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NOTICE OF DRUG OR ALCOHOL TEST RESULTS <br /> EMPLOYEE NAME: <br /> DATE RECEIVED FROM TESTING ORGANIZATION: <br /> CHECKS AS APPROPRIATE: <br /> The results of your drug/alcohol test was NEGATIVE. <br /> The results of your drug/alcohol test was POSITIVE. <br /> RIGHTS OF EMPLOYEE OR JOB APPLICANT IF TEST RESULTS ARE POSITIVE: <br /> 1. The employee or job applicants has the right to request <br /> and receive from the City of Mounds View a copy of the <br /> test result report. <br /> 2 . Within three (3) working days after notice of a positive <br /> test result, the employee or job applicant may submit <br /> information to the City of Mounds View, in addition to <br /> any submitted prior to a test, to explain the test <br /> result. <br /> 3 . Within five (5) days after notice of a positive test, the <br /> employee or job applicant may request a confirmatory re- <br /> test of the original sample ,at the employee's or job <br /> applicant's expense. Within three (3) days after <br /> receiving the employee;s or: job applicants re-test <br /> request, the City of Mounds View shall notify the testing <br /> agency of the employee's or job applicant's request. The <br /> employee or job applicant may request a different testing <br /> agency licensed under Chapter 181 (Minnesota State <br /> Statute) . If the confirmatory re-test does not confirm <br /> the original positive result, no adverse personnel action <br /> based on the original confirmatory test may be taken <br /> against the employee or job applicant. <br /> I have received a copy of this completed document. <br /> SIGNATURE: <br /> DATE: <br />