General Information

Customer Name:
Address:
City: State: Zip Code:
Daytime Phone Number: Evening Phone Number:
e-mail address:

Boat Make: Boat Model: Boat Length:
Boat Model Year:

Engine Model Year: Engine Size (CID) Drive Type
Engine Configuration: Single Twin Twin (Staggered) Triple
Engine(s) equipped with Through Prop Through Hull Silent Choice exhaust

Power Steering

Power steering mounted to: Starboard cylinder head Port cylinder head

Total number of power steering pumps:

Power steering driven by: V-belt Serpentine (flat) belt

Accessories

Accessories mounted to starboard exhaust riser (check all that apply):
Shift interrupter bracket Wire harness plug Drive reservoir bottle

Accessories mounted to port exhaust riser (check all that apply):
Ignition or Engine control module Oil filter header Drive reservoir bottle

Oil filter header mounts to:
Base of Riser Top of riser Steel power steering/engine lifting bracket

Riser spacers:

Port Eng:
Center Eng:
Starboard Eng:

Cooling System

Engine cooling hoses feed: Manifolds and risers (2 hoses per side) Manifolds only (1 hose per side)

Additional notes:

 

 

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