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❑:INITIAL SERVICE U REGULAR SERVICE IJ EXTRA SERVICE TIRMINIX. 04'--09 - i:,r,e.Itt a,eiT r` ft t x, COMMERCIAL - • REPORT IIBRANChi - • - ftF1ANDhi : ,. �1CGOf NT "�RT I�It�T IeEPHONE. GRE131JQ DAY, IAF i�f.: PRODUGTION`� TIME fel :TIME,'O T s ';7 f � k 1:7 r 3 f 1 A w� 7.1 }, .7 i::' - 6 - 'Ci r}•g'�,�- «tfi '5t:7.ti 1.5eS6 t '.0Y )65---37',i `, 4. BRANCH u. . .�' i:Il:f..:li'} 'I'al��`fli^if•t"'E::.s;'•.•i.:S "j'i:::l�4+N`'i:l:ht.l::K :iso•t-0:::f�.(�ir.'xT7:[:E1`dt�li_ 24. 'S• SAN :,�I_}I'SCs�€=.1.�1 S:,'T ' 226 [...{ i;iCE' X R r iT(SE (}` ( ".'j 2t A? ;'i Y'('11" i '€' tt (' k 91":*s¢yr:,; ut:'t 4�::l.....r3239 OPERATOR NAME&CERTIFICATION NUMBER SUPERVISORNAME&CERTIFICATION NUMBER .i i�• i�t i_:int'�' .i:3 ir r�i:i f'i:'t d��E:f Target ❑ German Cockroaches 0 Pavernent Ants 0 Rats ❑ Occasional Invaders Materials 9Used sUsed Pests ❑ American Cockroaches ❑ ArgenItne Ams ❑ Mice 0 Scored Product Pests 450 Insiders 620 WIND-UP TRAPS 3-06antal Cockroaches 0. Fire Ants ❑ Silverfish ❑ Other 400 Insect Monitors - 610 TIN CATS ❑'-Other Cockroaches ❑ Other" - - ❑ Flies 0 -Other 410 Pheromone Traps 546 Rat Bart Stations 600 Glue Tres 640 Mouse Batt Stations Pest Contrei:Materials Used EPA Reg.I! TIC FJC Amount . 630 Snap Traps - 655 Liquid Batt Stations 293 Advance Granular Ant Bait(Abamectin Bl)0.011% 499.370 Areas Inspected and/or Treated - 295 Advance Dual Choice Ant Bait(Abamectln B1)0.011% 499-496 :PestOontrolmateriels useU inGicafed by Codes from#St at kft 316 Ascend Fire'A it Bah(Abemectin B1)D.D119A - 499-370 30 m 9 Avert Roach Bait Stations(Abaectin)0.05% 499-467 in Peeaa J rZ 355 Advance 38BB Ant Gel Balt(Borax)5.4% 499-492 O Offices 100 Borid Dust(Orthot7oric ac4'991/. 9444-129 ❑Public Areas 15 'Demand CS(Lambda-cyhalothdn). 00,015% -❑0.03% U -100-1066 . _ 210 DelG Dehamethdn}0:05% 432-836 ❑.IgesVLocker Rooms 158 TdDie Bulk Dust(Silica Gel)40%(Pyrethrins)1.0% 499-429 17 Display Areas 7 41 GentroLEC{Hydmprene)0.06% 2724-351 0 Lsundry/Soller Room 540 Generation Mini Blocks Bait(DdethWona)0.0025% 7173-218 Ll 5tora0enitiitty 541 Generation Blue Max Blocks Bait(Dttethialone)6:0025% 7173-236 0 warehouse Area 39 •:Idea Granular Ball(Orthoboric A010 5.0% - - 73079-2 ❑processing Areas 43 'locker EC(Pyrethrins) 00.05% ❑0.1% ❑0.2% . 432=1145 ❑Patient Rooms 550 LiquTax II Bait(Disodium Satt of Diphacinone)4.106% 12455-61 0 Guest Rooms 352 :Maxleroe FC Roach Bait Stations(Rpronil)0.05% 432-1257 f ❑Bssamem 351 Maxforce FC Ant Batt Stations(Apronll)0.01% •: 432-1256 Roo 357 c.Maxtorce FC-Ant Gel Bait(Fipronil)_11.001%. - - 432-1264 - 31A ':MWorce FC Select Roach Bait Gel(Rpronil)'0.01% 432-1259 Z)Extedor Perimeter • 355 Maxforre FG Insect Belt(Hydramethylnon)1.0% 432-1262 d Landscaped Pleas 46'Nylar:EC.(Pyriproxyfen)>130.016% 0 0.02% 11715-30M7076 ❑Loading Dock0umpster --.. 151'-:PT'Cy-Kick Aerosol(Cylluihrin)0.1%.. .... - .. - 499.470 _. ❑Other 70 PTGy-Kick;C5'(0y11uthrin}:p0.0075% 00025%::A0.05%00.1% 499-304 , 312;PIT Avert Gel-Balt(Atiamcti en Bl)0.05% 499-410.. Precautions. Keep out of ionschi dron and pets. 69 -PT 565 Plus'XL0 Aerosol(Pyrethrins)0.596 499-290 May cause eye,nose,throat or skin kritalicn. 159 r.PTT.riDle Aerosol(Silica Aerogel)4.B%(Pyrethrins)0.5% - - ',:499-385 - Avoid braatNng vapors mists,or dusts.Hamdul If swallowed. >.e1` Terripo Ultra WP(CyOuthrin) 00.025% ❑D:O5%-:00.1% '...... 432-1304' bampon;granules to activate. 83.ri.Tempo SC Ultrfl.(CyOuthrin))]0.025% 0 0.05% ❑0.1%' 132-1363 Do not tamper with rodenticide placements. Do not return to room until after ventilation. 91"'ULDIBP 300 ULV(Pyrethrins)1.0%> 499452/11540-9 'r:: Do not touch treated areas until dry. :s2 -,ULD-BP'300:ULV(Pyrethrins)3.0% 499.450/11540.1.- � -:. -For fleatreatrnorfts,remain off treated.area for a minimum of four hours orumil dry. Ill Weatherblok XT Ball-(Brodifacoum)0.005% - - -.1 1)0-1055 - TirestinerdCode(170): C=Crsck a CraAce V=Vold: G=General -' S=Spat..-ABT=Bak OC=DimetadCon[act =B=3'Bantl SP Space IN=Impact- Equipment Code.(EJCi: CS=Comp:Air Sprayer T=Trap _ Be=Bak station HD=Hand Duster A=Aerosol . - - - - - - - 8111 Bait Gun Pr=Power Treatment F-ULV . - - -Posting Service Sticker? ❑yes O No Supei lsor's Comments: c7 r' ii,rt:€.::Tt e.:e j,9 0 , 0 r:? .v. _ .. SR�CrAL.SEfVICE INSTRUCTIOhis ::i :lI# N I...lC1IR a ?"rs.:.i-:. (aft [ KID ID No i..l . I...f1 (', A D D:C'T'1:t:i N."3 I... J:.1`!..#. T' Inl TLAL. ,13 Iw :l,1.;-� J 1"'I-. i': I JIF50H At:il:ilii:t.VAL, L?4' f3llNE-1 ? CUSTOMERS SIGNATURE 190 0 0 AMOUNT.PAID SERV TECHNICIAN NA. DTE/ cases,.: UNRESOLVED PROBLEMS? °d�17 cHEcw :CALL 1-800-TERMINIX(1-800-837-6464) f:l IST(')MFR:s C(7PY