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3/23/23,8:53 AM RFS Store Assessment-US Section 7:Gas Dispensers(SV,GL) Pass Value Fail 1. Is all anti-skimming tape in place,correctly applied,with no evidence of having been altered, and is Pass 1.00 the tape itself kept in a secure location? Placement- upper door across the seam. (VW# PIL-SG05- 105) 3. Check/Clean all gas card readers. (VW# P4GCR80P) Pass 1.00 99. Check all lighting in dispenser heads. Pass 1.00 99. Are all fire extinguishers mounted and fully charged, with annual unexpired certification tags attached Pass 1.00 to the units? (Certification tags are good 12 months from the date punched on the tag). Verify they are placed every 50 feet on the fuel islands. 201.Are credit card hold stickers detailing the hold on credit cards displayed on all gas pumps? Keep Pass 1.00 surplus on company truck to replace as needed (VW# PFJCCDECUS). 202.Check condition of hoses, nozzles, nozzle cradles, breakaways, splash guards, whips, and swivels. Pass 1.00 Replace as needed. 204.Are all pumps clean,to current planogram, with pump toppers in place, and fully functional?(Click Pass 1.00 here to open link.) Auditor Section Comments: Section Score: 100 Section 8: Dispenser Parts on Hand Pass Value Fail 1. Gas or Stage II Nozzle(NEPNL-0-01-2) -three on hand Pass 1.00 2. Auto Diesel Nozzle(NEPL-0-01-2) -three on hand Pass 1.00 3. Hi-Flow Diesel Nozzle(NM 1P-AR AD) -three on hand Pass 1.00 4. Gas/Auto Diesel Hose(CT--3408) -three on hand Pass 1.00 5. Diesel Hose(CT-108) -three on hand Pass 1.00 6. Gas/Auto Diesel Breakaway(CTM75) -three of each on hand Pass 1.00 7. Hi-Flow Diesel Breakaway(8331) -three of each on hand Pass 1.00 8. Gas/Auto Diesel Whip Hose (CT-WHP3408) -three of each on hand Pass 1.00 9. Hi-Flow Diesel Whip Hose (CT-WHP108) -three on hand Pass 1.00 10.Gas/Auto Diesel Swivel (c720 3/4) -three on hand Pass 1.00 11.Hi-Flow Diesel Swivel (C720 1X1) -three on hand Pass 1.00 12.Fuel Filters(gas, auto diesel, high flow diesel) -one case (12) of each on hand NA - 13.DEF Nozzle(12150187N-01) - one on hand NA - 14.DEF Hose(OPW-2IGU-H15) - one on hand NA - 15.DEF Breakaway(013185) - one on hand NA - Auditor Section Comments: Section Score: E� nvironmental person check this list 100 Section 10: Refrigeration(GL,DM) Pass Value Fail 1. Clean ice machines inlet water screens assuming easy shut off, inspect water filters check and Pass 1.00 document the water filter installed date. 2. Verify defrost heaters,time clock,defrost termination thermostat and fan delay are operational. Pass 1.00 3. Verify condenser and evaporator fan motors are operational,and oil condenser motors, if Pass 1.00 required. 4. Verify drain heaters are operational. Pass 1.00 5. Verify freezer door frame heaters are operational. Pass 1.00 6. Vacuum or brush off coils and change filters on condenser coils on all u ndercou nter/reach in Pass 1.00 units including all restaurant equipment(1/4" foam media -Grainger 6U636). knxgenapps01/StoreAssessment/ViewAssessment.aspx?HeaderlD=2134095 4/9