Title Page

  • Site conducted

  • Conducted on

  • Prepared by

Outside

  • Gas & diesel pumps and area incl. screens, cradles, nozzles and hoses free from dust, dirt and grease, pad, pavement around pumps clean (no puddles/potholes/not sticky/etc), valances clean.

  • Are all pumps in working order/out of order bags used/No handwritten signs (N/A with work order number).

  • Landscape minimal litter and/or weeds, grass is mowed. Outdoor vegetation in healthy shape.

  • Fuel price sign (MID) visible and functional - Prices on pumps match MID. All LED's lit/Brand panel and Circle K panels in place, lit and in good condition.

  • Doors and windows cleaned inside and out, including window ledges.

  • Wash buckets are at least 50% full, not frozen, clean, no odor, and squeegees are available in every bucket and in good condition.

  • Garbage cans near pumps, by front entrance and in containment areas are clean inside and out, no bad odors, not more than 60% filled.

  • Outdoor signage is correct and in good condition.

  • Parking lot stripes are visible and in good condition.

  • Outside merchandise rack/product and surrounding area is clean, ice chests clean.

  • Lot and area around pumps snow removal up to standard. Snow cleared around pumps, area salted and lot is plowed if more than half an inch of snow on the ground.

  • Sidewalks cleared of snow up to standard. Snow is cleared from sidewalk and a wide shovels length from the curb.

  • Parking lot free of slip/trip/fall hazards (maintenance tickets for pot holes, cracked curbs, etc).

Car Wash

  • Car Wash windmaster and menus signs posted, current and clean on each pump and windmaster is in place with correct signage.

  • Car Wash functional, interface box operational and not damaged, Doors open (open when warm/above 45, closed when it's cold/below 45).

  • Entry area is clean with a garbage can less than 75% filled.

  • Car Wash Bay and windows clean with minimal litter/mud/debris, leaves, garbage, algae, residue, moss/mold and brushes clean.

Staff

  • Proper uniforms are clean and nametags are worn (S&D Quisberg uniform policy being followed).

  • Greeting, eye-contact and closing or parting remark. Employees connecting with customer, creating a friendly atmosphere.

  • Employees are at least 75% trained

  • 95% or more of employees are Vape Trained

  • Day/Night/General checklists are current and being utilized.

  • Were all customers who appeared to be under 40 asked for ID prior to sale.

Check-out

  • Front counter is well merchandised (clean, organized and face fronted).

  • Bonus Baskets and racks are well stocked, has current signage and product.

  • Cell phone policy is being utilized and no cell phones are visible.

  • Employee food and/or beverages are not visible from customer viewpoint.

  • Floor clean of clutter

  • Drop boxes being utilized properly ( locked, less than $400, etc)

  • Ovens/cooler/freezer clean and working

  • Lift screens are active and fully functional.

Food Area

  • Counters and cabinets are clean. No spills, debris, stains, etc

  • Coffee Brewers, Urns, Cappuccino, Bulk Creamer, Ice Coffee machines and warming plates are clean and stocked no old grounds or blinking lights.

  • Coffee, Cappuccino and iced coffee machines are in working order

  • Coffee Condiments, Cups are clean and stocked and organized.

  • Food Condiments are stocked and available, and are correctly dated.

  • Hatcos and roller grill stocked appropriately for time of day.

  • Wash bucket available and at correct pH level.

  • Bakery case clean (shelves and windows, lights working).

  • Hatch/Roller Grill/Bakery signage good condition and current.

  • Sandwich case in stock, clean, free of dirt and bugs, vents dust free.

Cooler

  • Cooler is well stocked (no more than one hole per door average).

  • Cooler is well merchandised (according to planogram, face fronted, shelf tags aligned, promotional signage in place).

  • Cooler doors are clean and door lights working properly.

  • Dairy and other like items stocked, rotated, and not expired.

Center Store

  • Ceilings are clean, no water spots, minimal dust on vents. And all lights working properly.

  • Floors are clean, free of dust/debris/stains/spills and are not sticky. Rug in good condition/lying flat on floor, no large gaps between rug and front doors/counters.

  • Seating area - counters, chairs, floors clean with no trash laying, not used for storage.

  • Promotional cooler stocked and faced.

  • Store passed date check of minimum of 8 random items.

  • Store passed rotation check of minimum of 8 random items.

  • No, or limited, dust on shelves.

  • Able to walk around store and access shelves (nothing blocking product).

  • Music at appropriate volume, playing appropriate music.

  • Bait tanks clean of mildew, scum, etc.

  • Reasonable amount of dead bait.

  • Bait cooler clean (inside and out).

  • Tackle area clean and organized.

  • Interior of store free of slip/trip/fall hazards.

  • Wet Floor signs and Mop Buckets are used as needed, sign in good condition, not dirty.

Restrooms

  • Toilet bowl/Urinals clean inside/outside and base.

  • Garbage cans clean/with lids, no more than 75% full.

  • Floors clean, changing tables, walls, baseboards and doors clean with no stains, no excessive dust on ceiling vent and no graffiti.

  • All restroom doors/stalls lock properly and easily.

  • Sink is clean, mirror is clean with minimal soap/water marks.

  • Restrooms are stocked with toilet paper in dispenser, functioning dryer / paper towels, and hand soap.

  • Restrooms smell fresh and are free of unpleasant odor (chronic not situational).

Backroom/Hallways

  • Clear and free of clutter

  • Storage - heavy items stored on bottom shelves and lighter items stores on top shelves, no fire exits or electrical panels are blocked.

  • Wash sinks being utilized properly.

  • Camera system verify all cameras are functional.

  • Reasonable back stock and organized.

  • Water filters in good shape.

Additional information

  • Any site notes or tasks to be followed up on?

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.