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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 />Covered Positions <br />40 <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 />XIII. <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 DRUG/ALCOHOL PLAN <br />(�� NATIONAL COMPLIANCE MANAGEMENT SERVICE., LNG. rNCMS� 2011 (uptlate 2�21). The NCMS plan is 3 <br />the subJecl of e reglsterad roPYrt9ht antl Is Vmtecletl ny copyright laws In rho U.S. antl olsewhera NI rlgh�s <br />reserved. <br />