Title Page

  • Store #

  • Conducted on

  • Location
  • Manager

  • Personnel on duty

  • Prepared by

  • All promotional signage is up. 1 Missing OK, 2 Missing Fair, 3 or more Poor

  • All promotional signage from prior month is gone. 1 OK, 2 Fair, 3 or more Poor

  • Shippers are being worked

  • All shippers are more than half full.

  • All Tobacco signs match price sheet- Missing 1 Off Good, 2 Off Fair, 3 or more Poor

  • All items in open faced coolers are priced and dated. 1 missing Good, 2 Fair, 3 or more Poor

  • Open Face Cooler is stocked and full.

  • How many holes in the Non-Alcoholic Drink Section (less than 3 OOS)

  • All key cooler items (non carbonated/soda) are stocked.

  • How many holes in the Beer/Wine Section..less than 3?

  • All beer is priced.

  • Fountain area stocked, priced, clean, with No beverages Out of Stock

  • All Fountain, Frozen, Roller Grill & Hot Foods area Clean and working properly and stocked

  • Frozen, Roller Grill & Hot Foods have signage

  • Ice Merchandiser is over half full

  • Gondola Shelf tags are up and priced correctly

  • Gondola Shelving Out of stocks...less than 3?

Restrooms -

  • Walls/stall dividers - wiped down, clean, unsoiled?

  • Mirrors - wiped down, clean, unsoiled?

  • Sinks - wiped down, clean, unsoiled?

  • Toilet - clean tank, base, lid, bowl, behind, seat tight?

  • Urinal - flushes properly, floor clean?

  • Stocked - toilet paper, paper towels, soap, air freshener, diaper deck liners?

  • Operational - toilets flush, sink runs/no leaks, soap dispenses, and hand dryer in good repair?

  • Trash - emptied, clean?

  • Floor - clean, bug free, litter free?

  • Lighting - all bulbs burning, lenses clean, bug free?

  • Vents - clean, dust free?

  • Brill is on and working

  • Restroom Checklist is being used

Checklist

  • Check to see if store has proper stock on Star Saver items.

  • Discuss out of stocks with manager.

  • Talk with manager about any vendor issues.

  • Check on any OOD items that may be able to get credit

Signature

  • Attach prior month's promo sheet, current promo sheet, cigarette price sheet, OT price sheet, OT planogram, and soda/non-carb planogram.

  • I hereby certify that the above form is true and accurate to the best of my knowledge.

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