Pest Control Survey IPM

• Site conducted

• Conducted on

  Date

• Prepared by

• Location

Initial Findings

• Level of Internal Hygiene

  Poor

  Satisfactory

  Good

• Level of Internal Maintenance

  Poor

  Satisfactory

  Good

• Level of External Hygiene

  Poor

  Satisfactory

  Good

• Level of External Maintenance

  Poor

  Satisfactory

  Good
Environmental Observations

• Details of Issue Found

  Select Poor House Keeping Large amounts of Rubbish or Harbourage Build up of compost or vegetation Repair required EFK Requires Servicing Deep Cleaning Required Recommendations Carried Out Protected Species Present

  • Poor House Keeping
  • Large amounts of Rubbish or Harbourage
  • Build up of compost or vegetation
  • Repair required
  • EFK Requires Servicing
  • Deep Cleaning Required
  • Recommendations Carried Out
  • Protected Species Present

• More Information

• Photo Evidence

  Media

• Proposed Correction Method

• Recommended Start Date

  Date

• Recommended Timescale

  Select Immediately One Week Two Week One Month Four Months Continuance

  • Immediately
  • One Week
  • Two Week
  • One Month
  • Four Months
  • Continuance

• Responsible Person

Pest Activity Observed

• Pests Observed

  Select Rodent (Rat) Rodent (Mice) Grey Squirrel Rabbit Mole Black Ant Varied Carpet Beetle Cockroaches Pigeon Gull Pharoah Ant Wasps Bee Fruit Fly's Cluster Fly's Silverfish Woodlice Bed Bug Stored Product Insect House Fly

  • Rodent (Rat)
  • Rodent (Mice)
  • Grey Squirrel
  • Rabbit
  • Mole
  • Black Ant
  • Varied Carpet Beetle
  • Cockroaches
  • Pigeon
  • Gull
  • Pharoah Ant
  • Wasps
  • Bee
  • Fruit Fly's
  • Cluster Fly's
  • Silverfish
  • Woodlice
  • Bed Bug
  • Stored Product Insect
  • House Fly

• Infestation Level

  Low

  Moderate

  High

• More Information

• Proposed Correction Method

  Select Baiting Programme Prevention Activity Chemical Treatment ULV Treatment Trapping Programme Heat /Tempature Treatment Do Nothing

  • Baiting Programme
  • Prevention Activity
  • Chemical Treatment
  • ULV Treatment
  • Trapping Programme
  • Heat /Tempature Treatment
  • Do Nothing

• Recommended Start Date

  Date

• Recommended Deadline

  Select Immediately One Week Two Week One Month Four Months Continuance

  • Immediately
  • One Week
  • Two Week
  • One Month
  • Four Months
  • Continuance

• Responsible Person

Key Findings

• Key Finding of this Survey

• Recommended Timescale for corrective action

  Select Immediately One Week Two Week One Month Four Months Continuance

  • Immediately
  • One Week
  • Two Week
  • One Month
  • Four Months
  • Continuance

• Technician Signature

  Sign