Gas Station Audit Checklist
Complete this checklist to assess the condition, safety, and compliance of the gas station.
Auditor Name
*
First Name
Last Name
Audit Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Gas Station Name/Location
*
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
General Cleanliness Assessment
*
Rows
Excellent
Good
Fair
Poor
Forecourt
1
2
3
4
Restrooms
5
6
7
8
Convenience Store
9
10
11
12
Fuel Dispensers
13
14
15
16
Safety Equipment Status
*
Rows
Present & Functional
Present but Needs Repair
Missing/Unusable
Fire Extinguishers
17
18
19
Spill Kits
20
21
22
First Aid Kit
23
24
25
Emergency Shut-off
26
27
28
Are all required safety and compliance signs posted and visible?
*
Yes
No
Pump Functionality
Rows
Working
Needs Repair
Out of Order
Pump 1
29
30
31
Pump 2
32
33
34
Pump 3
35
36
37
Pump 4
38
39
40
Lighting Conditions
*
All areas well-lit
Some areas dim
Significant lighting issues
Any observed hazards or urgent issues?
Fuel leaks/spills
Trip hazards
Obstructed exits
None observed
Other (please specify)
Additional Comments or Observations
Auditor Signature (confirming the accuracy of this audit)
*
Submit Audit
Submit Audit
Should be Empty: