Appendix E - Appendix E to Part 40—Drug Testing Semi-Annual Laboratory Report to DOT
Mail, fax or email to: U.S. Department of Transportation, Office of Drug and Alcohol Policy and Compliance, 1200 New Jersey Avenue SE, Washington, DC 20590.
Fax: (202) 366-3897.
Email: [email protected].
The following items are required on each report:
Reporting Period: (inclusive dates) Laboratory Identification: (name and address) 1. Specimen Type: —oral fluid or urine 2. DOT agency —FMCSA, FAA, FRA, FTA, PHMSA, or USCG 3. Test Reason —Pre-Employment, Random, Reasonable Suspicion/Cause, Post-Accident, Return-to-Duty, Other, and Follow-up A. DOT Specimen Results Reported (total number) B. Negative Results Reported (total number) 1. Negative (number) 2. Negative-Dilute (number) C. Rejected for Testing Results Reported (total number) By Reason 1. Fatal flaw (number) 2. Uncorrected Flaw (number) D. Positive Results Reported (total number) By Drug 1. Marijuana or Marijuana Metabolite (number) 2. Cocaine and/or Cocaine Metabolite (number) 3. Opioids (number) a. Codeine (number) b. Morphine (number) c. 6-AM (number) d. Hydrocodone (number) e. Hydromorphone (number) f. Oxycodone (number) g. Oxymorphone (number) 4. Phencyclidine (number) 5. Amphetamines (number) a. Amphetamine (number) b. Methamphetamine (number) c. MDMA (number) d. MDA (number) E. Adulterated Results Reported (total number) By Reason (number) F. Substituted Results Reported (total number) G. Invalid Results Reported (total number) By Reason (number)