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We <br />C 0 N F I D E N T I A L <br />WASTE INDUSTRIES USA <br />N.C. CONTROLLED SUBSTANCE EXAMINATION REGULATION ACT <br />POST -TEST NOTICE TO EMPLOYEES/APPLICANTS <br />The sample you provided on, as required by our company policy and the N.C. <br />Controlled Substance Examination Regulation Act ( "CSERA "), has tested positive for <br />We were notified of this positive result on . In accordance with 13 NCAC <br />20.0402, this Notice explains your rights and responsibilities under the CSERA (Chapter 95, <br />Article 20 of the N.C. General Statutes) and the corresponding administrative rules (Title 13, <br />Chapter 20 of the N.C. Administrative Code). <br />o You must be given written notice of any positive result of a controlled substance <br />examination within thirty (30) days of employer notification of the positive result. <br />o You must be given a copy of this Notice or other written notice of your rights and <br />responsibilities regarding re- testing. <br />• You may request, in writing, a re -test of the above sample at the same or other approved <br />laboratory with ninety (90) days of the date you are notified of the result. You must pay all <br />expenses associated with the re -test. <br />• Results of controlled substance examinations, medical histories and use of lawful <br />prescription drugs must be kept confidential by the employer. <br />o You can file a complaint with the N.C. Department of Labor - - Wage and Hour Bureau at <br />(919) 807 -2796 or 1- 800 -NC -LABOR if you believe procedural requirements of the CSERA <br />were violated. The Department has no jurisdiction regarding an employer's requirement for <br />controlled substance testing or its decisions regarding results of controlled substance <br />testing. <br />Employee /Applicant <br />Employer Representative <br />Date <br />Title <br />Disclaimer: The foregoing information is presented solely for the convenience of the reader and <br />is not intended to replace any official source. Under no circumstances shall the Department of <br />Labor be liable for any actions taken or omissions made from reliance on any information <br />contained herein. <br />