FO-SHE-19

ALCOHOL TEST
LOG

WAREHOUSE:
Persons conducting tests are to ensure that all Company & Legislative requirements are met. Guidance can
be obtained in company OHS Manual (2P-SHE-01) Section 5.16

MONTH/YEAR CONDUCTED

NAME OF PERSONNEL SUBJECTED SIGNATURE OF PERSON SIGNATURE OF PERSON

NO. POSITION BAC, %
FOR ALCOHOL TESTING SUBJECTED FOR TEST CONDUCTEDTHE TEST

REVIEWED & NOTED BY: _________________________________________

Revision No.: 01 Effective Date: October 01, 2018

Date of Revision: May 31, 2023