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VI. <br />ALCOHOL MISUSE PREVENTION PROGRAM <br />28 <br />1. DOT- Required Alcohol Tests <br />28 <br />2. Alcohol Test <br />30 <br />3. PHMSA Inspection Protocol for Alcohol Testing Sites <br />31 <br />VII. <br />PROGRAM ELEMENTS COMMON TO DRUG AND ALCOHOL <br />33 <br />1. Substance Abuse Professional <br />33 <br />2. Employee Assistance Program <br />34 <br />3. Supervisor Training <br />34 <br />4. Contractor Monitoring <br />35 <br />5. Recordkeeping <br />35 <br />6. Management Information System <br />37 <br />VIII. <br />APPENDIX A <br />Acknowledgement/Receipt Form <br />38 <br />IX. <br />APPENDIX B <br />Designated Personnel and Service Agents <br />39 <br />X. <br />APPENDIX C <br />40 <br />Covered Positions <br />XI. <br />APPENDIX D <br />Company Disciplinary Actions and Additional Procedures <br />41 <br />XII, <br />APPENDIX E <br />PHMSA Anti -Drug and Alcohol Misuse Prevention Program Inspection Protocol Form, <br />Substance Abuse Program Comprehensive Audit and Inspection Protocol Form Specimen <br />Collection Sites, Alcohol Testing Sites and Changes to Model Plan <br />43 <br />Xills <br />APPENDIX F <br />Post -Accident or Reasonable Cause/Suspicion Supervisor Written Record <br />56 <br />XIV. <br />APPENDIX G <br />Reasonable Cause/Suspicion Observation Checklist <br />57 <br />Premium Concrete Services, Inc.- PHMSA DRUGIALCOHOL PLAN <br />(� NATIONAL GOMPLIA�IGE MANAGEMENT SERVICE. IfIC. (NCMS)1011 (upaata 2021) The �IGMS plan �s 3 <br />the subject of 2 regis�eretl c'�rnyrlghl and is proleGetl by mpyrfphl laves n the U.S. antl alsewitora. ltll rights <br />eserved <br />