This government document is issued by Drug and Alcohol Programs for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:ug3qpcrqbm4&q=https://www.ddap.pa.gov/Licensing/Documents/Recovery%2520House%2520Licensing/House%2520Manager%2520form.pdf&sa=U&ved=2ahUKEwjPiK-hrPGFAxVXif0HHRyjAqA4ChAWegQIAxAB&usg=AOvVaw0tcOm3cMew_FhrpR2d0mQZ