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DONOR CERTIFICATION: I certify that I provided my urine specimen to the collector; that the specimen bottle was sealed with a tamper-proof seal in my presence; and that the information provided on this form and on the label affixed to the specimen bottle is correct.

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Should the results of the laboratory tests for the specimen identified by this form be confirmed positive, the Medical Review Officer will contact you to ask about prescriptions and over-the-counter medications you may have taken. Therefore, you may want to make a list of those medications as a "memory jogger." THIS LIST IS NOT NECESSARY. If you choose to make a list, do so either on a separate piece of paper or on the back of your copy (Copy 4-Donor) of this form-DO NOT LIST ON THE BACK OF ANY OTHER COPY OF THE FORM. TAKE YOUR COPY WITH YOU.

TO BE COMPLETED BY PERSON COLLECTING SPECIMEN AFTER DONOR HAS COMPLETED SECTION VII-(See Copy 3 of Form)
COLLECTOR'S NAME-PRINT (first, middle, last)
VIII.

COLLECTION SITE LOCATION

DATE OF COLLECTION

REMARKS CONCERNING COLLECTION:

Split sample collected in accordance
with applicable Federal requirements. Yes

No

I certify that the specimen identified on this form is the specimen presented to me by the donor providing the certification on Copy 3 of this form, that it bears the same identification number as that set forth above, and that it has been collected, labelled and sealed as in accordance with applicable Federal requirements.

SIGNATURE OF COLLECTOR:

COPY 4-DONOR

BACK-SIDE OF COPY 4-DONOR

LIST PRESCRIPTION DRUGS. IT IS NOT REQUIRED, AND IS FOR YOUR USE ONLY.

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DONOR CERTIFICATION: I certify that I provided my urine specimen to the collector; that the specimen bottle was sealed with a tamper-proof seal in my presence; and that the information provided on this form and on the label affixed to the specimen bottle is correct.

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TO BE COMPLETED BY PERSON COLLECTING SPECIMEN AFTER DONOR HAS COMPLETED SECTION VII-See Copy 3 of Form) COLLECTOR'S NAME-PRINT (first, middle, last)

VIII.

COLLECTION SITE LOCATION

DATE OF COLLECTION

REMARKS CONCERNING COLLECTION:

Split sample collected in accordance
with applicable Federal requirements. Yes □ No

I certify that the specimen identified on this form is the specimen presented to me by the donor providing the certification on Copy 3 of this form, that it bears the same identification number as that set forth above, and that it has been collected, labelled and sealed as in accordance with applicable Federal requirements.

SIGNATURE OF COLLECTOR:

COPY 5-COLLECTOR

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DONOR CERTIFICATION: I certify that I provided my urine specimen to the collector; that the specimen bottle was sealed with a tamper-proof seal in my presence; and that the information provided on this form and on the label affixed to the specimen bottle is correct.

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TO BE COMPLETED BY PERSON COLLECTING SPECIMEN AFTER DONOR HAS COMPLETED SECTION VII-(See Copy 3 of Form)
COLLECTOR'S NAME-PRINT (first, middle, last)
VIII.

COLLECTION SITE LOCATION

DATE OF COLLECTION

REMARKS CONCERNING COLLECTION:

Split sample collected in accordance
with applicable Federal requirements.

Yes

No

I certify that the specimen identified on this form is the specimen presented to me by the donor providing the certification on Copy 3 of this form, that it bears the same identification number as that set forth above, and that it has been collected, labelled and sealed as in accordance with applicable Federal requirements.

SIGNATURE OF COLLECTOR:

COPY 6-EMPLOYER

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TO BE COMPLETED BY PERSON COLLECTING SPECIMEN AFTER DONOR HAS COMPLETED SECTION VII-(See Copy 3 of Form)
COLLECTOR'S NAME-PRINT (first, middle, last)
VIII.

COLLECTION SITE LOCATION

DATE OF COLLECTION

REMARKS CONCERNING COLLECTION

Split sample collected in accordance
with applicable Federal requirements.

Yes

No

I certify that the specimen identified on this form is the specimen presented to me by the donor providing the certification on Copy 3 of this form, that it bears the same identification number as that set forth above, and that it has been collected, labelled and sealed as in accordance with applicable Federal requirements.

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THE RESULTS FOR THE ABOVE IDENTIFIED SPECIMEN ARE IN ACCORDANCE WITH THE APPLICABLE SCREENING AND CONFIRMATION CUTOFF LEVELS ESTABLISHED BY THE HHS MANDATORY GUIDELINES FOR FEDERAL WORKPLACE DRUG TESTING PROGRAMS (found only on copies one and two).

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X.

I have reviewed the laboratory results for the specimen identified by this form in accordance with applicable Federal requirements My final determination/ verification is POSITIVE

(Check one)

NEGATIVE

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PART 71-STANDARD TIME ZONE BOUNDARIES

Sec.

71.1 Limits defined; exceptions authorized for certain rail operating purposes only. 71.2 Annual advancement of standard time.

71.3 Atlantic zone.

71.4 Eastern zone.

71.5 Boundary line between eastern and central zones.

71.6 Central zone.

71.7 Boundary line between central and mountain zones.

71.8 Mountain zone.

71.9 Boundary line between mountain and Pacific zones.

71.10 Pacific zone.

71.11 Alaska zone.

71.12 Hawaii-Aleutian zone.

71.13 Samoa zone.

AUTHORITY: Secs. 1-4, 40 Stat. 450, as amended; sec. 1, 41 Stat. 1446, as amended; secs. 2-7, 80 Stat. 107, as amended; 100 Stat. 764; Act of Mar. 19, 1918, as amended by the Uniform Time Act of 1966 and Pub. L. 97449, 15 U.S.C. 260-267; Pub. L. 99-359; 49 CFR 1.59(a), unless otherwise noted.

SOURCE: Amdt. 71-11, 35 FR 12318, Aug. 1, 1970, unless otherwise noted.

§ 71.1 Limits defined; exceptions authorized for certain rail operating purposes only.

(a) This part prescribes the geographic limits of each of the eight standard time zones established by section 1 of the Standard Time Act, as amended by section 4 of the Uniform Time Act of 1966 (15 U.S.C. 261). It also contains lists of operating exceptions granted for specified rail carriers, whose operations cross the time zone boundaries prescribed by this part, authorizing them to carry the standard of time on which the major portion of a particular operation is conducted into an adjoining time zone. (b) Any rail carrier whose operations cross a time zone boundary prescribed by this part may apply for an operating exception to the General Counsel, Department of Transportation, Washington, D.C. 20590. However, each rail carrier for which an operating exception is granted shall, in its advertisements, time cards, station bulletin boards, and other publications, show arrival and departure times in terms of

.

the standard time for the place concerned.

(c) The time zones established by the Standard Time Zone Act, as amended by the Uniform Time Act of 1966, are Atlantic, eastern, central, mountain, Pacific, Alaska, HawaiiAleutian, and Samoa.

[Amdt. 71-11, 35 FR 12318, Aug. 1, 1970, as amended by Amdt. 71-21, 52 FR 41631, Nov. 18, 1986]

§ 71.2 Annual advancement of standard time.

(a) The Uniform Time Act of 1966 (15 U.S.C. 260a(a)), as amended, requires that the standard time of each State observing Daylight Saving Time shall be advanced 1 hour beginning at 2:00 a.m. on the first Sunday in April of each year and ending on the last Sunday in October. This advanced time shall be the standard time of each zone during such period. The Act authorizes any State to exempt itself from this requirement. States in two or more time zones may exempt the eastermost time zone portion from this requirement.

(b) Section 3(b) of the Uniform Time Act of 1966 (15 U.S.C. 260a(b)) provides that "it is the express intent of Congress *** to supersede any and all laws of the States or political subdivisions thereof insofar as they may now or hereafter provide for advances in time or changeover dates different from those specified in [section 3(a) of that Act]", which are those specified in paragraph (a) of this section.

[Amdt. 71-11, 35 FR 12318, Aug. 1, 1970, as amended by Amdt. 71-21, 52 FR 41631, Nov. 18, 1986]

§ 71.3 Atlantic zone.

The first zone, the Atlantic standard time zone, includes that part of the United States that is between 52°30' W. longitude and 67°30′ W. longitude and that part of the Commonwealth of Puerto Rico that is west of 67°30' W. longitude, but does not include any part of the State of Maine.

871.4 Eastern zone.

The second zone, the eastern standard time zone, includes that part of the United States that is west of 67°30'

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