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Page Title:
Attachment 2 - Sample Gradi ng Checklist for RW II |
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|  DOE-HDBK-1130-98
Module 10.1: Instructions for Evaluators
Attachment 1
ATTACHMENT 2 - Sample Gradi ng Checklist for RW II
TRAINING COMPLETION RECORD
Name
SSN/EMPLOYEE#
COMPANY
Item Evaluated
Pt Val
Score
Pre-Job Preparation
total 20 pts.
Selected proper PCs.
5
Selected and properly wear dosimetry.
5
**
Donned PCs properly.
5
Recorded appropriate information.
5
Knowledge Level (See Attachment 5)
total 20 pts.
Enter results of knowledge-level evaluation.
20
Radiological Work Practices
total 20 pts.
**
Minimized exposure while completing task.
4
Minimized Radioactive Waste.
4
Didn't walk thru contamination unnecessarily.
4
Didn't spread contamination.
4
Chose low exposure route.
4
Emergency Response
total 20 pts.
** Responded to alarm.
Exited area.
5
Notified RCT upon exit.
5
Exit Practices
total 20 pts.
**
Followed undress procedure.
3
Did not contaminate step-off pad.
3
**
Did not contami nate self.
7
**
Performed whole body survey properly.
5
Surveyed DRD.
1
Read DRD correctly upon exit.
1
100 pts.
I was instructed on the proper performance of all items for which my performance was unsatisfactory. I had the opportunity to ask questions. I understand
that failure of this exercise restricts me from entering the following areas:
Student
Date
Instructor
Date
** Indicates significant mistake. If not identified by student, deduct 21 points.
Note: Comments on reverse.
130
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