SWMCrRLJ 6.13(b)
              EVIDENCE BLOOD DRAW CERTIFICATION


(1)  Certification of Qualification to Draw Blood and of
     Blood Draw Procedure

    (a)  Admission of Blood Draw Certificate.  In the absence of
         a request to produce the person who drew blood from the
         defendant made at least  seven (7) days prior to trial,
         certificates substantially in the following form are
         admissible in lieu of a witness in any court proceeding held
         pursuant to RCW 46.61.502 through RCW 46.61.506 for the
         purpose of determining whether a person was operating or in
         actual physical control of a vehicle while under the
         influence of intoxicating liquors and/or drugs.





                  BLOOD DRAW CERTIFICATION

     I do certify under penalty of perjury of the laws of
the State of Washington, the following: I am a (physician)
(registered nurse)  (qualified technician) and I am
qualified by medical training and experience to draw blood
from the human body.


     On   (date) at (time) I drew (number of samples) blood
samples from (name of person) at the direction and in the
presence of  ________________________________(name of officer).

     I further certify that with each sample, the blood draw
site was sterilized with a non-alcoholic preparation
(betadine)  (other  ______________), and that each blood
sample was drawn into a chemically clean dry container
(hereinafter referred to as blood draw containers)
consistent with the size of the sample and sealed with an
inert leak-proof stopper.   The blood draw containers are
known by me to contain a suitable anti-coagulant and enzyme
poison sufficient in amount to prevent clotting and
stabilize the alcohol concentration.  The anti-coagulant and
enzyme poison utilized in this blood draw were (sodium
fluoride and potassium oxalate)  (other:                  ).
To the best of my knowledge, no foreign substances or
chemicals, including alcohol, were involved in the blood
draw process other than those listed above.


Date and Place of signature.       Signature of person making certification.


(Adopted effective September 1, 2000)