Survey of Industrial Processes - Retail Gas Stations

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Information

If necessary, please make address label corrections in the boxes below.

  • 01: Legal name
  • 02: Business name
  • 03: Title of respondent
  • 04: First name of respondent
  • 05: Last name of respondent
  • 06: Address (number and street)
  • 07: City
  • 08: Province/territory
  • 09: Postal code
  • 10: Phone number

Purpose

The Survey of Industrial Processes (SIP) is an industry-specific business survey focusing on small- and medium-sized enterprises (SMEs). It is designed to link economic data with industrial processes and environmental outcomes. The SIP collects data on operational activities and engineering processes of industrial, manufacturing, and service oriented establishments.

Additional information

This survey collects information on the industrial processes and operational activities involved in Canadian retail gas stations. The information collected from this survey will help develop national estimates linking economic and environmental data. Participants have the option to receive customized results highlighting their own business processes and activities in comparison to a set of national average indicators representing all Canadian retail gas stations.

Authority

This survey is conducted under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19. Completion of this questionnaire is a legal requirement under the Statistics Act.

Confidentiality

Your answers are confidential.

Statistics Canada is prohibited by law from releasing any information from this survey which would identify a person, business, or organization, without their prior consent. The confidentiality provisions of the Statistics Act are not affected by either the Access to Information Act or any other legislation. Therefore, for example, the Canada Revenue Agency cannot access identifiable survey data from Statistics Canada.

These survey data will only be used for statistical purposes and will be published in an aggregate form only.

Data-sharing agreements

To reduce respondent burden, Statistics Canada has entered into data sharing agreements with provincial and territorial statistical agencies and other government organizations, which must keep the data confidential and use them only for statistical purposes. Statistics Canada will only share data with those organizations that have demonstrated a requirement to use the data.

Section 11 of the Statistics Act provides for the sharing of information with provincial and territorial statistical agencies that meet certain conditions. These agencies must have the legislative authority to collect the same information, on a mandatory basis, and the legislation must provide substantially the same provisions for confidentiality and penalties for disclosure of confidential information as the Statistics Act. Because these agencies have the legal authority to compel businesses to provide the same information, consent is not requested and businesses may not object to the sharing of the data.

For this survey, there are Section 11 agreements with the provincial and territorial statistical agencies of Newfoundland and Labrador, Nova Scotia, New
Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, and the Yukon.

Section 12 of the Statistics Act provides for the sharing of information with federal, provincial or territorial government organizations. Under Section 12, you may refuse to share your information with any of these organizations by writing a letter of objection to the Chief Statistician and returning it with the completed questionnaire. Please specify the organizations with which you do not want to share your data.

For this survey, there are Section 12 agreements with the statistical agencies of Prince Edward Island, the Northwest Territories and Nunavut.

For agreements with provincial and territorial government organizations, the shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.

Record linkage

To enhance the data of this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.

Security of emails and faxes

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the Statistics Act.

Return procedures

Please return questionnaire within 30 days.

Please mail the completed questionnaire in the enclosed envelope or fax it to Statistics Canada at 1-800-755-5514.

Lost the return envelope or need help? Call us at 1-877-858-3132, e-mail us at sip-rgs@statcan.gc.ca, or mail to:
Statistics Canada, Operations and Integration Division, 170 Tunney's Pasture Driveway, Ottawa, ON, K1A 0T6.

Assistance

Si vous préférez ce questionnaire en français, veuillez nous appeler au numéro
sans frais : 1-888-659-8157.

Thank you

Thank you for completing this questionnaire.
Please retain a copy for your records.

Visit our website at www.statcan.gc.ca.

Definitions

Section 2 - Fuel Types
- Ethanol blend gasoline: A petroleum substitute that is produced from agricultural feedstock. For example: E-10 gasoline is a mixture of 10% ethanol and 90% gasoline, while an E-85 gasoline is a mixture of 85% ethanol and 15%
gasoline.
- Ethanol-free gasoline: A gasoline that has no added agricultural-based products.
- Bio-diesel: A substitute for diesel fuel made of plant oils that can be used in a conventional diesel engine; for example a B-5 fuel is a mixture of 5% bio-diesel and 95% regular diesel while a B-20 fuel is a mixture of 20% bio-diesel and 80% regular diesel.

Section 3 - Gasoline and Diesel Transport
- Tanker truck: A large truck designed to carry liquid products such as gasoline, diesel, or other fuels.

Section 4 - Fuel Storage Tanks
- On-line gauge: An analogue or an electronic device that can be used to measure the level of fuel in a storage tank without the need to insert a dipstick.

Section 5 - Fuel Dispensers
- Dispenser: An apparatus to pump gasoline, diesel or other vehicle fuels. A dispenser may have more than one nozzle serving multiple clients. A dispenser may have several "pump numbers" to identify clients for payments.
- Hand-held automatic shut-off nozzle: A nozzle designed to help prevent spills during refuelling by customers. Such nozzles have a pressure sensitive mechanism that forces the release of the dispensing lever once the vehicle
tank is full.
- Hands-free nozzle with a locking lever: A nozzle that allows the attendant, mainly in a full-service gas station, to dispense fuel without holding the nozzle during vehicle refuelling. These nozzles are equipped with a manual mechanism that locks the dispensing lever in position once pulled during refuelling of vehicles. These nozzles keep hands free while fuel is being pumped into vehicles and shuts off the flow of fuel once the vehicle tank is full.
- Nozzle with a splash guard: A nozzle with a round rubber guard placed on it to guard against a back splash of fuel during a fill up.
- Nozzle with vapour recovery: A nozzle equipped with a vacuum system that sucks escaping fuel vapours during vehicle refuelling.

Section 6 - Maintenance and Operations
- Filter: A trapping device placed in dispensers to remove debris and to detect for the presence of water in fuel.
- Absorbent: A granular product placed over accidental spills in retail gas stations to contain and absorb the spilled fuel.
- Emergency shut-off: A valve that shuts off all pumps in a retail gas station during a major spill or leak.

Unit Conversion
- 1 US gallon = 0.833 UK (imperial) gallon = 3.785 litres
- 1 metre = 100 centimetres = 1000 millimetres

Instructions

Use a black or blue pen to:
Mark a circle OR Print in a box

Section 1 General Information

Please answer the following questions relating to this retail gas station.

Section 1 General Information - Question identifier:1.

How many years has this site been operating as a retail gas station under the current retailer?

Section 1 General Information - Question identifier:2.

How old is this retail gas station, including current and previous retailers?

  • 01: years
  • 02: Do not know

Please provide information to the following questions based on your most recently ended fiscal year.

Section 1 General Information - Question identifier:3.

The 12-month period you are reporting for is:

  • 01: From: (year/month/day)
  • 02: To: (year/month/day)

Section 1 General Information - Question identifier:4.

On average, how many hours per day did this retail gas station serve vehicle fuel? (Please round up to the nearest hour).

  • 01: hours per weekday
  • 02: hours per Saturday
  • 03: hours per Sunday

Section 1 General Information - Question identifier:5.

Indicate the busiest times of day for vehicle refuelling at this retail gas station.

  • 01: a.m.
  • 02: p.m.

Section 1 General Information - Question identifier:6.

Select all the services offered at this retail gas station. (Select more than one if applicable).

  • 01: Vehicle refuelling
  • 02: Car wash
  • 03: Convenience store/Restaurant/Fast food outlet
  • 04: Motel (accommodations)
  • 05: Automotive services/Mechanics/Body shop
  • 06: Vehicle sales
  • 07: Vehicle/Equipment rentals
  • 08: Other (please specify)

Section 1 General Information - Question identifier:7.

Select the fuel service type offered at this retail gas station.

  • 01: Only Self-service
  • 02: Only Full-service
  • 03: Self and Full-service (Split-serve)

Section 1 General Information - Question identifier:8.

Select the option that best describes the "brand" of this retail gas station.

  • 01: A retail gas station under a brand name banner (please specify the name of the brand):
  • 02: A retail gas station under own particular banner but
    serves a brand name fuel (please specify the name of the brand of fuel served):
  • 03: A retail gas station under own particular banner and
    serves fuel regardless of any brand (if known, please specify the name of the brand usually purchased):
  • 04: Other (please specify):

Section 1 General Information - Question identifier:9.

Does the current retailer have control over setting the price at the pump? (Please select only one response).

  • 01: No control, the price is set by the marketer
  • 02: Partial control, requiring approval from the marketer
  • 03: Full control, sets own price without approval from the marketer
  • 04: Other (please specify)

Section 1 General Information - Question identifier:10.

Does the current retailer have an ownership title to the land where this retail gas station is located?

  • 01: Yes
  • 02: No

Section 1 General Information - Question identifier:11.

Does the current retailer own the fuel inventory at this retail gas station?

  • 01: Yes
  • 02: No

Section 1 General Information - Question identifier:12.

How many vehicle fuel dispensers are present at this retail gas station, including both gasoline and diesel?

Section 1 General Information - Question identifier:13.

How many of the fuel dispensers at this retail gas station are equipped with high flow rate pumps for larger trucks?

Section 1 General Information - Question identifier:14.

How many of the fuel dispensers at this retail gas station are equipped with credit card/debit card, or a pay-and-go system?

Section 1 General Information - Question identifier:15.

How many fuel storage tanks are present at this retail gas station?

Section 1 General Information - Question identifier:16.

What is the name of the tanker truck company that delivers gasoline to your retail gas station?
(If more than one company, please specify all of the names).

Section 1 General Information - Question identifier:17.

What is the name of the tanker truck company that delivers diesel to your retail gas station?
(If more than one company, please specify all of the names).

Section 2 Fuel Types

Please provide information to the following questions based on the same 12-month reporting period provided in question 3.

Section 2 Fuel Types - Question identifier:18.

Indicate the approximate volume of each type of fuel sold at this retail gas station (litres per year).

  • 01: Regular Gasoline (ethanol-free and/or ethanol-blend)
  • 02: Mid-grade Gasoline (ethanol-free and/or ethanol-blend)
  • 03: High-grade Gasoline (ethanol-free and/or ethanol-blend) (premium and/or supreme)
  • 04: Diesel
  • 05: Bio-diesel
  • 06: Red dye diesel

Section 2 Fuel Types - Question identifier:19.

Please indicate the % ethanol in your ethanol-blended gasoline, if sold at this retail gas station.

  • 01: %
  • 02: Do not sell ethanol-blended gasoline
  • 03: Do not know

Section 2 Fuel Types - Question identifier:20.

Please indicate the type of bio-diesel blend, if sold at this retail gas station. (Select more than one if applicable).

  • 01: B-5
  • 02: B-15
  • 03: B-20
  • 04: B-other (please specify)
  • 05: Do not sell bio-diesel
  • 06: Do not know

Section 2 Fuel Types - Question identifier:21.

Indicate any other type of fuel sold at this retail gas station, and the approximate amount of each type sold per year.

  • 01: Litres
  • 02: Gallons
  • 03: Pounds
  • 04: Kilograms
  • 05: Canisters

Section 3 Gasoline and Diesel Transport

Please provide information to the following questions based on the same 12-month reporting period provided in question 3.

Section 3 Gasoline and Diesel Transport - Question identifier:22.

Please select the month during which you sold the greatest amount of fuel.

  • 01: Jan.
  • 02: Feb.
  • 03: Mar.
  • 04: Apr.
  • 05: May
  • 06: June
  • 07: July
  • 08: Aug.
  • 09: Sep.
  • 10: Oct.
  • 11: Nov.
  • 12: Dec.

Section 3 Gasoline and Diesel Transport - Question identifier:23.

During this busy month, how often was fuel delivered to this retail gas station?

  • 01: truck deliveries in this busy month for gasoline (all types)
  • 02: truck deliveries in this busy month for diesel (all types)

Section 3 Gasoline and Diesel Transport - Question identifier:24.

During this same busy month, what was the average volume of fuel delivered per truck delivery? (litres per delivery)

  • 01: Regular Gasoline
  • 02: Mid-grade Gasoline
  • 03: High-grade Gasoline
  • 04: Diesel (all types)

Section 3 Gasoline and Diesel Transport - Question identifier:25.

Please select the month during which you sold the least amount of fuel.

  • 01: Jan.
  • 02: Feb.
  • 03: Mar.
  • 04: Apr.
  • 05: May
  • 06: June
  • 07: July
  • 08: Aug.
  • 09: Sep.
  • 10: Oct.
  • 11: Nov.
  • 12: Dec.

Section 3 Gasoline and Diesel Transport - Question identifier:26.

During this slow month, how often was fuel delivered to this retail gas station?

  • 01: truck deliveries in this slow month for gasoline (all types)
  • 02: truck deliveries in this slow month for diesel (all types)

Section 3 Gasoline and Diesel Transport - Question identifier:27.

During this same slow month, what was the average volume of fuel delivered per truck delivery? (litres per delivery)

  • 01: Regular Gasoline
  • 02: Mid-grade Gasoline
  • 03: High-grade Gasoline
  • 04: Diesel (all types)

Section 3 Gasoline and Diesel Transport - Question identifier:28.

Select the time of day that fuel is usually delivered to this retail gas station.

  • 01: mostly during mornings
  • 02: mostly during afternoons
  • 03: mostly during evenings or nights

Section 4 Storage Tanks (Fuels)

Section 4 Storage Tanks (Fuels) - Question identifier:29 a.

Select the fuel type in this tank, one fuel type per tank.

  • 01: Regular Gasoline
  • 02: Mid-grade Gasoline
  • 03: High-grade Gasoline
  • 04: Diesel
  • 05: Other (please specify)

Section 4 Storage Tanks (Fuels) - Question identifier:29 b.

Select the blend type of the fuel in this tank.

  • 01: Ethanol-free
  • 02: Ethanol-blend
  • 03: Diesel
  • 04: Bio-diesel
  • 05: Do not know

Section 4 Storage Tanks (Fuels) - Question identifier:29 c.

Select the location of this tank.

  • 01: Above ground
  • 02: Underground

Section 4 Storage Tanks (Fuels) - Question identifier:29 d.

What is the age of this tank?

  • 01: years
  • 02: Do not know

Section 4 Storage Tanks (Fuels) - Question identifier:29 e.

What is the storage capacity of this tank? (Litres)

Section 4 Storage Tanks (Fuels) - Question identifier:29 f.

Select the tank material.

  • 01: Steel
  • 02: Concrete
  • 03: Fibreglass
  • 04: Other (please specify)

Section 4 Storage Tanks (Fuels) - Question identifier:29 g.

Select the type of tank wall.

  • 01: Single wall
  • 02: Double wall
  • 03: Tank contains a membrane liner

Section 4 Storage Tanks (Fuels) - Question identifier:29 h.

Select the method used to check for water in this tank.

  • 01: Wooden dipstick
  • 02: Other method (please specify)
  • 03: Do not know

Section 4 Storage Tanks (Fuels) - Question identifier:29 i.

Select the method used when measuring the level of fuel in this tank.

  • 01: Wooden dipstick
  • 02: Other method (please specify)
  • 03: Do not know

Section 4 Storage Tanks (Fuels) - Question identifier:29 j.

If using a dipstick to record the level of fuel in this tank, please provide the most common level that you record. (centimetres OR inches)

Section 4 Storage Tanks (Fuels) - Question identifier:29 k.

How many times per day is a lid on this tank opened for water check or level reading?

Section 5 Fuel Dispensers

Section 5 Fuel Dispensers - Question identifier:30 a.

What is the name of the manufacturer of this dispenser?

Section 5 Fuel Dispensers - Question identifier:30 b.

How many nozzles are attached to this dispenser?

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6

Section 5 Fuel Dispensers - Question identifier:30 c.

How many products are served by this dispenser?

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6

Section 5 Fuel Dispensers - Question identifier:30 d.

Select all gasoline products served by this dispenser (select more than one if applicable).

  • 01: Regular
  • 02: Mid-grade
  • 03: Premium
  • 04: Supreme (greater than 91 octane)

Section 5 Fuel Dispensers - Question identifier:30 e.

Select all diesel products served by this dispenser
(select more than one if applicable).

  • 01: Diesel
  • 02: Bio-diesel

Section 5 Fuel Dispensers - Question identifier:30 f.

Specify if other products are served by this dispenser.

Section 5 Fuel Dispensers - Question identifier:30 g.

Indicate the age of this dispenser. (If less than 1 year old, write '1'). (years)

Section 5 Fuel Dispensers - Question identifier:30 h.

Is the fuel pump serving this dispenser located inside or outside of the dispenser?

  • 01: Inside
  • 02: Outside

Section 5 Fuel Dispensers - Question identifier:30 i.

Select the type of meter display on this dispenser.

  • 01: Mechanical
  • 02: Digital

Section 5 Fuel Dispensers - Question identifier:30 j.

The pump for this dispenser starts with:

  • 01: a manual lever
  • 02: a push button

Section 5 Fuel Dispensers - Question identifier:30 k.

Are the hoses suspended from the top or the side of this dispenser?

  • 01: Top
  • 02: Side

Section 5 Fuel Dispensers - Question identifier:30 l.

The shut-off mechanism on the nozzles of this dispenser has:

  • 01: Automatic shut-off
  • 02: A locking lever
  • 03: No shut-off

Section 5 Fuel Dispensers - Question identifier:30 m.

Nozzles on this dispenser have splash guards:

  • 01: Yes
  • 02: No

Section 5 Fuel Dispensers - Question identifier:30 n.

Nozzles on this dispenser have vapour recovery systems:

  • 01: Yes
  • 02: No

Section 6 Maintenance and Operations

Please provide information to the following questions based on the same 12-month reporting period provided in question 3.

Section 6 Maintenance and Operations - Question identifier:31.

The number of hoses you replaced on your dispensers. (hoses per year)

Section 6 Maintenance and Operations - Question identifier:32.

The number of nozzles you replaced on your dispensers. (nozzles per year)

Section 6 Maintenance and Operations - Question identifier:33.

The number of filters you replaced in your dispensers. (filters per year)

Section 6 Maintenance and Operations - Question identifier:34.

The number of times absorbent was used to cover spills or leaks:

  • 01: times per day
  • 02: times per week
  • 03: times per month

Section 6 Maintenance and Operations - Question identifier:35.

Total amount of absorbent used:

  • 01: kilograms per year
  • 02: pounds per year

Section 6 Maintenance and Operations - Question identifier:36.

The number of times the emergency fuel shut-off was engaged. (times per year)

Section 6 Maintenance and Operations - Question identifier:37.

How many days was this retail gas station open for operation? (days open per year)

Section 6 Maintenance and Operations - Question identifier:38.

Indicate the dollar amount of all fuels sold at this retail gas station. ($ per year)

Section 6 Maintenance and Operations - Question identifier:39.

What was the total cost of energy bills (heat and electricity) paid for the operation of this retail gas station? ($ per year)

Section 6 Maintenance and Operations - Question identifier:40.

Please indicate the total number of hours worked per week by all people (employees and operator/owner) at this retail gas station. (hours per week)

Section 6 Maintenance and Operations - Question identifier:41.

Please indicate the total number of people (employees and operator/owner) who worked at this retail gas station.

  • 01: part-time employees
  • 02: full-time employees

Section 7 Option to Receive Customized Survey Results

In gratitude for the time spent completing this questionnaire, your retail gas station has the option to receive customized results of this survey. These results will highlight your business and operational activity in comparison with total average estimates of all Canadian retail gas stations in terms of economic and environmental variables.

Please select one of the following options:

1. I do not wish to receive the survey results.

2. I would like to receive the survey results and please mail them to:

- the same address and person as on the cover page.

- the following address:

  • 01: Name
  • 02: Business name
  • 03: Address Line 1
  • 04: Address Line 2
  • 05: City/Town
  • 06: Province/Territory
  • 07: Postal code
  • 08: Signature
  • 09: Date (yyyy-mm-dd)

Section 8 Option to Participate in the On-Site Fuel Evaporative Loss Exercise

Dear respondent,

To further enhance the outcome of this national survey, on-site measurements are needed. Measurements could be taken by a hand-held device that estimates the amount of fuels evaporated from the day-to-day activities of a retail gas station. Measuring the amount of fuels evaporated is costly and beyond the capacity of many respondents.

To that end, Statistics Canada under the confidentiality provisions of the Statistics Act is offering to conduct on-site measurements on a sample of retail gas stations, for those who agree to participate. Due to the costs involved, only a small sample of retail gas stations will be selected. Statistics Canada is prohibited by law from releasing any information from this survey and this measurement exercise which would identify a person, business, or organization. The confidentiality provisions of the Statistics Act are not affected by either the Access to Information Act or any other legislation.

Results from this on-site fuel evaporative loss exercise will only be used to validate estimates published by industry sources and to compare survey-based estimates with actual measurement data. These on-site measurements are NOT designed or intended for occupational health and safety measures or for exposure and threshold limit assessments.

This on-site measurement exercise is on a volunteer basis and will take place only if you indicate your willingness to participate. The owner/operator of a retail gas station who agrees to participate in this exercise will, along with an employee/engineer of Statistics Canada, conduct on-site emission measurements at their gas station. These are performed using a direct reading instrument to estimate the amount of fuels evaporated from the daily activities such as vehicle refuelling, tanker truck fuel delivery operations, and dipstick level measurements. All sampling and measurements will be supported, guided, and paid by Statistics Canada. Measurement results from your own site will be provided to you. All measurements and results will be confidential and protected under the Statistics Act.

Gas stations who participate in the exercise will be able to identify the main sources of fuel evaporation and losses, providing an opportunity to further improve their day-to-day operations.

The time needed to conduct these measurements is approximately 30 minutes.

If you agree to participate in this no-cost on-site measurement exercise please check the box below, fill out the required information, sign, and date. Otherwise please skip to the next page. Once agreed, and if selected, you will receive a call from Statistics Canada to set up a date and time that is convenient for you.

Section 8 Option to Participate in the On-Site Fuel Evaporative Loss Exercise - Question identifier:1.

I agree to participate in this on-site measurement exercise.

- Name of Respondent
--Telephone number to be contacted at, if selected
- Signature
- Date (yyyy-mm-dd)

Comments

Approximately how long did it take to collect the data and complete this survey?

  • 01: Hour(s)
  • 02: Minute(s)

We invite your comments or suggestions on the following or any other topic related to the Survey of Industrial Processes - Retail Gas Stations. We appreciate your assistance.

Questionnaire content
New questions of interest to your industry
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