Smog Check

General Information

Enter VIN #

Enter License Plate No.

Enter Mileage

Exhaust Configuration, when prompted (Single or Dual)

Vehicle Make

Body Type

Vehicle Model Name

Number of Cylinders

Engine Size

Transmission Type

Certification Type; (CA, FED, Referee)

BAR Referee Label Number

Fuel Type

Engine Make (Motor Homes, Referee)

Engine Year (Motor Homes, Referee)

Take photo of vehicle (optional)
Exhaust Emission Test Result

Hydrocarbons ppm (HC)

Carbon Monoxide % (CO)

Oxides of Nitrogen ppm (NOx)

COMPLETION

Comments/Recommendations

Full Name and Signature of Technician