Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer Representative
Appears in 4 contracts
Samples: Single Employees, Collective Bargaining Agreement, Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer Representative
Appears in 4 contracts
Samples: Single Employees, Memorandum of Understanding, Single Employees
Appearance. Red Eyes Constricted (small) Pupils Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX D UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 2 contracts
Samples: www.sf.gov, sfdhr.org
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX E: UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Collective Bargaining Agreement
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer Representative
Appears in 1 contract
Samples: Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX B UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX D: UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX B – UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Memorandum of Understanding
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX C – UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Memorandum of Understanding
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX B UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer Representative
Appears in 1 contract
Samples: Single Employees
Appearance. Red Eyes Dilated (large) Pupils Constricted (small) Pupils Frequent Sniffing Section III – NARRATIVE DESCRIPTION (MUST be completed in conjunction with Section I and/or Section II) ~Please print information~ Describe contemporaneous and specific observations regarding the Covered Employee’s symptoms or manifestations of impairment which may include: (a) any observable contemporaneous change in behavior suggesting drug or alcohol impairment; (b) any comments made by the employee; (c) specific signs of drug or alcohol use; (d) recent changes in behavior that have led up to your contemporaneous observations; and (e) the name and title of witnesses who have reported observations of drug or alcohol use. [Attach documentation, if any, supporting your reasonable suspicion determination] Section IV In addition to completing the narrative in Section III above: ▪ For Section I, you will need to identify at least one (1) contemporaneous observations (direct evident/sign(s) that occurs that causes you to test today) regarding the manifestations of impairment to initiate a test; or ▪ For Section II, you will need to identify at least three (3) contemporaneous observations, (signs that occur that causes you to test today), in two (2) separate categories, regarding the manifestations of impairment to initiate a test. Make note of date and time of the incident. Obtain concurrence of second supervisor and record their signature as noted. Conduct a brief meeting with the employee to explain why he or she the employee must undergo reasonable suspicion drug and alcohol tests. Escort the employee to the collection site. DO NOT LET THEM DRIVE. Print name of first on-site Supervisor Employee Representative Signature DATE: Print name of second Supervisor Employer RepresentativeRepresentative Signature DATE: APPENDIX B UNION ACCESS TO NEW EMPLOYEES PROGRAM
Appears in 1 contract
Samples: www.sf.gov