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SERVICE STATION CHECKLIST <br />p; I C # : 7524-2804 <br />-> .s;;:. DISPENSER AREA <br />Product <br />Dispenser <br />Number'' <br />Impact <br />Dispenser <br />Centlafntnont Sensor: <br />Containment <br />Do Any of the ' <br />B.S. Balance System <br />0 <br />Manufacturer <br />of <br />Valves <br />Containment <br />Mechanical; Electronic or None <br />' Sensor <br />Nozzles exceed a <br />H.S.: Healy System <br />Nozzles <br />Operational <br />Box <br />If electronic, write model type. <br />Operational <br />10 gpm flow rate? <br />V A Vacuum Assist <br />Regular <br />GILBARCO <br />8 <br />Yes <br />Yes <br />M Model: <br />Yes <br />V.A. <br />Plus <br />GILBARCO <br />8 <br />Yes <br />Yes <br />M Model: <br />Yes <br />V.A. <br />Premium <br />Model: <br />Diesel <br />Model: <br />Other <br />Model: <br />Comments <br />GENERAL INFORMATION <br />General Information: <br />Rev: 12/4/95 Page 3 of 3 <br />Emergency <br />ESO <br />Oty <br />Shutoff (ESO) <br />Operational <br />Present <br />0 <br />Exterior <br />f <br />Interior <br />Yes <br />Yes <br />General Information: <br />Rev: 12/4/95 Page 3 of 3 <br />