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ACKNOWLEDGMENT OF NOTIFICATION <br />OF VISU.SEWER'S <br />CONTROLLED SUBSTANCES/ALCOHOL POLICY <br />I acknowledge that I have received notification of Visu-Sewer's Controlled Substances/Alcohol Policy <br />I understand that controlled substances and/or alcohol testing is required as a part of pre-placement <br />examinations and as a condition of employment. <br />I consent to and authorize testing as established by the Policy. I understand that I will be notified in <br />advance of said controlled substances and/or alcohol tests. I understand that if I refuse to submit to the <br />controlled substances and/or alcohol test that consideration for employment will immediately cease. <br />As a prequalification for employment, I will not be allowed to begin work at Visu-Sewer untilthe results <br />of the controlled substances and/or alcohol test are known. lf the results of the test are positive, I will be <br />denied employment. <br />I acknowledge that I have had an opportunity to request a complete copy of the Policy and to ask any <br />questions I may have about the Policy and related issues. <br />By my signature, I acknowledge my acceptance of the terms and conditions of the Policy. <br />Date <br />Applicant's Printed Name: <br />Applicant's Signature <br />APPENDIX B