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Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item

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Page 1: Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item
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Page 2: Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item
Page 3: Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item
Page 4: Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item

ADAM J MICHELS

ALCO-SENSOR IV WITH PRINTER

1/3/2020

200009

1/3/2022

STATE OF MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES

BREATH ALCOHOL PROGRAM

INSTRUMENT OPERATOR CARD

The named cardholder is authorized to operate an evidential breath alcohol instrument for the determination of the alcoholic content in breath form of expired air in Missouri.

Operator MICHELS, ADAM Permit No 200009 Date Issued 1/3/2020 Date Expires 1/3/2022

+*ypy*odk*maw*vqg*yuy*pxy*ucw*BrD*whi*tkf*Ckk*eBA*- +*yoD*azE*tDn*mzi*zil*aFz*zha*wln*xgs*dwc*uaC*xdA*- +*pBy*qgz*ilk*rci*xru*agj*aCb*vui*fDw*jDa*its*zfc*- +*pwz*vEa*htk*vAq*txm*xus*tlD*aac*koa*sow*css*uds*- +*pxk*gzq*vbn*wfa*sqk*rFz*Drx*pyb*ypk*yoa*Ejq*xii*- +*uzE*Boi*asj*zcu*vub*agj*iks*bCg*jas*ejA*fjk*uzC*- +*uiz*kcn*eAk*qcE*tkf*sgn*ovk*ccc*dvk*uiz*lhs*dwy*- +*zdb*cjq*cyB*uDn*ubr*lbn*oBt*azn*CyB*ugC*roz*fyw*- +*zdv*DAr*rpk*mCz*axy*voj*jAm*lhz*kir*rkq*nlb*ynm*-

Page 5: Missouri · 2021. 3. 13. · 111648 LOCATION OF INSTRUMENT (STREET AND CITY) 891 Techmology Drive, Weldon Spring NAME OF AGENCY MSHP CHECKLIST: Place a mark in the box by each item