B08. Attachment 0010-TERMITE AND WOOD DECAY INSPECTION.pdf
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- Pest Control Services
- Solicitation number
- W519TC26QA023
About this file
This is a federal inspection form template for documenting termite and wood decay conditions in buildings. The form serves as a standardized reporting instrument for building inspectors to record inspection findings, infestation assessments, and treatment recommendations for permanent or temporary installations.
The form is organized into nine sections covering: (I) favorable conditions for termite and fungi infestation, including wood-soil contact, poor ventilation, water collections, and structural vulnerabilities; (II) specific location of infestations within building components such as foundation timbers, sills, floor joists, and roof members; (III) termite type classification as subterranean or nonsubterranean; (IV) fungi type identification; (V) damage assessment categorized as structural weakening or superficial with estimated repair costs; (VI) repair and treatment recommendations with columns for recommended and accomplished actions; (VII) chemical control methods including poison dust application, soil poisoning, wood replacement specifications, drilling and flooding treatments, and dry wood termite injection; (VIII) itemized cost tracking for labor, materials, and other expenses; and (IX) treatment effectiveness follow-up documentation. The form includes fields for date inspected, building number, inspector identification, installation type designation, and multiple signature lines for tracking individuals responsible for repairs and treatment completion, with space for follow-up remarks and inspector commentary across multiple inspection dates.
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Text version
Attachment H, TERMITE AND WOOD
DECAY INSPECTION
DATE INSPECTED BUILDING NUMBER
INSTALLATION TYPE BUILDING INSPECTOR
PERM TEMP
I. FAVORABLE TERMITE AND FUNGI INFESTATION CONDITIONS
WOOD IN CONTACT WITH SOIL POOR VENTILATION UNDER BUILDING
FORM BOARDS LEFT IN CONCRETE WATER COLLECTIONS UNDER BUILDING
WOOD MEMBERS SET IN CONCRETE FLOOR VINES AND SHRUBS AGAINST BUILDING
WOOD STEPS IN CONTACT WITH SOIL LEAKY PLUMBING IN BUILDING
WOOD STEPS WITHOUT SHIELDS WOOD SCRAP PILED UNDER BUILDING
WOOD SIDING IN CONTACT WITH SOIL LOOSE WIRE IN CONTACT WITH SOIL
PIPES IN CONTACT WITH SOIL AND WOOD OTHER (Specify)
NO SHIELDS ON FOUNDATION
FAULTY TERMITE SHIELD
II. LOCATION OF INFESTATIONS
FOUNDATION TIMBERS BASE BOARDS
WOOD PILLARS DOOR FRAMES
SILLS WINDOW FRAMES
CROSS BEAMS STEPS
FURNITURE ROOF
FLOOR JOIST OTHER (Specify)
FLOOR
STUDS
III. TYPE OF TERMITE IV. TYPE OF FUNGI V. DAMAGE
SUBTER-
RANEAN
NONSUBTER-
RANEAN
WOOD DECAY
WOOD
STAINING
STRUCTURAL
WEAKENING
SUPERFICIAL
ESTIMATED COST
VI. REPAIR AND TREATMENT
TYPE RECM ACCOMP TYPE RECM ACCOMP
REMOVAL OF WOOD FROM SOIL CONTACT REPAIR OF TERMITE SHIELDS
SEALING CRACKS IN CONCRETE REMOVAL OF CONCRETE FORMS
POINTING UP POOR MORTAR REMOVAL OF VINES AND SHRUBS
LOWERING GRADE LEVEL REMOVAL OF WOOD TRASH
CAPPING CONCRETE FOUNDATION OTHER (Specify)
IMPROVING DRAINAGE UNDER BUILDING
IMPROVING VENTILATION UNDER BUILDING
VII. CHEMICAL CONTROL
APPLICATION OF POISON DUST TO SHELTER TUBES
YES NO
CHEMICAL USED
SOIL POISON
YES NO
TRENCH DEPTH LINEAR FEET CHEMICAL USED
REPLACEMENT OF DAMAGED
WOOD YES NO
NO. OF M BD FEET REPLACED UNTREATED DIPPED SOAKED SPRAYED PRESSURE TREATED
DRILLING AND FLOODING TREATMENTS
YES NO
CHEMICAL USED
WOOD INJECTION FOR DRY WOOD TERMITE
YES NO
CHEMICAL USED
VIII. COST
LABOR MATERIAL OTHER TOTAL
0.00
IX. TREATMENT EFFECTIVENESS
DATE REMARKS INSPECTOR
DATE TITLE OF INDIVIDUAL AFFECTING REPAIR AND TREATMENT SIGNATURE
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