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Safety Performance History Records Request

Safety Performance History Records Request PART 1: TO BE COMPLETED BY PROSPECTIVE EMPLOYEE I, (Print Name) _____ _____ First Last Social Security Number Hereby author

To release and forward the information requested by section 3 of this document concerning my Alcohol and Controlled Substances Testing records within the previous 3 years from _____. (employment application date) ... Drivers who have previous Department of Transportation regulated employment history in the preceding three years, and wish to ...

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  Substance, Controlled, Regulated, Controlled substances

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