EXHIBIT F-1 OPERATIONAL CHECKLIST  


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  • ARIZONA DEPARTMENT OF PUBLIC SAFETY

    STANDARD OPERATIONAL PROCEDURE INTOXILYZER MODEL 5000EN

    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 TEST” or “PRESS START TEST BUTTON TO START NEXT TEST.” Ensure

    breath tube is warm to touch. (      )         2.     Press START TEST button.

    (     )         3.     If display reads “INSERT CARD,” do so.  (      )         4.     Input information in response to display. ( )      5.       Air blank completed.

    (     )         6.     If the display reads “IS SIMULATOR SOLUTION TEMPERATURE 34° C ± 0.2° C?,” check temperature using thermometer, type “Y” or “N;” verify Concurrent Calibration Check completed.

    (     )         7.     Insert the mouthpiece in the breath tube. Have the subject blow as long as possible. Record AC result above. (      )         8.     Air blank completed.

    (     )         9.     a.      If display reads “WAIT, go to Step 11

    OR

    b.        If display reads “TEST COMPLETE,” go to Step 10

    OR

    c.        If display reads “IS SIMULATOR SOLUTION TEMPERATURE 34° C ± 0.2° C?,” check temperature using thermometer, type “Y” or “N;” verify Concurrent Calibration Check completed, go to Step 10.

    (     )       10.      When the display reads “TEST COMPLETE,” remove the test record. (   )      11.   Repeat Steps 1 through 9, as necessary.

    Note: Duplicate breath tests shall be administered at intervals of not less than 5 nor more than 10 minutes apart and the two consecutive tests shall agree within 0.020 alcohol concentration.

    DPS Form Exh F-1 (Rev 05-01)

Historical Note

New Exhibit F-1 made by final rulemaking at 12 A.A.R. 1916, effective 9:00 a.m., May 18, 2006 (Supp. 06-2).

Department of Public Safety - Alcohol Testing