Ariz. Admin. Code § tit. 13, ch. 10, art. 1, exh. G-1
OPERATIONAL CHECKLIST
ARIZONA DEPARTMENT OF PUBLIC SAFETY
STANDARD OPERATIONAL PROCEDURE
INTOXILYZER MODEL 8000
DUPLICATE BREATH TEST
SUBJECT NAME ___________________________________DATE _____________________
AGENCY _______________________________OPERATOR ___________________________
INSTRUMENT SERIAL # _____________________LOCATION __________________________
TEST RESULTS 0. _______________ AC TIME _______________
0. _______________ AC TIME _______________
0. _______________ AC TIME _______________
Immediately preceding administration of the tests, subject underwent at least a 15-minute deprivation period:
From | ______________ | to | ______________ | by | _______________ |
(Time) | (Time) | (Name) |
( ) 1. Display reads "PUSH BUTTON TO START".
( ) 2. Push Start Test button.
( ) 3. Follow automated instructions on instrument display.
( ) 4. If test record reads "Successfully Completed Test Sequence" go to step 5
OR
If test record reads "Not a Successfully Completed Test Sequence", and subject will be tested again, remove test record and go to step 1
OR
If test record reads "Not a Successfully Completed Test Sequence", and subject will not be tested again, go to step 5
( ) 5. Remove test record.
Note: Duplicate breath tests shall be administered at intervals of not less than 5 minutes nor more than 10 minutes apart and the two consecutive tests shall agree within 0.020 alcohol concentration.
DPS Form Exh G-1 (Rev 05-1)
Ariz. Admin. Code tit. 13, ch. 10, art. 1, exh. G-1