Several other states have adapted the CARB emissions standards so its not just California. "There are a growing number of CARB states including California, Connecticut, Colorado, Delaware, Maine, Maryland, Massachusetts, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Washington D.C. Most of these states have strict emission standards and require vehicles to be tested annually or biennially (every other year)."
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Unless they have changed the procedures, Joyzee's inspection is a once every two years OBD2 plug-in (and I am not too sure just how far they even go with that, as they used to allow 1 out of the three required 'readiness monitors' to NOT be ready and still pass, and I doubt that they check the ECM's programming for aftermarket tunes), NO tailpipe, or tailpipe on the rollers checks, and basically NO other visual checks.
They used to use mirrors and check to see if the factory catcons were there, or even what looked like factory catcons, and do that gas cap EVAP leak check with the (vacuum?) machine, but not even sure that they do those anymore either.
Pennsyltucky on the other hand has a full, MUST be done at an approved; dealer, shop, etc., vehicle inspection where they check for catcons, do an OBD2 plug-in, check wheel bearings, tire tread depth, loose steering, parking brake hold, and pull two diagonal wheels to actually MEASURE the pads and rotor thicknesses, and then 'test drive' your ride.
As far as I've ever heard this is the most draconian of any U.S. state inspections, as only the German TUV and other Euro countries could possibly have more stringent inspections