Title Page

  • Conducted on

  • Prepared by

  • Site Name

  • Site Manager Name

  • Site Manager Contact Number

  • Site Manager Signature

  • Location

Service Standards

Entrance & Exit

  • Entrance & Exit Area is clean - free of litter & spills?

  • Picture of Entrance & Exit

  • Landscaping area/green belt is clean, green and well maintained?

  • Picture of Landscape area

  • Monolith is clean and functional

  • Picture of Monolith

  • Site is looking clean and bright?

  • All canopy branding is working & functional (Fascia, red bar)?

  • Picture of canopy branding

Forecourt

  • Forecourt Area is generally clean & free of litter, spills or water collection?

  • Forecourt Picture

  • All lights work & are switched on when dark? (ask staff or check CCTV footage of night)

  • Under Canopy Area is Clean and undamaged?

  • Picture of under canopy area

  • All Signage on Site is Clean and undamaged?

  • Picture of singages

  • All Fuel Dispensers are clean and functional?

  • Pictures of all dispensers

  • Nozzle jackets are in good condition & clean?

  • Pictures of Nozzle jackets

  • All forecourt staff are wearing complete uniforms?

  • All forecourt staff are wearing name badges?

  • All forecourt staff are wearing shoes?

  • Picture of staff

  • Staff greet the customer? Show zero and final meter?

  • Wiper bucket & Wiper is available on site?

  • Picture of Wiper bucket

  • Is there enough staff working on the site?

  • Total staff working at site (Including NFR)

  • Number of staff available during this shift

NFR

  • NFR Available at stie?

  • Name of the available NFRs

  • Pictures of the NFR

  • NFR area is clean

  • NFR Staff are wearing the complete uniform?

  • NFR Staff are wearing the name badges?

  • NFR staff are wearing shoes?

  • NFR Staff Picture

  • Price lists are displayed for the customers

Toilets

  • Customer Toilets present on site?

  • Toilet area/Forecourt is labelled to direct customers to toilets?

  • Toilets Area is clean & tidy?

  • Toilets are clean from the inside?

  • Toilets are stocked with soap & tissues/towel.

  • All equipment inside toilets are functional (no water leaking & toilet is usable)?

  • Toilet Pictures (inside and outside)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.