Account Info
* Dealer Code
* Dealer Name
Your Contact Info
* First Name
* Last Name
* Phone   Extension:
* Email
Inspection Info
* Model Number
* Serial Number
* Date Work Performed
* Inspection Results (Choose One):
A Found connection to be correct, terminals in good condition, installed safety modification parts, reconnected.
B Found connection to be incorrect, terminals in good condition, installed safety modification parts, reconnected.
C Contact area(s) damaged (as shown on page 2 of technical publication), should not be repaired.