The information appearing on the cover of the package was endorsed (among other things) as follows:
2 The information appearing on the cover of the package was endorsed (among other things) as follows:
Name of subject .............................................................................................
Prescribed sample taker .................................................................................
Time and date of taking blood sample ...........................................................
3. The sample was analysed in accordance with the Road Traffic (Blood Sampling and Analysis) Regulations 1975 and was found to contain ............................................. grams of alcohol per 100 mL of blood.
...................................................
Analyst.
[Form C amended: Gazette 23 Jan 1976 p. 132; 9 Aug 1991 p. 4232; 30 Jan 2001 p. 625; 14 Mar 2008 p. 832; 9 Oct 2009 p. 3997-8; 27 Jun 2017 p. 3449.]
Western Australia
ROAD TRAFFIC ACT 1974
Regulation 12: Road Traffic (Blood Sampling and Analysis) Regulations 1975
FORM D
To: (1) ...................................................................................................................
at (2) ...................................................................................................................
Acting pursuant to the provisions of section 66(5), 66(8B) or 66B(1) of the Road Traffic Act 1974, I, the undersigned police officer, hereby request you the said (1) .............................................................................. to take a sample of the blood of (3) ............................................................................................................ presently at (4) ................................................................................................... in accordance with section 69 of the Road Traffic Act 1974.
Dated at ................................................ this ......................................... day of........................................, 20..............
...................................................
Signature, Rank and Number.
Insert name of prescribed sample taker.
Address or name of hospital, as the case may require.
Name of subject.
Place where subject is then to be found.
[Form D amended: Gazette 2 Feb 1982 p. 398; 30 Jan 2001 p. 625; 11 Oct 2007 p. 5478; 23 Dec 2014 p. 4916; 7 Feb 2017 p. 1173‑4.]
FORM E
Western Australia
ROAD TRAFFIC ACT 1974
Road Traffic (Blood Sampling and Analysis) Regulations 1975
(Regulation 13)
I, ............................................................................................................................. chief executive officer of the Chemistry Centre (WA), hereby certify that .......... ................................................................................................................................ of ............................................................................................................................ * is an analyst/* was as at ................................................................... an analyst.
.....................................................
chief executive officer, Chemistry Centre (WA).
* Delete whichever is not applicable.
[Form E inserted: Gazette 25 Feb 1983 p. 650; amended: Gazette 9 Aug 1991 p. 4232; 14 Mar 2008 p. 832.]
FORM F
Western Australia
ROAD TRAFFIC ACT 1974
Road Traffic (Blood Sampling and Analysis) Regulations 1975
(Regulation 14)
I, ............................................................................................................................. chief executive officer of the Chemistry Centre (WA), hereby certify that .......... ................................................................................................................................ of ............................................................................................................................ * is a drug analyst/ * was as at ..................................................... a drug analyst.
.....................................................
chief executive officer, Chemistry Centre (WA).
* Delete whichever is not applicable.
[Form F inserted: Gazette 25 Feb 1983 p. 651; amended: Gazette 9 Aug 1991 p. 4232; 14 Mar 2008 p. 832.]
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