- ALCOHOL INFLUENCE REPORT FORM type name of police department here Defendant First name Age Initial Sex Last name Weight Eyes Case Number Sequential File No. Arrested by CHEMICAL BREATH TEST INFORMATION Instrument Breathalyzer Model 900 Instrument Serial Number Ampoule Control Lot Number Purge Results Dominator Albreath Samples Taken Date / Time Blood Alcohol Test 1 Test 2 Test 3 Test 4 BREATHALYZER CHECK LIST - N.J.A. C. 13 51-3. 6 a 2 Mark all applicable boxes with an X or a check mark. Set Up Phase TESTS N/A Verify Power switch is turned On. If the power switch is in the Off position turn the switch On. Preparation Phase Instrument temperature Verified temperature thermometer reached 50 C plus or minus 3 C. Reference Ampoule Gauged Inserted in left hand holder. Test Ampoule Gauged Opened Verified volume Inserted in right hand holder. Bubbler Inserted into test ampoule Connected to outlet. Light turned on Instrument balanced Blood Alcohol Pointer set on Start Line. Purge Phase Turne....
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How to fill out the NJ Alcohol Influence Report Form online
The NJ Alcohol Influence Report Form is an essential document used to record the circumstances surrounding an alcohol-related incident. This guide provides clear, step-by-step instructions on how to accurately fill out the form online, ensuring completeness and accuracy in your submission.
Follow the steps to successfully complete the NJ Alcohol Influence Report Form online
- Press the ‘Get Form’ button to access the NJ Alcohol Influence Report Form. This action will enable you to download or open the form in your preferred document editor.
- Begin by filling out the police department's name in the designated field at the top of the form.
- Next, input the defendant's first name, last name, and age. Include the initial of their middle name if applicable.
- Provide additional details such as the defendant's sex and weight in the corresponding fields.
- Record the defendant's physical characteristics, such as eye color.
- Enter the case number and sequential file number related to the incident.
- Fill in the name of the officer who arrested the defendant in the provided space.
- In the section labeled 'Chemical Breath Test Information', select the type of breathalyzer used and enter the instrument serial number.
- Document the results of the tests conducted. Specify the date and time each test took place.
- Record the blood alcohol percentage results for each test. Ensure that you accurately enter the results for all applicable tests.
- Complete the Breathalyzer Check List by marking all applicable phases with an 'X' or check mark, ensuring regulatory compliance.
- Follow the outlined preparation and purge phases to document the setup of the breathalyzer and any required readings.
- In the analysis phase, ensure to document the mouthpiece usage, breath sample collection, and any subsequent tests performed.
- At the conclusion of the form, include the breath test operator's name, rank, signature, badge number, and the date and time when the report is completed.
- Finally, save your changes, and download, print, or share the NJ Alcohol Influence Report Form as needed.
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Get answers to your most pressing questions about US Legal Forms API.
When you refuse to take the breath test in NJ you are subject to a violation surcharge of $1000 per year for?
First Offense An ignition interlock will be placed onto the individual's registered vehicle at the time of conviction and for 9-15 months after license restoration. The convicted individual must pay a DMV surcharge of $1000 per year for three years.
What is the first time consequence of refusing a breathalyzer?
Therefore, you essentially surrender your driving privileges if you refuse a Breathalyzer. States will generally penalize drivers for refusing to take the test by suspending their license for up to 12 months. Those with past DUI convictions can face even longer suspensions or jail time.
How does a breathalyzer work?
The alcohol vapor in a person's breath reacts with an orange solution known as potassium dichromate. When alcohol is present, this solution turns green. This color change creates an electrical current, which the breathalyzer can convert into a value to determine the BAC.
What happens if you refuse a breathalyzer test in NJ?
The first time you refuse a breathalyzer in New Jersey, you will face a fine of between $300 and $500. Your driver's license will be suspended until you an ignition interlock device (IID) in your vehicle. An IID requires you to test the level of alcohol in your breath prior to driving.
How do you beat a refusal in NJ?
It's tough, but you can beat a refusal charge. The law officer must show probable cause for both the vehicle stop and the request to have you take the breathalyzer test. If the state cannot prove probable cause, it must dismiss the Refusal charge.
What BAC is equal to a refusal of a breath test in NJ?
Better still, refusing the test does not guarantee that you won't be convicted – you could be found guilty of a DWI even if your refusal means that the state does not have proof that your BAC was over 0.08%, the legal limit for those over 21.
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