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Step 1
Customer Information
Customer Name
Date
todays date
Customer Phone Number
Customer Mailing Address
Email Address
Delivery Address
Directions to Delivery Address
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Current Tank Information
Customer Owned
Rented
New
Favorite Fruits
pick one!
Apple
Orange
Watermelon
Current Fuel Provider
Tank Size
Gallon
Amount Of Fuel In Tank
Gallons or %
Date Reading Taken
Location Of Tank
Appliances
Heating System
BTU Rating
Water Heater
BTU rating / Size in Gallons
Free Standing Stove
BTU Rating
Cook Stove
BBQ
Clothes Dryer
Other
Current Pricing Information
Date Service desired
Notes/Best time to reach you and preferred method of contact
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