Customer copy after each visit - doubles as an application record if every field is filled
| Company / phone / license no. | |
|---|---|
| Date / time in-out | |
| Customer / service address | |
| Service (e.g. quarterly, visit 2 of 4) |
| Area | Check for | Result: None / Low / Moderate / High |
|---|---|---|
| Kitchen | Droppings, roach activity under sink/appliances, gaps at plumbing | |
| Bathrooms | Moisture, silverfish, drain flies, plumbing penetrations | |
| Garage | Door seal gaps, rodent rub marks, webs, stored cardboard | |
| Attic / crawlspace | Droppings, nesting, moisture, mud tubes (or not accessible) | |
| Exterior perimeter | Mulch/soil against siding, vegetation contact, entry points, ant trails | |
| Eaves and windows | Wasp nests, webs, screen damage | |
| Devices / stations | Station ID, activity, bait consumed, replaced |
| Findings | |
|---|---|
| Conducive conditions |
| Product (brand) | EPA reg. no. | Concentration | Amount | Area / method | Target pest |
|---|---|---|---|---|---|
| Recommendations for customer | |
|---|---|
| Precautions (e.g. keep pets off treated areas until dry) |
| Technician / truck | |
|---|---|
| Date |
| # | Customer / address | Service | Window | Gate code / pets / notes | Done |
|---|---|---|---|---|---|
| 1 | |||||
| 2 | |||||
| 3 | |||||
| 4 | |||||
| 5 | |||||
| 6 | |||||
| 7 | |||||
| 8 | |||||
| 9 | |||||
| 10 | |||||
| 11 | |||||
| 12 | |||||
| 13 | |||||
| 14 | |||||
| 15 |
Free template from PestRouteDesk. Edit freely for your business.