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road racing fim superbike & supersport world championships & fim ...

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PRACTICE OR<br />

RACE N°:<br />

FIM ROAD RACING<br />

SUPERBIKE & SUPERSPORT<br />

WORLD CHAMPIONSHIPS<br />

FIM AND SUPERSTOCK CUP<br />

FUEL SAMPLES TAKEN ON ……/……/……<br />

FOR LABORATORY ANALYSIS<br />

Sample Can “A”<br />

143<br />

Can Label N° Can Seal N°<br />

Sample Can “B”<br />

RIDER: Can Label N° Can Seal N°<br />

MOTORCYCLE MAKE:<br />

TEAM:<br />

The above listed details refer to fuel samples taken from the fuel tank of the<br />

motorcycle specified after the race whilst in the Check Area for a period of<br />

60 minutes pending any protest.<br />

Sample “A” will go to the laboratory appointed by the FIM/IMS for analysis.<br />

Sample “B” will be safeguarded by the FIM in case a counter-expertise is<br />

required.<br />

As a responsible member of the team named on this sheet, I,<br />

(print name):<br />

have controlled the serial numbers of can seals and serial numbers of can labels<br />

and hereby certify the accuracy of the listed information.<br />

Time:<br />

Position in team:<br />

(Signature)<br />

(OWNER/MANAGER/MECHANIC)

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