Assessment Form - Continued - std_3006

DOE-STD-3006-2000

Personnel Contacted/Positions:

The individuals contacted while reviewing the criterion should be listed by title.

Records and Other Documents Reviewed:

The documents should be listed in bullet format.

Evolutions/Operations Witnessed:

List evolutions/operations with location (e.g., building) in bullet form.

Spaces Visited:

Indicate the areas of the facility visited.

Discussion:

Provide a discussion of the performance against the criteria

Conclusion:

Provide a conclusion as to whether the criteria have been met, and if not met, reference applicable Form

2s. This section of the Form 1 will provide the basis for the ORR Report and conclusions as to readiness

to startup. This section should be a stand alone statement that describes in detail whether or not the

criterion was met and why. It is anticipated that the wording in this section can be transcribed directly

into the report.

Inspected by:

The inspector who generates the form prints their name in order to identify the generator of the form.

Approved by:

The ORR Team Leader signs the form after all revisions/changes have been incorporated. This signature

indicates that the form is in final form. The team member should also sign the form to indicate agreement

with the content.

Appendix 4-20