Midpond Tech Sheet

Technical Inspection Sheet

Instructions: The participant is to bring this inspection form to an authorized technical inspection station with all necessary items needed for the event.

This inspection form must be filled out by the inspector and no changes shall be made to the equipment. All such changes will void the inspection sheet until equipment can be re-assessed by the inspector.

Date of Event      __________________________

Make                   __________________________

Event Title            __________________________                         

Model                   __________________________

Color                    __________________________                         

Car #                    __________________________

Last Name            __________________________

First Name            __________________________

License Plate #      __________________________

CHECK ITEM:

Modifications

___       Hub Spacer/Adapter

___       Engine

___       Suspension

___       Tires and Wheels

Brakes

___       Brakes are properly bled, linkages in good order and free of wear

___       Brake pads should have more than 25% of useful life

___       Master cylinder and calipers within specifications

___       Brakes free of fluid leaks

___       Brake lamps in good working order

Body / Suspension

___       Tires have minimum tread, do not have exposed belting, and have a wear

___      rating of 180 or higher (no temporary spare tires allowed)

___       Lug nuts torque to specifications

___       Steering system is in good working order

___       Suspension system in working order

___       Windows cannot have cracks over5 inches in length or .5 inches in     diameter

Engine

___       Battery secured properly, positive terminal covered

___       Air cleaner secured

___       Oils and fluids filled to specifications – No Leaks

___       Throttle action smooth / return spring to specifications

___       Ignition system and Fuel system – Cars with relocated Batteries, Fuel Cells or both Mush have an externally mounted Kill switch installed on the vehicle that disables the entire electrical system.

_______Drivers Initial if none is installed

___       Wiring harness secured

___       Exhaust system secured

Safety

___       Snell 2015 or newer rating approved DOT helmet  

___       Seatbelts in proper locations and secured according to 4points from unibody or harness bar ___   All convertibles, open top, soft top cars must have a properly installed, approved roll bar.

___       Tow hooks or straps must be present on at least one location on vehicle and clearly marked

_______Drivers Initial If not present

___       Remove floor mat, lose items (audio systems)

___     No cage – No Tandem

___       Minimum 4 point hallo configuration and Door bars Required - DOM .95wall and 1.5” or Larger Diameter required – Roll bar Padding should be installed where driver or passenger head may come in contact .

Internal Use Only (to be filled out by a technical inspections representative)

Inspector.s Signature / Date: __________________________Date:___________________

Owner.s Acknowledgement: I hereby acknowledge that the technical inspections performed on my automobile are solely for the purpose of meeting minimum standards for the event. I release the inspector Santioning Body and any affiliated hosting parties from any liabilities and issues arising

from their inspection of my car, including the failure or omission of the items listed on this inspection form.

Driver.s Signature:             __________________________Date:___________________

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