PEST PREVENTION SERVICE REPORT

• Audit Title

• Client / Site

• Conducted on

  Date
• Location
  Address

Pest Prevention Service Report

Wheatland Pest Management 1297 Comanche Mcpherson, Ks 67460 620-694-7162

• Certified applicator:

• Jeff Koehn Cert. Number 9816

• Jeff Beeghly Cert. Number. 22692

• Todd Winger Cert. Number. 300104

• Matthew Byard cert. Number. 26933

SERVICE SUMMARY

Service type performed:

• Performed regular Eco Sensitive pest prevention today.

Preventative treatments made:

• Performed preventative treatment for the following pest type: Mouse

• Performed preventative treatment for the following pest type: Grain beetle

• Performed preventative treatment for the following pest type: Spiders

Areas inspected/service:

Bait used for this location: Contrac All Weather Blox. EPA Reg. No. 12455-79 All bait will be placed in tamper proof bait stations in sensitive areas and warehouses will have light weight bait stations. In the Columns where it says, " amount of bait used". Only a number will be used. This will equal total blocks of bait used.

• OFFICE

  Yes

  No

  N/A

• Amount mice caught

• Amount bait used:

• Sprayed office for spiders

  Yes

  No

  N/A

• Product used:
  Tempo SC Ultra. EPA. Reg No. 432-1363
  Rate: 8ml/1 gal. H2O/1,000 soft. Crack and Crevice Treatment

• Amount used:

• SEED CLEANER/WAREHOUSE

  Yes

  No

  N/A

• Amount of mice caught:

• SHOP

  Yes

  No

  N/A

• Amount mice caught:

• Amount bait used:

• FERTILIZER PLANT

  Yes

  No

  N/A

• Amount mice caught

• Amount of bait used.

• BUNKER

  Yes

  No

  N/A

• Identify amount of bunkers serviced:

• Amount bait used

• Identify problem areas:

• Add media

  Media

• FEED MILL MAIN FLOOR

  Yes

  No

  N/A

• Amount mice caught

• Amount of bait used.

• FEED MILL BOOT

  Yes

  No

  N/A

• Amount mice caught

• Amount of bait used.

• SEED / VEHICLE WAREHOUSE

  Yes

  No

  N/A

• Amount mice caught

• Amount bait used

• FEED WAREHOUSE

  Yes

  No

  N/A

• Amount mice caught

• Amount of bait used.

• FEED MILL / BAG WAREHOUSE SPRAYED FOR GRAIN INSECTS

  Yes

  No

  N/A

• Product used:
  Tempo SC Ultra. EPA. Reg No. 432-1363
  Rate: 16ml/5gal. H2O/1,000 sqft. Walls, floor and bags sprayed

• Amount used:

• 1st GRAIN ELEVATOR

  Yes

  No

  N/A

• 1st GRAIN ELEVATOR IDENTITY:

• 1st Grain elevator exterior

  Yes

  No

  N/A

• Amount bait used

• 1st Grain elevator main floor

  Yes

  No

  N/A

• Amount mice caught

• 1st Grain elevator boot

  Yes

  No

  N/A

• Amount mice caught

• 1st Grain elevator tunnel

  Yes

  No

  N/A

• Amount mice caught

• If bait used in elevator. Please identify location and amount used.

• 2nd GRAIN ELEVATOR

  Yes

  No

  N/A

• 2nd GRAIN ELEVATOR IDENTITY:

• 2nd Elevator Exterior

  Yes

  No

  N/A

• Amount bait used

• 2nd Grain Elevator Main Floor

  Yes

  No

  N/A

• Amount mice caught

• 2nd Grain Grain Elevator Boot

  Yes

  No

  N/A

• Amount mice caught

• 2nd Grain Elevator Tunnel

  Yes

  No

  N/A

• Amount mice caught

• If bait used in elevator. Please identify location and amount used.

• 3rd GRAIN ELEVATOR

  Yes

  No

  N/A

• 3rd GRAIN ELEVATOR IDENTITY

• 3rd Grain Elevator Exterior

  Yes

  No

  N/A

• Amount Bait Used:

• 3rd Grain Elevator main floor.

  Yes

  No

  N/A

• Amount mice caught:

• 3rd Grain Elevator Boot

  Yes

  No

  N/A

• Amount mice caught

• 3rd Grain Elevator Tunnel

  Yes

  No

  N/A

• Amount mice caught

• If bait used in elevator. Please identity location and amount used.

• 4th GRAIN ELEVATOR

  Yes

  No

  N/A

• 4th GRAIN ELEVATOR IDENTITY:

• 4th GRAIN ELEVATOR EXTERIOR

  Yes

  No

  N/A

• Amount bait used:

• 4th Grain Elevator main floor

  Yes

  No

  N/A

• Amount of mice caught:

• 4th Grain Elevator Boot:

  Yes

  No

  N/A

• Amount mice caught:

• 4th Grain Elevator Tunnel:

  Yes

  No

  N/A

• Amount mice caught:

• EXTRA BOOT / OUTSIDE LEG

  Yes

  No

  N/A

• Amount mice caught:

• If bait used. Name location and how much.

• Pest activity found.

  Yes

  No

  N/A

• Select NO ACTIVITY LIGHT ACTIVITY MODERATE ACTIVITY EXCESSIVE ACTIVITY

  • NO ACTIVITY
  • LIGHT ACTIVITY
  • MODERATE ACTIVITY
  • EXCESSIVE ACTIVITY

• If yes, Please explain.

RECOMMENDED CLIENT CORRECTIVE ACTIONS

• Request client corrective actions

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Client signature

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