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Home My WebLink AboutDRC-2024-007429 CLIVE SITE LETTER OF TRANSMITTAL DATE: 11/4/2024 ATTN: LLRW CC; Treesa Parker Karen Kirkwood RE: Transmittal 2024-080 Description of Documents Transmitted Qty See attached for update to Qualification Cards. Q1147 Rev 5, Hydraulic Crane Operator 1 Q1156 Rev 4 Non-CDL Tractor Truck Operator 1 Q1201 Rev 5, Batch Plant Operator 1 Q2105 Rev 4 Cask Team Supervisor 1 Q2126 Rev 4 Lift Supervisor 1 ------------------------------------------------------------------------------------------------------------ Please replace your current procedure revisions with the documents within this Transmittal. You are not required to sign any documents to verify receipt of this distribution. However, you should make every effort to ensure that your copy of the License is current. FROM: EnergySolutions Document Control Clive Facility CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL WHO ARE OR MAY BE REQUIRED TO OPERATE A CRANE THAT IS OWNED OR OPERATED BY ENERGYSOLUTIONS. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS DEFENSIVE DRIVER TRAINING RIGGING/SIGNALING/TAGLINE OPERATOR Q2122 (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS APPLICABLE EQUIPMENT OPERATORS MANUAL CL-SH-PR-100 CLIVE HEALTH AND SAFETY PROGRAM CL-SH-WI-606-05 LIFT PLANNING CL-GF-4536 EQUIPMENT OPERATIONS JHA (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS WRITTEN EXAM PASSED AT 80% OR HIGHER COMPLETION OF 40 HOURS OF HANDS ON TRAINING COMPLETION OF PRACTICAL EVALUATION & PRE-USE INSPECTION FORM NCCCO EXTENDING BOOM SWING CAB CRANE CERTIFICATION OR EQUIVALENT Q1147 HYDRAULIC CRANE OPERATOR Qual Manager _Russell Brand_______________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation _Thomas A. Brown____________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE Yes Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: __5_ 11/1/2024 Russell Brand Digitally signed by Russell Brand Date: 2024.10.31 10:36:21 -06'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.comReason: I am approving this documentLocation: CliveDate: 2024-10-31 10:51:06Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 (ADD ADDITIONAL LINES AS NECESSARY)PRACTICAL CRITERIA: Task (Description) Satisfactory (Check Mark) SME Date (Completed) Initials Performs the Pre-Use Inspection correctly. Demonstrates ability to steer and turn smoothly. Demonstrates ability pickup, move, and place a materials. Demonstrates ability to brake and stop appropriately. Sounds horn at all appropriate locations. Keeps components in the appropriate position while traveling. Demonstrates ability to maintain a safe travel speed. Demonstrates ability to allow clearance when turning. Accelerates/Decelerates at gradual rate. Demonstrates ability to stop correctly. Demonstrates ability to maneuver turns correctly. Inspects and Wears all safety equipment (i.e. seat belt, harness, etc.) while operating equipment. Demonstrates ability to load and unload the equipment safely. Demonstrates knowledge and safe usage of attachments, if applicable. Demonstrates the ability to proper park and dismount the equipment. ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE Verification of Completed Documentation QUAL MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE ***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL WHO ARE OR MAY BE REQUIRED TO OPERATE THE BATCH PLANT THAT IS OWNED OR OPERATED BY ENERGYSOLUTIONS PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS DEFENSIVE DRIVER TRAINING Q1142 LOADER OPERATOR (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS APLICABLE EQUIPMENT OPERATORS MANUAL CL-SH-PR-100 CLIVE HEALTH AND SAFETY PROGRAM CL-GF-4536 EQUIPMENT OPERATIONS JHA CL-GF-12208 STAGING/EXITING MIXER TRUCK FROM UNDER BATCH PLANT BOOT. (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS WRITTEN EXAM PASSED AT 80% OR HIGHER COMPLETION OF 80 HRS HANDS ON TRAINING COMPLETION OF PRACTICAL DEMONSTRATION (ADD ADDITIONAL LINES AS NECESSARY) Q1201 BATCH PLANT OPERATOR Qual Manager _Russell Brand_______________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation _Thomas A. Brown____________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: _5_ 11/1/2024 Russell Brand Digitally signed by Russell Brand Date: 2024.10.31 12:56:17 -06'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.comReason: I am approving this document Location: Clive Date: 2024-10-31 13:25:52Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE Verification of Completed Documentation QUAL MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE ***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL WHO ARE OR MAY BE REQUIRED TO PERFORM CASK HANDLING ACTIVITIES AT THE ENERGYSOLUTIONS CLIVE FACILITY. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q2103 CWF CASK TEAM OPERATOR (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS ES-AD-PR-008 CONDITION REPORTS CL-SH-PR-500 CONTINGENCY IMPLEMENTATION PLAN ENERGYSOLUTIONS RADIOACTIVE MATERIALS LICENSE (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS WRITTEN EXAM PASSED AT 80% OR HIGHER COMPLETION OF PRACTICAL DEMONSTRATION (ADD ADDITIONAL LINES AS NECESSARY) Q2105 CASK TEAM SUPERVISOR Qual Manager _Russell Brand_______________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation Thomas A. Brown ________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: 11/1/2024 ________________ Revision No.: _4 Russell Brand Digitally signed by Russell Brand Date: 2024.10.31 12:57:11 -06'00' Digitally signed by Thomas Brown DN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.com Reason: I am approving this document Location: CliveDate: 2024-10-31 13:27:18Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE Verification of Completed Documentation QUAL MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE ***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL WHO ARE OR MAY BE REQUIRED TO OPERATE A TRACTOR TRUCK THAT IS OWNED BY ENERGYSOLUTIONS AND IS ONLY OPERATED ON ENERGYSOLUTIONS PROPERTY. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS DEFENSIVE DRIVER TRAINING (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS APPLICABLE EQUIPMENT OPERATORS MANUAL CL-SH-PR-100 CLIVE HEALTH AND SAFETY PROGRAM CL-GF-4536 EQUIPMENT OPERATIONS JHA JHA-CL-CWF-12408 TRAILER COUPLING (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS CLASSROOM TRAINING WITH WRITTEN EXAM PASSED AT 80% OR HIGHER COMPLETED PRACTICAL EVALUATION & PRE- USE INSPECTION FORM (ADD ADDITIONAL LINES AS NECESSARY) PRACTICAL CRITERIA: Q1156 NON-CDL TRACTOR TRUCK OPERATOR Task (Description) Satisfactory (Check Mark)SME Date (Completed)Initials Performs the Pre-Use Inspection correctly. Demonstrates ability to steer and turn smoothly. Qual Manager _Russell Brand_______________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation _Thomas A. Brown____________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE Yes Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: _4_ 11/1/2024 Russell Brand Digitally signed by Russell Brand Date: 2024.10.31 13:01:08 -06'00' Digitally signed by Thomas BrownDN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.comReason: I am approving this documentLocation: Clive Date: 2024-10-31 13:29:26Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 Demonstrates ability to brake and stop appropriately. Sounds horn at all appropriate locations. Keeps components in the appropriate position while traveling. Demonstrates ability to maintain a safe travel speed. Demonstrates ability to allow clearance when turning. Accelerates/Decelerates at gradual rate. Demonstrates ability to stop correctly. Demonstrates ability to maneuver turns correctly. Inspects and Wears all safety equipment (i.e. seat belt, harness, etc.) while operating equipment. Demonstrates knowledge and safe usage of attachments, if applicable. Demonstrates the ability to proper park and dismount the equipment. ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE RSO _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE Verification of Completed Documentation QUAL MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE ***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3 CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 1 of 3 EMPLOYEE NAME ___________________________________________ QUALIFICATION #: QUALIFICATION TITLE: QUALIFICATION APPROVAL: SCOPE: THIS DOCUMENT APPLIES TO PERSONNEL WHO ARE OR MAY BE REQUIRED TO SUPERVISE RIGGING ACTIVITIES OR CREATE A LIFT PLAN WHILE WORKING AT ENERGYSOLUTIONS. PREREQUISITE TRAINING/QUALIFICATIONS: DATE COMPLETED INITIALS Q2122 RIGGING-SIGNAL-TAGLINE OPERATOR (ADD ADDITIONAL LINES AS NECESSARY) PREREQUISITE READING MATERIALS: DATE COMPLETED INITIALS ES-SH-PG-600 HOISTING AND RIGGING PROGRAM ES-SH-PR-606 RIGGING AND BELOW THE HOOK DEVICES (BLTHD) CL-SH-PR-500 CONTIGENCY IMPLIMENTATION PLAN (ADD ADDITIONAL LINES AS NECESSARY) QUALIFICATION CRITERIA: Page No (if applicable) SME SIGNATURE DATE COMPLETED INITIALS WRITTEN EXAM PASSED AT 80% OR HIGHER COMPLETION OF 10 HOURS HANDS ON TRAINING COMPLETION OF DEMONSTRATION (ADD ADDITIONAL LINES AS NECESSARY) Q2126 LIFT SUPERVISOR Qual Manager _Russell Brand_______________ ___________________________ Date_________ PRINTED NAME SIGNATURE Radiation _Thomas A. Brown____________ ___________________________ Date_________ Safety Officer PRINTED NAME SIGNATURE No Practical Evaluation (included) Yes/No This SECTION is filled out by DOCUMENT CONTROL. Effective Date: ______________ ________________ Revision No.: _4 11/1/2024 Russell Brand Digitally signed by Russell Brand Date: 2024.10.31 13:46:33 -06'00' Digitally signed by Thomas Brown DN: OU=Health Physics, O="EnergySolutions, LLC", CN=Thomas Brown, E=tabrown@energysolutions.comReason: I am approving this documentLocation: Clive Date: 2024-10-31 13:49:55Foxit PhantomPDF Version: 9.7.5 Thomas Brown CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 2 of 3 ALL REQUIRED ITEMS HAVE BEEN COMPLETED AND THIS QUALIFICATION IS VALID: EMPLOYEE _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE EMPLOYEE MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE Verification of Completed Documentation QUAL MANAGER _______________________ ______________________ DATE_________ PRINTED NAME SIGNATURE ***ONCE COMPLETE, SCAN AND PLACE IN FOLDER FOR DATA ENTRY AND DOC CONTROL*** CL-TN-PR-100-F7 Revision 1 QUALIFICATION CARD Page 3 of 3