personnel

Chapter 5 - TYPES OF TESTING The FMCSA regulations require you to implement the following types of controlled substances and alcohol tests:

•     Pre-employment (controlled substances only)

•     Reasonable suspicion

•     Post-accident

•     Random

•     Return-to-duty

•     Follow-up.

This chapter describes the major requirements of each of these types of tests.

Section 1.  PRE-EMPLOYMENT TESTING All applicants for employment on a permanent or temporary basis as a CMV driver, or current employees who wish to remain CDL drivers, must be given pre-employment tests for controlled substances.  Prior to conducting the test, you must inform the applicant or driver in writing of the testing requirements (§382.601).

The purpose of pre-employment testing is to deter and detect controlled substances abuse by driver-applicants.  Pre-employment testing identifies drivers who could bring a controlled substances problem into your organization.

A driver-applicant shall not be allowed to perform as a driver unless the employer has a verified negative controlled substances test result from the MRO for the driver-applicant.

You are required to conduct pre-employment tests each time a driver returns to work after a layoff period when the driver has not been subjected to random controlled substances testing for more than 30 days or has been employed by another entity.  You must notify a driver-applicant of the results of a pre-employment controlled substances test if the driver-applicant requests the results within 60 days of being notified of the disposition of the

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employment application.  For examples illustrating whether or not you need to conduct pre-employment tests, please refer to table 5.1, Pre-employment Testing Examples.

Exceptions for Pre-employment Controlled Substances Testing

You may elect not to administer a pre-employment controlled substances test if

•      The driver-applicant has participated in a controlled substances testing program that meets the requirements of 49 CFR part 382 and part 40 (or another DOT agency's controlled substances testing program) within the previous 30 days, and

•      While participating in that program, the driver-applicant either was tested for controlled substances within the past 6 months or participated in a random testing program for the previous 12 months, and

•      The employer verifies that no prior employer of the driver-applicant has records of a violation of Part 382, subpart B or the controlled substance prohibited conduct rules of another DOT agency within the previous 6 months (§382.301(c)).

Pre-employment Controlled Substances Testing Exception Recordkeeping

You must obtain enough information to show that the driver is qualified under the regulations.  If you operate under either of the two exceptions mentioned above, you must contact the previous testing program to verify the following:

•      Name(s) and address(es) of the program(s),

•      That the driver participates or participated in the program(s),

•      That the program is in compliance with 49 CFR part 40,

•      That the driver has not refused to be tested for controlled substances,

•      The date the driver was last tested for controlled substances, and

•      The results of any tests taken within the previous 6 months.

You must obtain a release form signed by the driver-applicant authorizing the previous testing program to share this information with you and forward that release form to each of the driver's previous employers.


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Table 5.1  Pre-employment Testing Examples

REQUIRED TO TEST

The following are some examples that describe situations in which an employer MUST conduct pre-employment tests, unless the employer utilizes an exception.

•      A new employer just started operating CMVs.  All drivers hired to drive CMVs subject to this rule will fall under the pre-employment testing requirements.

•      A driver usually operates CMVs that do not require a CDL, but then is required to operate a CMV that requires a CDL for the same employer.  A pre-employment test is required.

•      Any driver who is hired and has not been part of a controlled substances program that complies with the FMCSA regulations for the previous 30 days must undergo a controlled substances test.

NOT REQUIRED TO TEST

The following are some examples that describe situations in which an employer may not have to conduct pre-employment tests.

•      Employer A purchases employer B.  Employer B drivers who are now Employer A drivers do not need to be tested because their employment status has not been interrupted.

•      Pre-employment tests are not required when an employer's name changes.

•      If a driver is transferred from one division to another within the same company, the pre-employment requirements do not apply.  However, when a driver transfers from one wholly owned subsidiary or independently operated company to another, a pre-employment test is needed, unless the driver is subject to one of the exceptions.

Drivers Who Drive for You Sporadically, but Are Regularly Employed by Another Employer

If you use, but do not employ, a driver more than once a year, you must assure yourself once every 6 months that the driver participates in a controlled substances testing program that meets the requirements of the regulations.  This means that if a driver is regularly employed by another employer

subject to part 382, and you use the driver to operate your commercial motor vehicles for two or more times in a 365-day period, you need only check with the driver's regular employer once every 6 months to obtain the pre-employment exception testing information, if you do not want to preemployment test the driver each time.

For example, a motor coach tour employer regularly employs a driver to operate


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motor coach tours along the Eastern seaboard.  The driver has some extra days off from the employer.  The driver asks you if you have any trips that will take 3 days to complete.  You have a load to be delivered and have the driver go through your hiring process.

For controlled substances testing under your program, the driver states that he/she has had a negative controlled substances test in the last month.  The driver provides you with a written authorization requesting that his/her regular employer release the information about his/her test results for the last 6 months to your employer.  You obtain all of the records required by the exception and verify that the driver did have a controlled substances test in the last month.  It was verified negative and the driver has no subsequent violations of the prohibited conduct in subpart B.

You use the driver for the trip and the driver returns to the motor coach employer after completing your trip.  You use the driver again in 1 month and again after 4 months.  You are not required by the regulations to check the driver's testing records at the motor coach employer when you use the driver at the one month and four month intervals.  The driver, however, returns 7 months after you first used him/her and since the last time you checked the driver's testing records.  Now you must again check with the motor coach employer to verify that the driver continues to

participate in the motor coach employer's testing programs and the driver has not violated the prohibited conduct regulations of the FMCSA or similar DOT agencies.

Two-Year Prior Employer Checks (49 CFR 382.413/40.25) You must also request the following information from previous employers concerning the driver-applicant's participation in a controlled substances and alcohol program within the preceding 2 years:

1. Did the employee have alcohol tests with a result of 0.04 or higher?

2. Did the employee have verified positive drug tests?

3. Did the employee refuse to be tested?

4. Did the employee have other violations of DOT agency drug and alcohol testing regulations?

5. If you answered "yes" to any of the above items, did the employee complete the return-to-duty process?

6. Did a previous employer report a drug and alcohol rule violation to you?

You must as an employer ask prospective driver-applicants if they have failed or refused a DOT drug or alcohol


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pre-employment test within the past 2 years from an employer who did not hire them (§40.25(j)). With respect to any driver-applicant who violated a DOT drug and alcohol regulation, you must obtain documentation of the individual's successful completion of DOT return-to-duty requirements (including follow-up tests).

You must obtain the driver-applicant's written consent (see sample forms) to obtain the information from the driver-applicant's previous employers as a condition of employment.  The FMCSA expects you to obtain the information as soon as possible and prior to using the driver to perform any safety-sensitive functions other than initial road testing of the driver.  However, if this is not

feasible, you will have up to 30 days after the driver initially performs safety-sensitive functions to obtain the information.

If you make a good-faith effort to obtain the information as soon as possible and you are unable to obtain this information within the 30-day period, you may continue to use the driver after the 30-day period, if you properly document your good-faith effort to request and obtain the information.  However, if you failed to request the information from any prior employer of the driver, you must stop using the driver.  See table 5.2 for an example of a good-faith effort to obtain a driver's prior employers' testing records.


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Table 5.2.  An Example of a Good-Faith Effort

for Obtaining Prior Testing Information

A good-faith effort might begin with obtaining the driver's written consent on your release of information form.  The driver should complete the document at the time the driver prepares other documents in the hiring process (e.g., §391.21, Application for Employment.)  Immediately after you make your conditional offer of employment, send the written consent, along with how you would like the information transmitted to you (e.g., by secure and confidential fax, by certified mail, by telephone to a designated person) to the previous employer by certified mail.

After a reasonable period, you should contact the driver's previous employers' alcohol and drug testing program manager(s) to ask about the status of your request to obtain the driver's testing records

the previous employer(s).  You should not wait until a few days before the first time you will use the driver to perform safety-sensitive functions to make a follow-up contact with the previous employers. 

Previous employers are required to forward their testing information immediately upon receipt of the specific written consent to you or the third-party administrator designated to receive the information.

If a driver's previous employer has gone out of business, refuses to comply with 49 CFR section 40.25 requirements to forward their testing information about the driver to you, or if for some other reason you cannot obtain the testing information from a particular employer, document the facts and any related information and retain them in your files.

The information should be provided on the release of information form sent to them. They should sign, answer the questions, and send it back. You are required to maintain a written, confidential record with respect to each past employer contacted for three years.

Once you have determined that you will hire the driver-applicant and the driver-applicant has provided the written consent, you must provide to each employer the written request authorizing release of the informaation to you.  You may wish to fax the consent form

to ensure the previous employer receives the driver's consent and request for information.

It is important to document the request for, and inability to receive, information from the driver's prior employers.  In the event of an FMCSA investigation of your program, you may be asked to produce this documentation for the FMCSA investigator. (See sample forms.)

If you have not heard from the driver's previous employer(s) after a day or so, you


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should contact them and determine the status of your information request.  In the event that you do not get an answer from the prior employer, or they ignore your request, document the attempt and file the information.

If you receive information indicating that the driver has tested positive for controlled substances, tested at or above 0.04 alcohol concentration, or refused to be tested, you must not use that driver to perform safety-sensitive functions unless the driver has followed the requirements of 49 CFR part 40, subpart O and has been advised by a substance abuse professional that the driver may return to work.  These requirements include being evaluated by a substance abuse professional, complying with any recommended treatment, passing a return-to-duty test, and having at least six follow-up tests within the first 12 months of returning to work as a driver.

If you obtain records from the driver's previous employers verifying that the driver has violated 49 CFR Part 382, subpart B within 30 days of your use of the driver, you must immediately stop using the driver and determine what, if anything, the driver has complied with in part 40, subpart O.  If the driver has not had a follow-up evaluation by an SAP, after any alcohol test above 0.04, any verified positive controlled substances test, or the driver is refusing to test, you may not use

the driver until you have received a follow- up letter from the SAP. The letter must follow the format shown in 49 CFR section 40.311(d).

If the driver has not had a return-to-duty test after obtaining a letter of compliance from an SAP, a return-to-duty test is necessary.  A pre-employment negative controlled substances test and an alcohol test result of less than 0.02 alcohol concentration conducted by you will satisfy the requirement for a return-to-duty test in this instance.  However, you will be responsible for ensuring that at least six follow-up tests are conducted within the first 12 months that the driver is employed or used at your organization.

If the driver has provided a previous employer with proper documentation for return to work and the driver has taken a return-to-duty test or a pre-employment test at the previous employer, but the previous employer did not complete all of the required follow-up tests within the first 12 months, you will be responsible for ensuring the remaining tests are conducted.

Section 2.  REASONABLE SUSPICION TESTING The FMCSA regulations require you to test a driver if a trained supervisor has reasonable suspicion that the driver has used a controlled substance or has misused alcohol as defined in the regulations (§382.307).  The request to undergo a reasonable suspicion test


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must be based on specific, contemporaneous, articulable observations concerning the appearance, behavior, speech, or body odor of the driver.  These observations may include indications of the chronic and withdrawal effects of controlled substances.  The chronic and withdrawal effects of controlled substances may not be the sole indicator for reasonable suspicion, but may be used in conjunction with other indicators.

Reasonable suspicion testing is designed to provide you with a tool to identify affected drivers who, through alcohol or controlled substances misuse, may pose a danger to themselves and others in their performance of safety-sensitive functions.  Drivers may be at work in a condition that raises concern regarding their safety or productivity.  A supervisor must then make a decision as to whether reasonable suspicion exists that a controlled substance and/or alcohol may be causing the behavior.

Supervisory Observations

Only one qualified supervisor or company official is required to witness the conduct of the driver; however, it is a good business practice to have at least two qualified supervisors or company officials witness the conduct.  Supervisors or company officials who make the determination of whether to test must be trained in the physical, behavioral,

speech, and performance indicators of probable alcohol misuse and use of controlled substances (see Chapter 4, education and Training.)

To protect yourself and your drivers, supervisors who make the determination that reasonable suspicion exists to conduct an alcohol test may not conduct the alcohol test on that driver, unless they have been trained.

Reasonable suspicion alcohol testing is permissible only if the supervisor's observations are made during, just preceding, or just after the driver is performing safety-sensitive functions or is attempting to perform safety-sensitive functions.  In contrast, you may test a driver for controlled substances under reasonable suspicion based on observations at any time the driver is on duty.

Besides recognizing valid objective signs and symptoms of controlled substances use and alcohol misuse, supervisors must also know the proper procedures for confronting and referring the driver for testing.  If supervisors are not trained, or are not fair and objective in requesting reasonable suspicion tests, driver complaints of harassment will result.  Be careful not to expect that training alone will make your supervisors experts in detecting substance abuse. 


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The overt signs and symptoms of substance abuse can often be masked and may be subtle enough to avoid direct detection.

If a supervisor, trained to identify the signs and symptoms of controlled substances use and alcohol misuse, reasonably concludes that objective facts indicate controlled substances use or alcohol misuse, this is sufficient justification for testing.  A final practical check is whether the supervisor would Truck driver receiving training from a supervisor in the passenger seat.

have been less responsible in not taking action than in asking the driver to submit to testing.  Remember, safety is the first priority!

If the alcohol test is not administered within 2 hours following observations triggering the request to test, you must prepare and maintain a record stating the reasons the alcohol test was not done promptly.  If the test is not conducted within 8 hours of the observations triggering the request to test, attempts to administer the test must cease, and the supervisor shall indicate in the record the reason the test was not conducted.  If the alcohol test is not conducted within 8 hours, the driver shall be placed out of service for 24 hours.

For controlled substances, the driver must report for collection within a reasonable time. However, you are encouraged to collect the specimen as soon as possible following the observations triggering the request to test, because the test's ability to detect controlled substances declines with the passage of time.

Supervisors making reasonable suspicion determinations shall document those observations within 24 hours of the observed behavior or before the results of the controlled substances test are released, whichever is earlier.


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Prohibited Conduct

Drivers shall not perform safety-sensitive functions if under the influence of or impaired by alcohol, as determined by their trained supervisor.  Following a reasonable suspicion determination, resulting in a positive test, supervisors shall not permit the driver to perform or continue to perform safety-sensitive functions until 24 hours have elapsed. If an evidential breath test device is unavailable, the motor carrier is required to remove the driver from performing safety-sensitive functions until 24 hours have elapsed.  You are prohibited from taking any additional action under FMCSA authority against a driver based solely on the driver's behavior and appearance.  You may have, however, additional policies under your own authority. Flow charts detailing the reasonable suspicion testing process for alcohol and controlled substances appear in the appendix at the end of this chapter.

Section 3.  POST-ACCIDENT TESTING

The FMCSA regulations require testing in specific CMV accidents (§382.303).  An accident is defined as an occurrence involving a CMV operating on a public road that results in (1) a fatality; or (2) bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene of the accident; or (3) one or more motor vehicles incurring disabling damage as a result of the accident, requiring the vehicle(s) to be transported away from the scene by a tow truck or other vehicle.

There is a significant difference between reasonable suspicion testing and post-accident testing.  Reasonable suspicion requires some indication of a link between witnessed behavior and substance abuse before a test can be requested.  Post-accident testing is mandatory when certain criteria are met.

Drivers subject to post-accident testing are those who

•     While performing safety-sensitive functions are involved in an accident resulting in the loss of human life, or

•     While performing safety-sensitive functions are involved in a nonfatal accident resulting in the driver receiving a citation under State or local law for a moving traffic violation arising from the accident.

Accident between school bus and car

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Type of Accident Involved Citation Issued to the CMV Driver Test Must Be Performed by Employer
Human Fatality Yes Yes
Human Fatality No Yes
Bodily Injury With
Immediate Medical Treatment Away From the Scene
Yes Yes
Bodily Injury With
Immediate Medical Treatment Away From the Scene
No No
Disabling Damage to Any Motor Vehicle Requiring Tow Away Yes Yes
Disabling Damage to Any Motor Vehicle Requiring Tow Away No No
Post-accident tests must be performed as soon as possible.  Controlled substances tests must be performed within 32 hours following the accident.  Alcohol tests must be performed within 8 hours of the accident.

If an alcohol test is not administered within 2 hours following the accident, the employer shall prepare and maintain a record stating the reasons the test was not promptly administered.  If an alcohol test is not administered within 8 hours or a controlled substances test is not administered within 32 hours following the accident, the employer shall cease attempts to administer the test and shall prepare and maintain the same record.  For employers requested by FMCSA to submit their annual calendar year summary, see Chapter 9, Section 5, Annual Calendar Year Summary-reporting Requirements for instructions on reporting required post-accident tests that were not to be administered.

Drivers subject to post-accident testing shall remain readily available for such testing or they may be deemed to have refused to submit to testing.  Drivers subject to postaccident testing must refrain from using alcohol for 8 hours following the accident or until completing a post-accident alcohol test, whichever comes first.  It is imperative that you provide drivers with necessary post-accident information, procedures, and instructions prior to their operating a CMV, so that they and you will be able to comply with the regulations.  This requirement is especially important if your operations occur in remote areas.

In the rare event that Federal, State, or local law enforcement officials administer alcohol or controlled substances tests on a driver involved in an accident, and the results are available to you, those results may meet the requirements of the FMCSA regulations, provided such tests conform to applicable Federal, State, or local requirements and certain conditions are met.

Alcohol tests conducted by law enforcement officials using breath or blood specimens will satisfy the postaccident alcohol test requirement when you obtain the test result.  Controlled substances tests conducted by law enforcement officials must use urine as the body fluid tested.  For examples illustrating this concept, please refer to table 5.3, Postaccident Law Enforcement Tests.


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Table 5.3 Post-Accident Law Enforcement Tests

The following examples describe situations where an employer may use test results from law enforcement agencies in lieu of its own test results.

•      An airport shuttle bus driver is involved in an accident on an airport access road with a non-CMV driver and the non-CMV driver is killed instantly. The shuttle bus driver must be tested under the FMCSA rules for both alcohol and controlled substances.  Before the employer learns of the accident, however, an airport police officer at the scene determines that the shuttle bus driver should be tested for alcohol use under the airport police department's authority.  The police officer requires the driver to submit to a blood test at the airport health clinic using procedures developed by the airport police department for alcohol testing.  When the airport shuttle bus company receives the results of the alcohol test, the test results will be allowed to substitute for the FMCSA-required test.  However, the airport shuttle bus company will have to require its CMV driver to also submit to a controlled substances test under this rule, since both tests are required after a fatality. •      A State CMV snowplow driver runs a red light, in full view of a State police officer who witnesses the snowplow impact a small automobile, injuring the automobile driver and completely destroying the automobile.  During the investigation, the State police officer issues a moving traffic citation to the CMV driver.  The officer, who is a drug recognition expert (DRE), determines that the CMV driver is probably under the influence of a substance, most likely amphetamines, and requests the driver to provide a urine specimen for analysis.  The driver is placed under arrest and the State will not allow the poice to conduct an alcohol test on the driver while the driver is in jail.

  The State's crime laboratory determines the urine specimen does contain amphetamines and will release the test results to you.

The requirement to test for alcohol and controlled substances following an accident should in no way delay necessary medical attention for injured people or prohibit a driver from leaving the scene of an accident to obtain assistance in responding to an accident or to obtain necessary emergency medical care.  The following steps should be taken in a postaccident situation:

1.      Treat injuries first.  Accident victims' health and safety are always a higher priority than conducting an alcohol or controlled substances test.


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2.      Cooperate with law enforcement officers.  Allow law enforcement officers to conduct their investigation.  For purposes of their investigation, the police may require a controlled substances or alcohol test for a determination of the presence of controlled substances or alcohol.

3.      Explain the need for testing.  Tell your driver that a test is to be conducted.  Point out to the driver that a negative finding will objectively put to rest any suspicion of controlled substances or alcohol as a cause of the accident.

4.     Conduct tests promptly.  The FMCSA regulations require that specimen collection be performed as soon as possible following the accident, but within 32 hours for controlled substances and within 8 hours for alcohol.

Flow charts detailing the post-accident testing processes may be found in the appendix at the end of this chapter.

Section 4.  RANDOM TESTING

The FMCSA regulations require random testing for all drivers subject to the CDL requirements (§382.305).  Random testing identifies drivers who use controlled substances or misuse alcohol but are unable to predict the test as they would in the case of

post-accident or pre-employment testing.  More importantly, it is widely believed that random testing serves as a strong deterrent against drivers beginning or continuing prohibited controlled substances use and misuse of alcohol. Selection Techniques

You must use a scientifically valid random selection method to select drivers for testing.  Drivers can be chosen from selection pools in several ways.  These include semiautomatic methods (using personal computers) or manual methods (using random number tables).  The computer-based methods are generally more efficient, but the manual methods can be equally fair and credible.

Commercially available computer-based random number-generating software programs enable you to match drivers to numbers and to select names from those lists for random controlled substances and alcohol tests.  Some of these programs are comprehensive, including scheduling and recordkeeping functions.  Alternatively, spreadsheet programs, commonly used for financial and operational analyses, often include a routine that provides random numbers.  Those random numbers can be assigned to your driver list and used for selecting drivers to be tested.  Because your driver pool may fluctuate, the list of driver names must be updated each time the pool


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fluctuates for smaller employers and at least monthly for larger employers.

If a computer program is not available for random selection, a manual sampling technique that uses a random number table may be used.  These tables are found in many statistics textbooks available in libraries and bookstores.  The scientific community does not consider drawing names out of a hat or container to be a scientifically valid method for sampling. While this technique is simple and appears fair because it can be done in full view of the affected drivers, it is actually less random than using a computer or a random number table because of inconsistencies in paper size, as well as the lack of control over the names included or excluded.  Also, it is very difficult to document how a selection is made and who is selected for testing.

The test dates must be spread reasonably throughout the year and should not establish a predictable pattern (e.g., the first Monday of each month).  The number of tests conducted weekly, monthly, or quarterly should remain relatively constant to the extent possible; however, drivers selected for that testing cycle must be tested.  Conducting all of your tests in one month, for example, does not achieve the goal of random testing.  Likewise, the testing should be performed on different days of the week and at different times throughout the annual cycle.  This helps to

office employees working on computers
prevent drivers from coordinating their controlled substances and alcohol use to the random testing schedule.

Random Testing Rates

The current random testing rates under FMCSA regulations are 50 percent for controlled substances and 10 percent for alcohol.  This means that the number of tests to be administered each year is equal to at least 50 percent and 10 percent, respectively, of the average number of driver positions subject to these regulations.  Remember, a driver is anyone who operates a CMV for you.  The driver positions will include other employees in your organization who occasionally drive or drive in rare circumstances.

A slightly higher percentage may have to be selected for testing to compensate for cancelled tests or drivers unavailable for


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testing.  If you join a consortium, the annual rate may be applied to each consortium-member employer or to all the DOT-covered safety-sensitive drivers within the consortium.

Because the random rates for controlled substances and alcohol are different and may vary on a yearly basis, you may wish to conduct separate selections for your alcohol and controlled substances random tests; however, you are not required to do so.  You may select for alcohol testing the first 20 percent of those drivers selected for controlled substances testing.  Other combinations for selecting drivers for alcohol and controlled substances testing may be used, provided you can prove that the method is scientifically valid and impartial toward the drivers (e.g., two-stage selections).

The FMCSA's random testing rates may be adjusted based on analysis of positive random test results within the entire CMV industry.  If this occurs, the change will be published in the Federal Register.  If the minimum annual percentage rate changes, the change will take effect starting January 1 of the year following publication in the Federal Register.

Only drivers performing safety-sensitive functions are permitted in the random pools.  If you decide to randomly test drivers who do not drive CMVs, those drivers must be placed in a separate pool and tested under

separate authority, not the DOT's or the FMCSA's.  The pool may, however, contain drivers subject to other DOT agency regulations.

How to Compute the Average Number of Driver Positions for Random Testing

There will be fluctuations in your driver work force, which will make an accurate computation of a testing rate important.  Your random testing program plan should take into account these fluctuations by estimating the number of random tests needed to be performed over the course of a calendar year.  If your driver work force is expected to be relatively constant (i.e., the total number of driver positions is approximately the same or changes at a relatively constant rate), then the number of tests to be performed in any given year could be determined by multiplying the average number of driver positions by the testing rate.

If there is a large fluctuation of driver positions throughout the year, you must base driver positions on the number of drivers eligible to be tested at the time of each selection period.  The total random tests taken for the year, however, must equal or exceed the average number of driver positions.

For example, if you decided to perform random selections four times a year, the number of controlled substances tests, to be performed


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during each of the four testing periods must equal or exceed 50 percent of the number of driver positions eligible to be tested (D), divided by the number of test periods per year (P).  As a formula, this may be expressed as:

T = 50% x D/P T = Total random tests (must equal or exceed) D = Driver positions eligible to be tested P = Number of test periods per year Note: 10 percent for alcohol

At the time of selecting the individuals to be tested, you determined that there were an average of 60 drivers eligible for testing during the period covered by the February selection, 80 drivers in May, 100 drivers in August, and 70 drivers in November.  Using the formula given above, you would have to perform 8 controlled substances tests in February (50% times 60 divided by 4 equals 7.5, rounded up to the nearest whole number), 10 tests in May, 13 tests in August, and 9 tests in November, for a total of 40 controlled substance tests.

However, throughout the year you needed to perform only 39 controlled substances tests in order to assure testing at the 50 percent rate.  This figure was computed using the same formula with D equal to the summation of the number of drivers eligible for testing in each of the selection periods (D = 60 + 80 + 100 + 70 = 310 drivers), and by

completing the formula, T = 50% times 310 divided by 4 = 38.75) and rounding up to the nearest whole number, 39.  In this example, you could perform one less controlled substances test in the last testing period.

Since driver populations may vary during any given period in a year, conducting random testing only during low-driver periods would not enable you to meet the 50 percent random testing ratio.

Your random testing policy or plan must be documented.  The FMCSA emphasizes that each selection for random testing must include all your drivers to whom the rule applies, regardless of whether or not your drivers have been tested in the past.  This would include individuals who do not regularly drive (such as clerks, mechanics, supervisors, officials), but whom you expect to be immediately available to perform the safety-sensitive function of driving a CMV.  It is quite likely with a large driver turnover that, over the course of the year, you will be employing/using more drivers than there are driver positions.  In determining the number of tests, you should use the number of driver positions, not the number of CMV drivers used/employed during the testing period.

To illustrate using the previous example, in the February selection (which represents the quarter January 1 through March 31), the employer determined that there were


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an average of 60 CMV driver positions. 

However, during the same quarter (at least up to the date the employer performed the random selection of drivers to be tested, say February 12) the employer used/employed a total of 75 individuals as drivers or persons expected to be drivers.  Of these 75 individuals, 15 were no longer used by the employer at the time the selection was made (February 12).  As noted earlier, eight individuals will be selected for controlled substances testing and two individuals will be selected for alcohol testing.

Random Testing Pools

To ensure that each of your drivers has an equal chance of being selected and tested, random testing pools must be established and maintained.  A random testing pool may include any persons who are subject to random testing under any DOT rule, as decided by the employer.  Likewise, a person who is subject to more than one rule may be included in more than one pool.  For example, a person who works for a railroad company subject to both FRA and FMCSA rules may be included in two separate pools or in one pool, at the discretion of the railroad company.

A single pool may be established for alcohol and controlled substances, provided all drivers have an equal chance of being selected

and tested using the applicable random testing rate (currently 10 percent for alcohol testing and 50 percent for controlled substances testing).  As stated above, you may select for alcohol testing the first 20 percent of the drivers selected for controlled substance testing.  Other combinations for selecting drivers for alcohol and drug testing may be used, provided that you can prove that the method is scientifically valid and impartial toward the drivers (e.g., two-stage selections).  Examples of a variety of random testing pools may be found in the appendix at the end of this chapter.

Sampling With Replacement

To ensure that the process is in fact random, all drivers, whether or not they have been chosen for testing in the past, will remain in the pool for each subsequent selection period.  This procedure ensures that the probability of any driver being selected each period is always the same, whether or not the driver was selected in a previous period.  This requirement is expected to serve as a deterrent for those drivers who, believing that they are in the clear, might otherwise consider using controlled substances or misusing alcohol following a recent negative test.

Driver Notification

After a list of drivers for random testing has been generated, you should test those drivers as soon as possible.


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Drivers should be notified in person, although this is not required by the regulations.  The notification should be both oral and in writing, with a written acknowledgment of the notification. Random testing is nonpresumptive:  that is, the driver is not being accused of using controlled substances or alcohol just because he/she is selected for the test.  If possible, the notification should be conducted away from other drivers, preferably in a private office or outside of a vehicle.

You are responsible for ensuring that a selected driver, once notified, proceeds immediately to a collection site.  Immediately, in this context, means that all the driver's actions, after notification, lead to an immediate specimen collection.  This ensures that a driver selected for testing will not have an opportunity to do anything that may affect the outcome of the test.  Any activity that does not directly lead to submitting a specimen should not be performed until after the specimen has been collected.  You should clearly indicate, in your random testing procedures, what these activities are so that there will be no misunderstandings among your drivers.

If you choose to notify your drivers while they are "on the road," you should establish procedures that will allow them to report to a nearby collection facility before continuing their current trip.  This may require a driver to detour from a planned route. 

Notifying drivers at terminals and while they are in heavily populated areas with testing facilities should minimize any negative effect these procedures may have on your operations.

Testing Time Frames

A driver shall be subject to random testing for alcohol only while the driver is performing safety-sensitive functions, just before the driver is to perform, or just after the driver has ceased performing such functions.  Performing a safety-sensitive function includes being immediately available to perform such functions.

Obviously, the best time to test for alcohol is before the driver begins to perform the safety-sensitive function.  However, if the driver understands that a random test will only be administered before he/she begins work and there is an opportunity to drink during work, deterrence is limited.

Controlled substances testing may be performed at any time the driver is at work.  The driver may be performing clerical or mechanical repair duties at the time of notification by the employer.  The driver should not be required to report for a test in the middle of vacation time, while sick, or on other types of excused leave.

Availability of Drivers

When drivers are off work due to long-


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term layoffs, illnesses, injuries, or vacations, will not return before the next selection, and are selected for random testing, you have the following two options:

•     The driver's name could be skipped if the driver selected is going to be gone throughout the entire testing period. You then may select an alternate by using a scientifically valid method, selecting one of the other available drivers in the pool, then testing that driver.

•     The name could be set aside until the driver comes back from the extended leave, and you would conduct the test at that time, as long as the driver returns before the next selection.

You may not require a driver to submit to a test while on an extended leave.  If you experience seasonal fluctuations in the number of drivers available for testing, you should adjust each random selection episode to reflect the fluctuation, thereby ensuring an equal chance of all drivers being selected.

If a driver leaves your employment or is reassigned to nondriving duties, and at some later point is rehired or reassigned to driving duties, the pre-employment testing provisions of this regulation apply.  If a driver primarily does other nondriving work for you and is on call to drive at any time you need the driver,

the driver must be in the random testing selection pool(s) at all times.

Flow charts detailing the random selection process may be found at the end of this chapter.

Section 5.  RETURN-TO-DUTY TESTING

Before you allow a driver to return to duty to perform a safety-sensitive function following certain prohibited conduct_a verified positive controlled substances test result, an alcohol result of 0.04 or greater, a refusal to submit to a test, or any other activity that violates provisions of subpart B_that driver must first be evaluated by a SAP, participate in any treatment program prescribed, and pass a controlled substances and/or alcohol return-to-duty test (Section 40.305).  In pre-employment testing situations, a verified positive controlled substances test or an alcohol result of 0.04 or greater does require a visit to the SAP if you hire the person to perform safety sensitive functions.

The purpose of the return-to-duty test and the evaluation of an individual's return-to-duty status by the SAP is to ensure that the driver receives proper care, if needed.  It is also to provide some degree of assurance to the


Types of Testing

5 - 19


employer that the individual is free of alcohol and/or controlled substances and is able to return to work without undue concern about continued substance abuse.

The driver must have a verified negative controlled substances test result or an alcohol test result of less than 0.02 to return to a safety-sensitive function.  As in any DOT test, if a controlled substances test is cancelled, you shall require your driver to submit to and pass another controlled substances test.

Flow charts detailing the return-to-duty process can be found at the end of this chapter.

Section 6.  FOLLOW-UP TESTING

Once allowed to return to duty, a driver for whom treatment was recommended must be subject to unannounced follow-up testing for at least 12, but not more than 60, months.  The frequency and duration of the follow-up testing will be recommended by the SAP as long as a minimum of six tests are performed during the first 12 months after the driver has returned to duty (§40.307).

It is important to remember that follow-up testing is separate from and in addition to the regular random testing program.  Drivers subject to follow-up testing must remain in the standard random pool and must be tested

whenever their names come up for random testing, even if this means being tested twice in the same day, week, or month.

If the driver is subject to controlled substances follow-up tests, the SAP may also require the driver to take one or more follow-up alcohol tests.  If the driver is subject to alcohol follow-up tests, the SAP may require the driver to take one or more follow-up controlled substances tests.

Flow charts detailing the follow-up testing process may be found at the end of this chapter.

Section 7.  PROFICIENCY TESTING

In addition to the six major driver testing categories described above, you are required to perform proficiency testing as a quality assurance measure for the testing laboratory that conducts your controlled substances testing.

As an employer or C/TPA with an aggregate of 2,000 or more DOT-covered drivers, you must send blind specimens to laboratories you use. If you have an aggregate of fewer than 2,000 DOT-covered drivers, you are not required to provide blind specimens. To each laboratory to which you send at least 100 specimens in a year, you must transmit a


Types of Testing

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number of blind specimens equivalent to 1 percent of the specimens you send to that laboratory up to a maximum of 50 per quarter.  These specimens are called blind performance tests because the testing laboratory does not know they are quality control specimens rather than actual driver specimens.

The blind quality control specimens must not be distinguishable from driver specimens.  Approximately 75 percent of the specimens you submit must be blank (negative) and approximately 15 percent must be positive for one or more of the five controlled substances, and approximately 10 percent must be adulterated with a substance cited in HHS guidance or substituted. If a laboratory reports a positive on a quality control specimen that was a blank (negative), you must notify the DOT immediately by phone or e-mail:

Office of Drug and Alcohol Program Compliance U.S. Department of Transportation (202) 366-3784 or e-mail: www.dot.gov./ost/dapc

If a laboratory reports a negative on a quality control specimen that was a spike (positive), you should notify the laboratory and attempt to discover the cause of the error.  Repeated false negative errors should be reported to the DOT at the above address.  If the laboratory reports conflicting results on the

two parts of a non-safety-sensitive split sample, you must report this to the DOT.

If your laboratory repeatedly reports inaccurate or conflicting results, you should consider changing laboratories.

DOT and FMCSA regulations do not specify where to obtain blind performance specimens.  However, you are encouraged to obtain blind specimens from specimen vendors.  A list of vendors is available from the Department of Health and Human Services (DHHS).


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Chapter 5 Appendix


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5 - 24


Terms and Definitions Used in Chapter 5


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Terms and Definitions

Accident An accident is defined as an occurrence involving a CMV operating on a public road which results in, (1) a fatality; or (2) a bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene of the accident; or (3) one or more motor vehicles incurring disabling damage as a result of the accident, requiring the vehicle to be transported away from the scene by a tow truck or other vehicle.

Unless an occurrence involving a CMV meets this definition of an accident, the accident is not considered to be an accident for purposes of Federal post-accident alcohol and controlled substances testing by employers of CMV drivers.

Alcohol Concentration The alcohol in a volume of breath expressed in terms of grams of alcohol per 210 liters of breath, as indicated by an evidential breath test.  In law enforcement, this is referred to as blood alcohol concentration (BAC).

Blind Sample, Blind Performance, or Proficiency Test Specimen A test submitted to a laboratory for quality control testing purposes, with a fictitious identifier, so that the laboratory cannot distinguish it from driver specimens, and which is spiked with known quantities of specific controlled substances or is blank, containing no controlled substances.

Disabling Damage Damage that precludes departure of a motor vehicle from the scene of the accident in its usual manner in daylight after simple repairs.

(1)     Inclusions.  Damage to motor vehicles that could have been driven, but would have been further damaged if so driven.

(2)     Exclusions.   (i)  Damage which can be remedied temporarily at the scene of the accident without special tools or parts.  (ii)  Tire disablement without other damage, even if no spare tire is available. (iii)  Headlamp or taillamp damage.  (iv)  Damage to turn signals, horn, or windshield wipers that makes them inoperative.

Follow-Up Test Unannounced alcohol and/or controlled substances testing given to drivers who previously tested positive for a controlled substances or alcohol and are returning to duty.


Types of Testing

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Postaccident Test A test administered to a driver in certain CMV accidents.  Drivers subject to postaccident testing are those who

• While performing safety-sensitive functions are involved in an accident resulting in the loss of human life, or

• While performing safety-sensitive functions are involved in a nonfatal accident resulting in the CMV receiving a citation under State or local law for a moving traffic violation arising from the accident, and

(1) There is bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene of the accident;   or

(2) One or more motor vehicles incurs disabling damage as a result of the accident, requiring the vehicle to be transported away from the scene by a tow truck or other vehicle.

Pre-employment Test A test given to an applicant or driver who is being considered for a safety-sensitive position.

Random Test A test administered to a predetermined percentage of drivers who perform safety-sensitive functions and who are selected on a scientifically defensible random and unannounced basis.

Reasonable Suspicion Test A test given to a driver who performs a safety-sensitive function and who is reasonably suspected by a trained supervisor of using a controlled substance or misusing alcohol.

Return-to-Duty Test A controlled substances and/or alcohol test prior to return to duty.


Types of Testing

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Flow Charts


Types of Testing

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Alcohol Testing Process for Random, Reasonable Suspicion, Post Accident - diagram  - There is the 'Initial Screen Test' and if Alcohol Concentration is greater than or equal to 0.02 then need to take another confirmation
     test again otherwise driver will return to work. After the confirmation test, if Alcohol Concentration is less than 0.02 then the driver returns to work.  Else if Alcohol Concentration is greater than 0.02 but less than 0.04 then driver will be
	 removed from safty sensitive function for 24 hours and then he/she will return to work. if alcohol concentration is more than 0.04 then driver is removed from safty sensitive function and Evaluated
     by SAP. Then Driver Follows Return-to Duty Process or is Removed from Safety Sensitive function through employer policy actions.

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Alcohol Testing Process for Return-to-Duty, Follow-Up  Diagram - Substance abuse professional evaluation (SAP) reviews whether driver followed recommendations for treatment.  If SAP approves then return to duty test is given but if SAP rejects the driver is not permitted to return to SS Function
       if the Return-To-Duty test Alcohol Concentration is above or equal to 0.02 then driver is not permitted to return to SS function else driver returns to duty after which follow up test is conducted.  If the follow-up Alcohol Concentration is above 0.02 then the driver is removed from SS function else driver remains on duty subject to further follow-up tests as determined by SAP

Types of Testing

5 - 32


Controlled Substances Testing Process for Random, Reasonable Suspicion, Post Accident  Diagram  First the specimen is collected and then the specimen analyzed by a Laboratory.  The lab results are reviewed by Medical Review Officer (MRO).  If the results are verified negative then the driver is allowed to return to duty.  If the results are verified positive, then the driver is not permitted to return to SS function and a split sample is analyzed if requested by the driver.  The Split sample is reviewed by MRO and if a failure to reconfirm positive, the test is cancelled and driver returns to duty along with notification of the employer, driver and Department of Transportation.  An additional step for a split sample request by the driver is that the driver is evaluated by a Substance Abuse Professional and driver follows return-to duty process.

Types of Testing

5 - 33


Controlled Substances Testing Process for Return-to-Duty, Follow-Up  Diagram  The first step is a Substance Abuse Professional (SAP) evaluation followed by education/treatment recommended.  The SAP then reviews whether driver followed recommendations for treatment and driver repeats program.  If the SAP rejects than the driver is not permitted to perform SS functions.  If the SAP approves then a return to duty test is given, a specimen is analyzed and the results are reviewed by a Medical Review Officer. See next page for continuation of this process.

Types of Testing

5 - 34


Controlled Substances Testing Process for Return-to-Duty, Follow-Up  Diagram  Continued from previous page.  If the Medical Review Officer results are verified positive then the driver is not allowed to perform SS functions and the driver is allowed to request a split sample analysis. If that test is positive again then the driver is not allowed to return to duty and must repeat Substance abuse professional process.  If the original MRO results are negative or the split sample is not reconfirmed, then the substance abuse professional recommends that the driver be allowed to return to SS position.  The driver is returned to SS position and is subject to follow-up tests.  If the follow-up tests are positive then driver is removed from the SS position while if the tests are negative then the driver remains in the SS positions.

Types of Testing

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Types of Testing

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Random Testing Pools


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Random Testing Pools

There are many ways to establish a random testing pool.  The rules allow for a variety of pool types to account for the variety of employer arrangements among employers regulated by the FMCSA.  The physical form of the pool is not specified.  However, there must be some method of identifying all the individuals in the pool for each selection (e.g., a hard copy or electronic list of each person's name, social security number, driver identification number, or other unique identifier).  The following examples illustrate several possible pool arrangements.  They are not the only acceptable arrangements.

Example 1: Company-Based Pool for Random Drug and Alcohol Testing

This pool consists of all drivers subject to random testing.  Drivers are selected using one of the following methods:

1. Names are drawn for controlled substances testing and the first 20% of the selected group of names are selected for alcohol testing.  It is imperative that after the first draw for the controlled substances testing, the names are not alphabetized before selection for the alcohol testing.

2. Names are drawn for controlled substances tests and then the names are returned to the pool for a second selection of names for alcohol testing.

Example 2: Company-Based Program With Separate Pools for Random Controlled Substances and Alcohol Testing

These pools are maintained separately for random controlled substances and random alcohol testing.  This situation would be necessary when some persons are not subject to random alcohol testing but are subject to random controlled substances testing (as is the case with a person who is subject to both FMCSA and RSPA rules, or FMCSA and USCG rules).

Example 3: Company-Based Pool for "Full-Time" Drivers and a Variety of Pools for "Part- Time" Drivers

This arrangement would be applicable for employer operations that use "trip-lease" drivers.

Example 4: Consortia-Based Pool

These pools are maintained by a consortium.  Part of the services provided by a consortium may involve maintaining the random testing pool(s) by using payroll information from each member system to update the pool membership.  Because drivers of all employers are pooled together, the pool is large enough that the likelihood of any one driver being repeatedly selected is lessened.  Likewise, since no employer representative is involved in the selection process (all selection is done by the consortium), no driver need fear that he or she has been unfairly singled out for testing.


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Types of Testing

5 - 40


Manual Random Sampling Technique


Types of Testing

5 - 41


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Manual Random Sampling Technique

The following manual procedure can be used for randomly selecting drivers for testing.  However, it is recommended that a software program be used for random number generation.

Make a copy of table 5.4 and Worksheets 1 and 2, which follow these instructions.

Worksheet 1

1.      Enter the current date on Line A.

2.      On Line B, enter the total number of drivers who are subject to random selection for testing.

3.      Below Line B, list the badge numbers, identification (ID) numbers, or Social Security numbers of all drivers who must be randomly tested in numerical order from the smallest to the largest.  Assign numbers in sequence to these badge, ID, or Social Security numbers.  (For example, assign the number "1" to the driver with the smallest ID number, the number "2" to the driver with the next highest number, etc.)  Use continuation pages of Worksheet 1 if necessary.  Alternatively, you can write the numbers in sequence next to the driver badge, ID, or Social Security number on a computer printout.

Worksheet 2

1.      Complete Lines A through D.  (The total number of drivers on Line C should be the same as the number on Line B of Worksheet 1.)

2.      Select any number on any one of the four pages of table 5.4.  This can be done by placing your finger, with your eyes closed, on one of the four pages.  Write the number selected in this way on Line E.

3.      Write the first two digits of the number you selected on Line F.  This is your "row number" key.

4.      Write the next two digits on Line G.  This is your "column number" key.

5.      Pick the range of column headings on table 5.4 that contains the number on Line G and enter it on Line H.

6.      Find the page of table 5.4 on which your row and column numbers (from Lines F and G) appear and enter the page number (1, 2, 3, or 4) on Line I.

7.      On the page recorded on Line I, find the five-digit number across from the row number (recorded on Line F) and the column number (recorded on Line H) and enter it on Line J.  This is your "starting location."  Place an asterisk beside it.

8.      On Line K, enter the fifth digit of the number on Line E.  This number gives you the direction in which to move from your starting location (marked with an asterisk) on table 5.4.  If the number is 1, 2, or 3, you move up; if the number is 4 or 5, you move to the right; if the number is 6, 7, or 8, you move down; and if the number is 9 or 0, you move to the left.  Circle the direction on Worksheet 2.


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9.      Count the number of digits in the number of drivers from which you are selecting a group to be tested (on Line C).  Enter a "1" on Line L if the total number of drivers is between 1 and 9; enter a "2" if the total number is between 10 and 99; enter a "3" if the number is between 100 and 999, etc.  This is your "scanning size."

10. Move from your starting location (marked with an asterisk) in the direction indicated by the number on Line K.  In each five-digit entry that you come to, scan the number of digits that correspond to the number entered on Line L until you come to a number that is less than your total number of affected drivers.  Record those digits at the bottom of Worksheet 2 until you have selected as many numbers as drivers to be tested (that is, as many numbers as are listed on Line D).

Do not select the same number twice.  Continue until you have chosen enough different random numbers for all your drivers.  You may have to skip many numbers because they are larger than the number of your drivers.

      If the scanning direction is to the right, continue on the next row down.  If the scanning direction is to the left, continue on the next row up.  If the scanning direction is down, continue on the next column to the right.  If the scanning direction is up, continue on the next column to the left.  If you run out of numbers on the page, continue to the following page if you are scanning to the right or down.  Continue on the preceding page if you are scanning to the left or up.

11.      The list of numbers you select in this random manner corresponds to the numbers you earlier assigned in sequence to your drivers.  The drivers whose sequence numbers were selected by this method are the drivers to be tested on the proposed date.

      Add the ID number of new drivers to Worksheet 1.  If a driver leaves the random number pool, remove the ID number.


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Table 5.4

Row
Number
Column Heading

 

00-04

05-09

10-14

15-19

20-24

25-29

30-34

25-29

30-34

35-39

40-44

45-49

00

35944

66132

45677

87728

79084

19868

66940

24287

23963

40769

76876

45105

01

19146

91425

05248

56715

81013

22544

64615

94653

51125

09601

61137

94067

02

89393

93297

16988

16323

90882

02224

84973

49253

63855

67913

32283

91568

03

39952

53053

31339

42811

64354

91551

53919

02770

19347

16836

96066

84251

04

85439

70582

20047

26806

04678

03530

32685

66702

75759

77382

94645

21023

05

85996

80397

37340

29043

32193

44715

52908

64160

91429

75102

08903

45392

06

38184

40546

73595

34493

72417

40332

36428

52487

58802

43803

48769

03970

07

62504

70916

17714

31543

20743

65848

50144

64556

98032

06130

72019

25022

08

16027

92981

20849

47517

31371

10090

75479

96698

36008

30154

37210

58547

09

81426

34245

12239

25280

53111

99077

90345

06568

90271

04556

90896

13825

10

26846

58222

08497

86110

47089

89304

39908

95065

95770

79059

91363

69475

11

11494

47828

22460

60243

34377

42492

35697

61635

15514

54149

50300

74346

12

84927

52241

87675

12204

74444

63284

60505

00247

47009

96303

93487

40599

13

84472

23603

67569

13653

89986

14992

15133

56994

96152

65552

40549

60214

14

34505

10993

39749

66564

07067

77597

55816

11862

33280

46778

07401

21387

15

42338

66021

77761

54041

78466

83304

12985

80336

40428

01360

95841

58037

16

86303

17774

43968

72562

80850

94424

48253

18331

87929

66164

15136

38872

17

99028

31125

75968

59317

48962

85669

93747

96792

34754

27399

93407

36587

18

68763

25467

00293

41013

15812

42585

08212

97320

24747

95643

02135

34249

19

13015

28239

39739

08504

64800

29894

27138

60809

27671

72333

96176

28072

20

58928

25119

05898

27389

02104

39275

09120

23639

80967

07567

36195

22587

21

13346

85837

39909

41109

73947

99425

85988

16271

15803

79117

42530

29742

22

08848

76887

60895

19245

27360

47131

12143

74941

11582

22504

10005

76031

23

23436

50487

72721

53798

41756

38550

99041

48863

60518

27368

69116

58587

24

91021

44376

37589

94667

08518

21163

94556

52623

37433

85386

41110

76759

25

04272

35671

71646

73571

62942

01048

04511

37904

41997

90006

40710

90973

26

01578

30072

63659

12546

73380

23361

23595

59479

50996

31815

22490

98723

27

29136

26169

31145

75325

99308

44268

61382

75761

00735

20601

93384

45889

28

92614

25427

63297

02512

84414

24160

50201

28970

61081

43649

13288

62336

29

76787

64760

48941

20493

50041

64784

39753

06111

03045

23401

33248

81161

30

64252

22283

57775

28962

53889

29280

37608

10081

77712

12838

14686

76958

31

91309

20209

39837

80079

28474

19267

87126

43096

14651

79173

31780

42601

32

37614

57818

47627

91310

70368

28070

38746

14879

53170

76114

42752

06574

33

90708

61212

77036

52790

90227

81618

06122

77299

35690

54395

35215

89469

34

41372

01251

58166

42479

52990

55728

04250

74424

53700

20353

62284

09896

35

42561

33036

06380

60091

06039

33290

43004

57397

45246

82250

22458

38325

36

38746

41586

34937

65167

10454

16876

80680

77222

61105

82071

56073

32481

37

17391

41294

99307

74420

04621

46824

03612

74694

06365

77826

31134

10110

38

05511

28643

61054

79254

79972

83425

16478

84843

80317

32548

81019

31729

39

39108

14491

36051

25022

93348

29566

47226

72441

01523

37920

94394

84605

40

91005

51283

23124

57794

05720

24869

35332

26230

99743

26844

83140

66667

41

35157

16089

49560

46736

49525

81510

36773

56789

96119

82834

40669

74356

42

95810

10606

66718

04682

69039

50789

56954

67096

86929

93547

38838

06928

43

86769

56447

40848

06338

55119

20283

29312

93884

18976

57782

51899

40749

44

32638

20331

34219

35114

95898

01777

59372

18054

35992

57722

74941

72376

45

55668

11116

30632

74444

58413

69180

69214

37471

27695

48715

43465

28236

46

21255

28620

46542

90990

51092

11385

84947

90370

76670

57762

17856

68032

47

33954

17842

33266

83365

11396

48929

14117

59594

05833

21643

21353

22903

48

67006

84642

02971

22629

32651

63753

79835

96971

43353

66170

82618

40546

49

76216

82754

39361

25662

73868

99685

87388

93666

48783

29577

72921

64695


Types of Testing

5 - 45


Table 5.4 (Continued)

Row
Number
Column Heading

 

00-04

05-09

10-14

15-19

20-24

25-29

30-34

25-29

30-34

35-39

40-44

45-49

50

65329

63270

40355

02999

07942

11645

38129

44998

08787

13543

90923

33593

51

93526

80088

58689

08276

85897

27481

48514

85816

84145

28738

54734

03574

52

95143

49809

96751

00624

78549

78860

85900

11768

40905

06094

29200

77232

53

75386

42921

05982

00447

80071

11088

22841

96979

04479

28338

64435

51151

54

22748

85904

49216

27675

69340

56561

05030

42643

91149

87953

63719

01584

55

28710

96698

80867

48458

02130

31998

42100

06256

56271

27764

37566

27838

56

32037

13983

32058

45073

11336

91786

86687

59805

57801

39470

81011

81429

57

60896

13965

00685

49638

27110

57937

54239

54624

62248

80091

57501

93308

58

89058

22117

20514

75796

54156

61471

04730

81174

10359

01856

29380

30391

59

09568

25382

94676

08981

04980

50222

98457

96442

11970

08674

96858

85324

60

22196

00675

30458

58436

12432

87919

71959

14639

90006

87978

97650

41393

61

49945

53796

19047

44949

57842

67113

22511

53350

45931

57670

13596

93886

62

29476

50406

39614

58507

62957

72171

58818

65498

75309

75942

16021

43748

63

18703

74764

03056

41567

25299

86109

54614

40856

28969

58242

76673

89184

64

49873

62207

72534

20702

16556

49276

10316

73538

90644

82928

59321

18203

65

19985

25369

84812

46227

61888

88301

81836

61107

65104

79408

12059

53842

66

03154

90677

36455

53677

55678

83915

19290

28003

15858

25563

82237

25088

67

25578

18710

13424

65929

85388

60134

16455

55994

30488

41961

61383

58570

68

99273

72840

28541

71743

18139

87311

70662

99117

22685

54271

75276

97177

69

87901

28559

96271

85456

70702

45054

20963

75628

67280

49463

73672

66568

70

63443

98416

42737

67833

95052

35696

37817

90977

87826

31048

21500

09798

71

00761

90586

85762

84934

53279

47885

97586

65287

04768

40276

56284

87226

72

95124

84830

05748

92443

61790

10450

40238

87931

49136

26589

71698

18313

73

57237

52741

11781

03523

05425

42234

81913

61161

44743

83906

29459

02148

74

93276

23749

16958

22242

90455

39647

26914

46398

95636

17589

30496

02133

75

92318

55306

27869

31793

91112

61083

44868

15589

55596

23807

57671

58321

76

91390

32323

07289

49282

21185

22059

03410

12377

03072

27518

78435

01068

77

93205

58549

22523

85906

60906

48768

18085

25739

45691

11518

66181

55147

78

01071

39567

56473

31132

57168

57782

61630

01772

43001

91806

18784

65182

79

03579

10414

54608

40789

28104

43665

23271

93758

24532

97310

05340

27265

80

60477

35811

98288

50701

48956

93693

17079

94874

12059

95117

65205

57421

81

39681

86748

36782

45102

08913

15043

55716

56000

77215

37127

02358

90606

82

22033

84934

09148

41396

16459

40141

26964

98296

53585

95995

42686

21741

83

14101

00047

52602

55407

40129

62935

86167

75095

03341

92998

35762

04599

84

06873

92484

87149

35994

63525

56983

23715

23862

57883

33680

54883

97219

85

30797

92813

17274

51500

66217

16708

89997

63219

44764

67689

33433

72050

86

15747

10396

36476

75160

22022

19820

86886

27470

50174

56334

10351

49636

87

61998

32653

60143

30542

35514

21819

03840

99554

83167

14558

69962

35498

88

09684

04756

23555

19460

85547

26428

44293

14592

01970

91553

63148

20910

89

61404

34976

94332

66889

99632

79871

40258

60827

25993

45670

38481

46632

90

25245

57862

39826

16944

15981

04018

29136

28150

65239

83628

60395

55419

91

09484

87160

66976

79755

06238

42612

92961

27993

85152

46068

74000

40002

92

98011

99251

82349

43715

45699

85124

03911

93499

56695

75753

20000

20716

93

76638

13665

49438

20357

64420

79414

37568

45791

88321

88727

49952

87973

94

64423

68413

06440

46531

14931

14156

09510

20126

20417

41024

51343

71800

95

61707

18827

41733

54540

48588

36569

39203

67613

58873

91631

33064

56484

96

10486

38306

17680

66579

21226

30958

90600

85520

93744

53787

07026

32207

97

47555

13139

63109

09541

57782

23091

25448

47825

66126

98921

98785

19546

98

72026

34279

76997

68348

58053

02899

16268

97317

95836

81952

81638

10556

99

48001

41086

99695

26225

12763

36369

31577

17714

17060

67833

04756

27266


Types of Testing

5 - 46


Table 5.4 (Continued)

Row Number Column Heading

 

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90-94

95-99

00

73137

45987

77079

42671

57474

40782

42681

34880

29982

44007

01

18484

12788

71464

88004

80105

34482

46110

33828

20194

34524

02

77228

43460

99853

89432

30668

48410

76366

56971

16466

52707

03

74064

47482

30684

86869

47448

29043

98906

25613

46286

54060

04

93832

33562

09926

14854

65178

38543

27224

87954

42083

88169

05

42096

79561

26902

64081

52927

02348

67981

57788

96808

65315

06

15225

90935

41981

15978

58895

73271

63773

57887

52412

56796

07

95849

47924

83559

56475

49014

76723

37698

08789

90322

79588

08

48093

73731

83515

75826

79328

93155

97177

21357

47951

52282

09

09967

04011

44935

23539

68271

71622

65741

63627

12806

11152

10

27591

12901

31792

33932

35284

57792

19408

81105

37001

45143

11

28077

30438

28612

01385

23467

26144

95304

34932

82686

20257

12

99131

79046

94608

91136

21009

02454

84859

04655

20139

69458

13

08771

30330

77476

29295

06517

57614

41927

43044

86599

92762

14

22763

65483

45791

64638

33907

34887

80043

45285

78601

55673

15

94472

88988

12427

74496

90499

57289

90409

08428

62542

11887

16

00171

24440

73891

68558

30951

65579

12954

62591

57333

94155

17

77503

70628

96565

62934

98758

99571

21447

74319

11400

78879

18

09183

49458

73690

45164

40982

93785

61612

83259

11476

28203

19

46479

40760

14186

81494

87979

60959

29446

44333

83009

23045

20

84974

54583

27562

80223

67484

39051

07053

19900

38065

28487

21

58091

85789

46174

14255

11174

37610

40665

70658

72431

90617

22

42327

66659

51903

94623

11756

12266

70926

59140

50334

00353

23

90545

48354

39981

29604

84328

64429

59050

81367

71308

46846

24

96948

01154

61945

61943

16247

61538

60879

44465

88601

46322

25

15081

97304

24765

89003

78487

80204

98675

25251

23899

39496

26

80726

88712

41544

79621

31206

97924

36707

93675

80946

10251

27

65126

88820

38191

99672

82740

21379

46805

02613

73551

00152

28

74802

12716

89447

87669

19226

20328

62370

25331

72030

68437

29

00681

23400

45797

65906

42471

65721

60113

47352

10855

29314

30

51818

90150

24191

90189

13531

83141

32221

51986

46109

90064

31

21741

64279

86121

15747

22778

55853

44068

42037

57768

07804

32

04743

51845

42808

70484

31354

22147

66622

25310

12507

66779

33

17515

73527

81034

36107

67558

26224

32749

91331

06737

56475

34

75188

81409

43443

64255

59351

56197

28121

11157

31807

79833

35

88798

41465

52327

39584

18591

11905

44991

31491

95710

57733

36

38415

04433

62111

88999

65731

98678

78365

76674

03088

28296

37

49759

16898

11606

15457

44562

87908

90013

62978

00351

84388

38

12253

20197

64374

87115

62194

80169

64829

79667

11628

14685

39

46530

56684

50377

57435

08598

07948

97387

76604

39429

14502

40

39056

92672

87833

22799

22790

95141

85024

88590

91106

46777

41

19066

46713

15104

97993

40299

48765

03448

37406

30523

85345

42

44411

08105

55720

78858

10811

96961

64975

93300

00861

00388

43

29062

36691

93014

75198

08001

37206

43816

05449

73994

32228

44

46246

77789

99330

63726

76353

33614

32298

89766

33246

59878

45

68334

00824

54832

52672

72328

53138

35463

06908

66724

70735

46

03240

62813

67785

59876

29335

99386

38278

11450

41907

51384

47

57040

05371

75986

47217

40540

87306

42301

41017

42216

11719

48

76415

82540

09893

80330

67264

63861

68330

80941

35476

61634

49

14783

60615

77332

17725

06514

23220

22661

88541

58100

83133


Types of Testing

5 - 47


Table 5.4 (Continued)

Row Number Column Heading

 

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90-94

95-99

50

73332

63452

19036

17987

97357

71591

70281

21729

96772

23313

51

07125

43322

51153

17584

95875

36386

15139

01406

57256

29704

52

55805

21704

33656

50958

78536

55083

44755

34241

12376

50093

53

30450

85984

69694

60633

56777

91361

08410

93312

16785

16213

54

79266

34754

52040

61618

64706

06121

47134

99721

09389

98740

55

35257

13931

41548

30513

26683

75826

93846

12820

05709

24857

56

65320

42448

10530

46587

64422

24065

75098

71139

53258

87333

57

43583

34411

80069

01115

45060

73271

79331

46079

17004

06189

58

02121

61321

30230

41134

29611

78063

24139

62321

87091

23315

59

59700

27260

81495

55324

75035

12425

04631

39136

51349

70949

60

82465

58923

00420

34123

23195

31253

36499

62936

34740

41082

61

01038

21773

60671

18735

52087

78695

49111

76936

80201

80700

62

58674

50958

09717

92001

39943

35895

12164

72299

45328

39070

63

47207

63363

22134

76801

27527

88267

52163

35589

34827

54922

64

23607

55153

21076

06020

48044

11653

13788

50331

50321

80349

65

73518

61210

35079

90891

89598

56527

38846

16500

53375

26612

66

21410

69618

82958

19425

78792

52834

88222

16317

74198

72487

67

48693

83604

77960

81259

71478

85003

52750

44267

62537

95078

68

87029

35995

79974

20486

41923

55126

79209

08207

63508

79175

69

02926

69190

34393

20266

07625

17868

69314

51310

83781

98299

70

93179

90023

55650

17508

58102

22226

74201

78952

12631

11409

71

64558

25251

21637

66793

21347

57796

01309

52703

01767

59199

72

36060

06353

59656

90432

85911

90241

14864

88610

11316

71914

73

75873

80676

52896

04703

13088

96939

28108

77108

02121

64082

74

12033

30392

27350

45432

78199

65203

11250

64687

60657

39536

75

42473

14701

83902

86015

98514

79468

83938

03338

69537

85217

76

53067

81634

57100

61799

37554

20963

57021

07012

11569

47846

77

12222

34023

81396

71121

73353

41315

65854

62294

51585

60436

78

22760

32884

29544

42737

52215

94978

24351

91140

04641

63316

79

30430

84286

50513

89190

77806

95817

71861

03175

02316

68536

80

39604

03405

87105

32453

87042

98522

73645

68204

27074

95431

81

34712

40513

83655

42473

31263

73869

59228

13177

46565

12092

82

21018

11689

91983

51581

47609

19624

45289

79938

26643

46819

83

65452

65559

59616

33196

76515

32353

87737

32379

99970

00113

84

63848

60431

82004

33309

91254

70613

00767

97987

05231

09811

85

96701

79966

45075

32770

19855

07123

00851

77967

17801

06214

86

60235

91092

84473

67106

11982

30995

14371

95264

91620

50856

87

75986

98749

50491

54363

83264

42508

41134

04397

64230

43547

88

98450

88188

08270

87246

34841

34834

42815

02091

14231

99744

89

55931

75741

10173

49042

88651

68473

97277

50865

94366

11837

90

48495

84779

91922

65460

68407

39901

34749

00554

24043

54269

91

58795

84649

45846

98520

18591

21066

31496

18774

94556

01144

92

74678

96980

37154

33190

68084

65983

54926

36887

03956

43052

93

29467

44134

47557

38817

97975

90661

43553

72160

97565

84138

94

68106

64205

94530

98131

72715

44929

99481

04524

88964

12404

95

73446

02619

71757

90688

24693

31089

89948

48977

31907

85536

96

11255

27475

33676

96130

25898

18738

61813

60297

66556

07364

97

65586

73333

94015

68728

81326

45366

00831

21149

13402

79755

98

11842

08167

12212

23410

57127

80363

68895

54522

51663

52529

99

42818

76639

48297

67582

42621

76470

34321

61958

07237

71368


Types of Testing

5 - 48


Worksheet 1

(A) Current Date: ______

(B) Total No. of Safety-Sensitive Functions:

SEQUENCE NUMBER                DRIVER ID NUMBER

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.


Types of Testing

5 - 49


Worksheet 2

(A) Current Date:

(B) Proposed Testing Date:

(C) Total No. of Drivers in Selection Pool:

(D) No. of Tests Needed on Proposed Test Date:

(E) Key to Starting Location: 

(F) Row Number of Starting Location:          

(Digits 1-2 of entry E)

(G) Column Number Key:

(Digits 3-4 of entry E)

(H) Column Heading of Starting Location using (G):  ( - )

(I) Page of Table 5-4 which contains row from entry (F) and column heading from Entry (H):  (Page 1,2,3, or 4)  

(J) Starting Location Number found on page (I), row number (F), and column heading (H):

(K) Code for Direction from Starting Location (Digit 5 from entry E):  (1,2,3 = up   4,5 = right  6,7,8 =  down  9,0 = left)

(L) Scanning Size:  Total no. of digits used to write entry (C) = 1,2,3, or 4:

ORDER OF SELECTION SELECTED NUMBERS
1. ___________________
2. ___________________
3. ___________________
4. ___________________
5. ___________________
6. ___________________
7. ___________________
8. ___________________
9. ___________________
10. ___________________
11. ___________________
12. ___________________
13. ___________________
14. ___________________
15. ___________________
16. ___________________
17. ___________________
18. ___________________
19. ___________________
20. ___________________
ORDER OF SELECTION SELECTED NUMBERS
21. ___________________
22. ___________________
23. ___________________
24. ___________________
25. ___________________
26. ___________________
27. ___________________
28. ___________________
29. ___________________
30. ___________________
31. ___________________
32. ___________________
33. ___________________
34. ___________________
35. ___________________
36. ___________________
37. ___________________
38. ___________________
39. ___________________
40. ___________________
ORDER OF SELECTION SELECTED NUMBERS
41. ___________________
42. ___________________
43. ___________________
44. ___________________
45. ___________________
46. ___________________
47. ___________________
48. ___________________
49. ___________________
50. ___________________
51. ___________________
52. ___________________
53. ___________________
54. ___________________
55. ___________________
56. ___________________
57. ___________________
58. ___________________
59. ___________________
60. ___________________

Types of Testing

5 - 50


Sample Forms


Types of Testing

5 - 51


Page Intentionally Left Blank


Types of Testing

5 - 52


Release of Information Form

I. To be completed by the new employer, signed by the employee, and transmitted to the previous employer:
Employee Printed Name:
_______

 

Employee SS or ID Number:_____

I hereby authorize release of information from my Department of Transportation regulated drug and alcohol testing records by my previous employer listed in Section IA. to the employer listed in Section I- B. This release is in accordance with DOT Regulation 49 CFR Part 40, Section 40.25. 1 understand that information to be released in Section II-A by my previous employer, is limited to the following items for the past two years:

1 . Alcohol tests with a result of 0.04 or higher;

2. Verified positive drug tests;

3. Refusals to be tested;

4. Other violations of DOT agency drug and alcohol testing regulations;

5. Documentation, if any, of completion of the return-to-duty process following a rule violation;

6. Information obtained from previous employers of a drug and alcohol rule violation.

Employee Signature:_______ Date:_______

A.

Previous Employer Name: _______

Address:_______
_______

Phone #:_______________ Fax #:_______

B.

New Employer Name:_______

Address:_______
_______

Phone #:_______ Fax #:_______
Designated Employer Representative:
_______

SectionII. To be completed by the previous employer and transmitted to the new employer:
A. In the previous two years, for DOT-regulated testing

1. Did the employee have alcohol tests with a result of 0.04 or higher? YES NO

2. Did the employee have verified positive drug tests? YES NO

3. Did the employee refuse to be tested? YES NO

4. Did the employee have other violations of DOT agency drug and

alcohol testing regulations? YES NO

5. If you answered "yes" to any of the above items, did the

employee complete the return-to-duty process? N/A YES NO

6. Did a previous employer report a drug and alcohol rule

violation to you'? YES NO

[NOTE: Previous employer, if you answered "yes" to any item in Section II-A, you must also transmit a copy / copies of the appropriate documentation (e.g., CCFs, MRO results reports, BATFs, SAP reports, follow-up testing record) to the new employer.]

B.

Name of person providing information in Section II-A:

Title:__________

Phone #:_______

Date:__________

 


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Company

Add PHO:

City, ST, ZIP FAX:

 

Prior employer Check 49 CFR 382.413/40.25. Good Faith Effort

 

1. Call the prior employer and record who was contacted. Fax the required release. Go to step 2.

 

2. Call the prior employer and record who was contacted. Ask if they received the fax. If they say YES the fax was received, ask for the information that is required.

 

If the prior employer refuses to release the information record it below and file with the drivers original release of information.

 

Prior Employer

Address

City, St, Zip

PHO:

FAX:

 

DRIVER NAME:

Social Security Number

 

Date of contact:

By Telephone/Fax?

Name of contact at prior employer.

 

 

 

1. NOTES

 

 

Date of contact:

By Telephone/Fax?

Name of contact at prior employer.

 

 

 

2. NOTES

 

 

 

Conducted By:


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RELEASE & DOCUMENTATION OF PRE-EMPLOYMENT TESTING INFORMATION BY APPLICANT/DRIVER REQUIRED BY PART 40.25(j).

PART 40.25(j) requires Employers to ask Applicant/Driver whether he/she has tested positive or refused to test on any Pre-employment alcohol or drug test administered by an Employer to which the Applicant/Driver applied but did not obtain safety sensitive transportation work covered by DOT agency alcohol and drug testing rules during the past two (2) years.

NAME_____________________________________ DATE ___________________

SOCIAL SECURITY # ____________________________

Applicant/Driver to answer items listed below.

During the past two (2) years have you tested positive on a Pre-employment alcohol or drug test administered by Employer to which you applied for but did not obtain a safety sensitive transportation work covered by Department of Transportation (DOT) drug and alcohol testing rules?

YES _________________ NO ___________________

During the past two (2) years have you refused to test on a Pre-employment alcohol or drug test administered by an Employer to which you applied for but did not obtain a safety sensitive transportation work covered by the Department of Transportation (DOT) drug and alcohol testing rules?

YES __________________ NO ___________________

If you answered YES to either of the questions above, please provide documentation of your successful completion of the return to-duty process required by Part 40 Subpart O.

Date _____________________ Name (printed) _____________________________

Signature of Applicant/Driver_____________________________________________

Witness_______________________________________________________________

Record keeping requirements: If "Yes" to either question 5 year retention.

If "No" to either question-discard after employment terminates.


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CONTROLLED SUBSTANCES TEST RESULTS NOTIFICATION FORM

Purpose of Form

 

 

The alcohol and controlled substances testing regulations require the employer to notify a driver of a verified positive controlled substance test result following a random, reasonable suspicion, post-accident, return-toduty, or follow-up test. In the case of a pre-employment controlled substance test, a driver-applicant requesting results within 60 days of notification of the disposition of his or her employment application must be notified of the results by the employer (49 CFR 382.411 a).

 

Employer - Complete the following:

 

____________________________________ _________/_______/______

Name of Driver (Print) (Month) (Day) (Year)

 

Type of Test: Pre-employment Reasonable Suspicion Random

Post Accident Return-to-Duty Follow-up

 

Test Results: Negative Positive

 

If the driver is an employee who has tested positive, indicate the drug identified:

Marijuana CocaineOpiates

Amphetamines Phencyclidine (PCP)

 

I have received the above results.

 

_______________________  ________/______/______

(Driver Signature) (Month) (Day) (Year)

 

Witnessed by:

 

________________________________                                  ________/_______/______

(Signature of Employer Representative) (Month) (Day) (Year)

 

________________________________

(Title)


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PRE-EMPLOYMENT URINALYSIS AND BREATH ANALYSIS
CONSENT FORM

 

I understand that as required by the Federal Highway Administration Regulations, Title 49 Code of Federal Regulations, Section 382.301, all driver-applicants of this employer must be tested for controlled substances and alcohol as a pre-condition for employment.

 

I consent to the urine sample collection and testing for controlled substances, and the breath sample collection and testing for alcohol.

 

I understand that a verified positive test result for controlled substances and/or an alcohol concentration of 0.04 or higher will render me unqualified to operate a commercial motor vehicle.

 

The medical review officer will maintain the results of my controlled substance test. Negative and positive results will be reported to the employer. If the results are positive, the controlled substance will be identified.

 

Alcohol test results will be maintained by the employer.

 

The results will not be released to any other parties without my written authorization.

I understand the above conditions and hereby agree to comply with them.

 

_______________________ ______/______/________

(Applicant's Name - print) (Month) (Day) (Year)

 

_______________________

(Applicant's Signature)


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PRE-EMPLOYMENT VERIFICATION 382.301(c)(1)

 

Company:

Address:

City, State:

PHO:

FAX:

 

I hereby authorize release of information from the testing program listed below to release information listed in 382.301(c)(1).

 

DRIVER NAME:

Social Security Number:

Driver Signature

 

CONTROLLED SUBSTANCES TESTING PROGRAM

Company:

Address:

City. State:

FAX:

PHO:

 

This is to verify that the above driver has participated in our controlled substances testing program for the past ____ Months.

 

The testing program conformed to 49 CFR Part 40 and Part 382. The driver was properly qualified under part 382 and did not refuse to take a test.

 

The last date the driver was tested for controlled substances was: __________________

 

The MRO verified results: _____________________________

 

SIGNED: ____________________ DATE: ____________________

 

 

This form was developed to assist the employer's controlled substances deterrence program administration.


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ALCOHOL AND CONTROLLED SUBSTANCES ACCIDENT TESTING REPORT

 

Company

Add

City, ST, ZIP

PHO:

FAX:

 

Driver Name:

 

Type Of Accident: [ ] Fatal [ ] Injury [ ] Towed Vehicle [ ] Non DOT

 

Citation Issued?: [ ] Yes [ ] No (Injury & Towed Vehicle)

 

Is Controlled substances and Alcohol testing required? [ ] Yes [ ] No

 

Name of Collector:

Address:

City, ST:

Telephone No.:

 

Reason Alcohol Test Not Completed within: [ ] 2 Hours. [ ] 8 Hours.

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

 

Reason Controlled Substances Test not completed within 32 hours:

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________


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Random Testing Documentation Form

Employer Name

Address

City, St Zip

PHO:

FAX :

 

Calendar Year (CY):

CY Average No. of Driver Positions =

Selection Periods Per Year =

Selection period this report =

 

TOTAL TESTS REQUIRED =

Controlled Substances Test:

Alcohol Test:

TOTAL TESTS COMPLETED =

Controlled Substances Test:

Alcohol Test:

Name of Selected Employee

CST Date and results

Alcohol test date & results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Verified by Date

 

This form was developed to assist the employer's controlled substances deterrence program administration. It documents the random selection process, including checking that the appropriate number of tests are performed each testing period in order to meet the annualized rate requirement.


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5 - 61


Company

Add

City, St, Zip

PHO:

FAX:

No Driver Name Hire Date ID Number Used Date In Random Pool Date Dropped from Random Pool
1          
2          
3          
4          
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29          
30          

 

This form was developed to assist the employer's controlled substances deterrence program administration. It documents the random selection process, including checking that the appropriate number of tests are performed each testing period in order to meet the annualized rate requirement.


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Company

Add

City, ST, ZIP

PHO:

FAX:

 

No

Name

Hire Date

ID No. Used on CCF

Selected for

1

 

 

 

 

2

 

 

 

 

3

 

 

 

 

4

 

 

 

 

5

 

 

 

 

6

 

 

 

 

7

 

 

 

 

8

 

 

 

 

9

 

 

 

 

10

 

 

 

 

11

 

 

 

 

12

 

 

 

 

13

 

 

 

 

14

 

 

 

 

15

 

 

 

 

16

 

 

 

 

17

 

 

 

 

18

 

 

 

 

19

 

 

 

 

20

 

 

 

 

21

 

 

 

 

22

 

 

 

 

23

 

 

 

 

24

 

 

 

 

25

 

 

 

 

 

Selection Period = Selection date ____________________

 

Verified By____________________ DATE ____________________

 

This form was developed to assist the employer's controlled substances deterrence program administration. It documents the random selection process, including checking that the appropriate number of tests are performed each testing period in order to meet the annualized rate requirement.


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OBSERVED BEHAVIOR-REASONABLE SUSPICION RECORD

 

Employee:

Name: _________________________

Identification Number: _________________________

 

Observation:

Date: _________ Time: (from _____ am/pm: to____ am/pm)

Location: ____________________________________________________________

(Street) (City) (State) (Zip)

 

CAUSE FOR SUSPICION

 

1. Presence of Drugs, Alcohol, and/or Paraphernalia (specify): _________________________

 

2. Appearance: Normal Flushed Puncture Marks

Disheveled Bloodshot Eyes Inappropriate wearing of sunglasses

Dilated/Constricted Pupils Profuse Sweating Tremors

Dry-mouth Symptoms Runny Nose/Sores Body Odor

Other ___________________________________

 

3. Behavior

Speech: Normal Incoherent Slurred Silent

Confused Slowed Whispering

Other ___________________________________________

 

Awareness: Normal Confused Mood Swings Euphoria

Lethargic Lack of Coordination Paranoid Disoriented

Other ____________________________________________

 

4. Motor Skills

Balance: Normal Swaying Falling Staggering

Other _____________________________________________

 

Walking &

Turning: Normal Swaying Arms Raised for Balance

Stumbling Falling Reaching for Support

Other ______________________________________________

 

5. Other Observed Action or Behavior (specify): ____________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 

Witnessed by: (must be a supervisor or company official trained in physical, behavioral, speech, and performance indicators of probable alcohol misuse and use of controlled substances)

 

_________________________ _________________________ _________ ______ am/pm

(Signature) (Title) (Date) (Time)

 

_________________________ _________________________ _________ ______ am/pm

(Optional 2nd Signature) (Title) (Date) (Time)

This document must be prepared and signed by the witnesses within 24 hours of the observed behavior or before the results of the test are released, whichever is earlier (49 CFR 382.307(f)).

 


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