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BKR Site Survey Data Input
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Date
*
Title
*
Short description of requested work.
Surveyor Name
*
First
Last
Site Contact Name
*
Contact Phone Number
*
Contact Email
*
Site Address
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Fuel Marketer / Supplier
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Permiting
*
Exiting Permits
Permits Required
Permits Not Required
New Construction
Unknown
Permit Description
Existing permit (if any) types, numbers, and county / city approved (CARB, Fire, Conditional Use, Environmental Health, Construction, etc.
Tanks
List each tank separately. Locations (or proposed locations if new construction), AST / UST, single-wall or double-wall, size (in gallons), UL listing of each tank, tank manufacturer.
Piping / Sumps / Pumps
Drawings, sketches, locations, types and condition of piping; sump types and locations; pump types, sizes and manufacturers.
Dispenser or Pump Make / Model
List each dispenser or pump separately. Locations, UDCs, dispenser communications, electrical connections.
Electrical Layout / Drawings
Fuel system electrical block diagram, single line drawing, sketches.
Main Power Electrical Connections
Location of main power panel, panel power schedule, distance from fuel equipment to panel, circuit breaker availability and size, availability of conduit or conveyance.
Cash Register System / Networks
Location and manufacturer of cash register system, internet network provider and point-of-presence, network interfaces and locations, EMV processing networks.
Card Reader / Fuel Management System (FMS)
Location and manufacturer of card reader(s), manufacturer of FMS (PetroVend, FuelCloud, Card Master, etc.), site controllers, dispenser communications and junction boxes.
Monitoring System
Monitoring systems (INCON, Veeder-Root, Other) sensor types and locations, tank gauges.
Sumps Power (FMS)
Additional Notes / New Construction Details
Include site layout if new construction.
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