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by 2019 Equipment Survey <br /> 0 Site Number nv Date - ? <br /> rimes Breakaways <br /> Dispenser p Manufacturer Model Number Manufacturer Model Number <br /> Ender the specific CA=Callow CA=Callow <br /> fueling position B.If EW-Emco Yfieaton EW=Emco Wheaton <br /> the position has gas& HA=Harco EBW <br /> (hesel kat separate HE=Healy Mile Model Number in space provided HE=Healy Write Model Number in space <br /> (i.e.2 gas.next row 2 HK=Mushy HK-Husky Provided <br /> diesel) OPW OPW <br /> VST=Vapor Sysl. VST=Vapor Syst. <br /> l <br /> \)51 1 141A-CMZ SWP, <br /> 71 - <br /> 1 V L V-4%4-z- <br /> s L <br /> - [IL- SIVA <br /> tj13bLg-L VS" <br /> - .Iz - s v <br /> Ott, �`fi _ 33 CC) <br /> 9st ova << a A <br /> -Sk ova <br /> 4 -9k Urw \A VL tis 330 <br /> canopy [board "W V~ <br /> Number of IN=Inside Bur<*Vftosk S=Solar Panels A=Attached Is there a Billboard on the Does ft site have Low <br /> e9lop Switch$ BUILD=Outside on the Does the estop have S of <br /> r Area Vie appropriate canopies F=Non-Solar F=Free Standing property? Voltage Emeryeney Stwl-aH <br /> sIches DISP=In kie Dispenser Area <br /> onsIND <br /> ite TANK=In the Tank Pad Area � � onsite (tar Data 1 CR <br /> NA=No Canopy WA=No Canopy Yes of No Intercom)? <br /> ITOr <br /> issued 01/12/2019 Page 4 of 4 <br />