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3/23/23,8:53 AM RFS Store Assessment-US 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 Fail 1.00 Comments:needs two swivels 12. Fuel Filters(gas, auto diesel, high flow diesel) -one case (12) of each on hand Fail 1.00 Comments:needs one case for gas, auto diesel 13. DEF Nozzle(12150187N-01) - one on hand Pass 1.00 14. DEF Hose(OPW-2IGU-H15) - one on hand Pass 1.00 15. DEF Breakaway(013185) - one on hand Pass 1.00 Auditor Section Comments: Section Score: 86.7 Section 9:Oil Water Separator(SV,GL) Pass Value Fail 3. Is the retention pond free of stains and oil sheens and does vegetation appear to be growing within it? NA - 4. Are the ditches around the facility free of"stains" and oil sheens on any standing water? Pass 1.00 5. Check lift station pumps. NA - 6. Are there at least 100 Absorbent Pads on hand, 4 Absorbent Booms (10' Long)and 1 bag of Oil Dry on Pass 1.00 hand at the store? 99.Measure the oil water separator and post results to PTCEIS. Also note readings in comment section. NA - (Click here to open link.) 99.Verify a minimum of 3 empty drums are onsite. Order from the PTCEIS website if needed. (Click here to Pass 1.00 open link.) 99.Check storm drain condition. Pass 1.00 99.Check discharge pump operations.There should be no fuel in the discharge chamber. NA - 99.Clean/Empty the catch basin going to the OWS . NA - Auditor Section Comments: Section Score: 100 Section 11 : Deli Equipment(GL, DM) Pass Value Fail 1. Check date of last cleaning cycle on Bean to Cup equipment. Clean if needed. Clean out Pass 1.00 grounds with brush. 2. Visually check that roller grills are operational. NA - 97. Is lighting adequate for cleaning and food handling tasks, with shatterproof lightshields over Pass 1.00 lights? 99. Verify safety wires for fryers are secured to the fryer(s) and the wall. Pass 1.00 99. Are water filters marked with the date on which they were installed and not found installed Pass 1.00 longer than 6 months? Note date installed in comments. Replace semiannually. Comments:changed on 4/14/20 99. Are beverage cooler door heaters functioning properly(no condensation)? Pass 1.00 203. Check deli cabinets for structural integrity and leaks; straighten doors and vacuum debris as Pass 1.00 needed. 204. Check that the fountain machine translight is illuminated. Pass 1.00 knxgenapps01/StoreAssessment/ViewAssessment.aspx?HeaderlD=2091169 3/7