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Shop Name<br />
Phone<br />
Address<br />
City<br />
State, Zip<br />
RISK MANAGEMENT/ 85<br />
Date Report Completed / / Workshop Ticket Date / /<br />
Workshop Ticket #<br />
Inspector's Name Position<br />
A. Description of System Rented Purchased<br />
Ski Brand Model Size<br />
Serial # Inv. #<br />
Boot Brand Model Size<br />
Binding Brand Model Size<br />
B. System Performance<br />
Boot Sole Length mm Binding Indicator Toe L R<br />
Setting<br />
Condition Heel L R<br />
Testing Device Last Calibration date / /<br />
Chart date / /<br />
“In Use” Torque Tolerance: Forward Lean Twist<br />
Measured Release Values:<br />
SYSTEM PERFORMANCE REPORT<br />
Clockwise Ctr Clockwise Clockwise Ctr Clockwise<br />
Toe L R<br />
Heel L R
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