Note: Please try and complete as much of the information below as you can.
Please leave fields blank for whatever you don't know.
Please Use Proper Capitalization, NOT ALL UPPERCASE, and not all lower case.
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| Station Name |
* Required
Note: First the BRAND of gas, Then station name, eg. Shell - Barny's Pit Stop
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| Address |
* Required
| Notes: | 1) Please use the street address of the station itself, not a PO Box, not just 2 cross streets. |
| | 2) Pls Abrv where Approp |
| | 3) Does the street have two names? Please use the format: 2120 Main St (SR 123) |
| The address may be on the receipt, or you can often find it by searching
Google
for the phone number, but the best way is to go in and ask the attendant. |
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| Cross-Street |
(Important, but not required)
| Notes: | 1) Do not list the same street again |
| | 2) If it is at, or near, an intersection, please use the format: @Something St |
| | 3) Does the cross-street have two names? Please use the format: @Main St (SR 123) |
| | 4) Are there more than 2 streets intersecting? Please use the format: @High St/Low St |
| | 5) Is it far from any intersection? Please write near Jones St or between Rock Rd and Hard Plc |
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| City, State Zip |
,
* All Required
Note: Please use the City as listed by the US Postal Service
for the address (you can find the ZIP+4® there as well).
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| Phone Number |
Note: Please use the format: (xxx) xxx-xxxx
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| Website |
http://
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| Hours |
Note: Please use the format: 24/7 or Mon - Fri 5am - 12am / Sat 6am - 11pm / Sun 7am - 10pm (as needed)
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| Owned By | I'm not sure Company Franchise Independent |
Types of Fuel (optional)
Most stations have 3 grades of gas for cars, but not all. Some have additional types of fuel.
We know some of these questions are for fuels that are not readily found yet, but think how useful it will be when they are ...
Fill in as much as you know, don't stress yourself.
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| Fuel Type |
(if you don't know, leave it as it is)
|
| Mid-Grade (88 or 89) | I'm not sure Yes, they have it No, they don't |
| Premium (90 or up) | I'm not sure Yes, they have it No, they don't |
| E85 | I'm not sure Yes, they have it No, they don't |
| Car Diesel | I'm not sure Yes, they have it No, they don't |
| Truck Diesel | I'm not sure Yes, they have it No, they don't |
| Bio-Diesel | I'm not sure Yes, they have it No, they don't |
| Ultra Low Sulfer Diesel | I'm not sure Yes, they have it No, they don't |
| Kerosene | I'm not sure Yes, they have it No, they don't |
| Propane | I'm not sure Yes, they have it No, they don't |
| Electric Car Charger | I'm not sure Yes, they have it No, they don't |
| Hydrogen Fuel | I'm not sure Yes, they have it No, they don't |
Amenities (optional)
Gas stations have more than just fuel |
| ATM |
Note: Which network? Star? Jeannie? etc
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| Restaurant |
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| Feature |
(if you don't know, leave it as it is) |
| Pay at the Pump | I'm not sure Yes, they have it No, they don't |
| Car Wash | I'm not sure Yes, they have it No, they don't |
| Service Bay/s | I'm not sure Yes, they have it No, they don't |
| Convenience Mart (w/coffee) | I'm not sure Yes, they have it No, they don't |
| State Lottery Tickets | I'm not sure Yes, they have it No, they don't |
| Restroom | I'm not sure No Inside "Outside" (separate entrance) |
| Air (for tires) | I'm not sure No Free Pay Broken |
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