Sound Easy Pump Site Survey

Company Name

Site Information

New Field

City

State

Zip

Email

phone

owner name

owner phone

owner email

Is the site an unbranded/independent gas station? Is the site an unbranded/independent gas station? Yes No

Time Zone? Time Zone?PST - Pacific Standard TimeMST - Mountain Standard TimeCST - Central Standard TimePST - Pacific Standard Time

Store Hours

Pump Idle Prompt Pump Idle Prompt Welcome to "Store Name" Other

Pump Start Prompt Pump Start Prompt Select Grade Lift Lever

Pump Service Company

service contact name

service contact phone

City

Pump Service Address

State

Zip

Estimated Installation Date

Network Information Network Information FD Buypass Heartland Other

other network

Debit Encryption Key

Wireless Network Enabled? Wireless Network Enabled? Yes No

MNSP Installed? MNSP Installed? Yes No

MNSP Type

Point of Sale Point of Sale Wayne Nucleus Gilbarco Passport Verifone Other

Verifone POS Verifone POS Ruby Supersystem Ruby 2 Topaz XL Ruby Cl

Other POS - please specify

Forecourt Controller (device that turns the pumps on/off) Forecourt Controller (device that turns the pumps on/off) Gilbarco Passport Verifone Wayne Fusion Other

Gilbarco Passport Requirements Gilbarco Passport Requirements My pumps meet the Gilbarco Passport Requirements

Verifone Controller Type Verifone Controller Type Commander Ruby Cl Sapphire

Other Forecourt - please specify

Commander Software Requirements Commander Software Requirements My Commander software version meets the requirements

Dispenser Information

fueling points

fueling positions

Dispenser Name Dispenser Name Wayne Gilbarco Tokheim Bennett Other

Other dispenser - please specify

Dispenser Model Dispenser Model Vista I Vista II Vista III Vista IV Ovation 1 Ovation 2 Helix Harmony

Dispenser Model Dispenser Model Encore 300 Encore 500 Encore 500S/700S Advantage

Dispenser Model Dispenser Model Premier B Premier C 262A

Dispenser Model

Dispenser Model

Wayne Vista Keypad - Which keypads are installed? Wayne Vista Keypad - Which keypads are installed? TRSM Keypad (flat surface) SPM Keypad (keys are raised)

Which Wayne printer is installed? Which Wayne printer is installed? DW-10 or DW-12 Clamshell TearBar Printer DCPT Printer

Pictures