A declaration which is referred to in subsection 2 of NRS 50.315 must be in substantially the following form:
I, ..........................................., hereby declare:
That I am a ............... (occupation) employed by ................ (employer);
That on ......................... (date) I prepared a ............... (chemical solution or gas) consisting of ................ (description and composition of solution or gas) as necessary for accurately calibrating the ................ (name of device).
I declare under penalty of perjury that the foregoing is true and correct.
Executed on ......................................... .............................................................................
(Date) (Declarant's Signature)
.............................................................................
(Declarant's Title)
Nev. Admin. Code § 50.035
NRS 50.315