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

Mail,The fax,following oritems submitare electronicallyrequired to:on U.S.each Departmentlaboratory ofreport:
Reporting Transportation,Period: Office(inclusive ofdates)
Laboratory DrugIdentification: (name and Alcoholaddress)
Employer PolicyIdentification: and(name; Compliance,may W62-300,include 1200Billing NewCode Jerseyor Avenue,ID SEcode)
C/TPA Identification: (where applicable; name and address)
A., Washington,Urine DCSpecimens
1. 20590,Urine Fax:Specimen Results Reported (202Total Number) 366By Test Reason
(a) Pre-3897,employment Submit(number)
(b) Electronically:Post-Accident http://www.dot.gov/ost/dapc/mro_split.html.(number)
The(c) followingRandom items(number)
(d) areReasonable requiredSuspicion/Cause on(number)
(e) eachReturn-to-Duty report:(number)
1.(f) MROFollow-up name,(number)
(g) address,Type phoneof number,Test andNot faxNoted 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)
[7388 FR 3597527651, JuneMay 252, 20082023]