Logistics Management Class A
Resume:
Cardinal Logistics Management Corp.
Concord, NC 28027
**-**-**** *:26:51PM CDT
IntelliApp
Thank you for your interest in Cardinal Logistics Management Corporation. To apply for a driving position, please complete our online application for employment. Incomplete information will delay the processing of your application or prevent it from being submitted.
In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
Complete your name exactly as it appears on your Driver License Position City State/Province
Class A CDL Truck Driver -
Home Weekly
Dubuque IA
Personal Information
Referral Code: 852_cdljobnow_dubuque
Name James Mckinley Steeples, Jr.
Residence 5 years or longer (If No,
previous addresses shown below)
Yes
Current Address 17301 Glenmore
Address 2 1
City, State/Province Zip/Postal Redford Township, MI 48240 Country United States
Residence 5 years or longer (If No,
previous addresses shown below)
Yes
SSN/SIN 3929
Date of Birth
Primary Phone 313-***-****
Cell Phone 313-***-****
Preferred method of contact Cell Phone
Best time to contact you Morning
Email *********@*****.***
Yes, I agree to receive information
concerning future opportunities or
promotions from Cardinal Logistics
Management Corp. by email or other
Yes
1
commercial electronic communications.
Would you like to receive communication
from Cardinal Logistics Management Corp.
via text message?
By participating, you consent to receive
text messages sent by an automatic
telephone dialing system, which may
contain recruiting/advertising messages.
Consent to these terms is not a condition
of being hired, contracted, or leased. You
may opt out at any time by texting STOP to
unsubscribe. You also agree that Cardinal
Logistics Management Corp.'s service
provider receives in real time and logs your
text messages with Cardinal Logistics
Management Corp..
Yes
Company Questions
GENERAL INFORMATION
What position are you applying for? Company Driver Vehicle License Class A
Do you have straight truck experience? Yes
Do you have flatbed experience? Yes
Do you have any Tanker experience? No
Are you interested in Solo or Team? Solo
Have you ever been known by another
name?
No
Please list (and when):
Do you have the legal right to work in the
U.S.?
Yes
Have you ever previously applied for
employment/lease with a Cardinal
company?
No
Were you referred by a Cardinal
employee?
No
If yes, provide the Name and employee #:
What type of employee referred you?
How did you hear about this Cardinal
career opportunity?
Internet-Indeed.com
Please provide additional detail. For
example, if a newspaper or magazine,
which one?
You'll called me I spoke to a recruiter
2
Do you have a active passport? No
Are you an Owner / Operator? No
Equipment Description (Tractor):
Type:
Year:
Make:
Model:
Color:
VIN:
Weight
Mileage
Fifth Wheel Height
EXPERIENCE
Do you have 9 months within the past 3
years or 24 months within the past 5
years.
Yes
Do you have at least 12 months Grocery
experience?
Yes
Do you have at least 12 months Reefer
experience?
Yes
Do you have at least 12 months Tanker
experience?
No
GCLID
Licenses
Please include ALL licenses held.
License Number 785
Licensing Authority MI
Country US
License Class Class A
License Expiration Date 10-12-2024
DOT Medical Card Expiration Date 12-24-2024
Current License Yes
Commercial Driver License Yes
Endorsements None
3
Employment / Unemployment
Pride Staff
Company Pride Staff
Start Date 10-2023
End Date 10-2023
Address 29856 Northwestern Hwy.
City, State/Province Zip/Postal Southfield, MI 48034 Country United States
Phone 248-***-****
Position Held Hilo Driver
Reason for leaving? Present
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job subject to drug and
alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Pride Staff
Company Pride Staff
Start Date 09-2023
End Date 09-2023
Address 29856 Northwestern Hwy.
City, State/Province Zip/Postal Southfield, MI 48034- Country United States
4
Phone 248-***-****
Position Held Hilo Driver
Reason for leaving? Present
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Local MICHIGAN
Miles driven weekly 0-500
Pay Range (cents/mile) $16.00 hr.
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 08-2023
End Date 08-2023
Comment
Calhoun Truck Libes
Company Calhoun Truck Libes
Start Date 05-2023
End Date 07-2023
Address 10700 Ford Rd.
City, State/Province Zip/Postal Dearborn, MI 48120 Country United States
Phone 313-***-****
Position Held Class A CDL DRIVER
Reason for leaving? Lack of Work,
Were you terminated/discharged/laid off? Yes
5
Termination Explanation Lack of work.
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Local
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Day Cab
Most common trailer Container
Trailer length 53 feet or more
Unemployment
Start Date 02-2023
End Date 04-2023
Comment
Fourthenth Avenue Cargo company
Company Fourthenth Avenue Cargo company
Start Date 05-2022
End Date 12-2022
Address 4401 Stecker St
City, State/Province Zip/Postal Dearborn, MI 48126 Country United States
Phone 313-***-****
Position Held Regional Truck
Reason for leaving? Dispute with Owner
Were you terminated/discharged/laid off? Yes
Termination Explanation Confrontation with owner on a daily basis. Is this your current employer? No
Yes
6
May we contact this employer at this time?
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven local
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 04-2022
End Date 04-2022
Comment Due to the recent death of my brother and
illness with my father, I did not return back
to work.
Orion Express
Company Orion Express
Start Date 05-2019
End Date 03-2022
Address 26420 N Line Commerce # 800
Address 2 26420 N Line Commerce # 800
City, State/Province Zip/Postal Taylor, MI 48180
Country United States
Phone 734-***-****
Position Held Company Driver
Reason for leaving? Family Emergency
Were you terminated/discharged/laid off? Yes
Termination Explanation Due to the death of my brother and my father's amputation, I was not able to take
the time grieve or support my family.
7
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven local
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Diamay North America Automotive
Company Diamay North America Automotive
Start Date 11-2016
End Date 07-2019
Address 24400 Plymouth
City, State/Province Zip/Postal Redford, MI 48239
Country United States
Phone 313-***-****
Position Held Hi-Lo Driver and Material Handler
Reason for leaving? Secured a better job.
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
8
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
TV Minority
Company TV Minority
Start Date 03-2014
End Date 10-2016
Address 9850 Pelham
City, State/Province Zip/Postal Taylor, MI 48180
Country United States
Phone 313-***-****
Position Held Company Driver
Reason for leaving? Secured a better job.
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven OTR
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
9
Trailer length 53 feet or more
Driver's Logistics
Company Driver's Logistics
Start Date 04-2011
End Date 02-2014
Address Middlebelt Road
Address 2 Middlebelt Road
City, State/Province Zip/Postal Livonia, MI 48152
Country United States
Phone 248-***-****
Position Held Company Driver
Reason for leaving? Secured a better job.
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Local
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Trucking School
Start Date 06-2005
End Date 08-2006
School US Truck Driving
10
Address
Address 2
City, State/Province Detroit, MI
Country United States
Phone 313-***-****
Did you graduate? Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while attending this truck
school?
Yes
Did you perform any safety sensitive
functions at this truck school, regulated by
DOT, and subject to drug and alcohol
testing?
Yes
GPA
Hours of Instruction 200
Border Crossing No
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
Motor Vehicle Record
Has any license, permit or privilege in the
last 10 years been denied, suspended or
revoked for any reason?
Yes
Month/Year 6/2016
Please Explain Company.took their time about paying overweight ticket,I was still working,letter
from secretary of state inform me license
suspended, I was let go,I payed the price
Have you in the last 10 years been
convicted of driving during license
suspension or revocation, or driving
without a valid license or an expired
license, or are any charges pending?
No
Month/Year
Please Explain
Have you in the last 10 years been
convicted for any alcohol or controlled
substance related offense while operating
a motor vehicle, or are any charges
No
11
pending?
Month/Year
Please Explain
Have you in the last 10 years been
convicted for possession, sale or transfer
of an illegal substance (including but not
limited to, marijuana, amphetamines, or
derivatives thereof) while on duty, or are
any charges pending?
No
Month/Year
Please Explain
Have you in the last 3 years been
convicted of reckless driving, careless
driving or careless operation of a motor
vehicle, or are any charges pending?
No
Month/Year
Please Explain
Have you ever tested positive, or refused
to test on a pre-employment drug or
alcohol test by an employer to whom you
applied, but did not obtain safety-sensitive
transportation work covered by DOT
agency drug and alcohol testing rules in
past three years, or have you ever tested
positive or refused to test on any
DOT-mandated drug or alcohol test?
No
Month/Year
Please Explain
Vehicle Accident Record
Were you involved in any accidents/incidents with any vehicle in the last 5 years (even if not at fault)?
Type of Accident / Incident Non-Injury
Date of Accident / Incident 12-2022
Nature of Accident / Incident
Hazmat Accident / Incident No
Was the vehicle towed away? Yes
City Toledo
State/Province OH
Were you in a commercial vehicle? Yes
12
If yes, was this a Department of
Transportation recordable accident?
Yes
Were you at fault? No
Were you ticketed? Yes
Description Vehicle struck me, I was bobtail,Vehicle hit me in rear tires. I went to Court Courts
cleared me of all charges
Traffic Convictions \ Violations
Have you had any moving violations or traffic convictions in the past 3 years? No Violations
Signature
Full Name James Mckinley Steeples, Jr.
IP Address 2607:fb91:10a2:9
Signature Date/Time 10-21-2023 9:26 PM
By signing my application below, I agree to use an electronic signature to demonstrate my consent. An electronic signature is as legally binding as an ink signature. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Signed Date: 10-21-2023 9:26 PM
Signed:
Federal FCRA Summary of Rights Acknowledgment
By checking this box, I (a) acknowledge
that I have read and understand the
federal FCRA Summary of Rights and
have been given the opportunity to
copy/print the Summary of Rights and (b)
agree to use an electronic signature to
demonstrate my consent. An electronic
signature is as legally binding as an ink
signature.
Yes
13
PSP Disclosure and Authorization
By checking the box, I (a) acknowledge
that I have read and understand the PSP
Disclosure and Authorization and also
have been given the opportunity to
copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
FCRA Disclosure
By checking the box, I (a) acknowledge
that I have read and understand the above
FCRA Disclosure For Procurement of
Consumer Reports and also have been
given the opportunity to copy/print it, and
(b) agree to use an electronic signature to
demonstrate my consent. An electronic
signature is as legally binding as an ink
signature.
Yes
FCRA Authorization
By checking this box, I (a) acknowledge
that I have read and understand the above
FCRA Authorization to Obtain Consumer
and Investigative Consumer Reports and
also have been given the opportunity to
copy/print it; (b) authorize the Company to
obtain one or more consumer report(s) or
investigative consumer report(s) about me;
and (c) agree to use an electronic
signature to demonstrate my consent. An
electronic signature is as legally binding as
an ink signature.
Yes
Employment Verification Acknowledgment and Release (DOT Drug and Alcohol) By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
14
Clearinghouse Release
By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse begins January 6, 2020
Checking the box acknowledges receipt of
educational information required by 49
CFR §382.601(b)(12).
Yes
Summary of Rights Under 15 U.S.C. Section 1681m(a) By checking the box, I (a) acknowledge
that I have read and understand the
Summary of Rights Under 15 U.S.C.
Section 1681m(a) and have been given
the opportunity to copy/print the 1681m
Summary of Rights and (b) agree to use
an electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
California State Release
I agree to the above language Yes
Background Investigation Authorization
I agree to the above language Yes
FCRA DISCLOSURE FOR PROCUREMENT OF INVESTIGATIVE CONSUMER REPORTS
By checking this box, I represent that I
understand and agree to the above
FCRA Disclosure For Procurement of
Investigative Consumer Reports.
Yes
15
Agreement
By checking this box, I represent that I
understand and agree to the above
language.
Yes
NOTICE TO CALIFORNIA EMPLOYEES AND JOB APPLICANTS REGARDING THE COLLECTION OF PERSONAL INFORMATION U
Acknowledgement
By signing below, I acknowledge and
confirm that I have received and read and
understand this disclosure.
Yes
User Requested Copy
User requested a copy to be sent to this
email address *********@*****.***.
Yes
16
FCRA DISCLOSURE FOR PROCUREMENT OF CONSUMER REPORTS In connection with your online employment application, Cardinal Logistics Management Corp. may order one or more consumer report(s) (commonly known as "background reports" or "background checks") about you from one or more consumer reporting agencies. If you are hired, additional consumer reports may be obtained in connection with and throughout your employment for employment purposes. To the extent allowed by law, the consumer report(s) may include information concerning your character, general reputation, personal characteristics, and mode of living. For instance, the consumer report(s) may include the following type of information: drug and alcohol test results, motor vehicle records, driving records, criminal history, public court records, employment history (including names and dates of previous employers, reason for termination of employment, work experience, and accidents), social security number validation, education, licensure, or verification of other information supplied by you. Such reports may be obtained from private and public record sources, including sanctions databases, CDLIS (including but not limited to CDLIS Central Site, CDLIS Master Pointer Record data and your driver record from the jurisdiction identified in the CDLIS data, in accordance with applicable state law and the Driver Privacy Protection Act), former employers, public court records, and federal, state, and other government agencies that maintain such records.
Printed Name:
James Mckinley Steeples, Jr.
Social Security #:
3929
Signed Date: 10-21-2023
James Mckinley Steeples, Jr.
17301 Glenmore
1
Redford Township, MI 48240
Gender:
17
FCRA AUTHORIZATION TO OBTAIN CONSUMER AND
INVESTIGATIVE CONSUMER REPORTS
Pursuant to the Fair Credit Reporting Act, 15 U.S.C. 1681 et seq. ("FCRA"), I authorize Cardinal Logistics Management Corp. ("Company") to obtain one or more consumer report(s) or investigative consumer report(s) about me. If hired as an employee of the Company, I understand this authorization shall remain on file and shall serve as ongoing authorization for additional consumer reports or investigative consumer reports to be obtained from any consumer reporting agency at any time during my employment without asking me for authorization again. Printed Name:
James Mckinley Steeples, Jr.
Social Security #:
3929
Signed Date: 10-21-2023
James Mckinley Steeples, Jr.
17301 Glenmore
1
Redford Township, MI 48240
Gender:
18
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Cardinal Logistics Management Corp. ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Cardinal Logistics Management Corp. ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. Printed Name:
James Mckinley Steeples, Jr.
Signed Date: 10-21-2023
19
Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse
I hereby provide consent to Cardinal Logistics Management Corp. to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse. I understand this consent shall remain on file and shall serve as ongoing consent for Cardinal Logistics Management Corp. to conduct multiple limited queries of the Clearinghouse at any time during my employment or contract period without asking me for additional consent.
I understand that if I refuse to provide consent for Cardinal Logistics Management Corp. to conduct a limited query of the Clearinghouse, Cardinal Logistics Management Corp. is required to prohibit me from performing safety-sensitive functions, including operating a commercial motor vehicle.
I understand that if the limited query conducted by Cardinal Logistics Management Corp. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Cardinal Logistics Management Corp. unless I give additional specific consent within the Clearinghouse. However, I understand that Cardinal Logistics Management Corp. will be required to conduct a full query of the Clearinghouse within 24 hours after a limited query indicates that drug or alcohol information exists and that if I do not grant consent within the Clearinghouse for that full query I will be removed from performing safety-sensitive functions, including operating a commercial motor vehicle. 10-21-2023
James Mckinley Steeples, Jr. Date
20
Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing Records
And changes in Parts 390 and 391 of the FMCSA
X 10-21-2023
Date
X 3929
Social Security Number
James Mckinley Steeples,
Jr.
17301 Glenmore
1
Redford Township, MI 48240
Gender:
X
James Mckinley Steeples,
Jr.
Print Name (First, MI, Last)
X
Signature
I, the above mentioned signer, hereby authorize Pride Staff To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to Cardinal Logistics Management Corp. DISCLOSURE AND AUTHORIZATION UNDER 49 C.F.R. PART 391.23 INCLUDING DOT DRUG AND ALCOHOL INFORMATION
For purposes of an investigation in accordance with 49 C.F.R. Part 391.23, I authorize my previous employers, contractors (if owner-operator), and trucking schools, as applicable, to release and forward to Cardinal Logistics Management Corp. ("Company") the following information for the past three (3) years: 1. DOT alcohol and controlled substance information in accordance with Parts 382 and 40 of the Federal Motor Carrier Safety Regulations (49 CFR Part 382 and 49 CFR Part 40, Section 40.25) limited to the following DOT regulated testing items, including pre-employment testing results: (i
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