TOUCH HYGIENE SERVICE PVT LTD

• SITE NAME

• STORE CODE

• FORMAT : Fresh/ Trends/ FC/ DC/ Others

• Conducted on

  Date

• Prepared by

• Location
  Address

External Environment

• Overhanging Tree Branches

  Yes

  No

  N/A

• Stagnant Water Bodies

  Yes

  No

  N/A

• Open Public Drainages

  Yes

  No

  N/A

• Presence of weeds or shrubs within the plot

  Yes

  No

  N/A

• Garbage Dumping Spots

  Yes

  No

  N/A

• Manholes Status

  Safe

  At Risk

  N/A

• Pest infested near by buildings

  Yes

  No

  N/A

Status of Building Exterior :

• Presence of Air Curtain at ENTRANCE/ EXIT Doors

  Yes

  No

  N/A

• Functioning of Air Curtain (working condition)

  Yes

  No

  N/A

• Flow of air curtain (Towards external site of the store)

  Yes

  No

  N/A

• Presence of unused/ Scrap items - Externally

  Yes

  No

  N/A

• Presence of Entrance/ Exit Door Gaps

  Yes

  No

  N/A

• Presence of Cable/ Ducts openings from externally

  Yes

  No

  N/A

• Exhaust Fan Window (Meshed/Auto shuttered)

  Yes

  No

  N/A

• Drainage Points (Grilled with long linear drainage lids)

  Yes

  No

  N/A

• Presence of Gaps/ Cracks & crevices around the Entrance/ Exit door

  Yes

  No

  N/A

• Presence of Pest Bird (Pigeons/ Sparrows) & its droppings around the store

  Yes

  No

  N/A

• Presence of Active Rodent Burrows

  Yes

  No

  N/A

Status of Building Interior :

Pest : Rodents

• OBSERVATION :

• ACTION PLAN FROM POT :

• ACTION PLAN FROM CLIENT :

• Add media

  Media

• Add media

  Media

• Add media

  Media

• Add media

  Media

Pest : Cockroaches

• OBSERVATION :

• ACTION PLAN FROM POT :

• ACTION PLAN FROM CLIENT :

• Add media

  Media

• Add media

  Media

Pest : Flies

• OBSERVATION :

• ACTION PLAN FROM POT :

• ACTION PLAN FROM CLIENT :

• Add media

  Media

• Add media

  Media

Pest : Mosquitoes

• OBSERVATION :

• ACTION PLAN FROM POT :

• ACTION PLAN FROM CIENT :

• Add media

  Media

• Add media

  Media

Pest : Others

• OBSERVATION :

• ACTION PLAN FROM POT :

• RECOMMENDATIONS :

• Add media

  Media

Additional services required apart from standard contract (Kindly specify)

• Type of Service Required :

  Select

• Service Frequency :

  Select

• Suggested Action Plan :

Documentation :

• Pest Management File available with all documents - CPMP File @ Store

  Yes

  No

  N/A

• Presence of Rodent boxes @ Store

  Yes

  No

  N/A

• Rodent Boxes Installed

• Presence of Rodent Layout Map @ Store

  Yes

  No

  N/A

• Presence of Service Checklist @ Store

  Yes

  No

  N/A

• Insect Light Traps installation Height (ideal height 5-6 feet)

  Yes

  No

  N/A

• Insect Light Traps Total Installed @ Store

Auditor Recommendation

• undefined

Customer Comments

• undefined

Signature

• Auditor Signature

  Sign

• Customer Signature

  Sign