Pest Management Survey Checklist Template FREE

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Pest Management Survey Checklist Template

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Paperwork/Systems review

Paperwork / Log Book Review

Who is the primary contact at this location?

Date of last Terminix audit

Is there a log book in place?

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

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

Updated insurance information on file?

Scope of service and contract present in the log book?

How often are we servicing the location?

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

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

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

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

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

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

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

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)?

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?

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

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

Are all stations numbered and noted correctly on site map

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

All all stations anchored?

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

Does the location need rodent stations?

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

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?

Our recommendation to ensure these buildings are free of pests?

Is a perimeter weed control program in place?

Our recommendation/issues observed.

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

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?

Our recommendation/issues observed.

Are there exclusion issues that need to be addressed?

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

Select pest

Our plan/suggestion to solve the wildlife issue.

Outdoor sanitation/site review

Does the location have a dumpster on property?

Is the area a source of pest or rodent issues?

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

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

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

Does the site need spider web removal?

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

Other areas of concern are.

Interior Audit

Interior Rodent Monitoring Devices

Does the location have interior rodent control stations?

Are all stations set to requested standards?

Are all stations numbered and noted on the site map?

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

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

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

Number of guards recommended.

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

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

Our suggestion to adjust the interior rodent control programm.

Does the location need an indoor rodent control program?

Insect Management

Does the location have insect light traps (ILTs)

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

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

Suggested number of insect light traps and placement.

Are all devices labeled and noted on the site map?

Bulb replacement dates noted?

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

Are insect light traps recommended for this location?

Number and location placement of traps.

Does the location have a pheromone monitoring program?

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

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

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

Recommended changes to pheromone program.

Is a pheromone monitoring program recommended?

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.)

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).

Our recommendations to address the pest control program.

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

Issues identified, and our plan to resolve.

Kitchens and Breakrooms

Does the location have a commercial kitchen?

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

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

Are floor drains free of organic matter?

Our recommendation to treat the drains.

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

Recommendations on treatment of these areas.

Wrap up

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?

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.

Signatures

Contact Signature

Terminix Representative

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.