SD 450.2-1A, NNSA Delegation Nomination (template)

[image: NNSA2]NNSA SD 450.2-1A NNSA DELEGATION NOMINATION [bookmark: _Hlk138256857]Delegate Name/Position/Organization: Note: Provide latest approved organizational chart (with sufficient granularity), based on approved staffing allocations [bookmark: _Hlk138256965]Delegations Proposed: Note: 1. Include any restrictions and conditions (e.g., delegate would approve only revisions to existing DSAs). 2. Indicate if CTA concurrence is required. Delegate’s Education and Experience/Expertise: [bookmark: _Hlk138176204]Note: 1. List technical or other degrees, professional licenses, and relevant certificates. 2. Include summary of years of relevant experience/expertise. 3. Attach biography. Qualification: Note: Provide certificates or proof of STSM and NELT. Compensatory Measures / Corrective Actions: Note: If compensatory measures are necessary, indicate how compensatory measures will be implemented and documented (see NNSASD 450.2-1A, Appendix A for additional info). [EXAMPLE] Until such time that [candidate] completes the NELT/STSM qualification, the delegated authorities will be exercised with documented concurrence from [designated individual, name/title], who meets the qualifications for individuals delegated nuclear safety authorities. [designated senior manager, name/title] will serve as an independent review, any disagreements related to these delegated authorities will be presented to the NA-ESH Cognizant Secretarial Officer for resolution. Upon completion of NELT/STSM qualification by [candidate] the documented evidence will provide to NA-ESH (NA-ESH will then issue a new delegation to [delegate]). [bookmark: _Hlk138257129]Organization’s Capability/Capacity: Authority Grade Supporting Documentation Safety Design Basis Safety Basis P&T Startup/Restart Exceeds Expectations A thorough summary affirmed (evidence) from the Chief of Defense Nuclear Safety (CDNS) Biennial Review (BR), self-assessment (SA), or independent assessment(s) that the site capabilities/ capacities exceed expectations. Meets Expectations A short narrative affirmed (evidence) from the CDNS BR, SA, or independent assessment(s) that the site capabilities/capacities meet expectations. Needs Improvement Citation(s) from the CDNS BR, SA, or independent assessment(s) providing basis for needs improvement. Include planned improvements to meet expectations. Does Not Meet Expectations Citation(s) from the CDNS BR, SA, or independent assessment(s) providing basis for does not meet expectation. Include planned improvements to meet expectations. Note: Provide the following: 1. Latest eTQP data and status of TQP qualifications for key functional area(s) supporting the delegated authority. 2. Status of corrective actions for latest CDNS BR, SA, or independent assessment(s). [bookmark: _Hlk138257605]Other Conditions to Justify Delegation: [bookmark: _Hlk138258592]Provide status of corrective actions associated with key functional areas (e.g., safety basis, radiation protection, conduct of operations, criticality, fire protection) for supporting documentation for adequacy of the organizational capability/capacity. Page 1 of 7 image1.png