ࡱ > 5 7 4 U bjbjnn 4" aa : : 0 \ ^ ^ ^ ^ ^ ^ $ " R Y Y Y \ Y \ Y Y : ev2 " L H 0 V R # $ # # Y A # : B | : UTAH STATE LAB, BUREAU OF FORENSIC TOXICOLOGY PO Box 144300, Salt Lake City, UT 84114 GOVERNMENT RECORDS REQUEST FORM To: Utah State Bureau of Forensic Toxicology Address: PO Box 144300, Salt Lake City, UT 84114 Description of Records Sought: Any and all records, including the screen results, such as EMIT, ELISA, or any other screening method used, regarding Laboratory Case No. *** / Agency Case No. ***; suspect name in this case is *** ***. Any and all records, including GC/MS or LC/MS chromatography results regarding Laboratory Case No. *** / Agency Case No. ***; suspect name in this case is *** ***. The GC/MS or LC/MS results, including chromatography, for the positive and blank controls. If a positive or blank control from a different batch or day was used, provide the chromatography for both the unused batch or day and the used control(s). The GC/MS or LC/MS results, including chromatography, for the calibrators used in the drug test. If calibrators from a different batch or day were used, provide the chromatography for both the unused batch or day and the calibrators that were actually used. The chromatography for the internal standards for each sample listed above, including the Defendants sample, the positive and blank controls, and the calibrators. The calibration curve with associated R2 value. Any other information regarding the drug test for the above-mentioned individual, including any notes not included in the above documents. The Standard Operating Procedure (SOP) for the ** drug test performed. Associated internal and external chain of custody documents; photocopies of specimen bottle, bottle seal and bottle specimen ID Resume or Curricula Vitae of the scientist(s) who certified the test results. THIS REQUEST IS SPECIFICALLY ASKING FOR THE CHROMATOGRAPHY AND CALIBRATION CURVES FOR THE GCMS OR LCMS RESULTS, INCLUDING THE POSITIVE AND NEGATIVE CONTROL(S) AND CALIBRATORS FROM THE CASE DESCRIBED ABOVE. This request includes the above-described information related to drug test analysis performed by Forensic Scientist *** ***. I would like to receive a copy of the records. I understand I may be responsible for fees associated with copying or research charges as permitted by Utah Code Ann. 63G-2-203. I authorize costs up to: $25.00. (Please call ** at (***) ***-**** if costs will exceed $25.00 so she may seek authorization of the director of her office.) Pursuant to Utah Code Ann. 63G-2-203(4), I am requesting a waiver of costs for the following reason(s): I work as a public defender in ** County, Utah, and my client is indigent. CERTIFICATION OF REQUESTOR I, the undersigned, do hereby certify that the following apply to me: I am one of the attorneys assigned to represent *** *** in this case in which he is charged with ***. Some evidence in the case has been submitted to your bureau for analysis. Name and Address of Requestor: _____________________(Lawyers name and address). Phone #: ____________ (Lawyers Cell Phone) Date of Request: __________________. Signature: ________________________ Date: ________________ - . U & 0 F J | 4 8 Y y # J K T i ' ئآ̞ h# h hc hc H*hV h h