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by 2018 Equipment Survey <br /> Site Number_ro 80 Date 6 - ? 6t — Ice <br /> rBliptakhWao <br /> rGr-ada(ffappCcabIs) <br /> HimA=Cetlow .. _enser No.dFuel CA=Callow <br /> EW-Emco Wheaton EW=Emco Wheaton <br /> HA=Harco EBWAre they Installed/mounted d <br /> a single hose gas <br /> Ibt dbpq only HE=Healy Write Model Number In space provided HE=HastyWrite Model Number in functioning property <br /> Please write It In <br /> 1 Mgufer,2 midgrede,3, HK-Husky HK=Husky 'pace provided <br /> 4,5 di'a'l,etc) <br /> OPW OPW Yes or No <br /> VST=Vapor Syst VST=Vapor Syst. NA=None <br /> ` v45 V� U � � � Vi <br /> 2 v5� �S U �� Q�► S I4, �j 1\ �J A <br /> tv S R N A <br /> SBIL Ili A �j A <br /> J S�lc V J- <br /> i"IAR D 2018 <br /> WENT <br /> S*Itch. Cho 9lU _ Law.Vdita e: <br /> What is the locatlon of the estop? <br /> IN=Inside BulldinglK losk How many S Sol4_Pan,1. A=Attached Is there a Billboard on Does the afte have Low Does the site seg E-85,B6 to <br /> BUILD=Outside on the Building canopies are F=NF-Free Standing the property? Voltage Emergency Shutoff B20 or have an Electric Car <br /> DISP-Outside in the Dispenser Area onsite? Charging Statlon? <br /> TANK=Outside near the Tank FIBS NA=NNA=No Canopy Yes or No (for(Data/m)? / <br /> Intercom)? <br /> (Ctrcle ALL that appy) Yes or No <br /> �7BIJ 1LD DISP TANK . <br /> issued 12/04/2017 Pane 4 of d <br />