Pop/Juice Line Cleaning Request Form

Pop/Juice line cleaning

Now that our food service industry is starting to prepare to open, there are some things that may need to be looked at before things begin. After being closed for several months, it is very possible that pop and juice lines will need to be cleaned and sanitized prior to use. As members of this great community, we have decided to offer line cleaning at no cost. This offer is temporary but will be in place until such a need is no longer relevant.
Please fill in the following details and we will contact you with a scheduled date/time.
Name of Establishment *
Name
Your Name *

Name Position
Phone Number *

Area Code Phone Number
E-mail *
Address *

Street Address

Street Address Line 2

City
We have asked the information below in order for us to properly prepare when we arrive at your location. This information will not be shared with any suppliers or providers.
Number of Dispensers

1 Dispenser 2 Dispensers (1 bar) 2 Dispensers (2 bars) 3 or more Dispensers
Size of Dispenser

8 Flavours 10 Flavours 12 Flavours Other
Approx distance from product to dispenser
Current provider (for configuration and equipment information only)
Not required
Special Instructions (prefered days/times)
Should be Empty:

Pop/Juice line cleaning