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Get Wa 3000-110-197 2013

F BIRTH STREET ADDRESS CITY / STATE / ZIP CODE M DRIVER S LICENSE NUMBER CDL ENDORSED? STATE DATE / TIME OF ARREST F COUNTY OF ARREST CASE / CITATION NUMBER (CHECK IF YES) BAC Readings: 1st Sample 2nd Sample Refused Test The subject was lawfully arrested. At that time, there were reasonable grounds to believe that the arrested person had been driving or was in actual physical control of a motor vehicle within this state while under the influence of intoxicating liquor or drugs,.

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