|
|---|
Category:License-Fitness for Duty (FFD) Performance Report
MONTHYEARML23058A2912023-02-27027 February 2023
Annual Report Form for Drug and Alcohol Tests for 2022
ML23051A0232023-02-20020 February 2023
Single Positive Test Form Collected on 03/15/2022
ML23051A0302023-02-17017 February 2023
Annual Fatigue Reporting Form for 2022
ML23051A0282023-02-16016 February 2023
Single Positive Test Form Collected on 07/25/2022
ML23051A0252023-02-16016 February 2023
Single Positive Test Form Collected on 05/09/2022
ML23051A0292023-02-16016 February 2023
Annual Reporting Form for Drug and Alcohol Tests for 2022
ML23051A0272023-02-16016 February 2023
Single Positive Test Form Collected on 06/22/2022
ML23051A0212023-02-16016 February 2023
Single Positive Test Form Collected on 01/26/2022
ML23051A0242023-02-16016 February 2023
Single Positive Test Form Collected on 04/28/2022
ML23051A0262023-02-16016 February 2023
Single Positive Test Form Collected on 05/11/2022
ML23051A0202023-02-16016 February 2023
Single Positive Test Form Collected on 01/05/2022
ML23051A0222023-02-16016 February 2023
Single Positive Test Form Collected on 03/07/2022
ML22054A1362022-02-23023 February 2022
Annual Fatigue Form for 2021
ML22054A1342022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A1332022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A0832022-02-17017 February 2022
Single Positive Test Form Collected on 03/15/2021
ML22054A0902022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A1272022-02-17017 February 2022
Single Positive Test Form Collected on 03/15/2021
ML22054A0882022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A0862022-02-17017 February 2022
Single Positive Test Form Collected on 07/06/2021
ML22054A1282022-02-17017 February 2022
Single Positive Test Form Collected on 03/31/2021
ML22054A0842022-02-17017 February 2022
Single Positive Test Form Collected on 03/31/2021
ML22054A1322022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A0852022-02-17017 February 2022
Single Positive Test Form Collected on 04/05/2021
ML22054A0912022-02-17017 February 2022
Single Positive Test Form Collected on 10/07/2021
ML22054A0892022-02-17017 February 2022
Single Positive Test Form Collected on 09/13/2021
ML22054A0872022-02-17017 February 2022
Single Positive Test Form Collected on 07/12/2021
ML22054A1292022-02-17017 February 2022
Single Positive Test Form Collected on 04/05/2021
ML22054A1352022-02-17017 February 2022
Single Positive Test Form Collected on 10/07/2021
ML22054A1312022-02-17017 February 2022
Single Positive Test Form Collected on 07/12/2021
ML22054A1302022-02-17017 February 2022
Single Positive Test Form Collected on 07/06/2021
ML22054A0822022-02-16016 February 2022
Annual Reporting Form for Drug and Alcohol Tests for 2021
ML22054A1262022-02-16016 February 2022
Annual Reporting Form for Drug and Alcohol Tests for 2021
ML21055A7942021-02-24024 February 2021
Annual Report Form for Drug and Alcohol Tests for 2020
ML21055A7932021-02-24024 February 2021
Single Positive Test Form Collected on 12/03/2020
ML21055A7922021-02-24024 February 2021
Single Positive Test Form Collected on 09/21/2020
ML21055A7912021-02-24024 February 2021
Single Positive Test Form Collected on 09/17/2020
ML21055A7902021-02-24024 February 2021
Single Positive Test Form Collected on 09/15/2020
ML21055A7892021-02-24024 February 2021
Single Positive Test Form Collected on 08/30/2020
ML21055A7882021-02-24024 February 2021
Single Positive Test Form Collected on 08/24/2020
ML21055A7872021-02-24024 February 2021
Single Positive Test Form Collected on 08/17/2020
ML21055A7862021-02-24024 February 2021
Single Positive Test Form Collected on 08/10/2020
ML21055A7852021-02-24024 February 2021
Single Positive Test Form Collected on 06/30/2020
ML21054A1582021-02-21021 February 2021
Annual Fatigue Form for 2020
ML21054A1522021-02-11011 February 2021
Single Positive Test Form Collected on 08/24/2020
ML21054A1512021-02-11011 February 2021
Single Positive Test Form Collected on 08/17/2020
ML21054A1542021-02-11011 February 2021
Single Positive Test Form Collected on 09/15/2020
ML21054A1502021-02-11011 February 2021
Single Positive Test Form Collected on 08/10/2020
ML21054A1532021-02-11011 February 2021
Single Positive Test Form Collected on 08/30/2020
ML21054A1552021-02-11011 February 2021
Single Positive Test Form Collected on 09/17/2020
2023-02-27
[Table view] |
Text
- L.S.N f::J rogl am Pel fOllllclllce Dellcl f'\epoillllg System , -S'ilCJlc 1)['0,' 'J:) I il (llill I , D Submission o Oolote IIRB: Update Submission
- 1) AI,,,o/da
... roqu/ferl
_opt _0 ma,lrerl*opt/_. ZJEntIfo.In._"""_",.,.to.ultln_".,,._
Unique Reference Number (Ucansaa SIJI)Pliedl
__ """'fIo/da. 12013-PAL-007 I 3) II .. A_ Roorler' 01' 'ole, for fills ""'" 10 ---'I'. 4J Hold YOUI' IIIOUH ov.,.. fomt field to view Select Facility Ipalisades
[50-255] I Date 01 Collaction (mmiddlyyyy) 112118/2013 I R .. aon for T_nt/-26.717(b)(5)
P .... Access Testing Raeson (optionaQ Plaese elaborate (optional)
I Pre-Access I Iinitial Authorization I I I Employment Type-26.717(b)(3)
IcontractorNendor I I.abor Ca1ef1 01Y-26.717(b)(3)
IMaintenance (Craft) I Refuaa/* 26.717(b)(7)
& 26.75 Was this collection refusod (yos' No)? Tuf R .. ub -26.717(b)(4)
Test Validity IVaiid I Test Type(s) for Result(s)
Reported -26.717(b)(2)
Drug Testing IDrugonly I IUrine I We.ttl/a collection aba.1Wd (Yu I No}1-26.717(b)(7)
& 26.75 INo I Suba1ance-26.717(b)(2)
& (b)(6) Addltlona' Suba1ance (a. appllcab'e)
Additional Subatenee (u applicable)
IMarijuana I /Please Select I /Please Select I Use NRC Cutoff (yes' No)? I. thl ** Z4-HourReportlnt/
EII8n1 (Y * .mo}1-Sub"",'on Attempta -26.717(b)(7) and 26.75(b) Did this coRaction involve a subvorsion attempt (Yes/No)?
INO I ""'ef18tJl8n1 A_. -26.717(b)(8)
& 26.75 Roason lor the Action IFirst drug or alcohol positive I Sanction Applied (NRC Minimum or Ucens .. Adm i nistrated) ILicensee Administrated I Specific Sanction Appliod 13-Year Denial I Person(a}
Reapona/b/.
for Inform81lon Provided Person 1 (required)
- IBrion IlsuPervisor. Aoce .. Authoriz._FD I bnlbide,;.ntefgy
.com First Name cast Name Pos i tionTltla Company Email Address Person 2 (optional)
- IBam !l eomon Iluconli1 D Sp.cllllst I First Name LSstName t'osition nus Company E mail Address Flnel sr.p (Required)
-NRC will consider this form authentic in accordance with 26.11 only when the "Validate
& Lock" bulton has been selected and all errors (i.e .* those highNghted in red) have been corrected.
The "Validate
& Lock" button will change to "Locked" alter the data validation procass has boan successtuny completed and the form is ready for submission.
_ Form Locked On: I Feb 13, 2014 at 2:03:55 PM I I Seve to Local PC I I Print this Report I Single Positive Test Form (version 1.5.0 -January 1, 2014)
