Pest Management Advice

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Details

• Building/Area Description

  Select House Unit Apartment Business Other

  • House
  • Unit
  • Apartment
  • Business
  • Other

• Construction Type

  Select Single Story Multiple Level High Set High Set- Fully Enclosed High Set- Partial Enclosed Low Set Shed Temporary Structure

  • Single Story
  • Multiple Level
  • High Set
  • High Set- Fully Enclosed
  • High Set- Partial Enclosed
  • Low Set
  • Shed
  • Temporary Structure

• Wind 0-10

Pests Treated

• Cockroaches

  Select Australia American German Oriental Brownbanded All Other

  • Australia
  • American
  • German
  • Oriental
  • Brownbanded
  • All
  • Other

• Rodents

  Select Norway Rat Roof Rat House Mouse All

  • Norway Rat
  • Roof Rat
  • House Mouse
  • All

• Birds

  Select Indian Mynar Pigeon Plover Magpie Sparrow Stirling Other

  • Indian Mynar
  • Pigeon
  • Plover
  • Magpie
  • Sparrow
  • Stirling
  • Other

• Bird Lice

  Yes

  No

  N/A

• Ants

  Select Ghost Pharaoh Household Black Sugar Meat Carpenter Coastal Brown Green Whitefooted House Odorous All Other

  • Ghost
  • Pharaoh
  • Household Black
  • Sugar
  • Meat
  • Carpenter
  • Coastal Brown
  • Green
  • Whitefooted House
  • Odorous
  • All
  • Other

• Spiders

  Select All Webbing Red-Back Daddy Long Legs Funnel Web Golden Orb white Tailed Huntsman Trapdoor Other

  • All Webbing
  • Red-Back
  • Daddy Long Legs
  • Funnel Web
  • Golden Orb
  • white Tailed
  • Huntsman
  • Trapdoor
  • Other

• Borers

  Select Pinhole Borer Furniture Beetle Powderpost Beetle Jewel Beetle Longicorn Beetle European House Borer Other

  • Pinhole Borer
  • Furniture Beetle
  • Powderpost Beetle
  • Jewel Beetle
  • Longicorn Beetle
  • European House Borer
  • Other

• Termites

  Select Coptotermes Nasutitermes Mastotermes Darwiniensis Microcerotermes Neotermes (Dampwood) Cryptotermes (Drywood) Cryptotermes Brevis Hertotermes All Other

  • Coptotermes
  • Nasutitermes
  • Mastotermes Darwiniensis
  • Microcerotermes
  • Neotermes (Dampwood)
  • Cryptotermes (Drywood)
  • Cryptotermes Brevis
  • Hertotermes
  • All
  • Other

• Fleas

  Yes

  No

  N/A

• Silverfish

  Yes

  No

  N/A

• Mosquitoes

  Select Unknown Culex Spp. Aedes Spp. Anopheles Spp. Coquilettida Spp. Mansonia Spo. Toxorhynchites Spp. Verrallina Spp. All Other

  • Unknown
  • Culex Spp.
  • Aedes Spp.
  • Anopheles Spp.
  • Coquilettida Spp.
  • Mansonia Spo.
  • Toxorhynchites Spp.
  • Verrallina Spp.
  • All
  • Other

• Bees

  Select European Honey Native Carpenter Asian Honey All Other

  • European Honey
  • Native
  • Carpenter
  • Asian Honey
  • All
  • Other

• Wasps

  Select Paper Green European Mud Dauber Potter All Unknown Other

  • Paper
  • Green
  • European
  • Mud Dauber
  • Potter
  • All
  • Unknown
  • Other

• Ticks

  Brown Dog

  Paralysis

  Unknown

  All

  Other

• Other- Type In

Treatment Area(s)

• Internal

  Select Kitchen Internal Walls Skirting Boards Dining Area Electrical Equipment Roof Void Office Area Sub-Floor Wet Areas Other

  • Kitchen
  • Internal Walls
  • Skirting Boards
  • Dining Area
  • Electrical Equipment
  • Roof Void
  • Office Area
  • Sub-Floor
  • Wet Areas
  • Other

• External

  Select Gardens External Walls Nest Direct Stumps Posts Trees Fence line Other

  • Gardens
  • External Walls
  • Nest Direct
  • Stumps
  • Posts
  • Trees
  • Fence line
  • Other

Chemical Used & Quantity

• Termidor (Fipronil 100gms/Ltr)

• Biflex Ultra Low Odour (Bifenthrin 100gms/Ltr)

• Biflex Aquamax (Bifenthrin 100gms/Ltr)

• Cislin (Deltamethrin 25gms/Ltr)

• Ditrac Blocks (Brodifacoum 0.005%)

• Dragnet Dust (Permethrin 20gms/Kg)

• Maxforce Gold Cockroach Gel (Fipronil 0.3gms/Kg)

• Optiguard Ant Gel (Thismethoxam 0.1gms/Kg)

• Battle Axe Areosol (Propoxur 20gms/Kg, Tetramethrin 2gms/Kg)

• Maxforce Granular (Hydramethylnon 10gms/Kg)

• Cislin Ultra Aerosol (Bioallethrin 1.5gms/Ltr, Deltamethrin 0.2gms/Ltr)

• Amdro Ant Granular (Hydramethylnon 7.3gms/Kg)

• Advion Ant Gel (Indoxacarb 6gms/Kg)

• Advion Cockroach Gel (Indoxacarb 6gms/Kg)

• Stratagem Blocks (Flocoumafen 0.05gms/Kg)

• Antmaster (Imidacloprid 0.05gms/Ltr)

• Chill (D-allethrin 1.3gms/Kg)

• Aquatain AMF (Polydimethylsiloxane 754gms/Ltr)

• Amdro Cockroach Gel (Hydramethylnon 20gms/Kg)

• Other- Type In

Service Type

• Regular

• Warranty

• Scheduled

Warranty Provided

• Warranty Period

  Select No Warranty 3 Months 6 Months 12 Months Other

  • No Warranty
  • 3 Months
  • 6 Months
  • 12 Months
  • Other

Additional Information

• Comment/Recommendations

• Add media

  Media

• Technician

  Select Adam Herrick- Lic. 14177 Shaun Allen Lic. 14751

  • Adam Herrick- Lic. 14177
  • Shaun Allen Lic. 14751

• Add signature

  Sign