Site-Survey Form Fill out the form before every service call! Site Survey Form All entries with an asterisk are required before submission. An images of equipment that will be worked on is required. More than one image or video is preferred Name Date of Site Survey Time-In Projected Installation Date Location Name Location Address Parking Location Image of Store Front Is a Counter Already in Place for a Beverage Unit Yes No N/A Will you have an Ice Machine on top of Dispenser?* yes No N/A Is there Drain access? Yes No Power Outlet Available for All Electrical Equipment? yes no, need more Is there Access to Water? Yes No Is there Space Allowed for Water Filters? Yes No Will there be a Water Valve on the dispenser? Yes No Will you have Bag In Box Syrups? Yes No CO2 Location Image of CO2 Location What Type of CO2? Bulk Canister Tech Notes or Comments Are there any Additional Photos to Add? Walkthrough Video of Surveyed Site Time-out On-site Manager Signature Send