Gasboy SiteOmat Maintenance Manual - Manual (Page 273)

269 SiteOmat Setup and Maintenance Manual – MDE 4817G
APPENDIX B
SITE SURVEY FORM – HOME BASE STATION
Date: / /
Prepared by:
e-mail:
Phone: @
Home Base Gas Station Identification
:
Company name
Address
Contact person:
Phone: Mobile phone:
Home Base Station Data
:
Station name:
Site Name:
Power Supply: AC 220V 110V Other
Type of Pumps:
Number of Pumps:
Number of nozzles:
Number of Authorizers required:
Electronic Pulser installed: Yes No
If Pulser installed, model?
Data Download Method
Cellular modem installed: Yes No