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CASCADE HEALTH SOLUTIONS <br />COLLECTION SITES: The testing lab is Legacy Metro account # 16620. The MRO is: Thomas Thrall, M.D. fax <br />(541) 228-3186. Bill this company directly gnly for your collection fee and for breath alcohol testing if needed. We will bill <br />the company for the drug testing fee and the MRO fee. <br />JoLynne Anderson CONFIDENTIAL <br />Anderson's Erosion Control <br />PO Box 205 <br />Junction City, OR 97448 <br />Certification of Enrollment in Random Selection <br />8/25/2009 11:41:43AM Batch R0004258 Generated on 8/24/2009 <br />This document certifies that your company's employees are subject to computer- generated random selections <br />for alcohol and/or drug testing. You should store this document with your other permanent drug testing <br />records. <br />Number of your employees eligible for selection: <br />Number of your employees selected for Drug testing only: <br />Number of your employees selected for Alcohol testing only: <br />Number of your employees selected for dual Drug/Alcohol testing: <br />Total number of your employees selected for testing: <br />Total number of participants in this random pool: <br />Total number of participants selected from this random pool: <br />Total percentage of eligible participants selected for Drug Testing: <br />Total percentage of eligible participants` selected for Alcohol Testing: <br />Auth riz d►Signature <br />4 <br />0 <br />0 <br />1696 <br />509 <br />30.01 <br />6.01 <br />"Random Selection - Selected Participants" page indicates who is selected and for what test(s). <br />Drug and Alcohol tests are two separate testing..processes. DOT forms are required for both. <br />Employees are required to test immediately upon 'noti ication Company testing should be completed as soon as <br />possible, but must be completed and reported to the' consortium by: September 30"' , 2009. <br />Owner Operators must test immediately upon receiving this notice. <br />Communication: Send written•totice by either.: fax, mail,-or email to communicate the following: <br />1. Changes to participant list: Send: date, name of participant, name of company, add or drop. <br />2. Participants selected for testing will not be tested. Please include the reason for not testing. <br />3. If your testing is completed anywhere other than the Suzanne Way location: For compliance verification, <br />please send written notice indicating the dates any drug or alcohol tests were completed. <br />Scheduling: Cascade Health Solutions: (541) 228-3100 2650 Suzanne Way Suite 200 Eugene, OR. <br />Questions? Mary Stine (541) 463-7789 Fax: (775) 201-6256 marystine@comcast.net <br />Address: 2650 Suzanne Way Suite 200 Eugene, OR 97408 <br />