• I understand that as a condition of employment with Vulcan Oil Company, I must provide the Company with written authorization to obtain the results of all U.S. Department of Transportation-required alcohol and drug tests, refusals to test, rehabilitaion and follow-up testing when I was employed as a driver or other safety-sensitive employee positions I held for the preceding three years. I also understand that signing this authorization does not constitute an offer of employmentt or any guarantee of future employment with the Company.

    I hereby authorize the Company to obtain from my previous employers listed below, and hereby authorize the below named previous employers, to release to the Company the following information from my personnel and alcohol and drug files fro the preceding three years.

    • Instances of reporting for duty or remaining on duty requiring the performance of safety-sensitive functions while having an alcohol concentration of 0.04 or greater.
    • Instances of performing safety-sensitive functions within four hours after using alcohol.
    • Any use of alcohol for eight hours following an accident, while waiting for a post-accident test.
    • Any refusals to submit to a post-accident alcohol or controlled substances test.
    • Refusals to submit to a random alcohol or controlled substances test.
    • Refusals to submit to a reasonable suspicion alcohol or controlled substances test.
    • Instances of reporting for duty or remaining on duty requiring the performance of safety-sensitive functions when under the influence of any unauthorized controlled substance.
    • Reporting for duty, remaining on duty or perform a safety-sensitive function, after testing positive for, or adulterating or substituting a test specimen for a controlled substances.
    • Records pertaining to completion, or failure to complete alcohol and/or drug rehabilitation prescribed by a Substance Abuse Specialist.
    • Any post rehabilitation positive test for alcohol with a result of 0.04 or higher conscentration.
    • Any post rehabilitation verified positive drug test or refusal to test for alcohol or drug(including verified adulterated or substituted drug test results).
  • The following is a list of my previous employers during the preceding three years from whom I am authorizing the release of the aforementioned alcohol and drug information to the Company
    Employer NamePeriod of Employment 
  • I have carefully read and fully understand this authorization to release my alcohol and drug testing information. I certify that all information provided on this form is true and complete and that I have identified all of my previous employers for the preceding three years.
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