EXHIBIT F ADA Maintenance Checklist
QuikTrip Store # _________
Address:___________________________________________________
City: ___________________________________ State:____________
Form filled out by: __________________________Date: ___/___/___
1. ACCESSIBLE ROUTE
Accessible routes must be kept free of obstructions such as display racks, trash receptacles, or merchandise. The pavement must be smooth and level, and free of severe cracks, potholes, other deterioration, debris, snow, ice, mud, and gravel to provide a path that is easily traveled.
a. Are the accessible routes kept free of obstructions such as display racks, trash receptacles, or merchandise? ___ Yes ___ No
b. Is the pavement smooth and level, and free of severe cracks, potholes, other deterioration, debris, snow, ice, mud, and gravel to provide a path that is easily traveled? ___ Yes ___ No
2. ACCESSIBLE PARKING AREA
Access aisles must be kept free of obstructions, including snow and ice, to allow customers with disabilities room to get in and out of their vehicles.
The pavement for accessible parking spaces and access aisles must be smooth and level.
a. Is the accessible parking space clear of unauthorized cars and other obstructions? ___ Yes ___ No
b. Are all accessible parking signs in place, in good condition, and visible over vehicles parked in the spaces, including vans? ___ Yes ___ No
c. Are the accessible parking space(s) and the surrounding area relatively smooth? ___ Yes ___ No
d. Are the accessible parking spaces and surrounding area free of severe cracks, potholes, or other significant deterioration? ___ Yes ___ No
3. CURB RAMPS
Curb ramps or ramps are used to allow customers with disabilities to enter the store if there is a curb or step in the accessible path. The area around the curb ramp must be kept clear, and the curb ramp must not be obstructed by parked vehicles or other objects, including snow, ice, or debris.
a. If present, is the curb ramp unobstructed, and is the area around the curb ramp clear? ___ Yes ____ No
b. If present, is the curb ramp relatively smooth and free of severe cracks, uneven settlement at the top and bottom, or any other significant deterioration? ___ Yes ___ No
4. CUSTOMER ENTRANCE
The customer entrance must be easy for customers with disabilities to approach and enter. This includes providing ramps where there is a curb and rugs that lie flat to prevent tripping and other problems.
There also must be sufficient maneuvering room in front of the door on either side.
a. Is there an unobstructed clear flat area at the exterior side of the accessible door? ___ Yes ___ No
b. Is there an unobstructed clear floor area at the interior side of the accessible door? ___ Yes ___ No
c. Are the door handles at the accessible door firmly attached and in good working order? ___ Yes ___ No
d. Is the door easy to open? ___ Yes ___ No
e. Does the door closer take at least 3 seconds to close the door? ___ Yes ___ No
f. Is the ADA service decal installed on the window? __ Yes ___ No
5. STORE INTERIOR
Customers with disabilities must be able to access the areas where goods are available.
Items on self-service shelves and dispensing devices for prepared food and beverages, and accompanying tableware, dishware, and condiments, must be within reach of a customer using a wheelchair, with sufficient clear floor space for approach and maneuvering room.
Other self-service shelves and displays, such as those for packaged foods, must be on an accessible route with sufficient clear floor space for approach and maneuvering room.
If items on shelves cannot be reached by customers with disabilities, employees must provide assistance in retrieving such items.
Interior aisles must be at least 36" (3 feet) wide and must be free of obstructions such as display racks, trash receptacles, or stacked merchandise.
The floor must be smooth and level.
a. Is there sufficient clear floor space in front of all items on self-service shelves and dispensing devices? ___ Yes ___ No
b. Have employees been trained to provide assistance to people with disabilities to reach, locate, view, and carry items; use dispensers; and read product labels and prices? ___ Yes ___ No
c. Are all merchandise aisles kept clear of temporary displays and stacked merchandise that narrow circulation paths to less than 36" wide or less than 32" wide for lengths of more than 24"? ___ Yes ___ No
d. Is the floor relatively smooth and level? ___ Yes ___ No
6. CHECK-OUT COUNTERS & TRANSACTION DRAWERS
Interior check-out counters must be accessible to customers with disabilities. At least part of the check-out counter or transaction drawer must provide a space at least 36" (3 feet) wide that is no higher than 36" (3 feet) from the floor. This area must be kept free and clear of obstructions such as displays, cash registers, and merchandise.
There must be sufficient clear floor space for approach and maneuvering room by a wheelchair.
a. Is a portion of the check-out counter accessible to customers with disabilities? ___ Yes ___ No
b. Is there sufficient clear floor space, which is free of obstructions, in front of the check-out counter? ___ Yes ___ No
7. CUSTOMER RESTROOMS
Public restrooms must be accessible to customers with disabilities.
a. Is there visible signage with braille and raised letters at each customer restroom? ___ Yes ___ No
b. Is the wheelchair maneuvering clear floor area on both sides of the restroom doors kept free from obstructions? ___ Yes ___ No
c. Is the door easy to open? ___ Yes ___ No
d. Does the door closer take at least 3 seconds to close the door?___ Yes ___ No
e. Are the accessible features in the toilet room in good working order (e.g., toilet, grab bars, toilet paper dispenser)?___ Yes ___ No
f. Are the drain line and hot water supply lines insulated so they will not burn a customer's leg? __ Yes ___ No
g. Is the clear floor area at fixtures kept free of obstructions? ___ Yes ___ No
h. Is the restroom free of extra furniture, merchandise, and other things that reduce the space used for maneuvering a wheelchair?___ Yes ___ No
8. FUEL DISPENSERS & PUMP ISLAND EQUIPMENT
Fuel dispensers have call buttons for requests for assistance.
a. Are fuel dispenser call buttons and self-service card readers in good working order? ___ Yes ___ No
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