Appendix C to Part 40-DOT
Mail, fax, or email to:
U.S. Department of Transportation
Office of Drug and Alcohol Policy and Compliance
W62-300
1200 New Jersey Avenue, S.E.
Washington, DC 20590
Fax: (202) 366-3897
Email: ODAPCWebMail@dot.gov
The following items are required on each report:
Reporting Period: (inclusive dates)
Laboratory Identification: (name and address)
1. DOT Specimen Results Reported (total number)
2. Negative Results Reported (total number)
Negative (number)
Negative-Dilute (number)
3. Rejected for Testing Results Reported (total number) - By Reason
(a) Fatal flaw (number)
(b) Uncorrected Flaw (number)
4. Positive Results Reported (total number) - By Drug
(a) Marijuana Metabolite (number)
(b) Cocaine Metabolite (number)
(c) Opiates (number)
(1) Codeine (number)
(2) Morphine (number)
(3) 6–AM (number)
(d) Phencyclidine (number)
(e) Amphetamines (number)
(1) Amphetamine (number)
(2) Methamphetamine (number)
(3) MDMA (number)
(4) MDA (number)
(5) MDEA (number)
5. Adulterated Results Reported (total number) - By Reason (number)
6. Substituted Results Reported (total number)
7. Invalid Results Reported (total number) - By Reason (number)
[73 FR 35975, June 25, 2008, as amended 75 FR 49864, August 16, 2010]