TCM – Reporting Alcohol Testing Problems

This form facilitates the documentation of a variety of problems that can occur in the alcohol specimen collection and testing process. These will be reviewed to include recommendations for corrective action when and if required.

This form is to be prepared in response to the following “problems”.

Reference numbers refer to DOT Part 40 sections. Refer to these for a detailed explanation.

Subpart N – Problems in Alcohol Testing

§40.261 What is a refusal to take an alcohol test, and what are the consequences?
§ 40.263 What happens when an employee is unable to provide a sufficient amount of saliva for an alcohol screening test?
§ 40.265 What happens when an employee is unable to provide a sufficient amount of breath for an alcohol test?
§ 40.267 What problems always cause an alcohol test to be cancelled?
§ 40.269 What problems cause an alcohol test to be cancelled unless they are corrected?
§ 40.271 How are alcohol testing problems corrected?
§ 40.273 What is the effect of a cancelled alcohol test?
§ 40.275 What is the effect of procedural problems that are not sufficient to cancel an alcohol test?
§ 40.277 Are alcohol tests other than saliva or breath permitted under these regulations?

Complete the following form:

Alcohol Test Collection Problem Date Reported:
Problem Reported By:
Reported By E-mail:
Reported By Phone:
Problem Date:
Problem Narrative:
Alcohol Test Number:
DER E-mail:
DER Phone:
Employee Name and Number:
Health Enhancement Center
8615 Commerce Drive
Easton, MD 21601
Jim Proctor, President
410-822-8690 (office)
410-822-9434 (fax)

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