BCC Mosquito Operations Treated Site Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Safety

• Is the site easily accessed and the work area safe?

  Yes

  No

  N/A

• What can be done to improve safety at this site?

Site Characteristics

• Site Category

  Cat 1

  Cat 2

  Cat 3

  Cat 4

• Is the site Fresh Water or Salt Water

  FRESH WATER

  SALT WATER

• Is the water Permanent, Semi Permanent or Temporary.

  Permanent

  Semi Permanent

  Temporary.

• How many days since the site last treated?

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 >14

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • >14

BTi

• Was BTi used at this site

  Yes

  No

  N/A

• What was the mix rate?

  1000ml per Litre

  2000ml per Litre

  Other

  Not Applicable

• If other, describe here.

Methoprine Sand

• Was Methoprine Sand used at this site?

  Yes

  No

  N/A

• Approximately how much product is needed to treat the site?

Mosquitoes

• Where Mosquitoe larvae present at the time of treatment?

  Yes

  No

  N/A

• How may larvae per dip

• Are mosquito larvae present at the time of inspection?

  Yes

  No

  N/A

• If yes, are the larvae chemically affected?

  Yes

  No

  N/A

• What stage are the larvae?

  Select 1st 2nd Early 3rd Late 3rd Early 4th Late 4th Pupa

  • 1st
  • 2nd
  • Early 3rd
  • Late 3rd
  • Early 4th
  • Late 4th
  • Pupa

• How may larvae per dip (presently)

Efficacy

• Was the treatment timely?

  Yes

  No

  N/A

• Was the treatment effective?

  Yes

  No

  N/A