ORR Assessment Form 1 - std_3006

DOE-STD-3006-2000

ORR ASSESSMENT FORM 1

FUNCTIONAL

OBJECTIVE , REV. 0

CRITERIA MET

AREA:

DATE:

YES

OBJECTIVE: as stated in the CRAD

Criteria as stated in the CRAD

Approach as stated in the CRAD

Record Review: as stated in the CRAD

Interviews: as stated in the CRAD

Shift Performance: as stated in the CRAD

Records Reviewed:

Interviews Conducted:

Shift Performance Observed:

Discussion of Results:

Note: Discussion of results in three distinct sections related to Records, Interviews, and Shift

Performance may not be the most efficient and clear manner to discuss the results of the review. In some

cases, it may be preferable to discuss the overall results. In others, it may be preferable to discuss the

results by individual criteria. The method chosen must ultimately end in clear communication of the

results of the review. The team leadership must provide direction or guidance in this area.

Record Review: Write the results of your review here.

FORM 1

Appendix 4-27