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Establishment
Name:_______________________ Date:________ |
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Address:
_______________________________________ |
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Hours of Operation: from _____ to _____
Survey Time: ________
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How many miles is the establishment
from the Tecate Port of Entry? a) 1/2 mile b) 1
mile c) 1 1/2 miles d) 2 - 5 miles e) 6-10 miles
f)0ver 10 miles
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Type of Establishment: a) Grocery Store
b) Mini-Market c) Liquor Store d) Bar e) Nightclub f) Restaurant g)
Other, describe:______
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Proximity to other bars, restaurants,
or club: a) Next Door b) Within same block - 1/8 mile c)
Within 2 blocks - 1/4 mile d) Beyond 2 blocks
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| Exterior
Maintenance of Establishment |
- Good, little trash &
in good shape
- Fair, some trash &
some repair
- Poor, lots of trash &
disrepair
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Establishment is at: a) Street
Level b) Upstairs c) Downstairs
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Size of the Establishment (pace off the
front of the building and look inside): _____ paces in
front _____ depth in paces _____one story _____ two stories
_____ three stories
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Outside signage
|
| sign |
number
of signs displayed |
Signs
written in English, Spanish or Both |
| Beer
Specials |
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| Two
for One Specials |
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| Happy
Hour Specials |
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| Minors
not permitted |
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| Liquor
Specials |
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| Sports
Event Specials |
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| Never
a Cover Charge |
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| Ladies
Night |
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| Drink
Specials |
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| All
you can drink specials |
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| Free
Tequila shots |
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| Food
Specials |
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| You
must be 18 to purchase alcohol |
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| We
check IDs for alcohol purchases |
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| Other
/ Describe |
|
|
|
|
Outside signage
|
| sign |
number
of signs displayed |
Signs
written in English, Spanish or Both |
| Beer
Specials |
|
|
| Two
for One Specials |
|
|
| Happy
Hour Specials |
|
|
| Minors
not permitted |
|
|
| Liquor
Specials |
|
|
| Sports
Event Specials |
|
|
| Never
a Cover Charge |
|
|
| Ladies
Night |
|
|
| Drink
Specials |
|
|
| All
you can drink specials |
|
|
| Free
Tequila shots |
|
|
| Food
Specials |
|
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| You
must be 18 to purchase alcohol |
|
|
| We
check IDs for alcohol purchases |
|
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| Other
/ Describe |
|
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How many
customers/patrons are in the establishment? a) 1-5 b) 6-10 c) 11-20
d) 21-30 e) 31-50 f) more than 50
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How old do the
customers/patrons appear to be? ____% are 10-15 years old _____% are
16-17 years old _____% are 18-20 years old _____% are 21-30 years
old _____% are 31+ years old
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What percentage of the
customers/patrons appear to be US or Mexican citizens? _____% are
Mexican _____% are US
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Do the customers/patrons appear to be
mostly men or women? ____% are male _____% are female
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How many employees are working? a)1 b)
2 c) 3-5 d) 6-10 e) 11-15 f) 16-20 g) more than 20
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How many cars are parked in the parking
lot or on the street near the establishment? a)1 b) 2 c) 3-5 d) 6-10
e) 11-15 f) 16-20 g) more than 20
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| Write down the
price for the following: |
| Item |
Brand
Name or Type |
Price |
| one beer |
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| six pack
of beer |
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| 40 oz.
beer |
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| one wine
cooler |
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| 4 pack of
wine coolers |
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| one
bottle of wine |
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| 750 ml of
hard liquor |
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| cost for
a mixed drink |
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| cost for
a shot of liquor |
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Additional Observations/Comments:
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Return to Action Kit
Index
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