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DOE-STD-3006-2000
ID #:
This number correlates the finding (Form 2) and resolution (Form 3) documents and should be the same
number listed on the applicable Form 2.
Issue:
The finding issue statement from the corresponding Form 2 is placed here.
Finding Designation:
This section indicates whether the finding is a prestart or post-start finding.
Responsible Individual:
The individual that management has assigned to be responsible for correcting the finding is identified in
this block. The name and phone number of the person should be provided.
Action Plan:
A description of the plan to resolve the finding, along with proposed dates of completion, is presented in
this section. A compilation of these plans taken from all the Form 3s generated during the ORR would
form the basis for the action plan that is submitted to the appointing authority for approval. Modifications
to the action plan made by the appointing authority would need to be incorporated in the Form 3.
Resolution:
A description of the actual actions taken, the reasons for concluding that closure has been achieved and
how referenced documents support closure, along with dates of completion, is provided. This becomes
the formal documentation of the corrective measures used to resolve the finding.
Certified:
This block is used by management to certify that the actions specified in the action plan and detailed in the
resolution block have been completed. The designated manager would sign this block when satisfied that
all corrective action are completed.
Verified:
This signature block is used by the official designated by the appointing authority to verify management's
successful fulfillment of the corrective actions.
Appendix 4-26


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