This is to certify that I have been provided educational materials that explain the requirements of 382.601 and my employer’s policies and procedures with respect to meeting the requirements.

1. The designated person to answer questions about the materials.
2. The categories of drivers subject to part 382. {SEE EX. A}
3. Sufficient information about the safety-sensitive function and periods of the workday that Compliance is required.
4. Specific information concerning prohibited driver conduct.
5. Circumstances under which a driver will be tested.
6. Test procedures, driver protection and integrity of the testing process, and safeguarding the validity of the test.
7. The requirement that tests are administered in accordance with part 382.
8. An explanation of what will be considered a refusal to submit to a test and the Consequences.
9. The consequences for Part 382 Subpart B violations including removal from safety­Sensitive functions and 382-605 procedures.
10. The consequences for drivers found to have an alcohol concentration of 0.02 or greater but less than 0.04.
11. Information on the effects of alcohol and controlled substances use on:
– an individual’s health- signs and symptoms of a problem
– work – personal life
– available methods of intervening when a problem is suspected

MY SIGNATURE INDICATES I HAVE READ AND UNDERSTAND THE INFORMATION

ON THE ABOVE LISTED ITEMS, AND AGREE TO ALCOHOL TESTNG ON A REASONABLE CAUSE, POST- ACCIDENT, AND A RANDOM BASIS ONLY.