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SHOW ME WEIGHTS DELIVERY SITE SURVEY

Janssen Household
Facility Name: _________________________ Cortney Ellis and TJ Janssen
On-Site contact: ______________________

7750 S Engle Creek

Street Address: ________________________________________________________________

Barnhart
City: _________________________________ State: __________
MO Zip: ____________
63012

314-971-5058
Cell Phone: _______________________ Contact Email: ____________________________
CortneyREllis@gmail.com

Please answer the following questions with accurate information to ensure proper delivery/service and
installation of Show Me Weights fitness equipment. Inaccurate information may result in delays and
additional charges.

Is this a business site or residential site? ____ BUSINESS ____ RESIDENTIAL

Is the site new construction or an existing facility? ____ NEW ____ EXISTING
Can your street accommodate and park a box truck (Length up to 26’, Height 13’6”) ___YES ____ NO
How close can the box truck get to the delivery entrance? 60_____ FEET
Is there a loading dock? ____ YES _____ NO
Is this a ground level delivery? _____YES ______ NO
If no, how many stairs to the equipment room? 0 ________ Are stairs up or down? 0___________
What is the width of the smallest stairway? 0 _______ INCHES
Is there any 90 degree turns along the path to where the equipment is going? ____ YES ____ NO

2001 Hitzert Ct. Fenton, MO 63026 P: (636) 326-1885 E: Sales@showmeweights.com W: www.showmeweights.com

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If yes on 90 degree turns what is the measurement of the area for this turn (in inches)? ___ W ___L ____H
Is there a freight elevator available for delivery purposes? ______ YES ______ NO
If yes, what are the dimensions in inches? _____ L n/a W
______ ______H
What is the width and height of the entry door(s) in inches? 28.5 ______ W76 ______ H
n/a
If double doors, can the center post be removed? ______ YES ______ NO
What are the smallest width/height of any door we are going through in inches: _____ W _____ H
0
What is the distance from the entry doors to the equipment in the room? ______ FEET
What type of facility flooring will the equipment be placed on? _________________________________
carpeting

Are there dedicated (non-looped grounded) electrical outlets installed? _____ YES _____ NO
Are there cable jacks installed? (only necessary for cardio pieces with TV’s) ____ YES _____ NO
Is there anything unusual about your facility/home that could impede this installation?

By signing below, you are stating that the above information is correct. You will be responsible for any
additional charges that result from inaccurate or incomplete information.

Cortney Ellis
dotloop verified
02/28/23 8:00 PM CST
0AXD-RN0D-TXVC-ORVD
_______________________________________ 2/27/2023
__________________________________
Authorized Signature DATE

______________________________________ __________________________________
Print Name Title

INSTALL DATE: ___________________________

2001 Hitzert Ct. Fenton, MO 63026 P: (636) 326-1885 E: Sales@showmeweights.com W: www.showmeweights.com