Assessment Form - std30060113

DOE-STD-3006-95

Appendix 4

ASSESSMENT FORM (FORM 1)

Form 1's are used to document the methods and actions taken by a team member in the criteria evaluation

process. Each Form 1 covers a specific objective and lists the means the team member used to measure the

site's performance relative to the objective provided in the Criteria and Review Approach Document (CRAD) or

Criteria and Review Approach (CRA) lists 1. The form should be complete enough to allow a reviewer of the

form to follow the inspection logic and means utilized to verify the facility's performance with respect to the

criteria and to thereby validate the ORR's completeness and adequacy. Ensure that the approach used is what

the CRAD called for. If for some reason the approach used does not exactly match the approach described in

the CRAD, the reason should be documented.

Functional Area:

Print the ORR functional area to which the CRAD has been assigned.

CRA Number/Title:

Specifically identify the CRA or portion of the CRA that the Appraisal Form is to support. Provide the name

and number of the CRA or portion of CRA.

Date:

Provide the date on which the form is generated. Change the date as updates or revisions to the form are

generated.

Method of Appraisal:

Use this section to clearly describe the approach taken to review the criterion against the CRAD guidance. If

for some reason the approach used does not exactly match the approach described in the CRAD, the reason

should be documented here.

Note: CRA and CRAD are used interchangeably in this document and refer

to the criteria document upon which the ORR is based.

Appendix 4-12