Please fill out this information form below completely so we can better serve you.  If you need a response within 24 hours, please contact us directly at:
JB Carburetors
Phone: (530) 623-0562
Fax: (530) 222-2714
Tech support: (530) 623-0562
Email: jb@jbcarburetors.com
Contact Information
First Name: Last Name:
Street Address: City:
State:  ZIP Code  
 
How fast a turnaround do you need?:
Day Telephone: Alternate Telephone:
When do you want to be contacted?:  
 
E-Mail: E-Mail Address for which to send Copy:
Carburetor Form (Fill in the Blanks and When Finished, Submit)
Vehicle Year: Make: Model: Weight:
Application
Carburetor #   Circle Track
Street/Strip   Dragster
Chassis Car / Door Slammer   Show Car
Jet Boat   V-Drive
Carburetor Brand, Size and Number
Engine and Transmission Information
Cubic Inches: Small Block? Big Block? Engine Make: Compression Ratio:
Transmission Type
Automatic w/Overdrive   Powerglide
Manual   C4-AOD
V-Drive   Stem Drive
Jet Drive  
Transbrake: YES  NO
Performance Data
Step Controller: Stall Speed/RPM: Max Launch RPM: Shift RPM:
  YES  NO
Current Carburetor and Intake Modifications
Fuel Type
Pump Gas   50/50 Mix
Alcohol   Race Gas
Nitrous   Other
Intake Flange
4500 Series Dominator   Dual Dominator
4150/4160 Series Holley   Dual 4150
Quadrajet   2-Barrel
3x2 Triple Duece  
Intake Manifold Brand
Intake Manifold Modifications: Please Explain Below:
Cylinder Head, Camshaft Specs and Ignition
Have the Heads been Flowed?
  YES  NO
Cylinder Head Brand
Cylinder Head Modifications
Gasket Matched
Polished Chambers
Port Work
Additional Work- Explain:
Camshaft Brand:
RPM Power Band on Camshaft:
Camshaft Type:
Solid   Solid Roller
Hydraulic   Hydraulic Roller
Camshaft Specifications:
  Intake Exhaust
Duration @ .050:
Gross Valve Lift:
Rocker Arm Ratio:
(Camshaft Degrees Normally Between 108 and 114:)
Intake Centerline (Crankshaft Degrees):
Ignition Type: Ignition Amp Box Type
Ignition Coil Type:
Air Filter, Exhaust, Gear Ratio & Drive
Air Filter:
  YES  NO
Header Tube Diameter: Collector Size:
Exhaust System
Stock Manifold with Cats   Stock Manifolds with Performance Mufflers
Headers with Cats   Headers with Performance Mufflers
Open Headers YES   NO
Rearend Gear Ratio: Rear Tire Height:
Tire Brand: Tire Width:
Racing Data
Best E.T.: Best MPH: What Class Do You Run In?
Do You Race Multiple Tracks? Mostly Where Do You Race?:
Dirt:
  YES  NO
Asphalt:
  YES  NO
Circle Track Cars    
Degree of Bank: Driving Style - Agressive or Conservative Sanctioning Body You Race With:
Marine (Recreational, Hotboat, or Drag Boat):
Offroad (Rock Crawler, Sand Racer, or Mud Buggy):
Drag Car 1/8 or 1/4 Mile Include your 60' Times.
 
Special Requests
Special Request or Considerations:
Job Requests:
Send in your carburetor for work
A JB Performance Carburetor
Considering the most cost effective option
Options to be Considered:
Billet
Show Car Quality Finish
Fuel Lines
Fuel Pumps and Regulators

You can also submit this form via FAX to: 530-222-2714, or call our Shop/Tech Line at: 530-623-0562.

To verify your form, please enter the sum of 2 + 3

JB Carburetors
Phone: (530) 623-0562
Fax: (530) 222-2714
Tech support: (530) 623-0562

Joe Ballard
7403 Pacheco Road
Redding, CA 96002
jb@jbcarburetors.com
Monday—Friday 8AM-5PM PST

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