Title Page

  • Site conducted

  • Record No.

  • Conducted on

  • Supervisor

  • Supervisor No.

  • Signature

  • Keep reach out of the children & Pets

  • Before the treatment inform all the members of the room earliest.

  • Technicians

  • Location
  • Customer Name

  • Customer Contact

  • Pest Control Treated areas

Chemical Details

  • Gel Used

  • Spray chemical type

  • Rat Poison

  • Other Chemical Type

Treatment Type

  • Gel Treatment

  • Spray Treatment

  • Fogging

  • Termite

  • Rodent Control

Pest Activity Evidence Noted

  • Cockroach

  • Bedbug

  • Rat/Mouse

  • Mosquito

  • Ant

  • Flea

  • Fly

  • Termite

  • Others

  • Other Recommendations

  • Months Guaranteed

  • DHS.

  • I/ We the client Confirm that the above services has been carried out satisfactory

  • Customer Name & Signature

  • NOTE- GUARANTEE VOID SERVICE RECORD MISPLACE

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.