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-1-Fispenser Conversion Evaluation Form <br />MANUFACTURER, 41L.,riAyt" <br />SPECIFIC MODEL <br />MANUFACTURER. <br />SPECIFIC MODEL " •L94-01 <br />Existing <br />DISPENSER /HYDRAULIC CABINET <br />Is it a Bravo UDC? Vor Make/Model <br />Shallow pan or Deep Sump? <br />Water splash lip opening (I.D.): Length 'S rYq-§-"Width-Z'y"/3q" <br /># of existing Anchor Bolts for concrete pad / island: 2? <br />Does the existing UDC have a water splash lip? Nb <br />F <br />e t <br />Does conduit exist within 2" of the inner opening? N® (IF YES, IMAGES ARE REQUIRED) <br />121 Does conduit exist outside of the UDC water splash lip? '0 (IF YES, IMAGES ARE REQUIRED) <br />I---' <br />11101111! 111 <br />BRAV <br />0WWW.SBR"O.COM made <br />