Total master

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 Shop

• 1.1 Are the walls clean & free from defects

  Yes

  No

  N/A

• 1.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 1.3 Are the shelves, counters & display units clean & free from defects

  Yes

  No

  N/A

• 1.4 Are all the products packed safely

  Yes

  No

  N/A

• 1.5 Are all the lights in the shop working & free from defects

  Yes

  No

  N/A

• 1.6 Are there any electrical & health hazards

  Safe

  At Risk

  N/A

• 1.7 Are all the windows clean & free from defects

  Yes

  No

  N/A

• 1.8 Is the ATM clean & free from defects

  Yes

  No

  N/A

• 1.9 Are all the fire fighting equipment serviced

  Yes

  No

  N/A

• 1.10 Do all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 1.11 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

• 1.12 Are there fire fighting equipment location signs visible & are they free from defects

  Yes

  No

  N/A

• 1.13 Are there Emergency Evacuation signs visible & are they free from defects

  Yes

  No

  N/A

• 1.14 Is the emergency evacuation route & door unobstructed

  Yes

  No

  N/A

• 1.15 Are the staff wearing the correct uniform

  Yes

  No

  N/A

• 1.16 Are the staff Uniforms clean

  Yes

  No

  N/A

• 1.17 Is personal hygiene being practiced by the staff

  Yes

  No

  N/A

2.0 Bakery & Grilling kitchen

• 2.1 Are the floors & walls clean & free from defects

  Yes

  No

  N/A

• 2.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 2.3 Are all the lights free from defects

  Yes

  No

  N/A

• 2.4 Are all the preparation tables & counters clean & free from defects

  Yes

  No

  N/A

• 2.5 Are the ovens & griller's clean & free from defects

  Yes

  No

  N/A

• 2.6 Are all the coffee machines clean & free from defects

  Yes

  No

  N/A

• 2.7 Are all the basins clean & free from defects

  Yes

  No

  N/A

• 2.8 Are all the shelves clean & free from defects

  Yes

  No

  N/A

• 2.9 Are all the windows clean & free from defects

  Yes

  No

  N/A

• 2.10 Are all the fire fighting equipment serviced

  Yes

  No

  N/A

• 2.11 Do All the fire fighting equipment have their seals

  Yes

  No

  N/A

• 2.12 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

• 2.13 Are all the fire fighting equipment location signs visible & are they free from defects

  Yes

  No

  N/A

• 2.14 Is there a emergency gas shut off valve & is it free from defects

  Yes

  No

  N/A

• 2.15 Are all the emergency Evacuation signs visible & free from defects

  Yes

  No

  N/A

• 2.16 Is the emergency evacuation route & door unobstructed

  Yes

  No

  N/A

• 2.17 Are there any electrical & health hazards

  Safe

  At Risk

  N/A

• 2.18 Are the staff wearing the correct uniform

  Yes

  No

  N/A

• 2.19 Are the staff Uniforms clean

  Yes

  No

  N/A

• 2.20 Is personal hygiene being practiced by the staff

  Yes

  No

  N/A

3.0 Store room & walk in fridges

Store room

• 3.1 Are the walls & floors clean & free from defects

  Yes

  No

  N/A

• 3.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 3.3 Are the shelves clean & free from defects

  Yes

  No

  N/A

• 3.4 Are products packed safely

  Yes

  No

  N/A

• 3.5 Are all the lights free from defects

  Yes

  No

  N/A

• 3.6 Is the store room free from electrical defects

  Yes

  No

  N/A

• 3.7 Are all the windows clean & free from defects

  Yes

  No

  N/A

• 3.8 Are all the fire fighting equipment serviced

  Yes

  No

  N/A

• 3.9 Do all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 3.10 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

• 3.11 Are all the fire fighting equipment location signs visible & free from defects

  Yes

  No

  N/A

• 3.12 Are all the emergency Evacuation signs visible & free from defects

  Yes

  No

  N/A

• 3.13 Is the emergency evacuation route & door unobstructed

  Yes

  No

  N/A

• 3.14 Are there any electrical & health hazards

  Safe

  At Risk

  N/A

Walk-in fridges

• 3.15 Are all the walk-in fridges walls & floors clean & free from defects

  Yes

  No

  N/A

• 3.16 Is the walk-in fridges ceiling clean & free from defects

  Yes

  No

  N/A

• 3.17 Are all the shelves in the walk-in fridges clean & free from defects

  Yes

  No

  N/A

• 3.18 Are the staff wearing the correct uniform

  Yes

  No

  N/A

• 3.19 Are the staff Uniforms clean

  Yes

  No

  N/A

• 3.20 Is personal hygiene being practiced by the staff

  Yes

  No

  N/A

• 3.21 Are there any electrical defects in the walk-in fridges

  Yes

  No

  N/A

4.0 Generator & air compressor

Air compressor

• 4.1 Are all guards around moving parts in place at the compressor

  Yes

  No

  N/A

• 4.2 Is the compressor operating within the safe working pressure as indicated on the gauge

  Yes

  No

  N/A

• 4.3 Are the receiver line's drained daily

  Yes

  No

  N/A

• 4.4 Is the compressor within a secure area to prevent unauthorized access

  Yes

  No

  N/A

• 4.5 Are all combustible materials located outside the secure area

  Yes

  No

  N/A

• 4.6 Are the compressor, pipework & fittings free from defects

  Yes

  No

  N/A

• 4.7 Is the compressor free from electrical defects

  Safe

  At Risk

  N/A

• 4.8 Is a log book available & is it in use

  Yes

  No

  N/A

• 4.9 Are there any electrical defects

  Yes

  No

  N/A

• 4.10 Have the fire fighting equipment been serviced

  Yes

  No

  N/A

• 4.11 Are the fire fighting equipment sign posted & free from defects

  Yes

  No

  N/A

• 4.12 Does all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 4.13 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

Generator

• 4.14 Are all guards around moving parts at the generator

  Yes

  No

  N/A

• 4.15 Is the generator within a secure area to prevent unauthorized access

  Yes

  No

  N/A

• 4.16 Are all combustible materials located outside the secure area

  Yes

  No

  N/A

• 4.17 Is the generator free from defects

  Yes

  No

  N/A

• 4.18 Are there any electrical & health hazards

  Safe

  At Risk

  N/A

• 4.19 Are all the fire fighting equipment serviced

  Yes

  No

  N/A

• 4.20 Do all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 4.21 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

• 4.22 Are all the fire fighting equipment location signs visible & free from defects

  Yes

  No

  N/A

5.0 LPG storage & usage

Are the following permanent stamp markings visible & legible

• 5.1 The letters LPG/VPG

  Yes

  No

  N/A

• 5.2 The tare mass TM in kg

  Yes

  No

  N/A

• 5.3 The applicable standard (e.g. SABS 1792-2)

  Yes

  No

  N/A

• 5.4 The year of manufacture

  Yes

  No

  N/A

• 5.5 The test pressure in kPa

  Yes

  No

  N/A

• 5.6 The manufacturer's name or trademark

  Yes

  No

  N/A

• 5.7 The water capacity in liters

  Yes

  No

  N/A

Are the following permanent stamp markings visible & legible on cylinders of 9kg & less

• 5.8 A warning that the container must not be placed on stoves or hot plates & must be used in the upright position

  Yes

  No

  N/A

• 5.9 The maximum mass of gas in k's the container may contain

  Yes

  No

  N/A

• Are cylinders free of the following defects

  Yes

  No

  N/A

• 5.10 Excessive corrosion or pitting

  Yes

  No

  N/A

• 5.11 illegible stamping

  Yes

  No

  N/A

• 5.12 Any container manufactured before 1969 (containers of this age must be heat treated & have the heat treated symbol (N)

  Yes

  No

  N/A

• 5.13 Excessive fire damage

  Safe

  At Risk

  N/A

• 5.14 Excessive cutting or gouging

  Safe

  At Risk

  N/A

• 5.15 Defective fittings

  Safe

  At Risk

  N/A

• 5.16 Unacceptable modifications

  Safe

  At Risk

  N/A

• 5.17 Excessive bulging & denting

  Safe

  At Risk

  N/A

• 5.18 Defective delaminating

  Safe

  At Risk

  N/A

• 5.19 Welding Arc or torch burns

  Safe

  At Risk

  N/A

Are valves

• 5.20 Protected with permanent, fixed collars or screw

  Yes

  No

  N/A

• 5.21 Type protective caps, valve guards or shrouds

  Yes

  No

  N/A

• 5.22 Hand wheels not too tight, undamaged & operable

  Yes

  No

  N/A

• 5.23 Outlet threads clean & undamaged

  Yes

  No

  N/A

• 5.24 Valve boss is not tilted

  Yes

  No

  N/A

• 5.25 Without cracks or flaws on the container neck

  Yes

  No

  N/A

• 5.26 (Safety relief valve) without damage or corrosion

  Yes

  No

  N/A

• 5.27 Plugging or anything preventing it's operation

  Yes

  No

  N/A

• 5.28 Are foot rings in a serviceable condition

  Yes

  No

  N/A

• 5.29 Are faulty components replaced or the cylinder returned to the owner

  Yes

  No

  N/A

• 5.30 Are the LPG bottles in a safe & lockable area to prevent unauthorized access & away from all ignition materials

  Yes

  No

  N/A

6.0 Staff & Customer ablutions

Staff ablutions

• 6.1 Are all the floors & walls clean & free from defects

  Yes

  No

  N/A

• 6.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 6.3 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 6.4 Are all the toilets clean & free from defects

  Yes

  No

  N/A

• 6.5 Are all the toilet doors clean & free from defects

  Yes

  No

  N/A

• 6.6 Are all the counters & basins clean & free from defects

  Yes

  No

  N/A

• 6.7 Are the hand dryers clean & free from defects

  Yes

  No

  N/A

• 6.8 Is the soap dispenser full, clean & free from defects

  Yes

  No

  N/A

• 6.9 Are the showers clean & free from defects

  Yes

  No

  N/A

• 6.10 Are all the mirrors clean & free from defects

  Yes

  No

  N/A

• 6.11 Are all the lockers clean & free from defects

  Yes

  No

  N/A

• 6.12 Are there no electrical defects

  Safe

  At Risk

  N/A

• 6.13 Are all the windows clean & free from defects

  Yes

  No

  N/A

Customer ablutions

• 6.14 Are all the floors & walls clean & free from defects

  Yes

  No

  N/A

• 6.15 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 6.16 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 6.17 Are all the toilets clean & free from defects

  Yes

  No

  N/A

• 6.18 Are all the toilet doors clean & free from defects

  Yes

  No

  N/A

• 6.19 Are all the counters & basins clean & free from defects

  Yes

  No

  N/A

• 6.20 Are the hand dryers clean & free from defects

  Yes

  No

  N/A

• 6.21 Is the soap dispenser full, clean & free from defects

  Yes

  No

  N/A

• 6.22 Are all the mirrors clean & free from defects

  Yes

  No

  N/A

• 6.23 Are there no electrical defects

  Safe

  At Risk

  N/A

• 6.24 Are all the windows clean & free from defects

  Yes

  No

  N/A

7.0 Attendant kiosk

• 7.1 Are all the walls & floors clean & free from defects

  Yes

  No

  N/A

• 7.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 7.3 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 7.4 Are all the tables & chairs clean & free from defects

  Yes

  No

  N/A

• 7.5 Are there any electrical & health hazards

  Safe

  At Risk

  N/A

• 7.6 Is there a housekeeping schedule & is it in use

  Yes

  No

  N/A

• 7.7 Is there a service station rules & regulations on display on the business letterhead

  Yes

  No

  N/A

• 7.8 Is there a Drug & alcohol abuse policy displayed on business letterhead

  Yes

  No

  N/A

• 7.9 Is there a emergency & hazardous plan on display

  Yes

  No

  N/A

• 7.10 Emergency telephone #'s on display

  Yes

  No

  N/A

• 7.11 Is the DB board labeled & lockable for safe isolation

  Yes

  No

  N/A

• 7.12 Is the DB board unobstructed

  Yes

  No

  N/A

• 7.13 Is there a fire equipment available & is it sign posted

  Yes

  No

  N/A

• 7.14 Has the fire equipment been serviced

  Yes

  No

  N/A

• 7.15 Does the fire equipment have seal

  Yes

  No

  N/A

• 7.16 Are the fire fighting equipment free from defects

  Yes

  No

  N/A

• 7.17 Is the a unobstructed view of the Forecourt

  Yes

  No

  N/A

8.0 Forecourt

• 8.1 Is the Forecourt clean from any spills

  Yes

  No

  N/A

• 8.2 Is the Forecourt demarcation visible & legible

  Yes

  No

  N/A

• 8.3 Are all the pump Island, rhino lining clean & free from defects

  Yes

  No

  N/A

• 8.4 Are all the pumps clean & free from defects

  Yes

  No

  N/A

• 8.5 Are all the non smoking, cellphone, ignition & to turn engine off signs visible & legible

  Yes

  No

  N/A

• 8.6 Are all the product signs visible & legible

  Yes

  No

  N/A

• 8.7 Are all pump pipes & nozzles clean & free from defects

  Yes

  No

  N/A

• 8.8 Are the pillars clean & free from defects

  Yes

  No

  N/A

• 8.9 Is the canopy clean & free from defects

  Yes

  No

  N/A

• 8.10 Is the canopy lights clean & free from defects

  Yes

  No

  N/A

• 8.11 Are all the man holes & earth points clean & free from defects

  Yes

  No

  N/A

• 8.12 Are all the man holes filler point cap seal free from defects

  Yes

  No

  N/A

• 8.13 Are all man holes filler point cap locked

  Yes

  No

  N/A

• 8.14 Are all the fire fighting equipment serviced

  Yes

  No

  N/A

• 8.15 Are all the fire fighting equipment free from defects

  Yes

  No

  N/A

• 8.16 Are all fire fighting equipment sign posted

  Yes

  No

  N/A

• 8.17 Do all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 8.18 Are the breather pipes clean & free from defects

  Yes

  No

  N/A

• 8.19 Are all the hazards signs in place & free from defects

  Yes

  No

  N/A

9.0 Garden

• 9.1 Have weeds been removed

  Yes

  No

  N/A

• 9.2 Has the lawn been closely mown

  Yes

  No

  N/A

• 9.3 Are shrubs & bushes trimmed

  Yes

  No

  N/A

10.0 Building

• 10.1 Are all the walls clean & free from defects

  Yes

  No

  N/A

• 10.2 Are all the windows clean & free from defects

  Yes

  No

  N/A

• 10.3 Are all the shop sign clean & free from defects

  Yes

  No

  N/A

• 10.4 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 10.5 Are the doors clean & free from defects

  Yes

  No

  N/A

• 10.6 Is the fuel attendant pay point clean & free from defects

  Yes

  No

  N/A

• 10.7 Are there any electrical defects

  Safe

  At Risk

  N/A

11.0 DB board

• 11.1 Is the DB board labeled & legible

  Yes

  No

  N/A

• 11.2 Are all the DB board switches labeled & legible

  Yes

  No

  N/A

• 11.3 Are all the DB board switches free from defects

  Yes

  No

  N/A

• 11.4 Are the DB board door clean & free from defects

  Yes

  No

  N/A

• 11.5 Is the DB board unobstructed

  Yes

  No

  N/A

• 11.6 Is there a lockout available & in use

  Yes

  No

  N/A

• 11.7 Is there fire fighting equipment & is it serviced

  Yes

  No

  N/A

• 11.8 Does the fire fighting equipment have their seals

  Yes

  No

  N/A

• 11.9 Is the fire fighting equipment free from defects

  Yes

  No

  N/A

• 11.10 Is the fire fighting equipment sign posted & are the signs clean & free from defects

  Yes

  No

  N/A

12.0 Waste area

• 12.1 Is the waste area sanitary

  Yes

  No

  N/A

• 12.2 Are the waste bins sanitary & free from defects

  Yes

  No

  N/A

13.0 Spill control equipment

• 13.1 Is there a Spill control equipment available

  Yes

  No

  N/A

• 13.2 Is the Spill control kit fully equipped

  Yes

  No

  N/A

14.0 Cleaning equipment

• 14.1 Is all the cleaning equipment sanitary & free from defects

  Yes

  No

  N/A

• 14.2 Is the cleaning equipment fully equipped

  Yes

  No

  N/A

• 14.3 Is the wet floor sign in use

  Yes

  No

  N/A

15.0 First Aid

• 15.1 Is the first Aid box fully equipped

  Yes

  No

  N/A

• 15.2 Is there a trained first aider on site

  Yes

  No

  N/A

• 15.3 Is the first aid box sign posted

  Yes

  No

  N/A

16.0 Wash Bay

• 16.1 Are all the floors & walls clean & free from defects

  Yes

  No

  N/A

• 16.2 Is the ceiling clean & free from defects

  Yes

  No

  N/A

• 16.3 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 16.4 Are all the windows clean & free from defects

  Yes

  No

  N/A

• 16.5 Are there any electrical defects

  Safe

  At Risk

  N/A

• 16.6 Are the piping free from defects

  Yes

  No

  N/A

17.0 Outside lights & signs

• 17.1 Are all the lights clean & free from defects

  Yes

  No

  N/A

• 17.2 Are all the signs clean & free from defects

  Yes

  No

  N/A

18.0 Drainage system

• 18.1 Are all the drain system clean & free from defects

  Yes

  No

  N/A

19.0 Battery storage

• 19.1 Is the battery cage clean & free from defects

  Yes

  No

  N/A

• 19.2 Is the battery cage unobstructed & easily accessible

  Yes

  No

  N/A

• 19.3 Is there any fire fighting equipment at the battery cage

  Yes

  No

  N/A

• 19.4 Has the fire fighting equipment been serviced

  Yes

  No

  N/A

• 19.5 Do all the fire fighting equipment have their seals

  Yes

  No

  N/A

• 19.6 Is the fire fighting equipment sign posted & free from defects

  Yes

  No

  N/A