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DataMaster DMT Monthly Update Check-list

Department/Agency: /1ai4cJ1 rrter fJ> · OM serial #: 1001ts-

Supervisor: °]) 5/~6/P . Date: ·011 08 I J'f~

Provided None this month ''

Operators Logbook @' D Maintenance Logbook cef' D Breath Test History Report [Zf D Status History Report [i2( D

·Log On History Report 0 D Calibration Report D [2f

Certification Report D B Installation Report D 8 '

Annual Preventative Maintenance D @

Routine Pelformance Check D G:J· Simulatbr Solution Change D G' Other Reports D 8.

List other report type and date:

'

Appendix A August 2011

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DATAMASTER DMT OPERATOR USE LOG

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Date DMT Operator's Name Subject's Name Simulator Simulator 1 ·

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· DATAMASTER DMT MAINTENANCE LOG

fr/oH•ok~7er /)oJ . /t::Jd 16f DepartmenVAgency DataMaster DMT Serial Number

DATE TYPE OF SERVICE PERFORMED

_______ _ J;_t:':- rT°""_lL _ f_e_v ______________ -·- __ _ /J.r¢>7oco.. I (

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[ For RPC or Simulator Solution Change Place Label Here]

------------------------'----.-----------------------------------------.---------·:..··-··--------------------·.:...·-----------·----

ALC 803 REV 03 08/2011 ·

1

PERFORMED BY (Name and Title)

I

DATE

DATAMASTER DMT MAINTENANCE LOG .. ' ·. ~ \ j' ··' ' . \. > ·. . • \ . . . : », 11an?:'e(/et- \ P72 /ocitG'b. · ' ,_,,,, · "· \ · 1

DepartmenUAgeney DataMaster DMT Serial Number

TYPE OF SERVICE PERFORMED

DataMaster Simulatol' Solution : Lot# 12-;38-100 EtOH,, Cone: 0.101 !-·-·-··-·-·-·---· .. Range: 0.096 -0.!06 . ' L b I H ] Preparati'o.nDate: 11/17/2011 Expires: ll/17!2012 ye a 9 ere

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[ For RPG or Simulator Solution Change Place Label Here]

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DataMaster Simulator Solution ................ _.Lot# 12-64-100 EtOH,, Cone: 0.101

Range: 0.096 - 0.106 · [ For RI P1<paration Date: 02/l7/2012 Expires: 02117/2013

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ALC 803 REV 03 08/2011

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DATAMASTER DMT MAINTENANCE LOG

DepartmenUAgency DataMaster DMT Serial Number


DataMaster Simulator Solution ------------------------- Lot#_ 12-64-100 EtOH,q Cone: 0.101

[For RPC Range: 0.096 - 0.106 . --------·-----·-----··-·· Preparation Date: 02/17/2012 Expire:;: 02/17/2013


I··----------------------·---- - - - - - - - - - - -- - - - - - - - -- - - --

[For RPC or Simulator Solution Change Place Label Here]

DataMaster Simulator Solution

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~J I -[-F;~-RI ~~~:~~~~~~~.105Et0Haq Cone: 0.100 . r~~~-L~b~l-H~~~l :_ . . . ~/ II-( I) /)_ ________ ~::::::0~~~7~r,:2~~-~x~;~24/~.13 Yo~ ' ---------------·------------ y. . . . . ------------------------ -----------------------------

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DataMaster Simulator Solution · ·-·--·--------------· Lot# iZ-72-100 EtOHaq Cone: 0.100 · ·' / I [ For RP( Range: 0.095 -0.105 __ ()1( 11:)" f J . ·-··-··--·-··-··-··- ~reparation Date: 04/24/2012 Expires: 04/24/2013

--:------------- -----------c-- OPENED: 02/1s/1:J ])[_

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' ALC 803 REV 03 08/2011

3

DATE


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___ feLfur~~--1\eti_Qf'ohico\ __________ , __ . __ _ [For RPC or Simulator Soluiion Change Place Label Here]

DataMaster Simulator Solution Lot# 12-87-100 EtOHaq Cone: 0.101


I [For RPC Range:0.096-0.106

o'1 ,~//'J ·-.. -.. -.. _ .. _,,_ .. _ .. _, Preparation Date:10/31/2Q12 Expires: 10/31/2013

_________________ .. _______ OPENED: 06/!6/n :zxs:

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·-··-··-··-··-··-··-··-· · DataMaster Simulator Solution .[For RPC Lot#12-88-10D EtoHaq Conc:0.098 ·

·-··-·--··--·-··-··-··-· Range: 0.093- 0.103 ·

Preparation Date: 11/9/2012 Expires: 11/9/2013

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ALC 803 REV 03 0812011 ·

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DATE TYPE OF SERVICE PERFORMED

DataMasterSimulator Solution lot# 13-13-100 EtOHaq Cone: 0.100

·-··-··--·-·--·--·-· Range: 0.095 - 0.105 . i--··-·--·--··-··-··-··-··-··-··-·-

[ For RF Preparation Date: 06/24/2013 Expires: 06/24/2014 lee Label Here]


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[ For RPC or Simulator Solution Change Place Label Here]

[For RPC or Simulator Solution Change Place Label Here]

ALC 803 REV 03 08/2011

5

Breath Record History Page 1 01/08/2014

Test Test Agency Operator Name Alcohol Alcohol Sim. Sim. I Status Message

Date Time Val. 1 Val. 2 Cone. 1 Cone. 2

12/24/2013 00:25:36 l'li'.ANCHESTER PD JAMES D BOSSONG REFUSED 0.098 12/23/2013 01:04:49 WINHALL PD JEREMIAH J ROGERS 0.141 0.145 0.099 0.097 12/22/2013 03:30:09 SHAFTSBURY VSP ELLIOTT JUSTINGER I o. 086 0.097 12/21/2013 02:30:02 WINHALL PD CRAIG L WATROUS SR 0.119 0. 098 RESPONSE TIMEOUT 12/17 /2013 20:58:59 WINHALL PD GREGORY C GOULD 0. 038 INCOMPLETE 0.097 0.098 12/10/2013 04:02:23 SHAFTSBURY VSP ELLIOTT M JUSTINGER 0.042 0.098 12/09/2013 14:35:36 Manchester JAMES D BOSSONG 0.190 INCOMPLETE 0.098 0.098 12/09/2013 14:16:24 Manchester JAMES D SOSSONG REFUSED 0.098 12/09/2013 14:06:24 Manchester JJ:\MES D SOSSONG INCOMPLETE 0.097 RESPONSE TIMEOUT

I 12/09/2013 13:45:29 Manchester JAMES D BOSSONG INVALID 0.098 ' 12/06/2013 00:02:02 SHAFTSBURY VSP ZACHARY S WOOD REFUSED 0.100

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DMT Serial Number #100165 Page 1 ofl 01/08/2014 8:28 PM

Status Record History Page 1 01/00/2014

Status status Test Type Status Message Date Time

12/21/2613 02:34:23 DUI Subject Record RESPONSE 'l'IMEOU1' 12/09/2013 14:13:01 DUI Subject Record RESPONSE TIMEOUT ···-··· .

DMT Senal Number #100165 Page 1 ofl 01/08/2014 8:33 PM

-

Log On Record History Page 1 01/08/2014

- ----·--

Test Test Name

Date Time -·----··

DMT Senal Number #100165 Pagel of 1 01/08/2014 8.34 PM

datamaster dmt monthly update check-list dmt discovery...datamaster dmt monthly update check-list...

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