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VI. ALCOHOL MISUSE PREVENTION PROGRAM <br />28 <br />1. <br />DOT- Required Alcohol Tests <br />28 <br />2. <br />Alcohol Test <br />30 <br />3. <br />PHMSA Inspection Protocol for Alcohol Testing Sites <br />31 <br />VII. <br />PROGRAM ELEMENTS COMMON TO DRUG AND ALCOHOL <br />33 <br />1. <br />Substance Abuse Professional <br />33 <br />2. <br />Employee Assistance Program <br />34 <br />3. <br />Supervisor Training <br />34 <br />4. <br />Contractor Monitoring <br />35 <br />5. <br />Recordkeeping <br />35 <br />6. <br />Management Information System <br />37 <br />VIII. 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 />0 <br />Premium Concrete Services, Inc.- PHMSA ❑RUGIALCOHOL PLAN <br />NATIONAL COMPLIANCE MANAGEMENT SE?�iif'E. INC. (NCh1S)20'11 (Update 2021) The NCN15 plan is 3 <br />Ibc subject of a registered enpyilght and is pr,)ler.Ird b,, eoPYI'Ight Iaws In the LI 5. and alsewherc All nghls <br />saanarl <br />