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01780 767561

CELLAR SURVEY FORM

Business Name

Technician Name

Select a Date

Beer Dispense Quality (Smell, Taste, Look) *

Excellent

Average

Poor

Tap Dispense Temp *

All products below 5°C

Products identified above 5°C

Tap Dispense Flow Rate *

Excellent

Average

Poor

Tap Dispense Notes

Main Cellar Temp *

Under 11°C

12°C - 13°C

14°C - 16°C

17°C +

2nd Cellar Temp

Under 11°C

12°C - 13°C

14°C - 16°C

17°C +

3rd Cellar Temp

Under 11°C

12°C - 13°C

14°C - 16°C

17°C +

4th Cellar Temp

Under 11°C

12°C - 13°C

14°C - 16°C

17°C +

5th Cellar Temp

Under 11°C

12°C - 13°C

14°C - 16°C

17°C +

Cellar Temp Notes

Overall Cellar Hygiene *

Excellent

Average

Poor

Remote 1

Temp under 3°C

Ice Bank Formed

Re-Circlulation Line Clear

Service Required

Remote 2

Temp under 3°C

Ice Bank Formed

Re-Circulation Line Clear

Service Required

Remote 3

Temp under 3°C

Ice Bank Formed

Re-Circulation Line Clear

Service Required

Remote 5

Temp under 3°C

Ice Bank Formed

Re-Circulation Line Clear

Service Required

Remote 4

Temp under 3°C

Ice Bank Formed

Re-Circulation Line Clear

Service Required

Remote Notes

Stock in Date *

Yes

No

Stock Notes

Glassware Condition *

Excellent

Average

Poor

Glassware Notes

Glass Washer Condition *

Excellent

Average

Poor

Glasswasher Notes

Bar Hygiene Chemicals Required

Beer Caps

Sanitiser Tablets

Renovate

Keg Spray

None Required

Nozzle Hygiene

Beer Caps in Use.

Nozzles in Sanitiser

Fruit Fly Present

Procedures not being followed

Additional Survey Notes

Main Bar Number of Taps

Main Bar Wastage Per Tap

2nd Bar Number of Taps

Main Bar Products

2nd Bar Wastage Per Tap

2nd Bar Products

3rd Bar Number of Taps

3rd Bar Wastage Per Tap

3rd Bar Products

Additonal Wastage (4 or more bars)

Thanks for submitting!

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