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Just finished installing the x wheel on my 2001 f 250 7.3 manual trans. truck. It took me about 5 hrs. not hurrying. The worst part was probably the lower rear turbo housing bolt and hooking back up my exhaust. I did not remove the turbo from engine. I took it for a test run and all seems fine....I guess I'll really know if my surge is gone when I tow again.
It has a higher pitch / whistle but not too much. Very close to stock. I'm sure I will hear it better when I am in the "zone" that I was getting the surge in.
I installed that wheel in mine back mid summer and it cured my surge for the most part when pulling my 9000lb trailer. I heard just a small amount on some really long hills. I was very happy with the results. Wish I had done it a few years ago.