1902 Mc Gaw

Irvine, CA 92614
P: 949-567-9000
F: 949-567-9010
www.cp-carrillo.com

CUSTOMER INFORMATION
Cus tomer N ame Cus tomer ID# N ew:

S uite or C/ O P hone Fax

Addr es s E -mail

City Contact

S tate Zip Code P O#

Cr edit Car d# E xp Date N ame CC Zip

ORDER
ORD E RINFORMATION
IN F O
Cus tom P is ton Info
Date R equir ed S hip M ethod R TS LTS All S ame

R ef. J ob# R ef P ar t# P ins P ar t#

Cus tom P is ton Qty R TS LTS All S ame Locks P ar t#

M otor Type Dis placement S pacer R ails P ar t#

Car b Fuel Inj B lown/ Tur bo N OS P infit Y N

Us age Appr ox HP RPM R ing S et P ar t#

B or e (CI/ Alum) S tr oke R od W idth R od S / A R ing Cyl S et

P in Diameter P in Length Int M illing

Head Type Head CC P lunge V/ R

Flat/ Angle M ill How M uch Comp R atio Gas P or ts

B lock Height Comp Dis t P in B uttons P ar t#

Gas ket Thicknes s CC Vol Deck Clear M is c

Int Valve E xh Valve N otes :

Lift/ Lift a t Overla p Rockers Int Sub Total

Int E xh Exh
Lobe S epar ation Ins talled @
Tax
Fr ee Dr op Int E xh Dur @ . 0 5 0
Shipping Total
Top R ing Width 2 nd R ing Width Oil R ing Width
Total
Top Ring Depth 2 nd Ring Depth Oil Ring Depth

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