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I <br /> I <br /> I <br /> i <br /> 1 COMPUTER CHANGE RCA�IeRATION Record of Computer Change, Meter Change, or Calibration <br /> SHELL 01 L COMPANY <br /> El METER CHANGE F-1 WDM NOTIFIED <br /> STATION ST EET ADDRESS CITY / DATE - <br /> cr15C <br /> WIC NO.: DEALER: <br /> FP-U AKE AND MODEL SERIAL NUMBER CALIBRATION <br /> C� ��� CHECKED ADJUSTED TO <br /> MONEY GALLONS FAST SLOW FAST SL W <br /> FINISH / _- <br /> TOTALIZER In �- <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> START 1 �( o YES NO OYES ONO <br /> PRODU T GALLONS RETURNED O STORAGE OLD SEAL NO. NEW SEAL NO. <br /> 1 i <br /> PUI�P•MAKE AND MODEL SERIAL NUMBER! / CALIBRATION <br /> J 4 V�: -r C_ 7(1 [) CHECKED ADJUSTED TO <br /> / <br /> /. <br /> ' MONEY GALLONS FAST SLOW FAST SLOW <br /> �- <br /> i TOTALIZER FINISH J 0 0221 <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> START 1 U ) C]YES D NO AYES ONO <br /> PRODU T GALLONS RETURNED TO STORAGE OLD SEAL NO. NEW SEAL LVO�� C� <br /> PUMP•MAKE ANO MODEL SERIAL NUMBER CALIBRATION <br /> ( ? v - - p( �,� �_�.L- al 00` CHECKED ADJUSTED TO <br /> MONEY GALLONS FASTSLOW FAST SLOW <br /> FINISH b — U <br /> TOTALIZER o 0 o 2. <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> (,) OOH <br /> START \1 l') ❑YES NO QYES C] NO <br /> PRODUCT - GALLONS RETURNED TO STORAGE OLD SEAL NO. NEW SEAL NO. <br /> ' <br /> PUMPiMAKE AND MODEL SERIAL NUMBER rr CALIBRATION <br /> � �� <br /> r ! ( � o � -)_(, ) uI b `I CHECKED ADJUSTED TO PC T I•.� l � <br /> FINISH <br /> MONEY GALLONS FAST SLOW FAST SLOU <br /> �IV� <br /> TOTALIZER 6 1-72 <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> START / <br /> /\ /`r r �2— QYES Q'NO QYES ONO <br /> PRODUCT GALLONS RETURNED TO STORAGE OLD SEAL NO. NEW SEAL NO. <br /> ' / <<<f <br /> PUMP•M KE AND MODEL SERIAL NUMBER CALIBRATION <br /> JT 1 f ) U� t/( 7lti) 1 ? rl�,777 CHECKED ADJUSTED TO <br /> MONEY GALLONS FAST SLOW FAST -SLOW <br /> FINISH ` <br /> � <br /> TOTALIZER 1�. i <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> START Moe) <br /> 7 DYES C] NO QYES 0 NO <br /> PRQDUCT- GALLONS RETURNEDTOSTORAGE OLD SEAL NO. NEW SEAL NO. <br /> f 6 PUMP- AKE AND MODEL SERIAL NUMBER CALIBRATION <br /> I r SIC ) K< ! / ;: > (r i �f CHECKED ADJUSTED TO <br /> MONEY GALLONS FAST SLOW FAST <br /> SLOW <br /> FINISH C� {I <br /> TOTALIZER0 0 Ul) l <br /> READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED <br /> STARTOo yi QYES [:]'NO OYES Q NO <br /> JPRpO�CT GALLONS RETURNED TO STORAGE OLD SEAL NO. NEW SEAL NO. <br /> ((jj <br /> I- <br /> MAINTENANC C!MPANY� / <br /> DEALER'S SIGNATUREMAINTENANC MAN'S SIGNATURE <br /> I <br /> I SR-80.03 COPY DISTRIBUTION: 1 &4 ADMINISTRATIVE OFFICE;2 DEALER;3 CONTRACTOR <br />