DOT Drug and Alcohol Program Requirements
DOT/PHMSA reporting forms and requirement information
Step 1 ~ Anti-Drug Program & Alcohol Misuse Prevention Program
If your company does not already have a DOT drug and alcohol program, you can obtain the services of a Third Party Administrator (TPA) or a Consortium. A TPA will help insure all Federal Regulations are met as changes occur. If you are interested in obtaining the services of a TPA, please contact Bridget Schmidt at 620.669.4412 or Tricia Radke at 620.669.4423 for more information.
Step 2 ~  DOT/PHMSA Contractor Audit Request Form [Download]
 
Fill in your basic company information and use this as a checklist for all items that are required to be sent to NCMS.
Step 3 ~ Statistical Data Form

In the past all DOT statistical data reports were completed separately for PHMSA, FMCSA, USCG and FAA random pools when reporting to NCMS. NCMS has implemented a new process for reporting DOT statistical data reports which allows the combining of the data to be on one report form.

NCMS is not requiring that you combine your pools; we are merely referring to the “reporting” of the DOT statistical data to NCMS.

  • Add numbers of all DOT pools that are performing pipeline(PHMSA) covered functions and place total on one report.
    EXAMPLE:

    Your PHMSA pool size in the 1st quarter has a pool size of 25
    Your FMCSA pool size in the 1st quarter has a pool size of 15
    The total pool size for that quarter on the report should be 40
       
  • Continue with each section of the statistical data report in the same manner as the example above
  • Exceptions:
     If you are submitting DOT statistical data from multiple pools and one of the pools might require “random” alcohol testing then do not include the number of random alcohol tests performed since PHMSA does not have a random alcohol test requirement.
     In reference to documenting DOT post accident tests on this statistical data form; ONLY report numbers of PHMSA post accidents that meet the criteria of a DOT reportable accident. Do not include numbers of post accidents that are strictly related to FMCSA, USCG, or FAA. It is very important that you only report PHMSA post accident numbers on this report.

Click here to download new 2008 form
 

Step 4 ~ DOT Covered Employee List

The DOT employee list should be a “current” list of ALL employees that could or would perform a Pipeline covered function. If you have employees in a FMCSA, USCG, or FAA pool that could or would also perform a PHMSA covered function then they should be listed on this form. There are a few revisions to this form i.e. “date of most recent” DOT drug test, so be sure to review the form carefully.

Any individual who could or would perform an operation, maintenance, or emergency-response function on an operator’s pipeline and that function is subject to the Federal pipeline regulations as stipulated in 49 CFR Parts 191, 192, 193, or 195. Such functions as performing clerical, payroll, and administrative duties are not considered as performing a pipeline function and would not subject the employees to drug testing. Click here to see a List of Covered Functions

Click here to download new 2008 form
 

Step 5 ~ SUPR TRAINING

DOT Supervisor Training Definition [Download]

DOT Supervisor Training Listing [Download]
 
Each contractor shall conduct 1 hour of drug and 1 hour of alcohol training for each supervisor who may be involved in making determinations with regard to requiring any employee to submit to reasonable cause drug testing or reasonable suspicion alcohol testing.

GUIDANCE: Fill out the Supervisor Training list with the supervisor's name, and date the 1 hour of drug and 1 hour of alcohol training was received.

Step 6 ~

DOT CUSTODY & CONTROL FORM
 
Obtain a COPY (BLANK) Federal Custody & Control Form from your TPA or your collection site and submit it to NCMS for your file. 

GUIDANCE: Insure that all tests that are performed on behalf of your Federal DOT testing program are performed on a Federal Testing form.

Extra ~ (Operators Only)

Spot Check Form [Download]
 
The "Spot" check form is a procedure whereby an operator can determine if the contractor employees on their pipeline property or facilities have been pre-employment drug tested under the DOT regulations and the employees are listed in the contractor's random testing pool.  

GUIDANCE:  Please print out the "Spot" check form and the "instruction" page and follow the procedures outlined for conducting the spot check and the review process by NCMS.

Extra ~

Covered Functions [Download]


Covered Function Guidelines [Download]


 

Background Check Affidavit Form [Download]

 

B-C Form [Download]

Covered Functions Criteria:  The information provides guidance on what functions performed by a contractor are considered as performing a "Covered Functions" under the PHMSA pipeline regulations.  There is a list of  covered functions; functions which may not be covered functions; and a listing of functions which may require additional guidance as to whether they are covered or not considered as covered.  There is also information on "Emergency Response" contractor information.

GUIDANCE:  Pipeline operators may want to review this information to determine if a particular function that is to be performed by a contractor would be considered as performing a "Covered Function" and thus would subject the contractor to have in place a DOT pipeline drug/alcohol program that address all the regulations under the Pipeline and Hazardous Materials Safety Administration, 49 CFR Part 199 and the Department of Transportation, 49 CFR Part 40 regulations.  


Contractor Package

The attached package of correspondence and forms are to be completed by each contractor and forwarded to NCMS for evaluation to determine the contractor's compliance with the pipeline drug/alcohol testing regulations. All files must be downloaded and completed before submitting to NCMS.

PHMSA Contractor Packet

 


The items above may be filled out and e-mailed to
tricia@nationalcompliance.com or mail entire package to:  NCMS (DOT Audit) - 7 Compound Drive - Hutchinson, KS 67502.

All files are saved in ZIP format. Click here if you need to download Winzip
   

National Compliance Management Service, Inc. | 7 Compound Drive | Hutchinson, KS 67502
Phone: 620 669-0954 | Fax: 620 669-8430 | www.nationalcompliance.com