Appendix D to Part 40 Appendix D to Part 40—DOT Drug Testing Semi-Annual Laboratory Report to Employers

FaxThe orfollowing mailitems to:are Departmentrequired ofon Transportation,each Officelaboratory ofreport:
Reporting DrugPeriod: and(inclusive Alcoholdates)
Laboratory PolicyIdentification: (name and Compliance,address)
Employer 400Identification: 7th(name; Street,may SWinclude Billing Code or ID code)
C/TPA Identification: (where applicable; name and address)
A., RoomUrine 10403,Specimens
1. Washington,Urine DCSpecimen 20590Results Reported (faxTotal Number) 202By Test Reason
(a) Pre-366employment (number)
(b) Post-3897.Accident (number)
1.(c) MRORandom name,(number)
(d) address,Reasonable phoneSuspicion/Cause (number,)
(e) andReturn-to-Duty fax(number)
(f) Follow-up (number.)
(g) Type of Test Not Noted on CCF (number)
2. CollectionUrine siteSpecimens name,Reported
(a) address,Negative (number)
(b) Negative and phoneDilute (number.)
3. DateUrine ofSpecimens collection.Reported as Rejected for Testing (Total Number) by Reason
4.(a) SpecimenFatal I.D.flaw (number.)
5.(b) LaboratoryUncorrected accessionFlaw (number.)
64. PrimaryUrine specimenSpecimens laboratoryReported name,as address,Positive and(Total phoneNumber) by Drug
(a) Marijuana Metabolite (number.)
7.(b) DateCocaine resultMetabolite reported(number)
(c) orOpioids certified(number)
(1) byCodeine primary(number)
(2) laboratory.Morphine (number)
8.(3) Split6-AM specimen(number)
(4) laboratoryHydrocodone name,(number)
(5) address,Hydromorphone and(number)
(6) phoneOxycodone (number.)
9.(7) DateOxymorphone split(number)
(d) specimenPhencyclidine result(number)
(e) reportedAmphetamines or(number)
(1) certifiedAmphetamine by(number)
(2) splitMethamphetamine specimen(number)
(3) laboratoryMDMA (number)
(4) MDA (number)
5. Urine Adulterated (Number)
106. PrimaryUrine specimenSubstituted results(Number)
7. Urine Invalid Result (eNumber)
B.g Oral Fluid Specimens
1., nameOral ofFluid drug,Specimen adulterantResults Reported (Total Number) inby theTest primaryReason
(a) specimen.Pre-employment (number)
11.(b) ReasonPost-Accident for(number)
(c) splitRandom specimen(number)
(d) failureReasonable Suspicion/Cause (number)
(e) Return-to-reconfirmDuty result(number)
(f) Follow-up (e.number)
(g.,) drugType orof adulterantTest notNot present,Noted specimenon invalid,CCF split(number)
2. notOral collected,Fluid insufficientSpecimens volumeReported
(a). Negative (number)
12(b) Negative and Dilute (number)
3. ActionsOral takenFluid Specimens Reported as Rejected for Testing (Total Number) by theReason
(a) MROFatal flaw (enumber)
(b) Uncorrected Flaw (number)
4.g., notifiedOral employerFluid ofSpecimens failureReported toas reconfirmPositive (Total Number) by Drug
(a) Marijuana (number)
(b) Cocaine and/or requirementCocaine forMetabolite recollection(number).
13.(c) AdditionalOpioids information(number)
(1) explainingCodeine the(number)
(2) reasonMorphine for(number)
(3) cancellation.6-AM (number)
14.(4) NameHydrocodone of(number)
(5) individualHydromorphone submitting(number)
(6) theOxycodone report(number)
(7) Oxymorphone (ifnumber)
(d) notPhencyclidine the(number)
(e) MROAmphetamines (number)
(1) Amphetamine (number)
(2) Methamphetamine (number)
(3) MDMA (number)
(4) MDA (number)
5. Oral Fluid Adulterated (Number)
6. Oral Fluid Substituted (Number)
7. Oral Fluid Invalid Result (Number)
[88 FR 27651, May 2, 2023]