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Differing Professional Opinion (DPO) Submittal Form
Do you believe this issue involves a risk of imminent danger that would warrant an immediate stop work or a shutdown?:
Yes
No
1. What is the Issue?
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2. What is your recommended action?
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3. What could happen if there is no change?
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4. Which technical experts would you recommend to be included on the panel to review the DPO?
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5. What should we read to help us resolve the issue?
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6. What else have you tried to resolve the issue (review and comments, discussions with technical personnel and management, local DPO processes, etc.) and what were the results?
*
This DPO involves (select the applicable entry)
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National Nuclear Security Administration Facility
Office of Science Hazard Category 1, 2, or 3 Nuclear Facility
SC Facility or Activity other than a Hazard Category 1, 2, or 3 Nuclear Facility
Office of Nuclear Energy Nuclear Facility
Office of the Under Secretary for Management & Performance Nuclear Facility
All other DOE facilities
Contact Information
Name:
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Email:
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Organization:
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Relationship to DOE:
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DOE Employee
DOE Contractor
DOE Subcontractor
Phone:
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Complete Mailing Address:
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Best way to contact you for additional information:
Certification
I certify that the above information is true.
Please select Certification before submitting.