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safety_sen (type: esriFieldTypeString, alias: Step 1. Is this employee safety sensitive? (Safety Sensitive Functions - select all that apply for employees who perform or will perform one of these functions.), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
acc_incident (type: esriFieldTypeString, alias: Step 2. Was the employee involved in an accident or incident? (complete A, B, & C), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes - proceed below], [No: No - proceed to Step 3])
incident_type (type: esriFieldTypeString, alias: A. Check all that apply:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
acc_def (type: esriFieldTypeString, alias: D. Does the event meet FTA/DOT Post-Accident Definitions? (mark all applicable), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
post_acc_type (type: esriFieldTypeString, alias: Question 1 - Do any of the FTA/DOT Post-Accident Types noted above apply?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
two_hours (type: esriFieldTypeString, alias: Was the Drug and Alcohol Testing completed within two (2) hours of event?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
test_time1 (type: esriFieldTypeString, alias: Time of Drug Test:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
test_explanation (type: esriFieldTypeString, alias: If no, provide a detailed explanation., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
suspension (type: esriFieldTypeString, alias: Employee Notification of Suspension from Duty, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
susp_text (type: esriFieldTypeString, alias: You were recently tested for drugs and/or alcohol under the Bi-State Development's Drug and Alcohol Policy. The DAPM and the DER have been notified that, as a result of this testing, you are suspended from duty without pay immediately and directed to contact the DAPM and the DER for the Metro's Drug and Alcohol Program as soon as possible. Your failure to contact the DAPM or the DER within two business days of this notification could result in discipline up to and including employment termination. You should not enter any Bi State Development building, unless you have notified your Supervisor in advance., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
test_note (type: esriFieldTypeString, alias: Note to Manager/TSM: BJC will require this form be completed entirely before authorizing Drug and Alcohol Services. A copy of this form shall also be e-mailed to Gerald Abernathy., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
contacts (type: esriFieldTypeString, alias: Gerald Abernathy (DER/DAPM): 314-458-6537 | Email: GEAbernathy@metrostlouis.org | D & A Mail Stop: 128, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
dapm (type: esriFieldTypeString, alias: 1. Drug and Alcohol Program Manager (DAPM) - An employee authorized by the employer to manage and monitor the drug and alcohol testing program. This person may make required decisions in the testing and evaluation process, maintain required records, update policy and procedures, and monitor contractors and vendors. The DAPM may also receive test results and other communications for the employer, consistent with the requirements of 49 CFR Part 655. The DAPM may act as the DER., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
der (type: esriFieldTypeString, alias: 2. Designated Employer Representative (DER) - An employee authorized by the employer to take immediate action(s) to remove employees from safety-sensitive duties, or cause employees to be removed from these covered duties, and to make required decisions in the testing and evaluation processes. The DER also receives the test results and other communications for the employer, consistent with the requirement of this part. Service agents cannot act as DERs., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
dot (type: esriFieldTypeString, alias: 3. DOT, The Department DOT - These terms encompass all DOT agencies, including, but not limited to the United States Coast Guard (USCG) the Federal Administration (FAA), the Federal Railroad Administration (FRA), the Federal Motor Carrier Safety Administration (FMCA), the Federal Transit Administration (FTA), the National Highway Traffic Safety Administration (NHTSA), the Research and Special Programs Administration (RSPA), and the Office of the Secretary (OST). These terms include any designee of the DOT., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
fta (type: esriFieldTypeString, alias: 4. Federal Transit Administration (FTA) - an agency within the United States Department of Transportation (DOT) that provides financial and technical assistance to local public transportation systems., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
emp_injury (type: esriFieldTypeString, alias: B. Was the employee injured?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
injury_care (type: esriFieldTypeString, alias: C. Does the employee request medical care?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [No: Employee declines medical care], [Yes: Employee requests medical care], [Declines medical care: Employee declines medical care], ... 1 more ...)
no_incident (type: esriFieldTypeString, alias: Please contact the Drug and Alcohol Dept. at 314-982-1400 ext 1576 or ext 1342. DO NOT submit this form., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
acc_def2 (type: esriFieldTypeString, alias: D. Does the event meet FTA/DOT Post-Accident Definitions? (mark all applicable), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)