Title Page

  • Site Name

  • Conducted on

  • Prepared by

  • Location

Exterior Areas

  • Evidence of pest activity?

  • Evidence of pest harborage areas?

  • Adequate trash handling?

  • Proper trash containers?

  • Proper storage of waste paper & cardboard?

  • Pavement areas in good repair and properly drained?

  • Adequate weed management adjacent to builing?

  • Adequate exterior rodent management plan?

  • Adequate exterior insect management program?

  • Building free of roosting birds?

  • Sufficient cleaning capabilities to prevent buildup of food which may attract pests?

  • Evidence of plumbing or sewer leaks?

  • Are open doors and windows screened?

  • Visible condensate lines clear and clean?

Interior Areas

  • Walls: Clean, proper materials, and in good repair?

  • Floors: Clean, proper materials, and in good repair?

  • Ceilings: Clean, proper materials, and in good repair?

  • Floor drains clean and secured with covers?

  • Plumbing in good repair as related to pest potential?

  • Visible condensate lines clear and no pooling of water?

  • Interior of the building free from pest activity?

  • Inspection aisles properly maintained?

  • Packaging materials properly stored?

  • Damaged/returned goods isolated?

  • Equipment clean and pest free?

  • Maintenance areas clean and no evidence of pests?

  • Sanitation area clean and no evidence of pests; mops and tools stored off floor?

  • Compliance with pest portion of GMPs?

  • Pest management equipment clean and maintained?

Trending Risk Assessment

  • Rodent activity decreasing (Low), remaining the same (Medium) or continuing to increase (High)?

  • Insect and other arthropod pest activities decreasing (Low), remaining the same (Medium), or continuing to increase (High)?

Exterior Risk Assessment

  • Is there risk of unmaintained weeds, grass and brush around facility to harbor pests?

  • Is there risk of weeds or other material along the fence line permitting rodent harborage?

  • Is there risk of rodents burrowing around the perimeter of the building?

  • Is there a risk of standing water on the building grounds to attract pests?

  • Is there a risk of spillage, exposure or accumulation of waste in the garbage containment area?

  • Is there a risk of fly infestations in the garbage containment area?

  • Is there a risk of pest entry through gaps under or around exit doors?

  • Is there a risk of pest entry through broken, open or unscreened windows/vents?

  • Is there risk of pest entry through holes, cracks, or crevices around windows or doors?

  • Is there risk of pest entry around plumbing and electrical service pipes & lines?

  • Is there risk of pests hiding in holes, cracks and crevices in exterior walls?

  • Is there risk of rodent harborage on the building grounds?

  • Is there risk of birds nesting or roosting on or around the building?

  • Is there risk of feeding or nesting Geese on the exterior of the building?

  • Is there a risk of equipment and material stored near the building to provide harborage for pests?

  • Is there a risk of fluorescent lights used on or near the building to attract night-flying insects?

  • Is there a risk of inadequate number of perimeter rodent stations to ensure control of rodents?

Current Device Counts

  • Rodent Traps

  • Rodent Bait Stations

  • Insect Light Traps

  • Pheromone Monitors

  • Insect Monitors

  • Other

Suggested Device Counts (Based on assessment & trending)

  • Rodent Traps

  • Rodent Bait Stations

  • Insect Light Traps

  • Pheromone Monitors

  • Insect Monitors

  • Other

Threshold Levels

  • Mice

  • Rats

  • Cockroaches

  • Flies

  • Stored Product Pests

  • Birds

  • Occasional Invaders

Comments & Corrective Actions

  • undefined

Signature

  • Add signature

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