Title Page

  • Store Name

  • Store Number

  • Conducted on

  • Prepared by

Store Information

  • Store Address
  • Store Manager

  • Store Tel No.

  • Store Contact Name

  • Store Contact Position

Checkout Survey

  • Checkouts

  • Till
  • Handing

  • Single or Tandem

  • Controller Name

  • Number of Storage Boxes

  • Operator Door

  • Is an End Panel Installed

  • Tracking Type

  • Is the Checkout Operational

  • Detail Any Issues

  • Any Damage or Missing Equipment

  • Any Issues that Prevent Cladding

  • Take Photos from all 4 corners of checkout and 1 for each identified issue

Work Summary

  • Number of Checkouts to Clad (Tandems and Singles)

  • Number of Checkouts to Remove

  • Number of Checkouts to Relocate

  • Any Other Comments

General Information

  • Signing In Location

  • Delivery Restrictions

  • Noise Restrictions

  • Store Access for Works

  • Overall Photo

  • Any Other Comments

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.