Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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P = Priority (-15%); PF = Priority Foundation (-5%); C - Core (-1.5%)
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Squeegees hanging near/at all pumps<br>
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Windshield washer fluid at least 1/2 full and clean<br>
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Entrance clean of cigarette butts and ashtray maintained<br>
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Outside of store appearance<br>
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Garbages maintained<br>
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Sidewalk area clean<br>
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Ceiling tiles and vents clean
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All lighting in working order
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Clean bathrooms
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No odor in bathrooms
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Bathroom supplies properly stocked
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Drinking fountain clean
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Signs on display items
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Open product labeled and dated/Out-dated product found on display (Non-Vendor items)
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Vendor Out-dates
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Sell-by-dates (Burritos, Hot pockets, sandwiches, Nemo cakes)
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Cross-contamination concern
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Condition of bakery case
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Bakery Case Food Allergen Sign
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All beverage dispensers have ingredient statements
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Flavored syrups (cleanliness of bottles)
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All beverage dispensers are clean
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Beverage area properly stocked
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Coffee filters
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Temperature Log
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Temperature of brats
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Condiment table/area clean
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Cooler temps (cheese, sandwich, etc)
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Milk temperature
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Chemical programs are followed/ MSDS sheets available
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Product 6" off the floor
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Sanitizer concentration
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Clutter by electrical boxes (not covering boxes)
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Backroom OR Equipment room (clutter?)
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Storage of personal belongings
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Name tags
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Dress code followed
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Sanitizer log
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Handsink properly stocked and clean
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Sanitizer log
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Calibration log
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Employee Illness Log
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Food equipment and utensils maintained clean and stored in a manner to prevent contamination
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Coolers maintained clean
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Customers receive a greeting
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Customers receive greeting at pump
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Did you have gas today?
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Would you like a car wash?
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Car Wash Instruction Sheet given with code
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Customers receive a thank-you and are offered a receipt
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Employees using 1-2 call for help
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Signature of Auditor
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Signature of PIC
