Pest Management Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Paperwork / Log Book Review

• Who is the primary contact at this location?

• Date of last Terminix audit

• Is there a log book in place?

  Yes

  No

  N/A

• All required business and applicator's licenses up to date and in the log book?

  Yes

  No

  N/A

• All required training and certificates up to date and copies in the log book?

  Yes

  No

  N/A

• Updated insurance information on file?

  Yes

  No

  N/A

• Scope of service and contract present in the log book?

  Yes

  No

  N/A

• How often are we servicing the location?

• Contact information provided (phone numbers, e-mail, after hours/emergency contact information)

  Yes

  No

  N/A

• Is there a site specific schematic with all monitored devices labeled on the schematic?

  Yes

  No

  N/A

• Current labels and MSDS sheets maintained and up to date in the log book?

  Yes

  No

  N/A

• Does the customer require the use of a pesticide usage log?

  Yes

  No

  N/A

• Review current work orders. Are all pesticides used listed on the approved pesticide list?

  Yes

  No

  N/A

• Review work orders. Are all pesticides recorded correctly on the pesticide usage log?

  Yes

  No

  N/A

• Does a log book or any of the information found in a log book need to be provided or updated for the customer?

  Yes

  No

  N/A

• What standard/guidelines were used to set up the pest management program (I.e. AIB, Primus Labs, Customer provided, etc.)

• Is this location audited by any third party auditing companies (I.e. AIB, Primus Labs, FDA)?

  Yes

  No

  N/A

• Date of last third party inspection/audit.

• Any follow up or action items from this audit?

• Any updates or changes that need to be made to pest management program based on updates to third party standards/regulations.

Exterior audit

Exterior Rodent Monitoring Devices

• Does the location have exterior rodent bait stations?

  Yes

  No

  N/A

• Does the location have access/key for the rodent control stations.

  Yes

  No

  N/A

• Are all stations set to requested standard (spacing, location, etc)?

  Yes

  No

  N/A

• Are all stations numbered and noted correctly on site map

  Yes

  No

  N/A

• Do all stations have sign placards that are in good condition and labeled correctly?

  Yes

  No

  N/A

• All all stations anchored?

  Yes

  No

  N/A

• Are all stations in good working order, labeled correctly, and free of dirt/clutter buildup?

  Yes

  No

  N/A

• Does the location need rodent stations?

  Yes

  No

  N/A

• Do past records/observations/trend reporting show a need to adjust exterior rodent control program?

  Safe

  At Risk

  N/A

• Suggestions for exterior rodent control program.

Outdoor Pest Harborage

• Are there any out buildings that are not being addressed by the current rodent and pest program?

  Safe

  At Risk

  N/A

• Our recommendation to ensure these buildings are free of pests?

• Is a perimeter weed control program in place?

  Yes

  No

  N/A

• Our recommendation/issues observed.

• Is landscaping being maintained as to prevent rodent and insect harborage.

  Yes

  No

  N/A

• Our recommendation/issues observed.

• Is the exterior storage of product and equipment well-maintained as to prevent pest harborage and/or pest access to the building?

  Yes

  No

  N/A

• Our recommendation/issues observed.

• Are there exclusion issues that need to be addressed?

  Safe

  At Risk

  N/A

• Our plan/recommendation to solve the exclusion issue is.

• Is their any evidence of wildlife on grounds or harboring in/on/around the exterior of the building

  Safe

  At Risk

  N/A

• Select pest

  Select Squirrels Birds/Geese Snakes Racoons Armadillos Other

  • Squirrels
  • Birds/Geese
  • Snakes
  • Racoons
  • Armadillos
  • Other

• Our plan/suggestion to solve the wildlife issue.

Outdoor sanitation/site review

• Does the location have a dumpster on property?

  Yes

  No

  N/A

• Is the area a source of pest or rodent issues?

  Safe

  At Risk

  N/A

• Is the dumpster in need of replacement and/or cleaning?

  Safe

  At Risk

  N/A

• Are there any suggestions/treatments we can recommend for this area.

  Safe

  At Risk

  N/A

• Does the outdoor lighting need to be addressed to help with spiders and flying insect control?

  Safe

  At Risk

  N/A

• Does the site need spider web removal?

  Safe

  At Risk

  N/A

• Are there any other issues or areas of concern that need to be addressed?

  Safe

  At Risk

  N/A

• Other areas of concern are.

Interior Audit

Interior Rodent Monitoring Devices

• Does the location have interior rodent control stations?

  Yes

  No

  N/A

• Are all stations set to requested standards?

  Yes

  No

  N/A

• Are all stations numbered and noted on the site map?

  Yes

  No

  N/A

• Do all stations have sign placards that are in good condition and labeled correctly?

  Yes

  No

  N/A

• Are all stations in good working order labeled correctly and free of dirt/clutter buildup?

  Yes

  No

  N/A

• Do rodent control devices need metal guards to protect them from damage?

  Yes

  No

  N/A

• Number of guards recommended.

• Does this location have the correct amount/type of equipment for its rodent control program?

  Yes

  No

  N/A

• Do past records/observations/trend reports show a need to adjust the interior rodent control program?

  Safe

  At Risk

  N/A

• Our suggestion to adjust the interior rodent control programm.

• Does the location need an indoor rodent control program?

  Safe

  At Risk

  N/A

Insect Management

• Does the location have insect light traps (ILTs)

  Yes

  No

  N/A

• Are the current insect light traps installed correctly and in the proper locations?

  Yes

  No

  N/A

• Does the location have the correct number of insect light traps needed to identify and control flying insects?

  Yes

  No

  N/A

• Suggested number of insect light traps and placement.

• Are all devices labeled and noted on the site map?

  Yes

  No

  N/A

• Bulb replacement dates noted?

  Yes

  No

  N/A

• Are the types and quantities of insects found in light traps documented and used to identify and eliminate the source of activity?

  Yes

  No

  N/A

• Are insect light traps recommended for this location?

  Safe

  At Risk

  N/A

• Number and location placement of traps.

• Does the location have a pheromone monitoring program?

  Yes

  No

  N/A

• Are all monitors labeled correctly and noted on the site map?

  Yes

  No

  N/A

• Are the types, placement, and number of monitors enough to properly identify the type and source of the pest activity?

  Yes

  No

  N/A

• Do past records/observations/trend reports show a need to adjust the current pheromone monitoring program?

  Safe

  At Risk

  N/A

• Recommended changes to pheromone program.

• Is a pheromone monitoring program recommended?

  Safe

  At Risk

  N/A

• Description of recommended pheromone monitoring program.

• Are there any exclusion issues that need to be addressed (holes, seal cracks, replace screens on vents/windows, door sweeps, etc.)

  Safe

  At Risk

  N/A

• Areas of concern and recommendations to solve.

• Does the pest management program properly address the pest control needs of the location (locations, treatment methods, covered pests, frequency, equipment).

  Yes

  No

  N/A

• Our recommendations to address the pest control program.

• Are there any issues outside the scope of service that need to be addressed?

  Safe

  At Risk

  N/A

• Issues identified, and our plan to resolve.

Kitchens and Breakrooms

• Does the location have a commercial kitchen?

  Yes

  No

  N/A

• Are monitoring devices being used in the kitchen (ILT's, glue boards, tin cats, etc)

  Yes

  No

  N/A

• Are proper IPM service protocols being followed (insect monitors, baiting, IGR's, etc)

  Yes

  No

  N/A

• Are floor drains free of organic matter?

  Yes

  No

  N/A

• Our recommendation to treat the drains.

  Yes

  No

  N/A

• Are employee break rooms being treated using proper IPM service protocols (monitoring devices, baiting, etc)

  Yes

  No

  N/A

• Recommendations on treatment of these areas.

Customer feedback

• The control of pests meets the expectations of our customer

• Service professional is prompt, uniformed, and conscientious

• Service professional responds to questions and problems promptly

• Service reports are legible and completed

• Service professional reviews sanitation and structural problems

• Stations/devices are initialed, dated, and/or scanned per scheduled

• Office staff is helpful in resolving problems/issues

• Overall satisfaction

• If the customer could change one aspect of their service it would be.

• What is the customer's favorite feature of their current service.

• Would the customer recommend Terminix Commercial to others?

  Yes

  No

  N/A

• If no, why? Plan to correct.

Follow-up/comments

• Any follow-ups, action items, comments for this location.

• Customer would like additional information on the following Terminix Services.

  Select Fly Control Bird Control Drain Service Termite Service Rodent Control ScanMaster Bed Bug Auditing Agencies

  • Fly Control
  • Bird Control
  • Drain Service
  • Termite Service
  • Rodent Control
  • ScanMaster
  • Bed Bug
  • Auditing Agencies

Signatures

• Contact Signature

  Sign

• Terminix Representative

  Sign