **Date
                                                         Complete**

  1\. Facility written exam comments or graded exams     
  received and verified complete                         

  2\. Facility written exam comments reviewed and        
  incorporated and NRC grading completed, if necessary   

  3\. Operating tests graded by NRC examiners            

  4\. NRC chief examiner review of operating test and    
  written exam grading completed                         

  5\. Responsible supervisor review completed            

  6\. Management (licensing official) review completed   

  7\. License and denial letters mailed                  

  8\. Facility notified of results                       

  9\. Examination report issued (refer to NRC MC 0612)   

  10\. Reference material returned after final           
  resolution of any appeals                              
  ------------------------------------------------------ ----------------

[]{#BM_26_ .anchor}**ES-501 Power Plant Examination Results Summary
[Form ES-501-2](../sr1020r9-sup1-final-forms-ms.doc#ES-501-2)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

<table style="width:100%;">
<colgroup>
<col style="width: 20%" />
<col style="width: 8%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 8%" />
<col style="width: 20%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 5%" />
<col style="width: 9%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><strong>Power Plant Examination Results
Summary</strong></td>
</tr>
<tr class="even">
<td colspan="5">Facility:</td>
<td colspan="5">Plant Status: Hot <img src="media/image11.wmf"
style="width:0.20208in;height:0.1875in" /> Cold <img
src="media/image12.wmf" style="width:0.20208in;height:0.1875in" /></td>
</tr>
<tr class="odd">
<td colspan="5"><p>Written Examination Date:</p>
<p>Prepared by: Facility <img src="media/image13.wmf"
style="width:0.20556in;height:0.1875in" /> NRC <img
src="media/image13.wmf"
style="width:0.20556in;height:0.1875in" /></p></td>
<td colspan="5"><p>Operating Test Date(s):</p>
<p>Prepared by: Facility <img src="media/image13.wmf"
style="width:0.20556in;height:0.1875in" /> NRC <img
src="media/image13.wmf"
style="width:0.20556in;height:0.1875in" /></p></td>
</tr>
<tr class="even">
<td colspan="10">NRC Examiners:</td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Overall Results</strong></td>
</tr>
<tr class="even">
<td colspan="3">Applicants: Total #</td>
<td colspan="2"># Passed</td>
<td>% Passed</td>
<td colspan="2"># Failed</td>
<td colspan="2">% Failed</td>
</tr>
<tr class="odd">
<td>RO</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>SRO</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="10"><strong>Individual Results</strong></td>
</tr>
<tr class="even">
<td colspan="2" rowspan="2">Name</td>
<td colspan="2" rowspan="2"><p>Docket #</p>
<p>55-( )</p></td>
<td rowspan="2">Type (1)</td>
<td rowspan="2"><p>Written Grade</p>
<p>RO / SRO / TOT</p></td>
<td colspan="4">Operating Test(2)</td>
</tr>
<tr class="odd">
<td>W-T</td>
<td colspan="2">ADM</td>
<td>SIM</td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td>/ /</td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="10"><p>NOTES:</p>
<p>(1) 1=RO; 2=SRO-I; 3=SRO-U; 4=RO-Retake; 5=SRO-I-Retake;
6=SRO-U-Retake; 7=SRO-Fuel</p>
<p>(2) P=Passed; F=Failed; W=Waived</p></td>
</tr>
</tbody>
</table>

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

**ES-501 2 [Form
ES-501-2](../sr1020r9-sup1-final-forms-ms.doc#ES-501-2)**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+-------------------+---------+-----+-------------+-----+-----+-----+
| **Power Plant     |         |     |             |     |     |     |
| Examination       |         |     |             |     |     |     |
| Results Summary** |         |     |             |     |     |     |
|                   |         |     |             |     |     |     |
| **(Continuation   |         |     |             |     |     |     |
| Sheet)**          |         |     |             |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
| Facility:         |         |     |             |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
| Examination       |         |     |             |     |     |     |
| Date(s):          |         |     |             |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
| **Individual      |         |     |             |     |     |     |
| Results**         |         |     |             |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
| Name              | Docket  | T   | Written     | Ope |     |     |
|                   | \#      | ype | Grade       | rat |     |     |
|                   |         |     |             | ing |     |     |
|                   | 55-( )  | \(  | RO / SRO /  | T   |     |     |
|                   |         | 1\) | TOT         | est |     |     |
|                   |         |     |             | (2) |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     |             | W-T | ADM | SIM |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
|                   |         |     | / /         |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+
| NOTES:            |         |     |             |     |     |     |
|                   |         |     |             |     |     |     |
| \(1\) 1=RO;       |         |     |             |     |     |     |
| 2=SRO-I; 3=SRO-U; |         |     |             |     |     |     |
| 4=RO-Retake;      |         |     |             |     |     |     |
| 5=SRO-I-Retake;   |         |     |             |     |     |     |
| 6=SRO-U-Retake;   |         |     |             |     |     |     |
| 7=SRO-Fuel        |         |     |             |     |     |     |
|                   |         |     |             |     |     |     |
| \(2\) P=Passed;   |         |     |             |     |     |     |
| F=Failed;         |         |     |             |     |     |     |
| W=Waived          |         |     |             |     |     |     |
+-------------------+---------+-----+-------------+-----+-----+-----+

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

[]{#BM_27_ .anchor}**ES-601 Examination Security Agreement
[Form ES-601-1](../sr1020r9-sup1-final-forms-ms.doc#ES-601-1)**

**1. [Pre-Examination]{.underline}**

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

**2. [Post-Examination]{.underline}**

To the best of my knowledge, I did not divulge to any unauthorized
persons any information concerning the NRC requalification 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 operators who were administered these examinations,
except as specifically noted below and authorized by the NRC.

PRINTED NAME JOB TITLE / RESPONSIBILITY SIGNATURE (1) DATE SIGNATURE (2)
DATE

1\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

2\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

3\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

4\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

5\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

6\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

7\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

8\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

9\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

10.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

11.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

12.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

13.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

14.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

15.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_

NOTES:

[]{#BM_28_ .anchor}**ES-601 Evaluation Checklist
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

**for Facility Reference Material**

The following checklist represents the minimum content
of facility-generated reference material. Items marked "optional" should
be checked if requested from the facility licensee
by the chief examiner. The chief examiner or designee may use
this checklist to make a quick, general evaluation of the completeness
and adequacy of the facility licensee's references. The chief examiner
may resolve any specific questions about the references with
the facility staff as necessary.

I. [Quantity]{.underline}

> Actual
>
> [Reference Material]{.underline} [Required Minimum]{.underline}
> [Submitted]{.underline}

A. Open-reference written 350 per section;

> examination items bank is to be dynamic,
>
> With at least 150 revised,
>
> reviewed, or newly generated
>
> questions per year

B. Simulator scenarios 25; + 5 per year following

> the initial requalification exam
>
> until at least 30 scenarios
>
> covering all aspects of the EOPs
>
> are developed

C. Job performance 95; + 10 per year following

> measures the initial requalification exam
>
> until the JTA is fully covered

D. Technical specifications 1 copy

E. Applicable 1 set (optional)

> plant procedures

F. Emergency plan 1 copy

G. Applicable 1 copy (optional)

> administrative procedures

H. Sample plan 1 copy

I. Requalification cycle 1 set (optional)

> training reference material
>
> (lesson plans, handouts, etc.)

J. Appropriate sections 1 set (optional)

> of JTA or facility-specific
>
> K/A Catalog

Reviewed by:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-601 2
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

II\. [Usability]{.underline}

[Circle one]{.underline}

A. The reference material is legible. yes no

B. The reference material is properly arranged and labeled for its
function. yes no

C. The reference material indicates a SAT program. yes no

D. Reference material is available to verify that test items
are appropriate, job relevant, and technically accurate. yes no

E. Reference material is available to adequately support the examination
topics. yes no

[Comments]{.underline}

Reviewed by:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-601 3
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

III\. [Quality]{.underline}

[Exam Section]{.underline} [Required Standards]{.underline}
[Comments]{.underline}

A. Sample Plan Subjects covered in requalification cycle

> are identified.
>
> The test outline incorporates:

-   time spent on topic

-   relative importance

-   frequency of performance

-   job level (RO or SRO)

    The test outline identifies

    K/As (or facility equivalent)

    of sufficient importance.

    Plant-specific priorities are identified

    (LERs, procedure changes,

    system modifications, risk-dominant

    accident scenarios, risk-important

    systems and operator actions[^1] identified

    in the facility licensee's PRA/IPE, etc.).

    Appropriate testing methods

    are indicated for each K/A

    (i.e., JPM, written exam, and/or simulator).

    Applicable learning objectives

    are associated with K/As.

    Methodology exists to tie

    test items to a learning objective

    and a K/A.

    Sample plan includes important

    important topics not covered in

    the requalification cycle.

    Test areas appropriate to ROs

    and SROs only are identified.

    Reviewed by:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-601 4
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

III\. [Quality]{.underline} (cont.)

[Exam Section]{.underline} [Required Standards]{.underline}
[Comments]{.underline}

B. Written At least 10 percent of all

> test items shall be reviewed
>
> using Form ES-602-1.
>
> Test items are important to safety.
>
> Test items are clearly written.
>
> Test items are appropriate
>
> to license level.
>
> The criteria for open-reference
>
> examinations are met.
>
> Test items are associated
>
> with K/As of 3 or greater
>
> and are adequate discriminators.
>
> A learning objective
>
> and applicable reference
>
> are identified for each test item.
>
> The facility has identified
>
> SRO-level questions
>
> for both sections of the exam.

If the above criteria are not adequately met, the NRC will conduct
further review of the examination bank utilizing ES-602, Attachment 1,
"Guidelines for the Development and Review of Open-Reference
Examinations," and Form ES-602-1, "NRC Checklist for Open-Reference Test
Items."

Reviewed by:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-601 5
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

III\. [Quality]{.underline} (cont.)

[Exam Section]{.underline} [Required Standards]{.underline}
[Comments]{.underline}

C. Walk-Through At least 10 percent of the JPM bank

> were reviewed using Form ES-C-2.
>
> Test outline identifies
>
> applicable plant systems:

-   systems covered in

    requalification cycle

-   new or recently modified systems

-   systems in recent facility LERs

    or vendor notices

-   PRA-identified risk-dominant systems

-   systems in NRC generic

    communications

    Tasks/abilities for identified systems:

-   are applicable to the facility

-   are at the AO/RO/SRO level

-   have a K/A value of 3 or greater

-   include JPMs pertinent only to SROs

    Some JPMs are performed

    under low-power or shutdown

    operating conditions.

    Some JPMs require the operator

    to implement alternative paths

    within the facility licensee's

    procedures.

    Facility JPMs contain

    the information found on Form ES-C-1.

    Reviewed by:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-601 6
[Form ES-601-2](../sr1020r9-sup1-final-forms-ms.doc#ES-601-2)**

III\. [Quality]{.underline} (cont.)

[Exam Section]{.underline} [Required Standards]{.underline}
[Comments]{.underline}

D. Simulator At least 10 percent of the scenarios

> reviewed using Form ES-604-1.
>
> Scenarios are an appropriate
>
> measure of the material
>
> covered in the sample plan.
>
> Scenarios are based on:

-   lessons covered in the requal cycle

-   recent industry events

-   LERs

-   emergency and abnormal procedures

-   design and procedural changes

    Scenarios exercise crew's ability

    to use facility procedures

    in accident prevention and mitigation.

    Scenario events

    have a K/A of 3 or greater.

    Some scenarios are based on 

    low-power[^2] operations.

    Some scenarios are based on 

    the dominant accident sequences (DAS)

    for the facility as determined by PRA/IPE.

    Scenario identifies critical tasks

    that meet the criteria of Appendix D.

    Proposed examination scenarios

    that were used for training

    during the most recent training cycle

    have been reviewed by the NRC

    and replaced or modified, if appropriate,

    to ensure the validity of the examination

    and to minimize the potential

    for examination compromise.

    Reviewed by:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_   

[]{#BM_29_ .anchor}**ES-601 Power Plant Requalification Results Summary
Sheet [Form ES-601-3](../sr1020r9-sup1-final-forms-ms.doc#ES-601-3)**

**Privacy Information --- For Official Use Only**

  ------------------------------- ----------------- ------- --------- --------
  Facility:                       Overall Results   Total   Passed    Failed

  Exam Date:                                        \#      \# / %    \# / %

  NRC Examiners:                  Reactor Operator:                   

                                  Senior Operator:                    

                                  Total:                              

                                  Operating Crews:                    
  ------------------------------- ----------------- ------- --------- --------

+----------------------+-------+-----+---+-----+-----+---+----+-----+
| Operator             | D     | Gra | J | W   | R   |   |    |     |
|                      | ocket | der | P | rit | esu |   |    |     |
|                      |       |     | M | ten | lts |   |    |     |
|                      | 55-(  |     | s |     | (P  |   |    |     |
|                      | )     |     |   | (A  | or  |   |    |     |
|                      |       |     | \ | &   |  F) |   |    |     |
|                      |       |     | % | B)  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       |     |   |     | W   | S |    | W/T |
|                      |       |     |   |     | rit | i |    |     |
|                      |       |     |   |     | ten | m |    |     |
|                      |       |     |   |     |     | u |    |     |
|                      |       |     |   |     |     | l |    |     |
|                      |       |     |   |     |     | a |    |     |
|                      |       |     |   |     |     | t |    |     |
|                      |       |     |   |     |     | o |    |     |
|                      |       |     |   |     |     | r |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       |     |   |     |     | C | I  |     |
|                      |       |     |   |     |     | r | nd |     |
|                      |       |     |   |     |     | e | iv |     |
|                      |       |     |   |     |     | w |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+

[]{#BM_30_ .anchor}**ES-601 Power Plant Requalification Results
Continuation Sheet
[Form ES-601-4](../sr1020r9-sup1-final-forms-ms.doc#ES-601-4)**

**Privacy Information --- For Official Use Only**

+----------------------+-------+-----+---+-----+-----+---+----+-----+
| Operator             | D     | Gra | J | W   | R   |   |    |     |
|                      | ocket | der | P | rit | esu |   |    |     |
|                      |       |     | M | ten | lts |   |    |     |
|                      | 55-(  |     | s |     | (P  |   |    |     |
|                      | )     |     |   | (A  | or  |   |    |     |
|                      |       |     | \ | &   |  F) |   |    |     |
|                      |       |     | % | B)  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       |     |   |     | W   | S |    | W/T |
|                      |       |     |   |     | rit | i |    |     |
|                      |       |     |   |     | ten | m |    |     |
|                      |       |     |   |     |     | u |    |     |
|                      |       |     |   |     |     | l |    |     |
|                      |       |     |   |     |     | a |    |     |
|                      |       |     |   |     |     | t |    |     |
|                      |       |     |   |     |     | o |    |     |
|                      |       |     |   |     |     | r |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       |     |   |     |     | C | I  |     |
|                      |       |     |   |     |     | r | nd |     |
|                      |       |     |   |     |     | e | iv |     |
|                      |       |     |   |     |     | w |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | NRC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+
|                      |       | FAC |   | \%  |     |   |    |     |
+----------------------+-------+-----+---+-----+-----+---+----+-----+

[]{#BM_31_ .anchor}**ES-601 Individual Requalification Examination
Report [Form ES-601-5](../sr1020r9-sup1-final-forms-ms.doc#ES-601-5)**

+----------------------+---+---------------------+------------------------+
| **U.S. Nuclear       |   |                     |                        |
| Regulatory           |   |                     |                        |
| Commission**         |   |                     |                        |
|                      |   |                     |                        |
| **Individual         |   |                     |                        |
| Requalification      |   |                     |                        |
| Examination Report** |   |                     |                        |
|                      |   |                     |                        |
| (Privacy Information |   |                     |                        |
| --- For Official Use |   |                     |                        |
| Only)                |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Facility:            | O |                     |                        |
|                      | p |                     |                        |
|                      | e |                     |                        |
|                      | r |                     |                        |
|                      | a |                     |                        |
|                      | t |                     |                        |
|                      | o |                     |                        |
|                      | r |                     |                        |
|                      | ' |                     |                        |
|                      | s |                     |                        |
|                      | N |                     |                        |
|                      | a |                     |                        |
|                      | m |                     |                        |
|                      | e |                     |                        |
|                      | : |                     |                        |
+----------------------+---+---------------------+------------------------+
| Docket No: 55-       | L |                     | Expiration Date:       |
|                      | i |                     |                        |
|                      | c |                     |                        |
|                      | e |                     |                        |
|                      | n |                     |                        |
|                      | s |                     |                        |
|                      | e |                     |                        |
|                      | N |                     |                        |
|                      | o |                     |                        |
|                      | : |                     |                        |
+----------------------+---+---------------------+------------------------+
| Exam Type: RO / SRO  | R |                     | Date of Last Exam:     |
|                      | e |                     |                        |
|                      | t |                     |                        |
|                      | a |                     |                        |
|                      | k |                     |                        |
|                      | e |                     |                        |
|                      | : |                     |                        |
|                      | 1 |                     |                        |
|                      | s |                     |                        |
|                      | t |                     |                        |
|                      | / |                     |                        |
|                      | 2 |                     |                        |
|                      | n |                     |                        |
|                      | d |                     |                        |
|                      | / |                     |                        |
|                      | N |                     |                        |
|                      | o |                     |                        |
+----------------------+---+---------------------+------------------------+
| **Written            |   |                     |                        |
| Examination          |   |                     |                        |
| Results**            |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Date(s) of Exam:     |   | NRC Examiner        | Facility Evaluator     |
|                      |   | (Print):            | (Print):               |
+----------------------+---+---------------------+------------------------+
| Section A (Points)   |   | **NRC Grading**     | **Facility Grading**   |
+----------------------+---+---------------------+------------------------+
|                      |   | of                  | of                     |
+----------------------+---+---------------------+------------------------+
| Section B (Points)   |   | of                  | of                     |
+----------------------+---+---------------------+------------------------+
| Overall Score (%)    |   | \%                  | \%                     |
+----------------------+---+---------------------+------------------------+
| **Simulator          |   |                     |                        |
| Examination          |   |                     |                        |
| Results**            |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Date(s) of Exam:     |   | NRC Examiner(s)     | Facility Evaluator(s)  |
|                      |   | (Print):            | (Print):               |
+----------------------+---+---------------------+------------------------+
| Crew Evaluation      |   | Pass / Fail         | Pass / Fail            |
+----------------------+---+---------------------+------------------------+
| Individual Followup  |   | Pass / Fail / NA    | Pass / Fail / NA       |
+----------------------+---+---------------------+------------------------+
| **Walk-Through       |   |                     |                        |
| Examination          |   |                     |                        |
| Results**            |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Date(s) of Exam:     |   | NRC Examiner(s)     | Facility Evaluator(s)  |
|                      |   | (Print):            | (Print):               |
+----------------------+---+---------------------+------------------------+
| No. of Successful    |   | of  5               | of  5                  |
| JPMs                 |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Exam Results (%)     |   | \%                  | \%                     |
+----------------------+---+---------------------+------------------------+
| **NRC Examiner       |   |                     |                        |
| Recommendations**    |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Category             |   | Results             | Signature/Date         |
+----------------------+---+---------------------+------------------------+
| Written              |   | Pass / Fail         |                        |
+----------------------+---+---------------------+------------------------+
| Simulator            |   | Pass / Fail         |                        |
+----------------------+---+---------------------+------------------------+
| Walk-Through         |   | Pass / Fail         |                        |
+----------------------+---+---------------------+------------------------+
| **NRC Supervisor     |   |                     |                        |
| Review**             |   |                     |                        |
+----------------------+---+---------------------+------------------------+
| Date:                |   | Pass / Fail         | Signature:             |
+----------------------+---+---------------------+------------------------+

[]{#BM_32_ .anchor}**ES-602 NRC Checklist
[Form ES-602-1](../sr1020r9-sup1-final-forms-ms.doc#ES-602-1)**

**for Open-Reference Test Items**

**[Test Item Level]{.underline}**

\_\_\_\_ 1. Does each test item have a documented link to important
operator tasks, K/As, and/or facility learning objectives?

\_\_\_\_ 2. Is each question operationally oriented (i.e., is there
a correlation between job demands and test demands)?

\_\_\_\_ 3. Is the question at least at the comprehension-level
of knowledge?

\_\_\_\_ 4. Is the context of the questions realistic and free of window
dressing and backward logic?

\_\_\_\_ 5. Does the item require an appropriate use of references
(i.e., use of analysis skills or synthesis of information either
to discern what procedures are applicable or to consult the procedures
to obtain the answer)?

\_\_\_\_ 6. Is the question a "direct lookup" question, or does one
question on the examination compromise another? A "direct lookup"
question is defined as a question that only requires the examinee
to recall where to find the answer.

\_\_\_\_ 7. Does the question possess a high K/A importance factor (3.0
or greater) for the job position?

\_\_\_\_ 8. Does the question discriminate a competent operator from one
who is not?

\_\_\_\_ 9. Is the question appropriate for the written examination
and the selected format (e.g., short answer or multiple choice)?

\_\_\_\_ 10. Do questions in Section A take advantage of the simulator
control room setting?

\_\_\_\_ 11. Does any question have the potential of being
a "double-jeopardy" question?

\_\_\_\_ 12. Is the question clear, precise, and easy to read
and understand?

\_\_\_\_ 13. Is there only one correct answer to each question?

\_\_\_\_ 14. Does the question pose situations and problems other than
those presented during training?

\_\_\_\_ 15. Does the question have a reasonable estimated response
time?

[]{#BM_33_ .anchor}**ES-602 Written Requalification Examination
[Form ES-602-2](../sr1020r9-sup1-final-forms-ms.doc#ES-606-2)**

**Cover Sheet**

+-----------------------------------+-----------------------------------+
| **U. S. Nuclear Regulatory        |                                   |
| Commission**                      |                                   |
|                                   |                                   |
| **Written Requalification         |                                   |
| Examination**                     |                                   |
+-----------------------------------+-----------------------------------+
| **Operator Information**          |                                   |
+-----------------------------------+-----------------------------------+
| Name:                             |                                   |
+-----------------------------------+-----------------------------------+
| Date:                             | Region: I / II / III / IV         |
+-----------------------------------+-----------------------------------+
| Facility/Unit:                    | Reactor Type: W / CE / BW / GE    |
+-----------------------------------+-----------------------------------+
| Start Time:                       | Stop Time:                        |
+-----------------------------------+-----------------------------------+
| **Instructions**                  |                                   |
|                                   |                                   |
| Use the answer sheets provided    |                                   |
| to document your answers. Staple  |                                   |
| this cover sheet                  |                                   |
| on top of the answer sheets.      |                                   |
| Points for each question are      |                                   |
| indicated in parentheses          |                                   |
| after the question. The passing   |                                   |
| grade is 80.00 percent. You have  |                                   |
| a total of 3 hours to complete    |                                   |
| both sections of the examination. |                                   |
+-----------------------------------+-----------------------------------+
| **Operator Certification**        |                                   |
|                                   |                                   |
| All work done on this examination |                                   |
| is my own. I have neither given   |                                   |
| nor received aid.                 |                                   |
|                                   |                                   |
| \_\_\_\_\_                        |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| Operator's Signature              |                                   |
+-----------------------------------+-----------------------------------+
| **Results**                       |                                   |
+-----------------------------------+-----------------------------------+
| Test Value (Points) Section A:    |                                   |
| \_\_\_\_\_\_\_\_\_\_              |                                   |
|                                   |                                   |
| Section B: \_\_\_\_\_\_\_\_\_\_   |                                   |
|                                   |                                   |
| TOTAL: \_\_\_\_\_\_\_\_\_\_       |                                   |
+-----------------------------------+-----------------------------------+
| Operator's Score (Points)         |                                   |
| Section A: \_\_\_\_\_\_\_\_\_\_   |                                   |
|                                   |                                   |
| Section B: \_\_\_\_\_\_\_\_\_\_   |                                   |
|                                   |                                   |
| TOTAL: \_\_\_\_\_\_\_\_\_\_       |                                   |
+-----------------------------------+-----------------------------------+
| Operator's Grade (Combined)       |                                   |
| \_\_\_\_\_\_\_\_\_\_ Percent      |                                   |
+-----------------------------------+-----------------------------------+

[]{#BM_34_ .anchor}**ES-603 JPM Summary Matrix [Form
ES-603-1](../sr1020r9-sup1-final-forms-ms.doc#ES-603-1)**

  ------------------------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --
  **Operators' Names \>\>\>**                                               

  **JPM Number/Brief                                                        
  Description**                                                             

  1\.                                                                       

  2\.                                                                       

  3\.                                                                       

  4\.                                                                       

  5\.                                                                       

  6\.                                                                       

  7\.                                                                       

  8\.                                                                       

  9\.                                                                       

  10\.                                                                      

  11\.                                                                      

  12\.                                                                      

  13\.                                                                      

  14\.                                                                      

  15\.                                                                      
  ------------------------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

[]{#BM_35_ .anchor}**ES-604 Simulator Scenario Review Checklist [Form
ES-604-1](../sr1020r9-sup1-final-forms-ms.doc#ES-604-1)**

***Note: Attach a separate copy of this form to each scenario reviewed.
The examination team uses this form as guidance as they conduct their
review of the proposed scenarios.***

**SCENARIO IDENTIFIER: REVIEWER: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**[Qualitative Attributes]{.underline}**

1\. The scenario summary clearly states the objectives of the scenario.

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

3\. The scenario consists mostly of related events.

4\. 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

    5\. 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.

    6\. The events are valid with regard to physics and thermodynamics.

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

    8\. 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.

    9\. The simulator modeling is not altered.

    10\. All crew competencies can be evaluated.

    11\. The scenario has been validated.

    12\. If the sampling plan indicates that the scenario was used for
    training during the requalification cycle, the need to modify or
    replace the scenario has been evaluated.

**ES-604 2 [Form
ES-604-1](../sr1020r9-sup1-final-forms-ms.doc#ES-604-1)**

**Simulator Scenario Review Checklist (Continued)**

**Note: The following criteria address scenario traits that are
numerical in nature. A second set of numbers indicates a range to be met
for a set of two scenarios. Therefore, to complete this part of the
review, the set of scenarios must be available. This page should be
completed once per scenario set.**

**Scenario Set Consists of Scenario [             ]{.underline} and
Scenario [               ]{.underline}**

**[Quantitative Attributes]{.underline}**

13\. total malfunctions inserted: 4 to 8/10 to 14

14\. malfunctions that occur after EOP entry: 1 to 4/3 to 6

15\. abnormal events: 1 to 2/2 to 3

16\. major transients: 1 to 2/2 to 3

17\. EOPs used beyond primary scram response EOP: 1 to 3/3 to 5

18\. EOP contingency procedures used: 0 to 3/1 to 3

19\. approximate scenario run time: 45 to 60 minutes
(one scenario may approach 90 minutes)

20\. EOP run time: 40 to 70 percent of scenario run time

21\. crew critical tasks: 2 to 5/5 to 8

22\. technical specifications are exercised during the test

COMMENTS: [         ]{.underline}

> [        ]{.underline}
>
> [        ]{.underline}
>
> [         ]{.underline}

[]{#BM_36_ .anchor}**ES-604 Simulator Crew Evaluation Form [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

The examination team should use this evaluation form during the dynamic
simulator component of the requalification examination. The rating
scales on this form are for evaluating the crew as a whole, rather than
the individual operators. Use the following instructions when rating
team performance on the simulator examination:

1\. Review the rating scales before the simulator examination so that
you are familiar with each competency to be evaluated.

2\. Use Form ES-D-2, "Required Operator Actions," or an equivalent
facility form to make notes during the examination, as described in
Appendix D and ES-302, "Administering Operating Tests to Initial License
Applicants."

3\. Complete this form immediately after the simulator examination.
Evaluate the crew's performance on each applicable rating factor by
comparing the actions of the crew against the associated behavioral
anchors and selecting the appropriate grade. The tasks planned and
performed during the crew's scenario set may not permit you to evaluate
every rating factor for every crew. Annotate those rating factors
that are not used in the evaluation.

> The examination team should pay particular attention to the completion
> of tasks that they identified as critical to plant safety. The crew
> may compensate for actions that individual operators performed
> incorrectly, as long as the critical task was completed
> satisfactorily. Other less-significant deficiencies should also be
> accounted for in the rating factor evaluations to provide a source of
> information for crew remedial training during subsequent
> requalification training.

4\. Justify all rating factor grades of "1," and document each
justification in the space for "Comments" on the form. Rating factor
grades of "1" must be linked to the performance of at least one critical
task.

5\. Complete the examination summary sheet, recording for each scenario,
the scenario name (or identifier), and the critical tasks performed by
the crew. Annotate whether the critical task was performed
satisfactorily or unsatisfactorily. Complete the crew's overall
evaluation using the criteria listed in the next paragraph. Space is
provided for additional comments about the crew's performance.

6\. The threshold for failing the simulator portion of the examination
is to receive a (behavioral anchor) score of "1" in either of the
following:

> a\. any two rating factors in any one competency
>
> b\. any one rating factor in any one competency if, in the judgement
> of the examination team, the crew's performance deficiency jeopardizes
> the safety of the plant or has significant safety impact on the
> public. (NRC management will make the final decision concerning all
> crew failures resulting from a single rating factor evaluation of
> "1.")

**ES-604 2 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Simulator Examination Summary Sheet**

Facility: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Examination
Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Overall Dynamic Simulator Crew Evaluation: SAT or UNSAT**

+-----------------------------------------------------------------------+
| Crew Members Docket No. Scenario #1 Scenario #2                       |
|                                                                       |
| > Position Position                                                   |
|                                                                       |
| 1\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
|                                                                       |
| 2\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
|                                                                       |
| 3\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
|                                                                       |
| 4\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
|                                                                       |
| 5\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
|                                                                       |
| 6\. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 55-\_\_\_\_\_\_\_\_\_  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_                 |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+

  -------------------------------------------------------- --------- -----------
  Scenario #1: \[Enter scenario descriptor\]                         

  **Crew Critical Tasks**                                  **SAT**   **UNSAT**

  1\. \[Enter critical task descriptor\]                             

  2\.                                                                

  3\.                                                                

  4\.                                                                

  5\.                                                                
  -------------------------------------------------------- --------- -----------

  -------------------------------------------------------- --------- -----------
  Scenario #2:                                                       

  **Crew Critical Tasks**                                  **SAT**   **UNSAT**

  1\.                                                                

  2\.                                                                

  3\.                                                                

  4\.                                                                

  5\.                                                                
  -------------------------------------------------------- --------- -----------

Comments:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 3 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Diagnosis of Events and Conditions Based on Signals or Readings**

Did the crew---

\(a\) recognize off-normal trends and status?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Recognized status      | Recognized status   | Did not recognize     |
|                        |                     | adverse               |
| and trends quickly     | and trends at the   |                       |
|                        | time of,            | status and trends,    |
| and accurately         |                     |                       |
|                        | but not before,     | even after alarms and |
|                        | exceeding           | annunciators sounded. |
|                        | established limits. |                       |
+------------------------+---------------------+-----------------------+

\(b\) use information and reference material (prints, books, charts,
emergency plan implementation procedures) to aid in diagnosing and
classifying events and conditions?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Made accurate          | Committed minor     | Failed to use, or     |
| diagnosis              | errors              | misused,              |
|                        |                     |                       |
| by using information   | in using or         | or misinterpreted     |
|                        | interpreting        |                       |
| and reference material |                     | information or        |
|                        | information and     | reference             |
| correctly and in a     | reference           |                       |
| timely                 |                     | material that         |
|                        | material.           | resulted              |
| manner.                |                     |                       |
|                        |                     | in improper           |
|                        |                     | diagnosis.            |
+------------------------+---------------------+-----------------------+

\(c\) correctly diagnose plant conditions based on control room
indications?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Performed timely       | Committed minor     | Made incorrect        |
|                        | errors              | diagnosis,            |
| and accurate           |                     |                       |
| diagnosis.             | or had minor        | which resulted in     |
|                        | difficulties        | incorrect             |
|                        |                     |                       |
|                        | in making           | manipulation of any   |
|                        | diagnosis.          | safety                |
|                        |                     |                       |
|                        |                     | control.              |
+------------------------+---------------------+-----------------------+

Grade for diagnosis of events and conditions based on signals and
readings: SAT or UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 4 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Understanding of Plant and System Responses**

Did the crew---

\(a\) locate and interpret control room indicators correctly and
efficiently to ascertain and verify the status/operation of plant
systems?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Each crew member       | Some crew members   | The crew members made |
|                        |                     |                       |
| located and            | committed minor     | serious omissions,    |
| interpreted            | errors              | delays,               |
|                        |                     |                       |
| instruments accurately | in locating or      | or errors in          |
|                        | interpreting        | interpreting          |
| and efficiently.       |                     |                       |
|                        | instruments or      | safety-related        |
|                        | displays.           | parameters.           |
|                        |                     |                       |
|                        | Some crew members   |                       |
|                        | required            |                       |
|                        | assistance.         |                       |
+------------------------+---------------------+-----------------------+

\(b\) demonstrate an understanding of the manner in which the plant,
systems, and components operate, including setpoints, interlocks, and
automatic actions?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Crew members           | The crew committed  | Inadequate knowledge  |
|                        | minor               |                       |
| demonstrated thorough  |                     | of safety system or   |
|                        | errors because of   |                       |
| understanding of how   |                     | component operation   |
|                        | incomplete          |                       |
| systems and components | knowledge           | resulted in serious   |
|                        |                     |                       |
| operate.               | of the operation of | mistakes or plant     |
|                        | the                 |                       |
|                        |                     | degradation.          |
|                        | system or           |                       |
|                        | component.          |                       |
|                        |                     |                       |
|                        | Some crew members   |                       |
|                        |                     |                       |
|                        | required            |                       |
|                        | assistance.         |                       |
+------------------------+---------------------+-----------------------+

\(c\) demonstrate an understanding of how their actions (or inaction)
affected systems and plant conditions?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| All members understood | Actions or          | The crew appeared to  |
|                        | directives          | act                   |
| the effect that        |                     |                       |
| actions                | indicated minor     | without knowledge of  |
|                        |                     |                       |
| or directives had on   | inaccuracies in     | or with disregard for |
|                        | individuals'        |                       |
| the plant and systems. |                     | the effects on plant  |
|                        | understanding, but  | safety.               |
|                        | the                 |                       |
|                        |                     |                       |
|                        | crew corrected the  |                       |
|                        | actions.            |                       |
+------------------------+---------------------+-----------------------+

Grade on understanding of the response of plant and systems: SAT or
UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 5 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Adherence to and Use of Procedures**

Did the crew---

\(a\) refer to the appropriate procedures in a timely manner?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew used          | The crew committed  | The crew failed to    |
| procedures             |                     | correctly             |
|                        | minor failures to   |                       |
| as required and knew   | refer               | refer to procedure(s) |
|                        |                     | when                  |
| what conditions were   | to procedures       |                       |
|                        | without             | required, resulting   |
| covered by procedures  |                     | in faulty             |
|                        | prompting, which    |                       |
| and where to find      | affected            | safety system         |
| them.                  |                     | operation.            |
|                        | the plant's status. |                       |
+------------------------+---------------------+-----------------------+

\(b\) correctly implement procedures, including following procedural
steps in correct sequence, abiding by cautions and limitations,
selecting correct paths on decision blocks, and transitioning between
procedures when required?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew followed      | The crew misapplied | The crew failed to    |
|                        |                     | follow                |
| the procedural steps   | procedures in minor |                       |
|                        |                     | procedures correctly, |
| accurately and in a    | instances, but made |                       |
| timely                 |                     | which impeded         |
|                        | corrections in      | recovery              |
| manner, demonstrating  | sufficient time     |                       |
|                        |                     | from events or caused |
| a thorough             | to avoid adverse    |                       |
| understanding          | effects.            | unnecessary           |
|                        |                     | degradation           |
| of the procedural      |                     |                       |
| purposes               |                     | in the safety of the  |
|                        |                     | plant.                |
| and bases.             |                     |                       |
+------------------------+---------------------+-----------------------+

\(c\) recognize EOP entry conditions and perform appropriate actions
without the aid of references or other forms of assistance?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew recognized    | The crew had minor  | The crew failed       |
|                        |                     |                       |
| plant conditions and   | lapses or errors.   | to accurately         |
|                        |                     | recognize             |
| implemented EOPs       | Individual crew     |                       |
|                        | members             | degraded plant        |
| consistently,          |                     |                       |
| accurately,            | needed assistance   | condition(s) or       |
|                        |                     | execute               |
| and in a timely        | from others to      |                       |
| manner.                | implement           | efficient mitigating  |
|                        |                     |                       |
|                        | procedures.         | action(s), even with  |
|                        |                     |                       |
|                        |                     | the use of aids       |
+------------------------+---------------------+-----------------------+

Grade on adherence to and use of procedures: SAT or UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 6 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Control Board Operations**

Did the crew---

\(a\) locate controls efficiently and accurately?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Individual operators   | One or more         | The crew failed to    |
|                        | operators           | locate                |
| located controls       |                     |                       |
|                        | hesitated or had    | control(s), which     |
| and indicators         | difficulty          |                       |
|                        |                     | jeopardized system(s) |
| without hesitation.    | in locating         |                       |
|                        | controls.           | important to safety   |
+------------------------+---------------------+-----------------------+

\(b\) manipulate controls in an accurate and timely manner?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew manipulated   | The crew            | The crew made         |
|                        | demonstrated        | mistakes              |
| plant controls         |                     |                       |
| smoothly               | minor shortcomings  | manipulating          |
|                        |                     | control(s)            |
| and maintained         | in manipulating     |                       |
|                        | controls,           | that caused safety    |
| parameters within      |                     | system                |
|                        | but recovered from  |                       |
| specified bounds.      | errors              | transients and        |
|                        |                     | related               |
|                        | without causing     |                       |
|                        | problems.           | problems              |
+------------------------+---------------------+-----------------------+

\(c\) take manual control of automatic functions, when appropriate?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| All operators took     | Some operators      | The crew failed       |
| control                | delayed             |                       |
|                        |                     | to manually control   |
| and smoothly operated  | or required         |                       |
|                        | prompting           | automatic systems     |
| automatic systems      |                     |                       |
|                        | before overriding   | important to safety,  |
| manually, without      |                     |                       |
|                        | or operating        | even when ample time  |
| assistance, thereby    | automatic           |                       |
|                        |                     | and indications       |
| averting adverse       | functions, but      | existed.              |
| events.                | avoided             |                       |
|                        |                     |                       |
|                        | plant transients    |                       |
|                        | where               |                       |
|                        |                     |                       |
|                        | possible.           |                       |
+------------------------+---------------------+-----------------------+

Grade on control board operations: SAT or UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 7 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Crew Operations**

Did the crew members---

\(a\) maintain a command role?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew took early    | In minor instances, | The crew failed       |
|                        |                     |                       |
| remedial action        | the crew failed     | to take timely        |
|                        |                     | action,               |
| when necessary.        | to take action      |                       |
|                        | within a            | which resulted        |
|                        |                     |                       |
|                        | reasonable period   | in the deterioration  |
|                        | of time.            |                       |
|                        |                     | of plant conditions.  |
+------------------------+---------------------+-----------------------+

\(b\) provide timely, well-planned directions to each other that
facilitated their performance and demonstrated appropriate concern for
the safety of the plant, staff, and public?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Supervisor's           | In minor instances, | The supervisor's      |
| directives             | the                 |                       |
|                        |                     | directive(s)          |
| allowed for safe       | supervisors gave    | inhibited safe        |
|                        | orders              |                       |
| and integrated         |                     | crew performance.     |
|                        | that were           | Crew                  |
| performance            | incorrect, trivial, |                       |
|                        |                     | members had to        |
| by all crew members.   | or difficult to     | explain               |
|                        | implement.          |                       |
|                        |                     | why order(s) could    |
|                        |                     | not                   |
|                        |                     |                       |
|                        |                     | or should not be      |
|                        |                     | followed.             |
+------------------------+---------------------+-----------------------+

\(c\) maintain control during the scenario with an appropriate amount of
direction and guidance from the crew's supervisors?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Crew members stayed    | Crew members had to | Crew members had to   |
|                        |                     |                       |
| involved without       | solicit assistance  | repeatedly request    |
| creating               | from                |                       |
|                        |                     | guidance. The crew    |
| a distraction, the     | supervisors or each | failed                |
| crew                   | other,              |                       |
|                        |                     | to verify successful  |
| members anticipated    | interfering with    |                       |
| each                   | their ability       | accomplishment of     |
|                        |                     | orders.               |
| other's needs, and the | to carry out        |                       |
|                        | critical action(s). |                       |
| supervisors provided   |                     |                       |
|                        |                     |                       |
| guidance when          |                     |                       |
| necessary.             |                     |                       |
+------------------------+---------------------+-----------------------+

*Crew Operations Continued on Next Page*

**ES-604 8 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Crew Operations (Continued)**

Did the crew members---

\(d\) use a team approach to problem solving and decision making by
soliciting and incorporating relevant information from all crew members?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Crew members were      | At times, crew      | The crew was not      |
|                        | members             | involved              |
| involved in the        |                     |                       |
| problem                | failed to get       | in making             |
|                        | involved in the     | decision(s).          |
| solving and decision   |                     |                       |
|                        | decision making     | The crew was divided  |
| making processes       | process             | over                  |
|                        |                     |                       |
| for effective team     | when they should    | the scenario's        |
|                        | have,               | progress,             |
| decision making.       |                     |                       |
|                        | detracting from the | and this behavior was |
|                        | team-               |                       |
|                        |                     | counter-productive.   |
|                        | oriented approach.  |                       |
+------------------------+---------------------+-----------------------+

Grade on crew operations: SAT or UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**ES-604 9 [Form
ES-604-2](../sr1020r9-sup1-final-forms-ms.doc#ES-604-2)**

**Communications**

Did the crew---

\(a\) exchange complete and relevant information in a clear, accurate,
and attentive manner?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Crew members provided  | Crew communications | Crew members did not  |
|                        |                     |                       |
| relevant and accurate  | were generally      | inform each other     |
|                        |                     |                       |
| information to each    | complete and        | of abnormal           |
| other.                 | accurate,           | indication(s)         |
|                        |                     |                       |
|                        | but sometimes       | or action(s). Crew    |
|                        | needed              | members               |
|                        |                     |                       |
|                        | prompting, or the   | were inattentive      |
|                        | crew                |                       |
|                        |                     | when important        |
|                        | failed to           | information           |
|                        | acknowledge         |                       |
|                        |                     | was requested.        |
|                        | the completion of   |                       |
|                        |                     |                       |
|                        | evolutions, or to   |                       |
|                        | respond             |                       |
|                        |                     |                       |
|                        | to information from |                       |
|                        | others.             |                       |
+------------------------+---------------------+-----------------------+

\(b\) keep key personnel outside the control room informed of plant
status?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| Crew members           | In minor instances, | The crew failed to    |
|                        |                     | provide               |
| provided key personnel | the crew needed to  |                       |
|                        | be                  | needed information.   |
| outside the control    |                     |                       |
| room                   | prompted for        |                       |
|                        | information         |                       |
| with accurate,         |                     |                       |
| relevant               | and/or provided     |                       |
|                        | some                |                       |
| information throughout |                     |                       |
|                        | in                  |                       |
| the scenarios.         | complete/inaccurate |                       |
|                        |                     |                       |
|                        | information.        |                       |
+------------------------+---------------------+-----------------------+

\(c\) ensure receipt of clear, easily understood communications from the
crew and others?

+------------------------+---------------------+-----------------------+
| 3                      | 2                   | 1                     |
+------------------------+---------------------+-----------------------+
| The crew requested     | In minor instances, | The crew failed to    |
|                        |                     | request               |
| inf                    | the crew failed to  |                       |
| ormation/clarification | request             | needed information,   |
|                        |                     | or                    |
| when necessary         | or acknowledge      |                       |
|                        |                     | was inattentive when  |
| and understood         | information from    |                       |
|                        | others.             | information was       |
| communications         |                     | provided;             |
|                        |                     |                       |
| from others.           |                     | serious               |
|                        |                     | misunderstandings     |
|                        |                     |                       |
|                        |                     | occurred among        |
|                        |                     |                       |
|                        |                     | crew members.         |
+------------------------+---------------------+-----------------------+

Grade on communications: SAT or UNSAT

Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[]{#BM_37_ .anchor}**ES-701 LSRO BWR Written Examination Outline [Form
ES-701-1](../sr1020r9-sup1-final-forms-ms.doc#ES-701-1)**

<table>
<colgroup>
<col style="width: 23%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 13%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13">Facility: Date of Exam:</td>
</tr>
<tr class="even">
<td rowspan="2">Tier</td>
<td colspan="12">K/A Category Points</td>
</tr>
<tr class="odd">
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td><p>G</p>
<p>*</p></td>
<td>Total</td>
</tr>
<tr class="even">
<td><p>1.</p>
<p>Emergency &amp; Abnormal Plant Evolutions</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>10</td>
</tr>
<tr class="odd">
<td><p>2.</p>
<p>Plant</p>
<p>Systems</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>20</td>
</tr>
<tr class="even">
<td colspan="2" rowspan="2">3. Generic Knowledge and Abilities
Categories</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">3</td>
<td colspan="2">4</td>
<td colspan="2">GFE</td>
<td rowspan="2">10</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| Note: 1. Ensure that at least one topic from every K/A category is    |
| sampled within each tier.                                             |
|                                                                       |
| > 2\. The point total for each tier in the proposed outline must      |
| > match that specified in the table. The final point total for each   |
| > tier may deviate by ±1 from that specified in the table based on    |
| > NRC revisions. The final exam must total 40 points.                 |
| >                                                                     |
| > 3\. Select topics from many systems and evolutions; avoid selecting |
| > more than two K/A topics from a given system (except fuel handling  |
| > equipment) or evolution (except refueling accident).                |
| >                                                                     |
| > 4\. The shaded areas are not applicable to the category/tier.       |
| >                                                                     |
| > 5.\* The generic (G) K/As in Tiers 1 and 2 shall be selected from   |
| > Section 2 of the K/A Catalog, but the topics must be relevant to    |
| > the applicable evolution or system.                                 |
| >                                                                     |
| > 6\. If the applicants have not previously taken the GFE, Tier 3     |
| > shall include basic reactor theory, component, and thermodynamic    |
| > topics that apply to fuel handling operations.                      |
| >                                                                     |
| > 7\. Systems/evolutions within each tier are identified on the       |
| > associated outline. Enter the K/A numbers, a brief description of   |
| > each topic, the topics' importance ratings (IR) for the SRO license |
| > level, and the point totals (#) for each system and category. Enter |
| > the tier totals for each category in the table above.               |
| >                                                                     |
| > 8\. For Tier 3, select topics from Section 2 of the K/A catalog,    |
| > and enter the K/A numbers, descriptions, importance ratings, and    |
| > point totals (#) on Form ES-701-3.                                  |
| >                                                                     |
| > 9\. Refer to ES-401, Section D.1, for guidance regarding the        |
| > elimination of inappropriate K/A statements. The facility           |
| > licensee's JTA for fuel handlers should be used as the basis for    |
| > eliminating or adding testable topics.                              |
+-----------------------------------------------------------------------+

<table>
<colgroup>
<col style="width: 31%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 41%" />
<col style="width: 5%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p><strong>ES-701 LSRO BWR Written Examination Outline
<a href="../sr1020r9-sup1-final-forms-ms.doc#ES-701-1">Form
ES-701-1</a></strong></p>
<p><strong>Emergency and Abnormal Plant Evolutions - Tier
1</strong></p></td>
</tr>
<tr class="even">
<td></td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>295003 Partial or Complete Loss of AC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295004 Partial or Total Loss of DC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295014 Inadvertent Reactivity Addition</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295018 Partial or Total Loss of CCW</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295021 Loss of Shutdown Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295023 Refueling Accidents</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295033 High Secondary Containment Area Radiation Levels</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295034 Secondary Containment Ventilation High Radiation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295006 SCRAM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295008 High Reactor Water Level</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295009 / 295031 Reactor Low Water Level</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295017 / 295038 High Offsite Release Rate</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295019 Partial or Total Loss of Inst. Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295020 Inadvertent Cont. Isolation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>295030 Low Suppression Pool Wtr Lvl</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>295035 Secondary Containment High Differential Pressure</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>600000 Plant Fire On Site</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Tier Point Total:</td>
<td>10</td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 24%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 35%" />
<col style="width: 4%" />
<col style="width: 6%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p><strong>ES-701 LSRO BWR Examination Outline <a
href="../sr1020r9-sup1-final-forms-ms.doc#ES-701-1">Form
ES-701-1</a></strong></p>
<p><strong>Plant Systems - Tier 2</strong></p></td>
</tr>
<tr class="even">
<td></td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>205000 Shutdown Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>215004 Source Range Monitor</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>233000 Fuel Pool Cooling/Cleanup</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>234000 Fuel Handling Equipment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>262001 AC Electrical Dist.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>263000 DC Electrical Dist.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>290002 Reactor Vessel Internals</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>201002 RMCS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>201003 Control Rod and Drive Mechanism</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>203000 RHR/LPCI: Injection Mode</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>204000 RWCU</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>211000 SLC</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>212000 RPS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>214000 RPIS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>215001 Traversing In-Core Probe</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>215003 IRM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>215005 APRM / LPRM</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>223001 Primary CTMT and Aux.</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>223002 PCIS/Nuclear Steam Supply Shutoff</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>261000 SGTS</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>264000 EDGs</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>272000 Radiation Monitoring</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>286000 Fire Protection</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>288000 Plant Ventilation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>290001 Secondary CTMT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>300000 Instrument Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>400000 Component Cooling Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Tier Point Total:</td>
<td>20</td>
</tr>
</tbody>
</table>

[]{#BM_38_ .anchor}**ES-701 LSRO PWR Written Examination Outline Form
ES-701-2**

<table>
<colgroup>
<col style="width: 23%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 6%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 13%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13">Facility: Date of Exam:</td>
</tr>
<tr class="even">
<td rowspan="2">Tier</td>
<td colspan="12">K/A Category Points</td>
</tr>
<tr class="odd">
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td><p>G</p>
<p>*</p></td>
<td>Total</td>
</tr>
<tr class="even">
<td><p>1.</p>
<p>Emergency &amp; Abnormal Plant Evolutions</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>10</td>
</tr>
<tr class="odd">
<td><p>2.</p>
<p>Plant</p>
<p>Systems</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>20</td>
</tr>
<tr class="even">
<td colspan="2" rowspan="2">3. Generic Knowledge and Abilities
Categories</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">3</td>
<td colspan="2">4</td>
<td colspan="2">GFE</td>
<td rowspan="2">10</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="13"><p>Note: 1. Ensure that at least one topic from every
K/A category is sampled within each tier.</p>
<blockquote>
<p>2. The point total for each tier in the proposed outline must match
that specified in the table. The final point total for each tier may
deviate by ±1 from that specified in the table based on NRC revisions.
The final exam must total 40 points.</p>
<p>3. Select topics from many systems and evolutions; avoid selecting
more than two K/A topics from a given system (except fuel handling
equipment) or evolution (except refueling accident).</p>
<p>4. The shaded areas are not applicable to the category/tier.</p>
<p>5.* The generic (G) K/As in Tiers 1 and 2 shall be selected from
Section 2 of the K/A Catalog, but the topics must be relevant to the
applicable evolution or system.</p>
<p>6. If the applicants have not previously taken the GFE, Tier 3 shall
include basic reactor theory, component, and thermodynamic topics that
apply to fuel handling operations.</p>
<p>7. Systems/evolutions within each tier are identified on the
associated outline. Enter the K/A numbers, a brief description of each
topic, the topics’ importance ratings (IR) for the SRO license level,
and the point totals (#) for each system and category. Enter the tier
totals for each category in the table above.</p>
<p>8. For Tier 3, select topics from Section 2 of the K/A catalog, and
enter the K/A numbers, descriptions, importance ratings, and point
totals (#) on Form ES-701-3.</p>
<p>9. Refer to ES-401, Section D.1, for guidance regarding the
elimination of inappropriate K/A statements. The facility licensee’s JTA
for fuel handlers should be used as the basis for eliminating or adding
testable topics.</p>
</blockquote></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 27%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 44%" />
<col style="width: 4%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p><strong>ES-701 LSRO PWR Written Examination Outline
Form ES-701-2</strong></p>
<p><strong>Emergency and Abnormal Plant Evolutions - Tier
1</strong></p></td>
</tr>
<tr class="even">
<td></td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>A1</td>
<td>A2</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>000025 Loss of RHR System</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000026 Loss of Component Cooling Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000032 Loss of Source Range NI</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000036 (BW/A08) Fuel Handling Accident</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000061 ARM System Alarms</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000033 Loss of Intermediate Range NI</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000055 Station Blackout</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000056 Loss of Offsite Power</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000057 Loss of Vital AC Inst. Bus</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000058 Loss of DC Power</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000062 Loss of Nuclear Svc Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000065 Loss of Instrument Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>000067 Plant Fire On Site</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>000069 (W/E14) Loss of CTMT Integrity</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>W/E16 High Containment Radiation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Tier Point Total:</td>
<td>10</td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 24%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 33%" />
<col style="width: 4%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><p><strong>ES-701 LSRO PWR Written Examination Outline
<a href="../sr1020r9-sup1-final-forms-ms.doc#ES-701-2">Form
ES-701-2</a></strong></p>
<p><strong>Plant Systems - Tier 2</strong></p></td>
</tr>
<tr class="even">
<td></td>
<td>K1</td>
<td>K2</td>
<td>K3</td>
<td>K4</td>
<td>K5</td>
<td>K6</td>
<td>A1</td>
<td>A2</td>
<td>A3</td>
<td>A4</td>
<td>G</td>
<td>K/A Topic(s)</td>
<td>IR</td>
<td>#</td>
</tr>
<tr class="odd">
<td>005 Residual Heat Removal</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>015 Nuclear Instrumentation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>033 Spent Fuel Pool Cooling</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>034 Fuel Handling Equipment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>103 Containment</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>062 AC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>063 DC Electrical Distribution</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>002 Reactor Coolant</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>004 Chemical and Volume Control</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>008 Component Cooling Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>013 Engineered Safety Features Actuation</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>064 Emergency Diesel Generator</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>072 Area Radiation Monitoring</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>076 Service Water</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>078 Instrument Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>079 Station Air</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>086 Fire Protection</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>K/A Category Totals:</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2">Tier Point Total:</td>
<td>20</td>
</tr>
</tbody>
</table>

+------------+-----+-------------------------------------+-----+-----+
| []{#BM_39_ |     |                                     |     |     |
| .ancho     |     |                                     |     |     |
| r}**ES-701 |     |                                     |     |     |
| LSRO       |     |                                     |     |     |
| Generic    |     |                                     |     |     |
| Knowledge  |     |                                     |     |     |
| and        |     |                                     |     |     |
| Abilities  |     |                                     |     |     |
| Outline    |     |                                     |     |     |
| (Tier 3)   |     |                                     |     |     |
| [Form      |     |                                     |     |     |
| ES-701-    |     |                                     |     |     |
| 3](../sr10 |     |                                     |     |     |
| 20r9-sup1- |     |                                     |     |     |
| final-form |     |                                     |     |     |
| s-ms.doc#E |     |                                     |     |     |
| S-701-3)** |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| Facility:  |     |                                     |     |     |
| Date of    |     |                                     |     |     |
| Exam:      |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| Category   | K/A | Topic                               | IR  | \#  |
|            | \#  |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| 1\.        | 2   |                                     |     |     |
|            | .1. |                                     |     |     |
| Conduct of |     |                                     |     |     |
| Operations |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .1. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .1. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .1. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | Su  |                                     |     |     |
|            | bto |                                     |     |     |
|            | tal |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| 2\.        | 2   |                                     |     |     |
|            | .2. |                                     |     |     |
| Equipment  |     |                                     |     |     |
| Control    |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .2. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .2. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .2. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | Su  |                                     |     |     |
|            | bto |                                     |     |     |
|            | tal |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| 3\.        | 2   |                                     |     |     |
|            | .3. |                                     |     |     |
| Radiation  |     |                                     |     |     |
| Control    |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .3. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .3. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .3. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | Su  |                                     |     |     |
|            | bto |                                     |     |     |
|            | tal |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| 4\.        | 2   |                                     |     |     |
|            | .4. |                                     |     |     |
| Emergency  |     |                                     |     |     |
| Procedures |     |                                     |     |     |
| / Plan     |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .4. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .4. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | 2   |                                     |     |     |
|            | .4. |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | Su  |                                     |     |     |
|            | bto |                                     |     |     |
|            | tal |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| 5\.        |     |                                     |     |     |
|            |     |                                     |     |     |
| Generic    |     |                                     |     |     |
| Fu         |     |                                     |     |     |
| ndamentals |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
|            | Su  |                                     |     |     |
|            | bto |                                     |     |     |
|            | tal |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+
| Tier 3     |     |                                     |     | 10  |
| Point      |     |                                     |     |     |
| Total      |     |                                     |     |     |
+------------+-----+-------------------------------------+-----+-----+

[]{#BM_40_ .anchor}**ES-701 LSRO Operating Test Outline [Form
ES-701-4](../sr1020r9-sup1-final-forms-ms.doc#ES-701-4)**

+-----------------------------------------------------------------------+
| Applicant Docket Number: 55- Page 2 of                                |
|                                                                       |
| Facility: Date of Examination:                                        |
+-----------------------------------------------------------------------+

+------------------------------------+-------+---------+--------------+
| **Title / Description of Tasks     | **T   | **Evalu | **Comment    |
| (JPMs)**                           | ype** | ation** | Page**       |
|                                    |       |         |              |
|                                    | *     | **(S or | **Number**   |
|                                    | *Code | U)**    |              |
|                                    | s\*** |         |              |
+------------------------------------+-------+---------+--------------+
| **Administrative**                 |       |         |              |
+------------------------------------+-------+---------+--------------+
| 1\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 2\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 3\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| **Systems**                        |       |         |              |
+------------------------------------+-------+---------+--------------+
| 1\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 2\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 3\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 4\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| **Emergency/Abnormal Plant         |       |         |              |
| Evolutions**                       |       |         |              |
+------------------------------------+-------+---------+--------------+
| 1\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 2\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| 3\.                                |       |         |              |
+------------------------------------+-------+---------+--------------+
| Type Codes & Criteria:             |       |         |              |
| (A)lternative path (2 systems; 1   |       |         |              |
| E/APE))                            |       |         |              |
|                                    |       |         |              |
| > (C)ontrol room                   |       |         |              |
| >                                  |       |         |              |
| > (D)irect from bank (≤ 7)         |       |         |              |
| >                                  |       |         |              |
| > (I)n-plant                       |       |         |              |
| >                                  |       |         |              |
| > (N)ew or (M)odified from bank    |       |         |              |
| > including 1(A) (≥ 1 / section)   |       |         |              |
| >                                  |       |         |              |
| > (L)ast NRC exam (≤ 1 / section)  |       |         |              |
| >                                  |       |         |              |
| > (R)efueling accident (1)         |       |         |              |
| >                                  |       |         |              |
| > (T)echnical specification (≥ 2)  |       |         |              |
+------------------------------------+-------+---------+--------------+

[]{#BM_41_ .anchor}**ES-701 LSRO Examination Outline Quality Checklist
[Form ES-701-5](../sr1020r9-sup1-final-forms-ms.doc#ES-701-5)**

+----+------------------------------------------------------+---+---+---+
| F  |                                                      |   |   |   |
| ac |                                                      |   |   |   |
| il |                                                      |   |   |   |
| it |                                                      |   |   |   |
| y: |                                                      |   |   |   |
| Da |                                                      |   |   |   |
| te |                                                      |   |   |   |
| of |                                                      |   |   |   |
| Ex |                                                      |   |   |   |
| am |                                                      |   |   |   |
| in |                                                      |   |   |   |
| at |                                                      |   |   |   |
| io |                                                      |   |   |   |
| n: |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
| It | Task Description                                     | I |   |   |
| em |                                                      | n |   |   |
|    |                                                      | i |   |   |
|    |                                                      | t |   |   |
|    |                                                      | i |   |   |
|    |                                                      | a |   |   |
|    |                                                      | l |   |   |
|    |                                                      | s |   |   |
+----+------------------------------------------------------+---+---+---+
|    |                                                      | a | b | c |
|    |                                                      |   | \ | # |
|    |                                                      |   | * |   |
+----+------------------------------------------------------+---+---+---+
| 1  | a\. Verify that the outline fits the model in        |   |   |   |
| \. | accordance with ES-701.                              |   |   |   |
|    |                                                      |   |   |   |
| W  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| I  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| N  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Assess whether the outline was systematically    |   |   |   |
|    | and randomly prepared in accordance with Section D.1 |   |   |   |
|    | of ES-401 and whether all K/A categories are sampled |   |   |   |
|    | at least once.                                       |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Assess whether the outline over-emphasizes any   |   |   |   |
|    | systems, evolutions, or generic topics.              |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | d\. Assess whether the justifications for deselected |   |   |   |
|    | or rejected K/A statements are appropriate.          |   |   |   |
+----+------------------------------------------------------+---+---+---+
| 2  | a\. Verify that the overall operating test:          |   |   |   |
| \. |                                                      |   |   |   |
|    | 1.  includes at least two tasks that require the use |   |   |   |
| O  |     of technical specifications                      |   |   |   |
|    |                                                      |   |   |   |
| P  | > \(2\) does not duplicate any tasks from the        |   |   |   |
|    | > applicants' audit test(s)                          |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| A  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| T  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| I  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| N  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| G  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Verify that the administrative tasks:            |   |   |   |
|    |                                                      |   |   |   |
|    | > \(1\) are distributed among the four               |   |   |   |
|    | > administrative topics described in ES-301          |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(2\) include no more than one repeat from the     |   |   |   |
|    | > last NRC licensing examination                     |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(3\) include at least one task that is new or     |   |   |   |
|    | > significantly modified                             |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Verify that the systems walk-through includes:   |   |   |   |
|    |                                                      |   |   |   |
|    | > \(1\) two tasks requiring the manipulation of fuel |   |   |   |
|    | > handling equipment                                 |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(2\) two additional tasks related to Tier 2       |   |   |   |
|    | > systems other than fuel handling equipment         |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(3\) two tasks requiring implementation of        |   |   |   |
|    | > alternative path procedures                        |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(4\) no more than one repeat from the last NRC    |   |   |   |
|    | > licensing examination                              |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(5\) at least one task that is new or             |   |   |   |
|    | > significantly modified                             |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | d\. Verify that the E/APE walk-through includes:     |   |   |   |
|    |                                                      |   |   |   |
|    | > \(1\) three JPMs based on the Tier 1evolutions,    |   |   |   |
|    | > including a refueling accident                     |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(2\) one task requiring implementation of an      |   |   |   |
|    | > alternative path procedure                         |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(3\) no more than one repeat from the last NRC    |   |   |   |
|    | > licensing examination                              |   |   |   |
|    | >                                                    |   |   |   |
|    | > \(4\) at least one task that is new or             |   |   |   |
|    | > significantly modified                             |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | e\. Determine whether there are enough different     |   |   |   |
|    | outlines to test the projected number of applicants  |   |   |   |
|    | and ensure that no items are duplicated on           |   |   |   |
|    | subsequent days.                                     |   |   |   |
+----+------------------------------------------------------+---+---+---+
| 3  | a\. Assess whether plant-specific priorities         |   |   |   |
| \. | (including PRA and IPE insights) are covered in      |   |   |   |
|    | the appropriate exam section.                        |   |   |   |
| G  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| N  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| E  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| R  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| A  |                                                      |   |   |   |
|    |                                                      |   |   |   |
| L  |                                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | b\. Assess whether the 10 CFR 55.41/43 and 55.45     |   |   |   |
|    | sampling is appropriate.                             |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | c\. Assess whether the sampling process adequately   |   |   |   |
|    | considered plant-specific refueling components,      |   |   |   |
|    | systems, and procedures that are not included in the |   |   |   |
|    | generic models.                                      |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | d\. Ensure that K/A importance ratings (except for   |   |   |   |
|    | plant-specific priorities) are at least 2.5.         |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | e\. Check for duplication and overlap among exam     |   |   |   |
|    | sections.                                            |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | f\. Check the entire exam for balance of coverage.   |   |   |   |
+----+------------------------------------------------------+---+---+---+
|    | g\. Assess whether the proposed sample is consistent |   |   |   |
|    | with the LSRO's job responsibilities.                |   |   |   |
+----+------------------------------------------------------+---+---+---+
| P  |                                                      |   |   |   |
| ri |                                                      |   |   |   |
| nt |                                                      |   |   |   |
| ed |                                                      |   |   |   |
| Na |                                                      |   |   |   |
| me |                                                      |   |   |   |
| /  |                                                      |   |   |   |
| S  |                                                      |   |   |   |
| ig |                                                      |   |   |   |
| na |                                                      |   |   |   |
| tu |                                                      |   |   |   |
| re |                                                      |   |   |   |
| Da |                                                      |   |   |   |
| te |                                                      |   |   |   |
|    |                                                      |   |   |   |
| a  |                                                      |   |   |   |
| \. |                                                      |   |   |   |
| Au |                                                      |   |   |   |
| th |                                                      |   |   |   |
| or |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
| \_ |                                                      |   |   |   |
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+----+------------------------------------------------------+---+---+---+
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+----+------------------------------------------------------+---+---+---+

\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[]{#BM_42_ .anchor}**ES-701 LSRO Written Examination [Form
ES-701-6](../sr1020r9-sup1-final-forms-ms.doc#ES-701-6)**

**Quality Checklist**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

+-------------------------------------+-----+---+---+-----+---+---+---+
| Facility: Date of Exam:             |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| Item Description                    |     |   |   |     | I |   |   |
|                                     |     |   |   |     | n |   |   |
|                                     |     |   |   |     | i |   |   |
|                                     |     |   |   |     | t |   |   |
|                                     |     |   |   |     | i |   |   |
|                                     |     |   |   |     | a |   |   |
|                                     |     |   |   |     | l |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
|                                     |     |   |   |     | > | > | > |
|                                     |     |   |   |     |   |   |   |
|                                     |     |   |   |     | a | b | c |
|                                     |     |   |   |     |   | \ | # |
|                                     |     |   |   |     |   | * |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 1\. Questions and answers are       |     |   |   |     |   |   |   |
| technically accurate and applicable |     |   |   |     |   |   |   |
| to the facility.                    |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 2\. a. NRC K/As are referenced for  |     |   |   |     |   |   |   |
| all questions (as applicable).      |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| b\. Facility learning objectives    |     |   |   |     |   |   |   |
| are referenced as available.        |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 3\. Questions are appropriate for   |     |   |   |     |   |   |   |
| LSRO applicants.                    |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 4\. The sampling process was random |     |   |   |     | [ | [ | [ |
| and systematic (If more than 3      |     |   |   |     | ] | ] | ] |
| questions were                      |     |   |   |     | { | { | { |
|                                     |     |   |   |     | . | . | . |
| repeated from the last 2 NRC        |     |   |   |     | m | m | m |
| licensing exams, consult the NRR OL |     |   |   |     | a | a | a |
| program                             |     |   |   |     | r | r | r |
|                                     |     |   |   |     | k | k | k |
| office).                            |     |   |   |     | } | } | } |
|                                     |     |   |   |     |   |   |   |
|                                     |     |   |   |     | [ | [ |   |
|                                     |     |   |   |     | ] | ] |   |
|                                     |     |   |   |     | { | { |   |
|                                     |     |   |   |     | . | . |   |
|                                     |     |   |   |     | m | m |   |
|                                     |     |   |   |     | a | a |   |
|                                     |     |   |   |     | r | r |   |
|                                     |     |   |   |     | k | k |   |
|                                     |     |   |   |     | } | } |   |
|                                     |     |   |   |     |   |   |   |
|                                     |     |   |   |     | [ | [ |   |
|                                     |     |   |   |     | ] | ] |   |
|                                     |     |   |   |     | { | { |   |
|                                     |     |   |   |     | . | . |   |
|                                     |     |   |   |     | m | m |   |
|                                     |     |   |   |     | a | a |   |
|                                     |     |   |   |     | r | r |   |
|                                     |     |   |   |     | k | k |   |
|                                     |     |   |   |     | } | } |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 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       |     |   |   |     |   |   |   |
| >                                   |     |   |   |     |   |   |   |
| > \_\_ the licensee certifies that  |     |   |   |     |   |   |   |
| > there is no duplication, or       |     |   |   |     |   |   |   |
| >                                   |     |   |   |     |   |   |   |
| > \_\_ other (explain               |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 6\. Bank use meets limits (no more  | B   | M |   | New |   |   |   |
| than 30 questions                   | ank | o |   |     |   |   |   |
|                                     |     | d |   |     |   |   |   |
| from the bank, at least 4 new, and  |     | i |   |     |   |   |   |
| the rest modified);                 |     | f |   |     |   |   |   |
|                                     |     | i |   |     |   |   |   |
| enter the actual question           |     | e |   |     |   |   |   |
| distribution at right.              |     | d |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
|                                     |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 7\. Between 50 and 60 percent (20   | Mem |   | C |     |   |   |   |
| and 24)                             | ory |   | / |     |   |   |   |
|                                     |     |   | A |     |   |   |   |
| of the questions on the exam are    |     |   |   |     |   |   |   |
| written                             |     |   |   |     |   |   |   |
| at the comprehension/analysis       |     |   |   |     |   |   |   |
| level;                              |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| enter the actual question           |     |   |   |     |   |   |   |
| distribution at right.              |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
|                                     |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 8\. References/handouts provided do |     |   |   |     |   |   |   |
| not give away answers               |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| or aid in eliminating distractors.  |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 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 assigned;                  |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| deviations are justified.           |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 10\. Question psychometric quality  |     |   |   |     |   |   |   |
| and format meet guidelines in ES    |     |   |   |     |   |   |   |
| Appendix B.                         |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| 11\. The exam contains 40           |     |   |   |     |   |   |   |
| one-point, multiple choice items;   |     |   |   |     |   |   |   |
| the total is correct                |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| and agrees with value on cover      |     |   |   |     |   |   |   |
| sheet.                              |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| Printed Name / Signature Date       |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| a\. Author                          |     |   |   |     |   |   |   |
| \_\_\_\                             |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| ­­\_\_\_\_\_\_\_                      |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| b\. Facility Reviewer (\*)          |     |   |   |     |   |   |   |
| \_\_\_\                             |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_                      |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| c\. NRC Chief Examiner (#)          |     |   |   |     |   |   |   |
| \_\_\_\                             |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_                      |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| d\. NRC Regional Supervisor         |     |   |   |     |   |   |   |
| \_\_\_\                             |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |     |   |   |     |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |     |   |   |     |   |   |   |
| \_\_\_\_\_\_\_                      |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+
| Note: \* The facility reviewer\'s   |     |   |   |     |   |   |   |
| initials/signature are not          |     |   |   |     |   |   |   |
| applicable for NRC-developed        |     |   |   |     |   |   |   |
| examinations.                       |     |   |   |     |   |   |   |
|                                     |     |   |   |     |   |   |   |
| \# Independent NRC reviewer initial |     |   |   |     |   |   |   |
| items in Column "c"; chief examiner |     |   |   |     |   |   |   |
| concurrence required.               |     |   |   |     |   |   |   |
+-------------------------------------+-----+---+---+-----+---+---+---+

[]{#BM_43_ .anchor}**ES-701 LSRO Operating Test Quality Checklist [Form
ES-701-7](../sr1020r9-sup1-final-forms-ms.doc#ES-701-7)**

+-----------------------------------------------------------+---+---+---+
| Facility: Date of Examination: Operating Test Number:     |   |   |   |
+-----------------------------------------------------------+---+---+---+
| Item Description                                          | I |   |   |
|                                                           | n |   |   |
|                                                           | i |   |   |
|                                                           | t |   |   |
|                                                           | i |   |   |
|                                                           | a |   |   |
|                                                           | l |   |   |
|                                                           | s |   |   |
+-----------------------------------------------------------+---+---+---+
|                                                           | a | b | c |
|                                                           |   | \ | # |
|                                                           |   | * |   |
+-----------------------------------------------------------+---+---+---+
| 1\. The operating test conforms with the LSRO's job       |   |   |   |
| responsibilities and the previously approved outline      |   |   |   |
| (Form ES-701-4).                                          |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 2\. Any changes from the previously approved outline have |   |   |   |
| not caused the test to deviate from any of the acceptance |   |   |   |
| criteria (e.g., item distribution, bank use, repetition   |   |   |   |
| from the last two NRC examinations) specified on the      |   |   |   |
| outline.                                                  |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 3\. There is no day-to-day repetition between this and    |   |   |   |
| other operating tests to be administered during this      |   |   |   |
| examination.                                              |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 4\. The operating test does not duplicate items from the  |   |   |   |
| applicants' audit test(s). (See Section D.1.a of ES-301). |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 5\. Overlap between the written examination and the       |   |   |   |
| operating test is within acceptable limits.               |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 6\. It appears that the operating test will differentiate |   |   |   |
| between competent and less-than-competent applicants.     |   |   |   |
+-----------------------------------------------------------+---+---+---+
| 7\. 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:           |   |   |   |
|                                                           |   |   |   |
| ```{=html}                                                |   |   |   |
| <!-- -->                                                  |   |   |   |
| ```                                                       |   |   |   |
| -   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  |   |   |   |
+-----------------------------------------------------------+---+---+---+
| Printed Name / Signature Date                             |   |   |   |
|                                                           |   |   |   |
| a\. Author                                                |   |   |   |
| \_                                                        |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| ­­\_\_\_\_\_\_\_                                            |   |   |   |
|                                                           |   |   |   |
| b\. Facility Reviewer (\*)                                |   |   |   |
| \_                                                        |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_\_\_\_\_\_                                            |   |   |   |
|                                                           |   |   |   |
| c\. NRC Chief Examiner (#)                                |   |   |   |
| \_                                                        |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_\_\_\_\_\_                                            |   |   |   |
|                                                           |   |   |   |
| d\. NRC Supervisor                                        |   |   |   |
| \_                                                        |   |   |   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |   |   |   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |   |   |
| \_\_\_\_\_\_\_                                            |   |   |   |
+-----------------------------------------------------------+---+---+---+
| Note: \* The facility reviewer\'s initials/signature are  |   |   |   |
| not applicable for NRC-developed examinations.            |   |   |   |
|                                                           |   |   |   |
| \# Independent NRC reviewer initial items in Column "c";  |   |   |   |
| chief examiner concurrence required.                      |   |   |   |
+-----------------------------------------------------------+---+---+---+

[]{#BM_44_ .anchor}**ES-701 LSRO Written Examination [Form
ES-701-8](../sr1020r9-sup1-final-forms-ms.doc#ES-701-8)**

**Cover Sheet**

+-----------------------------------+-----------------------------------+
| **U.S. Nuclear Regulatory         |                                   |
| Commission**                      |                                   |
|                                   |                                   |
| **LSRO Written Examination**      |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Information**         |                                   |
+-----------------------------------+-----------------------------------+
| Name:                             |                                   |
+-----------------------------------+-----------------------------------+
| Date:                             | Region: I                         |
|                                   | ![](media/image14.w               |
|                                   | mf){width="0.16666666666666666in" |
|                                   | height="0.15208333333333332in"}   |
|                                   | II                                |
|                                   | ![](media/image15.w               |
|                                   | mf){width="0.16666666666666666in" |
|                                   | height="0.15208333333333332in"}   |
|                                   | III                               |
|                                   | ![](media/image15.w               |
|                                   | mf){width="0.16666666666666666in" |
|                                   | height="0.15208333333333332in"}   |
|                                   | IV                                |
|                                   | ![](media/image15.w               |
|                                   | mf){width="0.16666666666666666in" |
|                                   | height="0.15208333333333332in"}   |
+-----------------------------------+-----------------------------------+
| Facility/Unit:                    | Reactor Type: W                   |
|                                   | ![](med                           |
|                                   | ia/image16.wmf){width="0.15625in" |
|                                   | height="0.15625in"} CE            |
|                                   | ![](med                           |
|                                   | ia/image17.wmf){width="0.15625in" |
|                                   | height="0.15625in"} BW            |
|                                   | ![](med                           |
|                                   | ia/image17.wmf){width="0.15625in" |
|                                   | height="0.15625in"} GE            |
|                                   | ![](med                           |
|                                   | ia/image17.wmf){width="0.15625in" |
|                                   | height="0.15625in"}               |
+-----------------------------------+-----------------------------------+
| Start Time:                       | Stop Time:                        |
+-----------------------------------+-----------------------------------+
| **Instructions**                  |                                   |
|                                   |                                   |
| Use the answer sheets provided to |                                   |
| document your answers. Staple     |                                   |
| this cover sheet on top of the    |                                   |
| answer sheets. The passing grade  |                                   |
| requires a final grade of at      |                                   |
| least 80.00 percent. Examination  |                                   |
| papers will be picked up 4 hours  |                                   |
| after the examination begins.     |                                   |
+-----------------------------------+-----------------------------------+
| **Applicant Certification**       |                                   |
|                                   |                                   |
| All work done on this examination |                                   |
| is my own. I have neither given   |                                   |
| nor received aid.                 |                                   |
|                                   |                                   |
| \_\_\_\_\_                        |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| Operator's Signature              |                                   |
+-----------------------------------+-----------------------------------+
| **Results**                       |                                   |
+-----------------------------------+-----------------------------------+
| Test Value \_\_\_\_\_\_\_\_\_\_   |                                   |
| Points                            |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Score                 |                                   |
| \_\_\_\_\_\_\_\_\_\_ Points       |                                   |
+-----------------------------------+-----------------------------------+
| Applicant's Grade                 |                                   |
| \_\_\_\_\_\_\_\_\_\_ Percent      |                                   |
+-----------------------------------+-----------------------------------+

[]{#BM_45_ .anchor}**ES-702 Individual LSRO [Form
ES-702-1](../sr1020r9-sup1-final-forms-ms.doc#ES-702-1)**

**[Requalification Examination Report]{.underline}**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+-----------------------------------------------------------------------+
| **U.S. Nuclear Regulatory Commission**                                |
|                                                                       |
| **Individual LSRO Requalification Examination Report**                |
+-----------------------------------------------------------------------+

+-----------------------+-----------+-----------+-----------------------+
| Operator's Name:      |           | Facility: |                       |
+-----------------------+-----------+-----------+-----------------------+
| Docket No.: 55-       | Retake    |           | Date of Last Exam:    |
|                       | Exam:     |           |                       |
|                       | 1st/2nd/# |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| License No.: SOP -    |           | E         |                       |
|                       |           | xpiration |                       |
|                       |           | Date:     |                       |
+-----------------------+-----------+-----------+-----------------------+
| **Written Examination |           |           |                       |
| Results**             |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Date of Exam:         | NRC       |           | Facility Evaluator:   |
|                       | Examiner: |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Overall               | NRC       |           | Facility              |
|                       |           |           |                       |
| Grade (%) \>\>\>\>    |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
|                       | \%        |           | \%                    |
+-----------------------+-----------+-----------+-----------------------+
| **Operating Test      |           |           |                       |
| Results**             |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Date of Test:         | NRC       |           | Facility Evaluator:   |
|                       | Examiner: |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| No. of JPMs Correct   | of        |           | of                    |
+-----------------------+-----------+-----------+-----------------------+
| Final Grade (%)       | \%        |           | \%                    |
| \>\>\>\>              |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| **NRC Examiner        |           |           |                       |
| Recommendations**     |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Category              | Results   |           | Signature             |
+-----------------------+-----------+-----------+-----------------------+
| Written               | Pass /    |           |                       |
|                       | Fail      |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Operating             | Pass /    |           |                       |
|                       | Fail      |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| **NRC Supervisor      |           |           |                       |
| Review**              |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| Date:                 | Pass /    |           |                       |
|                       | Fail      |           |                       |
+-----------------------+-----------+-----------+-----------------------+

PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY

[]{#BM_46_ .anchor}**ES-702 Power Plant LSRO [Form
ES-702-2](../sr1020r9-sup1-final-forms-ms.doc#ES-702-2)**

**Requalification Results Summary**

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

+--------+------------+------+---+---+------+------+-------+---------+
| *      |            |      |   |   |      |      |       |         |
| *Power |            |      |   |   |      |      |       |         |
| Plant  |            |      |   |   |      |      |       |         |
| LSRO** |            |      |   |   |      |      |       |         |
|        |            |      |   |   |      |      |       |         |
| **Req  |            |      |   |   |      |      |       |         |
| ualifi |            |      |   |   |      |      |       |         |
| cation |            |      |   |   |      |      |       |         |
| R      |            |      |   |   |      |      |       |         |
| esults |            |      |   |   |      |      |       |         |
| Sum    |            |      |   |   |      |      |       |         |
| mary** |            |      |   |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
| Fac    |            |      |   | E |      |      |       |         |
| ility: |            |      |   | x |      |      |       |         |
|        |            |      |   | a |      |      |       |         |
|        |            |      |   | m |      |      |       |         |
|        |            |      |   | D |      |      |       |         |
|        |            |      |   | a |      |      |       |         |
|        |            |      |   | t |      |      |       |         |
|        |            |      |   | e |      |      |       |         |
|        |            |      |   | : |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
| Exam   |            |      |   |   |      |      |       |         |
| iners: |            |      |   |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
| O      | Total \#   |      | P |   |      |      | F     |         |
| verall | of         |      | a |   |      |      | ailed |         |
|        |            |      | s |   |      |      |       |         |
| R      | Operators  |      | s |   |      |      | (# /  |         |
| esults |            |      | e |   |      |      | %)    |         |
|        |            |      | d |   |      |      |       |         |
| \      |            |      |   |   |      |      |       |         |
| -\--\> |            |      | ( |   |      |      |       |         |
|        |            |      | # |   |      |      |       |         |
|        |            |      | / |   |      |      |       |         |
|        |            |      | % |   |      |      |       |         |
|        |            |      | ) |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      |   |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
| **Indi |            |      |   |   |      |      |       |         |
| vidual |            |      |   |   |      |      |       |         |
| Res    |            |      |   |   |      |      |       |         |
| ults** |            |      |   |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
| Oper   |            | Do   | G |   | JPM  | Wri  | Re    |         |
| ator's |            | cket | r |   | %    | tten | sults |         |
|        |            |      | a |   |      |      | (P/F) |         |
| Name   |            | 55-  | d |   | Ove  | (%)  |       |         |
|        |            |      | e |   | rall |      |       |         |
|        |            |      | r |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      |   |   |      |      | Wr    | Op      |
|        |            |      |   |   |      |      | itten | erating |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | N |   |      |      |       |         |
|        |            |      | R |   |      |      |       |         |
|        |            |      | C |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+
|        |            |      | F |   |      |      |       |         |
|        |            |      | a |   |      |      |       |         |
|        |            |      | c |   |      |      |       |         |
+--------+------------+------+---+---+------+------+-------+---------+

**PRIVACY ACT INFORMATION --- FOR OFFICIAL USE ONLY**

[]{#BM_47_ .anchor}**ES-702 LSRO Written Requalification [Form
ES-702-3](../sr1020r9-sup1-final-forms-ms.doc# ES-702-3)**

**Examination Cover Sheet**

+-----------------------------------+-----------------------------------+
| **U.S. Nuclear Regulatory         |                                   |
| Commission**                      |                                   |
|                                   |                                   |
| **LSRO Written Requalification    |                                   |
| Examination**                     |                                   |
+-----------------------------------+-----------------------------------+
| **Operator Information**          |                                   |
+-----------------------------------+-----------------------------------+
| Name:                             |                                   |
+-----------------------------------+-----------------------------------+
| Date:                             | Region: I / II / III / IV         |
+-----------------------------------+-----------------------------------+
| Facility/Unit:                    | Reactor Type: W / CE / BW / GE    |
+-----------------------------------+-----------------------------------+
| Start Time:                       | Stop Time:                        |
+-----------------------------------+-----------------------------------+
| **Instructions**                  |                                   |
|                                   |                                   |
| Use the answer sheets provided to |                                   |
| document your answers. Staple     |                                   |
| this cover sheet                  |                                   |
|                                   |                                   |
| on top of the answer sheets.      |                                   |
| Points for each question are      |                                   |
| indicated in parentheses          |                                   |
| after each question. The passing  |                                   |
| grade requires a final grade of   |                                   |
| at least 80.00 percent.           |                                   |
| Examination papers will be picked |                                   |
| up 2 hours after the examination  |                                   |
| begins.                           |                                   |
+-----------------------------------+-----------------------------------+
| **Operator Certification**        |                                   |
|                                   |                                   |
| All work done on this examination |                                   |
| is my own. I have neither given   |                                   |
| nor received aid.                 |                                   |
|                                   |                                   |
| \_\_\_\_\_                        |                                   |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |                                   |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   |                                   |
| Operator's Signature              |                                   |
+-----------------------------------+-----------------------------------+
| **Results**                       |                                   |
+-----------------------------------+-----------------------------------+
| Test Value \_\_\_\_\_\_\_\_\_\_   |                                   |
| Points                            |                                   |
+-----------------------------------+-----------------------------------+
| Operator's Score                  |                                   |
| \_\_\_\_\_\_\_\_\_\_ Points       |                                   |
+-----------------------------------+-----------------------------------+
| Operator's Grade                  |                                   |
| \_\_\_\_\_\_\_\_\_\_ Percent      |                                   |
+-----------------------------------+-----------------------------------+

[]{#BM_48_ .anchor}**Appendix C Job Performance Measure [Form
ES-C-1](../sr1020r9-sup1-final-forms-ms.doc#ES-C-1)**

**Worksheet**

Facility: Task No: \_\_\_\_\_\_

Task Title: Job Performance Measure No: \_\_\_\_\_\_\_\_\_

K/A Reference: \_\_\_\_\_\_\_\_\_\_\_\_\_\_

Examinee: NRC Examiner: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Facility Evaluator: Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[Method of testing:]{.underline}

Simulated Performance \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Actual Performance
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Classroom \_\_\_\_\_\_\_\_\_\_\_\_\_\_ Simulator
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Plant \_\_\_\_\_\_\_\_\_\_

***Read to the examinee:***

I will explain the initial conditions, which steps to simulate or
discuss, and provide initiating cues. When you complete the task
successfully, the objective for this job performance measure
will be satisfied.

Initial Conditions:

Task Standard:

Required Materials:

General References:

Initiating Cue:

Time Critical Task: Yes/No

Validation Time:

**Appendix C 2 [Form
ES-C-1](../sr1020r9-sup1-final-forms-ms.doc#ES-C-1)**

**Performance Information**

***Denote critical steps with a check mark***

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_ Performance step:

Standard:

Comment:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_ Performance step:

Standard:

Comment:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_ Performance step:

Standard:

Comment:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Terminating cue:

**Appendix C 3 [Form
ES-C-1](../sr1020r9-sup1-final-forms-ms.doc#ES-C-1)**

**Verification of Completion**

Job Performance Measure No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Examinee's Name:

Examiner's Name:

Date Performed:

Facility Evaluator:

Number of Attempts:

Time to Complete:

Question Documentation:

Question:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Response:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Result: Satisfactory/Unsatisfactory

Examiner's signature and date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_

[]{#BM_49_ .anchor}**Appendix C Job Performance Measure [Form
ES-C-2](../sr1020r9-sup1-final-forms-ms.doc#ES-C-2)**

**Quality Checklist**

Every JPM should:

1\. \_\_\_\_\_ be supported by the facility licensee's job task
analysis.

2\. \_\_\_\_\_ be operationally important (meet the NRC's K/A Catalog
threshold criterion of 2.5 (3 for requalification exams) or as
determined by the facility and agreed to by the NRC). JPMs shall not
test only for simple recall or memorization (refer to ES-602 Attachment
1).

3\. \_\_\_\_\_ be designed as either SRO only, RO/SRO or AO/RO/SRO.

4\. include the following, as applicable:

> a\. \_\_\_\_\_ initial conditions
>
> b\. \_\_\_\_\_ initiating cues
>
> c\. \_\_\_\_\_ references and tools, including associated procedures
>
> d\. \_\_\_\_\_ validated time limits (average time allowed for
> completion) and specific designation of those JPMs that are deemed to
> be time-critical by the facility operations department
>
> e\. \_\_\_\_\_ operationally important specific performance criteria
> that include:
>
> \(1\) \_\_\_\_\_ expected actions with exact control and indication
> nomenclature and criteria (switch position, meter reading), even if
> these criteria are not specified in the procedural step
>
> \(2\) \_\_\_\_\_ system response and other cues that are complete and
> correct so that the examiner can properly cue the examinee, if asked
>
> \(3\) \_\_\_\_\_ statements describing important observations that the
> examinee should make
>
> \(4\) \_\_\_\_\_ criteria for successful completion of the task
>
> \(5\) \_\_\_\_\_ identification of those steps that are considered
> critical
>
> \(6\) \_\_\_\_\_ restrictions on the sequence of steps

[]{#BM_50_ .anchor}**Appendix D Scenario Outline
[Form ES-D-1](../sr1020r9-sup1-final-forms-ms.doc#ES-D-1)**

+-------+-------+-------+----------------------------------------------+
| Faci  |       |       |                                              |
| lity: |       |       |                                              |
| \     |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| Sce   |       |       |                                              |
| nario |       |       |                                              |
| No.:  |       |       |                                              |
| \     |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| Op    |       |       |                                              |
| -Test |       |       |                                              |
| No.:  |       |       |                                              |
| \_\_  |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| Exami |       |       |                                              |
| ners: |       |       |                                              |
| \     |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| Opera |       |       |                                              |
| tors: |       |       |                                              |
| \_\   |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| > \   |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| > \_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| >     |       |       |                                              |
| > \   |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| > \_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| In    |       |       |                                              |
| itial |       |       |                                              |
| C     |       |       |                                              |
| ondit |       |       |                                              |
| ions: |       |       |                                              |
| \_\_  |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| \_\_  |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| Turn  |       |       |                                              |
| over: |       |       |                                              |
| \_    |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
|       |       |       |                                              |
| \_\_  |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
| \_\_\ |       |       |                                              |
| _\_\_ |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
| **    | **    | **    | **Event**                                    |
| Event | Malf. | Event |                                              |
| No.** | No.** | Typ   | **Description**                              |
|       |       | e\*** |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
|       |       |       |                                              |
+-------+-------+-------+----------------------------------------------+
| \*    |       |       |                                              |
| (N)o  |       |       |                                              |
| rmal, |       |       |                                              |
| (R)   |       |       |                                              |
| eacti |       |       |                                              |
| vity, |       |       |                                              |
| (I)   |       |       |                                              |
| nstru |       |       |                                              |
| ment, |       |       |                                              |
| (C    |       |       |                                              |
| )ompo |       |       |                                              |
| nent, |       |       |                                              |
| (M    |       |       |                                              |
| )ajor |       |       |                                              |
+-------+-------+-------+----------------------------------------------+

[]{#BM_51_ .anchor}**Appendix D Required Operator Actions
[Form ES-D-2](../sr1020r9-sup1-final-forms-ms.doc#ES-D-2)**

+------+----------+---------------------------------------------------+
| Op-  |          |                                                   |
| Test |          |                                                   |
| No.: |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| Scen |          |                                                   |
| ario |          |                                                   |
| No.: |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| E    |          |                                                   |
| vent |          |                                                   |
| No.: |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| Page |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| o    |          |                                                   |
| f \_ |          |                                                   |
| \_\_ |          |                                                   |
|      |          |                                                   |
| E    |          |                                                   |
| vent |          |                                                   |
| Desc |          |                                                   |
| ript |          |                                                   |
| ion: |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
|      |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
|      |          |                                                   |
| \_   |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
| \_\_ |          |                                                   |
+------+----------+---------------------------------------------------+
| **Ti | **Po     | **Applicant's Actions or Behavior**               |
| me** | sition** |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+
|      |          |                                                   |
+------+----------+---------------------------------------------------+

[^1]: ^1^ Chapter 13 of NUREG-1560, "Individual Plant Examination
    Program: Perspectives on Reactor Safety and Plant Performance,"
    identifies a number of important human actions that may be
    appropriate for evaluation.

[^2]: ^1^ NUREG-1449, "NRC Staff Evaluation of Shutdown and Low-Power
    Operation," defines "low power" to include the range
    from criticality to 5 percent power.