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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?:

1. What is the Issue?  
2. What is your recommended action?  
3. What could happen if there is no change?  
4. Which technical experts would you recommend to be included on the panel to review the DPO?  
5. What should we read to help us resolve the issue?  
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)  

Contact Information
Name:     Email:  
Organization:     Relationship to DOE:  
Complete Mailing Address:    
Best way to contact you for additional information:  
I certify that the above information is true.   Please select Certification before submitting.